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Home My WebLink AboutBuilding Permit #374-2016 - 47 ELMCREST ROAD 9/23/2015 BUILDING PERMIT NORTFI o��.LED TOWN OF NORTH ANDOVER 101 APPLICATION FOR PLAN EXAMINATION Permit No#.. �I Date Received �qss^TEC�5��5 AC►iU Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Pint PROPERTY OWNERS/s?i4M)o Print 100 Year Structure yes MAP .& PARCEL: Mc� ZON1NG DISTRICT: Historic District yes Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building , One family [I Addition ❑ Two or more family ❑ Industrial [I Alteration No. of units: 11 Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Flootlplair; Wetlantls: ❑ 11Natershed�®istr flSeptie 0 Well - - - �'Watee/Sewers - DESCRIPTION.OF WORK TO BE PERFORMED, a` ✓ zc Yo I ti kation- Plea yp or Print Clearly OWNER: Name: Phone:q&-d'@T- Address: L � y Contractor Name: �h�d. , 56� Phone: �� o-17,e- Email: Address: Supervisor's Construction License: OOV�1 Exp. Date: 4 2j Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: 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: $ s Ute FEE: $ Check No.: 4 14 M Receipt No.: on` bo NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Location No. 514-2o!( Date "' • - TOWN OF NORTH ANDOVER �.... �_ Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee w $ Other Permit Fee ,$ � TFD TOTAL $ 2� Check#4G i� j Building Inspector A Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swh=iRg Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENT'S CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature e COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/snafure ®ate Driveway Permit DPW Town Engineer: Signature: ------T P�y RaTiaM`n�iEtSNirSeT et T � ; . Located . 384 Osgood Street "epmsfer=onsitersfyesa ftTemp m . ?®, u - ocated ai 24z =7 1 r ' IJ V it ;FireDepartment si nature%date 4 ` ` 4 �� ,� :xs _' 1``ta • ti'31 ,-. f_" ' # <° `z�`e' T iJ7g' � I-1- f�r� AA, COMMENTSa ` j 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.$1oo-$1000 fine NOTES and DATA— (For department use) ® Notified for pickup Call Email Date Time Contact Name Doc.Suilding Pennit Revised 2014 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 OTE: 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 4- Photo Copy of H.I.C. And C.S.L. Licenses � Copy Of Contract -Floor/Cross Section/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 OTE: 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 46 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 NORTH Town of s EAndover 0 �• f � 2 h h ver, Mass, at cocM�cHew�c.. y1. S V BOARD OF HEALTH Food/Kitchen PER: LD Septic System THIS CERTIFIES THAT .............. ...... .... .. . .... ...... .. ... ....................................................... BUILDING INSPECTOR has permission to erect .......................... build son .... ..... . ..... M.�C,&0I9"r°................... Foundation ` Rough to be occupied as p� ......5. ....................... ...........��. . ........................................................ Chimney provided that the person acc ting this permit shall in every respe onform to the terms of the application Final on file in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR • UNLESS CONSTRUCT ST S Rough Service .............. ........ .. ............................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. The Commonwealth ofMassachusetis Department oflndirstrial Accidents 7 Office of Investigations i 600 Washington Street �J l _ Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly t Name (Business/Organization/Individual): Address: City/State/Zip: o Phone•#: 1el-_ 91(- 303 [2.0 re you an employer? Check the approp ate box: Type of project (required) � : 1-am-a;e'np ❑loyer with I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have ( S. ❑ Demolition working for me in any capacity. employees and have workers' ` 9. E] Building addition No workers' comp.insurance comp. insurance.t � tN required.] 5. E] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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 employees. [No workers' 13.0 Other comp.insurance required.] 'Any applicant that checks box 41 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. 1Contractors 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: AkAt,�� Policy 9o Self=ins:Lic.#: 9121 w QS G `Ar, Expli-atioti Date: 1ob.Site Add "JI! Ci y/State/Zip '� Attach a copy of the workers' cotnpensatioir poiicy 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 u to $250.00 a da against the violator- Be advised that a P y g t co of this statement may be forwarded to the Office of PY Y Investigations of the DIA for insurance coverage verification. I do hereby certify under a pains and penalties of erjury that the information provided above is trite and correct. �+w �/✓ Si nature: -/ + - (/ Date: Phone #: 7/ '0, 1( 30113 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): I.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: .a-01016 Massachusetts -Department of'Public Safety Board bf Building Regulations and Standards Construction Supervisor License: CS-068.461 NIICHAEL J OKE)'FEUJ4. _ 21 Francis Street North Reading]V1C� 0 " Expiration V 02/24/2016 i Commissioner # Office of Consumer Affairs&Business Regulation SOME IMPROVEMENT CONTRACTOR egistration: _1,46,722 Expiration:=_--r= �--" TYpe: -511=N2fl� DBA "EEFE CONSTRl1G _lsj. 21 r-R9 OWEEFE IS STREE NORTHRE�ING, MA018 4 Undersecretary Page No. of Pages Supervisor CS 068461 P Fully Licensed & Insured Home Construction Reg.# 146722 Q'Keete GOSETTS,� f Roof mg, bYs-77o� North Reading, MA ' 7920 ' H Authorized COLL978-276-3043 ca 11e51aeeRaiRueft11 Iler Certainneed!M PROPOSAL SUBMITTED TO / PHONE dnol 607 DATE STREET (/ JOB NAME CITY,STATE 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: Wla er ❑2 layers ❑3 layers or more Repair/or Replace any roof decking; not to exceed 50sq.ft. Install 8"aluminum drip-edge/and rake-edge along entire perimeter. Choice of mill wh' or brown Install ICE&WATER underlayment along horizontal eaves,valleys, sidewalls and sky-lights&chimneys 6 . V Install premium base sheet underlayment between roof deck and roofing shingles 0d15 Ib.felt❑30#.felt • Install 25yr CertainTeed/GAF/IKO traditional 3-tab roof shingles ❑30 year Install CertainTe /GA IKO architectural Lifetime roof shingles 'See manufacturer warranty policy for more details t/ Install new aluminum vent-pipe flange(s) Chimney(s)-counter-flash and re-step existing flashing ❑Cut& Install new lead flashing 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 O'Keefe roofers will properly dispose of all roof debris in our own dump truck. *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. We Propose hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: Total price not including options. dollars($ Payment to be made as follows: 30%deposit required upon delivery of materials.Balance due in full upon day of completion. Please make all payments out to Michael O'Keefe,21 Francis St., No. Reading, MA 01864 Late charges of$50 per week for all outstanding bills due upon day of Authorized ' completion. Signature -Accepting proposal means agreeing to the terms of the enclosed binder Note:This proposal may be contract. withdrawn by us if not accepted within days