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Home My WebLink AboutBuilding Permit #10 - 515 MASSACHUSETTS AVENUE 7/7/2008 BUILDING PERMIT o* r►ORTF/ ,,-T.rD 16�ti TOWN OF NORTH ANDOVER APPLICATI:ON FOR PLAN EXAMINATION so- * � Permit NO: l Date ReceivedArp -� �t7 ��SSAc►+usE�,c`� Date Issued. 0 n IMPORTANT: Applicai%t dust complete all items on this page. LOCATION .��K I�YJrS"� tuSs' v - Print PROPERTY OWNER_,QJ U � Print MAP NO:D �3 C,_PARCEI_Pdyo ZONING:DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family A Two or more family Industrial No. of units: Commercial pair, replacement Assessory Bldg Others: emo i ion Other Septic Well floodplain Wetlands . Watershed District,_ Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: � Qr� 44,& dve�e Identification Please Type or Print Clearly) OWNER: Name: 4 Phone: A E/l�i41� Address: CONTRACTOR Name:' Phone: �slr ' Address:C,. lS Supervisor's Construction'License: .5</5,z Exp. Date: 3 .,20/40 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: $ v�ga� FEE: $ l Check No.: /R U �a Receipt No.: 1 0� NOTE: Persons contracting with unregistered contractors do not have access to theguaranty fund i gnatFure of Agent/Owner, Signature of contractors �,, 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 Dor.INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL ' Public Sewer Tanning/Massage/Body Art Swi ing Pools Well Tobacco Sales , Food Packaging/Sales i Private(septic tank,etc. Permanent Dumpster on Site� l 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 Town Engineer: Signature: Located 384 Osgood Street .FIRE DEPARTMENT -Temp Dumpster,on.site yes no Located;at 1-24'Main Street Fire:Department signature/date COMMENTS 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 Location �� l¢✓'G No. U Date pORT1y TOWN OF NORTH ANDOVER owl9 iwo ; : Certificate of Occupancy $ �'�s'•^ E<�' Building/Frame Permit Fee $ ncHus Foundation Permit Fee $ "" Other Permit Fee $ t TOTAL $ Check # 2 4 299 Building Inspector CONTRACT WORK SPECIFICATIONS aw x Mass HIC# 100468 RI HIC# 17166 01 'M_ _ Initialing this page indicates receipt of the CONTRACT TERMS T AND REQUIRED NOTICES as page 1 of this agreement. DMsion oto L�-J�I��" DIHIc#100468 MA 17166 RI q q est 1959 Owners Names A 1 y e. E k f\AGt� :50 Getchell`WaYh Canton, MA 02021 781-963-7900 Home Tel.No. `1 TS - U75 i! , H(,,Z.3 Bus.Tel. No. e-mail Job Site Address �: �kk A-,j t- CitST MA Zip 0%3`-i.S . Details of work to be performed and materials to be supplied follow . ON L ea w +n S c.�' C, f w . :1 e,c) Q °e\t,v� +� �Lf5tCtv-\A-t_ V, C< < (�i 1 '�`✓+ -w ``-X' i ` R.-,,, f� { t+S'�` b V ^�. C-Cl'\ ' ' 1 o c_ `, Y Sl G f 11 1, .r 1 nnii )C `C r C ,- t 1 4•�-Com`%W\nom' n �� VV��.,�. �}.-✓aJ f\-�C.N 4+.�r/ 'ry{rte � � .�...1..� �:T a+ �..^ham t MSS C j {p-,p 'Initials Acknowledging this page:Alumabilt,Inc. Hwner �/ Homeowner Date tc. / l C HOMEOWNER: Do not sign this contract if there are any blank spaces. You have a right to a copy of this contract. Page of 1 ' 71 Board of Building Regulations and Standards r HOME IMPROVEMENT CONTRACTOR Registr 000, 151245 ESpltttt3 5/?3/2010 Tr# 266180 JW MALING CON$T,.R( JAMES MAILING 1 r 4196 MAIN ROAD TIVERTON, RI 02838 Administrator VkORTH Town of _ Andover to No. o Ip o = :; o �` dower, Mass., ' y o0 �. COCMICMEWICK RATED BOARD OF HEALTH Food/Kitchen PERMIT T D - Septic System o BUILDING INSPECTOR THIS CERTIFIES THAT...../..4..IV1......... ..d� . .. Foundation has permission to erect........................................ buildings . ............r . .......! �.l ...^.�.............. Rough • to be occupied as../.....0A.4. di�!!r....�......�.....�.o 1�.:..s.......... ........A&-t.� i. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR ARTS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det.. r \ The Common wealth to Mas Of sachtrsetYs' 1 Department of Ad=trial Accidents ;.rl DffWe gf1,n estigatioW . ti54 1500 Washi>zdjon Street Boston, r� MAOZIII Workers' Compensation Iaeuraaee www"=Mgov/dia A Applicant Information fftdavi� Buijders/Confractors/EiectriciRns/Plambers Please Print Leoib Name:fBnsiness/Qrgaaizatioti/Individt�aF}: ly Address: C9� City/state/ : - ' ,9• ).��j Phone#:_ Are you an em employer?r?Check the appropr.mte•box: I•❑ I lima employer with 4. ❑ I am a Type-df Project(requite: employees(fu}}and/or part-time,* geruerai contractor and I. . . . 2C�1 atrt.asole ] havc hired the szi&contsac�ors 6 []New construction Piopnetor.or partner- listed on the attached ❑Remodeling ship and have no employees s sheet 7. g working for m td�-con�rs have g e �i g m any capaci1.y. workers, comp.insurance. Q Demolition` [NO workers' comp,insw'anCe 5. ❑ We are a corporation and its 9. ❑Bwlding addition ' requited.] 3.❑ I ain a homeowner doing all work officers have exercised theirright of !0.❑Etectrica}repairs or additions myself.. exemption per MQL I I.❑Plumbing [No•workers+gyp, c..t52, §14 'and we have no � r��or additions insurance requtred-]t 12.F7 nPs.[No workers' .❑Roof repairs 'Any RMO mittha eb comp..insurance required.]: 13.❑.Om� eekti bob#i mum also fi[t out flue section blow showing their workers'criittpensationPolicy t Homeowners Who sebMit the aruhivit ind' 4Contrnctots that check this box►oust tceteng they air.doing all work and.then hire outside con infonnati°n r attaobed an additioast shit showturg @sa Winne of the��submit a�'a�dnvit indicgtiog niaFi, f adr an erriP[oyer that.is• thaFr`4O� cOmA•poFFey inlnmtafion. prPvrdirtg:warkefs concperisatuih . inforniafion. �rzsrrrance j`or nry.e�P[aYe� Belo,u rs. . �Pommy mrd job site Insurance Company Name: ' ee^ Policy#or Self-ins. Lic Job Sitz - Eipiraiion Date: Addross: �/S Attach a copy of the.workers''t:out peusation Policy decE$ration Failure to secure coverage as uired under pap(ahowiag the policy Dumber stud expiration dstte} fins up to SI,500.00 and/or one-yt rim Section 25A of MGL c. I52 can lead to the imposition of criminal of up to$250.00 a da imprisonment,as weal as civil penalties intim fonn of a STOP yV0}tK O peruahies of a Investigationsy m°vio}ator. Be advised that a copy of this gmtement may be fnrw PDER and a fine of the DIA for insurance coverage verification. y . wiled to the Office of 1 do herebY certify nder the anis P and penalties afP�T�'y the the iii orma Si f tion provided obave is trice and cormd Phone Dom' Offxial«se only. Do not write tri this area m brz completed by city or town offrcio[ . City or?owls: Issuing AuthoritycPermitLl;ic=Re# Circle one): 1. Boa i d of Health Other 2- Building Deimrtmeot 3.CiWTown Clerk 4.-Electrical IDspector S.OthPlumbing IDspector Contact Person: phone#; Information. a aid Instructions Massachusetts General Laws chapter 152 requires" empIoyers 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, acc< ation,corporation or other legal entity,or any.two or more ofthelbregoing engaged in a joint enterprise,and includiing the legal ropresentatives of a deceased employer,or>ho receiver ortrust_--of an individual;partnership,association or other le P� tP .gal entity, employing employees. Howeverthe owner•of a dwelling house having not more than three apartrnerrts and who resides therein,or the occupant of the dwelling house of another who employs persons,w do maintenance,construction or repair wrrk on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an empioyer." MGL chaptcr 152,§25C(6)also states that"every state o►;- local 6edusing Woe.Y shah 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, MOL chapter 152,§25C(7)states"Neither the:commonwealth nor any of its-polifical subdivisions shall enter into any-contract for the performance of public work until-acceptabit evidence of compliance with the insurance requiremeztts 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-con ractar(s)name(s),address(es)said phone number(s)along with their csrtificate(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 =ry workers'compensation insurance. If an LLC.or LLP does have employees,a.policy is regiiiirZ Be advised.fiW this afirid mv.it.may be submitted to the Department of Industrial Accidents for confirmation of insunnce covwzp.. Also la a sure to sign and slate the affidavit The affidavit should be returned w the city,or town that the applanation 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 requimd to obtain a workers' compensation palloy,:pleasc-mll the Department at the number.listed below. Self insured companies should entertheir soil=iizsuuance.ficenac numoar on the'appropriate line. City or Tonin 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 retarding the applicant Please be raiz to fill in the.permit/license number which-will be used as a reference number., in addition,an appiicant that.must submit multiple.pe rnitllicmusc applications in arty given year,need only submit one affidavit indicating•eurrant policy'infonnation(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy ofihe affidavit that has been officially stamped or marked by the city or town may beprovided to the applicant as proof that a valid afndavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Wherx 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 bum leaves etc.)said parson is NOT required to-compicte this affidavit The Office of investiQ&ns would It z to:ti=k ynu in advance for your cooperation and should you have any questions, please do not.hesitate to give us.a call., The Depamrnent's address,telephone and fax number . The Commonwealth of Massachusetts Departt=nt of Iadustlial Accidents Qfce of Iaveskvsdons " 600 Washington Street Boston-, IIIA 62111 TeL 4 617-7274900 ext 406 or 1-977-MA.SSAFE Revised 5-26-05 Fax:4 61'.7-727-7744 v►ww.iaass.gov/dia I T1. Board of Building Regulations and Standards j Construction Supervisor License License: CS 35196 Up�ratn 13/2.010 Tr# 12612 I�e��ctton 00 �" JAMES W MALINGj 4196 MAIN RD TIVERTON, RI 02878 _Y Commissioner j � lee ��mmwn.,irea/,C,/ a�✓�taaaac/z�,�a� V ,; Board of Building Regulations and Standards s. I HOME IMPROVEMENT CONTRACTOR Registratla 100468 ? i Exp�ratk-, - '1812006 I "' Type Sup''Olement Card ALUMABILT, INC l JAMRS MALING 0j ik 50 GETCHELL WAY'r CANTON, MA 02021 µy Administrator d