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HomeMy WebLinkAboutBuilding Permit #067 - 229 WINTER STREET 7/28/2007 BUILDING PERMIT o�,yORTF� J.,,90 ,bgao TOWN OF NORTH ANDOVER �O 'p " 6 Lp APPLICATION FOR PLAN EXAMINATION Permit NO: Oro 7 Date Received rED SSACHU`+� Date Issued: -77 IMPORTANT: Applicant must complete all items on this page -YF 9* ro LOCATION - r PROPERTY OWNER.' r Pnnt MAP NO: 6*117 PARCEL': , ZONIN&DISTR CT: Historic District. k yes .--,no _. ,. 'Machine`Shop Village' _yes „ no z,, 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 SepticmV1%ell Flootlplin 'Wetlands = „� �Waters hedDistrict1 . 'Water/Sewer ,. DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: z CONTRACTOR Naie: ' % � f Phone: Addresse Supervisor's ConstrUdioln ,.License: -Exp. Date: Home Im rovement License. t� 4"Ex .:=Date w/-O p p ae , ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. ; 71,0 Total Project Cost: $ ` FEE: �� o� � S Check No.: � �- y Receipt No.: NOTE: Persons contracting with,unregistered c tractors do.not have access to the guaranty fund c , - - 7 signature of Agent/Owner .. ;SJanature Jana contrac or; r Plans Submitted Plans Waived Certified Plot Plan Stamped Plans j TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS j 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 :FIRE DEPARTMENT Terrlp;gDurnpster"on site yes y �no u. _ rv*. Located.at 124 Nlain Strut A d + . Fire Departmentxsigna`ture/date m- - 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 21A—F and G min.$100-$1000 fine NOTES and DATA– (For department use ❑ Notified for pickup - Date .........__._......._.—_...............................................................................-------.................................................................................................................................................................._..........._.__..._...............................................................-----._............................................. . Doc.Building Permit Revised 2008 Building Department The followingis a list of the required forms to be filled out for theappropriate ermit to be obtained. qP Roofing, Siding, Interior Rehabilitation Permits j ❑ 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/Crossection/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 j Hydraulic Calculations (If Applicable) ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Locations No. [%a �7 Date 7� 6 r NORM TOWN OF NORTH ANDOVER F 9 s ; ; Certificate of Occupancy $ �'�s ^°•Eta' Building/Frame Permit Fee $ cFZ`-"°" ncMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ R. Check # 1, T L 361 4 iigdiing inspector y �1ORTH TO'" of No. O �` - o dover, Mass., W. o COC M I C FIE WICK, A0RATE0 °s BOARD OF HEALTH Food/.Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... .... .v . , . ..................... .. .................... Foundation has permission to erect..................................../bDildings on ��. ., ...� .::<` ' .. ................................ Rough tobe occupied as........................:..........?�. . .... ... ..... .. ......... ............................ .. ..........z.,.:.,................... Chimney provided that the person accepting this,perml in every respect 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 CONSTRUCTION TARTS Rough Service o- BUILDING INSP �. 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 �''� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please.Print Leizibly Name (Business/Organization/Individual): 4"Z?''4 Address lo, G�e hTC S✓ City/State/Zip: �C�L�• L� /�?� /�' Phone.#: .�� �� r�f� Are you an employer? Check the appropriate box: Type of project(required): a employer with 4. ❑ I am a general contractor and 1 6. E] New construction 1' employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor of partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp; insurance comp. insurance.$ 5. ❑ We are a corporation an required.] its 10.0 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.❑ Roof repairs insurance required.] t c. 152, §1(4), and we ave no employees. [No workers' 13.[: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 subrnif 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 sub4contractots 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: Policy#or Self-ins. Lie. #: 1r1+%Q MeO old AO 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 MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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$250:00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificat on. I do hereby certify und5A,a pains and penalties of perjuiy that the information provided above is true and correct. Si ature: Date: Phone#: Offrcial use only. Do not write in this area, to be completed by city or town offcciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: 1/ B�o/ar o Building K aatons an tandards — One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 149221 Type: Private Corporation Expiration: 12/6/2009 Tr# 262486 LAMBERT ROOFING CO RICHARD LAMBERT 265 WINTER STREET HAVERHILL, MA 01830 - -- �- Update Address and return card. Mark reason for change. Address ❑ Renewal ❑ Employment i_--1 Lost Card DPS-CAI 0 50M-07/07-PC8490 ----------------- *-. �1;u�uchu�cti� Ihll;irnnrni i I'uhlicrNMIEL Bmu tl of Buildin- Rc'--Wmim1. and �tantl;trd" Construction Supervisor License License: CS 78130 Restricted to: 00 RICHARD J LAMBERT +' 95 MAPLE AVE ATKINSON, NH 03811 --G-- �` E x p,r a(ion: 6/2/2010 ( innii. i •nrr Tr" 27762 I n n � 1 ,�;I'' ,Ila-, -�.�-2�0' � ' �'� p I 71 ASS 1�' IAI�In ;1S� ANC �c r�P�TP j� 1r1:�lIJ D �SI-T _ AUG. �U, �Ol r ;IbPh1 � _ T1i r6RT11(cA7�IS 15SUaD/9 1 r{{ ,fTSR OP rr�toPtl UCER I CONPb�NO RIGH'1'S USD R�C�TLPJCTH A T,�i'PkAQp APFORDEDI[�7YATIL ?ROD FND EX nca AevncY!nc I p06S NOT A1d I oplo Injure POLICT3 5FLOu', �n 0 box 606 F-- COIPANIPS i4FFC'P-D CQ I �'ti'obum,�,fn OIEOJ 'NSI. 2ED 1..4 h ua� losulaucc Co R 65 11`in;or$acct iavwhlll,t iA �l 00 ran�sD.�uove 1 on ll h ro- >I IS:E.',7LT'T,TO- L Ok COND!T1011 OF,'t,NY -C1!��-RAC"1,OR OT!it�;� RTL}Tl'TFlI+T THb F'OL1l.lbS OP LT'SVk�\1:,:E LIST(:D©CLOW H.aJe HBE�'J ISSUBD?YJ THE IIJSUKB:J hl' 1570 C6 :ST,�NL)INCJ "NY" F-1'-L RdSLIX !CE IFFG(iDFD P}'TIF 1`0.fC lL.; I'I_IUOD 'DICAT6D, CISJUFll OD.?,f.'Y PLRT,aNI,THd 4E k3Fj6i1{ UU)'I U UY I'hIU " ICH T1 CERTIFICATE M2, B rli FOL JCI!5.L?rtITS SHuV,N MAY Hti TO1i, ;Ir,iTr 7'p F,LL TrlBELUSIONS,�1�CONDI"1'lOtJS LICi UtGCTIYL TOL!G� rfnon —� roucrnu•rr::: I oxrol}rwoo-rr) o.ro(uluvG�') ______ (U -YtE of lh-Np, 'GG QENYA1J.n:A f'y`-^T c C CZ`�[A.LL.LI AD RJTY tLA-SDK'.L F/,Cn'.VIINt'{ i I O Co,�A L Q v 011IL ILlry EACH I OCG L/1AC"r C9 Q E:3 aAIH)`+fie=C,�cux IlYY W.>la CID WYr[wv i O CyvNyAt 4CON[�-�'T 0a'�raoY. data Y�O'411i( ��+°' COMIIMBD YVYL11 (.IN ff �VT`0/.✓d Alit U.,31 I.7T7' p OpJ[.Y 411VAV K1ICO ItCD.[UTQS 0.0Py"f MIUtV I (ro.cdJ�r,p nl-'NJTOJ 'r.C1+.pw).'FA nI,TGf FA0 U i.9 tLM' {..,[Celia LL-LLITY I AfL�.-L LUTL LoynAE1,!„i rGA}f OT1SL.4 Tlt+�'' LU roA.0 r,TUTV RI'Ut.�rrS Cn1t 1LP&�3-ti7lOfr�uU - X -- w0R1vZFJ c0I 500,000 11 CHPLOYERs LLl9LLIT'Y i Ul_E/,CN aCGIDH=�T• A o I 08x18/2007 08/28J2008 EL 01�5E-.1'0UCYU1aIT 500,000 vr�asu�� 60099660120G ei D�snse-EnCH r j NZ � I BtdFL0YEE1 i LO`t� 1y DEg( 21PTION OF OPERATIONS O1�LONIONS; I I NOtJLD,tNI'OP'rHEA80 bPSC'x1oflD10i-1C1P9D6W;G5LLMDUOMTHFV,2M .TICNUar n HEALaY,+THl11,M)INQcomp'kTY P LDAP O1M�LUS GlNO 9Pl( oO `• C�tiOO LIGnTj� tOUMR.W1NC73ESr�� vtACAtAhfW Tu A LLIEILJ TY OP NY YJN�UPON THH CO Kr.r.NY,1T9 AUY 1fr5 UK}i17r i.GS C^(T,.Tf.`CG it/ ) 171 R10UNT 1"EFtNO14 ST CtILSTER,h'1A 0 18J r 05 033 313 T'GMassy MA Reg. Hic# 149221 j mbert cs MA Lic. #UCS 018130 - N Single ply Lic. # 1111 .-ting w BBB ti _Cu'-P 1932 ■ -. ■ 265 Winter Street,Haverhill,MA 01830 MEMBER We are: ✓ Licensed V Insured V Factory Trained V Factory Certified Installers Name: 1 0 C.:i-f�'L Date: Address: 2 L7 u t r._)"lmx=T P Telephone 1: ;f City,Town: a/+ t�C�-'. {; "ir ,'f (1' i {�?/cG u: Telephone 2: Job Location: ._y 1 Ire'1 c. City/Town: State: Zip: L.R.C. agrees to commence described work on/or about u.i:`.: and described work will be completed in about working days. L.R.C. shall not be held liable for delays due to circumstances beyond our control. L.R.C. shall not be liable for any damage to landscape,attics, interior walls or ceilings and/or fixtures due to circum- stances beyond our control. L.R.C. can not and will not be held liable for any damage to the surface that the disposal container is placed on. L.R.C. shall not be held liable for pre- existing conditions including but not limited to mold and/or wood rot,defective,faulty,rotted or worn building counterparts such as but not limited to siding,gutters,masonry,plumb- ing,and windows that jeopardize the watertight integrity of the building and are not covered under the roofing warranty. The following work includes all permits,labor and materials needed to complete your job in a professional workmanship like manner. Steep slope Quick-quote proposal to furnish and install the following: Approximate roof area i �1, New Roof ❑ Re-roof ❑ Gutter ❑ Repair ❑ Ventilation '01APrepare for re-roofing by ensuring all safety measures are taken in accordance to OSHA standard regulations and landscape is properly protected. iO Remove existing layers of shingles down to.roof deck and dispose of in a legal fashion from the job site.Inspect wood deck,if we discover any rotted wood, replacement will be performed at$ *per LF for roof deck boards. If substantial deck rot is discovered,re-sheathing of roof deck can be performed�t S *per SE If individualsheets are found to be rotted and/or delaminated,removal,disposal and replacement will be performed atSO per sheet.If any trim boards are rotted,replacement will be performed at$ _` i *per LF for new pre-primed pine(not to exceed 1"x 8").If wood is � sound,we will re-nail any loose wood to rafters,sweep deck and prepare for roofing. i 6nstall 8"Drip edge ❑ Install 5" Drip Edge ❑ Install Hug edge(Re-roofs only) /J 4«- 1''` l.' >'7"..T? Color`.x-s- &fApply ice&water shield(UNDERLAYMENT)as pernmanufacturers specifications, and or 0 Apply j., #felt paper(UNDERLAYMENT)to the balance of the exposed wood deck. t❑ ,,Reflash all stack pipes,tie-ins,chimneys and/or any roof penetrations as required and dictated by good roof practice to ensure water tightness. Ef If upon inspection,we discover chimney lead to be worn or deteriorated,replacement will be performed at per chimney for single flue and per chimney for multiple flues. r BRQ�;woa D r. (J nstall a new Year ❑ Traditional i"Architectural style shingle roof system Color Manf. c >1 F=i 0 -rnish and Install a new shingle over style ridge vent system ❑ Soffit vent system $P-J/-i a All debris generated by Lambert Roofing Co.,Inc. will be cleaned up and disposed of from the job site in a legal fashion. Under no circumstances will the watertight integrity of the building be compromised. Special Notes till! uj Warranty options: ❑ Standard LRC ❑ Manufacturers Upgrade $ * Denotes additional costs above the total estimated price. UPON COMPLETION AND PAYMENT IN FULL,ROOF SHALL HAVE A WORKMANSHIP GUARANTEE FOR A PERIOD OF TEN YEARS HONORED AND ISSUED BY THE LAMBERT ROOFING COMPANY AND YEARS HONORED AND ISSUED BY THE SHINGLE MANUFACTURER. This document can serve as a contract, however if a more elaborate contract is desired we will issue it at the owners request. Please sign and return one copy upon acceptance. NOTE:if this contract is not accepted in days, it'may be withdrawn by LRC. Financing is available A finance charge of 1.5%per month(18%per year)will be charged on post due accounts over 30 days. Total Estimate Price: $ ` -- / C..::'= Date of Acceptance �r�f i ' .1�L�Ilf� Payment to be made as follows: `.. (Home/Business owner - - --- Signature (LRC) c' Signature Haverhill MA 978 374-9224 • Lawrence MA 978-687-7339 • Atkinson NH 603-362-9500 • 1-888-SOS-ROOF (767-7663) • Fax: 978 521-5791 "Our Proof is on Your Roof" www.lainbertroofiiig.com