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Home My WebLink AboutBuilding Permit #450 - 32 BRIDGES LANE 12/5/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION NORTh '9 -'LED " /V OL �O 7�0 r Permit NO: Date ReceivedC04 Date Issued: ' s �� 9 gOkgrs pfPy�5 SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION_ _,1)— & D&Ar-s I-A/' - Print PROPERTY OWNER—&-L/�ti ® PLho 5(l�f �ysl J Print MAP NO.: U G-- PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Resid ntial Non-Residential ❑New Building VlOne family ❑Addition ❑Two or more family ❑Industrial ❑ teration No. of units: N"Repair,replacement ❑Assessory Bldg ❑Commercial ❑Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED L N i�3 �/ lei v�-l— �12,�� 1=�LC ✓,�� Identification Please Type or Print Clearly) OWNER: Name: ar,AZ a ��,t/-90 ;1,/ Phone: 976 02 ' ��7 Address: S L AB CONTRACTOR Name: , Lz j �/� .19 K S76" zV Phone: 179 °-Pe -ogl Address:2=1Z L= iA,— L.L & v` �,4 Supervisor's Construction License: Exp. Date: 4 L/- 9-0- J Home Improvement License: 02-4° 7 Exp. Date: 0 ARCHITECT/ENGINEER A Name: Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ ��, x12.00=FEE:$ QQ Check No.: Receipt No.: Page lof4 ........"Fd''°� I" Location _ d Date No. i gORTIy TOWN OF NORTH ANDOVER 9 ♦ s Certificate of Occupancy $ Building/Frame Permit Fee $ V------ SIACHU56 Foundation Permit Fee $ Other Permit Fee $ ,I TOTAL $ u Check # 19157 Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art E]Public Sewer Well F1Tobacco Sales ❑ Food Packaging/Sales El ❑ ❑ Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to proj ect NOTE: Persons contracting with unregister d c tractors do not have access to the guaranty fund 0 Signature of Agent/Owne / Signature of contractor Plans Submitted ❑ PI s Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM 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 ❑ ❑ r COMMENTS r Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Si2nature&Date Driveway Permit Temp Dumpster on site yes—no— Fire Department signature/date Building Setback Front Yard Side Yard Rear Yard Required Provided Re uired Provides Required Provided 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 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC.Jm.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 paor 4 of 4 NORTIy Town of over 0 ' No. dover, Mass.,/j9 'WCW0 0 LAKE 19, COCHICNEWIC AD ATED C7 WARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.........'d ..4.#.#1..........16". ..meo.....". ............. BUILDING INSPECTOR has permission to erect........................................ buildings on,.....:5.....a..*..........0-- *"'*'*******"*'*"*"**"***"""*"***"*' Foundation ..... 001.....•*............................... Rough 40 Chimney to be occupied as.....01*.)P 4.......f*4 .....%.00V.Ae0.*............................... in every respect conform to the ter of the application on file in Final provided that the person accepting this perm-iftoosixa'--li*7 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 sow Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL IN oug UNLESS CONSTRUC TTfT',,,S Rh ................................ ................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocaipy 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. NEW ENGLAND CUSTOM DESIGN, INC. 226 LOWELL STREET WILMINGTON, MA 01887 #978-658-0881 Home Improvement Contract Registration No. 102467 ROOFING AND SIDING AGREEMENT This is a legally binding contract. Make sure you read this Agreement and understand it before signing it. Do not sign this contract if there are any blank spaces. NOTICE: All home improvement contractors and subcontractors, unless specifically exempted by Massachusetts Law, must be registered with the Commonwealth of Massachusetts. All inquiries about registration should be directed to: DIRECTOR-HOME IMPROVEMENT CONTRACTORREGISTRATION One Ashburton Place,Room 1301 Boston,Massachusetts 02108 Telephone:#617 727-8598 This Agreement is made on / f L 120 by and between New England Custom Design,Inc.(herinafrer, "Contractor")and ownerO/U8, NS01-( (hereinafter, "Owner"), of City/Town NO-tIt AV,&.V f& State m a- Zip HPhone Job Address ("The Premises") _j_U ,/7r211 4,,5 ��/V- WPhone New England Custom Design Inc Salesperson �n�r L�,Pr`w 1.P 3- --- Roofing will be applied only on slope roof surfaces below,over present roofing shingles unless specified under REMARKS. MATERIAL........................................................... Color ........................................... ................ ,................................................ - piz Main Roof........................Bay Windows....... ..................Extensions.......................... .......................................................I............. n O Porch ront......................Side........... .. . Rear......... Other Roofs................................... ............ E:Roof board Replacement Cos per foot OR r 4'x 8'sheet of inch CDX Plywood. 3 uN I I We will covert ow slope roofs specified here with............................................................................................I.................. O0 Roofs to be ered.............................................................................................. olor................................................. � x Siding will be applied only on outside perpendicular walls where specified below. MATERIAL e'1��i41. 1 f.1...h?0.!!l Cx!�t4r!1....tiuHj�i 01MAERIAL........CC?R.tileIZ-5......sFttl�v,mg.6............ C7 Color ................................... Color.........�/.+i J:!1 ..... .r P..(elf. (........................................ z AUnderlay ..........................:............................:.... Underlay .................................................................................... vs APPIy where.!`�/./..PU.'I.S 0 ... <��....A!'4 f?............... Apply where............................................................................... Enclosed porch: House wail? ............................... Porch Bulkhead: Inside?........................................................... Are window casings to be covered with siding?...w. ............................................................................................................... Wood trim specified below will be covered with aluminum trim. Window casings:Number...A.lX............... Color, 4,d1j,e..D'.k00W.Sillsonly:Number...:..:..�-:........Color........................ Z ;5-: Door casings:Number.-#//....................... Color s5A,6/.f..8.f9.k0,,-1.................................................................................... aSoffit and facia:Color.fA.4J't...$.tvLV,-1... Facia only: ........................................................ aOther and where............................................................................................................................................................................. Q V) 3 �2 Doors:Number. -- ......................Type.................... .............Style.........................................Color........................................... OWindow:Number.........r-...................Type.........................-............Style...............7:77:7�....................Color........................................... .............................. ................................... . ................�.Ct............................ ................ .......... ....................................................... cn Shutters:NumberPR...../Y................Colon}/ kit.till.2tbe7...Style... ................Where..rrwt.f...................... .................j.../.............................................� . ...........................................................................................................j........................... A// L)" "VIS 4J,ll 6,? r'cwe �- ........................... .........................,.............................................................................................................................................................. �..:....�.h.aep.e tK nn X../ �rd. 1."✓....CqS.�I... ,p/ir'(Y. `fhrsc Cti.ar�-S w.'6/ b2 F7ddeD -to oc %V,L rke)(dr-,c p&e7Yr-,rr,.; L() The Contractor agrees to perform in a good and workmanlike manner all work detailed above. PsT7 MV fT{ LaST,✓3ae °" /L�. eta NOTE: All Roofing Customers CASH PRICE $.....�:tB.r...�Sa.............................. g DOWN PAYMENT $................ .p.Q.:. .................. New England Custom Design,Inc.will not be held PAYABLE ON START OF WORK $.....-7 ...:: ......................... responsible for dust and debris falling in attic area °� �v--05 b roof installation.during PAYABLE ON COMPLETION $.......7r. t-P .S....�.2..:.. ......................... 9,5,-06 e-�,mt,014ed Sd}U ° Please remove or cover valuables. DATE:..............I/ /'.....................................................20.!9..... RIGHT TO CANCEL The Owner may cancel this agreement if it has been signed by the Owner at a place other than the address of the Contractor,which may be his main office or branch thereof,provided that the Owner notifies the Contractor in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery,not later than midnight of the third business day following the signing of this Agreement. See attached Notice of Cancellation. A cancellation fee representing 30%of the contract price will be in effect if cancellation is requested after the legally allotted time has elapsed. The Owner hereby certifies that he has read this Agreement,that the terms and conditions and the meaning thereof have been explained to him, and that he fully understands them and that there is no understanding between the parties,verbal or otherwise,than that which is contained in this Agreement,and agrees that the said Contractor is not responsible nor bound by any representations not contained in this Agreement,made by any of its agents,unless the same be redLced to writing and signed by the Contractor. ATTENTION HOMEO ER: DO NOT SIGN THIS CONT THER ARE ANY BLANK SPACES. / Owner' Signature Date w England Custom Desig ,Inc. Date AGO CERTIFICATE OF LIABILITY INSURANCE : i DATEa03/27/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A FATTER OF INFORMATION - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Kilgore Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 33 Centennial Drive ALTER.THE COVERAGE AFFORDED BY THE POLICIES BELOW, Peabody MA 01960 Phone: 978-531-6550 i'ax:978-531-9442 INSURERS AFFORDING COVERAGE NAICN wsuREO I441URrPA: Westarn World Insurance C Ian INSURER B: Safety Insurance Cc>I<npany 39454 Now E'Ag land Cnotom Desig i Ron Weinbargg va Lanza INSURER C; Travelers 8rperty & Casualt 2g6 Lowell 3treElt 84-A INSURER.D: 'Wilmington MA 018sss 11suRER E: COVERAGES THE POLICIES OF INSURANCE 1-I6TE0 RFI.OW HAVE BEEN ISMD TOTI IE INSURED NAMIN)ABOVE FOR THE POLICY PnIOO INDICAT'=D,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION Of ANY CON rRACT OR JTNIER DOCLIMEw WITH RESPECT TO WHICH'IHIS CERTIFICATE NIAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDFD DY THE POLICIES DE8CPISED HEREIN f5 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF BUCH P00,10GS.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY RAID CLAIMS. LTR INSIRC TYPE OF INSURANCE POLICY NUMBER DATE MMATDfYY) GATE IMMIPIL101�ry1 LIMITS GENERAL LIAOILITY EACH OCCURRENCE $1000000 Py �{ COMMERCIAL ULRAL 1.1+61LITY IN ISSUE 03/14/06 03/x.4/07 PREM13E5(ErL OCCur�Bn� $5000Q W- CLAIMS MADE OCCUR Mn RMP(Any o,.e person) $25D 0 ERSONAL RADV INJURY $1000000 _ GE __ rJERALACCREOATE $2000000 GCNt AGGREGATE LIMIT APP11.S PER PRODUCTS-COMP/OP IAOG $1000000 POLICY JFCO'.T LOC �— AUTOMOBILE UABILITY COMBINED SINGLE LIMIT B ANY AUTO 0062853 04/05/05 04/05/06 {Eaamdent) _ ALL OWNEDAI.ITOS POLICY RENEWS 04/05/06 04/05/07 BODILY INJURY $250000 �{ SCHEDL2EDAUIUB (Per person) HIRED MOS BODILY INJURY $500000 NON•OWNED AUT)$ (Per s.xidant) -- PROPERTY DAMAGE (Per accident) $10D000 6ARACE LIABILITY �- AUTO ONLY-FA ACCIDENT ANY AUTO EA ACC Hatrlrcir'rraN AUTO ONLY: qr,G 5 EXCBSSAIM9RELLALIAS16ITY CKH OCCURRENCE $ OCCUR ❑CLAi?,.S MADE AGGREGATE $ oEDUCTIOLf_ 5 RETF,NTION g WORKERS COMPENSATION AND x TORY M1T6 LIER _ G A11YPROPFZOPRIETORA'ARTNER/ES;ECLr7uE E4RS'LIABILITY 7>3JU8503X108705 03/14/06 03/14/07 E.L.EACHACCID[NT $100000 M— OFFICfRTAEMBER EXCLUDED? 51.DISEASE-EA EMPLOYEE $100000 If YYas,domibe under ----,•---.— SPECIALPROVISIONSbelow E.L.DISEASE-PCLICYLIMIT 1500000 OTHER OESCRIPTIQN OP OPBRATIDNS f LOCATIQ':3 f VEHICLES 1 EXCLL JiJS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Insuranri CERTIFICATE HOLDER CANCELLATION -- TO DO SHOULD ANY OF THE ASOVE DEBCkIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THER&OF,TAE ISSUING INSURSeR WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOL:;tR NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL i.�od�T `flt IMPOSE NO OBLIG Ti IABIL.,a OF INSURER,ITS 051.10ATION OR L ANY KIND UPON 7H61 , AGENTS OR REPRESENTATTVES,� AUTHORIZED REPF4I='9FhTA)9Vr P1 IZ111, ACORD 2$(?001100) 0AG G RPORATION 1886 Board of Building Regulations and Standards One Ashburton Place - Room 1301 T Boston. Massachusetts 02108 Home Improvement.tontractor Registration Registration: 102467 Type: Private Corporation Expiration: 7/2/2008 NEW ENGLAND CUSTOM DESIGN, INC.. Val Lanza 226 LOW ELL ST. WILMINGTON, MA 01887 Update Address and return card.Mark reason for change. F] Address r] Renewal 0 Employment Lost Card 7 a# 5OM-05/06-PC8490 - 71. TOomvmanu ea�l�s o�✓�faaaac�suaella BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number:.CS 008828 Birto(jote: 04/20/1.951 Expires.:04/20/2008 Tr.no: 21457 Restri-cte.d: :0.0° VAL J LANZA _ 34 BIXBY ST REVERE, MA 02151 Commissioner The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . 600 Washington Street Boston, MA 02111 nww.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Phivabers Applicant Information Please Print Legibly Name (Business/Organizationllndividual): 16 Al Address: G LQ Oil",LC S T City/State/Zip: k// L_ /�A . 0/9,97 Phone #: 9 79 Are you an employer? Check tbe-appropriate box: Type of project (required): am a employer with�_ 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet t 2 El Remodeling 2. (❑ I am a sole proprietor or partner- \ ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9_ ❑ Building addition [No workers'.comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.]' officers have.exercised their right of exemption per MGL 11.❑ Plumbing repairs or additions 3, ❑ I am a homeowner doing all work .P P myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. (No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing roorkers'rontpensation insurance for my employees. Below is the.policy and job site information. Insurance Company Name: 1 P 0 Policy#or Self-ins. Lic. #: 1;2�j(U 13 `��CI GS?O� Expiration Date: �t Job Site Address: 6e/V 3G it/ City/State/Zip: Attach a copy of the workers'. compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as req aired under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andlor one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against-the violator.--Be advised that a copy of this statement may be forwarded to the Office of Invesrigations of the DIA for ins.uraace cover�g�.verification. I do hereby certify under the pains andpenalties of perjury that the information provided above is true and correct. Si ature: Date: - Phone# Off cial use only. Do not write in this area,to be completed by city,or town official. City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2.Building Department 3_ City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: