HomeMy WebLinkAboutBuilding Permit #728 - 67 GREEN HILL AVENUE 5/20/2010BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
PRQPERTY,OW,NER
'MAP 210 `-- PARCEL:4
Date Received
licant must complete all items on this page
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;ZONING DISTRICT Histone District : „yes 4 r 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 1Nell 4 ± .Floodplain 1Netlands Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED:
:Z -/5V2
ARCHITECT/ENGINEER Phone:
Address:
Reg. No
FEE SCHEDULE: BULDING PERM
IT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ �` FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner _ Signature of contractor'-'
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
Doc: Building Permit Revised 2008
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
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH , Reviewed on
COMMENTS
Sianature
T-oning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Comments
Water & Sewer Connection/signature & Date Driveway Permit
DPW Town Engineer: Signature:
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
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 2010
LZ
Location - " &ILlet,,4 A4 /
No. .- Date %J
*oRT#j TOWN OF NORTH ANDOVER
..:�_..'
Certificate of Occupancyro
$
Building/Frame Permit Fee $ �
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # a
23.1 V6
Building Inspector
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978-262-0200 R REPOS All Work 100%Guaranteed
Cell 478.9946907 �� Q ee
Fax 978-262.0201 �O�ROOFI,�•aq MA Builders Lic#.060526
258 Salem Rd. Suite #3 S C MA Contractors Reg# 147080
Billerica, MA 01821 Fully Insured
SPECIALIST
PROPOSAL SUBMITTED 10 7/PHONE DATE
F
STREET JOB NAME i
;. DATE OR PLANS
s'
Ut PrOpOgt_ ,ereby to furnish material and labor — complbte in accordance
Payment to be made as lollows . f j
� rd
with specifications below, for the{j sum of:
dollars (S s _ ).
NOTICE All home improvement poniraetors and subcontractors engagod in home improve. ,&•;�. ,�'
mnnl contracting, amass speeiheaily exempt Irnm repislrp,ron by prorislons o1 Authorized f' [„--••--°` i �`` ,�..•"
S• nature
ChaplN 142A'n
me General Lara. mull be registered mth the Commonwealth of 9 t jai
LlSasachuselis. InQu,rNl about gg1stt111on and Status should be made to the Note- This proposal may be
D-riclor, Home Improvement Contract Registration. One Ashburton Place. Room
1301. Boston. MA 02109. withdrawn by us if not accepted within days.
We hereby submit spaolkatiorls and estimates tor: ; r -
ROOF WORK
❑ GO OVER ROOF ROOF ONE LAYER ASPHALT SHINGLES.
'13 STRIP ROOF OF kms- -` LAYERS OF ASPHALT SHINGLES,.COVER DECK WITHAUNOERLAYMENT
SER, COVER EXTERIOR WALLS AND FOLIAGE WITH TARPS TO HELP PREVENT DAMAGE.
INSTALL ICE 8 WATER SHIELD AT LEADING EDGE, VALLEYS AND ALL ROOF PENETRATIONS.
COVER ALL PERIMETERS WITH 8 INCH ALUMINUM DRIP EDGE a
=] INSTALL RIDGE VENT.
❑- INSTALL SOFFIT VENTING WITH RIDGE VENT.FOR PROPER ATTIC VENTILATION.
h.,,, COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS.
COUNTER FLASH CHIMNEY(S) WITH ALUMINUM FLASHING_AS N,EE .ED.
RELIAD CHIMNEY. CUT ALL EXISTING TAR AND LEAD FROM ; f CHIMNEY (S), CUT NEW REGLET, CEMENT
NEW LEAD IN PLACE WITH MORTAR. IF NEEDED FOR A WATERTIGHT JOB, ADD TO ABOVE PRICE.
�❑ REBUILD CHIMNEY FROM ROOF DECK UP WITH NEW OR U�ED,BRICK. ADD TO ABOVE PRICE.
COVER ROOF SURFACE WITH
�l REPLACE DEFECTIVE ROOF DECKING WITH a`� irH -AT AN ADDITIONAL COST OF,-"
STORM NAIL ALL SHINGLES WHEN APPLICABLE (SEE MFG. INSTRUCTIONS)
❑ INSTALL SKYLITES PROVIDED BY CUSTOMER, FRAME ROOF DECK AS NEEDED; PROPERLY SLASH UNITS WITH
FLASHING KIT(S) PROVIDED, CUSTOMER TO DO INTERIOR FINISH WORK. ADD TO ABOVE PRICE.
❑ REMOVE EXISTING GUTTERS. ❑ INSTALL NEW SEAMLESS .032 ALUMINUM GUTTER USING THE POSITIVE
LOCKING BAR HANGER SYSTEM.
❑ REPLACE FACSIA BOARDS AS NEEDED WITH PRE -PRIMED FACSIA BOARDS, ADD PER FOOT TO
ABOVE PRICE.
❑ INSTALL NEW ALUMINUM DOWNSPOUTS. POP RIVET ALL CONNECTIONS.
❑ IF MORE LAYERS ARE FOUND THAN INDICATED ABOVE, AN ADDITIONAL CHARGE OF WILL BE ADDED.
CLEAN ALL DEBRIS FROM OUTSIDE WORK AREA. OBTAIN ALL PERMITS AND CARRY ALL NECESSARY INSURANCES
AS REQUIRED BY LAW. WE CANNOT ACCEPT RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS. CUSTOMER
SHOULD COVER VALUABLES. GREAT CARE WILL BE USED TO PROTECT THE STRUCTURE DURING STRIPPING,
HOWEVER, SOME MARRING COULD OCCUR.
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SPECIAL INSTRUCTIONS, �
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�e' __i""s:�t:� df e "" Fl >S !rl,.'i2�' � ��:e,,.�.,.a .•`m�, � � . -�, �_ fj riafi'� �i,`� ,�'>r :<(.'�"...�" _ a«.L-f..�.-_„_.
WARRANTY — All work warranted iD be free of installation delec
be free of defects for f ( years, see mfg. warranty lor exact M
Customer has legal right under 16deral law to cancel this contract
telegram sent to Robert J. Repose, S Ketchen Ave., Billerica. MA
to installed item and its repair only. Material warranted by mfg. to
algr'or obligation within three business days from acceptance date by map or
reverse side for cancellation procedures.
Once all items in this contract are completed as agreed, customer has 3 days to ftilfill payment schedule or pay all attorney and legal tees incurred by Robert
J. Reposa, 5 Ketchen Ave.. Billerica. MA 01821. All parties agree that all disputes will be settled through binding arbitration�as provided by the Better Business
Bureau or the Secretary or the Executive Office of Consumer Affairs and Business Regulations. MGIC. 142A. Pieaase-'see—reverse side, Arbitration of
Disputes.
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Zleetptantt of 0170005411 The above prices, specifications
and conditions are satisfactory and are hereby accepted You are authorized Signature' `.j
to do the work as spoc,lied. Payment. will be made as outlined abovele-
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Date of Acceptance a
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oristruction, Supervisor License
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ROBERT i REPOSA
253 SALEM RD SUITE 3
-BILLERICA, -MA Oli 821
3884,
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