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Home My WebLink AboutBuilding Permit #211 - 81 STAGE COACH ROAD 9/20/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION 3r0b o p i Permit v0: Date Received + " '► Date Issued: — SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION Pnn PROPERTY OWNER2 ,0- 1 I'1 Print MAP NO.:,4p=CPARCF.I.: 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 C Alteratio No. of units: epai , replacement Assessory Bldg Commercial Demolitio - Movins;(relocation) Li Other -j Others: Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: 4f. K-C> (Z l l Phone: Address: I , CONTRACTOR Name: � 77�Mp V 1 U Phone: Address: J(4'�P�r�c.�C.�L Supervisor's Construction License: Exp. Date: I-Iome Impi-w cment License: �n�� Exp. Date: ARCl-IITECT, ENGINEER Name: Phone: ,'address: Reg. No. FEE SCHEDULE:BULDLVG PERjV $1200 PER$1200.00 OF THE TOTAL ESTIMATED COST BASED OA ,5125.00 PER S.F. Total Project Cost :$ x12.00=-EEE:$ Check No.: Receipt No.: Q h e Iot.1 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 o Building Permit Application ❑ 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) New Construction (Single and Two Family) j 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 ❑ ti-lass 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:I\SPECTIONAL SER\RTS DEPAR]VIEV'r:11PFOR\1115 TYPE OF SEWERAGE DISPOSAL — - Tanning-'Massage;Body Art Swimming Pools Public Sewer _ Tobacco Sales — Food Packaging-'Sales _ Well — __ Permanent Dumpster on Site Private(septic tank.etc. - Electric deter location to Project NOTE: Persons contracting with unregistered contractors do not have access to the guarana,fund Signature of Agent/Owner � ,,� Signature of contractor Plans Submitted Plans Waived i7 Certified Plot Plan i_ 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 DATE REJECTED DATE APPROVED r , HEALTH ❑ !J j z COMMENTS Zoning Board of Appeals: Variance, Petition No: Lomn� Dec is ion!receipt submitted )es Planning Board Decision: Conunents Conservation Decision: Comments 1Natcr,1Q Sewer con nectioWSignatulre& Date Driveway Permit Temp Dumpster on site yes_no i Y Fire Department signature:date 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 DA rA-(For dcpartMCnt use) II:vI.,c 3 of C I IC LS DI-PAR PVILN I'A!III01�1.'A,;i Location 8k 1 6rE Ca af-,t-i~- No. �� Date t � f NORTH 1 TOWN OF NORTH ANDOVER Certificate of Occupancy $ SSACNustt Building/Frame Permit Fee $ r Foundation Permit Fee $ f Other Permit Fee $ ' TOTAL $ Check # NOS-- Y 19596 Building Inspector F NORTH Town of / .w.M.�..,,.. kiA No. _ % = AKE = dover, Mass., COCHIC HE WICK ADRATED 1S BOARD OF HEALTH PERMIT ' T D Food/Kitchen Septic System * • BUILDING INSPECTOR THISCERTIFIES THAT...Pe..+&u.......�..�.... .S..S� ................................................................................... "" Foundation has permission to erect........................................ buildings on ..?l......ST... ►&. .A4.006........................ Rough to be occupied as.4-acc-epting ..... ". %AmA........xi� ...r Chimneprovided that the this permit shevery 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 36 low PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCARTS Rough ...................<z........ ........ Service D �iSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. it w Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 126893 Type: Supplement Card Expiration: 8/3/2008 THE Home Depot At-Home Services BUNROEUN CHHOUY 3200 COBB GALLERIA PKWY #200 AtIANTA, GA 30339 Update Address and return card.Mark reason for change. DPS-CA1 0 5oon-05/06-PC8490Q ❑ Address [] Renewal [] Employment Lost Card A Fx, Ur O�I9L777.6'I7(UPQLUL O��(.Cid6l7!.iLlL6P. 6 \ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 126893. Board of Building Regulations and Standards Expiration: 8/3/2008 One Ashburton Place Rm 1301 Boston,Ma.02108 Type: Supplement Card THE Home Depot At-Home Servic 9TJNROEUN CHHOUY 3200 COBB GALLERIA PKWY#20 HtIANTA,GA 30339 Administrator Not valid without signature Wednesday,September 13,2006 9:20 AM Craig Smith 603-594-5973 p.04 HOME IMPROVEMENT CONTRACT Sold.Furnished and Installed by: �{ Branch Name: Date: ��9 THD At-Home Services,Inc. V a� d/b/a The Home Depot At-Home Services 345A Greenwood Street,Worcester,MA 01607 Branch Number: Joh#: fie Toll Free(800)657-5182; Fax:508-756-2859 Federal ID#75-2698460 ME Lie#C 02439 RI Cont.Lie#16427 (T Linc#565522; MA Home Improvement Contractor -Reg.9[1I26�893 Installation Address: �C ()eir ity State Zip base s): Last 4 Digits of Driver's Lia#&Exp Mo1Yr: Work Pbone: Home Phone: Home Address: (If different from Installation Address) City State Zip E-mail Address(to receive updates and promotions from The Home Depot): Proiect Information: I/We/You("Purchaser"),the owners of the prtrperty located at the above installation address,offer to contract with Home Depot U.S.A.,Inc. Home De oV furnish,de liver and arrange for the installation of all materials as described on the attached Spec Sheet /-/ c if i icorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with tt a home,pricing errors or because work required to complete the job was not included in the Spec Sheet or Contract DEPOSIT PAYMENT OPTIONS (Subject to fund veriflcatton and/or credit approval.) i 1. Check,Cashiers Check or US Postal Service Money Order CONTRACT AMOUNT $ V (Made)ayable to The Horne Depot). `LESS DEPOSIT sL;P7,4. 2. Credit:ard"and/or other payment options-Circle One Below Vi< asterCard Discover American Express BALANCE DUE The Hom,De mprovement Loan The Home Depot Credit Card ON COMPLETION $an ,I New Acc,unt 7,Existing Account (HIL&HACC ONLY) 'Minimum 25%of Contract Amount due upon Available Credit:S (HIL&HDCC ONJ,Y) execution of this contract /51,..I GE, rb0 1 i1�7`�!� 0cac'� �� i �d� 8 r xp.bate: Name as it appears on card: Indicate Payment Method For -By my/oature below,I/We agree to allow Home Depot to BALANCE DUE ON COMPLETION: char referenced credit card for the deposit indicated. _� i o� f � holder'-> Signature Date HIL or HDCC Authorization Codes Deposit Final Payment Purchaser agrees that,immediately upon completion of the work,Purchaser will execute a Completion Certificate and pay any i balance due. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire Agreement:This agreement and its attachments,including at y financing agreement,contain the complete agreement between the parties and can not be amended or modified unless in writ ng in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign a Compie ion Certificate before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the conte act. You may cancel this transaction at any time prior to midnight of the third busidess day after the date of this contract. See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 25%of the contract amount if the job is cancelled by Purchaser AFTER the third busi Less day. BY MY/OUR SIGNATURE BELOW, I/WE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. UWE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, UWE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND I/WE AUTHORIZE HOME D--POT TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT C EDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INAD N 2I2ORS. ��j_�� SUBMITTED BY: Date: _-y �. ACCEPTED BY. Date: onteowner Date: Homeowner NOTICE:ADDITIONAL TERMS AND CONDITION:;ARE STATED ON THE REVERSE SIDE AND ARE PART OF TH13 CONTRACT 4-07-06 GSC White-Branch File Yellow-Custo ner Pink-Sales Consultant