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Home My WebLink AboutBuilding Permit #588 - 20 CHRISTIAN WAY 3/22/2006 Of NO oTl{ p TOWN OF NORTH ANDOVER �' . ,r"•' APPLICATION FOR PLAN EXAMINATION ,is emusEt Permit NO: !fy Date Received: Date Issued: 3 2 ?16 IMPORTANT: Applicant must complete all items on this page LOCATION G G M S - to 4 yj Prin PROPERTY OWNER 1��9w� �- r 1�, j1 K 0 � Print MAP NO.: � b l N 3 PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑Addition ❑ Two or more family ❑Industrial A Alteration No.of units: ❑ Repair, replacement ❑Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED L r c Do-LA, � � 'nl� ` /9"1re4o!14 L�rGt��S ed► /l@lr- / 2 X l2' Identification Please Type or Print Clearly) OWNER: Name: G e C ct-?A ►M k--)S ty` c/( Phone: Oi 7 � � �P- � L L�0 Signature Address: J G �V-(f r LA l-. VPV I/ CONTRACTOR Name: 11 A 1? 1cLK SJ-- ?e vs. vdtc�11, t Phone: Address: �l y /3,4 r( t-, -i.,.. f I� t 1��Yc�., G �/j�✓�cf Supervisor's Construction License: C Exp. Date: Home Improvement License: l `t -� '3 7 Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ '/ 7, ° w x10.00=FEE:$_ (• >D Check No.: '6 Receipt No.: Page 1 of 4 Location r sr/ 0 ,of No. n� Date .S l D NORTN TOWN OF NORTH ANDOVER 3 O 10. R 9 }�o Certificate of Occupancy $ s•►CMustj Building/Frame Permit Fee $ ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r r/ ilding Inspector TYPE OF SEWARGE DISPOSAL Swimming Pools 11❑ Tanning/Massage/Body Art ElPublic Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of Contractor Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zo inin ng Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature&date Temp Dumpster on site yes OL no Fire Department signature/date.-� Building Permit Approved and Issued by: Page 2 of 4 Building Setback(ft.) Front Yard Side Yard Rear Yard Required 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) Page 3 of 4 Doe:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan.2006 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 o 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 The Commonwealth of Massachusetts Department of Fire Services Office of the State. Fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 / PERMIT Date: North Andover Permit No Dig Safe Number (City of Town) (If Applicable) In accordance with the provisions of M.G.L.14$Chapter_1 n as provided in section—5 7 r MR 34 Start Date This Permit is granted to: Full name of person,Firm or Corporation Permissionto locate dumpster for construction/re.novati on/demolition of building. Comments: dumpster must be 25 ' from structure if unable to place with required Restrictions:clearance dumpster must be covered with plywood or tarp end of work day at Gfrs%T D (Give location by street and no.,oAesc3nmsuch manner as to/ ovied adequate identification of location) Fee Paid$ 50.00 1'e" Fire Chief This Permit will expire 06 (Signature of offical granting permit) Offical granting permit Title �r �-.,... ...-.-....T ... .r.�- r.�r ��►.e.r,r�i �� o� v nuc-rr_n i �n�►i �ru� n[�G'wAIOCO BOARD OF BUILDING REGULATIONS 4 License: CONSTRUCTION SUPERVISOR ; Number: CS 087229 } Birthdate: 02/14/1957 i Expires: 02/14/2008 Tr.no: 87229 Restricted: 00 RAYMOND G PARKHURST , ' 44 BATEMAN ST HAVERHILL, MA 01832 Act mis ones S 8 } l « �« �i,lua �ryrrirr%ava�.r�raf.(� o� ��rr:::�r.^ri*•st.'"� i Board of Building Regulations and Standards i t "' ' I HOME IMPROVEMENT CONTRACTOR i Registration: 142387 Expiration: 4/1/2006 Type: DBA RAY PARKHURST REMODELING RAYMOND PARKHURST 44 BATEMAN ST. NAVE'RHILL,MA 01832 Administrator ,, NORTFI Town of RAndover No. dover, Mass., :3 : VC 0 LA OF W I� COCHICHEWICK 7,p AORATED `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THISCERTIFIES THAT.......... .......��If. ....��.�...................... ............................................. .................. Foundation has permission to erect........................................ buildings on ...0? er:.!6 !!1f.. Rough i 14 ..... to be occupied as............ ,'owro/oxf ••�••�. ....lj�.1few.� }..i�� Chimney ..... . ....... . . . . .provided that the person accepting this permit sfryfir l in every respect onform 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 UNLESS CONSTRUCTI STARTS ELECTRICAL INSPECTOR Rough ............. ...... ...... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. Prow[ RAY PARKHURST REMODELING (INI r-)I HAVERHILL, MA No Job Too Small MA Lic. #CS087229 Tel,978-521-7512 MA Lic. #142387 Cell,978-609-5473 PROPOSAL SUBMITTED TO PHONE DATE STREET JOB NAME k f r ILL(X, cc CtfY,STATE AND ZIP CODE JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: .......... ............... ...........I.................... ...................... .......................................... ..................... j... . ................') r...............Q.c (,.(<........................................................... .............. ............... .......... . ........ . . ...... ........ .Ir.. ............ ... ........................... .................... ........................... .............................. 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I V.. .......... .. .. .... ........ ........ .... ................. ....... .... ................. .. .................... .. ... ... ... .. .. ... .. 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V propOIC hereby to furnish material and labor--complete in accordance with above specifications,for the sum of: o} &I l,0 Q'), joo, 0.0 ol�, e (JN,o le t-dollars($ toy v , Uj Pay6ent to be made a's follows: All material is guaranteed to be as specified.All work to be completed in a workmanlike manner Authorized according to standard practices.Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and Signature4 above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our workers are fully cov- Note: ered by Workmen's Compensation Insurance. This proposal may be withdrawn by us if not accepted within days. 0[cceptance of propont —The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the Signature tom, work as specified.Payment will be made as outlined above. Date of Acceptance: Z2211- Signature_ ACORD CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) V0211612006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cowan Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 359 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Haverhill MA 01830 INSURERS AFFORDING COVERAGE NAIC# INSURED Ray Parkhurst INSURER A: Western World Insurance Company 44 Bateman Street INSURER B: INSURER C: Haverhill MA 01832 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 'rHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'LTR NARN TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MM/DDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 000,000 A X COMMERCIAL GENERAL LIABILITY NPP887018 514/2005 51412006 DAMAGE TO RENTED $50,000 CLAIMS MADE 5x] OCCUR MED EXP(Any oneperson) $5,000 PERSONAL 8 ADV INJURY 000,000 GENERAL AGGREGATE $600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $600,000 X I POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $E AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F—I CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- riz TORY I]MIT.- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If Yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Carpentry contractor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Haverhill,MA 01830 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE AA ACORD 25(2001/08) ©ACORD CORPORATIOV988