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HomeMy WebLinkAboutBuilding Permit #717 - 430 MAIN STREET 6/4/2008BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received /o'tttieo o \ A ^� !y Date Issued: _(% _ Y� ` o, IMPORTANT: Applicant must complete all items on this page LOCATION' ✓� P '� PR- OPERTY {OWNER ° ` +�� •c 0 d,�,� l .+ Pfint MAP NO: T PARCEL:. ZONING DISTRICT: Historic District yes. no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family X Addition Two or more family Industrial Alteration No. of units: Commercial XT�epair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: ;xp 0/05—,- C) Ca ® /-- //VS ^/ V S' 7-,194- C /?/ to Us /eco Ir- Type or Print Clearly) NER: Name: ress: 161 Phone: CONTRACTOR Name.- av _ ale- v!-��°�' Phone: 1?7o,"77 7 r -el A?r t /ZW Address: �.r/ jar r����it,1 � Q�f� Supervisor's Construction License: Exp Date: A- �Z 41.me Improvement License "l/.• y'�"c� ��fF�r Exp. Date: ITECT/ENGINEER Phone: A Address: Reg. No. FEE SCHEDULE: BULDING 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 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 hoard of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit �c DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster onsite yes. no Eocated,at J24 -Vain Street :Fire Department signature/date QOM'MENTS - - 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 2008 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 2.2008 Location_�y�1//.� L' No. Date D ,.ORT#f TOWN OF NORTH ANDOVER • OL 9 Certificate of Occupancy $ P Y CMUsE<� Building/Frame Permit Fee $ ri Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 12 2 Building Inspector AcoRn. CERTIFICATE OF LIABILITY INSURANCE IODUCEt an Hurley Insurance Agency hestnut Green,' Suite 24 even Federal Street THIS CERTIFICATE IS ISSUED AS A ONLY AND CONFERS NO RIGHTS L HOLDER. THIS CERTIFICATE DOE: ALTER THE COVERAGE AFFORDE POLICY NUMBER anvers MR 01923-3620 DATE 611111100"LOTS Ihone:978-777-9394 Fax:978-777-3306 INSURERS AFFORDING COVERAGE SURED @ISLIRERX Preferred Mutua INSURER e: Granite state Ri.l% Brothers Construction Bartholomew Riley DHA 56 Conant street Danvers MA 01923- INSURER C. INSURERD: 1 I R E: OVERAGES 7HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED WHO ABOVE FOR THE POLICY PERIOD ITIOICATED. NOTWIT" ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OBER DOCUMENT WTH RESPECT TO WHRSI THIS CERTIFICATE MAY BE ISSUED MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS I m nrce ersoeraTc r naiTC VMIAffe MAY HAVE BEEN REDUCED BY PAID CLAIMS. IR TYPE OF INSURANCE POLICY NUMBER DATE O�fY) DATE 611111100"LOTS GENERALLUIBIUTY EACI+DCCURRENCE $ 300000 PREwsEs(Eaoccurence) $100000 9 X CoMMEM90ENEIMLIABILITY CPP0140564252 10/16/06 10/16/07 MED EXP (Any we person) $ 5000 CLAIMS MADE Fx] OCCUR PERSONAL a AN INJURY *300000 GENERAL AGGREGATE $ 600000 PROLLUCTS-C AGG x 600000 GEM AOGREGATELIMTAPPLIESPER, X7 POLICY, J LOC AUTOMO� LE LIABLITY COMBINED SINGLE LIMIT $ (Ea aeeidard) ANY AUTO ALL O WWO AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED ALTOS a x NONFWVNEo AUTOS PROPERTY DAMAGE $ (Pet accwerd) GA ZE UAm rTy ALTO ONLY - EA ACCIDENT $ EA ACC $�� ANAUTO R AGG x UAWTY EACH OCCURRENCE $ AGGREGATE $ OCCURCLAIMS MAGE $ $ LDEOUCnBLE S X TORY UNITS ER WORKERS COMPENSATION AND E.L. EACH ACCIDENT $100000 EMPLOVERS'LIABMITY WC2407407 06/20/07 06/20/08 E.L. DISEASE - EA EMPLOYEE $ 100000 B OOFFICEWMEmBERR EXCLUDEDCUTI1fE SIL ATTACHED NOTE E.L. DISEASE - POLICY LIMIT $ 500000 It yes, describe under SPECIAL PROVISIONS bnhyw OTHER --- -�� v � r.........� r. nremafe l VFFACI ES / FJLCLVSIOILS ADDED BY ENDORSBENT I SPECIAL. PROVISIONS E HOLDER CANCELLATION FORINFO SHOULD ANY OF THE ABOVE DESCRIBE) POUCIES BE CANCELLED BEFORE THE ExPIRAMON DATE 1HE187F, IRE ISSUING INSUFIEi WILL ENDEAVOR 70 MAL 10 DAYS WRITTEN For information purposes Only- NOTICE To THE CE3iTIFICATE HOLDER NAMED TO THE L ETI, BUT FAILURE TO DO so SHALL Please contact agency for N"SE NO OSNJGATWN OR LJABRJTY of ANY KIND UPON 1f!E 111MRSRr ITS AGENTS OR individual certificate. REPRESENTATIVES. i Huriey 441\ The Commonwealth of Massachusetts I I Department of Industrial Accidents have hired the sub -contractors Office of Investigations 'lil ; 600 Washington Street \f Boston, MA 02111 t' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: fit; K1n_Oti7- .fT City/State/Zip: dyve4j i;� Phone #: ;�P - 7 Are you an employer? Check the appropriate box: 1. ❑ 1 am a employer with 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 1 I.❑ Plumbing repairs or additions 12.gRoof repairs 13.❑ Other *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. #Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. (' Insurance Company Name:��g„-,e Policy # or Self -ins. Lic. #: W(�'..2 9/ii % 1,10 ;7 Expiration Date: 1!!� -,2- 0 0,P Job Site Address: J i//,9; a J7'" /I/d� vP, t City/State/Zip: 0/0P1915— 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. 1 do hereby certi� under the pains and penalties of perjury that the information provided above is true and correct �j Phone #: 9 7l�— % ,'?X — a -Y -J— f 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 #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two. or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. ## 617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax ## 617-727-7749 www.mass.gov/dia w O O EM4 o � C H O C .: w CS •ate CL c ev m CD c o cc CD : y i C m O r w r m ` O. _ { y 0 _ 1' off` c r V Cf i dR E �mm a C y y O = •: �3 r C m to C � � •p R •p cc EO m c CD Q S � CLL.)� m cm s C2 r C Z m CD O C3 y Z O W O"a cm CL H O yea m C •C = m tieCL 3 N ~ .Or y O •O+ ~ m CA) ujW O =,m •vyi as 1° Z ac •E CJ .0 � •y O • L3 LU co o m c g z ya _ E v o y•O o F- = w a 4- m F-4 NJ a� O O � L O v Z C CL O y 0 C O Om I C C 0.— wy G 'O W O O .CO2� m m CL CD � � L M O Cld CL�Q c CA = c CO C.3 FL O CD CO2 Z t5 C CD CL V y c C C Plft — C cc H LU cl Y♦ LLI Y/ W to o 0 a O w v cn or p w w U x a w" , U) w" rs: w rig cn 0 cn o � C H O C .: w CS •ate CL c ev m CD c o cc CD : y i C m O r w r m ` O. _ { y 0 _ 1' off` c r V Cf i dR E �mm a C y y O = •: �3 r C m to C � � •p R •p cc EO m c CD Q S � CLL.)� m cm s C2 r C Z m CD O C3 y Z O W O"a cm CL H O yea m C •C = m tieCL 3 N ~ .Or y O •O+ ~ m CA) ujW O =,m •vyi as 1° Z ac •E CJ .0 � •y O • L3 LU co o m c g z ya _ E v o y•O o F- = w a 4- m F-4 NJ a� O O � L O v Z C CL O y 0 C O Om I C C 0.— wy G 'O W O O .CO2� m m CL CD � � L M O Cld CL�Q c CA = c CO C.3 FL O CD CO2 Z t5 C CD CL V y c C C Plft — C cc H LU cl Y♦ LLI Y/ W to Massachusetts- DERE'mt i�tns Pu!b�tic Safe" a nd Standards Board of Bu'Idn ervisor Specialty License Construction Sup License: CS SL 98850 Restricted to: RF,WS BARTHOLOMEW KILEY 56 CONANT ST DANVERS, MA 01923 Expiration: 111/2012 Tr#: 98850 ('unnnisiiincr 71, f Building Regulatio d Standards License or registration valid for i Board ondividul use only s an before the expiration date HOME IMPROVEMENT CONTRACTOR. If found return to: I Board of Building Regulations and Standards Registration, 124852 , ;; One Ashburton Place Rm 1301 Expiation 13/2009 TO 133600 Boston, Ma. 02108 t 7y go jAvidual r a. Bartholomew C Isley �a Bartholomew Kiley' ?� -- 56. Conant St ��rc/ �'°`'Q"'"�` Not vali�dmvith out signature Danvers, MA 01923 AdministrM.0 CS �r Location (/.30 101 A iN %.A- Date 401t7h TOWN OF NORTH ANDOVER O 9 Certificate of Occupancy $ ACMUSBuilding/Frame Permit Fee $ IWO _..--- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �ap r --- Check # 717(_ 18 L 6 ✓ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING sw x BUILDING PERMIT NUMBER. DATE ISSUED: 1 Z SIGNATURE: Buil3n—g Commissioned) for of Buildings Date SECTION 1- SITE INFORMATION X1.1 Property Address: —G--�2i�V Std Nc�� 1�-Y' 1.2 Assessors Map and Parcel Number: 7 3 - Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R 'red Provided Provided __Required 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public 0 Privatep Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSEMAUMORIZED AGENT 2.1 Owner of Record NO, tgNda Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: a L o / Ci � A;1 1 � e. ��fi Ali) . 4Aldo L)d r M� Address t ® Q— 67�� 6 r OI ®©� Signature Telephone Not Applicable ❑ License Number / 11 �V 0G2 Expiration Date 3.2 Registered Home Improvement Contractor e (") 6,V"'O1 F �r 6mad Not Applicable ❑ Lo36---77 Company Name e- (" , /� 0 • f1/VC/0 0 �� 0 6--r rI (Al 14 I t-% 1— `l J j � /1� �/ Registration Number 9 AoG �t�Address OVAL (0. J?M�� 7 9 Expira tot n Date Signature Telephone M rn X Z v/ N 0 �i X r , rrrnmrnty a vvnnYri]c rnMPFNCAT1nN (M G_I- r 152 S 2.5c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. C 4 -0 VX63S1P Go ° Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building V Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Vi VI/ y L SreiX 1 S I / Ri bel t J li� Co se R C.ove r /9// LIP Pf IYY1 rs 0 es �rp AkwSh046 r L'IPi aryl 1s�fl 1/ F°..mV °L nog rd iV /JW �T e'e SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY I . Building( r U C) a) (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 PlumbinE Building Permit fee (a) X (b)�- 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BURDING PERMIT I � J 6160 /VOJ (5� op) as Owner/Authorized Agent of subject property Hereby authorize �i9 i) L 6 1 / Pi fro to act on My behalf; in all matters relative to work authorize by this building permit application. r r Q –.� SVII ture er i M f f P, Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I A tit �� � � � � as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name �•� S J x,40 Si ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB KD SIZE OF FLOOR TIIVIBERS 1 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SITE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 0 lL The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02919 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: 1660 /U r N p1We SIT City /U o - ANd o 0 8 Y•' 1!2� b Phone # 1 7P- 6 93-70 ®meq — I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name. Address City Phone* Insurance Co. Policv # Companv name: , Address City ' Phone #.7 Failure to segue coverage as required: under section 25A or MGL 152 can lead tothe anposition a crirriinat Penalties of a fine up to $1.500 and/or one years' imprisorvnent-as well -as _ch4,penattles-n-tb&Sarm-dA-S?9PY AORKINMERancLasm-4.(,$iDDm)-p tayag�� l understand that a copy of this statement may be forwarded to the Office of Investigations of the blA for overage verrficatfon. I do hereby certify under the Pains and penalties of perjury that the infamrahioirr provided above is true andGame 1. Print Official use only do not write in this area to be completed by city or town dWar .# U P 6 BS'10a7 City or Town EmmUicensing. Building Dept []Check if immediate response is mquined Q lJ4E'n3inQ BDafi/ Q Selectman's Office Contact person_ Phone # Q . Health Department Q Other v NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-95f, DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: (Location of Facility) I&I't Olt Signature of Permi A plicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector ve N ar PAUL A. PIEROG fo: 3 1000 TURNPIKE ST. Jt NORTH ANDOVER MA 01845 SAVINGS All, 978 685-1007 QUALITY CRAFTSMANSHIP j -Home Imp. Cont. Reg. No. 103577 SPECIFICATION SHEET Mass. Consto Lic. No. 039.928 Home Phone: 5�240- ele 4ff_5'tla IZ) w. -Owners Name Work Phone: F 'w,�L lHotne f Address City Aolllle4 State fJob zip", .f Address City State Zip" 7 1aSIDING 7-7, t,4 I.,' Siding Type Width, Color /_J19 f Areas to be done. Main House Breezeway'Garage Additions Porches Ddrmers,_ Bulkhead Other 3.' Prepare exterior walls for siding` ':4. Remove existing siding D Yes EKNo 51. insulation AA 0AJ/ 6: Aluminum trim cover, Yes ,,`� 0 No Color &Z//we, Trim to be done: Soffitts V 0- as P ak es " Ceilings 7� Casings;V00% 8. Gutters and spout No 'El 9. Shutters [Yes No 10. Storm Windows and Doors A/9 11. See notes, for feplacement windows, doors, awnings, carpentry, etc. 4, ROOM NG :t1111 J. Material Type Color Areas to be done_ Remove existing shingles 0 Yes DNo151b felt Metal Edging' 6 Chimney and vents, etc. Other Notes ;?-- 6'" 5�9�12-1_111200f. t1',Ze-,H'W V59ed JPJ!5�41, ��,OA �ne�74� ;P*r�, "'i $c;917d- 00 Deposit -T J,!A 't� payable as follows: Material and labor cost $ / $ R Fd 44110 6r I st instal Iment ,)J, d 0 2hd installment q it $ 1o,00Balanceo n comp�16tio Contractor will do all said work in a good workmanship manner. You may cancel this agreement ifithas been consummated be aparly thereto at aplace other than'an Is t, t` +. �'eaeldress of the seller, which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch be ordinary marl posted, by 5 telegram of be delivery, not later than midnight of the third business day following the signing of this agreement.' I NWITNESS THEREOF, the parties have hereunto signed their names this day of Signed ,i" 7F L Accepted: ER9qE)4TERIOR REMODELING & INSULATION Owner— NiPer; Signed re re*Vtiye 3 P Owner 'y' (,oe 'Strikes labor disputes, inclement weather, or material supplier delays resulting in work stoppage are beyond the control of the company. The company guarantees all k, f workmanship for a period of I year from the date on installation. Guarantee of workmanship assumes performance q/product installation under normal wear and conditions and does notguarantee against storm damage, acts ofgodor nature, neglect ofproper maintenance or malicious damage or vandalism. Materialguaranteesare the sole responsibility of the manufacturers. j) it, 4F 4% .4 4,Z,'4 i a L Jlze t�oota�nA�uuea�i o�sac/auartla BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS,.039928 Birthdate:- 03/16/1944 Expires 11 03116/2006 Tr. no: 18357 RestrictedY 00; Y PAUL A PIEROG 1000 TURNPIKE ST N ANDOVER, MA 01845 Acting C mis ones 4 CA m x m C m m v m v y d 10 o CD C2 Z y 06 �. o CL S y O CO') o p CD CDCL O cr CD CD cD c CD r' �. y C36 CD y CO CD I ac Z a O m ao ao y Z dn T n V* c m g o O y at .O'C : -4 6*4 JE:rm; o S O 7 O y a n Z` C o�p;w .m r a �.m Xi OCL U) OC C � bcn c r ^ c m l J c� m O d er . O > O y C Uj e. Ia.:.Jgn ti m : CO CH �., _ � tom. K o�m m • O .y0 o m e� O CD 0 � y � � c o o cn cn Gd ° o.�yg 0 C W CL 0 b A CD o a z y b Z p d H z a 00 H m � a i0 o O w X' C. I� O o y k � opo n C O Q A ° p 00 � G ° o O N C/1 p O N 0 CD �co CD �w �CDVi n va d � as �w C � Q CJI Q N o 0 fD .y CD � C1. b A CD o a z y b Z p d H z a 00 H m � a i0 o O w X' O Q ° p ° `a. O CD �co �CDVi d � � Q CJI Q N o 0 CD xeD CD y O o t7 b A CD o a z y b Z p d H z a 00 H m � a i0 o O Andover Board of Assessors Public Access Page 1 of 1 J NORTH North. Andover Board of Assessors Ot1«•a •��O 3.r e� r,,, ., M. • OL MATCHING PARCELS ,SSACHUS�t Click on a column title to sort data by that column Click Seal To Return One item found.l Search for Parcels Search for Sales Fiscal Year Parcel ID St.No. Street Owner Name 2009 210/057.0-0003-0000.0 430 MAIN STREET MIDDLETON, ALLEN W, One item found.1 http://csc-ma.us/PROPAPP/newSearch.do?town=NandoverPubAcc&from=NewSearch 6/3/2009