HomeMy WebLinkAboutBuilding Permit #131 - 29 WAVERLY ROAD 8/21/2008 BUILDING PERMIT *
Q��tLlG Ib�tiO
TOWN OF NORTH ANDOVER 03 : p
APPLICATION FOR PLAN EXAMINATION
71 Permit N0: Date Received T.o
Date Issued: L�
IMPORTANT:Applicant must complete all items on this page
ilk
IN,
� 7+ BMW,
1110—wffi,
01
� Ai � � ��: � "� 'tib RAE✓ x �. � � '� .� �;
l�l�� ARCD, s w {eS
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building )<One family
❑ Addition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units: 11 Commercial
Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
DESCRIPTION OF WORK TO BE PREFORMED:
71 -kdau- e /G o k®a rce � ( Cleo S4 Ctrs o,-1
Identhfi�ation Please Type or Print Clearly)
OWNER: Name: J:�-4: O C(C4 Phone:
Address: 6t)4 �0CAWOR 010 _
91 M
N sr[
4 �
1t - s `
z s*yip` d .ate-' •s a
,
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PER T:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
C), d U FEE: $
Cost: �
Total Project $
Check No.: fd'T Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have ss to fund
19A
IR » 5a� eSl—
�,
�cantr y r `,
.. �. -111x. ��
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 ❑ ❑
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 Drivewav Permit
Located at 384 Osgood Street
"�,R
..Loud at121at �ee`'�,• .,��"'
���
y�.�na�-}�.zr •:E� I� ��' r � ..a��"��" Z '�'a,;� � �#..�.'�� -FF �"�.cam"`; �. - �. ��' '� °��':
<X� �.r` �:,�� f. �.��^� ��g -�•� • 'a... �ti�� •` a "�a to �*e..r.•fl's�",.3fi 13r a�• 2,.. ��� �: r 'v u,
������.�,�+;" � ��� 'e � -`"'aaF„z�"�a`.�.y q �P�?�'�� � �. 1��� za ,� � ,tea �. ;..s, s�""v�•.
�Z
., � � �
^tea '" v'st �. � sfi� x�sF
:: 0,706 'aa F.0
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.s100-$1000 fine
NOTES and DATA— For department use
i
❑ Notified for pickup - Date
.._.........---..............._.__.............____....._................_..._....._..........._......................_........__._...............--._.
_..-_..........._................._..........._..._................._........................................ ...................
Doc.Building Permit Revised 2007
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
❑ 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
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:INSPECTIONAL SERVICES DEPARTMENTMITORM07
Revised 2.2007
Location HCl A)aV,10
/
No. Date 204
�pRTM TOWN OF NORTH ANDOVER
A
Certificate of Occupancy $
'ss�cMustt� Building/Frame Permit Fee $ y�
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # /� r
3 l'
` Building Inspector
NORT#q
ONM Of over
No. l / = _
oL
over, Mass.,
LAI
COC MIC KE WICK
ADRA7ED PP�t'\C
BOARD OF HEALTH
Food/Kitchen
PERM T D Septic System
!T, /-- _ BUILDING INSPECTOR
*—****—***1. �
............................... ... . .. ...........................................
THIS CERTIFIES THAT. ................. ....................... Foundation
haspermission to erect........................................ buildings .... ..... . � '� ` �`� Rough
P g � ............. ................
to be occupied as �,��� C.A-, .Q ./'...:� 'e'�, 'pL Chimney
.................. .
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 ST S Rough
.
. ....... ....... Service
LDING INSPECT
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.
nus 1.2 wo W-Tooll. F%ur'lwl Lor%wAU vua O-TL. -r7r-.j N. A
BOARD Of BUILDING 6GUI-0T614s.
L,C,,M; CONSTRUCTION SUPERVISOR
Number,, 065616.
0/1.&608 Tr.no'. 3707.0
3
ROGER OKOLO Aui
84 BALL RD
KINGSTON,,NH.,03846 commisslo6er
...........
Board of Building Regulations and Standards License or registration valid for individal use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 156547 Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Expiration: 7/1212009 Tr# 256098
Boston,Ma.02108
Type: Individual
ROGER OKOLO
ROGER OKOLO
134 RTE 125
KINGSTON,NH 03848 Administrator etid without signature
Id, ► Y 41/s'�b
+ OKI`
1
N S-tA
Alt 6- � M
t1v X16
1+ 1IT
tilt
The Four Oaks Corp. Agreement
Submitted To: Work to be performed at:
Name: Jeff Todd Name: Same
Address: 29 Waverly Rd Street:
City, St. No Andover MA City, St.
Telephone: 978-852-4363 Telephone:
Contact: Jeff Contact:
Proposal # JTNO808
Date: 8/15/08
Purpose:
Contractor agrees to furnish all the materials and perform all the labor necessary for the
repairs to the existing porch, for the price agreed upon below.
Specifications:
The project will be built in accordance with the proposal dated 8/1/08, and sketches dated
8/15/08
Permits:
Owner shall obtain all local permits.
Extras or Change Orders:
No deviation from the work specified in this Agreement will be performed with the express
written order of Owner and Contractor. Note change orders may prolong completion.
Insurance:
Workmen's Compensation and General Liability Insurance on the above work is to taken out
by the Contractor. Fire, theft, natural disaster and public liability insurance is to be taken out
by the Owner, and shall include the interests of the Owner and Contractor.
Time for Performance:
The Contractor agrees to start the work on or about August 25`h and said project will be
completed on or about Sept 5, 2008. Inclement weather may delay completion.
PO Box 46 388 Sandown Rd Fremont NH 03044 tel. 603-642-4425 'fax 603-895-2039
i
Page 2
Agreement
1
r
/ Warranties:
I Contractor warrants all defects in workmanship by The Four Oaks Corp. employees, or sub-
contractors, for one (1) year from the date of completion of the project. And further warrants all
materials purchased and installed by The Four Oaks Corp. employees or sub-contractors, for
one (1) year, except where manufactures warranties apply. The Contractor makes no other
warranties of any nature either express of implied.
Price:
The base price shall be Three Thousand Seven Hundred Fifty Dollars ($3,750.00), of which
Two Thousand dollars ($2,000.00) shall be payable upon the execution of Agreement.
Method of Payment:
Deposit: due at signing of Agreement
Final payment: due upon completion of the project
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.
Contractor: Owner:
The Four Oaks Corp.
b o8
ger 0 o Je To
44-1 - V,
s � i
f1s'r)w wb� c�,J.�ovs
- ,� t lAAA I
._
t'
t Ai
f \` • � i L
JL
�f
t1 .
(mac.- . .. ._.. _•..._ _._�_- ,! —_- .�- _�,��,
GC3•v S772UGT1�'� S v�P�"YtV 1 S T�. L I C.f'�S�` � C S o� �6 I !,
N o �ZESWL lcm 0NS
RES Ib113 V $
M (LOv 6-M C,Yl-7 C-0 t-JTato CM
lNDiVtn�r�!�.
-ra-4
I 7
c� 9
VV/ 1,!/CVVU VI .Jo rnAA rr ra ��ppiy 2 1J VV 1/VVL
- CERTF1CATEOF UASILITY INSURANCE PATE08/14/2008
JMwdwrrM
PRooucER (603)772-4781 FAX (643)772-3246 TM.CYEISFS$friEPABAM*TTI:ROf-MWORK"tew
Foy Insurance Croup - Exeter ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
64 Portsmouth. Ave HOLDER.THIS CERTIFICATE DOES NOT AMEND,.EXTEND OR..
MY Box 1030 ALTTEl�TfiE AFF9RDEDBY7ItE"POttcfMKLOw-
Exeter, NH 03833 INRURERS-AFFORDIN4COvERA" NAIC t
0410"o ffie Four Oaks Corp. INSURERA; National Crange Mutual 14788
PO Box 46 INSURER.&
3$8Sandown Road INSURER C
Fremont, NH 03044 IN6-uRER0:_.
INSURER E:
COVIERAGES
TME PM CTn-QF WSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITMSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSVEO OR
MAY PERTAIN,THE INSURANCEAFFORDED6Y THE POI_4CIES DWRIBE£}HEitLMN IS SUBJECT TGALL EKCUti$tpµSAµpC()NBIT{p►}¢pF StPGH,,.
P0t+C*%-A0SRL*GAI LIMITS Smomi p Y KAVE-gnN-RWLJCED BY PAID CLAIMS.
INSA TYPE OF NISURILNCE POLX:Y NUMBERS EFFECTIVE FOUCr EX TION
L1rRi
OFN6 IRtwAmyM MP86333 O7/ZZ'cr 6QS 07/22/2009 EACH OCCURRENCE f 1 r 000 000-
C
X COMMERCIAL GENERAL LIABILITY DAMAfE TO RENTED I. _f 500aOC'C{/T- MFO EXP(Any one Devon) 6 10APERSONAL 6 ADV INJURY S 1,OIIOGENERAL AGGREGATE 6 2000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS•COMP/OP AGG 3
PM, Z,000 00-C
JECT D
AUTOMOBILE LJABUTY
COMBINED SINGLELIMIT
ANYAUTO- �IE�xud«x) _f.
ALL OWNED AUTOS
BODILY INJURY r
5CHEOULED AUTOS (Per pef",
HIRED AUTOb
BODILY INJURY
NON-OWNWAUTOS- (P6r6oc4enl) t-
PROPERTY DAMAGE f
IPersc�O,tlt)
GARAGE LIABILITY AUTO ONLY•EA ACCIDENT 6
ANY AUTO-
OTHER THAN Fb4 I" 4-
AUTO ONLY: AGG f
F)ICEDBNMBIELLALAAMI Y EAZHOCCURRENCE... t; .
OCCUR a CLAIMS MADE AGGRE6AYE f
t
DEDUCTIBLE 6
RETENTION f f
WORKM COMPENJ2Ar*N AND WC STAT DTH-
LIABILITY 'Cu
ANY PROPRIE1OR/PARTmgpUECUTA4 EL:EACKACEIDEtfT- t
OiFi6EWMGMBERE�tUBEEPf —L—�
M yep dow be tMOsr E.L.DISEASE-EA EMPLOYEE 6 i
SPECIAL PROVISIONS below E.L..DISE.ASE.POLICY LIMIT- b
WNW
DE3CKWTION OF OPERATION8I UxAnON8 I vENICLEB I EYCCWSIONS ADDED BY ENBORJIEMENT/SPECIAL FROVISIONB
arpentry
ny person or organization including certificate holder is additional insured if written and signed
ontract, agreement or permit- to_.such- exists- prior to, loss- and--subje�t_toform 6a=S4$i..
dditionaT- insured is subject to all terms, conditions & limitations of the general liability
licy.
FICATEHOLDER CANCgLLATION-
"6"MAN`r'OFTKE"MrBCWRWEfffOE=9 BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE I&SUWG INSURFA MBLL ENDEAVOR TO MNL
NAZI W TO THE LEFT.
)off Todd BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLRIATION OR LlAujry
29- Wave-r l y- Road- DSAw wN6YFew1Nc
North Andover, MA 01845 AUTHORIZEDAEPRFSENTATIVE
Gary Rotor EK4I4CY
ACORo n(Yo me) FAX: (603)895-2039 CIACORD CORPORATION 1988
WJvvc/vvc
III
i
If the certificate.holder_isan.ADD1UONAL WSL DL the-poliey(iesYmust-be endorsect A statemea
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
IfSUBROGATfON IS WAIVED,6ubject to the terms and conditions of the policy,certain policies may
require an endorsement.A statement on this.certificate doesnot-canfer,rights-to the eertifieate-
holder in lieu of such endorsement(s).
DISCLANAM
The-Eeficate of irmurance orrthe reversestde of this form does not constitute a contract between
the issuing insurer(s),authorized representative or producer,and the certificate holder,nor doe.&iL
a lv*a►negaftvIy-YmerYd extendor alter-ft coverage afforded by the polfdes fisted thereon.
ACORQ Zs fzoatraiig
vuil"Ieuu8 08 42 FAX
CERTIFICATE OF Lt1�8IL" 114SURANCC �DD,�D02
Foy Insurance
FAX 3)772—}246 ThISEERfiff 08/78/20 g
Foy Insurance Group - Exeter ONLY �ONFE No"AWAVATRWT3 UPON IE C� IF p=per
64 Port1030 Arte 110LDER.TNI$CERTIiICATE DOES NOT.UMEND,EXTEND DR
CATE
PO Box 1030 �tT � �UC>=APf aTT F
Exeter, NH 03833
MISURERt.ItFFQRDIN0..CM MAW NAI&a
ailACv ger o 0
PO Box 46 NLCIJREAA The Trave ers IndQolnlicy Company
Fremont, NH 03044v�Ae.
MSURER C.
00MER 0
MSURER f.
iE
tEV
ANY REQ IREMENT,16 IM OR CONDI IO OW HAVE BEEN ISSL1Ep TO THE MiSURFO aAMED ABOVE FOR THE POLICY PERIOD WDICATED NOTWITHSTANpiNG
ANY REQUIREMENT,THE,TERMOR CONDITION It ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO NMICH TMS CERTIFICATE MAY BE ISSUED OR
MAY p S-AIN."ORT LIMITS wEFORDEO RY T► POLIC�ESDESCRIOW NgRdN IS-&MJEC7 TO•ALL THE-TfRMs.EXClVS10NS AND CONOYf 10NS OF-SUCH
pOLTGIES.A66Rl6�ITE LIMITS SMO"MAY HAVE SEENREDQ=ey PAID CLAIMS.
MCR v rM of I OURAROE
Pauly NIRIrCeR POUq,
efnefe tvAww UNTA
COMWW-AL OCKLAAL LMILITY S
CLMnS MMOC❑�� TOREN i
M40UpK17one peVOol i
------------
pERSONAt i• MlDYL• A/qy
GENL AOOREGATE LIMIT APPLES pER: GENERAL AGGRG"TE i
POUCT PRO. LOC PRODW..T6•COMM,Dp AGC i
Avrovovu UAMU N
ANT AUTO COM ONEO SINGLE NGIE LIMIT i
Mwa
L OCO AYT03 )
l"DMFD AUTO$ BOaky wiUR V
KKOAUTOS lP"D1"'m'T T
NON.pyyMEp AJTOi DOCRY MWV11T
IPw MKhHPI) i
PROPER Ty OAuAGF,
GAWALLAYUTy Illwoe <lwr) f
ANY AUTO AUTO ONLY•CAACCIOEM t
oTNER THAN EA ACC s
LWQS&%W&WLtAt/IWIMgT AMC04LT AGO i
OCCUR QCLAMI>;MAOC EAG"-KCURK*CE i
AGGREGATE i
OEOIA:TWti i
RETENTpN
Ew " gow" lury50""M0 6KUB=099B1 10-6-07 12/05 2007 12/0 2 WC .
"rpLoyeRo�LPN0.ITY GTN,
A 0.. EMIM e� ><k�c tmgvrE�I HH E.L CAC"AccofNT
u�q mi• 100
iPECNI PROV16rONE 071st E 1.a8eA3E•EA aMpLoyE f 1 0
DUN& E.L.DISEASE-POLICY LIMIT iSte,
aF apCMTIONi�taCATpIR!VF111CI�i I E7{Ctt;1Ei0Ni ADDED OV EMOOItirMpl►/IPECYI4P `
i A
ERDIR.OMp"M T+*AL7eY!llEaMlsror+Ce!ll�otIRELLEveeliDR['ltM('
E"10"44
4 DATE THEREOF,TR""VW MAN VALL INWAYOR TO MAIL
)eft Todd to
wrrAnuRf rD� T++rc�Rf,ACIrTe"eullr�we�T°T+lecdh
29 Maverly. Roa4 OrALLMIpOEENooiLlaAN)NO"OulaWY
North Andover, MA 0184S � 10N0Qp0araa►RwsEM+sAwwa
AUTMO"aIp REPAisEM7�TfVE
ACM 23(.zmM$) 611 ry Rohr^
WORD CORRORAT**"w