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Home My WebLink AboutBuilding Permit #150 - 50 MARBLEHEAD STREET 8/25/2006 TOWN OF NORTH ANDOVER pORTH APPLICATION FOR PLAN EXAMINATION of •o .6 6 r '6 0 Permit NO: � Date Received Date Issued: ��06 �9SSA NUS��gS IMPORTANT: Applicant must complete all items on this page LOCATION �® AUE] -ST' � P int PROPERTY OWNER > / �011E*ftmczo� r Print MAP NO.:__9__PARCEL: [ ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ❑ One family C Addition Two or more family 2 Industrial Alteration No. of units: Repair, replacement ❑ Assessory Bldg a Commercial Demolition -. Moving(relocation) ❑ Other ,J ! Others: Foundation only DESCRIPTION OF ORK TO BE PREFORMED ( C Identification Please Type or Print Clearly) OWNER: Name: 17ry C-0- " i rz�-. /-y c/`l v Phone: Address: t2�"aaeyk.e h ne: CONTRACTOR Name: ✓I"!�K��V [� P o Address: �/ � d� h�►/a.., I�ir�� ym Supervisor's Construction License: GSG �7��-C Exp. Date: <Y o '7 ? Home Improvement License: 3 � Exp. Date: ARCHITECT!ENGINEER Name: Phone: ,'address: Reg. No. FEE SCHEDULE:BULDI,NG PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ONS125.00 PER S.F. Total Project Cost :S f''!�4n041 x12.00-FEE:S Z6,00", Z>b Check No.: � Receipt No.: Paige Iol'3 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:INSITC ZONAL SERVICES DEPARTN1EN'1 MFORN105 TYPE OF SEWERAGE DISPOSAL Tanning/Massage!Body Art ❑ Swimming Pools _1 Public Sewer Well Tobacco Sales l Food Packaging/Sales ... .. _ Permanent Dumpster on Site _ Private(septic tank,etc. _ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans 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 ❑ ❑ COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision:"receipt submitted yes Planning Board Decision: Comments Conservation Decision: Conmients Water& Sewer connectioniSi n re& Date Driveway Permit Temp Dumpster on site ye._ no_ Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Re aired Provided Dimension Number of Stories:_ Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) Pale 3��f'4 Doc:INSPECTIONAL SIAMUES DEPARI'MEV"I':131'FORM05 Location Z F r ✓ `� L No. � Date S`- 6 '4 �oR,M TOWN OF NORTH ANDOVER SOL � 9 i Certificate of Occupancy $ +�mob+ ,•'s 'Ss,cMusEBuilding/Frame Permit Fee $ s Foundation Permit Fee $ t Other Permit Fee $ TOTAL u Check # 12 :7 1 y 19520 `r` `Buil g Inspector `ter txORTM Town of 4 L Andover No. �SO ' 0 LA E over, Mass., d& COCMICME WICK ADRATED PPa\ "♦y `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .... .....6-teol"Arr-I..�...... ................... ............... ...................... Foundation 1 g ..• �� Q � Rough has permission to�et.Jr*,tSh&.1q%. �v buildings,on...510..... g to be occupied as..... �t........ /f. .. .... ..� 1/ ��...A.... ..................................................... Chimney provided that the person acting this permit shall in Dry respect con orm to erms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspec ion, Alteration and Construction of Buildings in the Town of North Andover. Q / I W3 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final TOR UNLESS CONSTRUCTION ST ELECTRICAL INSPEC S Rough ...... Service ..... ... ... ..... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFina, No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. Page No. of Pages 7proposal R.D. PAINTING & ROOFING Roofing • Painting • Seamless Gutters • Decks Rich DesRoches 603-289-6648 John Smith 978-457-0821 PROPOSAL SUBMITTED TO PHONE / DATE A5 r STREET JOB NAME ✓ CITY,STATE and ZIP CODE JOB LOCATION ARdHITECT DATE OF PLANS JOB PHONE J-t MA Registration We hereby submit specifications and estimates for: Cover house and shrubs with tarpaulins for their protection. r' I Strip entire roof area of house. Renail all loose roof boards. L J Install0 or 6 feet of ice and water shield under shingles at all gutter edges,valleys, and chimney. Install aluminum drip edge to all edges, color (white, silver, brown). '6 Install 15 Ib. felt underlayment. '7?Reflash dormers and wall areas if any as necessary. i:8)Weave all valleys, if any. 9�Install new roof flanges on vent pipes. , L� Install new roof shingles to all roofs on house (manufacturer, style) S �`� color ,0) install new counter base flashing on chimney base. (1_' )Replace all rotted roof boards up to 50' no charge; $5.00 per foot thereafter. 13! Optional Features: ridge vent to all peaks hurricane nailing 11A new lead chimney flashing. 14 Flat roofs—A 15 Garage J/ Magnetic clean-up for nails.All debris to be removed. Fully licensed and insured. We take no responsibility for dust or debris in your attic. Please cover or remove valuables. Also, not responsible for dish operation. Rrath-&-3vw; Inc.will warrantee all labor for five years excluding storm or fire damage. "You may cancel this agreement if it has been consummated by a party thereto at a place other than an address of the seller which may be his main office or branch thereof,by a written notice directed to the seller at his main or branch office by ordinary mail posted,by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement." Contractor agrees to start work on/or about r weeks after final fittings and complete work in about working days. WE PROPOSE hereby to furnish material and labor- complete in accordance with above specifications, for the sum of: dollars Payment to be made as follows: c200 Credit card payment: ❑MC El Visa ❑ Discover One thiAdown, balance upon completion Card No. – Exp` ,per: Includes 5%Mass. sales tax. Signature All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications involving Signature Authorized extra costs will be executed only upon written orders,and will become an extra charge over and Signature above the estimate. All agreements contingent upon strikes, accidents or delays beyond our Note:This proposal may be control.Owner to carry fire,tornado,and other necessary insurance.Our workers are fully covered withdrawn by us if not accepted within days. by Workman's Compensation insurance. ACCEPTANCE OF PROPOSAL - The above prices, DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Signature Date of Acceptance: Signature Board of�ui ding�gulatidns:gad,'tan arils ? ', HOME IMPROVEMENT CONTRACTOR Registration: 142387 Expiration: 4/1/2008 Type: DBA F �i. RAY PARKHURST REMODELING RAYMOND PARKHURST 44 BATEM AN ST. t i. HAVERHILL, MA 01832 Deputy Administrator $ a, Y �.,�._._....�....»._, x. _....,._.•.c:..t:..•.s4'avd..,ac'le.+e«"m'"mya:;,.:`�r ACORD CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) TM 0811612006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cowan Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 359 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Haverhill MA 01830 INSURERS AFFORDING COVERAGE NAIC# INSURED Ray Parkhurst INSURER A: Western World Insurance Company 44 Bateman Street INSURER B: INSURER C: Haverhill MA 01832 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY.BE ISSUED..OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $300,000 A X COMMERCIAL GENERAL LIABILITY NPP887018 5/4/2006 51412007 DAMAGE TO RENTED $5O OOO CLAIMS MADE FX I OCCUR MED EXP(Any oneperson) $5,000 PERSONAL&ADV INJURY $300,000 GENERAL AGGREGATE $600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $600 000 X POLICY PRO LOC j AUTOMOBILE LIABILITY-..__._.._ ,l.I.... - .•+ - --- --' - ' - - - - COMBINED SINGLE LIMIT (Ea accident) ANY AUTO $--...accident) . .. ALL-OWNEDAUTOS ii BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F—I CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under ' SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER _ .__.. -- of DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS I Carpentry contractor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Dan St Jean ' DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 42 Smith Corner Road NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Newton,NH 03858 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988