HomeMy WebLinkAboutBuilding Permit #553 - 245 CHESTNUT STREET 2/20/2007 BUILDING PERMIT NORTF/
TOWN OF NORTH ANDOVER F
APPLICATION FOR PLAN EXAMINATION * ,�
Permit NO: Date Received �ysSgCHus���5
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
SLIZA nU4 S4
.Print
PROPERTY OWNER / d (;'1 0 L
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MAP NO: UPARCEL: ZONING DISTRICT: HISTORIC DISTRICT yes no
TYPE OF IMPROVEMENT PROPOSED USE
Resi entia Non- Residential
New Building One famil
A Two or more family Industrial
Alteratio No. of units: Comercial
Repair, replacement Assessory Bldg
Demolition
Water Sewer Well Other Others:
DESCRIPTION OF WORK TO BE PREFORMED:
IdentificationVease Type or Pr* t Clearly)
OWNER: Name:O���n oc PA cM l"1£��1 Phone:g 3
Address: S
CONTRACTOR Name:-/A Phone: (0� (000A3
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date: g
&,,A)o
ARCHITECT/ENGINEER Phone:
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: $ e-
Check No.: 3, y Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access the gu anty fund
Signature of A ent/Owner Signature of contracto
Sig g
Location,"? �z �/T r�%�u��✓�-f��
No. Date
NGRTM TOWN OF NORTH ANDOVER
0
` 9
+ Certificate of Occupancy $
ssACMUS Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
e i i
Building Inspector
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 ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
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
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
Located at 385 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 2 1 A—F and G min.$100-$1000 fine
NOTES and DATA— For department use
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❑ Notified for pickup - Date
................................................ ............. .......................................................................... ................ ......................._. ................................................. ................
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
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)
❑ JEngineering Affidavits for Engineered products
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
❑ Engineering Affidavits for Engineered products
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 2.2007
q � 3 -3q? -SSMo
Julien Dupont
Roofing, Siding& Remodeling
22 Maylane.Dr
Salem, NH 03079
603-893-4385
508-243-4191
Proposal Submitted to: Work to be performed at:
Weichert Relocation Company
245 Chestnut St
North Andover, MA
We hereby propose to furnish the materials and perform the labor necessary for completion of:
Strip all shingles off house.
Install 6ft ice and water shield on bottom edges. Felt paper remainder.
Strip flat roof over entry way. Install new rubber roof using 06 rubber.
Install new 8" white aluminum drip edge.
Will re:-roof house using 30 yr architect shingles color:
Install new ridge vent where needed
Install new vent pipe boots.
Dispose of all debris.
All material is guaranteed to be as specified,and the above work to be performed in accordance with the
drawings and specifications submitted for above work and completed in a substantial workmanlike
manner for the sum of.Nine Thousand Five Hundred Dollars.($9500.00)
Wit yments to be made ac fallnw4L
50%_$4750.00 due upon start of iob. CCx 1 5c�{,(-- C�CJ
B ana:of$4750.00 due on completion
`{Z 1 -- CtVv1L�c�st1� .
Respectfully Submitted:
_2.-r>'��
Per:____
Any alteration or deviation from above specifications involving extra costs Note-This 1"
Will be executed only upon written order.and will become an extra char e s proposal may be withdrawn
Over and above the estimate.All agreements contingent upon strikes,
g by, if not accepted within 7_days.
Accidents,or delays beyond our control. \
Acceptance of Proposal \
The above prices.specifications and conditions are satisfactory and are hereby accepted.
You are authorized to do the work specified.Payments will be made as outlined above.
Signature: C C-L,
t
SignatureI
:
elchert Relocation Resources, Inc.
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with th provision of MGL c 40 S 54, a condition of Building Permit
at: zLklk Ilu
is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c 11, S 150 A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
I OA.
The debris will be disposed of in:
(Location of Facility)
Signature o ermit Applicant
Fire Department Sign off:
Dumpster Permit
Date
02/20/2007 12:01 19786859460 HASBANY INSURANCY PAGE 01
ACORD M CERTIFICATE 4F LIABILITY INSURANCE -
02 20/2007
PfloDUCEP THIS CERTIFI ATE 19 ISSUED AS A MATTER 0 INFO MA nON
ga�any xasvralNce Agency ONLY AND CONFERS NO RIGHTS UPON THS CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEN EXTEND OR
236 JtleaBint St ALTER THE COVERAGE AFFORDED BY THE P LICIES BELOW-
Methuen, MIL 01844 I NAICII
phone: 978-685-3188 Fax: 978-685-9460 INSURERS AFFORDING COVERAGE
INSURED INSURER a pmm America
Julian Dupont INSURER& Trav'Olars - St. Paul.
3ulien Dupont Contracting NeURERC;
20 May Lane Drive INSURER e.
Salem, N8t 03079 INSURER EI
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWRMSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACY OR OTHER DOCUMENT wnH RESPECT TO WHICH THIS CERTIFICATE M BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN Is SUBJECT TO ALL THE TERMS, EXCLUSIONS AND DITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
AFFFECIryL PVT K IflATIOR L/ARA
L NERD TYPE OF NSURAWt POLICY NUMBER OAT4 WOO DA OlYY)
A QBRALLIABILIYV 1Rpp 1036601 05/23/2006 05/23/2007 EACH OCCURRENCE �t300 000
EN
N7
COMMERCIAL GENERAL UARILITY PREMISES(E9�ri1 mm 50,000
CI.IIMgMADE 7OCCUR MEDEXP(Ay9noven]N 5,000
PERSONAL&AD VWAY 000,000
ppm A00REOTE 600,000
GENREGAYE LIMIT APPLIES PERI PRWUDTS-OOMW AMD 300,000
X POLICY I I jECT LOC
AUTOMOBILE LIAMLITY COMBINED SINGLE LIMB' 'S
(E9 AC.MM�R
ANY AUTO
ALL OWNED AUTOS BODILY INJURY S
IPavelAoe}
SCHEDULED AUTOS
HIRED AUTOS BOOILY INJURY
NON-OWNED AUTOS
PROPERTY DAMAGE S
- (Poe amm.0)
AUTO Oh .En ACCIDENT +<
OARAD!LIASLITT
ANY AUTO OTHER TKAN EA ACC i
AUTO ONLY: AQG t
DXOlS9 NIBRELLAUABLISY EACMOCCURRbNCE S
OCcuR CLAIMS MADE AGGREGATE S
S
DEDUCTIBLE S
s
RETENTION $ Ulm_
$ MMKIIIIS60HPENBATION AND 7PJCM-5176C51-9-06 05/26/2006 05/26/2007 1TORY MI' X I ER
wPLOYER9•IAABLRY E.L.EACH ACCIDENT 41,000,001)
ANY PROPACTORIPARTNERIEMPUTME
OFTICEP&MASER EXCLUDEDt Exclude Owner E.L.OISUM-EA EMPLOYEE $1,000,000
ePyatliaaarovi�ivoN.eac.�Exclud Owner JUI.Jen Dupont E.L.DIWASE-POLICYLIMIT a 1,000,000
OTMPA
p Ap'YIBH OP OPlNATiDN9JLOOA710,19/VRMICLim/&=WWONS ADDED BY ENOOR9EMOIT/SPECIAL PR9%"W M
CERTIFICATE HOLDER CANCELLATION
Town of North Andover SHOULD ANY OF THE A99m 9))9DRIBBD POLICIES BE CANOlLLB9 8EF9RE TNR EXPIRATION
OATS THEREOF. MtNUINO NNINER WILL ENDEAVOR TO MA lO DAYS WHITTBN
Building Peet NOTICE TO THE CBRTMATE HOLDER NAMED TO THE LEFT, Bos FMLUAll TO 00 90 ]MALA
Osgood Street
9809E M9 OBLMA770N ON LIABILITY OR ANY K916 UPON 17SSMmumEm. RSI AGENTS OR
North Andover, MMR ABpRBg11TATMt.
[AMQREPR6NpTAl"
ric Jansen
ACORD 26(20MM) 1p AC I'
CO POTATION 1988
i
i
t
t
I Board of Building Regulations and Standards l
License or registration valid for individul
]� HOME IMPROVEMENT CONTRACTOR use only
before the expiration date. 1f found return to:
Registration: 137640 Board of Building Regulations and Standards
s ,3 Expiration 12/13/2008 Tr# 124907 One Ashburton Place Rai 1301 I
Type: Private Corporation Boston,Ma.02108
AC EXTERIORS INC.
ANNA CURRAO
67 LOWELL BLVD 1
METHUEN, MA 01844C
Administrator — Not v �d without signafure "
NORTH
Town of 19Andover
0
No.
Y Z - dover, Mass.,
T Q — LAKE
co
MIC ME WICK
7� RATED OkV �C
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
• BUILDING INSPECTOR
THIS CERTIFIES THAT40 0
��..C ... .... ��.� �.� .. �....................... Foundation
has permission to erect........................................ buildings on evor-7. .. V Rough
to be occupied as.... �!;r�' �t......5'�i0• Chimney
.............. . ... ..... .. ...... ... . .. . . .. .. . ......................................:..
provided that the person accepting this permit shaD in every r spect conform to t mf the application on file m 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 CONSTRUCTI TARTS Rouge,
.... ... ... ................. . ......... ....... Service
ffurww4k,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.