HomeMy WebLinkAboutBuilding Permit #654-2017 - 217 WINTER STREET 12/20/2017�L�-, BUILDING PERMIT of N�RTF;qA-
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TOWN OF NORTH ANDOVER 2 ti.:`'` °
APPLICATION FOR PLAN EXAMINATION
'K i by
Permit No#:(00 — Date Received
- ArACHUS ���
Date Issued:
IMPORTANT: Applicant must complete all items on this pane
LOCATION Q F
Print
PROPERTY OWNER_ 11/-) +, Y� it 2--
MAPO�PARCEL
ZONING DISTRICT:
100 Year Structure
Historic District
Machine Shop Village
yes no
ye no
ye no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
�e family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
S p i ®Vi7ell'
®Ffoodp a�n ®We lands
FWate shed mit
DESCRIPTION OF WORK TO BE PERFORMED:
Identification - Please Type or Print Clearly
OWNER: Name: nA- J 1,13 J -e- 1, 6 C) -) %`'r2
Address: ') ('1 LJ (`�,i Tell SF
Contractor Name: �� � V\ Phone: 9�'lij - )-25-,
Email: c, - 6i. TAhso a C
Address: A <�:h J C-, burr 4 �S
Supervisor's Construction License:
Home Imarovement License
ARCH ITECT/ENGINEE
Address:
2_-c, _ Exp. Date:
Exp. Date:
Phone:
Reg. No.
FEE SCHEDULE. BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total Project Cost: $ c�jb FEE: $ �2-
Check No.: Receipt Receipt No.-
NOTE: Persons contracting with 1<nreg4tered contractors do not have access to the guaranty fund
Z2
I
6
Plans Submitted ❑ Plans Waived ❑
Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
TanningfMassageBody Art ❑
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc. ❑
Permanent Dmmpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m U FORM
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
Signature
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH
',COMMENTS
Reviewed on
nature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Bate Driveway Permit
DPW Town Engineer: Signature:
F,IREfDEPAR
Located atf124M
Ei� 00epartM
COMMENTS
TMENT - Temp, Dumpsterton site -yes,. .
ent signatiareldate
Located M4 Usgood Street
hb off.►. «'.:�' i'1 'A
i , ? t � t F i'�iAn'�' K.'.�`i�r �L%C � , . r's"7'•,r ��, .
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires; approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A —F and G min.$10041000 fine
NOTES and DATA — (For department use
Ll Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014
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
Engineering Affidavits for Engineered products
IOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
Building Permit Application
Certified Surveyed Plot Plan
a, Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
Mass check Energy Compliance Report (If Applicable)
Engineering Affidavits for Engineered products
OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
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
4. 2012 I ECC Energy code
Engineering Affidavits for Engineered products
OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit
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
Doe: Building Permit Revised 2014
cic
Locatio
n
No. I VNJ Date
Check #
313610
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee
Other Permit Fee
TOTAL
Building Inspector
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Residential & Commercial Roofing
(0 W Es 0 = (M or
Chimneys All Types Of
Siding CHIMNEYS POINTED -REBUILT -CAPPED Expert Masonry Work
Mass Toll Free * Roof Leaks ' eris'6� Licensed & Insured
oca!/y Owned do Operated Since 1976 $ z License #034200
(924-84887)7)
1 -800 -WAIT -4 IKO® LCz& W oe m oe 9ohv -tom We Work Year Round
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Proposal To: David Leibowitz
Street: 217 Winter St.
N. Andover, MA
Roof proposal
Certainteed Landmark
1. Extra caution will be taken to protect house and
landscaping as best as possible. (tarps etc.)
Magnets run at final clean up.
2. Remove all shingles from entire house.
3. Inspect and re -nail any loose or lifted plywood or
roof boards. Any compromised plywood will be
replaced at an additional cost of $60.00 per 32'
sq/ft.
4. Install heavy gauge white aluminum drip edge to
all eaves and rakes.
5.. Install 6' of Certainteed Winter Guard ice and
water shield along all eaves.
6. Install Certainteed Diamond Deck synthetic
underlayment to remaining sheathing up to ridge.
7. Install all new pipe boots.
8. Install Certainteed Swift Start starter shingles to
all eaves.
9. Install Certainteed Landmark Limited Lifetime
architectural shingles to entire house. Certainteed
10 year material MFG. warranty. (See extended
warranty) All shingles will be installed and
fastened according to mfg. specs.
10. Install new GAF Cobra ridge vent and cap with
color matched Certainteed Shadow hip and ridge
shingles.
11. Counter flash existing chimney lead, wall
connections and all roof protrusions with ice and
water shield, tie into new shingles and seal with
clear Geo -Cel sealant.
Acceptance of Proposal—The above prices, si
accepted. You are authorized to do the work as
Date 12/17/2016
978-505-7722
David.leibowitz@oracle.com
12. Removal of all work related debris. Planks will be
placed under dumpster to prevent any damage to
driveway.
13. Building permit included.
14.Contractor workmanship warranty: 10 years under
normal wind and rain conditions.
Total Certainteed cost: $6,800.00
Certainteed 3Star extended MFG warranty:
A fully transferable 100% coverage against
material defects for a fully non pro rated period of
20 years. Please refer to pamphlet left in estimate
folder. Offered to our referred homeowners and
included in this proposal at no additional cost.
Balance due upon completion, no deposit required
Hi hlv rated member of the Accredited BBB and
Angie's List.
Thank you!
is and conditions are Rtisfactory and are herby
Payment will be ma&hs o tlined above.
Th8 Commonwealth of Massa' h et%
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Dgartmeylt offadastriaZAceldents
_ 1 cone-restfeet, Suite 100
F d Bostop, HA 02114-2017
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Wti�kers' Compensationlnmrance.A�f�davit: Builders/Coxixae�orsl�+Iggt czanslPlmnbers.
TO BE BLED WI`I'.Et TEE I"IMIYUrEINGAUTECORM.
A Ticaui Worma-don
Please Print Legibly
Namo (Bus ess/07ganizelionUndividuai): /� l X 111 �'� r ✓�
Address: 'jJ
city/state/zip: Phone;
Areyou an employer? checkfe appz opriaie pox:
1.F] I ama employer�vith employees (M anal/orpart'-ime).s
2.0 I an a sole propE!eiororparinership andhaveno employees working forme in
any capacity. [No wodcers' comp. insurance required.]
3 nIamahomeovnerdoiug4woxkmyselt INoworkers' c0mp.;nc=G01Bquired] i
4.[� I am a homeowneiandw.11 behiriog conbMdarsto conduct all wo11C onmyproperiy. I WM
ensure that all contractors either hays workers' compensadan ine=Co Or= sole
proprietors v thrio employees.
5.ageneral cmtacbr and Ihavehicedfihe sub-contactorslisted on the attached sheet.
�
w these sub-co�racior- faA employees audhavaworkue comp_ insurance
6.E] We are aoorporat�r Pditsofficershavecz=isedtheirrigbtof'egemptionperMGLc.
152, §1(4), and-W9hEvenoergpIoyees. [No workers' comp. insummeregairedl
Type of projeet (rer tdred).
7.- 0 New coAstraction
8. [] Remodelidg
9, [] Demolition
10 Building addition
11.[] Electrical repairs or additions
11[[Plumbingrepairs or additions
13. [[ Roafiepairs
14. Other
*Any, applicani;baf chealab6141 must also SII. outthe section below showingthe rworkms' compensEYionpo"(;YhfoM16on.
i gomeownes ratio st�lin=iii,4�'s affidaviiindicatingthey�re doing aTT�o�andthenhire outside cordractorsmustsiT�bmit aneY,r a�idav� indicating snob.
zConEcaciorshatcbecTrr7sbo�mns�afiacbedanadditonalsheetsluingffienameofrhesub comractorsands=atewheiEerornoir7ioseeniitieshave
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Ia rs are erriployer t%z ai
is-PYavic�zngW0,-kers' compensation insurancefor NYempiayeez.' BeZoiu is thepoZicy aridsite
infar�natiar2. -
Insurance Company 2Tame;
Policy# or Self -ins. Tic. 4;
Expiration.Date:
Job Site Address:
!� / J, r Cziy/State/Zip: N fT
Attach, a copyofthe�orkers' coxnpep4atioupolicy declaration page (showing the policynumber and expiration daze).
Failure to s-ecure, cov-6rage, as required under MGL c. 152, §25A is a criminal violation punishable by a fine 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 fine of up to $250.00 a
day against the violator_ A, copy of this statement may be forwarded to 'ih.e O.fdoe- ofInvestigations of the DIA for insurance
coverage veriticatiorz_
I do hereby ccnt5f user d pains and perzaities ofpefj�W that the information provided above is due (cid coPrect
A 919x --i%5- 3
Dffzcial Use onry. po not -write bz this arrea, to be completed by city ar town official
City or Tow -a'
Permitmeense
Issuing Authority- (circle one): i
1. Board oflfealffi Z. BuildiugDepartment 3. G/Town Clerk fir'. Electrical Inspector 5. Plmnbinglnspector
6. Other
Core act Person:.
Phone 9:
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TE DOES NOT AF�AYNny OR NEGATIVELY AMEND. t
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JOHN W WZA%�Z
30 DR : s
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MBTMENMA
O°mmrsslorra� 04/03/2017
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 137057
Type: DBA
Expiration: 10/2/2018 Tr# 291333
ALL UNDER ONE ROOF:'
JOHN LANZAFAME
166 A MERRIMACK ST
METHEUN, MA 01844
SCA 1 Ci 20M-05111
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Office of Consumer Affairs & Business Regulation
-,iHOME IMPROVEMENT CONTRACTOR
Registration: 137057 Type:
Expiration: 10/2/2018 DBA
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ALL UNDER ONE ROOF
JOHN LANZAFAME
166 A MERRIMACK ST
METHEUN, MA 018" 4dersecretary
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