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HomeMy WebLinkAboutBuilding Permit #131-11 - 78 JEFFERSON STREET 8/17/2010 BUILDING PERMIT of NORrh ,�tio TOWN OF NORTH ANDOVER 3� `'' -" o o - p APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �, opgATlp r `y�I �SSACH�ISE� Date Issued: —G IMPORTANT Applicant must complete all items on this page M M1, 10 t'_•,,{ur�.Y4"'- ., "tetl '� �.F z .f.' rt� �� a1 � UMP -Ric- aRn 1a SaT+' ry i='a^� ,,�ry�' �+��" �. �.� i.-� l; l'r �. 3 y„J�s��� 2a 3:.,��[ �rJ'.7-r'S;, •�' .'�-'c ?, r. e� i u.. �cF-�'n z���a:y� r: r S.` rr�'yl .• '��t���� ��2 �� ���r�3��°a�f�^�{�t�"gY�6 X31,��� �'�"ts,�� x .rs , �• � rs i -dSf”' L,d- � ��s^'i 'f t�� d :, l ���' a. '�'G4r� '}w �r��' �.� a F v" '°§i �I��a �'�'-P� ��1 i z 2 .rX ;r-.t`k,Lw+� .,z,a1 r�'}.f��;ya'L'3LN'ti"»'.:• nF*'_ � ' . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ' New Building One family_ Addition Two or more family Industrial Alteration No. of units: e'o%-A,0t,& I Commercial epair " .placemen Assessory Bldg Others: Demolition Other 1 a- s s i.'c"= - dt,*_u, " yv' 1 .-u:K..`"�L _ 2. ..w5>•i - 5'":,a-[ s .p sof ��yy - 1P.Ysy'— ry, Fy„� {s'T�� C•f 4 � F _ �7D 1 � ".tea '� a�.�M���_ # ns .t _ 1�m `�'.i'k�� I , DESCRIPTION OF WORK TO BE PREFORMED: 1 /V L�f-tJ U'LUICIO 1 . 4)el.e' K t+cA,e ..� GR 61 we�3 /UPr.� By4-71„roo y. i.t [,v t ,e ,lu OAK" dlect> Identification Please Type or Print Clearly) OWNER: Name:. & Ivi 65-4,4e-S . LLC- (Sv�niy) phone 17 6 -q7y 7 t �� Address: ;� �Ilr� let�y 44&4---o LIT TY Jid '. l�si ,�,-�3 WKu.:' - t•4!`�+ ', 4..rw�.e `ijG`- r 3 rvl�1`N e }41 e- n_a` �y3' �' 'T' „' .•..u�-•� �tn -c..s�w'-F 'v''� y"�' 'ux�x���-�� F..�.�4�e�s� �� � - '+s'SA a ('c�cS ,"aa,. 3v�� ��r v"wr�,• rr`a;"� -51 sdta� �.�_ ,�" J�,,_,a�+r� �� '� � t.'° �r .N a. dr 1. � C 4 �'id�t 4 '�' ,n'� � .,_3'' a y� •� r`y �ay � a d+: WAA...,,y "r,,.«.y .-�{crC 3 't$FY•9 J-., �} !. f;y �`�S•'r y(st"� 1$ 1 - a h. ..+ j 1. " MOM a �y',F �.. _ 'V .k,- xS :�'a` .� ia' f 1' 1�'•.. h a�. h, 1,-'�.�Gc ,� r•a. ,.+Cx^7 - a r J�'� Y 1 +xc�� mY" �r _�� f�"?K �Y � 4.i(tK' G' •� (.. F C �' Y - III All .Y�If�S C ,rr 4. 4 {. - .s 1 �n Y' �� JaAp�1 y�� u� �+ �+ La• r '' i ,f , [ 1 n jF�� N- } :, r"' -•s a o,�, ?.4: .�� 1V �N71 A✓6��7��.#:`. �i' �.5:...,.�.,....x�...fr.•_ v���n 4a � :t�. -cht� �' , F [u 1��"* Y'y�4.h . ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �©p�©tl FEE: $x(16 t- -2- Check No.: /0010 Receipt No.: 035. -3 ` NOTE: Persons contractine with unr istered contractors do not have access to the guaranty fund Ara.A 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 �ABuildin9 PP Permit Application 1"Workers Comp Affidavit a/Photo Copy Of H.I.C. And/Or C.S.L. Licenses w 'Copy of Contract tr'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 o 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 n New Construction (Single and Two Family) • �s ❑ 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 1 l 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 I HEALTH Reviewed on Signature COMMENTS i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con nection/Siq nature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood Street F��1� D�P43T11E 'T' r 'Dt� psterar� 7tee " Fri��e,par�en �s�?g �relate F X { Y n: COMMV 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 No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use) i ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 I Location ' No. Date G 7Z 0 NORTH TOWN OF NORTH ANDOVER 0 4L S Certificate of Occupancy $ _ �,SACHUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ ...-- ' TOTAL $ " Check # 2354, Building Inspector TOWN OF NORTH ANDOVER NORTH BUILDING DEPARTMENT °�<�``° '6q�o 1600 Osgood Street, Suite 2-36, North Andover Ma 01845 O * 4 NOTICE OF VIOLATION "� �9SSACHU`����"ArevCl Date: Address: d t� Building ❑ Zoning BylJE Stop Work Order7ificate of Inspections Electrical Plumbing Gas Violation observed: v ' 1 -�Z LaP Ali a ,VfJ l� Failure on your part to comply with this notice within 10 days may subject you to penalties prescribed by Massachusetts Law 780CMR r North Andover's Zoning aw. Please contact the Building Department for further information at 978-688-9545 j At Inspe o Home Owner Contractor TOWN OF NORTH ANDOVER pORTH BUILDING DEPARTMENT OF 't 10 46'6 1600 Osgood Street, Suite 2-36, North Andover Ma 01845 0 NOTICE OF VIOLATION �9SSACHUS���� Date: V Address: D 17-1 Building ❑ Zoning Byl Stop Work Order ❑ Certificate of Inspections Electrical 0 Plumbing ❑Gas Violation observed: IJ i Failure on your part to comply with this notice within 10 days may subject you to penalties prescribed by Massachusetts Law 780CMRr North Andover's Zoning aw. Please contact the Building Department for further information at 978-688-9545 0 1441 Inspe Home Owner Contractor ORTM Tovm of Andover Y �0 LAKE o dower, Mass., 0 S 2COCHICHEWICK ORATED pP��'`� S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ...... ........ .. ............ ........................ ... .. .............................. ................... Foundation has permission to erect... ....... ...........is uildings on ....... ....6� ........................... Rough 6to be occupied as.. ..� ..... .... . ... ......... ..............::L.. ..... '............................ chimney L.- provided that the person acceptingPthis permit shall every 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU pNnT4 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. i [ILANFR MF ODE: IL 0.1_11 SERIES 4000 Dual Glazed R Vinyl Double Hung Low E Glass National Fenestration Grid s Rating Council® ENERGY PERFORMANCE RATINGS U-Factor(U.S./1-P) Solar Heat Gain Coefficient 0 .35 .29 ADDITIONAL PERFORMANCE RATINGSI Visible Transmittance .50 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are detennlned for a fixed set of environmental conditions and a specific product size.NFRC does not recommend any product and does not warrant the suitability of any product for any specific use.Consult manufactuee11teature for other product perfornance I nfor m ati on www.nfrcor9 This window is ENERGY STARS qualified in all 50 States. 4000E Design lPsressuup to ee Rating-26 Ratings Ratings for sizes up to 44"x 60" : OP-30 QUALITY CERTIFICATION Rev.9/07 RI assachusetts Workers' Compensation Insurance Plan Acadia Insurance Company Administered by Berkley Risk Administrators Company, LLC PO Box 1100, Mpls, MN 55440-1100 222 S 9th St, Mpls, MN 55402 Acadia Insurance@ Phone (605) 945-2144 Fax (866) 215-8118 Toll Free (800) 634-4589 NCCI Carrier Code 33391 INFORMATION PAGE Renewal Of No. WC-20-20-001843-00 1. The Insured: Normal A/R Policy Number: WC-20-20-001843-01 SPIRO SKINSAKOS Risk ID: 0831790 564 DUTTON STREET Tax ID#: F 00-1588885 LOWELL, MA 01851 Date of Mailing: 12/2/2009 Other workplaces not shown above: LX 1 Individual Partnership See Schedule i_ I Corporation Other 2.The policy period is from 12:01 a.m.12/30/2009 to 12:01 a.m,12/30/2010 at the insured's mailing address. 3.A.Workers'Compensation Insurance: Part One of the policy applies to the Workers'Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury By Accident $500,000 each accident. Bodily Injury By Disease $500,000 policy limit. Bodily Injury By Disease $1,000,000 each employee. C.Other States Insurance: Part Three of the policy applies to the states,if any, listed here: SEE WC 20-03-06 (A) D.This policy includes these endorsements and schedules: WC000308 WC000403 WC000404 WC000414 WC200101 WC200301 WC200302A WC200303C WC200306A WC200307 WC200401 WC200405 WC200601A WC200604 WC990001A WC990601 4.The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. PREMIUM BASIS RATES ENTRIES IN THIS ITEM, EXCEPT AS SPECIFICALLY PROVIDED ESTIMATED ESTIMATED TOTAL PER$100 OF CODE ELSEWHERE IN THIS CONTRACT; DO NOT MODIFY ANY OF ANNUAL ANNUAL REMUNERATION NO. THE OTHER PROVISIONS OF THIS POLICY. PREMIUM REMUNERATION Manual Premium $309.00 See Schedule Increased Limits Stat Code 9808 $75.00 Subject Premium $384.00 Minimum Premium : $357.00 Modified Premium - $384.00 Standard Premium $384.00 Loss Constant $20.00 Expense Constant $250.00 Terrorism Stat Code 9740 $3.00 Total Estimated Annual Premium $657.00 Agency Name and Address DIA Assessment 1.072 $22.00 Total Fees&Premium $679.00 Cooney James L Net Deposit Premium Required $679.00 327 Gorham St Premium Paid to Date ($679.00) Lowell, MA 01852 Total Premium Due $0.00 I 00, i ignature: r *-- DATE: 12/2/2009 Sj ncludes copyright material of the National Council on Compensation Insurance used with its permission. WC 99-00-01 81983_@ 1991 National Council Compensation Insurance 8116 787749 �� I Contracting Agreement M Kj,,z F7544j LGC t referred to as OWNER and SI'r 6 l�S cr�t!e3e referred as CONTRACTOR,agree as follows: CONTRACTOR shall perform the following services for OWNER: � s 1 uus /J A J&4j wI,-Mu s r /)ew exrP N,ew A ,1)00y, 4 WLCAJ t4g, .trd fd On the following estimated schedule: ptv For the following price$. (dollars)Contractor shall be responsible for the following in addition to the workman like performance of the work stated above. Provision of all permits required for the services to be performed above. Provision of worker's compensation insurance and general liability insurance in the minimum amount of $1,000,000.00(dollars). The CONTRACTOR shall daily remove all trash and debris from the premises. Owner: Contractor: I� f =— Massachusetts- Dcpatrtment of Public Safety I Board of Buildin-Rcmdations and Stand tAs ; Construct-ion Supervisor License License: CS 72691 j Restricted to: 00 { s SPIRO C SKINSACOS 564 DUTTON ST f LOWELL, MA 01854 i ��— Expiration: 2/3/2012 ( nunissinner Tr#: 15207 6038822996 _ NASHUA WALLPAPER _ _ 003 13113 r*1=77Mi d — - �. Note.This drawing Is an uttistic Designed;8/10/2010 Interpretation of the general Nwoinaiis J Prinied.9/10/2010 appearance of the design.It is nol meant to be an exact rendition. LS 78 JEFFER90N 39'N ANDOVER All Llmwlug i1:1 _... _... -. . ..� ,,� — _ _ 004 6038822996 NASHUA WALLPAPER ^ r' Note:This drnwing[s an ar istic Designed:8/10/2010 InterpretAtion of the general ra<TGo�ooie�J Printed:9/10/2010 appearance of the design.1t Is not meant to be an exact rendition. SPIRO 78 7CPP13RSON ST N ANLIUVER All Drawing#_ l