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HomeMy WebLinkAboutBuilding Permit #156 - 29 MILTON STREET 8/28/2008 BUILDING PERMIT ° TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit NO: / Date Received ORATED 4`� �SSACHus�� Date Issued: . or IMPORTANT Applicant must complete all items on this page LflCATIG PRGPERT� � TYPE OF IMPRO_ VEMENT PROPOSED USE Residential Non- Residential ❑ Ne uilding ❑ One family ddition ❑ Two or more family ❑ Industrial [I Alteration No. of units: I] Commercial ❑ Repair, replacement ❑ Assessory Bldg q,,`Others: ❑ Demolition ❑ Other 5e fte �1VlI I%o lrt� .. �elads 1JIatrshed�C3istatbt � / DESCRIPTION OF WORK TO BE PREFORMED: 1u- armor 61 Ile✓Z- ,tom,s .�--, �'�n 42 e�l e' Identification Please Type or Print Clearly) OWNER: Name: Phone: Address sm`WNTF, r.*,,,r�m A err NM .a xA. a r ' 5uperuars st r tlo rens �.0 r ra � ga � , � 'rYr 1=�orn���rrrpro�r��e �,L�cer�se 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: $ $'0�� _FEE: $ Check No.: �/ / Receipt No.: o�� l NOTE: Persons contracting with unregistered contractors do not have ac c s to the guaranty fund S466ature of A entlOwner" - ., S,�grtaturewof contracts 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 o Building Permit Application o Workers Comp Affidavit L3 Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract u Floor Plan Or Proposed Interior Work o 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 o Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ' ❑ 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 o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit j ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) L, 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 I Revised 2.2007 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 DATE REJECTED DATE APPROVED CONSERVATION ❑ . ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ S COMMENTS ZoningBoard of Appeals:ppeals: 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 .� FIRE DE=PART EDIT Ternp,'Umps b tin slte y s 51 j s 3 erre Depar mentasig»atureIdate W r t h. Dimension Number of Stories: (2�2, Total square feet of floor area, based on Exterior dimensions. 16 D 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.$10041000 fine NOTES and DATA— (For department use i ❑ Notified for pickup - Date .......... ........................................................................................................................_............_.................................._............................................................................................ ; Doc.Building Pen-nit Revised 2007 Location No. Date NORTH TOWN OF NORTH ANDOVER ~ 9 Certificate of Occupancy $ '�i�s',•°''�<�' 9 Buildin (Frame Permit Fee $ � • s�cMuse Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check A___L__- 20541 Building Inspector AUG-28-2007 06:36AM FRO*C G INSURANCE +1 683 884 6383 T-007 P.001/002 F-028 FAX (603)$70-%0 THIS CERTIFICM-IS ISSUED AS A MA OF INFORMATIM C & G It►svrance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 299 North Broadway ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Salem, NH 03079 Jared W sh. X12 INSURERS AFFORDING COVERAGE MAIC d ric razer INs Ra Penn America DBA: Salem Craftsman Construction 40 Townsend Ave INSURER C: Salem, NH 03076 INSURER 0. INSURER E: COVERAGES 7A—E;0=9 OF WSURANCE LISTED BELOW HAVE SEEN ISSUED TO TNI) URED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NO THSTANDING ANY r'EC)UREMENT.TEF&A OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH SECT TO WHICH THIS CERTIFtCATE:MAY BE ISSUED OR MAY PERTAiM THE INSURANCE AFFORDED BY THE POIJCJES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LI STS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. L TYPE DIF WWRANCE PONJCY NUMBER GATE DA7N= UMITS ►comet"UABR_ITY PAC6483408-2 04/18/2007 04/19/200$ I:ACHOGGuRRENCE S 1,000 00 i X l C0UU0=&1 GENERAL LIABLITY DAMAGE70Ia "Cu5ronftj 50,0001 CAMS MAI E If OCCUR MED FXP W1 one perste) S S,00 A I PERSON&a AoV INJURY a 11000,000 _ GENERAL AGGKOATE s 20000,000 :.GG:X-k-.0 L ff APPI=PER PRODUCTS-COMPIOP AGO S 11000,00 PMJCY 71 im F7 LOC AdTONOOME DASRn'Y COMBINED SINGLE UMTT AJ%1f AUTO (E''ate) S ALL OW[*=DAVrOS OODIL' "UURY SCHEDULED A UrOS (Per owm) S i rol"M ALTO'S BODILY INJURY i�lir:aAT�AUTOS (Poraccioaru) S i PROPERTY DAMAGE i (PereoddeM) S i 1 CARAGE UABI.ITY AUTO ONLY-EA ACCIOE JT S ANY AUTO OTHER THAN EA ACC 5 I` RAUTO ONLY•. AGO s ETn:;;; "I uaSIUTY EACH OCCURRENCE s OCOJR ED L'LAIMS MADE AGGREGATE 5 1 r ' i RET8010K 5 $ WORI M COWWWAM M ATO >��.s LM8 nY DRY UM Ax'-.F.-'7V--JR9AMKR E E.L.EACH AOINDENT S OFF7GS2%13fiIER Saxjj0W $1-MSEASE.EA EMPLOYEE S E,es arsabeLsr2w 9ELS:1;H O!S -- tow E.L.DISEASE-POUCY LIMIT t OTHER I r I -n NIS 1 V6HI S t LXCLUMNS ADDED 13Y ENWRSIENT I SPECIAL VISIONS I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE OESCRiBGD POLICIES BE CANCELLED BEFORE THE PEMRATNON DATE WEREOF.THE ISSUING INSURER WILL ENOEAVOR TO MAIL 10 DAYS WRITTEN NOTNCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. Pat and Michael O'Connor BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OSuGATION OR UABRlTY 29 Mi 1 ton 51trefit OF ANY KIND UPON THE INSURER,TTS ENT=OR W.S86 N. Andover, MA 01$45 AUTHORRED REPRESENTATM ACORD 25(2001/08) CACORD CORPORATION 1288 r. . �. •+ ., ,. ' ' a ,. .. .. ,... .�. ..� .� ,Y ' ' t J ,. ' .e . .. - � i. I � � w � ..,. _. _. ._... _._ _ _.�. .. o ... ' � !. .. ) � i .. _ -. _ .. _ _. �...�.. � � ./rte Craftsman Construction, Inc. 40 Townsend Avenue General and Sub-Contract Construction Salem,N.H. 03079 603-893-9381 ° PROPOSAL Proposal Submitted To Ph ./�y Dace Q Street Job Name AVQISZ�� 22 City, State B Zip CodeJob Location Ma '� Sa Date of Plans 7 We hereby propose to furnish all materials and labor as necessary for the completion of the following products in accordance with the specifications and drawings. ::ZZ L10 /b' �r C a L Z j T 2 P t/Gv v s�Y 1-92 /N /Rcn-12) 22 �/ Z/1 ....-., ~Xis ©J )-2 GY <Y 4 , `7' Total contract price is: ............. dollars($72)?RV ? 4iT. ................................................... Payment To Be Made As Fo11ow.L _ /. f� /�1/tSOcit . �l/I�,Gac%... .. l/�-Ti.Gv �E'0d/ .0/v. /!/"/�7dl�S✓�i+-6� Rau.-t -P/�s>►�� t�c/at,c� aim C�,H��Tr1r�' f... Invoices not paid within 30 days will be charged I%% per month on the unpaid 7 f balance. All expenses on billing requiring attorneys fees and/or court action will be Authorized charged to the customer. Signature . . .. ... ............... All material is guaranteed to be as specked.All work to be completed in a workmanlike ............' ..'. ' . .' ...' '' '' '..'' '.'...'......... manner according to specifications submitted per standard practices.Any alteration or deviation from above specifications involving extra cost will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents,or delays beyond our control.Owner to NOTE: This proposal may be withdrawn carry fire,tomado and other necessary insurance. by us if ncepted within .. ............... .......days. ACCEPTANCE OF PROPOSAL — The above prices,specifications and conditions are �/ Vr¢ satisfactory and are hereby accepted.You are authorized to do the work as specified. Signature .... ......... Payment will be made as outlined above. Signature Date of Acceptance .. / ...: .7............................... ..e In..� _�.. _ .._ . .i�.l? _ _ . � . . . �. _�, _ . _. _. __ . __ � a � ._ . .r, +f ' .�? , .. E � � ' � ' � t ,� . I 1 i l i I I I f 4. 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Ti ffoe.-,dividual 9M. x FRAZER L FREfpRICKSx r Frazer Fredricks 1f 40 Townsend Ave Salem,NH 03079 Deputy Administrator - - ,r� ter.rw, �;>-.a.� •�-"""'"'y �"� °'� � .J�te- W0077YII20'ILC!% 0� ��,g`i�` 'mss •��`` 66AR41F S,UILGItG R " 44AON'�``;, icense:,CONSTRUCTIONSUPERVISOR' Number-.--. 003470 s? Birthdate 10/25/1947 Expires 10/25/2007.. Tr.no: 7923.0 FRAZER L FRE�RICICS 40 TO NSE AVENUE ] SALEM NH 03079{ Commissioner / C'SC�%/fid