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Home My WebLink AboutBuilding Permit #115 - 325 GREAT POND ROAD 8/15/2006 TOWN OF NORTH ANDOVER taORT}1 APPLICATION FOR PLAN EXAMINATION o��t�.o ,6•6 ms �O to Permit NO: I S Date Received Date Issued:A I 15 Oss,T�o � ACHU � IMPORT/A�NT: Applicant must complete all items on this page LOCATION f C� �� 12G W �! PROPERTY OWNER 1 6 lT� 9 LI—o 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 F❑ Alteration No. of units: epair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition C Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO.BE PREFORMED Thi /97V-�5� oC i��1�- �`' 0A i 7t Identification Please Type or Print Clearly) OWNER: Name: —fd' X'A) 2�EZG-O Phone: Address: ? 1V &4dW CONTRACTOR Name: Phone Address: �C/ Supervisor's Construction License: Q 6 Exp. Date: Home Improvement License: 3� Exp. Date: AJL0 ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PE / :$12. 0 PE $1000.00 OF THE TOTAL EST/MATED COST BASED O�5.00 PER S.F. Total Project Cost l J x12.00=FEE:$ Check No.: (,QQ2- Receipt No.: Page 144 J TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site IJ Private(septic tank,etc. El Permanent Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor Plans Submitted ElPlans Waived El 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 a HEALTH ❑ i - COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Continents Water& Sewer connection/Signature& Date Driveway Permit Temp Dumpster on site yes no_ Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required 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) i I I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENTa3PPORM05 Creased.IYIC..Ian'006 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 o 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 DEPARTMEN"I'MFORN105 P;me 1 of d r _ Location Z 60-AP4 roj IM No. Date 9- ) o NORT1y TOWN OF NORTH ANDOVER 1O? • • Op ` Certificate of Occupancy $ �ss+cMU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ► �� 3a Building Inspector i i _---—' ,�rh �`"• d Standards Six c� Board otguild10% N(CONt�CTOFt HOME 1Mp 100239 Re9lstration' 6j1512p05 --,% Type' D `EYIgI.D &REMODEL G• ROgERt C gAl dmin►stra' Robert Baitel pernty A 499 Waove� MP, N•An - -- �ie �e-cnnzaoacaecc�C� of�T�a.tsnr�ure BOARD OF BUILDING REGULATIO License: CONSTRUCTION SUPERVISO Number: CS 025620 Birthdate: 03/10/1947 Expires: 03/10/2008 Tr.no: 13: Restricted: 00 ROBERl"C BAILEY 499 WAVERLY RD q� N ANDOVER, MA 01845 Commissioner I Robert C. l��1.1�aflleFinisk Work a Specialty � Quality Workmanship47-1 Free Estimates ' Building & Remodeling .� 499 Waverly Road Builders License #025620 North Andover, MA 0]845 Home Improvement , Telephone (978) 682-7087 Contractor #100239 TO JOB LOCATION � John Belko 325 Great Pond Road North Andover, Mass . 01845 same L L DATE DATE COMPLETED TERMS CONTRACT PROPOSAL BILLING PAGE NO. 8/ 12 0 XXX OF__-j__PAGES JOB DESCRIPTION: Installation of Andersen Re- t—n-fl-i The contractor shall remove all of the existing double hung sash throughout the house and replace them with Andersen Woodwright double hung replacement units to match existinglight patterns . All Andersen units shall be aluminum clad on the exterior, prefinished or clear pine interiors, Low E hgih performance glass., integral grilles both inside and out,, and standard locking hardware . All Andersen units shall be supplied by the owner with necessary exterior stops and installation hardware supplied with the units. The contractor shall supply the necessary labor to remove existing upper and lower sashes, install fiberglass insulating material around newly installed sash units (Andersen ) , and re-install remove interior stop moldings . There is no provision in this quote for the installation of new exterior window casings or sills . The existing storm window units shall be removed and disposed of . The owner shall provide an on-site dumpster for the removal of window debris and also the necessary permit fee for the Building Permit. All interior finish painting and/or staining shall- be the responsibility of the owner. Nail holes in removed stop molding pieces shall be filled by the contractor upon re- installation of the pieces . Any and all alarm work shall be the responsibility of the owner . ! Hereby Propose to furnish laboryVg in accordance with the above specifications for the sum of $ _7A20 .00 (Seventy-nine HUadred�-w-enty and �Of 36 4t�hirI OQ Andersen replacement units ( �_ABOR ONLY ) Wit payment o e ma as o s: $1980 .00 due upon installation of every nine !.ndersen replacement units All material is guaranteed to be as specified.All work is to be completed in a workmanlike �� manner according to standard practices. Any alteration or deviation from above Authorized �✓ � f specifications involving extra costs will be executed only upon written orders and will Signature !% . r become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other Note: This proposal may be -4 drawn us if/not necessary insurance. within ! 3 0 f accepted 1 1 days. Acceptance of Proposal-The above prices, specifications and ' ,1 conditions are satisfactory and are hereby accepted. You are G authorized to do the work as specified. Payment will be made Signature /LZ �-- _; as outlined above. Si9 nature Date Accepted NORTH Town of Andover No. 0o dower Mass.,I_] 0 coLA CHICHEWICK RATED P' BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT................ ........3....... . .............. ............................. .................. Foundation has permission to erect........................................ buildings on ....3.2.T....... ......... ...Pd4...... .. ............. Rough to be occupied as.34.......4A.#6Ww.4T...... Chimney provided that the person accepting his 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 q5-- PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTI 'RTS Rough .... Service ........................ .. ..... .......... ..... 16M BUILD�IN 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. The Commonwealth of Alass achrlselts t J Department of Industrial,lccidents n 1 R Office of Investigations %ti ,.; 1 � 1 ;,;I,= ; M 600 Washington Street Boston, .11,-102111 tvww.nwss.guv�ilia Workers' Compensation Insurance Affida-vit: 13uilders/ContractorsiElectriciansiPlumbers 1pplicant Information Please Print Legibly ��llne Illu�inc".t)rt;u',i�:,Iii n,Lt�liviluall: ,Q �,�� 9 City State-Zip: IV- U �- Phone #:- '7�) 7d 9-2 kre you an employer?Check the appropriate box: Type of project(required): I.❑ I tin a employer with }. ❑ 1 am a general contractor and 1 6 ❑ New construction X oyees(Full and,'or part-time).* have hired the sub-contractors I am a Sole proprietor or partner- listed on the attached:,heet. ` ' ❑ Remodeling ship and have no employees These'sub-contractors have 3. [] Demolition working For ire in any capacity. '.vorkers' comp, insurance, y. Building addition [No workers' comp. insurance 5. ❑ We are a corporation ind its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 .im a homeowner doing all work right of exemption ppr'AU I I,] Plumbing repairs or additions myself. [No workers' comp. c. 152, §10),and we have no I?.❑ Roof repairs insurance required.]t employees. [No workers' 13.0 Other comp. insurance require] ---- ny ippticant that uhccks box.,I must A-,t)IIII•:ut the:Cc Lion bdew:,hewing their workers'compen_aticn policy infonlilt r,n. II.ntecwners wlit),nhm,t this affidavit indicating the,,are doing all work and then hire outside contractors must muhmit anew affidavit indicating uch. .ntractcrs that.heck this box nnist.Iitachcd an.tddiIirnal:heel;howinif the n;une of the ,uh-contractor,and tlie ir'.vcrkcrs' .,,)nip.policy inti.rmatit)n. 1 am an employer that is providing workerscontpemsolion insurance Jim my employees. Below is the policy and job vile i n%ormation. Insurance Cumpuny Vane: - — - ---------— -- ----------------------- - — Policy 'i)r Self ins. Lic. : — _ —_ Expiratiun Date: t�;b Site.Wdress: City State.Zip: ----- - — - -- \trach a copy of the workers' compensation policy declaration pagre(showing the policy number and expiration (late). Failure to .ccure coverage as required under Section 25.1 of M61-c. 15'Lan Icatd to the imposition of criminal penalties 01"A tine up to'61,50(1,)0 and,or one-,_ar imprisonment,as well as civil penalties in the turn of STOP`i, (ORK ORDER end a tine ,)f up to`52:0.00 a day against she violator. Be advi:cd that a copy of this tatemcnt may be Forwarded to the Office of 1w ,, ti,,Aions ufthe DLA for insurance coverage vcritication. I la herchy certify miller the pains dirdpenallies al'perjury that he in%artntitian proeided,tbuv i% trugitintleorrect ---- -- - - ---.— — -- -- -------._--------- --Date: /( /) ht nc i- —,��. >` ! N...1-,l'. I ,) ;'/?+ ,I 'il.IJ' .e '•I 'n .1<' .. 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