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Home My WebLink AboutBuilding Permit #446 - 181 HIGH STREET 12/4/2006 TOWN OF NORTH ANDOVER NORTFI APPLICATION FOR PLAN EXAMINATION 4"-*D 6;'tio .., s O N i 'A 7,- , Permit NO: Date Received ry *q COt.M[M v �9.TSACNUS v , Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION ��! PROPERTY OWNER Print MAP NO.: PARCEL: 3 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE j Residential Non- Residential El New Building One family ❑ Addition —?'Two or more family ElIndustrial ❑Alteration No. of units: Repair, replacement ❑Assessory Bldg ❑Commercial ❑ Demolition 0 Moving(relocation) ❑Other ❑ Others: 0 Foundation only DESCRIPTION OF WORK TO QE PREFORMED Awl-q74 /idy Identification Please Type or Print Clearly) OWNER: Name: C'��CS � � Phone: 7� Address: Phone: CONTRACTOR Name: - Address: e � 0,6 Zo 2-CP Ex Date: �� 2 `+</6 7 Supervisor's Construction License: p• L Home Improvement License: i 3119 S I;L Exp. Date: I ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PE IT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost S Z' (off FEES Check No.: 11 S- Receipt No.: Page I of 4 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application i Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools 1111Tanning/Massage/Body Art F] g Public Sewer .. _ -Tobacco Sales ❑ Food Packaging/Sales, 1.�❑ Well F1' ❑ Permanent Dumpster on Site 111 Private(septic tank,etc. Electric Meter location to project NOTE:__ Persons.contracting,with unregistered contractors.do not have access to the gU ty ju Signature of Agent/Owner Signature of contract Plans Submitted ❑ Plans Waived ❑ .'Certified Plot Plan ❑ WStamped P ns ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY 4 INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH _ ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on sit es' o Fire Department signature/date- COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: ' ' Comments r• I Water& Sewer Connection/Signature& Date Drivew v Permit i r' Building Setback(ft.) Front Yard Side Yard Rear Yard Re uired Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use � -- QEti d►�., �0 r (v N 6 Page 3 f4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 Location�� 5 h -s� No. Date HORTq TOWN OF NORTH ANDOVER f P + Certificate of Occupancy $ .�s ,^°•Eta', Building/Frame Permit Fee $ swCNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 19853 Building Inspector - %AORTH T0VM Of Andover 0 "A No. C, LAKE ndover, Mass., COC MIC MEWICK x,95 RATED APa` �� WARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... A..........4.00.4.4-4w........ ... . Foundation low has permission toe ...................................... buildings on./.&./...... Rough s ............ to beaccupled as.... .. ...... .... Chimney provided that the person ac Ing shall conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TS Rough .............. I%................. Service " BUILDING INSPECTOR Final Occupancy Permit Required to Ocatpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. NOV-30-2006 THU 12:54 PM FAX NO. 9784750303 P. 01/02 i I Clients:11 7 ACORD�„ CERTIFICATE OF LI BILITY INSURANCE a,E FQOou�p 71/2010 Doh"Inaursna Agency.Inc. 'mom CERTIFICATE IB ISBUW AS A MAT Mk OF INFOR AATM P.O.eau toss ONLr AND CONFERS NO RIOHTS UPON THE CIERTIFiCATe 21 Elm S� At�R TME�yERAGEAAFF�D NOT TAFtME P�D OR SELL Andovar.lYlA 01870 w' maimed d INBURMS AFFORDING COVERAOE NAIL e Barry Flne Homes IL Itenovatiena NNILMRA, AMMIla Mutual Inwirance.company Man BUM(DBA) MRM It Pit MM Insurance Co 30 Rlverina Road L Andover.MA 01810 COVeRAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE aEFN LOAM To THF ANY REQUIREMENT.TERM OR CONORION Of ANY CONTRACT OR OTHER E FOR TME POUCV PN:RIOD INDICATED.NOTWITHSTANDING MAY PERTAIN,THE INSURANCI;AKORDED BY 111E P�IGES DESCRIBEpT TN WHICH THIS CERTIFICATE MAYeE ISSUED OR' LICIES AGGREOIITE LINNTS SHOWN MAY HAVE pEgNRMOLICEDGYPIU E IONS AND CONDMONS OF$UCH LTL TYPNSOiNALNRAMPOLICIA UADuTv 8500027070 .5amew, WAITSX COWA MAL GENERAL LIA ILITY 07/01/07 EACH OOCURRA,(E 81 D0 0 C L4"MAm p I, aoo X OCP NALAADVNA Y at 000 OENLAOOREGATE umrrAm uwmt GEkERALAoaFwGAu 00 000 Poucy, Loc PRWUM-carwaPAoo No B Aurol"DSILeLIAMTV PMC71tiZ88o 09JZSlpB 0312y0T ALLOYMEW AUTO y"� 'T a1�000�000 AuowNN�Auros X SCHEOULEDAUT06 LRY a X mw;D mx X NON-OWN®AUTOS K I N?A1AAO@ s OAAAOE LIABILITY ANVAuTD AUTO ONLY-I*ACCIDET I 2%ERTNIAN EAAOC a AUTO aNlw AGG I WWR ❑CLARAD MAOE EAC►1° � AOORrMMTE a OEGUCT19tP • -E REIENTmN. aWIXIMPISCOMPENM • vAga uAsKM I AN0 FR•' voc ANY PROPptETOgNpARTN�IpyOyF DFdRfME,rIeERo6aUOW7 LL6AGmA, T a "s dMWft Ea.olor�ee.EN►r�uDY�a , E1 .PQL,ICT L"T I o orr M9Fot1MTNNNannrATM&ovpr IprgyapW coving operatlons usual to the Insunrd... � I C TIFICATE HgLOER CANCELLATION Chris Barker I a►TV IANY ar na AeOYE oNarc p PouN:NN3 eF CANc0440 BWOM TK aW MTN011 T 181 Hlgh Street ,TW"MC NN•UM w".L RNOEAVOR To MAIL _-U, CAVO WRM N North AndoverMA Ot8A5 'W"M BATFHMAMNAMToTWUIFttr.WTPAIUAICToOOuO&m" IaFaE No CK"rim QR LIAW"OF ANY NDNQ uPON THE NNW RRJL rtb AeeNT•QR FAX!2784NMW W2 N�rrsamrrAmes A4TIIOR� A ACORD 26(2001lOa)i of s aY21088 B ACORD CORPORATION 122 The Commonwealth of,llassaehuselts Department of Industrial.lceidents l i Office of Investigations 600 Washington Street �., Boston, ,JL4 02111 www.mass.gov/din Workers' Compensation insurance ,affidavit: Builders/Contractors/Electricians/Plumbers applicant Information Please Print Lezibly Name 11)usiness,Urtaniialitm;lndividuall: � ��`�� Address: ��l/✓� � — City Stater Zip: Phone #: V/7 F21 employer?Check the appropriate box: Type of project(required): employer with 4. ❑ 1 am a general contractor and I 6. F1 New construction ees(full and/or part-time).* have hired the sub-contractors sole proprietor or partner- listed on the attached sheet. ' C] Remodeling ship and have no employees These sub-contractors have 3. ❑ Demolition working for me in any capacity. workers' comp, insurance. y• ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.E] Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑Other comp. insurance required.] — `.\ny applicant that checks box;?I must also till out the section below showing their workers compensation policy intixmation. 'l lomeowncrs who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractorsand their workers'comp.policy information. l um an entployer that is prnvialittg workers'compensation insurance far my employees. Below is the policy and job site inf ormalion. Insurance Company Name:__.—__ – --------_._--- --- __-- Policy 't or Self-ins. Lic.'1: —_ Expiration Date:__ Job Site Address: City State,'Zip: _ — — Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of%IGL c. 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine Of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c211Asun, penalties oJ•perjury thitt the information provided above is true and correct. tii nnhtre: nate: �>lficiul ate Duly. 1?n;trN mile h►this'nr<n, ru be..'nrrrplcled hp c'r%► rar rr.�twt /ficial. ('qty iir T,)wn: :rartit/License issuing,Authority(circle one): I. /Hoard of Health 2. Building Department 3.City/T,iiwn Clerk 4. Electrical Inspector Plumbing Inspector 6.Other ( otvt7et P^r:nt1: Phone f#: —_._..._..__ Barry Firle Homes&Renovations Estimate 30 Riverina Road Andover, MA 01810 Date Estimate# 11/10/2006 1 Name/Address Chris Barker 181 High Street No.Andover,Ma.01845 Project Description p Qty Rate Total Exterior: Remove temporary patch of damaged area(plywood&tar paper). Remove shingles&sheathing or planks to expose damaged rafters. Build temporary wall to support ridge and roof. Remove temporary or scabbed in rafters. Install new rafters soffit to ridge. Rebuild soffit on the left side of the house.(revmoved to install new rafters) Rebuild extended rake on each side of the front gable(soffit to ridge).Rake consists of pine trim,crown moldings'&decorative brackets. intall vent on gable end.(match existing) Install drip edge,ice&water&re-shingledamaged area.(both sides of house) Install plywood,tyvec&cedar clapboards on front of house above windows. Repair any damaged trim around second floor windows. Paint soffit area on the left side of the house,paint the front of the house from the porch roofline to the top of the house. Repair two sections of damaged front walkway. Remove tree stump.(front of the house next to the walkway) Total $0.00 Phone# Fax# 978 475 5443 978 475 6564 Barry Fine Homes &Renovations Estimate 30 Riverina Road Date Estimate# Andover,MA 01810 11/10/2006 1 Name/Address Chris Barker 181 High Street No.Andover,Ma.01845 Project Description Qty Rate Total Interior: Remove Remaining plaster on the bedroom ceiling(to the top of the Kneewall) Remove any other damaged plaster. Install insulation to code. Hang wallboard and plaster walls and ceiling. Prime and paint ceiling. Hang wallpaper on walls. Fix light in front stairwell and the back bedroom. Fix the light&switch in the front bedroom Material&Labor 18,180.00 18,180.00 Mark-up&profit 5,454.00 5,454.00 Total $23,634.00 Phone# Fax# 978 475 5443 9794756564 'y � ,�omtonan�BU1LD REGULA�ONS �r 1NG VISOR r; 1 BOLO OF CTION SUPER CONSTR11 License: , 082026 Number: CS C t 1310aate. 1 X12411965 Tr,no: 19112 { txores' 1112412007 ^^ 'estrietv ARRY // k BRIAN R B � 30 RIVERINA RD 01810 Commissioner ER. MA ANDOV � 10 a a RACTOR B OVEMENT HOMEIMPR logRegistration: 136892 Expiration:'911012008 c' k Type SBA �^ k:i, 2 Oj f`+. RENVATIONS BARRY FINE f10ME5& BRIAN BARRYAdministrator s peputy 30 '1,4ERINA ANpOVER MA p1g10, } . Barry Fine Homes & Renovations MA Registration No. 136892 Brian Barry 30 Riverina Road f Andover,MA 01810 i 978-360-6488 We propose hereby to furnish material and labor, complete in accordance with specifications, for the sum of: $ Qdmaterial and labor $ permit fee $ Contractor permit fee for time/expense in obtaining permit $ ` ®1 ,o O total Payment to be made as follows: 1 - lr abor $ 200 with authorization' �Oy/�-�%,P—S r ..Total es $ with authorization or $ S when work half-completed 77-6141-3 11 a a or $ ,3�0 -OCA upon completion of all authorized work �,,,,��L All work to be completed in a workmanlik ner ac rdi s and prac iices. Authorized Contractor Signature Note: This contract may be withdrawn by us if not accepted within days All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by provisions of Chapter 142a of the General Laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to: Director Home Improvement Contractor Registration One.Ashburton Place, Room 1301 Boston, MA 02108 (617) 727-8598 Registrant's Name: Barry Fine Homes and Renovations Brian Barry Registration Number: 136892 ACCEPTANCE OF CONTRACT The prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Owner(s) Signature � Date of Acceptance 0 4 M(2_,,:LYZ- `2-L a 0 p t0 THIS CONTRACT IS NOT TRANSFERABLE PAGE 2 OF 3