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HomeMy WebLinkAboutBuilding Permit #657 - 55 VEST WAY 4/13/2005tjORT11 0 'rom'N OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION SA US Pennit'NO: Date Received: Date Issued: -6k9 I -M PO RTA N T: A led"t Must complete all Itclils oil this )(2 PROPERTY ONN'NERZ0ke;-/-/--1t- Print MAP NO.: )O -Lt -,6 -.--_PARCEL: 6 ZONING DISTRICT: T17PE AND USE OF BUILDING HISTORIC DISTRICT YES El TYPE 7 OI= I Al " K U v'EMENT PROPOSED U -SE Residential New Budding 'V. One family -i Addition Two or more family Alteration I No. Of L11litS: Repair, replacement Assessory Bidg j Demolition Moving (relocation) Other Foundation only DESCRIPTION OF WORK TO M - PREFORMED - K S4, (I Vk- OWNER: Nanie: Address: S CONTRACTOR Narne: Address . : -* Supervisor's Construction License: Non- Residential -- Industrial ,L.1 Commercial 1-. Others: aturc L -- f Exp- Date: 1-follicillipi,o�eliiciitLicense: -Exp. Address: Naine: Phone: Reg. No. FEE SCHEDULE: BULDING PER,411T.SMUM PER $1000.00 OF THE TOTAL ESTLIM TED COST BASED OA $125.00 PER S. F. Total Project Cost Y Check No. .: x10.00 FEE:$ ���� Receipt No.: ME f TYPE OF SBk ARGE DISPOSAL Public Sewer i - Well Pri\ate (septic tank, etc. Tannin�,,r'IVlassa e,Body ,\i -t Tobacco Sales Permanent Dempster on Site SNvimming Pools - Food Pa4a in- Sales L---- — — NOTE: Persons rontrartinti otvith wrregi.st orad Contractor, da not have access to the guarant). ./rued SWIInjture. of Agent%Owner _ Signature of Contractor Plans Submitted Plans Waived DCettitied Plot flan Stamped Plans !__! THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION .x COMMENTS__ HEALTH COMMENTS DATE REJECTED DATE APPROVED ❑ u Water Shed Special Permit I -j Site Plan Special Permit ❑ Other DATE REJECTED DATE APPROVED ❑ E DATE REJECTED DATE APPROVED Jl 'Coning Board of :'Appeals: Variance, Petition No: 7.onine Decision,'recciptsubmitted yes ---_._.-_-- Planninu Board Decision: -------_--.--Comments Conservation Decision:— _----comments-- \k --Comments—AA iter & Scwcr connection signature &, date _ Temp Dumpstcr on itc yes__no__ Fire Department ,J.natUre'date Building Permit ,approved and Issued by: Building Setback (ft.)F----Fi-oiit Yard Side Yard Rear Yard DIMENSION Numhu ofStcxicu:___ Total land uou yl. fi.: Total square feet o[floor area. hxscd'mFxbriordimcusions—___—__-- IN o"~.IM( '=z~o 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 Lj Debris Removal Form ❑ Workers Comp Affidavit Photo Copy Of H.I.C. And,`Or C.S.L. Licenses u Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Pen -nit Application ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Form ❑ 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 ❑ Form U ❑ 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 Fnergy Compliance Report In all cases iI' a i ariancc or special permit was required the Toy+n Clerics 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 H ith the building application Doc: INSPECTION U. SER% R ES nr:11.%R'rNiB\'r:BrroR\I09 Location S,(— tl6o-�— No. Date TOWN OF NORTH ANDOVER .7 Certificate of Occupancy $ Building/Frame Permit Fee $ 3 CHUS Foundation Permit Fee $ k/ Other Permit Fee, ?0 0),$ TOTAL $ Check # 19123 Building Inspector FROM :DEMPSEY ROOFING FAX NO. :1979 368 1104 Apr. 13 2006 01:55PM P1i1 Dempsey Construction & Roofing Specialists 7 Richardson Street Billerica, Ma 01821 978-670-8904 �- t.ustomer Name Loretta Middleton Address .5 Vest Way City North Andover State Ma ZIP 01810 Phone _._. mmmmom Proposal el Date 4,'13/2006 Order No. Rep FOB .,....-_—•-. __. _ _ Deaeriptlon _ _ _ Unitr Pities TOTAL Install B" aluminum drip edge around entire perimeter.. " ' ._ - Install new 3" pipe flange Counter flash and tar chimney where necessary. Install 30 Yr roofing Minglt?ss. nnlnr R ,style determined home owner. Cut in and install shingle over ridge vent. Remove existing solar heat unit before work begins & re- install after roof is completed at an additional cost of $40.00 per man hour. Price includes material and labor. raymunt ve161r5 O > ® Check O payable to Eric Do ey SubTotal Shipping & Handling Taxes State -TOTAL $4.400.00 ........... _...... _ .... Office Use Only Five year warranty on workmanship O z W) w W V " T ©®! z C T U w a w F U W U W w0' cn w c� p a w W O cin a� cn 2 y CD .co CL O Z c O CD 0 m r -M GO O O CL y C O m C ear CO)LLI LLI U) W W ce W U) ca C'w' O m C C i O ` O N C O C.3 CU • : ac ev oCc EQ CF N O m E y.v � mo '03 H c a•c a p s _m Mo cc 44 ccc OEm o :g 0: a- _ c cv � m o m cc ac os c c I:cNa Ma �+ .S m w Z o �+ c O O. C_ CD . = m 421 a N O w m W t •CNd O dZ C `r cc •N Z O LLJ C.3 4D O CD CL i lt/Jp `O H O Q K m :vp 2 y CD .co CL O Z c O CD 0 m r -M GO O O CL y C O m C ear CO)LLI LLI U) W W ce W U) ca n ✓i2e "�JO�r�YIs20�'w/P,CL%ifi2 a�✓�CZdolLcfiuGeiC6 - I Board of Building Regulations and Standards — HOME IMPROVEMENT CONTRACTOR Registratio9;:150272 Exp'irat10n 3l21/2008 Type Ifidi ual DEMPSEY CONST & ROOFING ERIC DEMPSEY 7 RICHARDSON ST �uQ, BILLERICA, MA 01821 D putyAdm"inistrator License or registration valid for individul use only I before the expiration date. If found return to: li Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ma. 02108 ,I Not valid hout signature A 0%,0% w a "-imu.. CERTIFICATE OF LIABILITY INSURANCE PRODUCER E SCHAFFNER INSURANCE 078 851 2727 TWIS CERTIFICATE IS ISSUED AS IANCE AGENCY ONLY AND CONFERS NO RIGW A N ATTEF of 1147 MAIN #201SUR Ts JPON THE HOLDER. THIS CERTIFICATE DOES PO BOX 777 TEWKSBURY, MA 01876 INSURED DEMPSEY CONSTRUCTION ROOFING SPECIALIST,INC 7 RICHARDSON ST BILLERICA MA 01821 e ENE AFFORDED EIYO T EI POL DATE (MM/DD/YYyy) 02/03/20o5 ITE OR INSURERS AFFORDING COVERAGE NAIC # INSURERA NAUTILUS INS COMP ____ _._. _ __ INSURERB: INSURER^ ... _ .___. _. ._.._ _.... ... . Ii URERD; COVERAGES � _�-- -- - oURER E. _._.._.. _......_— ..._.._-- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ANY REQUIREMENT, TERM OR CONDITION OF ANY C'ONTRACT MAY PERTAIN, THE INSURANCE AFFORDED BY ABOVE FOR THE POLICY PERIC D IN 71C TTEI WITHSTANDING .NOT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS . HE POLICIES THE R AGGREGATE LIMITS SHOWN MAY f?Y THE P N RE D CER'"IflCAT MAY BE ISSUED OR SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS: EXCLUSIONS AND 1 ONDITIONS IPOLICIES. _ - - - - -PUCE INSR I DD'L — -- D BY PAID CLAIMS. OF SUCH _ R 1"--- P POL.iCYNUMBER OUCYkFFEGTIVE POLIC'EXPIRATION -- ' I DarErMMroDmI �- --- GENERALLIABILITY A COMMERCIAL GENERAL LIABILITY niC381714 _ DnTs,ug � EAchoc u r ITS 1.DDd,�O� -t � _X —. ; _... i 1 CLAIMS tdADE occur, DAAG�I!RREFICE .-.. _. _ _ 9!3104 9/3/05 i REN'ED_ .... PREP W S (Ea ocI urence)s 50 000 - _ I ;.MEDEXP(At so onr Pern) S r _ 1,000___ - ----- -- PERSONAL 3 ADV INJURY S_ 1 000 000 - .... _ GR -- LAGGREGATE _ GENERALAaGRFGATE $ 2,DOD,000 ✓_ i _GEIJLAGGREGATEt.IMITA�PLIESPER _t II POLICY " PROS �— i (( LOC PRODUCTS, CON PIOP AG( S 1,000 DOO - -- [AU OMOBILE LIABILITY ANY AUTO �— t COMBINED';INGL- LIMIT (Ee accident) ALLOWNFOAUTOS F - -- ---------.__.--- SCHEDULEDAUTOS BODILYINJLRY (Per person) E I HIREDAUTOS r---BODILY NONOWNEDAUTOS INJLRY I (Per accident, LS /r- I PROPERTY DAMAaE ! ; (Peracciden[ u GARAOELIABILITY AUT0ONLY EAA,:CIDENT 3; ANYAUTO..._-.--_._—.•-- OTHER THAN EAACI Z �' AUTOONLY:- EXCESSIUMBRELLA LIABILITY - ( (OCCUR nCLAIMS EACH OCCURREN:E $ �- MADE AGGREGATE . , I DEDUCTIBLE $ RETENTION $ ---..._._-- .I .. ---------=---__._ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY - r WC STf TU --%TI I$ _TORY LIIILITS...._� ANY PROPRIETORIPARTNER)EXECUTIVE I i E.L.EACH ACCIDE! IT OFFICERANEMBER I I E.L.DISEASE EA! $ z eunderEXCLUDED? If yae, deacrlbe antler � SPECIAL PROVISIONS below _ _ E.L. DISEASE > POL ICY LIMIT IS ! OTHER -- L_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CARPENTRY AND ROOFING CERTIFICATE HOLDER CANCELLATION ----- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES IBE CA VCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOF TO MAII _ DAYS WRITTEN NOTICE TO THE CERTIFICAT ' LOER NAMED TO THE LE F BUT 141LURE TO 00 50 SHALL IMPOSE NO OBLIGATION IA ITY O N D UP E ISU ER, ITS AGENTS OR REPRESENTATIVES. IIIIII AUTHORIZED REPRESS TA E AC DRD CI IRPORATION 1988 RightFax Norcross 0/21/2005 10:26 PAGE 006/010 Fax Server POLICY PERIOD TO WHICH THIS ILL. THE TERMS, $ 77. $ B $ $ $ S $ 100 ODO $ 500 000 $ 100,000 COVERAGE. .. IFICATE IS DAS A . A, T141S PRODUCER ONLY AND CONFERS NO RIGHTS UPON THI JOHN MCBRIDE JR INS AGCY PO Box 173 HOLDER. THIS CERTIFICATE DOES NOT AMEN ALTER THE COVERAGE AFFORDED BY THE POLICI COMPANIES AFFORDING IMVI:RAGE NORTH BILLERICA MA 01862 COMPANY 72RJG A CONTINENTAL CASUALTY COMPANY INSURED COMPANY DEMPSEY, ERIC B 7 RICHARDSON ST BILLERICA MA 01821-2514 _ COMPANY C COMPANY D VBRAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TH INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH IESPEC' CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB..ECT TO EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(IWDD\.YY) POLICY EXPIRATION DATE(MM\DD`,YY) ,. IT LIMIT . GENERAL LIABILITY GENERAL AGGREGA`"E PRODUCTS-COMP/CP AGG COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR. PERSONAL B :IDV. IP JURY OWNER'S 8 CONTRACTORS PROT- EACH OCCURRENCE FIRE DAMAGE Any ois fire) MEC. EXPENSE. (Any me perso AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) HIREDAU70S BODILY INJURY NON -OWNED AUTOS (Per Acvdent) FROPERIY DAMAGE GARAGE LIABILITY AUTO ONLY - EAAi:CIDENT OTHER THAN AUTO ONLY. ANY AUTO EACH A ,CIDENT AGG?EGATE EXCESS LIABILITY EACH OCCURRENCE: UMBRELLA FORM. I AGGREGATE T� OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND EMPLOYER'S LIABILRY THE PROPRIETOR/ PARTNERSlEXECUTIV[ (UB -665X918-0-05) 08-27-05 08-27-06 STATUTORYLIMITS EACH EACH ACCIOEiJT DISEASE—POLICY LI AIT DISEASE—EACH EMPLOYEE OFFICERS ARE: X EXCL -RIERIPT—' OTE ION OF OFFRITIONS/LocA-noNwvE-Me—LT&-grgTR-MNSiSPFCNAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WO:2KEI.S COM POLICY PERIOD TO WHICH THIS ILL. THE TERMS, $ 77. $ B $ $ $ S $ 100 ODO $ 500 000 $ 100,000 COVERAGE.