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HomeMy WebLinkAboutBuilding Permit #805 - 354 MAIN STREET 6/6/2007BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: © " ` Date Received - Date Issued: F I& `* ^64 <x.atwewKK _ I& TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building X One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: I ❑ Commercial X Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address - ARCHITECT/ENGINEER / Phone: Address: No. FEE SCHEDULE: BUL13ING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ "� �� 0-r-1 FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to Me guaran fund 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 ❑ ❑ COJ",IMENTS 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 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.$100-$1000 fine NOTES and DATA — For department use ❑ 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 DEPARTMENT:BPFORM07 Revised 2.2007 Location 36Y No, Date _W MaRTh TOWN OF NORTH ANDOVER i ; ; Certificate of Occupancy $y� s'„�° � E MUS AC Building/Frame Permit Fee $ Foundation Permit Fee i $ Other Permit Fee $ TOTAL $ Check # 20214 Building Inspector 0) m x m m x CA CA F) m y d �a r/ J CD 0 co) CL O �■ MM CL y ®® CD CD CL cr CD CD® 0 C CD yCD� CL ® CO) CD CO O 1 CD O CD O CD 1 " VJ 0 I./ cn �l C O F 0z _ O dy `.a ti y CL .► = ^► "-*d C R I �po� o y co) � o?m: a a O.0 0 -� O <� O ti C07N � CA C ® O N • 1 nC 0 CDCL m3 Im y CLcr goW Cl) b7 O H 'Ii7 p ;t7 r c m 1 H 'r] p H = 'r1 w (� x i0 G ri O go CAO �CAO,Q: Cn 0 cp al O �5 oma$ CD 0 • M 'p O • O O m CD 01 o �• =CD: d CLte: C4 _®. C3. . w 0 CD Cl) b7 O H 'Ii7 p ;t7 r �? �- rb O CA ''3 'r] p 7� O b 0 'r1 w (� x i0 G ri O p Cn 0 cp al O M M O C IL k1; cel �,� �411i, c v 1 '015 �,5-11 q7 � - 8��- 9�� 3 �1 �'8c� 00 >7u �L W DO r. F•-� ON 0 V ON � a (D f... C �a ��Y CONSTRUCTION 20 BERESFQRD STREET LAWRENCE, MA 09843 PHONE 978-976-02421 FAX 978-975-0242 E-mail fayconIOD-comcast.net David Bouvais 354 Main street North Andover„ Ma. 01845 David Bouvars 354 Main street North Andover„ Ma. 01845 Provide materials,labor permit and inspection for the foiling work Main deck 1.00 $4,000.00 $4,000.0 Dig out and ibstall footings for deck and stairway. Construct 10"x!6 preasure treated deck 0 ,posts,railings and stairway per drawing. Deck frame will be 2x10 pt joist supported by a double 2x10 beam sitting on 12" poored concrete footings. These will be set back 24 inches from outsid edge of deck and spaced at 7 apart. Posts and railings will be PT 44 posts 2x4 top and bottom rails with 1112 ballasters spaced at 3 per foot. Install kick board under slider. Poor concrete pad under last step. Side stairway and landing 1.00 $800.00 $800.00 Poor footings 2ea.install landing and stairway per drawing with the removal of stairs to rear yard.ame construction as main deck. Removal of all debris and clean up of work area, sorry for the delay in sending this Est. SUBTOTAL $4,800.00 If you decide to use me for this project, let me know so I can get it done before i start bathrooms on 5-15. Thanks, TAX $0.00 Chuck TOTAL AMOUNT $4,800.00 AMOUNT RECEIVED $0.00 BALANCE DUE $4,800.00 Oft y04 0, rP`� \a iah 0 i 16Ioa� ,) �°; WDOii gra H nPov' 1 --.MAW *T. 05'01'-19 MORTGAGE INSPECTION PLAN LOCATED IN jUYER; .PAvio 09AVAI rJoaTH A0r20AR C / /.,, WMASSACHUSETTS TO THE .AW20,19P- yA\1INC1/9 'U4 AND ITS TITLE INSURERS I HEREBY CERTIFY THAT I HAVE EXAMINED THE PREMISES AND ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN. 1 FURTHER CERTIFY THAT THE BUILDING SHOWN 00( )CONFORM TO THE /C n ZONING LAWS AND AMENDMENTS, i.e. (FRONT,SIDE a REAR YARD SET BACK ONLY)OF 4.A400\/EIZ WHEN CONSTRUCTED. I FURTHER CERTIFY THAT THIS PROPERTY IS 40f .. LOCATED IN THE ESTABLISHED FLOOD HAZARD AREA. DEED Crry� NOTE THIS CERTIFICATION IS BASED ON THE LOCATION OF SURVEY MARKERS OF OTHERS, AND BOON . DOES NOT REPRESENT A PROPERTY SURVEY. PAGE EXAMINATION OF THE RECORDS IS MADE ONLY SUBSEQUENT TO THE RECORDED DATE OF THE LATEST DEED AND DOES NOT INCLUDE VERIFYING THE ACCURACY OF THE DEED DESCRIPTION PLAN PREVIOUS TO ITS DATE OF RECORD. THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE NO. RECORDED DATE OF THE LATEST DEED OF RECORO. BOOK WHENEVER BUILDINGS ARE SHOWN L[SS THAN ONE FOOT FROM THE PROPERTY LINE IT IS PAGE ADVISED THAT A MORE PRECISE SURVEY BE MADE TO VERIFY THES MESUREMENTS. _... .. - a THIS CERTIFICATION TO Bt USED FOR MORTGAGE PURPOSES ONLY CERT. N0. _- �tN PF° )SZ,, MA-7 �. _.. ,1985 DFORD ENGINEERING CO. SCALE: 1" = 4o'JAMESP.O. BOX IP4f BOUGIO overkill, Moss oIBSI James W. BOUGIOUKAS RLS t• • 05`97� TEL. 373 2386 10 0 F4 X OQ 10 0 F4 X The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: CSI -1 e�.0 we f _ '9� Phone #: 2 2J- �> ?.f— azV Z_ Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ❑ I am a general contractor and I 2)� employees (full and/or part-time).* have hired the sub -contractors 1 am a sole proprietor or partner- listed on the attached sheet. # ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have workers' comp. insurance. 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): New construction 7 Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # I 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 workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Job Site Address: Expiration Date: 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 required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or 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 Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Signature: Date: Phone #: Official 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 #: Jauoiss!wwoo i': t °01 VN '30N32JMVI 02IO3S3i 09 0z Xd3 V S3DbdH0 09£92 :ou 'jl 800Z/L l/SO s4JFdx . £99290 SO.jegwnN 2JOSIA2i3dnS NUionHiSNOO :esuao!-1 SNO.Ilvinom JNIaiina �O aNvos y �/' g ✓/� �omvnto�u„ea�ii ��/�iaaaacicuaetla lugBoard of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Regist ationl 147062 CHARLES A FAY„ CHARLES FAY 20 BERESFORD S LAWRENCE, MA 0 Administrator