HomeMy WebLinkAboutBuilding Permit #117 - 82 LINDEN AVENUE 8/15/2006 TOWN OF NORTH ANDOVER
No
APPLICATION FOR PLAN EXAMINATION 0 or6
t • '• p
O A
112
Permit ti0: Date Received �' i +'
A•'�AT20
Date Issued: �//o �SSACHUS
IMPORTANT: Applicant must complete all items on this page
LOCATION L i ,a'eri � /1 V`
Print
PROPERTYOWNER
Print
NIAP NO.:=aa PARCFI.: ZONING DISTRICT:
TYPE AND USE OF BUILDING --HISTORIC DISTRICT YES 0
TYPE OF IMPROVEMENT PROPOSED USE
Resid tial Non- Residential
New Building ?"'One family
-- ,Xddition =Two or more family = Industrial
Alteration No. of units:
Repair, replacement Assessory Bldg Commercial
Demolition
i/Iovinv-(relocation) -j Other --j Others:
-: Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
I entification Pease Type or Print Clearly)
OWNER: Name: ��� G'n a`w`e– Phone:
Address: e � a��--Q"'( � _ I4 6 �o
CONTRACTOR Name: Phone: 5 7(L
Address: -�> 4 ��2.e flt�oo� 5� , UJOC'C2 54-cc-
Supervisor's Construction License: Exp. Date:
v
I-Ion-le lnipro�ctnent License: 01-;5 Exp. Date:
SFr3—G1T�
ARCF-IITECT• ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:.510.00 PER 81200.00 OF THE TOT,4L ESTIMATED COST BASED OA 5125.00 PF.R S.F.
Total Project Cost :S I'l+U9D x12.00==1FEES 162 —
No.:Check \o.: Receipt No.: /93.. 7
Nage lot-1
i
I
I
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
❑ Workers Comp Affidavit
a 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
:i 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:I16PEC IONA .SERN I(Ta 1)E'I'1Rl'Vb:.VT:nPFOR 1105
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l
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 tileter location to
project
NOTE: Persons contracting with unregistered contractors do not have access to the guuranttjund
Signature of Agent/Owner
�.4��ti1. �Signature,of contractor
Plans Submitted ❑ Plans Waived '❑ Certified Plot Plan ❑ Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF- L FORM
-DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ �!
[]Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ IJ
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ;�
COMMENTS
i
Zoning Board of Appeals: Variance.. Petition No:
Zoninu Decision:receipt submitted ycs
I'lanning Board Decision: Comments
Conservation Decision: Comments
Nater& Sewer connection,Signature& Date Drivewav Permit
Tem on site ves n '-r
Temp Dum ster p _ o� Fire Department sr�nature date
Building. Setback (
FrontYard
ront Yard Side Yard Rear Yard
Required Provided_ Required
Provides Required Provided
f—
Dimension
Number Of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
NOTES and DA FA—1 Por department use)
I. P',ICLS UL-PAR I"VLN 1'.1!ill()I,'A,!i
Location Irl-V 4416
No. // DateOC//r1a 0
40RTh TOWN OF NORTH ANDOVER
O'� .•o ;•1'MO
y Certificate of Occupancy $
s'••°MU� <�' Building/Frame Permit Fee $ �
'�CS
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # / v
19357
�b�&g Inspector
NOTH
0Tof
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1
over
No. 1
dover, Mass.,
T fib-
0 = CA E 1•
�J COCNICKEWICK
7 ORATED
'9S ti BOARD OF HEALTH
Food/Kitchen
PER
.�
Septic System
THIS CERTIFIES THAT......... T........
BUILDING INSPECTOR
. Q. .�i ./ ......................... :: :.........................................
. .. Foundation
has permission to erect........................................ buildings on ....8 ....I�.1.�/ ./y #4.JWO.............. Rough
• • •
to be occupied as........... .. .. �. .. j.... f.i...... Chimney
provided that the pe accepting this perm all in every respe con orm to the terms of the app ' ion on i e in Final
this office, and to the provisions of the Codes and By relati to the Inspection, Alteration a . Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
o PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CON STRUCN STARTS Rough
ej�4
B
Service
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.
IFsESmoke Det.
E REVERSE SIDE
rlijg G? OG 01 . 20p Michael Bedard 1 -401 -246-2868 P. 1
03:56N LAW- T-116 F 0011U'l F-401
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Uil nMeg�u al. Itan 9ea
e itn.
One Ashburton Place - Romn 1301
Boston. Massachusetts 02109
'Home Inirrovemerit Contractor RegistTation
7ype:
THE Home Depot At-Home Services--.
BOYD LIPHAM
3200 C106B GALLERIA PKINY#200.
AtIANTA, GA 30339
Update Address and return card.hark reason fur tharige.
Renewril !j Employment Lost Curd
OPS-CA! 0 VM-t WM,FC1"W
Tltri rd of Ito ild I fig lkngulm ifem. ind Standw ds License or registration valid lid for indiv;dol use only
k
HOME WROVEMENT CONTRACTOR before the gzpirmioin date. If found return so:
Board of Building RtgulafriorLs and Standards
One Ashburton PInce Kin 1361
Boston,Me.0110$
Type Private Corporation
THE Home 06polA,__Horje$.*ices
BOYD UPHAM
$200 C05E GALLEWA PK'N.Y '20
AliAN7A,GA 30339
FROM : KIMBLY FAX NO. 6033629679 Aug. 14 2006 10:47PM P7
HOW VMPRO'VVIvIENT COINTRACr
"Old,Furnished and Installed by:
Branch Tame:_. Date-, `fH[)At-Roane Services,Inc.
dib/a The Horne Depot Al-Home Services
345A Greenwi.xtd Street,Worcester,MA 01507 0
Branch\umhec: ' Jt)h k: ��. f Toll Flee(800)657.5182: Fax:508-756-2859 �/1►
Ftdt•ral IDs 75.2698450 ME Lic s C 02439 RI Com.Ltcs 16427
CT Lk 05W22: MA tlatnte Fmprovem®1CannacrorRcg t I2688d
lnatallation Address: " A"
City Sthte Zip
1 Lap 4 D a otiorivr't lAr.a dr E HetYr. W uric Dont_ q q�
Home Address:
(If different from installation Address) City Stele Zip
t
E-mad Addrerts(to reteiae tlpdates and pMenotimas from The Holm bepot)-T --
e ormation: 1AVd cm('Ptur:haser),the owners of the property located at the above installation address,offer to '
contras wit t treteDepot U.S.A.,Inc,(`Home Depot')to furnish.deliver and arrange for the installation of all materials as
described on the attached Spec Sheet it incorporated herein by reference and made a part hereof. j
Ulome Depot reserves the right to encel this contract if,upon minspection of the job,Home Depot determIlm that it
cannot perform Its obligations Clue to a structural problem with the home,pricing errors or because work required to
complete the job was not iacluded in the Spec Sheet or Contract.
DEPOSIT PAYMENT OPTIONS
(Suhim to turd wrilltatlon and/or ctcdtt approval) i
C.ONTRA(TAMOUNT 5 lL yqG 1. Check ay2bl toll*
o e pascalSewteeMorayoda
1`l f Q Lytade payahk to 7ha Horne pcpot)•
*LESS DEPOSIT 3 1I '7 t , 2 Credit Cud*andlor other paytnem options-Cucte One Below
Vip W sWiCud Diawvor Atnencan Express
BALANCE DUE O I pa I� ry1G Hume Dopa Cmdtl Cu
ON COMPLETION S J The Home De Hoo>c
clew Acrouat 'l rt%k0n¢Aewnat (HIL HOC:C ONLY)
'Hlelmum 25%of Contract Amount true upon Avausbu credte s�b'� (1111,&trOCC ONLY)
cxscntioa of this contract. y
AMC ��-51$(p���
Name m it appe on cud:
Indicate Payment Method For -By my/our signature below.We agree to allow Home Depot to
BALANCE DUE ON COMPLETION, charge the above referenced a it card for the depatit indicated.
C I��17Ta 4�
-41 one _ IIate
HIL or HDCC Authorintion Cottee
DepositIFinal Pa Ment
# (311-7b1 #0
Purchaser agrees that,immediately npon completion of the work,Purchaser will execute a Completion Certificate and pay any
halance due- Purchaser also agrees to be jo imly and severally obligated and liable hereunder_
Entire:gement This agreement and its attachments.Including any financing agreement contain the complete agreement -
between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties.
NOTICE TO PURCHASER
Do not iign this contract before Jou read it- You are entitled to a completely filled-in copy of the coalraet at the time
you sign. Keep it to protect your rights. Do not sign a Completion 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 contract.
You may cancel this transaction at any time prior to midnight of the third business 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 contmet
amount if the job is cancelled by Purchaser AFTER the third business day.
8Y MY!0(;R SICNA11IRF BRI-OW, (/WF.,AGREE TO BE BOUND BY THE TFRMS OF THIS CONTRACT. 1,WF
ACIftiOWLFDGE RECEIPT OF A COPY OF THUS CONTRACT AND TWO COMPLETED COPIES OF THE NTOTIC.E
OF CANCELLATION.
BY MWOUR SIONATUR BELOW,I/WE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF
MY/OUR CRL-DIT FIISTORY AND IfWF AUTHORIZE 140ME DEPOT TO VERIFY AND kFIVIFW MYIOUR CREDIT )
RECORD WITH AN IND PE. ifttRLDl0Tr70PORT1NC AGENCY ANI)RELEASE THEM FROM Al..I.LIABILITYINCURRED FROM A l2 EItRURS,
SUBMITTED BY =54 - Uftwit
: i}ate ^T._
.ACCEPTED BY: — Date: 0
w e 4 _.._.
? i1�-z yrz�saP� Date £t*
-rtrr I(r
NOTICE:ADDITIONAL TERMS AND CONDITIONS sitL SKATED ON THE REVERSE SIDE
AND ARE PART OF THIS CONTRACT
4-07-06 CSC Whits—R191nch Fi14 YBnWJ—Cu:lt)tt12r PMt—»t?5 CtIMlt:lfll