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Home My WebLink AboutBuilding Permit #012 - 40 SUMMIT STREET 7/12/2006 G TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION Of+,�•o 1tio o p Permit NO: 00— Date Received E Datc Issued: / SS us IMPORTANT: Applicant must complete all items on this page LOCATION S T + _ Print PROPERTY OWNER T 116LI, S-LIL r S Print ! IAP 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 .E Alteration No. of units: epair, replacement Assessory Bldg Commercial Demolition I. Moving(relocation) J Other Others: -. Foundation only DESCRIPTION OF WORK TO BE PREFORMED 611 Of Identification Please Type or Print Clearly) OWNER: Name: f—t&-?22 4 S 1ZLL> Phone: Address: '-I 0 5 v141M JT S 0�1. G}1lt f G�d�s7 CONTRACTOR Name: cu S ��ii" au S zo-,e ' 'CPhone Address: `�� 6 L-O".-Ic .l � T W I- k;,7& . Supervisor's Constniction License: VA-L 4&A44,4 Exp. Date: I-Ion-►e Impro,,anent License: L 6'Z d/G 7 Exp. Date: "7 ARCI-IIIECT• ENGINEER 4-- Name: Phone: ,-address: Reg. No FEE SCHEDC,LE:BGLDLNG PERMIT.510.00 PER.51100.00 OF THE TOTU ESTIMATED COST BASED On 5115.00 PER S.F. Total Project Cost S 7 S, — x12.00=FEE:$ Check No.: 120 Receipt No.: I'aee I of-1 TYPE OF SEWERAGE DISPOSAL _ Tanning Massage;Body Art Swimming Pools Public Sewer _ Well — Tobacco Sales - Food Packaging,•Sales Permanent Dumpster on Site Private(septic tank.etc. - Electric 'kleter location to project NOTE: Persons contracting with «nregistered contractors do not have access to the guarana—find Signature of Agent'Owner-��U rr Signature of contractor Plans Submitted -i Plans Waived 11 Certified Plot Plan Stampe P s 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 J ;� COMMENTS Zoning Board ot'Appeals: Variance. Petition No: Zonimi Dec is ion.,receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments �1 ater& 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 DA rA—(For department LISO 3,u1'.} C D) \I.SI-PA i(A:S DF PAR FMLN AIC. 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:I\SPECTIO.NAL SEA%WES UP:I'.\R'I'\IEV'f:nPl OR\1115 I:r•r 1 nl.t 4: 1 Location 1 No. Date �`l Z— Of NORTH TOWN OF NORTH ANDOVER O'�t.w ,•'�,y0 j 3? . . • O 9 • ; ; Certificate of Occupancy $ ' ..._ ; , — qi b'+ne r►'`,�j �ss�cHUS Building/Frame Permit Fee $ Foundation Permit Fee $ , Other Permit Fee $ TOTALell- $ Check # (f 1 ! 4�) 7 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING .. ... •,;..yx ..._:_. �,r _ ... � Fad,,,-`.ate-` �:z BUILDING PERMIT NUMBER DATE ISSUED: M SIGNATURE: Building Commissioner r of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide ReqWred Provided ReqWred Provided v 1.7 water Supply M.GI—C.100. 34) 1.5. Flood Zone hforination: 1.8 Sewerage Disposal System: D Public 0 Private 0 Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No rn 2.1 Owner of Record Name( nt) Address for Service: X � zzz, - Signaty& Telephone 2.2 Owner of Record: Name Print Address for Service: O z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES go 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor. O License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name rn Registration Number r Address r Z Expiration Date G) Signature Telephone 0// Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 102467 Type: Private Corporation Expiration: 7/2/2008 NEW ENGLAND CUSTOM DESIGN, INC. Val Lanza 226 LOWELL ST. WILMINGTON, MA 01887 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card 'S-CAI is 50M-05/06-PC8490 aeORDM CERTIFICATE OF LIABILITY INSURANCE OP)D K Dare(/2 /YYWj NLWEN 1 03/27?/OG PRODUCER THIS CERTIFICATE IS ISSUED ASA 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 rax:978-531-9442 i INSURERS AFFORDING COVERAGE I MAIC 9 INSURED IlatiQ;ZFRA.: Westarn World Insurance C an INAWRER13: Safety Insurance Company 39454 New England Custom Design Ron Weinber & Va1, Lanza INSURER C; Travelers Prperty E Casualty 226 Lowell re 84-P1, INSIJRERCI: Wilmington MA 018$$$$ L--- INS'JR'cR E: COVERAGES THE POLI(_IES)F IN':7JRANCE 1-15TEr,1 A='L^.\N MME BEEN IFSVE0 i0 7117-INSURED 4,OVE FOR THE POLICY P811 OO INDICA'eD.t:0 WITHST"NDIm(i ANY REOUIRFMCNT,TERMOR C01401T10N 01'-ANY CON(RACT OS'.,THBR CNCL4VIENr 110TH RESPECT TO LVHICH i'HIS CEfW-CkTE MAY BE ISSUED OR NsAY PERTAIN,TYC INSSURANCE AFFORD17D BY THE POLICIES GE8CRI3ED`iER'E;N IS SUBJECT TO.ALL 1iE TE i'nS,EXCLL'°;IONS 4^ID CONDITION.0 OF SUCH POLICIES.AGC-*REG.A,7B LIMITR AHO'1y'N tv'Af HAvE BEEN RECNCED BY P-AID.CLA-IMS'. INbW LTR NSR TYPE DF INSURANCE POLICY NUMBER I DATE MMIDD/YY) DATE 1IGY Mx71WDMY)y LIMITS i GENERALLIACIILITY I I EACHOCCQRRENCE y.1000000 v,.t IQ, -I :f.L A X COMMERCIAL(;tf�RALLI,._,LITY IN 19SUE 03/14/06 i 03/14/07 PRe118E5(E]o urgme) $50000 LAIMS IdADE oCCVR C1.�1F('i RXP(A.ny dofb a ryan) $2 SO o I..... "lR_ON4I A/,DV!NJUPY s 1000000 GENEwAL.A(�CREG.4TF S2000000 ' GCNILAGGPECUADUC .ATELIMITAPFGPFR. f PROTS-COMPIOPAGG T2.000000 POLICY ,JF�.7' LOC AUTOMOBILE LIABILITY (N'MP_IIJEO SINGLE WAT B ANY AUTO10062853 04/05/05 04/05/06 Esacradsnt)'_ ALL OYrNE0,N.1T0S POLICY RENEWS 04/05/06 04/05/07 BODILY INJURY $250QQQ i { 3CHEDULED'amc,'� (Por person) HIREU,aUTUS BODILYIN.4ARY 50QOQ0 NON•OWNEDALITCj; i (?erstcidart} PRCPE—PTY DANIAGE $1,00000 �w (Per accldclr) GARAGE LIABILITY I I I AUTO ONLY-EA.ACCICENT $ ANY AUTO r1rHFR'rNary EA ACC f ALR)ONLY: A.GC $ EXCESSIUMBRELLA LIABILITY I CACH OCCURRENCE 0(1-UP CLA.I.%.$MADE I Aryl:f2tC+A'i E $ DEDUCTI U-7 I A I F REIFIN IION g WORKERS COMPENSATION AND ! TORY LIh1l 1l%' IEP _ EMPLOYERS'LIABILI7Y C .144 PROPPIETORl!'M,TraEF.1EYEC1171 E 7pN5303=08705 03/14/06 03/14/07 E.L.Ek7.HA Cir.) rr I,$100000 OFFIC:fR'1MEMEEREXCLUDEV E.L.DI'EA��-EA EI,;PLOYEE '$100000 It vas,dc•x6bA under _.._..E -- SPECIAL PROVISION5 Gelow I E.L.DIti..A__S= E- .PC.L._Yuu: •I 1P,500000 ,�SQQQQQ OTHER I j i I I j { DESCR(PTION OF OPERATIONS I LOCArO":S 1 VEHICLES I EXCLL 7NS AOOED BY ENDORSEMENT r SPEOIAL PROVISIONS Evidence of Insuranci CERTIFICATE HOLDER -� CANCELLATION �- -� TQXAMO SHOULD ANY OF THE ASOV6 15E8CRIARD POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 7119REOP,THE ISSUING INSUR9R WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLT tR NAMED TO THE LES.,BUT FAILURE TO DO SO SHALL i%%uari=,'_111r IMPOSE NO OBLIGATION OR LIABIL(,(OF ANY KIND UPON YHE INSURER,R3 AGENTS OR REPRESENTATNES, AUTHORIZED REPAESENTA E ACORD 25(2001100) U 6 ACrjCbRPORATION 1998 "Contractor") and owner 049k 'vL.J �r j` S a y » _ (hereinafter, "Owner"), of City / Town 1-" 7W 't�o y-e/2 State Zip HPhone Job Address ("The Premises") U S 6)In % WPhone p 7_ 90 New England Custom Design, Inc. Salesperson f/ �,� (Je -e,T C Roofing will be applied only on slope roof surfaces below,over present roofing shingles unless specified under REMARKS. w2 MATERIAL...................... ::::.':..................................................................................... Color ........................................... 0 w Main Roof............... .............Bay Windows...........................Extensions............................. .................................................................. 0 Porches: Fro ...................... Side ................................... Rear...................... ................. Other Roofs................................... 1:4NOTE: of board Replacement Cost per foot OR per 4'x 8'sheet of inch CDX Plywood. 3 a w We will cover the low sJPpn6ioofs specified here with .................................................... 00 0 Roofs to be cover Color................................................. Siding will be app}}-ied onl on outside perpendicul,4y walls where specified below. MATERIAL 6'CJ�9 . AC...... 4�� MATERIAL.�..^...Cc».nj�fZ�........�.S;r�9ivr)v12�....... 2 Color......11��! .L......- ?�r.�............................. Color............[� !$.Ci.[t :.....>r<c,l6.(.l`.-c.............................. Ca Underlay ............................... Underlay .........I .......................................... ............................ cn Apply where A1.1..L3+~ffS'.%%}.......� /j........................ Apply where.............................................I.............................. Enclosed porch: House wall? ..............`-'............................. Porch Bulkhead: Inside? ........................................... ............... Are window casings to be covered with siding? ........` ....................................................................................................... Wood trim specified below will be covered with aluminum trim. ,t ( w �D Window casings: Number...A...l/................. Color.G 6..,urlt........Sills only:Number.......—..............Color......:":............ z 2 Door casings:Number....iQ.IJ..................... Color C- &C..1z 4A..tr.x.................................................................................. Soffit and facia: Color...r-4<r0c ..Wkth... Facia only: Color...... .../li.cr:C/.t....sal. ..:................................................... QOther and where......iJ ..... sJ,r=r= .....z .......................................... .. 30 Doors:Number.........................................Type.................~:..................Style.........................................Color........................................... Window:Number........."......................Type...............:-:...................Style......................................Color........................................... .................................................................................................................................................... . .......... Shutters:Number" ..............Color...l�Afd(..OfL�-...Style.�&ljz4...1%�%Y..>...�-..Where.�'-nyr1`....�??�rr.:^�..l. c� Ww Aluminum Gutters:Color.........:...............................................Where..................................................................................... QAluminum Leaders: Color .........................I............................ Where ................................................................................... v _j Remove existing gutters and leaders? ...........—................... Facia ..........."... .............. REMARKS / EXTRAS: Missing or defective lumber is not included in any category of work unless specified under REMARKS. -��Sr.'ur.�.....:�3/��:`!.......Bt..�t�.�.r�� -r; .��.<�!-�� •:+.....�� : ��t?�....F'.ttC�.�..�`r�.....l�C��? .r...:..�,�l��-Y ................................................................................................................................................................................................................................ ................................................................................................................................................................................................................................ ................................................................................................................................................................................................................................ ................................................................................................................................................................................................................................ .................. ...............................fr....................................................... .... ............................................................................................................. �1 1�.....1".. '�.!Yt!r�....C�G `l 1..7C.sr � .... �. ;4............ 5. :. ............................................................................................. The Contractor agrees to perform in a good and workmanlike manner all work detailed above. CASHPRICE $......... .... .. .../... :..................... NOTE: All Roofing Customers DOWNPAYMENT $.............. U° New England Custom Design,Inc.will not be held ................. g b PAYABLE ON START OF WORK $......... ..:.... ...................... responsible for dust and debris falling in attic area PAYABLE ON COMPL�'ION $........:��^G........5... ` ....................... during roof installation. cl` � Please remove or cover valuables. ......:�j...... 3 DATE: ...............................................................20.0!�...... RIGHT TO CANCEL Tha()wnar may rsnral thic naraamont;f rt hoc k— o*—A I tho r)--,.t�—1—..A,e..+I,-- tl,e-AA..--- ,.0.1 -�'I NO R Tty own of And O No. d 12.. h 2 - oG o over, Mass.,_, - I� COCHICHEWICK 7�ADRATED PPS\ 5 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.............1A.Al"..40.4..............G.M.I................................................................................ Foundation has permission to erect............................�.......... buildings on .....4/d..........so �........ ............. Rough to be occupied as.......Fv.I..[.........V1=7..L.....0 ..r. ..l .. .�............................................................... Chimney provided that the person accepting this perm shall in every respect co arm 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 a (� mom PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUC TARTS_ ELECTRICAL INSPECTOR Rough Service BUILDING IN 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 Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. [JE—SEE REVERSE SIDE Smoke Det.