HomeMy WebLinkAboutBuilding Permit #830 - 862 SALEM STREET 6/21/2006Permit N4 -2D
Date Issued: 0 -
OORTH
6
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
C
Date Received e2
I IMPORTANT: Applicant must complete all items on this page I
LOCATI
PROPERTY 0
MAP NO. PARCEL: `<'�S I Print ZONING DISTRICT:
9rV'DU A 1%T" 1TQr n1V RITIT -nYN9--
T4lqTnRTC DlqTRICT WN F1
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
0 Addition
0 Alteration
5 One family
0 Two or more family
No. of units:
El Industrial
P(Repair, replacement
0 Demolition
El Assessory Bldg
El Commercial
0 Moving (relocation)
L1 Other
0 Others:
D Foundation only
DESCRIPTION OF WORKTO BE PREFOKMED
OWNER:
Address
41
A A ne�-j Ca-C'-,1kh
�;6e, Ca^ 1 V7�
Identification Please Type or Print Clearly)
Name: 11�tv) C�—A UAldc— Phone:
86 �P, 'StcA Li Pft--� d o oeY—, Ar
CONTRACTOR Name: Tii%o CA'
Address: 4,t� " CA.> -P, I 1 -0-
MOZ
a8q I IF
I
Supervisor's Construction License: A 096 309 —Exp. Date:_ 6 11 C1 1,�tx or;—
Home Improvement License: -Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: —Reg. No
FEE SCHEDULE. BULDING PERMIT. S10.00 PER S1000.00 OF THE TOTAL ESTIMATED COST BAS 0 $125.00PERS.F.
I ED
Total Project Cost 1 1 J57, Coo. 0 0 xlO.00=FEE:$ 500,!,�>
Check No.: Receipt No.:aq�—Cl
Page I of 4
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
u Building Permit Application
u Workers Comp Affidavit
u Photo Copy Of H.I.C. And/Or C.S.L. Licenses
u Copy of Contract
u Floor Plan Or Proposed Interior Work
Addition Or Decks
ci Building Permit Application
u Surveyed Plot Plan
u Workers Comp Affidavit
a Photo Copy of H.I.C. And C.S.L. Licenses
u Copy Of Contract
u Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
u Building Permit Application
u Certified Proposed Plot Plan
u Photo of H.I.C. And C.S.L. Licenses
u Workers Comp Affidavit
u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Copy of Contract
u 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Page 4 of 4
TYPE OF SEWARGE DISPOSAL
Tanning/Massage/Body Art
Swimming Pools 11
Public Sewer F1
F1
Tobacco Sales
Food Packaging/Sales 11
Well
Permanent Dumpster on Site
Private (septic tank, etc. 11
Electric Meter location to
project
NOTE: Persons contracting with unregistered contractors do not have access to till e guarantyfund
Signature of Agent/Owner_zy� Signature of
Contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans El
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
fiEALTH
COMMENTS
Zoning Board of Appeals: Variance, Petition
Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Water & Sewer
DATE REJECTED
El
E]Water Shed Special Permit
El Site Plan Special Permit
11 Other
DATE APPROVED
DATE REJECTED DATE APPROVED
n F1
DATE REJECTED
11
Comments
Comments
Temp Dumpster on site yes_no 11 Fire Department signature/date
101
DATE APPROVED
Permit
Building Setback (ft.)
Front Yard
Side Yard
Rear Yard
Required
Provided
Required
Provides
Required
Provided
ION
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
NU I b�i and DATA — (For department use)
Doc: INSPECTIONAL SERVICES DEPARTMENT: BPFORM05
Created JMC. Jan.2006
DIM
ENS
Locationyk;2.5�4/e/"
No. 10 0 Date J -j
"ORTh TOWN OF NORTH ANDOVER
Certificate of Occupancy $
1 ra * (1'6 1
-T Building/Frame Permit Fee $
CHU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check 16 -1�
9454 fl� -J�
Building Inspector
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41i
Remodeling Proposal
Francisco Veguilla Const.
437 Lowell st �V
Lawrence,, Ma. 0 1841
978-223-7282
Licence # 088308
Date: 31 -May -06
Submitted to - Brenda Clarke
Address. Walem St.
City, St, Zip: North Andover, MA
Good until: 30 -Jun -06
Job name/no- Brenda
Approx. start, 28 -Jun -06
Approx. end - 17 days from start
We hereby submit specifications and estimates for:
Remove old cabinets, remove interior wall joining dining room & kitchen, continue hardwood
through kitchen, install new cabinets, sand & refinish hardwood floors, install new triple
-casement window, install larger toe -kick heater, add more small appliance branch circuits in kitchen,
-add trim (around window, baseboard, & 2 doors), add pendant lighting for island,
-install in -and -under cabinet lighting, install soffit / beam across ceiling & down wall,
-hook-up appliances
This proposal does not include:
Purchasing cabinets or granite countertops, and installation of granite countertops
We propose to furnish material and labor, complete in accordance with above
specifications, for the sum of -
fifteen thousand dollars $ 15,000.00
Payments to be made as follows: $5,000.00 deposit
$5,000.00 after cabinets are installed
$2,250.00 after floor is installed
$1,750.00 after floor is sanded & finished
$1,000.00 retainer paid when completely satisfied
Contractor's signature: 4el", :�4
Acceptance of proposal - The abc(ve price, specifications and conditions are satisfactory and are
hereby accepted. You are authorized to do the work as specified. Payment will be made as
shown above.
Owner's signature: 7
Date.
Gerald A. Brown
Inspector of Buildings
Please print
DATE:
JOB LOCATION:
_ Number
HOMEOWNER
Name
�JK%JL 1.1 rXill"W T kll%
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 0 1845
Telephone (978) 688-9545
Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
PRESENT MAILING ADDRESS
I , I / ,
City Town
�Sq I C M 94,
Street Address
a a M
Map/Lot
ta-k-L 1�7F_6mjo
Home Phone If Work Phone
3,eJvt A
State
ol(�
Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and
to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner
acts as supervisor). State Building (Code Section 108.3.5. 1)
DEFINITION OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to
be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be
considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other
Applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
,APPROVAL OF BUILDING OFFICIAL
Reviwd 10.2-005
Forin Homomiers Exemption
BOARD OFAPPEALS 688-9541 CONSERVATION 688-0530 HEALTH (M-9540 PLANNING 08-
Q535
Ltv; 6/20/2006 Time: 10:53 AM To: G? 1978,,',853332
paget. OQ?004-
DATE (MMIDDYM)
A -CORP, CERTIFICATE OF LIABILITY.INSU RANCE 06/20/2 1 006
PRODUCER CCERT'�ICATE IS ;S ;I�'[jA.IAMA*"TE7,�OFi�ii:CIRMATION
Lakeside Insut-7,;,cc .'.qLncy, UP-ATAIECERTIFECATE
HOL61ERITHIS CERTIFICATE DOES NOT AMEND, EXTEND OR
One Wall Street ALTER THE C�')VERAGE AFFORDED BY THE POLICIES BELOW.
Windham, NH 03087
su�_FD_ Rra_ncfi_c_6__V_eg`L, fl-Ta'-C—on—st r_ur_ti_o__.r__._________
�',QEQ,,: Travel ers St. Pairl
PERIOD INDICATED, NO)TWITHSTANDiNG
ANY REQUIREMENT, TERM OR CONDITK)N OF ANY CONTPAC' "R 017-11711 DO('
43,' t-ow.�11 ko;,d
'PRTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AF ' 'FORDED BY THE POLICIES D�SCRISFD HERFIN
IS -SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGA17E LiMITS SHOVJN MAY HAVE BE�EN F"�DUCED By �'AID CLA"VS.
--10- 3�YS WRIT -1 EN NOI ICE TO T HE CERTflrATE HOLDER, NANIEU 70 THE LEF-I.
Lawrence, MA 01841
POLICY EL.FFSCTIVE
BUT FAWRE TO NAIL SUCH 1107 ICE SHALL FYIPO$E NO OBLIGATION OR LIABILir(
3NSR TYPF (IF INSURANCE POLICYNUMBER
GENERAL LIA611. lr� W06
5347C693
'-_WE
05/30/2006 05/30/2007
I -PATS
X L ALL. TY 1
1
1-, 000, 000
717, 707E I Q F-tt-INT' D 50,000
FAD -
7-u=H 6_;1_1Z_FDR_'E_P_R_E:SE NTATWE
Edwin Duvall/BFTMA
r�nc
VtL) LAPiAny oner)kr,cn, $ 5,(100
THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED
NAMED AEOVE FOR THE POLICY
PERIOD INDICATED, NO)TWITHSTANDiNG
ANY REQUIREMENT, TERM OR CONDITK)N OF ANY CONTPAC' "R 017-11711 DO('
UMENT WTH RESPZOTTO� �AIHICLJ T�J!�
'PRTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AF ' 'FORDED BY THE POLICIES D�SCRISFD HERFIN
IS -SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGA17E LiMITS SHOVJN MAY HAVE BE�EN F"�DUCED By �'AID CLA"VS.
--10- 3�YS WRIT -1 EN NOI ICE TO T HE CERTflrATE HOLDER, NANIEU 70 THE LEF-I.
TN -§R A -0-D I
POLICY EL.FFSCTIVE
BUT FAWRE TO NAIL SUCH 1107 ICE SHALL FYIPO$E NO OBLIGATION OR LIABILir(
3NSR TYPF (IF INSURANCE POLICYNUMBER
GENERAL LIA611. lr� W06
5347C693
'-_WE
05/30/2006 05/30/2007
I -PATS
X L ALL. TY 1
1
1-, 000, 000
717, 707E I Q F-tt-INT' D 50,000
PC
7-u=H 6_;1_1Z_FDR_'E_P_R_E:SE NTATWE
Edwin Duvall/BFTMA
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AUTOMOBILE LIABiLIT(
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ACORD 25 (200110R) (-j'ACORD CORPORATION 1988
SHOULD ANY O�'*,,A: ABOVE DESMSED POLIZiES BE CANCELLEDBEFORE THE
EXP:P.4TION C-AW,.THEREOF,THF:;SSL4NG INSURERWILL GNL)FAVOR TO ?VAIL
Town of Nor?,.h Andover
--10- 3�YS WRIT -1 EN NOI ICE TO T HE CERTflrATE HOLDER, NANIEU 70 THE LEF-I.
Building Deot
BUT FAWRE TO NAIL SUCH 1107 ICE SHALL FYIPO$E NO OBLIGATION OR LIABILir(
400 Osgood Street
Cr ANY KIND UPON THE i-,-SJRER, ITS AGENTS OR REPRESENTATIVES.
North And(over, MA 01845
7-u=H 6_;1_1Z_FDR_'E_P_R_E:SE NTATWE
Edwin Duvall/BFTMA
ACORD 25 (200110R) (-j'ACORD CORPORATION 1988
tte� 6/20/2006 Time: 10:53 AM To: (0, 19786,..'EN3332
Page: 004--004
If the cerrific;ate, holder is an ADDITICNAL INSURED, the policy(ies) must be endorsed A statement
on this ce-fificate does not confer rights to the certIf!cate noldet in HOL: of such enciorsemert(s).
If SUBRO�3ATC-N IS WAIVED. subjectto the terms and conditions of the policy, crertair pcliciesm�Ry
require an endorsement. A statement or this ce-tificate �oes not confer rights to the cert.ficate
holder in 1:ou of such endoisement(s).
DISCLAINIER
The C�,-aificata of insurance or) the reverse side of this 'oon does riot constitute a wntiact between
the issuing m5urer(s), authorized representative cr producer, and the cellificate holde., nor does it
afti, matively or negatively amend, extend or alter the coverage aftrdec �)y the policies listed thereon.
ACO ZD 25 (2001"08)