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Home My WebLink AboutBuilding Permit #782-13 - 426 SUMMER STREET 5/1/2018 ,AoRT#1 ',"so 16 . BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION 44 Permit NO: Date Received 7- 0 Date Issued: Ss S IMPORTANT:Applicant must complete all items on this page IR 0 zP-M an", AAV IN- -`NJ W; R TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building W One family [I Addition 0 Two or more family 11 Industrial 11 Alteration No. of units: El Commercial D<Repair, replacement El Assessory Bldg El Others: [I Demolition 11 Other 5 w M ,in wt f i* q r 2, 0 ",- PQ D19Q- r10-&OA ry,--I I 1-S y 4e�-,s 6,1 e- 2L i_C, A- C I C 0/2A 7P�I 1`S J Identification Please Type or Print Clearly) OWNER: Name: Ki ( a� A-j A 11eL, Phone: (0 Address: L)-yl V,-1 Q (S v", N 7 MR. 6 rlse,- � hQ Yn. Q A , - -01", ON 19, 0 ARCHITECT/ENGINEER 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: $ FEE: $ Check No.:— , Receipt No.: ®i2r. y// NOTE: Persons co ratting with unregistered contractors do not have access to egu,arant d 4- TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page -� 61. PRO_p,ER�TYOINNER Print ructuro yes nog: MAP'N® __:: T PARCEL _gZONING DISTRICjT Histone Qistncf yes no) MachineShopsVillagea yeS) nod .TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other .:.-.,-r,___""-,r _ _ -"s' ''_ - -- - �--•-- - .:;„y, =ma=r i ❑Septics RWI ❑?Floodplain ❑Vl/etland'sa ❑ Watershed�Dlstrict* 3 ❑Water/Sewer; � DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRAC:TQR�sName- _r _ __ Ptone:-- _ T Address - Su ervlsor sConstrucf on�License=, --- EXp} Date H©rne�Impro�ementLicense.; ARCHITECT/ENGINEER 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans El 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS 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 DPW To-wo Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT '-Terhp Dumpster on site yes no Located at 124 Maui I.Street . -Fire Dep artieitsignature/date'" COMMENTS Dimension Number of Stories: Totals square feet of floor area, based on Exterior dimensions. q _ Total land area, sq. ft.: ELECTRICAL: Movement of Dieter location, mast or service drop requires approval of Electrical Inspector Yes leo DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A-F and G min.$10041000 fine NOTES and DATA— (For department use D Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fohpgwing 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 o Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products DOTE: 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 Li 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 apt,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm_tted with the building application Doc: Doc.Buil,-iing Permit Revised 2012 Location L/ o�,L �CJh�/1`�J/�C 57r No. Date 6 3 t , • - TOWN OF NORTH ANDOVER w • _ Certificate of Occupancy $ � Building/Frame Permit Fee $ .CXR Foundation Permit Fee $ - `'' Other Permit Fee $ TOTAL $ Check# OV-- 4 26411difiig�g �-i Inspector NORTH oven of � s ndover o :. No. - 4 h ver, Mass, COC NI(Nl WICK �� TED I .�5 S U BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT ..........l.l.... ?1..../.�7.:/ ................................................................................. BUILDING INSPECTOR has permission to erect .......................... buildings on ..�Z'. .....5�'��i^ J Foundation ..............o r to be occupied as ....... Rough provided that the person accepting this permit shall in every respect conform to the terms of the application Chimney on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Final Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TARTS Rough �� Service ......... ...... . 14% ................................... INSPECTOR. Final GAS INSPECTOR Occupancv Permit Required to Occupy BuildinZ 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. EFE:SEE REVERSE SIDE Smoke Det. • - ��e�pamvrrto-�uueal�-d�C��avoa�urte� Office of Consumer Affairs&Business Regulation W'ME IMPROVEMENT CONTRACTOR gitration: 103052 Type: piration- ::7/6/2014 , Individual r ! EUGENE R.WEISENBORN, ' Eugene Weisenborn 44 North St. Methuen,MA 01844 I • I Undersecretary '= Massachusetts- Del), -tinent()f Public Bciartl4 rtf"`$tiiltlin Re-uhitions and S#ar�tt it tls Construction Supervisor License License: cs 42328 EUGENE R WEISENBORN t 44 NORTH ST METHUEN, -MA 01844 `` " Expiration:' 12/9/2013 (`onunisi°aer Tr#: 7578 l i • i Eugene Weisenborn W=��' �� Weisenborn Builders 44 North St. DATE ESTIMATE NO. Methuen, MA 01844 3/28/2013 1119 (978) 688-2820 Customer Information Kim&Richard Allen 426 Summer Street N.Andover, MA 01845 PROJECT Deck Railings PROJECT DESCRIPTION TOTAL Option#1 4,140.00 Replace hand rails and balusters on existing deck and stairs with wood mahogany rails(mahogany finish), and 2x2 mahogany balusters. This option does not include new caps or posts. New gate to match above. 1/3 DEPOSIT AND BALANCE AT COMPLETION. PRICE INCLUDES MATERIALS, 0.00 LABOR AND REMOVAL OF ALL DEBRIS The above estimate is based on typical construction methods.In the event of any unforseen conditions,such as,but not limited to, insect infestation,structural rot,or pre-existing sub standard work,.it is my intent to correct/upgrade said issues during the construction schedule to comply and meet current building practices/requirements. Such defects if found will be completely discussed and identified with the client and removed,repaired and/or upgraded as needed at a cost no greater than what is required to meet current building code compliance. MA Construction Licence# 042328 Home Improvment# 103052 TOTAL. $4,140.00 The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as SIGNATURE specified. Payments will be made as outlined above. The Commonwealth of Massachusetts Print Forms `; Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 L Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 0-7 Q tjPl C 12 in Address: Alo k4y City/State/Zip: A A/o A. y Phone #: Are you an employer? Check the appropriate box: I am a general contractor and 1 Type of project(required): 4. 1.[N I am a employer with ,� ❑ g employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' insurance.+ 9. E] Building addition [No workers comp.comp. insurance required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no i employees. [No workers' 131-1 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 1 Q 7rY/6•i Q QHS T1 C 0✓'rDn c 9_ C-01 Policy#or Self-ins.Lic. #: Expiration Date: a^(0— Job Site Address: /V C3 6 k3y w►&-,Pl C� City/State/Zip:w &J we— 04A 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 certi nder the pains d enalties o er ury that the in ormation provided above is true and correct. 1 I Si nature. —_ _. ., �... _._ . _. .- -.-_-- .___ ___.,.a ., _ _. Dater_ Phone#• q"7 f Ko 9) 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#: