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HomeMy WebLinkAboutBuilding Permit #224-13 - 22 HARWOOD STREET 9/20/2012 N TOWN OF NORTH ANDOVER 2APPLICATION FOR PLAN EXAMINATION Permit NO: Z 2�/ Date Received Date Issued: IMPORTANT:Applicant.must complete all items on this page y IMCATION 3 h 2 r g k x 3 TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential New Building ! One family Addition Two or more family Industrial Alteration No.of units: I Commercial Repair,Ireplacement.. .. . Assessory Bldg - -- Others: . Demolition Cather DESCRIPTION OF WORK TO BE PERFORMED: strip and re-roof using architectural shingles Identification Please Type or,Print Clearly) OWNER: Narne: LLarry Savoia Phone617.594.0344 Address: 7 9 Roxftird St North Andover, Ma CO T AGTORd Atires 1-2 I M+ �t7Ev lrlh�, vt't 4 rper�r� r's Cor� ltte :�cel�st "A AIR L,4_ ARCHITECTJENGINEER Phone: . . Address: Reg: No. PEE SCHEDULE;Bt)LDI NG PERMIT_$12.00 PER x+1000.00 DP THE TOTAL ES77MATED COST BASED ON$125.00 PER S.F. Total Project dost: :$_ 5,400I�E> : $_ (p 6. AD Check.No.: �a Receipt No.:: v NOT jO TT'i� Dns•ansc• s,....r.i�.—�. . s,. L. i i::J a.a_.. .c ca uviaa Cv�sra tia.0 �m•a ii ate:-c cu 4vlcl/uc.4-- a" -root ttF�s v access tv th �"uaranty fa d if 1m, �~ �gnatt of ntrtor . Plans Submitted Plans Wai Certified Plot Plan amped Plans 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 MGI.Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA For department use ❑ Notified for pickup - Date Doc-..Building Permit Revised 2008 a TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pooh Well Tobacco Sates Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision:/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway,Permit DPW Town Engineer: Signature: Located 384 Osgood Street 1=IRE flEATIL'IT ernPpster Lcrcatet'�t ��4iit3akn:,�tr`eet - �lre fleprrfnrl�r+t s gnat /clue 3 Location 2,2 +16,- 01 a b C No. � / Date / 2 f� / • - TOWN OF NORTH ANDOVER ti t,ED Certificate of Occupancy $ F Building/Frame Permit Fee $( Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 4A2 � } 25730 uilding Inspector Ji Contract Larry Savola, Homeowner, desires to contract with Arone Exteriors of 18 Mount Vernon Dr Pelham, NH, to perform work on the property located at: 22 Harwood St No Andover, Ma. 1. Job Description: See attached proposal. 2. Payment Terms: See attached proposal. 3. Time of Performance: See attached proposal. 4. License Numbers: See top of this form. 5. Permits and Approvals: Arone Exteriors will be responsible for determining and obtaining necessary permits, as well as the costs incurred. 6. Materials: All materials shall be new, in compliance with all applicable laws and codes, and shall be covered by both the manufacturer's warranty and a 15 year warranty on installation through Arone Exteriors. 7. Change Orders: Should unforseen events alter the original cost estimates, or should the Homeowner decide to change any part of the attached proposal, those items shall be discussed and a 'Change Order' form will be signed by both parties outlining the new details. 8. Site Maintenance: Materials shall be stored in the following location: Work shall be performed between the following hours: 7:30am - 7:30 pm We agree to use equiment (generators, pneumatic guns, etc.) only during these hours. We will use our own equipment but may request the use of an electrical outlet. 9. Yard Sign: Home improvement projects often generate inquiries from neighbors. We have modest yard signs listing our name and contact information. Please check the box below if you agree to the following: El Arone Exteriors may place one yard sign in front of the home for the duration of work being completed. Once complete, it is the responsibility of the contractor to collect the sign unless other considerations are arranged up front. 10. Payments: In general, we do not require any payments up front and only request that payment be made in full upon completion of the work. If products requested require a special order, we do request a deposit in the amount of $ to place that special order with the manufacturer. Pg 1 of 3 11. Legal info from the State: All home improvement contractors and subcontractors shall be registered (which we are, see license numbers at the top of this contract) and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, Ma 02116 617.973.8700 Owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. Failure to pay in full for the work completed may result in a lien or security interest on the residence as a consequence of the contract for the sum of labor, materials and lawyer fees. The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract, the contractor may submit such dispute to a private party arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c 142A. The signatures of the parties apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor, The owner may initiate alternative dispute resolution even where this section is not signed seperately by the parties. The homeowner has a three day cancellation option under MGL c93 s48: MGL c 140Ds 10 or MGL c255D s 14 as. Arone Exteriors will grant a 15 year labor warranty on all work completed. The manufacturer's warranty will depend on materials selected. 12. Additional motes: pg2of3 ZZAL�A�_Z�AQ A-a-y! 4�-Xlu, Name Larry Savoia Address 22 Harwood St North Andover, Ma WORK PERFORMED: BENEFIT: t/ Obtain necessary town permits. t/ Install a tarp from edge of roof to ground. t/ Protects home and landscaping from debris. • Strip roof to bare wood. V Removal of old shingles reveals any defects in • Nail loose deck boards. decking that might otherwise go undetected. It • Replace rotted wood (up to 32 ft. of also provides a flat surface to lay new shingles deck board material and labor free). for a better looking roof. t/ Completely strip and re-lead chimney. V Flashing diverts water away from the structure v, Replace pipe boots on all vents. or penetration and keeps it on top of the shingle. • Paint vent pipes to blend With roof. V Vents become less Visible for a cleaner look. • Apply Ice&Water shield to first six feet of v1 Only available when removing old shingles,this wood roof, and all protrusions. waterproof material adheres to your wood deck • (If skylights exist) Remove flashing, install providing protection from the elements as well Ice &Water around unit and re-install flashing. as ice dam build ups. • Apply Premium High Performance Deck Armor V 600% stronger tear strength than 30# felt, breath- to the remainder of exposed deck boards. able and prevents moisture under the roofing system. • Install eight inch metal drip edge. V This helps to direct water off of the roof, prevents wicking under shingles, keeps water from running down fascia behind soffits and walls, and reduces water back up causing ice dams. • Install a 'starter course' at base of eaves. V Prevents leaks and wind blow off. • Install GAF Timberline, Owen's Coming V Superior appearance, practically priced, durable. Duration or Certainteed Landmark Includes Lifetime limited warranty. architectural shingle. • Install ridge ventilation. V Prevents condensation problems(false leaks), deterioration of deck, mold growth and premature Cap ridge vent with matching shingles. deterioration of shingles. V A dumpster is supplied in this quote . V Will be used to remove all debris and nails from the property and neighboring properties. **Customer V Remove debris from all gutters. may want to cover any items in attic and vacuum upon completion of work. Proposed Payment: (NO DEPOSIT REQUIRED UP FRONT UNLESS A SPECIAL ORDER ITEM) Total payment of$5,400 (or$3,800 for an overlay) ---------- ------------------------------------------------------ _;_V_-, -------------------------- i Date Homeow gnature --------------- ntractore Date �t"r Signature No other documents are part of this contract. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES pg 3 of 3 ':as.sachusctts Dc:p,'rfrr+cnt cf Pubi.*.z S.:Ftt J Board of Building RegJ1Jt'0ms *td Sta^1*1.:rds t •1"�Irtt.i�. €t ti.-n� >, .. %.-, ,-'f ✓ CSSL-100542 k , JOSEPH M ARONE 18 MOUNT Vt?RNON DRfVE Pelham NH $3176 l 0311712014 _- Office of Consumer Affairs and Business Regulation - 10 Park Plaza. - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 160710 Type: DBA Expiration: 8/19/2014 Trak 229534 ARONE EXTERIORS JOSEPH ARONE 18 MOUNT VERNON DRIVE ----------- -- PELHAM, NH 03076 Update Address and return card.Mark reason for change. j Address ❑ Renewal F Employment CJ Lost Card DPS-CAI 0 50M-0004-G101216 Consumer Affairs ass Regxcliu� License or registration valid for individul use only \ Office of Consumer Affairs&Bssiness Regulation g y �? HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 160710 Type: Office of Consumer Affairs and Business Regulation ' 10 Park Plaza-Suite 5170 Expiration: 8/19/2014 DBA Boston,MA 02I16 AR LE EXTERIORS JOSEPH ARONE 18 MOUNT VERNON DRIVE PELHAM,NH 03076 Undersecretary Not valid without signature NORTH own o _E : ., Andover No. - 0 10 SAN! h ver, Mass, A10, -.-° C OCNIC Nl WICK S U BOARD OF HEALTH Food/Kitchen PERMI� T T LD Septic System f THIS CERTIFIES THAT ................................ .. ......... .............. . .W O.A. ................................. BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .... ... ....... .il1.!,.� .... :. Rough ...... .. ,, ....... nd p' .... .... ........ ....: .... ............... t0 be OCCU led as ... ...... :. .. ... .. ............ Chimney provided that the person accept g this permit shall in every respect confor to the terms of the application Final on file in 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 IN .� PERMIT EXPIRES Ik6MONT S ELECTRICAL INSPECTOR UNLESS CONSTRUCS 'RTS Rough Service ........... ..... ................. ..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE NORTH Town ofndover 0% Z T O�h ver, Mass, . - �A COC HICMEWICK�V�• /, s � BOARD OF HEALTH Food/Kitchen PERMI�T T WonLD Septic System e THIS CERTIFIES THAT ...............................L..rA ......... .............. . .I. ................................. BUILDING INSPECTOR � Foundation has permission to erect .......................... buildings on ... ..., .. .... ... .......x°:.'!1.!1. . .:.. :........ R � ugh tobe occupied as ..........: ... .. ...... ........ .............. . . .. :: ` ......................................... Chimney provided that the person accept g this permit shall in every respect confor to the terms of the application Final on file in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONT S ELECTRICAL INSPECTOR UNLESS CONSTRUC,T�'.4J1 S RTS Rough Service ........... ......... ..... ....................:.......vt..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina' No-Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Date.,/. . .. .. . . . . ... . .. . NORTH pF •.ao ,°,•tiO TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SACHUSEtS 1 This certifies that . . . ... . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . 1-t . . . . . . . . • . . . . . . . in the buildings of . . . ...`. . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . a . . . . . . . . . .. .`.`. . . . . .. . . . . . . . . . .. North Andover, Mass. r Fee. .. . . . . . . Lic. No.!. . . . . . :. . . . . . . . . . . .. . . . . . . -�:. . . . . . GAS INSPECTOR Check# Z) MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date ('" 2 pJ 1 NORTH ANDOVER,MASSACHUSETTS aoL t`lYa�W Building Locations ���.� � Permit# 3 ,2 2� �- `1A%"-L\J S 1A\-k D 1 Cn Owner's Name Amount$ Z Ot New❑ Renovation Replacement ❑ Plans Submitted k w 0 d o vs Fw+ o a a d o o O w 3 A a > q a H O SUB-BASEMENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR fTH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) � , l S QlJw��ykl �, h�a� one: Certificate Installing Company Name tJCorp. Address "ZYXo1A AL4 ❑ Partn� Business Telephone \V\-1. 8 Sq-X71 1 ❑ Finn/Co. Name of Licensed Plumber or Gas Fitter 0411,I&,,3 C lb�q4 vyno INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes,pleA�md* to the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ i hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse State Gas Code and Chapter 142 of the General Laws. c � Vyr� By: Signature of Licensed Plumber Or Gas Fitter Title Plumber log 2 l0 City/Town ❑ GasFitter License Number ❑ Master APPROVED(OFFICE USE ONLY) ❑ Journeyman Date.. No v LORTH TOWN OF NORTH ANDOVER Jo 'A PERMIT FOR WIRING This certifies that ....... ...... ....... t has permission to perform ........ ........... .............................. ,wiring in the building of... r . . at... ."..A. ... . .............................../No.r...h... k...n..d..o..v..e.r.<...M...Q..4.... Fee....2�16 '.... Lic.No.J.&)Y`...>.. E�LECTRI�4SPECTOR Check # J 3 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THE(DA MUNWE LIHMMAJ►"CH(SKJIN Uthce Use only DEPARTAffi fOFPUBLIC&4FM Permit No. BOARD OFFREPREVE MONRWUMTIOAN527CMR 12:00 VA Occupancy&Fees Checked4 PPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat G Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Z 2 /-!r,r woo 5•7 Owner or Tenant A/'r y /-Ar G✓U0c Owner's Address Vr1G Is this permit in conjunction with a building permit: YesNo (Check Appropriate Box) Purpose of Building 5,hG/-c poy/o-z' Utility Authorization No. U S4;SZ Existing Service UD Amps /, D/ LW Volts Overhead Underground No.of Meters New Service a00 Amps Volts Overhead ® Underground Q No.of Meters t Number of Feeders and Ampacity T� Location and Nature of Proposed Electrical Work K,'f[t^t n Re&7g'A-! rvr-te- C/,C*i fe No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA vNo.of Lighting Fixtures Swimming Pool Above Below Generators KVA _ ground ground No.of Receptacle Outlets /q No.of Oil Burners No.of Emergency Lighting Battery Units +No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals / No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections l,jo.of Water Heaters KW No.of No.of _ Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP `r OTHER hn=veCo&aW-R»SuaYmthetagtaternartso ad�se>$Ga�a�alLaws IhawaamatLmbt7AyhnlrarePchyml&gCarVAk CovwdWcrilssksbnialegivWat YES NO Ihaw%hnfedvltidMdCfsatnetotheOffie YES RRN IfjuutmedvdWYES,pleasemdc*,hetMeCfWY dWbydxckrgthe w c� � BOND oRI&RR�� ( SPS') Estim&dvahte tWait$ WoktoStatt hnspeciialDa*Rape*d RD# Fetal Sig W ur deM penahies ofpejtay: FIRM NAME tioa>seNa Lioatsae �:c�� S>; C Lr(� i Sigriatiae � IioaseNo 3 O a- C\ ------ rr Bisiness Td Na 2 x�- 3 a`/l S 3 7,r' /� 4 /cp;, Jf yy/G//�z 1l M� 6�I1/ AlLTeLNa �/"�:/.� 7G0 OWNER'SINSURANCEWAIVER;I.amawatethattbeLicam ftmmu=ammWaiss*WcWe*w.,abtasmquWbyktmmdudtsCiard Laws aoddEtmysigratut Mftpemtg arwaiksdisMW,WTlad. /� \ (Please check one) Owner F-1 Agent Telephone No. PERMIT FEE U�/ Date. %.: .-. o'<".O RT:1� TOWN OF NORTH ANDOVER 10 PERMIT FOR PLUMBING �,SSACNus This certifies that . . . . c r has permission to perform . . . .K .S . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . :)/14. . . . . . . . . . . . . . . . . . . . at . . . a. . . .11eq A.�'." ` `l S f . . . . . . ., North Andover, Mass. r r Fee.? .�. . Lic. No.. . . . . . . . . !=. . . . . . . . PLUMBING INSPECTOR Check # 4. 1711 2)^-• MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS 11 ,, 1 \ /Date D�S d Lam_ Building Location a;c IVIAYI W 0DUl.�� Owners Name 1.i( AA2 -1 %t..t 41-N - Permit# Amount Type of Occupancy _ New Renovation Replacement ri Plans Submitted Yes No FIXTURES a w x a d a � 0. w H w &* a Cn z H cc Cnz x W w Q w A x = A a a H ex a z a F z W E~ w SBM BAS04 VI' M FLOOR 210 FLOOR 3M FLOOR 4M ROM 5TH FL M 6M ROCK 7M FLOOR SIH FLOOR (Print or type) ^ Check one: Certificate Installing Company Name MCo Address (.lwb 1 Partner. Business Telephone B 7-7-77) Firm/Co. Name of.Licensed Plumber. Cl W r C Cr\C,1z OCA/'y Insurance Coverage: Indicate the type ' surance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner F� Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa setts State Plumbing Code and Chapter 142 of the General Laws. By: Signa QI LlGenSeartumoer Type of Plumbing License Title p ' t g 3 L0 Ci ' ty/Town icense um er Master E� Journeyman a APPROVED(OFFICE USE ONLY Location �a ,46/l(i Od d S �` No. 0 / Date AO NORTH TOWN OF NORTH ANDOVER 3? o • OL Certificate of Occupancy $ �+ Cwt�sE Building/Frame Permit Fee $ —�-� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # / s-v2 5 ,, 6 3 Building Inspector TOWN T NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUB.DING PERMIT NUMBER: DATE ISSUED: n � � - SIGNATURE: A, Building Comngssionel9ffct6r of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: aL a,�� � S `� I Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoni,g District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide Required Provided red Provided 1.7 Water Supply M G LC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System ys Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ > SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT --i 2.1 Owner of Record — C�-v C) A qa-,(,w oo� Name(Print) Address for Service: 6 - / 3VV Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z Si nature Tel hone M SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Constructio SupeENrTAA1 ' r: II '' FE— — License C Q, rV r Licensed Construction Supervisor:O� r Address �; 5ignatu Telephone 3.2 Registered Home Imrla- -�0111 oveme t Co tracto Q e Not Applicable ❑ &4 t C1 any Name 3A- M �� M 1- S� ' v Regi a tonttont Nu ber rs kddress —t�� . i natur `76 - Expiration ate Telephone SECTION 4-WORKERS COMPENSATION(NLG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building unit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Desci i tion of Proposed Work cher all applicable) New Construction 0 Existing Building Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. 0 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Qwao&� ----- o QS SECTION 6-ESTRUATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be M- 11, Completed b permit app licantIN, t 1. Building .(a) Building Permit Fee Multiplier 2 Electrical -(b) Estimated Total Cost of Construction 3 Plumbing M Q Building Permit fee(a)x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Si nature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT,DECLARATION I, L r ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true,and accurate,to the best of my knowledge and belief Print N me //A o� Signature of vvner/A ent Date RIES SIZE BASENT,XT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3RD SPAN DIMENSIONS OF SILLS DMIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUIL DING CONNECTED TO NATURAL GAS LINE r North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (LocationFac' ) ILt Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector r: The Commonwealth of Massachusetts Department of Industrial Accidents r Office of Investigations - Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name N� C�e�F • CrU�Wyt) Location City 1 " , ova — Phone am a homeowner performing all work myself. Ll am a sole proprietor and have no one working in any capacity 1 am an employer providing workers' compensation for my employees working on this job. I Company name: Address City Phone#: Insurance Co. Policy# Company name: Address City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand 4opyofstatem t maybe forwarded to theOffice of Investigations of the DIA for coverage verification. Idoherbycins a penafties of penury that the information provided above is hue and correct.Signature Date ® ,Print namPhone Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#- ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION i I � - J�� Cammanue�zll o IlrrswrheaeM I' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 064835 •_ Birthdate: 06/26/1969 Expires:06/26/2002 Tr.no: 27982 + Restricted To: 00 1 k MICHAEL A CRAVEIRO 22 ANDREWS ST DANVERS, MA 01923 Administrator i i i � O =6znr J---1 O Note: This drawing is an artistic SAVOIA Dwg no. interpretation of the general LAWRENCE SAVOIA appearance of the floor plan. It is 22 HARWOOD ST not meant to be an exact rendition. NO ANDOVER vt� [I, --?LA c4 6 0r J*7 �3 ; J�'� Ell r771 I� m®0°mm 0 o0 w Note: This drawing is an artistic SAVOIA Dwg no. interpretation of the general OIA SA LAWRENCE V appearance of the floor plan. It is LL RENCE D V not meant to be an exact rendition. NO ANDOVER E:::D C� 17 NORTH Town of Andover O „�r�rw•. •4• ` �� COCMICM W, dover, Mass., ADRA T E D P'P�`��.(5 1S H � BOARD OF HEALTH PERMIT T D � Food/Kitchen Septic System . BUILDING INSPECTOR THIS CERTIFIES THAT........�...1�..�..r�.. .....................C1.... V C. 1 ......... .............................................................................. Foundation has permission to erect... �G'c........................... buildings on ..a ...... !.ZNu!,0.0..c`.....,6+'�.............. Rough to be occupied as ��� �"�'``v`� N S l ti (cY 5 t O�('-PSC C-t Chimney ........... .................................................................... ...................................... . ............... .. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and y-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. it (.0 0 / /P p,� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Fina' UNLESS CONSTRUCTION T TS ELECTRICAL INSPECTOR Rough J ' 1- C ......... ............................................................................................. 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 Will To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner ' Street No. SEE REVERSE SIDE Smoke Det.