HomeMy WebLinkAboutBuilding Permit #671-11 - 69 PROSPECT STREET 4/5/2011TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
I ORTANT: Applicant must complete all items on this page
LOCATION 2 zF' S�Ie Z
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PROPERTY OWNER s,/G —4::; (� -✓
a Print
MAP NO: g0 PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
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
❑ er
' Well ° � .,
' ®Falood m Wetlands k
P
_
Watershed istr
❑ Weater/S �
DESCRIPTION OF WORK TO BE PERFORMED:
Type or Print Clearly)
OWNER: N
Address: �q yas��G% S% if/' xz.1 ,ri�i�/-�
CONTRACTOR Name: hone:
Address: S`r 2Gls ��/ �-P-fJ-✓�f, i�rC�' ' ���� 3
Supervisor's Construction License: ��4ln Exp. Date: '' �f-�
Home Improvement License: /G� .2�a Exp. Date: 1`7'—,�; %Z
ARCHITECT/ENGINEER �— Phone:
Address: I--- Reg. No.
FEE SCHEDULE: BULDING PERMIT: $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ '16075-,' FEE: $ �1""L- — &-7C)
Check No.: Receipt No.: 9'93k--
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ i
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
PLANNING & DEVELOPMENT
COMMEN
DATE REJECTED DATE APPROVED
❑ ❑
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
f
y
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:
FIRE DEPARTMENT - Temp Dumpster on site
Located at 124 Main Street
Fire Departrnent signature/date
COMMENTS
Located 384 Osgood Street
yes no
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. fit.:
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 2008mi
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
(VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
II
❑ 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
I0TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit
i all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
lust be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
Location ��� 7
No. "` Date
NORTq
TOWN OF NORTH ANDOVER
' L
9
y
Certificate of Occupancy
$
JACNUSE
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check #
24068
Building Inspector
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Expiration X7/2212012 Private C'64 o
KR CARPENTRYNC
Kenneth Morgan
3 SIRIUS LANE)
i Pepperell, MA 0:14631
! Uridersecretary
tgVlassachusetts - Dcp.u-tment of Public Sakti-
MW l Butldiii" Re�rulaltotis AntJ f .cl�irds
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t =.L IConstr.uctiot� Su�ervisor� License
1 License:'CS•49598. 4 C
KENNETH R MORGAN_:
.3.SIRIUS LN �.
j PEPPERELL, MA 01463 i
Expiration: 7/29/2012
Tr#: 392
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APP/041/'201111YON 1 i ; 46 All P, 001 %'C':
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4 411011.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S UPON THE CERTIFICATE HOLDER, 1 -HIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE .A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. _
IMPORTANT: If the certificate holder Is; an ADDITIONAL INSURED, the polley(ies) must be endorsed.If SUBROGATION IS WAIVED, subject to
the terms and aondifions of the policy, certain policies may require an endorsement A statement on this certlficete does not confer rights to the
certificate holder In lieu of such endorsernen s).
PRODUCER 'wne; i -97t!1 �
I= (978)433-6425
L.F. Robbius loaursuoe Agcacy
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INSURER(S) AFFORDING! COVERAGE wr
Pepperell, Mtlssechusetts 4146;
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1t-Wi Carpenfrg Inc,
3 Sirius LEne
Pepperell, M q U146a
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INSURER A PPrerless lnswacae Company 24198
INSURER s: Travelers Insurance Co. $7736__1
wyuRER Q: Associated Fmy)oyers J;),-9pce COn3ps.y 11164
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INBURER D:
INSURER E: I --
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COVERAGES CERTIFICATE NUAIRER- RPVISInN NI IMFiFR.
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SHOULD ANY OF THE ABOVE D63CRIBED POLICIES Be CANCELLED BEFORE
LIMO BELOW HAVE BEEN ISSUED 10
TERM OR CONDITION OF ANY CONTRACT
THE INSURANCE AFFORDED BY THE POLICIES
L!MITS SHOWN MAY HAVE BEEN REDUCED BY
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OR OTHER
DESCRIBED
PAID CLAIMS.
NAMED 45OVE FOR TH= POLICY F=RIOQ 1
DOCUMENT WITH RESPECT TO WHICH THIS
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DESCRIPTION OF OPeAATIQNS I LOCATIONS IVEMCLES (At=h ACOkb tot, Additional Remark SehW ls, 1mome p84eIP r4geirrool �—
CEPTIFICATE HOLDER rra AFrrt=l t eTrnN
Holder's Nanus of loterest : Certificate Halder
SHOULD ANY OF THE ABOVE D63CRIBED POLICIES Be CANCELLED BEFORE
Town of Nord) AndovsT
THE EXPIRATION DATE THER=OP, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
69 Prospect Street
AU-, HDRIaED REPRFUtJ1A VE
Nore, Andover, lviA 0134s
I
% 1988.2D09 ACORD CORPORATION. All rights raservad.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
00tARPENTP 1.of
IM� age
v
3 Sirius Lane Pepperell, MA 01463
(978) 433-52.58
Fax:(978) 433-2701
PHONE
DATE
To: Joe. Do Giottor :•
03 _ 883-3fi00
Allanach Mortgage
JOB NAME /-LOCAT.ION
'76 Northeastern Blvd., Suite 25A F
69 Prospect St. #1' .:
•Nashua NH 03062
North And over,
Repairs:'
,:.
J OB NUMBER
.JOB PHONE
We hereby submit specifications and estimates for:
EXTERIOR DECKS = $3,250 d :..
2nd floor balcony will: be removed'
-Access window/ftor to balcony will be removed.:
1
Window opening will be repaired: and ,reframed as needed., fora new wind:ow unit
-New window will beinstall`ed and .insulated>,
Intedovand exterior will be tied, in to match eXi -ting;
Siding and exterior trim will be repaired: where balcony connected
Exterior materials will be prep rimed where possible -
Window•unit will be a white vinyl, sliding_ unit by Harvey, to include screen,, -
-Existing: side' entry deck wilt be removed 4
-New concrete .su.ppo is will be installed° -
-A 6'x8': entry deck wil •'.be constructed ;
-Joists will be.2x8 stock run 16"on center
Deck will' -be flashed roe.rl house
P p y @:`
Deck. will be fastened:.@ °housevith lag bolts _
Decking will be 5/4x6 pressure treated stock:
-
`-Rails will co°nsist of .2x2 balusters run 5" on c -..enter; 2x6. -handrails and 2x6 top `caps "A
-Stairs wial, be 2x12 stock run 16" on center .
-Stair railswil(match exlstir a
-Siding and trim will be tied:in
All stock wlilh be #1 pressure treated:..:
WE PrOpOBe, hereby to furnish -material and labor.""—complete in ,accordance with the above specifications, for the sum ot:..
Cont'd dollars ($
` Conf'd,.
Payment to be made as follows '
Progressive
All material is guaranteed to be.as,specified: All work to be completed ina professional ` .
manner according to standard practices. Any alteration or deViation from above speciffca- Authorized
tions involving extra costs will be executed only upon. written .orders, and -will become an Signature
extra charge over and above the estimate. Alkagreements contingent.upon'strikes,.accidents-
or delays beyond. our'oontrol. Owner to carry fire" tomado, and other necessary' insurance Note: This proposal' may be '
Our workers are fully covered by Worker's Compensation insurance,' withdrawn by, us if not accepted
days.
vuithinµ-
7
t
Acceptance o! Proposal—Th.,above prices,: apecifications and
conditions are satisfactory and are, hereby accepted. You' are authorized to`do the work Signature
as specs ied. Payment will be made -as outlined above:
Signature
I..,, Date of Acceptance
4�
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