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Home My WebLink AboutBuilding Permit #260 - 79 VEST WAY 10/10/2007 AORTM BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� U Date Received �pr/U�a 4q"` D Permit N0: � � Dq, '.� ED �SSACHUS�� Date Issued: fa r/d sd7 IMPORTANT:Applicant must complete all items on this page LOCATION .71 Vf 5-4- not ..Print_: MAP NO: —PARCEL: ZONING DISTRICT.—Historic District yes no Machine Shop Village yes no. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One famil Addition Two or more family Industrial Alteration No. of units: Commercial Re ace Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: 040(ve CKisTI'A l& r��s °f�� SJ D 11V6- W1 t Identification Please Type or Print Clearly) OWNER: Name: Sheyew IV7 Phone: 617 1711— VIS' Address: 172, Ve o- Te_vd, Dior CONTRACTOR Name: Phone: .Address: 10 1 Su Pervisor's Cons#ructionL�cense: e c ` Exp. Date: HomeImprovement.License: G p. ..�' � Ex Date; j ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ /�F 000 FEE: $ C�/6• Check No.: /G/ Receipt No.: C�06Gy NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund z _ _. Signature ofAgent/Owner Signature of contractor, 1 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS a r 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 Drivew6v Permit Located at 384 Osgood Street FIRE DEPARTMENT -Temp Du.m;pster on sites no Located at 124 Main Street Fire Department signature/date COMMENTS 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) ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location No. C-;,D Date 40RTh TOWN OF NORTH ANDOVER 0,,GO ,�rya a G F � A �a Certificate of Occupancy $ .ss•►CNusEt� Building/Frame Permit Fee $ �«n Foundation Permit Fee $ Other Permit Fee $ TOTAL $ C4 Check # 206U ', �- j " Binlding Inspector l Corey Cook C & S BUILDERS Steven Daloia 978-479-9979 978-804-8219 MA Lic # CS085044 MA Lic# CS085048 Building and Remodeling v 79 Vest Way 10-08-2007 N. Andover, MA The following contract is for your siding removal and replacement. 1. Remove all existing masonite siding and comer boards. If any rotted wood is found behind siding it will be addressed with homeowner at this time. 2. New corner boards and garage door trim will be installed with vinyl pvc trim boards. 3. Three existing gable end vents will be changed with new wood vents matching the old sizes. 4. All new siding will be installed over tyvek house wrap.New siding will be primed cedar clapboards installed with stainless steel nails. All trash will be removed by contractor by way of dumpster. Job site will be cleaned daily. All work will be conducted in a safe and timely manner as well as abide by state and local building codes. TOTAL PRICE: $18,200.00 Materials and labor included. X X Homeowner ��Coactor NORTH Town of :_ � Andover O dover, Mass., CHICMEWICK 7�ADRATE S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ..... ........................................................... ..... .............................................................................. Foundation has permission to erect... buildings on ..7 .. . ................. Rough �. ..... ...... ..... ...... ................................... to be occupied as. chimney ... . . . . . ..... .....................................................................................................I provided that the person accepting t ermit shall in every respect conform to the terms of the appltion on file in Final this office, and to the provisions of Codes and By-Laws relating to the Inspection, Alteration andonstruction 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 MON S ELECTRICAL INSPECTOR UNLESS CONSTRU ON S 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. Corey Cook C & S BUILDERS Steven Daloia 978-479-9979 978-804-8219 MA Lic # CS085044 SIA Lic # CS085048 iwgw Building and Remodeling 79 Vest Way 10-08-2007 N. Andover,MA - The-following contract its for your siding removal and replacement. 1. Remove all existing masonite siding and corner boards. If any rotted wood is found behind siding it will be addressed with homeowner at this time. 2. New corner boards and garage door trim will be installed with vinyl pvc trim boards. 3. Three existing gable end vents will be changed with new wood vents matching the old sizes. 4. All new siding will be installed over tyvek house wrap.New siding will be primed cedar clapboards installed with stainless steel nails. All trash will be removed b contractor b way of dum ster. Job site will be cleaned Y Y Y p daily. All work will be conducted in a safe and timely manner as well as abide by state and local building codes. TOTAL PRICE: $18,200.00 Materials and labor included. X X Homeowner ��Coactor 1ne Lummunweutin ul lriussuc;nusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 FM www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly J t ,, f Name (Business/Organization/Individual): S � Vr�i�V ®�I e.,Q f A Address: el,�_ MeA LW bRel K lej City/State/Zip: 17�e M,),OAI 104 0 Xhone #: 9,7c'5 e:�'�l j Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2�.I am a sole proprietor or partner- listed on the attached sheet. t ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their ME] Electrical repairs or additions required.] 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13�-Other �`/L1/Irl�;- comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy #or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provided above is 7truendcorrect. Si nature: Date: f d Phone#: !? 79 AU y cj,:�;.- , Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: — -- .�<, -L�rYl7UIre47uue�zfU7o��`�QIXGl2u6P,G�.� Board of Building Regulations and Standards j HOME IMPROVEMENT CONTRACTOR Registration: 145372 Expiration: 1/13/2009 Tr# 126342 Type: Individual STEVEN J.DALOIA ' STEVEN DALOIA 45 MEADOW BROOK AtY METHUEN,MA 01844 Administrator Ii: _ 3/4- - s Board opguildiay� Ponstruct- SuRegulationand St _ peryisor:License ndards ► t f Lt' ' CS ? . B�rthtlate 85046 12/1/1977 R� 12/,1720so08 Tr# 7075STE ENJ DACOI � 45 WAD OWBRbOK METHUEN,MA,01844 Commissioner f r