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Home My WebLink AboutBuilding Permit #436-2017 - 55 HARWOOD STREET 10/24/2016 � pORTh""i OFtt4ao 6Ati BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 1 Date Received 0/0 « Date Issued: 0 — a-t3/ �9SS^cHus cEMPORTANT:Applicant must complete all items on this page LOCATION PROPERTY OWNER r�tCri ,,,, (� Print MAP NO: PARCEL: (/l ZONING DISTRICT: Historic District yesrno / Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial 'Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer VO-Anoe- and &DICV r r . Identification Please Type or Print Clearly) OWNER: Name: L coi Phone: �s��Q, i�c� q Address: Sr, Ib M CONTRACTOR Name: 5(�� Phone: 7&L Z33 s5733 Address: L1 ,050-51 1AA 01 g 0 (o Supervisor's Construction License: "7 C 9 L D Exp. Date: � _� � t -� Home Improvement License: Exp. Date: U '.l 6 , ARCHITECT/ENGINEER Phone: Address: Reg. No. y FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 91 ' FEE: $ // -7 '! Check No.: Receipt No.: d'7 NOTE: Persons contractin • unre 'stered contractors do not have access :e g aranty fund Signature of Agent/Owner Signature of contractor 1Y Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ TypF`4F SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ j Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑ t THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS r CONSERVATION Reviewed on Signature t 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 124 Main Street Fire Department signature/date COMMENTS limension 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.Yrequires approval of Electrical Inspector lies No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine i I NOTES and DATA— (For department use) II I I - j i ❑ Notified for pickup Call Email ate Time Contact Name Doc.Building Pennit Revised 2014 r Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. r Roofing, Siding, Interior Rehabilitation Permits I o Building Permit Application o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Pp Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses Li Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) k ❑ Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract act ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products 40TE: 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 . I i l Location f�A4b w e6f) '5 r No. 413(9- 6/7 Date / u i t F, • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# �V r 3 9 Building Mspector f r 1 - NORTH - W" i ve' 'o O F ON 7n .� No. * - h ver, Mass, or 4016 [O["IC Nt wMa . S u BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT .......ST�wr.J� i�.......�.Q.�.�..�� . ................ . N .................................. BUILDING INSPECTOR .......... ...... ..... . ..... .....S.T.....H.A.U. .OA.b. s, � Foundation has permission to erect .......................... buildings on lC... .. .. �/ ....................... Rough ��p n to be occupied as ........ .......A............. Y�................................................................ Chimney provided that the person accepting this permit shall in every respect conform 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCPqN STARTS 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. PE Bo IM Estimate Saugus,MA 0190$US easte 33 5333 EASTED Neastemconstruction(r�comcast.net eastemconstru ction.net i CON STRUCT I ON ADDRESS Michelle Mulvena 55 Harwood Street North Andover,MA EsriMATE# DATE 6671 06/20/2016 P.O.NUMBER Strip Roof D!FSCRIPtOfu OF WORK 1---Tarp off house and yard as needed for protection against falling debris 9,775.00 2--Remove all existing shingles from entire roof of house 3---Remove and replace up to 60 square feet of roof decking at no extra charge *an additional charge of'$4.75 per square foot may be added to this estimate If more than 60 square feet are required 4---Resecure all exposed roof deckingg as needed 5---Repair and or replace all step flashings as needed 6--Install 6 feet of new ice and water shield on all lower edges and around all flashings 7---Install new 15 Ib felt paper over all exposed roof decking 8--Install new 8 Inch white aluminum drip edge on all edges of all roofs 9--Install new GAF architectural roofing shingles with a limited life time warranty on entire roof of house 10--Cut roof boards at peak of roof as needed to ensure proper ventilation 11--Install new Cobra Ridge Vent on peak of roof 12--Install new architectural ridging on peaks and hips 13--Seal all flashings using fibrated roof cement and asphalt membrane,and or Geocel Tripolymer Sealant 14--Remove all job related debris 15--Eastern Construction is responsible for all necessary permits 16--Workmanship on new roof Is warranted for 10 yrs under normal conditions 17-Deduct$980.00 from this estimate for not removing and replacing the rear roof of the garage All materials are guaranteed by the manufacturer. All work is to be completed in a professional manner according to standard practices. Any hidden conditions,alterations,or deviations from above specifications involving extra costs will be executed upon written orders,and will become an extra charge over and above the original contracted price. All agreements aro contingent upon weather and/or delays beyond the control of Eastern Construction. An initial deposit of$200.00 is to be paid upon proposal acceptance. 'Add 3%for Mastercard.Visa,and American Express transactions 'All roofing estimates are based on removing up to two(2)layers,unless stated otherwise 'When your roof is being removed,please remember to cover and or move any valuables in),our attic *Workmanship is warranteed on new roofs for 10 years under normal conditions 'All estimates are based on current product pricing and are subject to change without notice 'Any changes,variations,.or alterations to this estimate will result in additional charges License CS-075948 expiration 3/6/2017 TOTAL HIC#182642 expiration 7/13/2017 99775.00 Accepted By Accepted Date �7 l� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Naive (Business/Organization/Individual): Eastern Construction Address: City/State/Zi 01 Phone#: -797-233-5333 Are ou an employer? Check the appropriate box: Type of project(required): 1 I am a employer with 4• ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance. t ❑ required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ 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 13.F] Other employees. [No workers' comp. insurance required.] *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 anew affidavit indicating such. :Contractors 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: Policy#or Self-ins. Lic. 01 PJ 08a ala4_70 l 6 Expiration Date:_,:51:PiE[ 7 Job Site Address: S S K"YYY) J r City/State/Zip: .Mal 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. I do hereby cer ' (ier 1way'/xs�ed penalti perjury that the information provided above is ue and correct: Si ature: C�✓ Date: Phone#: Mf--cM I 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#• f A Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License:CS-075948 I IS '.N .. STEVEN R KAL*N ��% PO BOX 1266 = �? SAUGUS MA 01506 ' Expiration Commissioner 03/0612017 License or registration valid for individul use only before the expiration date. If found return to: -_Office of Consumer Affairs S Business Regulation 4HOME IMPROVEMENT CONTRACTOR Type office of Consumer Affairs and Business Regulation r�V,tPR182642 10 Park Plaza-Suite 5170 Corporation Boston,MA 02116 Expiration: 7!1312017 AA&K CONSTRUCTION CO,INC. STEVEN KALMAN �� _-_--_—_ ---- ------ - 4 HEWLETT STNot valid without signature SAUGUS,MA 01906 undersecretary 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 ❑ ❑ COMENTS 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: Comments Water& Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 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) i i i ❑ Notified foricku - Date P P Doc.Building Permit Revised 2012