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Home My WebLink AboutBuilding Permit #305-15 - 22 PUTNAM ROAD 9/25/2014 �e O� ft►ORTR .9 wtuto ib BUILDING PERMIT TOWN OF NORTH ANDOVER ° 4 APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received * 'p '�.y p�AwrEo►�,�� Date Issued: sS,�`HU 9#QITANT: A licant must complete all items on this page LOCATION PROPERTY OWNER —DrPrint u�� - Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building z One family ❑Addition ❑ Two or more family ❑ Industrial ,Z Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑ Wetlands ❑ Watershed District Water/Sewer Identification Please Type or Print Clearly) { OWNER: Name:. Vca ?154-e- Phone: !Q/-')Y- 670 , Address: .22 CONTRACTOR Name: /J Phone: 7 73 y 1. 7 �CclPyt r"� Address: Supervisor's Construction License: C c /O 3 iU-9 Exp. Date: Home Improvement License: /C '17 Exp. Date: !/ a?/16 ARCHITECT/ENGINEER Phone: Address: Reg. No. 1 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 00 Total Project Cost: $ JZ 06 FEE: $ 2 Check No.: Receipt No.: NOTE: Persons contrac in wi h unregistered contractors do not have acces o the guaranty fund Si r ature of Agent/Owner = 1 Signature of contractor e � 4 BUILDING PERMIT oFttNORORTh,bgti TOWN OF NORTH ANDOVER to�sy `'' APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received0 rep �gSSACHUS �� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT:Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: ti Identification- Please Type or Print Clearly t OWNER: Name: Phone: Address: Contractor Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: o Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check.,No.: Receipt No.: NOU: Persons contracting with unregistered contractors do not have access to the guarantyfund of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ t TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinuning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS 1 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments x Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 M—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ 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 NOTE: 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 ❑ 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 NOTE: 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) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: 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 Doc:Building Permit Revised 2014 Location h "� No,_ — � Date 2 C • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee s22 ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# OW Building inspector f -_ --- ---- - -- �� , '� -2� t � 167" - --- I 1002,. ._. - _ ._. .30"--- 4 12" } 24" -.. I 37" 184„ 41"- _. f - _ - 70---" 4 t E 116" 51',,. I _ 131" + 36 I N r t T W K< MWA00D W1236 WD2436L (O h W M M 30-GAS-RANGE',7"nw a? � CC) w./ W e, w- 0) I_ - 5:1, +30'11. 416 o i to V 2 M I M d' _39 z 1C qp N M ✓ W C --cli Imo\ 0 �- slw O , E O 00 --f rr O? W/� , W W W M N Gay N v W r 0 F M F W CU oo I / 0) T _ vi 792" 24" , 19'. 1.. + 962,. . 12" I . t 3'u n 42;, - 42 42 4 a 24" 2 - - 12" _ 1271" All dimensions _size designations 20This is an original design and must Designed: 5/t6/2014 given are subject to verification on TECHNOLOGIES not be released or copied unless Printed: 6/24/2014 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. OWN HOUS:E.kit TAIII i YOUR- -SPACE Landscape & Construction, Inc. August 1, 2104 Mr. David Pepe 22 Putnam Rd. North Andover, MA 01845 Re: Kitchen Renovation at 22 Putnam Rd.. We are pleased to offer pricing for the following: -Demo and dispose of existing kitchen fixtures. $ 1,400.00 - Install one laminated beam to expand wall opening to 72". $ 1,000.00 -Furnish and install new cabinets. $ 9,000.00 -Template and install new granite counters. $ 3,500.00 -Install new appliances, sink and lighting. $ 4,350.00 -Install new vinyl floor tile. $ 1,880.00 -Paint walls and ceiling. 990.00 Total $22,120.00 Acceptance of Proposal: 1-141A J )l N Hom wner: David Pepe Date P YOUR SPACE LAND&CONS4., Inc. Date r' 2 Blanchard Road Burlington,Massachusetts 01803 (781) 273-1950 - Fax (781) 273-2111 - wwwyourspacelandscape.com The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations ' I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Your Space Landscape&Const.,Inc. Address:2 Blanchard Rd. City/State/Zip:Burlington, MA 01803 Phone#:781273 1950 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 10 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ✓❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' insurance.: 9. E)Building addition comp.[No workers' comp.insurance P• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.F-1 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 131-1 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners 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-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Republic-Franklin Insurance Co Policy#or Self-ins.Lic.#:4519337 Expiration Date:3/6/15 Job Site Address:22 Putnam Rd. City/State/Zip:North Andover, MA 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 MGL c. 152 can lead to the imposition of criminal penalties of 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. 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 herebffceyW under thepains andpenalties o erjury that the information provided above is true and correct. Signature: _----- bate Phone#:781 273 1950 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: F NORTH Town of s ndover O - 1 No. 6 NIC HI MACK � ver, Mass >h COC oi '�Si9s R�lTEO I�P�`�,(5 U BOARD OF HEALTH Food/Kitchen PERMIT D Septic System THIS CERTIFIES THAT .......................�, ..�4t4. ........ ...�r...� .......................... BUILDING INSPECTOR ... .. .. . In 1111114 Foundation has permission to erect .......................... buildings on�.. ......V.... .. .... . ..................... ....... ............................................ ChimneRough .. tIZAX%01'�to be occupied as ................. ... ... ....................... y provided that the person accepting this permit shall in every respect conform 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 PERMIT EXPIRES IN 6 ONT ELECTRICAL INSPECTOR UNLESS CONSTRUCT&kS TS Rough Service ............ .................................................................. BUILDING INSPECTOR Final GAS INSPECTOR Occupancy Permit Reguired 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. NORToi Town of 2 sAndover o - :,r "t No. * - �` h ver, Mass .Q COC"IC neWIC w 1' S U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT ....................... Q,4�4., ........ ... ....�' .......................... ,,,,,, BUILDING INSPECTOR ... ..... . has permission to erect ... buildings on Foundation ' Rough K t .. fz^-w ... ............................................. Chimney to be occupied as ................. .. ....................... provided that the person accepting this permit shall in every respect conform 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 PERMIT EXPIRES IN 6 MONT ELECTRICAL INSPECTOR UNLESS CONSTRUC S TS 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 I Street No. Smoke Det. u t Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervi%or License: CS-103907 STEVEN L PEPE 20 EMERSON ROAD Watertown MA 02472 Expiration Commissioner 08105/2015 �hr (fonr�uo��rncull�n/ ll�r::�tc�rile/f :C—\. Office of Consumer Afrairs&Business Regulation krrLME IMPROVEMENTCONTRACTOR istration166139 Type, iration_ 4)27/2016 Private Corporatiot YOUR SPACE LANDSCAPE&CONSTR.INC. STEVEN PEPE 2 BLANCHARD RD. BURLINGTON,MA 01803 Undersecretary