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Home My WebLink AboutBuilding Permit #388 - 258 REA STREET 11/2/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 4a Date Received Date Issued: " IMPORTANT: Applicant must complete all items on this page LOCATION S7 X�2q Print PROPERTY OWNER 1414 'le j✓ Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes o 100 year-old structure yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 4?One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑Floodplain 'Q Wetlands ❑ Watershed Distnct f D Water%Sewer DESCRIPTION OF WORK TO BE PERFORMED: 2:JA IV t (Identification Please Type or Print Clearly) OWNER: Name: /��R 1Z C)t-IT L Phone: Address: ZQS a< 1 CONTRACTOR Name: JYl ZR/ ?G' Phone: IJ 3 Address: Supervisor's Construction License: Exp. Date: Home Improvement License: ��C? S Exp. Date: 2 (7--k Z 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: $ �� xb� C> FEE: $ Check No.: 33 Receipt No.: y � NOTE: Persons contracting with unregistered contractors do not have access to the g anty and th iSSignature of AgenUOwner_ i nature� ff tractor - `�' Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL i Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ j 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 I � CONSERVATION Reviewed on Signature I 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 FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS i 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 I i 4 ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. i 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/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 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 i Doc: Doc.Building Permit Revised 2008mi Location o9sgj e:GOL,- No. Zoe Date NORTIy TOWN OF NORTH ANDOVER ' O F 41R 9 • i , . Certificate of Occupancy $ cNus t� Building/Frame Permit Fee $ L Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # � 24 761 Building Inspector NORT►y ToVM of 0 "� L A K e o , dover, Mass., �� _ate• � COCHICKEWICK �� ADRATED S U ` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System /� BUILDING INSPECTOR THIS CERTIFIES THAT........... .... r. ............... ... ... ..............Sli �r. �.� . !................................ Foundation has permission to erect........................................ buildings on .. CP.......... tr • I 'b .... ..................... .... .................... Rough t0 be.Occupied as.........................i* .. ..................... w!�VA. �.... Chimney provided that the person accepting this mit shall in every respect conf 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 CONSTRUCTI Rough - ..... ...................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building ; GAS INSPECTOR Conspicuous Place on the Premises — Do Not Remove Rough Display in a Cons p 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. AC40RO- CERTIFICATE OF LIABILITY INSURANCE FLATE{ Iq�YY r}tOOUQq 091o7t2011 TM5 CERTIFICATE 8816WED AS A MATTER OF inFOR#IlA i5 P"}assurance Agency ONLY AND CONFERS NO RIGM UPON THE CERTIFICATE 922 Chickering Road MOWER.rills CgeTwicarE DOES NOT AIAEND.ExmD OR Nanh Andover. MA 01845 ALTER THE COVERAGE AFFORDED BY THE POLICIES LOW. +e.slleafl SMRERS AFFOROM COVERAGE MAIC y JOHN LAWZ4FAME OCA~A. ATLAM'IC CASUALTY ItNSURANCE - DSA ALL UNDER ONE ROOF wSURER a AIM _.•_., 30 TEMPLE DR missrREa c: METHUEN,MA 01844 Sao �....-. ... COVERAGES ;ACAVERAL U IEE OF tT TER i OR LWECONDI BEt04N►PAVE BEEN tSStJFD TO THE D HAWED ABOVE FOR THE POLICY PERIOD 90CATED.NOTWITHSTAMt?Itar� THE TERM Exit CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W RH RESPECT TO W"Mj4 THIS CERTtMATE MAY BE ISSUED OR MAY THE irISURANCE AFFORDED BY THE PODS Hr:RMN IS 3'aMCT TO Ail TW TERM k4.ExCtUSIOkS ANI?COlvt�rrlONs OF SUCN .AGGREGATE-LrLtrtS SHDWIN MAY HAVE BEEN RED%KGW BY DASD CLAW. lfldT3LLAaYJTY L148000227 9111!2041 9/11/2012 z7a.-, COMMERCIAL GCWRAL twal1TY £/LOM* 'tXGtEttGf 7 ICLAWS MADE Q OCCUR s SO,0m 00 M - __ Y.... MEOExN � an,a Iy b 2.5QOD6 PERSOAMt&ADV IRUUNY 1 W.O 0n GENERALAGGP. "tE 1 6DObw 00 " }tt AQOREOA7E t1AlT APPLIES PEIt. '. PRODISY."tS•COMPLaP AGO b.00-100W, AMOUDDILE U^IMLfT POLICYPRO.ACT ..,-.•-.., S r tOG 1 Af.IY AU70 (� SiTJTitE IIMtT S ALL OWNED AUTOS SCHEDULED AUTOS 8fk3tlYrN1URY ! rPa'r REL};t} I HIRED AUTOS _ W)N-OWNFDAUTC.S 80URX WOURY PiROP£RTY OAMAOE N'et aCu r liARllOf L.LASILfYY i AMY AUTO AUTO DsaY-EAACGL)Fttt S R - E.AACC %T A(itiy s EkCFSM AORELLA uAatuTY OCCUR CLAWS MA(* EACH OCCURRENCE AGGRE(=ATE ! DEDUCTMLE ttyyppe�I��,�g, REEpTENT,Qt+ 1 1 ow&u 11FRS'L.IA TL*"A*0 '� lrr AWC700$464012010 1110947011 11/0W2012 ---------T ur�Ts �a ANY aaoPal TOPJPART?*FVEXFCUTFrE OFFI( ,Et EXCLUDED" El.EACttACCQLNT ; I00.0wOka POI[nve uncal --- MPROVISIONSpaw. E.t D5EA& -EAEuat0rxE !, 1U0OOp W OTIeER E L,DISE.ASf•POLICY L KVT S 500 066 Cr} "" it 3 CERTIFICATE HOLDER FCAmnot i ATLON IOW K OF W ES7 MEW BURY !'"OILED ANY of THE A6oY&oE>itRID&o POLICIES BE CAUL` "to 01"Osm TNY EXOMAT, GAT&THOta .TW ISa^USM INSURER WILL C""AVOR TO MAIL tb bArb rmf +AIGCT A1C WRi low f.An t111M1S tTRI "*TILE TO TRE CERTIFICATE"OLDER NAMED MIKE LEFT.OUT FAUURF To Do sr)5rrA! . The Commonwealth of Massachusetts Department of Industrial Accidents - Office of Investigations 1 Congress.Street,,Suite 100 Boston,MA 02114--2017 www.mass.gov/dia Workers" Compensation Insurance Affidavit:Builders/Contractors/Electricians/Pla bens AR21icant Information Please Print Leg bly Name(Business/Organization/Individual): /I// (JL4J�. . 6uz Address: T City/State/Zip: -CAL) AU Phone#:. Are you'an employer?Check the appropriate box: Type of project(required): 1. _ . 4. E] I am a general contractor and I .�I am a employer er y with '6. E]New construction employees (full and/or part-time).* have hired the sub-contractors 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' 9 O Building addition [No workers' comp.insurance comp.insurance.1 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.❑,tRoof Z C. 152, §1(4),and we have no insurance required.]t 13. Other employees. [No workers' om comp.insurance required.] . *Any applicant that checks box 91 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 anew affidavit indicating such. TContractors 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 isprovidin.9 workers'compensation insurance for nay employees. Below is thepolicy andjob site informataom Insurance Company Name: A r tn' /"`s `"n, Policy#or Self-ins.Lie.#: ALJ C/? 2,`� `F`'4�(as! o Expiration Date: l Job Site Address: �l S� ` S 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 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 hereby certify under the p airsi.aidpenalties of edury that the information provided above is trace and correct Signature: -- n, - -------—-- Date._._I / ------ Phone# 2' I// " ` �Sj� Official use only. Do not write in this area,to be completed by city or town offaciaL City or Town: Permit/License# Issuing Authority(circle one): 1:Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person- Phone#: F pw 10,1,1,11511 "N IJI j ar M4_ -tit 11osidia Hat Commercial Roo4l. A11 Types Of Sidinff Lxpr� Na,,;onry irk Mass Tot! rreff Licease M1.34200 (5.24 548T) Worw' 0r';9'&1r'V We 11, AN ON. X- "®R A A 5" Proposal To: Mark Sateriale Date 8/30/2011 Street: 258 Rea St N. Andover ,MA 76 Roof proposal marsats@rocketmail.com 1. Protect house exterior and landscaping as best as possible. (tarps etc.) 2. Strip all shingles from entire roof. Total cost: $ 7.p0.00 3. Inspect and re—nail any loose or lifted plywood. 4. Any compromised plywood will be replaced at an additional cost of$50.00 per sheet of 1/2" cdx fir. Balance due upon completion 5. Install heavy gauge aluminum drip edge to all eaves and rakes. 6. Install 6' of IKO Armourguard ice and water Referrals available upon request shield along all eaves,wall connections and top to Hiiihly rated member of the accredited BBB and bottom in all valleys. Amies' List 7. Install all new pipe boots. 8. Above the ice and water shield, install synthetic Thank you! underlayment to the remaining sheathing up to the ridge. 9. Install BP Everest 40 year architectual shingles to entire roof. 10. Install new GAF Cobra ridge vents. 11. Counter-flash chimney ice and water-shield, re- seal and tie into new roof. 12. Shingles are covered by mfg. warranty 13. Building permit included. 14. Removal of all work related debris. 15. Contractor workmanship warranty=10 years un- der normal wind and rain conditions. Acceptance of Proposal—The above prices, specilications and conditions are satisfactory and are herby ac- cepted. You are authorized to do the work as specif ed. Payment will be made as dined above. Date of Acceptance: I- 2, 'A Signature: U Signature:. Page 1 of 1 8/26/2011 12:39:38PM �I i 1B.r...r.hu,rtl. l)cr,.,rtm.•nt ..i i'ulrlrc ,Uri i Biu:trd nt kitriirlin_ Kc�ulaliun, ,uui `+t:ultiurrs. Construction Suoervisor r_icens= License' CS 69120 JOHN W LANZAFAME 30 TEMPLE DR METHUEN,MA 01644 Expiration. 44M13 t •.skrr6—i..4wr Trp: 14108 �... Of`filce of Consumer Affairs and Ifusiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 021 10 1-40nlr Improvement Contractor Registration Registration. 1370-1, ' TYt3A t7$A ALL UNDER JNE ROOF Expiration 10/2/2J12 trot zoo ,, JOHN LANZAFAME 166 A MERRMACK ST. METHEUN. MA 01844 UPdale Address and return caro—Mark reason for rhautjoc Address Renewal t.mpioyment (.usr( arU