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Home My WebLink AboutBuilding Permit #131 - 38 FARNUM STREET 8/18/2006 O` NORTH 11, o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION SS.' use. Permit NO: Date Received: Date Issued:= •0 Iti11"ORTANT: Applicant must complete all items on this page LOCATION_ _ 1'rint PROPERTY LAMER 01 G ✓ _ ,�q Print MAP NO.: �y�-`PARCEL: ZONING DISTRICT: I TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT 1PROPOSEDUSE Resides ial Non- Residential New Building 1--6ne family Aottion Two or more family ` Industrial 141teration No. of units: Repair, replacement Assessory Bldg Commercial _= Demolition Movin T(relocation) r: Other Others: Foundation onlv i DESCRIPTION OF WORK TO BE PREFORMED X10, alb Iddtification Please TvDeor Pant Clearly) OWNER: Name: Phone: OVO / s- Signature Address: l CONTRACTOR Name: � )(1 �� Phone: Addres • O /UO "A 014pz/y Supervisors Construction License: Exp. Date: Hume Improvement License: !� �� Exp. Date: ARC'l1ITLC'T:FNGINFFR Name: Phone: Address: Reg. No. FEE SCHEDULE:BL'LDI,\'G P R.111T:SI0.00 PER$1000.110 OF THE TOTAL EST1,11ATED COST BASED ON 5125.00 PER S.F. 12,G V 1 f Total Project Cost S do C) Y.4-W TEE: 9 2 Check No.::n �h Receipt No.: I A 1� N(O VE L-..d Location 7 �� No. DateOf t „QRTN TOWN OF NORTH ANDOVER • ; , Certificate of Occupancy $ s�cHusEtA Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ -J Check # Building inspector F_ — - ------- -- TYPE OF SEVvARGE DISPOSAL -_ TanningiMassageBody ;art Swinlnlill" Pools j Public Sewer -- Tobacco Sales - I Food Packagin-;Sales Permanent Dunlpster on Site i Private(septic tank, etc. I '.MOTE: Pervoll1'contraelingWl/Z unregistered CIN rachAq do not have aCCess to the gittiraii(j,fimd c n Signature of Agent Owner , Signature of Contractor Plans Submitted 7-1 Plans Waived U Certified Plot Plan F] Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 11-1 ❑Water Shed Special Permit Site Plan Special Permit ❑ Other COMMENTS DATE, REJF,CTED DATE APPROVED CONSERVATION ❑ E COMMENTS DATE REJECTED DATE APPROVED HEALTH n I COMMENTS Tonin_ Board of Appcals: Variance, Petition No: Zoning Decision receipt submitted yes Pltllllllll-, L3011'd DECISIOII: __COnllllellts Conservation Decision:------ Commcnls � ater d;; Sewer connection signature&date Temp Dunlpstel�on site ycs_—no --Fire Department signature.'date Building 1'crmit'Appfoved and ISSucd by: Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides j Required I Provided j DIMENSION Number ol'Stories: Total square feet of floor area. based on Exterior dimensions. Total land area, sq. ft.: NOTFIS and DNI A—(1-or department use) I 11W1.'.1 ',l 10 1 I ii I,;.!,'I".I !T1 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 j Debris Removal Form Workers Comp Affidavit :j Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract :i Floor Plan Or Proposed Interior Work Addition Or Decks :j Building Permit Application a Fonm U o Surveyed Plot Plan Debris Removal Fon- Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract zi 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) o Building Permit Application j Form U • 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 a Klass check Ener_-gy Compliance Report In all rases if a Variance or special permit was required the Torn 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 cope wind proof of recording must be submitted with the building application Onc:I\SPEX TIONAL 5ER\ICES DEPAR'1'\IEv(':131FORNI05 6 - 8 Page No. of Pages Builders License # 58443 Home Construction Reg. # 109288 0 �9Sb 9� X44-9��4 X998) 6f�4-2569 f` "The Areas Oldest Roofing Company" P.O. Box 637, North Reading, MA 01864 I I PROPO ET ,JOB ME -<-J,30 I CIT TATE AND ZIP CODE JOB LOCATION We hereby submit specifications and estimates for: Recommended Optional (Included in price) (Not included in price) • Rip& Remove all shingle debris from roof&job site: ❑ 1 layer ❑2 layers ❑3 layers or more Repair/or Replace any roof decking; not to exceed 50sq. ft. 'I •- ' Install 8"aluminum drip-edge/and rake-edge along entire perimeter. Choice of mill,white or brown •' Install ICE&WATER underlayment along horizontal eaves,valleys, sidewalls and sky-lights&chimneys • Install premium base sheet underlayment between roof deck and roofing shingles • Install 25yr CertainTeed/GAF/Tamko or Owens&Corning traditional 3-tab roof shingles ❑30 year • Install 30yr CertainTeed/GAF/Tamko.or Owens&Corning architectural roof shingles ❑40 year ❑50 year ❑ Lifetime See manufacturer warranty policy for more details • Install new aluminum vent-pipe flange(s) • Chimney(s) -counter-flash and re-step existing flashing ❑Cut& Install new lead flashin0 • Ridge-vent/exhaust vent with low profile design, hidden by shingle caps ❑Soffit-ventilation ❑ Roof louver-vents • Seamless style aluminum gutters-custom fabricated at job site ❑downspouts • Other d I 11 - "Please Note:All items in roof attic should be removed or covered due to falling roof particles, at time of roof tear-off Price includes all items above that are checked only/others may be priced separately upon request. r�f _ We Prulause hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: Total price not including options. dollars($ ). P ment to be made as follows: 30%deposit required before ordering materials.Balance due in full upon day of completion. Please make all payments out to Kenneth Duval, mailed to: P.O. Box 637, No. Reading, MA 01864 Late charges of$50 per week for all outstanding bills due upon day of Authorized completion. Signature i ► f ! -Accepting proposal means agreeing to the terms of the enclosed binder Note:This proposal may be contract. Please sign contract&return top copy(white)with deposit. withdrawn by us if not accepted within 0 days NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 3s is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by NIGL . l1, S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: (Location of acility) Signature of Permit Applicant P� PP Fire Department Sign off: Dumpster Permit Date The Commonwealth of Massachusetts Department of Industrial Accidents E Office of Investigations 600 Washington Street ,tit fBoston,MA 02111 'i www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lc ibl Duvet Roaflng, LLC Name(l3usinesslOrgani2ation/individual): PO Box 6-3 F Address: N0. Reading, MA 01884 City/State/Zip: Phone#E:, IF/ �elyl Are yo employer?Check the appropriate box: Type of project(required): i.EErolani a employer with__,4,2_ 4. ❑ I am a general contractor and I 6. []New construction employees(full and/or part-time).* have hired the sub-contractors 7 [,Remodeling 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet 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 11. right of exemption 3.❑ I am a homeowner doing all work gper MGL ❑Plurepairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.[Ergoaf repairs insurance required.]f employees. nc workers' 131--]Other comp.insurance required.] "Any appticant that checks box#I must also fill out the section below showing their workers'compensation policy infmnation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tConuactors that check this brae 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.#:_ 3., -61 Expiration Date: Ac Y Job Site Address:3 a 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 forth of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties oj'perjury that the information provided above is true a correct. signature: �z Phone M f Official use only. Do not write in this area,to be completed by city or tows:official, City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#:_ AUG-17-2006 20:10 FROM: TO:19766BB9542 P.1 �e�n+asutArall� �•/g�aeea�iuoel� Board of Building Regulations and Standards License or M91sti-a60a valid for individul use only HOME IM?ROA-[MENT CONTRACTOR before the expiration date. If found return to: Rogistcation: 109288 Board of Building Regulations and Standards lug t:xpirwion: gM,,20C.,0 One Ashburton Place Rm 1301 Type: DBA Roston Ma.02108 DUVAL RooFING Kenneth DLp.�s! 72 NORTH ST N.READING,MA 01864 Administrator Not valid without signature I NORTH Town of 4Andover 131 _ T (Ar 16 C' LA E - dover, Mass., 'p -00CMICME WICK ADRA-rED pPa��S `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 6 BUILDING INSPECTOR THIS CERTIFIES THAT..... ...... ............ .......jo& .;.....(.4.Q.. *11A".1,................................................................... Foundation has permission to erect........................................ buildings on ..3.&......... ........$►r.................... Rough to be occupied as.. . . Chimney provided that the person accepting this permit shall inry respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By- s 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 LOOP PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI TARTS_ ELECTRICAL INSPECTOR Rough Service BUILDING '!"ECTOR 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 BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIRLJ Smoke Det.