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HomeMy WebLinkAboutBuilding Permit #140 - 27 FULLER MEADOW ROAD 8/22/2006 TOWN OF NORTH ANDOVER of NORTH q APPLICATION FOR PLAN EXAMINATION o2 �,t•���;•.,"o Permit NO: Date Received 4oRAr�o'�p,ty / 9SS�caus�� Date Issued: Y IMPORTANT: Applicant must complete\all items on this page LOCATION �y Ie-r- V P_cf "'i KA a� ii p(� Print ® PROPERTY OWNER bob t C�t� Q7c--&u,-e- t-C� Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building � One family ❑Addition ❑Two or more family ❑Industrial ❑Alteration No. of units: Repair,replacement ❑Assessory Bldg ❑Commercial ❑Demolition ❑Moving relocation ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE P FORMED �' �, Identification Please Type jor1 Print Clearly) OWNER: Name: ink, 1— PC%-J(.C%- I c%,V-t-e-, Phone: 7g— 7q 71 Address: Z1 �c>r�e - f. d moor rb4) TL&J CONTRACTOR Name: W i'nLJ f- boar` Sc 11 Q78 -7�yZ'000 Address: 10043 A)e4-JL" <li 1)4!vn i/eks ae.. ©tac z.3 Caw- Low.yc✓ 'fo c.oka St- {5everty v`4 C, 000( Supervisor's Construction License: l Exp. Date: Home Improvement License: 1 ZQ i Z O Exp. Date: �7 ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST A D ON$125.00 PER S.F. Total Project Cost :$ -,6--17S- x12.00=FEE:$ Check No.00 ` Receipt No.: b Page Iof4 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION O�st�a° �b;'tio L O M Permit NO: Date Received Date Issued: Sge►+us�`��� IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential New Building ❑One family C Addition ❑Two or more family Industrial _ ,Alteration No. of units: Repair, replacement ❑Assessory Bldg Commercial Demolition -. Moving(relocation) El Other Others: _. Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Mame: ___ Phone: Address: Supervisor's Construction License: Exp. Date: Home hnprovement License: Exp. Date: ARCHITECT,/ENGINEER Name: Phone: ,Address: Reg. No. FEE SCHEDULE:BULDCVG PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ x12.00=FEE:S Check No.: Receipt No.: Pate Iol•3 Location-' �V I Ifs da j JZw No. Q Date t Z I NORTq TOWN OF NORTH ANDOVER O N � A Certificate of Occupancy $ R Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # I 15.11 5 0 n ._..�� Building Inspector TYPE OF SEWERAGE DISPOSAL F— Tanning,%Massage,�Body Art ❑ Swimming Pools � Public Sewer Well 17 Tobacco Sales r Food Packaging/Sales _ Permanent Dumpster on Site Private(septic tank,etc. _ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund Signature of Agent/Owner Signature of contractor Plans Submitted ElPlans Waived ElCertified Plot Plan ❑ St ped Plan ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORINT DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision.-receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer connection/Signaturee& Date Driveway Permit Temp Dumpster on site yes_no V Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Re uired Provided Re l 1!uired Provides Required Provided 4 Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA—(For department use) Page 3 o f 4 Due:INSPEC ION\L SLIMCES DEPARTMENfa?PfORM05 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 pp 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:INSPE.C'HONAL SERVICES DEPARTMEN HIPPORNIII5 P:wr-1,W4 NORTly own of _� Andover A dover, Mass., 'O re rt COCMICMEWICK ^ ADRATED `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ' BUILDING INSPECTOR THISCERTIFIES THAT.....19L........... .rt .. . ................'................. ........................................................... Foundation has permission to erect........................................ buildings on ...�1.......IN11 ...... M► w....... Rough to be occupied as......I........�. 1 •.. .......�1►... ..a........ chimney provided that the person acceptin�this permit shall 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 PERMEXPIRES IN 6 MONTHS IT UNLESS CONSTRU . .. _ ST TS ELECTRICAL INSPECTOR Rough ............................................... Service BUILDING INSPECTOR 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. SELF INSURED LUMBER BUSINESSES ASSOCIATION NCCI CARRIER CODE NO. WC 00 00 01A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE 1. The Insured: Gove Lumber Company Policy No. WC 000806-6 Renewalof: WC 000806-5 Individual Partnership Mailing address: P. 0. Box 12 X Corporation or Beverly, MA 01915 04-1382050 Federal Employers I.D.# Inter/Intrastate Risk I.D. # 012217 Other I.D, # Other workplaces not shown above: See Schedule 2. The policy period is from 01/0 1/2006 12:01 a.m. to 01/01/2 007 12:01 a.m. standard time at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.The limits of our liability under Part Two are: Bodily Injury by Accident $ 500, 000 each accident Bodily Injury by Disease $ 500, 000 policy limit Bodily Injury by Disease $ 500, 000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06 A D. This policy includes these endorsements and schedules: See Schedule 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rate Per Code Total Estimated $100 of Estimated Classification No. Annual Remuneration Remuneration Annual Premium See Item 4 . Extension WC 00 00 01A Total Estimated Annual Premium $ 44, 362 Deposit Premium $ 11, 090 Minimum Premium $ 500 (MA) 5645 Expense Constant$ 284 MA - DIA Assessment 0 . 011 352 . 00 Premium Adjustment Period: Annual Countersigned by: Servicing Office: SELF INSURED LUMBER BUSINESSES ASSOCIATION Date: 11/03/2005 Producer: Copyright 1987 National Council on Compensation Insurance. Original - COMWWMvea" 0/ Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 129170 Type: Private Corporation Expiration: 7/19/2007 Gove Lumber Company, Inc. Bruce Gove 80 Colon Street Beverly, MA 01915 Update Address and return card.Mark reason for change. DPS-CA1 0 5.OM-04/05-PC8698 F-] Address ❑ Renewal [-] Employment ❑ Lost Card Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 129170 Board of Building Regulations and Standards Expiration: 7/19/2007 One Ashburton Place Rm 1301 Type: Private Corporation Boston,Ma.02108 Gove Lumber Company, Inc. Bruce Gove 80 Colon Street Beverly,MA 01915 Administrator�`°� Not valid without signature b iz—U6; 4:4zprv;i-roauct ion Control Gove LUMDer ;978 762 0008 # 1/ i F 100-B Newbury Street Route 1 South 978-762-0007 Danvers, MA 01923 978-762-0008 fax CUSTOMER Bob and Paula Barrett REVISION DATE 06/06/06 ADDRESS 27 Fuller Meadow Road JPROJECTNAIVIE Barrett Residence CITY,STATE,ZIP N. Andover, MA 1ADDRESS DAY TIME TEL 978-794-9717 CITY,STATE,ZIP SALESPERSON JDAY TIME TEL REV 02/06 LABEL QUANTITY DESCRIPTION PRICE I TOTAL Marvin Window: Picture Unit Primed Interior and Exterior Low E 11 Argon filled insulating glass Removable 3/4" wood grille 9/l6 jambs No exterior casing(Window to be trimmed on exterior in field) Rectangular sash with radius daylight opening 1 CCMP 67"x 75 3/4" R.O. 3,289.60 3,289.60 Variation#5 True Half Round 8 wide 3 high rectangular lites in grille with 20 radius lites to In existing. Tempered Glass J I Use Fluted Casing for side casings. Make keystone for center of head casing. Apply exterior trim in field to match up with existing siding. h 1 llBuilding Permit Fee 103.00 103.00 1 Installation Flat Labor Charge 1,500.00 1,500.00- 1 Miscellaneous Materials 300.00 300.00 1 Rubbish Removal Fee 51.00 51.00 All installations will be left broom clean at the end of the day. All painting is by others. Gove Lumber warrantees the installation labor only. All materials are covered under the Manufacturers warranty. Any rot found or extra work not specifically mentioned in this work order will be billed at an hourly rate plus the cost of materials. Customer will supply electrical power and water when necessary. Customer will prepare the work area by removing all furnishings and provide easy access to area. Massachusetts Home Improvement Contractor Registration#129170 9 — TERMS DEPOSIT OF $2,039.33 REQUIRED PRIOR TO PLACING ORDER 5UB TOTAL 5,243.60 $1,936.31 DUE WHEN MATERIALS TO BE INSTALLED ARE DELIVERED. DELV CHARGE 50.00 $1,500.00 FINAL BALANCE DUE ON THE LAST DAY OF INSTALLATION. 5% MA TAX 182.04 MAKE ALL CHECKS PAYABLE TO DOVE LUMBER COMPANY, INC. TOTAL $5,475.64 CUSTOMER HAS RIGHT TO CANCEL ORDER WITHIN 3 DAYS FROM DATE AT TOP ORDER ACCEPTED NO RETURNS ARE ALLOWED ON WINDOWS,BOORS,AND SPECIAL ORDER MILLWORK. iF YOU HAVE ANY QUESTIONS REGARDING YOUR INSTALLATION