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Home My WebLink AboutBuilding Permit #419-13 - 259 GRANVILLE LANE 11/27/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: " ��-- IMPORTANT: Applicant must complete all items on this page LOCATION 5 6—rany(Pe L ayyo Print PROPERTY OWNER f l Lcacro5s t n Print 100 Year Old Structure yes no MAP NO: 4 A. PARCEL: D� 5a ZONING DISTRICT: Historic District ye no Machine Shop Village yeq no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIP 101 01 WOR TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: pn,y Lc. Crp " Phone: 417 -2a,F-7.Po� Address: � 64TinV1llt 1Any CONTRACTOR Name: 17GVi(a eI m Phone: 7o9` 340 - gaDa2 Address: �� IQ�r an 4 i roo MA M Supervisor's Construction License: Z'15 36 S Exp. Date: l Ah Home Improvement License: 10 8 Z Exp. Date: ARCHITECT/ENGINEER VA- Phone: Address: Reg. No. FEE SCHEDULE:BULDING PER IT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �6 FEE: $ y C9. u Check No.: Receipt No.: NOTE: Persons contracting witA u eeis ered contractors do not have access u ty fund —0 ;Signature of Agent/Owner Signature_of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location ms`s/ No. Date//-,) �L • - TOWN OF NORTH ANDOVER • :,. ti Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 25979 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 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 Osciood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Departindr t 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 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use L) Notified for pickup - Date E Doc.Building Permit Revised 2010 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 o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 Doc: Doc.Building Permit Revised 2012 r , NORTN - � 0 No. , 1 * - . _ 4 -ih ver, Mass, ' COCHICHEWIC" y1' p0RATED S V BOARD OF,HEALTH Food/Kitchen .PERMIT L D Septic System THIS CERTIFIES THAT ........................... ....................... ................................ .............s................ .'. has permission to erect ........................... buildings on ...11& ..... r*jvs.�................ Foundation Rough to be occupied as .........p' �...-........ .?.a.�..i.4 .......... .......... ... .... Chimney 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 I ONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU TIO ST T Rough Service .......... .....................................:..:.. .....,........... Final BUILDING INSPEC R 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 \_ The Commonwealth of Massa chusetts %^- Depart»tent of Industrial Accidents Office of Investigations �_ 'r._�,�.�,,`^� �•,1-� 600 Washington Street Boston MA 02111 -= www.ntass.gov/dia Workers5 Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pltlrnbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): D l V� Q'�1Td�Y16 Qembcl Jain Address: �6 City/State/Zip: h ()1kqj Phone #: q7 3 6 0 — Aja pa Are ou an employer? Check the appropriate box: l. 1 am a emnlnvPr�xrith „-, 4. Type of project(required): r_..,__ —�— (� I am a general.con!ractor and I 7„•.0o is n .._ar,.___� , havP 11;r P the 6. ❑New construction 6 vt j.:..,t-time j. - d _._ 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. E] Remodeling ship and have no employees These sub-contractors have working for me in any capacity. employees and have workers' 8. ❑Demolition [No workers' comp.insurance comp. insurance.1 9. ❑Building addition required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l 1.❑Plumbing repairs or additions Myself [No workers' comp. right of exemption per MGL insurance required.]t c. 152, §1(4),and we have no 12.❑Roof repairs employees. [No workers' 13-❑ 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. 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: lk-T. M Av' ,.=V1W W L? Policy #.or Self-ins.Lic.. #:� c "Toa"j 33 6 - p . Q o��o� E c iratioti Date: Job Site Address: nlrl II`e City/State/Zi -~ P 'W 1 Attach a copy of the workers' compensation policy declaration page(showing the policy nuniber'and ex irati t . p on 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 ne year imprisonment,as well i as civil penalties n the form of a STOP WORK ORDER and a fine of up to$250.00 a day ag&thiolator- Be advised that a copy of this statement may be forwarded to the Office of Investigatio the DIA coverage verification. I do here y certi i n erd penalties of perjury that the information provided above is true and correct. Si nature: p Date: Phone #: 970 -360 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): -71 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 1 1'•/ta�SaC.`?��? S -�.a�`3�:;.,._..:' n` J'1^i:c Saici;' - Board c:3-widing Pea_labions and Standards �+i�.l�t: •'. .`4'..,, _i4C�.�.Se. CS-023365 DAVID RETTAKO 56 PLEASANT STREET METHIM SIA 01844 =::��ratt:.•:. I,c,.1miSsioner 1210412013 HOME IMPROVEMENT CONTRACTOR P� Regisfl8 on: - 108782 Type: 1V 6. 17 z Expiradon_ W52012 Private Corporazic• p fD REITANO REMODEL.&BUILD David Reitan 56 Pleasant St Methuen,MA 0184.4 Undersecretary j, -C1 ESS =GO ZTn OE i C C r (JJ r -12G1'C'CGAx C��%d/(-�s':1.1�F'c mJ��IJ_ � t� = Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home improvement Contractor Registration Reqistration: 108782 Type: Private Corporation Expiration: 8/25/2014 Tr# 230264 DAVID REITANO REMODEL & BUILD David Reitano 56 Pleasant St _.__---'----------___.. ...------------- Methuen, MA 01844 - — - -- - Update Address and return card.Mark reason for change. I._] Address ❑ Renewal L— Employment Lost Card SCA 1 Co 2OM-05/1 t r'��r �i rur�irnrrinrrrl/�n �lrr.uac�a;r/G :!Z-�' Office of Consumer Affairs&Business Regulation License or registration valid for individui use only �KOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: � egistration: 108782 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 xpiration: 8/25/2014 Private Corporation Boston,MA 02116 DAVID REITANO REMODEL&BUILD David Reitano 56 Pleasant St Methuen, MA 01844 �— - --- ---- - ----- ---__.._.._. Undersecretary Not valid without signature e �� STORE COPY INSTALLATION SERVICES CUSTOMER CONTRACT- MWORK - INT/EXT/PATIO DOOR LOWE'S OF SALEM, NH, STORE It 2382 STORE PHONE: (603)681-4218 541 SOUTH BROADWAY SALESPERSON:JOHN DEARDEN - - - SALEM, NH 03079-0000 SALESPERSON ID: 1439907 Document Print Date : 11/12/2012 This is only a Quote for the merchandise and services printed below. This becomes an agreement upon payment and issuance of a Lowe's receipt, upon which the entire agree- ment, including the specifically completed pages of this document, the Terms and Conditions included with this document, the applicable portion(s) of Lowe's receipt, and any other addenda or attachments hereto, shall be referred to herein as this "Contract." PLEASE READ THI5 ENTIRE DOCUMENT INCLUDING THE "TERMS AND CONDITIONS." BEFORE SIGNING Lowe's Registration or Contractor License Number/Lowe's Contractor Name Lowe's Home Centers, Inc.'s MA HIC NO.: 148688 Lowe's Home Centers, Inc.'s FEIN: 56-0748358 Customer Name S ERIK LACROSS Home Phone Customer Address 978-208-7804 259 GRANVILLE LN Other Phone L City State/Province D NORTH ANDOVER MA Zip/Postal Code Installation Address 01845 T 259 GRANVILLE LN O Installation City Installation State/Province NORTH ANDOVER Installation Zip/Postal Code MA 01845 MERCHANDISE AND INSTALLATION SUMMARY MERCHANDISE SUMMARY 21682 : 21682 : STK : 32" RB 6-PANEL LH : 32" RB 6-PANEL LH : AMERICAN BUILDING SUPPLY, INC. - QTY 1 193565 : 35114FJPMD : STK : PFJ CASE 351 2-1/2X11/16X14 : PFJ CASE 351 2-1/2X11/16X14 : EMPIRE COMPANY, INC. (THE) - QTY 1 193569 : 35170FJPMD : STK : PFJ CASE 351 2-112X11/16X7 : PFJ CASE 351 2-1/2X11/16X7 : EMPIRE COMPANY, INC. (THE) - QTY 4 234942 : 234942 : STK : 32-IN RB MINIBLIND W/GRILLES LH : 32-IN RB MINIBLIND W/GRILLES LH : AMERICAN BUILDING SUPPLY, INC. - QTY 1 238348 : 2828-8 : STK : 3/4X7.25X8 RF EMBOSD PVC TRM BRD : 3/4X7.25X8 RF EMBOSD PVC TRM BIRD : ROYAL MOULDINGS LIMITED - QTY 1 238354 : 2867 : STK : 1X5.5X10 RF EMBOSD PVC TRIM BOARD : 1X5.5X10 RF EMBOSD PVC TRIM BOARD : ROYAL MOULDINGS LIMITED - QTY 3 Materials Price $ 478.36 ore 2382 Project No. 367206271 for ERIK LACROSS Page 1 of 7 STORE COPY INSTALLATION DESCRIPTION Stock or SOS : Stock Select Location : 2 doors Door Type : Exterior Number of Doors to Install : 2 Select New Door : Single Pre-hung Hardwood (Mahogany or Oak) Door : No Side Lights or Transoms : No Number of additional holes bored for accessories : None Hidden Damage Description : None Install Storm Door : No Install Specialized Mortise Hardware : No Total Linear Feet of Custom Trim to be Installed : 56 Lead Safe Practices : No Customer Understands Scope of the Project : Yes Deliver Door : Yes Who Will Obtain Permit : Lowe's Permit Required : Yes Additional Miles Traveled over 20 : 0 Permit Fee : No Local Disposal Fee : Yes Bring Up To Code Description : None Other Work Charge : Yes Describe Other Work Needed : frame adjustments Comments : No Comment Labor Charges $ 1129.5 Detail Deduction -$ 35.00 Additional Specifications: Notation: Lowe's will not make structural modifications, paint or stain or remove/reinstall security system equipment. Customer is responsible to advise if prop- erty is governed by Historic District Regulations. Additional Specifications:Federal law requires Lowe's to provide you with the pamphlet Renovate Right: Important Lead Hazard Information for Families, Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. Child Care Providers and Schools. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES *where applicable SUB-TOTAL $ 1572 8 *TAX $ 0.0 DELIVERY $ 0.0 ORDER TOTAL $ 15720-4 Store 2382 Project No. 367206271 for ERIK LACROSS Page 2 of 7 STORE COPY BALANCE DUE Work is to commence upon reasonable availablity of Contractor which is/ anticipated to be_ )}� [fill in date]. Estimated completion date is - t [fill in date]. NOTICE TO CUSTOMER All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to custom- er. IF THE CONTRACT TOTAL IS $1,000-00 OR LESS Customer mustp-aym must -ain full. COW16ETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS 1 000.00: [W— Customer to Pay in Full; OR [_] Customer to use the following payment schedule: (1) Deposit $_ to be paid upon signing contract. Deposit should be 1/3 the total contract price; and (2) Payment of $ to be paid anytime after this Contract is signed and before commencement of installation, I/We authorize Lowe's to do one of the following (check appropriate box below): [_] Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or [_] Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed; and (3) Final payment of$100.00 to be paid upon completion of the installation and both parties' satisfaction. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CON- TAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT. YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c.142A LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS TRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRET- ARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB- Store 2382 Project No. 367206271 for ERIK LACROSS Page 3 of 7 F TOSU IARBITRATION-AS PROVIDED IN M.G.L. c.142A. STORE COPY Date: 's Home Centers Inc. By. — Date: Owner By: S Date:_ ouse THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT EVEN WHERE THE SECTITO M.G.L. c.142AO . THE WNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES. ON WITNESS OUR HAND(S) AND SEAL(S) BELOW THIS DAY OF Lowe's Home Centers, Inc. By:. �P (vim (Seal) Print Name: Address IJ C. � '1 Owner (Seal) City State/Province Zip/Postal Code Print Name Co-Owner or Witness (Seal) Print Name Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof. You the customer may cancel h any time prior to midnight on the third business day after the date of this transaction. See the attached Notice of Right to Cancel for an explanation this right. Y this transaction p anation of i� Store 2382 Project No. 367206271 for ERIK LACROSS Page 4 of 7 �'� ,,,v_