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Home My WebLink AboutBuilding Permit #672 - 266 BLUE RIDGE ROAD 4/26/2006M µORTFI OF " ".;a 7'YO 3r ,•,. , .._ � of p TOWN OF NORTH ANDOVER o :* APPLICATION FOR PLAN EXAMINATION ,Sg1CHU5E'� Permit NO: 7 Date Received: Date Issued: G U IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER�T MAP NO.: (, (' PARCEL: ,. r r Print % U ZONING DISTRICT: urcmnnrr n1CT1D1rPT V1Vq fl 1 rrr. H19 rJ U 0-u Vl' "U 1LL11V TYPE OF IMPROVEMENT — —'-- PROPOSED USE Reside tial Non- Residential ❑ New Building S116ne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION Uk WORK rU I3L FKP,1'utuv1L1) OWNER Address: CONTR Address; Identification Please Type or Print Clearly) Supervisor's Construction License:m— EGA Exp. Date: l - / / c' y Home Improvement License: �� Exp. Date:` ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT:$10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$_713(-12 Qs G'D x10.00=FEE:$ 35" Check No.: Dy Receipt No.: Page I of 4 Location -246 161ve 4// & No. OIL— Date TOWN OF NORTH ANDOVER , Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Z� .0 Building Inspector E TYPE OF SEWARGE DISPOSAL Public Sewer F1Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ Electric Meter location to project NOTE. Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ownery Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer connection signature & date DATE REJECTED ❑ ❑ ❑ Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE APPROVED DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED 11 Comments Comme x DATE APPROVED Temp Dumpster on site yes 11 Fire Department signature/date x'-06 r� Building Permit Approved and Issued by: -- Page 2 of 4 Building Setback( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. NOTES and DATA — (For department use) Page 3 of 4 Doc- INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC. Jan.2006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 Page 4 of 4 r 09/12/2005 10:17 1 POPOLIZIO INSURANCE PAGE 02/02 Q-80 CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY) ,A Pi.BCOC-1 09112/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Popoli zio Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 175 Littleton Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. EACH OCCURRENCE S-500 000 Westford MA 01886 Phone:978-692-8667 Fax:978-692-8588 INSURERS AFFORDINGCOVERAC,E NA1C0 INSURED INSURER A; PREFERRED MUTUAL INSURANCE INSURER B:— INsuI�ERc: ABCO CONSTRUCTION JOSEPH GYS 51 LOWELL MA.A011952OW DRIVE INSURER D; a ._ INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE, BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSR TYPE OF INSURANCE POLICY NUMBER DA E M OO DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE S-500 000 pL COMMERCIAL GENERAL LIABILITY CPP 0130 56 13 82 04/26/05 04/26/05 PREMISES uEmata:Ncclut:renceI $50,000 y CLAIMS MADE X t OCCUR _ MED EXP (Any one person) $5 .000 PERSONAL & A0V INJURY S 500, _— GENERALA_GGREG,ATE $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS -COMROPAGG S11000 000 PRO- POLICY 71 JECT LOC yTn ? AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Heacdaent) S - BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Pnr ommn) HIRED AUTOS BODILY INJURY $ NON.OWNEDAUTOS (Peraccldent) PROPERTY DAMAGE $ (Per awldenl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ��-- i ANY AUTO AUTO ONLY: AGO b EXCES$IUMBRELLALIABRITY EACH OCCURRENCE 5 OCCUR CLAIMS MADE AGGREGATE. $ _ $ DEDUCTIBLE S RETENTION S WORKERS COMPENSATION ANO TORY LIMITS ER EMPLOYERS LIABILITY E. . LEACH ACCIDENT —,. _ $ - ANY PROPRIETDR1PARTNER/EXECUTIVE E.L. DISEASE, EA EMPLOYE S OFFICER/MEMBER EXCLUDED? If yas, describe under SPECIAL PROVISIONS below E.L. DISEASE • POLICY LIMIT $ OTHER DEscRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CARPENTRY - WORJMRS COMPENSATION CERTIFICATE TO COME DIRECTLY FROM THE INSURANCE COMPANY CERTIFICATE HOLDER CANCELLATION CITYLOW 9H6LILD ANY OF THE ABOVE 0=C9tIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAR 10 DAYS WRITTEN CITNOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 90 SHALL 375 OF IMACKLOWELL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 375 MERRII�Ci{ STREET LOWELL MA 01852 REPRESENTATIVES. . 1 01 _ e 1 Richard J. Popolitleww''y • j 25 (2001!08) ®ACORD \00 \ », 0 9 <.�m G i0 0 } t z - n ■ �� ` \��. ` C, , \� } z0 r rr, . l-, # q /� R. \ \ 0 / § . . c q f a im} ■e kk OD �2toz U. z izz q . 2 $ 00 ■ U 2 oIr @ 8 f « .. ■. k � � 0$ ` �-10 G . 3 § $ J 2 � 2 mQ �. � oz< .. .. §: k #A$ - 0-0:0 j 2 \ », 0 9 x : r -G) i0 0 } t z - n ■ �� ` in: ` r rr, . l-, # q /� R. \ \ 0 / § . . c q f a <a ®. ID z OD �2toz . z °E f \! oto § ` �-10 �. � y m m m �o m N m 0 F d C � CA CO) � d 10 O CD St Z y CL �. � � O d= CO) 1 1 CD o p d� O Q CD CD o C CD cCDo) n0 y CD I z r cn n 0 F� r C E C O M g.!m N N = Q < o O. "p CO) m3 • C.Sr' N R tC O m �s C�y b w m H 0 m H O 0j O � � CD �7 a 1� Z d O N COf 0 CO aN � CL ?s o�y� �aCD m0 7 N ��: 97 CCD IE mm. N m O A ..F O m O CO) 'v o OCD O a� =Go y go CL= c 0 moo: o ea Q N z 0 'a 4 NLr 01) D w Z troCA lj O m �s C�y b w 0 � w "� C C C �7 g a 1� O 4 ^G� a ►Iti � w p troCA lj y C�y b w 0 � w "� C G 0 C b g a O � Esc: O C Page No. of. Pages' . ABCO ROOFING & CONSTRUCTION CO. CONTRACT LOWELL, MA 01852 HIC # 108424 a Super Contractor License # 092469 978-937-5840 or 978-475-7544 PROPOSAL SVPSMIITED TO 7 yiL1 , f� PHONE DATE f% (/ STREET `� r P I J08 AME CITY, ST / A D f l? CODE JOB LOCATION ARCHITECT DATE OF PLANS F We hereby submit specifications and estimates for: J iWA 4 CV �2d pt I/v oy 'T" . 'Ale wo Li i C.(✓. F ` ' �✓ fWe Propose`J hereby to furnish material and labor — complete in accordance with above specifications, for the tum of: dollars (S )- Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workman- like manner according to standord practices. Any alteration or deviation from above Authorized specifications involving extra costs will be executed only upon written orders, and Signature will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays . beyond, our control. Owner to carry fire, tornado Note: This proposal may be and other necessary insurance. Our workers are fully covered by Workmen's Com- pensation Insurance. withdrawn by us if not .accepted within days. ff Acceptance of Proposal -The above prices, specifications and conditions are satisfactory and are: hereby accepted. You are authorized to do the work as specified, payment will be made as outlined above. Signature Date of Acceptance Signature Page No. of Pages ABCO ROOFING & CONSTRUCTION CO. CONTRACT LOWELL, MA 01852 HIC # 108424e Super Contractor License # 092469 978-937-5840 or 978-475-7544 PROPOSAL SUBMITTED TO PHONE DATE 7/0 STREET JOB NAME / CITY, STATE AND ZIP CODE JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimat s for: V , I j.>� r 0/` //446,1 C�C'Aa 1 rI r G� We Propose hereby to furnish material and labor — complete in accordance with.above specifications, for the sum of: t ` ✓ .. CI ? •� ( 1 ? 1 l c (j� n k'e.lc i L dollars ($� Jm ). Payment to be made as follows: b ' 7S'C� All material is guaranteed to be as specified. All work to be completed !W. workman" ` like manner according to standard practices. Any alteration or deJiotion from abo Authorized ( f > specifications involving extra costs will be .executed only upon written orders, and Signature wiIfbecome an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond. our control. Owner to carry fire, tornado Note,` This proposal may be and other necessary insurance. Our workers are fully covered by Workmen's Com• withdrawn by us if not .accepted within days. nensntion Insurnnea. Acceptance of Proposal -the above prices, specifications and conditions are satisfactory and are- hereby accepted. You are authorized Sig naturef'fZ to do the work as specified. Payment will be made as outlined above. ;V Date of Acceptance r�llllG Signature I