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Home My WebLink AboutBuilding Permit #12 - 27 MEADOW LANE 7/6/2007 µORT# BUILDING PERMIT. OL TOWN OF NORTH ANDOVER o ` APPLICATION FOR PLAN EXAMINATION � e Permit NO: Date Received 3'"�qAr o �SSACHUb Date Issued: 71 161/ IMPORTANT: Applicant must complete all items on this page WE If -4 TO k, ,'q TYPE OF IMPROVEMENT PROPOSED USE Resid ial Non- Residential ❑ New Building One family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alt tion No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others ❑ Demolition ❑ Other rt zF j DES RIPTION OF WO TO BE PRE ORMED- O a c orit�' - w lA� Gni- . Identification Please Type or Print Clearly) OWNER: Name: kark-( e-o Phone: Address: C2 t 00 d 0 A/�- fat Y3r A a � 2r `,? 3 5� bo ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. f Total Project Cost:.$ /0 ,000 FEE: $ A7 Check No.: Receipt No.: 2 3 NOTE: Persons contracting wit unre istered contractors do not have access to the guaranty fund Signature of Agent/Owner,.� ` fir -- Signature of contractor 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 384 Osgood Street Fit D�PART �I "" "emp U4, It res n � � t )-o"cam d at 121 � , ,��+� � Fireepairt>r�erargnatureldat �, �`.'' 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 ❑ 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 o 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) ❑ Engineering 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 Location No. Date 7 6 D NORTh TOWN OF NORTH ANDOVER • ; : Certificate of Occupancy $ �'�s'•••°';<�' Building/Frame Permit Fee $ ACMuS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 0 Building Inspector ' e Commonwealth of Massachusetts Y � Department of Fire Services Office of the State Fire Marsha! P.0.Box.l02�.StiteoRo�apd Stow,MA 01775 PERMIT Date: �� North Andover Permit No {Cityof Town (Lf Applicable) Dig Safe Num Cr . ) In accordance with the provisions of M.G.L.14 8.Chap.ter_LQ as provided in sectio--5=--CMR 34 Start Dale This Permit is granted to: w< ¢� Full name.ofperson,Firm or Corporation Permission to locate dumps.ter for construction/renovation/demolition of building. Comments dumpster must be 25 ' from structure if unable to place with required Restrictions'clearance dumpster must he covered with /yJ plywood or tarp end of work day - --at at (Give location by street and no.,or descrbF in such maaue so ovic dequate identification of location) Fee Paid$ 50.00 ' Fire Chief This Permit will expire ` �`y� (Signature o tFical granting permit) Offical granting.permit (Title) AMERICAN ROOFING AND SERVICES 1260 WESTFORD ST LOWELL MA 01851 ' ,p�,uJ PHONE: 978-361-6383 JOB PROPOSAL STEEPLE CHASE BUILDERS PROJECT LOCATION: 27 MEADOW LN -N. ANDOVER—MA- 01845 THE PROJECT WILL CONSIST OF REPLACEMENT OF ARCHITETCTURAL SHINGLES DURABLE FOR 30 YEARS, IT WILL INCLUDE THE RIDGE VENT AND THE PLACEMENT OF THE DUMPSTER. AMERICAN ROOFING WILL PROVIDE THE MATERIALS, SUPPLIES AND LABOR. THE PROJECT WILL COST TEN THOUSAND DOLLARS (10,000.00) THE AMOUNT OF THE JOB SHOUD BE PAID IN FULL AT COMPLITION OF WORK THE ESTIMATED TIME FOR THE JOB TO BE PERFORMED WILL BE OF 3 BUSINESS DAYS. 4 INSURANCE AND REFERENCE IS AVAILABLE UPON REQUEST. IF YOY HAVE ANY QUESTIONS IN REGARDS TO THIS PROPOSAL, PLEASE CONTACT WALDECI DEOLIVEIRA AT 978-361-6383. ACCEPTANCE. You are hereby authorize to perform all labor required to complete the work mentioned in the above proposal, for which I agree to pay the amount mentioned in said proposal and according to the terms thereof. Since ely, Signature For A eric Roofing and Services Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: .152716 Expiration: 9/22/2008 Type: I DBA AMERICAN ROOFING SERVICES WALDEA DECLIVE.IRA 11 MILL ST LOWELL, MA 01852 Deputy Administrator ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE UDD/YYYY) 7/5/2007 PRODUCER (978)459-4547 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Alpha Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE House Account HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 11 Mi I I Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lowell, MA 01852 INSURERS,AFFORDING COVERAGE. NAIC# INSURED AMERICAN ROOFING & SERVICES INSURER A:Western World 1260 WESTFORD ST APT C30 INSURER B:GRANITE STATE Lowell , MA 01851 INSURER C: (978)361-6383 Ext. INSURERD: INSURER E: COVERAGES 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 IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY NPP1052940 07/27/2006 07/27/2007 PREMISES Ea oocurence $ 50,000 CLAIMS MADE �OCCUR MED EXP(Any one person) $ 1,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X POLICY J PRO- CT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY _ $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $E AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F-1 CLAIMS MADE AGGREGATE $ $ l DEDUCTIBLE $ RETENTION $ $ WC STATU- TORY COMPENSATION AND - X TORY LIMITS OTH•ER EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE 0365576 08/01/2006 08/01/2007 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED?Yes E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITY OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESC BED POLICIES BE CANCELLED BEFORE THE EXPIRA'iON DATE THEREOF,THE ISSUING INSU ER WILL ENDEAVOR TO MAIL 10 DAYS WRIT11:N NOTICE TO THE CERTIFICATE HOL ER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABI ITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) 0 ACORD CORPORATION ,$�'8 pORTW BUILDING PERMIT °F �T�•D �b.6 6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION #- L ..� % Permit NO: 12 Date Received �SSACHl75E� Date Issued: 1ZL A IMPORTANT: Applicant must complete all items on this page WE ,.. � `N y R1 0- ✓' TYPE OF IMPROVEMENT PROPOSED USE Resid ial Non- Residential ❑ New Building One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alt tion No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other ,mss t -� � � �� .�� c{{'�u'�' Y�� <rr � �s.�zk-� � � `]e■�� l �s•. '�y�� „_.. toks DES RIPTION OF WO TO BE PRE ORMED- O — <f:�U+ G a C ter, - Identification Please Type or Print Clearly) OWNER: Names: arU0 Al eo'\ Phone:Q18 -.115 -est Address: c2 lictdow 0 L' / wg � O a �s3 Q 7 -w 'T We gr Ax,, �` c x 3 r-r ^ r-�%^t ',� ,x,-„'. 11 M-'p ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:_$ �a► FEE: $ � `— Check No.: �' Receipt No.: NOTE: Persons contracting wit un re istered contractors do not have access to the guaranty fund Signature of Agent/Owner,Xa – Signature to of contractor � . A,. 00RT11 BUILDING PERMIT Of qti TOWN OF NORTH ANDOVER 3r ' � •6 APPLICATION FOR PLAN EXAMINATION Permit NO: 2 Date Received ►,T.o.P"`�y Date Issued: IMPORTANT: Applicant must complete all items on this page -5 " W 604 zWfix, ' TYPE OF IMPROVEMENT PROPOSED USE Resid ial Non- Residential ❑ New Building VOne family ❑Addition ❑Two or more family ❑ Industrial ❑ Alt tion No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other DES RIPTION OF WO TO BE PRE ORMED• OCA Identification Please Type or Print Clearly) OWNER: Name: arm 6 PdA0 eot / Phone:`11-8 Address: c2 l ao 0 Q IR itr ra ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cos#:_$ /0 , 000 FEE: $ �0 `"— Check No.: b Receipt No.: -�2() J 6 NOTE: Persons contracting wit unre istered contractors do not have access to the guaranty fund Signature of Si Agent/Owner. . g -� t�nx�.— nature of contractor f NORTH Town of No. Z41 C% o . '� dover, Mass., Z • 20 0 - LAKE COCMICMEWICK Ids RATED 7 V BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......... ... 1 . ��.l . .......... .... 11 ::.................................................... ................... . ................... Foundation has permission to erect........................................ buildings on ..........irk ", ��.I!��....... Rough to be occupied as . 40 9Chimney provided that the person accepting 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough ........ . ce BUILDING INR Servi 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.