HomeMy WebLinkAboutBuilding Permit #723 - 50 BLUE RIDGE ROAD 5/18/2010May 18 10 10:38a
Permit NO: Z3
NORTH ANDOVER
9786889542
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
p.2
0 (41-io-ift
, p
OWNER: Name:
tion Please Type or Print Clearly)
D
��t • � `tel
7
Location zw y .0&(No. --) Date
TOWN OF NORTH ANDOVER
Check # ;C�
23 1 /1
Building Inspector
Certificate of Occupancy
$
��s'••E<�
JAUS
CH
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check # ;C�
23 1 /1
Building Inspector
May 18 10 10:38a
Plans Submitted
TYPE OF SEWERAGE
Public Sewer
Well
Private (septic tank, etc.
NORTH ANDOVER
9786889542
Plans Waived Certified Plot Plan Stamped Plans
7T:nglMassageMody
Art Swimming Pools
Tobacco Sales i Food Packaging/Sales
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 Si nature
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/sig nature & Date
Driveway Permit
DPW Town Engineer: Signature:
P.3
May 18 10 10:39a NORTH ANDOVER 9786889542 p.4
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
NU I t5 and UA1 A — wor department use
ri
❑ Notified for pickup - Date
Doc.Building Permit Revised 2010
May 18 10 10:39a
IL
NORTH ANDOVER
9786889542
Building Department
The following is a fist of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
Building Permit Application
V Workers Comp Affidavit
Photo Copy Of H.I.C. And/Or C.S.L. Licenses
VCopy of Contract
p.5
zi Flow 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
n 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)
z, Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
zi Mass check Energy Compliance Report
o Engineering Affidavits for Engineered products
TOTE: 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 2008
Pat Peet
50 Blue Ridge Rd.
North Andover, MA 01845
(978)685-7619
(978) 685-3734 (fax)
Dear Pat,
Roofing • Siding • Painting
HIC #154326
EIN# 56-2618812
Job #:
May 6. 2010
The following estimate is for the roof installation for the property located at the above address. The following paragraphs describe the
work that will be performed.
Installation Procedure
d. Remove existing shingle roof on the entire house
4 Install an 8 inch drip edge on all leading edges
4 Install 6 feet of ice & water shield on front leading edges & valleys
4 Install 15 pound felt paper on all areas not covered by ice & water shield
Install new ridge vent
4 Install new vent pipe flanges
4- Replace any rotten or damaged roof decking plywood (we allow 32SF @ no charge, $65.00/sheet thereafter)
4- Replace any rotten or damaged roof decking ledger board (we allow 30ft. at no charge, $5.00/ft. thereafter)
4k Replace any rotten or damaged fascia or rake boards @ $10.50/ft
4, Install new GAF 30 -yr Architectural shingles
4 Chimney Lead Flashing - Remove existing lead flashing on chimney, install ice & water shield, step flashing, and grind new
lead flashing into chimney (included in price)
Additional Snecircations
4, Homeowner to choose color of shingles COLOR:
4 Our dumpsters are sent to a recycling facility; therefore no additional trash maybe placed in them. The transfer station will
charge us a fee which will be passed on to the homeowner.
,k Transition walls are an option, and if the existing flashing is in good shape, usually do not require replacement
4k We are not responsible for any of the cracks that may arise in any walls or ceilings
4 Please cover all your floors in your attic to protect from dust and debris
ak We will remove all of the job related debris
Permit costs vary from town to town and are not included in this bid
Cost for Labor & Material for New Shingle Roof:
$11,950.00
06,
Payment Terms: 1/3 deposit upon signing contract S ',Av. ,1/3 work in progress S and 1/3 upon completion $
Remit to: Alpine Property Services Company, Inc., P.O. Box 365, Topsfield, MA 01983
j
Total Amount Agreed To Be Paid: $ A
The following schedule will be adhered to unless circumstances beyond Alpine's control arise:
Work Scheduled to Begin: TBD
Expected Date of Completion: TBD
Warranty: Alpine Property Services Inc. guarantees all work performed for a period of one year. If any problems occur we will cover
the cost of all labor and material to correct the problem and meet the customer's satisfaction.
Do not sign this contract if there are any blank spaces.
(additional provisions follow and are incorporated herein by this reference)
Y ni aniatis, frroject Manager Pat Peet
Ipine Property Services Company Inc., Homeowner
d/b/a Olympic by (Name)
Tel: (800) 535-4312 • Fax: (978) 887-5875 • 239 Boston Street • Topsfield, MA 01983
1-888-50LYWIC • www.olympicroofing.com
y ACORD. ",1/1412010
4lUWim n ' '
s
PRDoucEA.
TMI8.CFRTIFICATE 1819$ vT;?r�awaATlolr
ONLY CONFERS NORIGH78 UPON THE.GEiitTlflCi4itf:,,
TTlatiND
H. J. Knight 1nteonal IOSIII8IICC AgrnCICs, Inc.1nC.
HOLDER• 1TIR CERT KATE DOES NOT AfAE]JDt EXTENp vR ...
500 'Victory Road - Marina Ray
ALTER 7TyE COVERAGE AFFOROED SY THE POlIC1ES 9i=1rnr,
North Quincy, MA 02121MPA
TrES MURU NG COVERAGE.
I
COMPANY
A Allautic Chericr Insurance Company VDAC
aAHA�
COMPANY
Alpine Property Serviccs Co., Inc.
• .
COMPAMY
PO Box 365
C
-TwOeld. MA;- - 01983 ..
co►,+PANr-...:..::..•: - _ ... ,.
.:p i
THIS is TO CSR760Y Y AT THE rOLIRES OF INSURANCE LISTED BELOW HAVE SEEN SSUeO TO YME Dmu ftv NAMED ABOVE FORTHE POLICY. P04100
INDICATED. NOTWITNSTANOaG ANT PMUIM eEW.TERM OR CONDITION OF ANY CONTRACT OR OTHER 009MV47 WITH RESPECT TO WFBeM TMIs
cermFICATE MAY BE ISSUED OR MAY PERTAIN, YK IMUitAPHCE AFPORDED BY THE POLICIES DESCP46EO HEREIN IS SUBJH;CY YO All THETEWAS,
E)LCLUSIONB ANO cONOITON5 OF SUCH POUM. UVM SMDWM MILY X^vE ftCh REDUCED BY PAID CLAIMS.
OO TYPE OF *sun'.= POLICTNUMBER
PDUCYErFKnVE FVLMULPIRATDN :L1MRS':
ETR
DANE (MAM W M DAYd (mum RY) {In Tiw••od•1
OVJV" tA=JIY
B=YNRYO
Zti13
CCMPREMENSVQ fQM4
BLYNURACp
REMEOv"TIONS
•
OAw
UFxNOPIrARB61R00t+U
PROPMY, DMB
aNGDT�LLAosE HA7AA0
OSI a PDm"ED OeCC
PRODUOTS=.WLEMOOPER
014PDCOMWNEDAG6 3
CONTRACTUAL
PM90N ►L IIUURY A00 T
RpEPENpENT CONMCIUMw
L.
{RaVORM MOPERTY OAIMCE
-
PFRSONALINJURY
AUO.
T.? LrASHuTY
Bi7011t lNAuaY
ANY AUTO
a�'P1E
. •.
ALL OrANI=D AITTOS (Pm�s Pwl
BODILY IKftw
ALL OAUTOS
VIMFA
IHyr ••rld•ml ` `
(OM•t Hn.n Plna• Ptwmwd
MIPEDAVIOS
PRWE-RT;'Ft>ANiAOE T
NONMED AUTOS
609tLY VLVRY L
caRAGIGL1ABIlRY
PwOPdAIY DAMAGE
COMRpviD ' 3
EXCESS LIA8A M
E4.1f GCW ErICE' >I V
%MMRIAfORIA
AGGREGATE i
GTNAA THAI• UMBRELLA FORM
'
--R
vroArMna CorrerasTlDN.ro WCV00754901
A
1/52010 1152011
srAnlroRYluwrB '. •
HUICRACCICE)rr ' T ' 500,000
oas;AsE-Pcuc{u mrr ' 500,000
WSEh9E-HJ►CiEErwWTfE•I3 500.000
OTHER
oP gnPATwwLmAnanrvaoa►mP/QN.OEm
SHOULD ANY OF THE ABOVE DESCM13SO POUGES BE CANCI:LL FD SSFOM THE
EXPIRATION DATE T! 99EOF, THE ISSUING COMPANY' VaLt ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE TO T646 CSRTWICAT9 HOLDER NAJAEO TO ;RHE 677.
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSES NO 0KIdd()N1 OR LIABIL(T
OF ANY KIND UPON THE COMPAN , AQENT5.OR rdVATIVES.
Aur"Qr4 OTtg6rm9"NTATVE I I A- - I .Ls
The Commonwealth of Massachusetis
MIJV Department of Industrial Accidents
Office oflnvestigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Ledbly
None (Business/Organization/Individual):
Address:_.2 gq 3 L sit
Phone #: 9:�
Are u an employer? Check the appropriate box:
1I am a employer with �_
4.❑ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2qham
a sole proprietor or partner-
listed on the attached sheet. t
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
3 LJequired.) officers have exercised their
am a homeowner doing all work right of exemption per MGL
myself. [No workers' comp. c. 152, § 1(41 and we have no
insurance required.] t employees. (No workers'
comp. insurance required]
of project (required):
]New construction
7. Kemodeling
8 peniolition
9. uildine addition
or additions
III Plumbing repairs or additions
13 F—Pther
•Any applicant that checks box gl must also fill out the section below showing (heir workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing AU 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.
I am an employer that is providing workers' compensation insurance for my employees Below is the policy and job site
Information.
Insurance Company Name:141+16, 4,d—
Policy # or Self -ins. Lic. #: C �% G� �'J� Expiration Date: /
Job Site Address; fl Al City/State/Zip:
i /State/Ziy– AI A-
DY sovs-
Attach a copy of the workers' compensate n 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.
Ido hereby certify un10, the pains and penaltie jury that the information provided above is true and correct
If
Oficial 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 #:
t
i
i
Massachusetts - Department of Public Safety
Board of Buildint, Re -,dations and Standards
Construction Supervisor License
License: CS 80145
Restricted.to:.00.
GEORGE-'WASIUA --b
5 PITCAlkh;,I VAY •.►
IPSWICH, VR:019-38
i
Expiration: 10262011
Commissioner Trac: 6238
Restricted to: uu
00 - Unrestricted
1G -1 2 Family Homes
Failure to possess a current edition of the
Massachusetts State Building Code
is cause for revocation of this license.
Refer to: WWW.Mass.Gov/DPS
BoaMRZ'auild and Standards
One Ashburton Place - Room 1301
Boston. Mass4phusetts 02108
Home Improvement Contractor Registration
Registration: 154326
Type: Supplement Card
�'• Expiration: 2/27/2011
ALPINE PROPERTY SERVICES 001T.N--
GEORGE VASILIADES s:
11 WILSON STREET ''
SALEM, MA 01970Update Address and return card. Marie reason for change
Address Renewal ❑ Employment r Lost Card
DPS -CAI 0 40M•02/08.OBSLIFORMCA10021200e
Board ofBuitding Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 154326
Ekpliation y272011
Type: ;AOVOlement Card
ALPINE PROPERTX6EES.0
BEeOGE VA
SI
11 WILSONSTREEr:::;!;
SALEM, MA 01970 Administrator
J
�j
License or registration valid for individul use only
before the expiration date. If found return to:
Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Boston, Ma. 02108
Not valid without signature
O;
11
cn
o
.o
c
w°
CJ y O
CC
J3
U
w
x
W
a
a�'
w
x.
o
w
v
a
m
C2
cn
w
o
�
W
cz
w
x
w
v
o
z
0
o
E c
:,moo m
O
os
m c
40
o :m3
cm m
C C
_ m
H O
H
m
:ave
- H m �
•mC
H
CJ y O
CC
J3
*4w
O
C H
p
H
r.. C
O
H,
V C�
W
.Q �
CL C
LL
m A
H
-
;t or
Ccm
D
O �
C�
a m. O42�
f-
C . C -L m
)
C.)
m
E c
:,moo m
O
os
m c
40
o :m3
cm m
C C
_ m
H O
H
m
:ave
- H m �
g
CD
I
INGw-
91
�i
i
.7
O
CD
L
O
Z o
fl.
O y
D �
� c cm
o•—
CD o v
CD
g m m
CD 0=
= O �
�3
'O
O G O
M O d
CL C a
ca
c
Co
C.3 'p
c
Z-ai
CL
V H
c
E
CO)
0
LU
LU
U)
W
W
to
C Q
H
CJ y O
CC
J3
Z
Ci
H
i
H,
O npH
W
CO �._.-02,
�• C
LL
m
•dL C
H
N
p y.+ •fA
O ®
Ccm
D
p C_
C�
a m. O42�
f-
C . C -L m
g
CD
I
INGw-
91
�i
i
.7
O
CD
L
O
Z o
fl.
O y
D �
� c cm
o•—
CD o v
CD
g m m
CD 0=
= O �
�3
'O
O G O
M O d
CL C a
ca
c
Co
C.3 'p
c
Z-ai
CL
V H
c
E
CO)
0
LU
LU
U)
W
W
to