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Home My WebLink AboutBuilding Permit #120 - 76 COLGATE DRIVE 8/16/2006 f NORTH O �Jo a�.tiO a OL TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SSACN1`'E4 PermitNO: go Date Received: Date Issued: kh&A.L IMPORTANT: Applicant must complete all items on this page LOCATION d Z Pk, Print PROPERTY OWNER Print MAP NO.:--9/—PARCEL: a2– ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building One family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: Repair,replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED K000r— )? Identification Please Type or Print Clearly) OWNER: Name: EO PD/✓ 0 11AA-1 Phone: Signature Address: �lO �O F 0.4rg 2)A CONTRACTOR Name: IPOIX,49 414P Phone: !29—a�7—&/Z 43 Address: 0 e- // a �� , A,0' VEl f Supervisor's Construction License: QaJ/0 Exp. Date:_ � d Home Improvement License: 13 Exp. Date: j ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDIN a RMIT.$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost : D. x10.00=FEE:$ Check No.: / 1-7 Receipt No.: Page I of 4 Location No. ,�2 Date —o�� NORTH TOWN OF NORTH ANDOVER � s T Certificate of Occupancy $ ss+cHusEt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # / Building Inspector TYPE OF SEWARGE DISPOSAL Public Sewer F1Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well F1Tobacco Sales LlFood Packaging/Sales 11 ❑ Permanent Dumpster on Site ElPrivate(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of Contractor /�`• Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS A 1 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 " Temp Dumpster on site yes Lrf6'-- Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA—(For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 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 Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan o 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 ❑ 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 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 r NORTH Town of 4Andover O ry l "A No. - o dover, Mass. 0 o > COCHICHEWICK 7�ADRATED FP�� 5 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......L �� ............. .d.. .1 .-.............................. ............................................ Foundation has permission to erect........................................ buildings on .1 ......C .� ....... .................................... Rough �r Chimney to be occupied as........ . ........................ . . .................... provided that the person accepts this permit shall in ev respect conform to the to ms of the pplication 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 7FinalV __ PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TRLt ST TS Rough ....... ........ ...................................... Service ........ . ...... .. . . ... BUI SPECTOR 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. Page#�_of pages Norman L Blad Construction 40 Fernview Ave. #10, N. Andover Tel: (978)687-6263 Lic# 016141 -MA Reg# 131950 Proposal Submitted To: Job Name Job# Address � � /T Job Location Date Date of Plans 7 0 Phone# / p� g? Fax# Architect 7�� hereby bmits i d► i ° .rs _ pe iflcat ons and estimates for. _.__ _ __ _ __ _ ._._ - ...............- - - .... �� { -..� i-- ------- _.._......... -'---_ tee -.. ..... . j -. _ '' - 'f'►fid._ .. _ ._._ _._ j-� a-15 _ _..........__...... . ......._...... __...._ ... ...._ ___ ---------_--- _- -------- -- .................._._ !_._. =..._...... _-.__.........-..__... _ ______ ____....... _ -._.._.._..__. ......I;........... . _-_._............. . _ - We propose hereby to furnish material and labor—complete In accordance with the above specifications for the sum of: $ 3.3-5 DollarE with payments to be made as follows: 5 rn-�' d .6— ' 2 /.p. Any alteration or deviation from above specifications involving extra costs will be Respe tfully executed only upon written order, and will become an extra charge over and i .. r ! above the estimate.All agreements contingent upon strikes,accidents,or delays submitted 7 t beyond our control. Note—this proposal may be withdrawn by us if not accepted within day: i k Ofcceptance of Propool -- The above prices,specifications and conditions are satisfactory and are Signatures hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined Pove. Date of Acceptance Signature�� ":�• )l`=?!�� ' k, 0-7� C/Id!)t/I72dltRllCCZIUL O�✓(�GQG6O�L[[6P.�.6 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 016141 Birthdate: 03/15/1947 i Expires: 03/15/2008 Tr.no: 20180 Restricted: 00 NORMAN L BLAD 40 FERNVIEW AVE#10 / ,4 N ANDOVER, MA 01845 Commissioner � T� -�� ✓G�oaac��aelta Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 131950 Expiration: 10/13/2006 Type: Individual NORMAN L. BLAD NORMAN BLAD 40 FERNVIEW AVE #10 N.ANDOVER, MA 01845 Administrator F a 4' :i 'I !i i a , it NORFOLK AND DEDHAM MUTUAL FIRE INSURANCE COMPANY SMALL CONTRACTORS POLICY RENEWAL CERTIFICATE Poiicy # R0412920 Named GLAD, NORMAN Agent INTERNET INSURANCE AGENCY, INC Insured 40 FERNVIEW AVE #10 Phone (978) 685-7690 N ANDOVER MA 01845 Agent # 20155 FORM OF BUSINESS: Policy Period: ONE YEAR from 02/04/06 to 02/04/07 This declarations page together with the policy jacket, the policy form and any endorsements, completes this policy. Coverage begins at 12:01 A.M. Standard Time at the covered premises. X. Basic Annual Endorsements State Taxes Total Annual Add'[/Return $957 $957 .IT >:.::.::.:.:::::.::.:::.::.:;; >:.;;:.;:.;:.;;:.;:.: Bid /Location 1 Address if Different Mortgagee Information Business Description CARPENTRY ad Premium POLICY DEDUCTIBLE $250 BUSINESS PERSONAL PROPERTY Limit $10,000 Included T 0 T A L P R E M I U M P E R B U I L D I N G $857.00 4. EXCEPT FOR FIRE LEGAL LIABILITY, EACH PAID CLAIM FOR THE THE FOLLOWING COVERAGES REDUCES THE AMOUNT OF INSURANCE WE PROVIDE DURING THE APPLICABLE ANNUAL PERIOD. PLEASE REFER TO PARAGRAPH D.4 OF THE BUSINESS LIABILITY COVERAGE FORM. LIAB & MED EXP (OCCURRENCE/GEN AGG/PROD COMP OPS AGG) $300/ $600/ $600 Included MEDICAL EXPENSES $5 Included DAMAGE TO PREMISES RENTED TO YOU $50 Included Premium I Premium SEE ATTACHED PAGE r #11C 1 >;::>::Ti3E:>If?# )wtCf::::3E30f1S1CtN5 :1E�1311 ?;Y FIAT:>A:: ` hl�`�itSiGN >< M.:N:M3lI~5......1)=.....AU..CAr�...................................... .....,. .. ................................................................... SCEL,P01fJEt �"o'iA .".T C?0 >aiit�<5`';`41� :A3:`> : .; ISI::... .::..:..:.:....:tia......: QIP.......:..:..:....... -.....:.:..:..:...:..:..:..:.:.......:.:.::.:::.:.:.:.:..::::::::,:::::::.::::::::::.::::.:.:.::::.:::: ::::: :: .::::::: BOP-2 MTV nain�) T%/r+P of Pavrnnnt' DTR€CT STLI. 10 PAY The Commonwealth of Massachusetts oDepartment of Fire Services Office of the State Fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 PERMIT Date: of /, , North Andover permit No Dig Safe Num er (City of Town) (If Applicable) In accordance with the provisions of M.G.L.14 8 Chapter 10 as provided in section-5 7 CMR 34 Start Date f This Permit is granted to: Full name of person,Firm or Corporation Pemussionto locate dumpster for construction/renovation/demolition of building. Comments: dumpster must be 25 ' from structure if unable to Place with required Restrictions:clearance dumpster must be covered with plywood or tarp end of work day at 4— -,-2� (Give location by street and no.,or describe in suy�ey a�oo r de uate identification of location). FeePaids 50.00 Y Fire Chief This Permit will expire e O'J,6� (Signature of offical granting permit) Offical granting pen-nit (Title) �� TWIC PERMIT M1 ICT RF 1011C1 v Pr1CTi=n I IPrw' THF PRFMICFC ��