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HomeMy WebLinkAboutBuilding Permit #203 - 76 HILLSIDE ROAD 9/19/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION °F�t�Eo °gtio o Permit NO: Date Received ^4 w Argo Date Issued: i /'(� 4j9SSACHUS��`9 IMPORTANT: Applicant must complete all items on this page LOCATION I >;0 e I\ P 'nt PROPERTY OWNER �� I 1 t 1! 5 Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building K One family ❑ Addition ❑Two or more family ❑ Industrial ❑Alteration - No. of units: ,'Repair, replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: i1 ❑Foundation only a DESCRIPTIQqN OF WORK-TO BE PREFORMED f Identification Please Type or Print Clearly) a r OWNER: Name: �'V V` 7=f/r �'/'��� Phone: I Address: 76 �� ► l`S i CONTRACTOR Name: Phone: `j,-G 1 Address: /�fIIY���--/,�,�L \ I� i �l�_t � ('1�� � �! Supervisor's Construction License: Exp. Date: I Home Improvement License: Exp. Date: _> ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERkVIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSBASED ON$125.00 PER S.F. Total Project Cost :$ V DC) FEES Check No.: Receipt No.: h 0 Page I of 4 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to, project - NOTE: Persons contracting with unregistered contractors do not have access to the guar d Signature of Agent/Owner Signature of contractor -' Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plens ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U.FORM _ - DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS _ DATE REJECTED DATE APPROVED 11 EALTH ❑ ❑ COMMENTS I FIRE DEPARTMENT - Temp Dumpster on site yes no fo��A-4 Fire Department signature/date \ COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments . Water&Sewer connection/Si nature&Date Driveway Permit Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Re uired 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 i i ' t Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan.2006 1 Lo cation & izlS/�Z. • (� No. ao3 Date � .. MORTh TOWN OF NORTH ANDOVER O ' + s Certificate of Occupancy $ iV bis''^NUSt 9 Buildin /Frame Permit Fee $ L sAC -`. . Foundation Permit Fee $ Other Permit Fee $ TOTAL $ F.l. Check # 19589 Building Inspector NORTH ® Of over No. 2wo.$ dover, Mass., • Q = LAKE CoCMICHEWICK oRATED BOARD OF HEALTH Li Food/Kitchen r- ERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT-76..........kh..n..r d... ........fat.e..6............ .... Foundation has permission to erect............................... building 6t. .7...... Rough 5 to be occupied as.. Chimney ................... � provided that the person accepting this permit shall in ry respect conform to the terms of the application 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 g Final PERMIT EXPIRES IN 6 MONTHS �T T � ELECTRICAL INSPECTOR UNLESS CO STR S . TS Rough . .............. ............................................................. Service BUILDING INSPECTOR 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. Dempsey Construction & Roofing Proposal# Specialists 7 Richardson Street Billerica, Ma 01821 978-670-8904 r Proposal — Customer Name Kevin Pendagast Date 6/22/2006 Address 76 HillsideRd Order No. City North Andover State Ma ZIP 01810 Rep Phone 508-328-0655 FOB i Qty Main House Unit Price TOTAL $trip_existing two layer down to roof-deck.- Inspect oofdeck._.Inspect plywood &re-nail where necessary. Any rotten or delaminated plywood will be replaced at an additional cost of time&material. Install 100% ice&water shield. Install 8" brown aluminum drip edge. Install 30 yr. shingles(color&style determined by homeowner) Re-use top&bottom on flanges on skylight&install new velex step flashing on sides. Counter flash and tar 1 bubble skylight. Remove all roofing debris Price includes materials, labor, dump;dump fees and all necessary permits&licenses.. Strip carport/utility shed& install dripedge, paper& shingles. Install water diverters where requested. If Timberline Ultra Shingles are to be used the total will , be$11,365.00 SubTotal $0.00 Payment Details Shipping & Handling 0 Check payable to Eric Dempsey Taxes State 0 0 0 0 TOTAL $10,365.00 $3;O00:00 down for nrat8rials._� Remainder due upon completion Office Use Only I Five year wawa tee on all work anship Ae --------, ` \ 13oara air'nuilding Ilegulnrionr and Staiidard.v License or registration valid for indhIriul a N onl3: HOME IMPROVEMENT CONTRACTOR before tine expiration date. if found recarn .u: Registration:, 1,50272 Board of Building Regulations arrd Sand.ar.ts EkPlration; 3/21[2,003 One Ashburton Place Rm 1301 Types: ,individual 13UstOn,,1�a,02108 DF-'mPSFY CONS': 8 Rt-0F1NG IRIS:DEMPSEY Nf(>.a PosON ST > � -- RI L RCA,IMA 01c321 - rpusY.`udhtaliaiztw,it(�c loot valid►`' Uut Slgn11ture j a,cu. 4, ,J LU V V,:4tiH ��ttl 'r'Nk.ii :['supLNCE r?nc1—r,00-ora000 l' page ACORD CERTIFICATE OF LIABILITY NSU�ANC DATjA�DD�IYYYyj PRODVCER PH , 5 _2 E _, 03R SCHAFFNER INSURANCE AGENCY THI'. CERTIFICATE Ig I r3` REb ASA MATT_ 7 lJF WtrgRMATI dNI.Y AND CGNFERO NO RMJ"TS UPON ME CHR7'tFICAT#e 1147 MAIN STREET SUITE 201 NOIDi`Fe: THIS CERTIFICATE; �aE;$ Nor � �neaA, L` FI OR PO I30X 777 AL 1 ER rHB COVE`RAl9E! AF R�D PLM, • 0LIC! a@LOW, TEwKssURY INSUREERS AFFORDING COVERAGE? i INsuRIaD — ._—. �.. .._ MAIC le DEMPSEY CONSTRUCTION 4INSUCE , ROOFING SPECIALIST,INC 7 RICHAR030N 3T BIL.LERICA.MAO 1821 COVERAQES -_.._,,..t,s+SUREVe: TI IF RCX.ICIES OF iN®URANC:t,ISTED Eic'.LOW NAVE SEEN ISSUED TO THE INSURE❑NI MED A9oVE FOR Tt1tc P ANY rtCRTAI[THE I TERM OR CoNpITIQN OF ANY CONTRACT OR OTHER DOCUbIEdT WITH RESPECT TO WHICH i MAY PERTAIN,rasa=INBUf:ANCF AkJroRG6o 9Y THE POUCIEB ncscRlgrG HERl=rry Is_ YD.GATE � NOTWITHSTANDING; Wn(.ICIES.ACCRECATa LIMITS SHOWN MAY HAVE MCEN REDUCED dY PAI �'H THIS CE iTIFICA' E MAY BE IrsUED OR 'UI3dEGT To ALL THE TERMS,GXGI.USIC Ns AND -ONL)ITION6 OV SUCH INSR' pp!L OCLAIMB. RDI Yr�t or IN�tne� c,. POLICY NUMBER POLICY�PIECTIVi �0�[{ XPi TION-r 1 E ERALLIABILITY A I -- ( MtTb - i x caMMERCIALCENERALUA1iIlITY NC478GC6 FAOiOCCURR_NCE � 9/31015 I 9!3/06 TCrxuc7ED - 1,000,OGta GAIMBmnDE L_.i OCCUR i. �.. EMI Sirtpixureneu► _ E 50 I ' I � � X00 I I t l_DFXptMryemPenvnl I_E 1 000 I f__ ,,�,"_ PFRSCdV1LLAA ,VfNJURY 'S 1, OQIQOQ CF.N'LACGRECATEc.fMlTgRpLIEBPER i �FNeRALAGOFCOATE y 2, ,00 I -1 rCLICY7;•F T GB Il I �PROOUCTSiCCMwOPAG 1 E_ 1,QOO,000 AU,0MOIJILE LWN �- — - — Ii I I ANVAUTO acaINE)SINtLELIMIT A61,OWNEDAU706 I I �• yCHEDULEDAL'TOS INeDa YIONJJURY ±8 J HIREDAUT08 N:7N,pVyryEDAUT03 I I BODILYSWURY i s I I j I ( I (Pnravckeny i I _ _ I I FROPEIhT` DAM,,.GE I� _GARAGE LIABILITY *.� fh�r tocideii� I t I AI4YAUTO j AUTOONLVVEA I I 'CIINCRTH.I,N EAAC :I T.. � ( I i l EXCEssrumBABLLA 41AVILI7Y - —' AUTOONit': - .. _ AG 7;S !OCCUR L CLAIMS MADE + ;.�ACIOC_CURREICE _ y f ' I 'AaCREGA'fE l �DL'D;.ICTi9LE I I I �--_� . •"'� i R?TENTION 7 -- �t WORKEReCOMPiMBATtONAND t -- AMPLOYBR&LIABILITY ++7-70Ti ANY PROPRikTOR/PARTNEi'/[XECU'IIYE I TO Y�+'".—°1..I Ef I :011-FICERIME MBEREXCLUUI:D? i j 'kL EACHJ,CCipI;NT y f {r ee deemluu unser +{ ! _ 1 SXECIAL PROVII;lON5bskrr - S•. �NBEAI,E t SA AI(PIOY! : y B.1 D18EA6E�`PaLlr-'Y- L- I^::`' .,•t�•...�._._. .^iEiCArPTION pF OP6NATION>!!LOCATIONS/VEHICLES l EXCLUSIONS ADOEC BY;NOORtIEtmrNT i ePECtAL;'�VYiSWNy CARPENTRY&ROOFING CERTIFICATE NOL©ER ----_ CANCET(ON��- 1-12 LD AN'T OF TNR ABOVE O&8CAI8Ep nL,Clli 3E CA(CELLED RFORETMfi 8XPlRA7tOM Th RSOF,THE I6auIRa INSURER WILL ENDIIAVOP TO MAIL DAYB WRITTEN B'0 THE C;R'fIFIC.ATE HOLDER NAMED TO INE LEFT,BUT F ILLIRE TO DO 80 SHALL 40 OSL;GATION OR LIABILITY OCANY K 10 UP)N THE K 3Ve;ERITS AGENTS 6R6gI:NTATIYREDW§P -p y� _ RCORb 26(2001108} (�,�' I 'A(R CQ PORATION 4988 The COMMOnwealth Of Massachusel t DERARTMENT OF INDUSTRIAL ACCIlif"iN I S 600 Waslflqvton street, . I., 11 * Massachusetts 0:11 Ail 1 74900 jjtt A- � req u;i p,//w%V.MaSS.gov/dla , "'! & M. this %-V bk' X'T-MsAchusct�s Gencrid Lm-�. Ch4ptcr 1321 Scclm 21 Z.'(- (v'c) h'I'Vc provided !cr pa�Trmm 0 ru. ill I under thc jt)c ve 0 : F-3111ce that It tpl�r hy, 11"iSul Ang with: CNA !NSURANCE COMPANIES A.M.E 0 F I N S U R ANC'E CO M PAN,Y oNE 'rot4ER SQUAR' HARTFII�pj 't- tL �61 83 ADDI'(ESS OF I.NISL,).RA-NC'E (UMPANN T ) POLICY NUNIBER f f T F CTI D.,vrr-s JOHN MCBPTDE OR INS AG-V pa TA 173 "M NORTH 81 LLE41CA MA 01861! NXMIE OF INSURANCE AGENT 4�DD R ESS PHONE. # M DEMPSFY, ERIC 7 RICHAADSON ST BILLEPICA 14A "1821 25�4 .Mi EMPLOY'ER 0DRESS Jn EMPLMTR'S WORKERS (UMPENSATI(YN 0HF1C-')--.'R (IF ANY) DATE MEDICAL TREATMENT Thc abow named Ausarcr Cs required in casc t,)t injuries arising out (..,f allij in I.,,, cl'urse of, empjomlent to finrnish adley ,le and reasonable ji ind medical scrv�ccs in jc.'ord : ce 'th the wl pr'ovisior's of the. wolkcrs' Compertsmit-1 ALt of the First RCfX-,1T1 Of h, - given to the injured empictyce. Thc (1mployce n?,,-i) sellea- b." cm -hc-r ,,--,-Nkrn phy;iciarj. 'T'jjc TedsOBAlle cost i the servic'--s JM pru\7dcd bNj the OC411jig phySicjaTj 'A;fl1 be, paid b} the u sure, ,c treatment is ncce..,s..jry jahly conneLied *to tri wnrk related tviur,,, In cases rcquir1in I , . 1. .g that the ami-aged for su'.01 awennon 'm Out MPIM-ces ire h eby n-offiec-1 N"VME. OF HOSPITiu, "U.}"DI t f--S S TO UPOSTED BY EMPLOYER n6w, W20PIG02