HomeMy WebLinkAboutBuilding Permit #263 - 97 BERKELEY ROAD 10/14/2008 BUILDING PERMITOf NORTH qti
TOWN OF NORTH ANDOVER �� - 0�
APPLICATION FOR PLAN EXAMINATION
Permit NO: //Y Date Received *
��SSACHUS�
Date Issued: CO�
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PR ED USE
es' ' i Non- Residential
New Building ne famiI
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
"Sp#�c `lll s F�o'odplam :Ve'ttaras Wrshe �s#rte#
r 'n tom/ aW..eTa_
DESCRIPTION OF WORK TO BE PREFORMED:
Iden 'fication Please a or Print Clearly)
OWNER: Name: , CICS �tJ�%AYL,61111c� Phone: C97F) 6 3,7
Address: � t,G y AICIM Of Y,5 A
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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: $ ��� . ' FEE:
Check No.: 34W5 Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access t Panty fund
r�aturaA° ertlOawner ry_
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Pel
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Location 19 e2,
No.
4<3 Date /P -
&ORTot TOWN OF NORTH ANDOVER
�°. s
�e Certificate of Occupancy $
s' MBuilding/Frame Permit Fee $ Y
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
2 i 5
Building Inspector
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-.,�A,
Private(septic tank,etc. Permanent Dumpster on Site .w
it
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED'
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
t�*OMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
It Located 384 Osgood Street
E ' 3r� ' ,Teraa Uapstrre �eo
`1tzt291a�oSr # '� 71 `
47
r
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 2008
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 2.2008
c
I,ORTH
Town of
0
No. Z G 3 YU., In
CN o over, Mass.,
Q - LAKE ^,
COCHICHEWICK V
7 ADRATED P'Pp�
'9S E BOARD OF HEALTH
Food/Kitchen
Septic System
PERMIT T D � l .
� BUILDING INSPECTOR
THIS CERTIFIES THAT �v s ��.v9.r... �? �`–
.................................... .................:....................................................................... Foundation
has permission to erect.................:...................... buUdings on .�,?�.. ....!5,� t :.�.....7. g
...... Rough
�/ v/n Chimney
to be occupied as......../z.. ..... .......�!�.... .........................y. —................................................':.................I.............
provided that the person accepting this perirll in 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
` J PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR.
UNLESS CONS TR T w Rough
J.
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.
P'
•
•
IP FIGS► 155U 5 A dIA R OF IN MATT
PRooveEft. ONLY AND CONFERS NO RIGHTS UPON THE CERN KATE
cCC1C6 Tnc. NOwER.THtB CERTIFICaTE DOES NOT AMF�IDr TEND OR
H,J,Knight Tntcrns tional Insurance tog r ALTFRTNE COVERAGE AFFORDED o5YTItE P LjCjrx OVEnA BELOW.
500 Victory Rosd-NIBr�B 13aY COMP i
.North QRiucyr MA 02121 c°qA"r Atl aTtiD ChLLrter insurance Co ILII YDAC
:@ coMPANY
INBURlDa
p,lpine Property ServiceB Co.,Inc. COMPANY
Olympic . C
11'Wllfivn Street ooMPANY
Splesn,MA 01970 D
THI$19 TO CERTIFY THAT TME
POLfGIE50F U GEIISTEnBELaf♦IAYr99e, EDTOTHEvaURm xuavEr EPOIIaYPwtO0
1NolcaTlEo.NOTYYMWA,NDOJG ANY KtOVI El9LarT'TERM OR cormrTlON OF ANY G TCA °acuM>I+r WITH IL-T M A to I'E TF IS
INDICATED.cEKM-ICATMAY DE ISSUET7 OR MAY PPRuiN.TFIE INSURANCE AFFORDED BY THe POLICIES DESCRIBED tiERERI IS 6U JEC7 TO ALL THETFRMB, 1
t7LCLUB10H8 AND CONDIIION4 OF SUCH P4��LOSS SKuwN K&Y HAVE DMH REDUCI D DY PAW CL.LSAS,
POLICY EFFEOm'S PA1E(Mtr I YI" tJour
CO TYPE OF INSURANCE POLICYNU/0ER DATE(MWOCII'YI nRTna�w�}
LTA BODILY INJURY OCC f
GENEAALLIAWA-tly BODILY INJURY AOQ 9
COMPREHENSIVE FORM
PROPERTY DAMAGE OCC 6
FREMP'EwOPM'ATIONS pROPERTY DAMAGE AGG f
VNpEROROUND
BIAfl)COMBWED OCC i
p7I,OBtQN a OOLLAPSEHAZARO 918 PO OOMBINED AGO f
PROOUI'.fB=tAPLETED OPER
pEpSONAL INJURY AGO
CONTRACTUAL
INDEPENDENT OUNTRACTORS
BROAD FokrA PROPERTY DNMGE
PERSONAL)NJVRY
BOOILYINJURY
M TOMOBILP LIABILITY
(Porpmaon) f
ANY AUTO
BOOILYINJURY
ALL OWNED AVTOs(FAVOW Povv)
J ALLOWNPDAUTOS IPeraoelaolN f
(OMyr Nan Pd-to PnmenDen
_ PROPERTY DAMAGE S
MIRED AUTOS
HON.OWNED AUTos BODILY INJURY a
PROPERTTOAMAGE
GARAGELIABiLn-(
COMBINED 6
EzQE66 LIABILITY
5
AGGREGATE f
UMBRELLA FORM )
S '
OTHBR THAN UMBRELLA FORM
WOR1Wf®illiATlOHAM WCV00754901 1/5/200$ 1/5/2009 STATUTORY L1MITS
�
MMOYER'a L"ILrrY EACH ACGDEM s 5001000
OI9mn-pOUQYLLMn i 5004000
DOME-EACHEMPLQYFF Z 500,000
onieR
i
OP3CLBPnoN OF oPERA11oN9AACAlIonWYE771Gk$�eGAL IIPJAB
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BNOITLOANYOP7HEABOVEOE9CR(BEDPOL{CfE58£CAHCALEABEFOR6Y"E
EISPIRATTON DATETHEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL:
17, DAYS WRMGNNOTICE TOTME CERTIRCATEHOLDER NAMED TOTHE LEFT.
PUT FAILURE•f0 MAIL SUCH NOTICE SHALL IM2pSE NO OSUGATJON OR UABIUTY
OF ANY KIND UPON THE COMPA^-ITS'AGBTIP OR REPRESS ilAti 65:.: '
• - wmoR®r®Reaan+rATlve ••�;�`;''7;�„$
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Ilk Boston MA 02111
t 3'�
www•nzass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers
Applicant Information Please Print Legibly
Name (Business/Organization/individual):---A,
�, !L 3
m�
Address:
City/State/Zip: Phone#:
Are you an employer?Check the appropriate box:
Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet 1 7• ❑ 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. U We are a corporation and its
required.] officers have exercised.their 10:❑ Electrical repairs or additions
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.] r employees. [No workers'
comp. insurance required.] 13.❑ Other
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
+homeowners who subtnit.tius affiiiavii indicating they arc daiiig at!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.#: �,(J Qp Z��p I Expiration Date: /
Job Site Address:_ 7 6�c Ia4c /L 4) City/State/Zip: 1 fes,
•
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 ST
of u to$250.0 amst the vt
. OP WORK ORDER
fine
P Y ag o a a advised that a co of
. copy this statement may be forwarded
Investigat' s of the DIA for insurance covera verification. Y d to the Office of
I do reby certify under the pains and pe es of perjury that the information provided f p ided above is true and correct
St Date: / a
Phone#:
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
ctor
6.Other
b P
Contact Person: Phone#:
11 W kill
7m"
HIC 9154326
Russ Quartarone rst 1958 EIN#56-2618812
97 Berkley Rd. Roofing Siding • Painting
North Andover,MA 01845
(978)688-8937
August 25,2008
Revised: September 3,2008
Dear Russ,
I have prepared the following estimate for the installation of the vinyl siding at the above location. This will be a full coverage job with no
maintenance required and lifetime warranty. All work will be performed to the manufacturer's specifications to ensure a lifetime warranty.
Below is a brief description of the work that will be performed.
Vinyl Siding:
• Strip existing clapboard siding off the entire house
• Inspect the sheathing
• Install 3/8"insulation board over all areas prior to vinyl installation
• Install Crane Market Square or CertainTeed MainStreet Double 4"vinyl siding IQr �-�' /fit(per
• Flash all windows and doors e
• Install fluted super corners_owlritr� 'p-e{pkL f<
• Take down and re-install gutters C 1 tl
• Securely nail all loose boards and wood
• Replace any rotted wood @$12.00/ft.
• Scrape away any old caulking around any doors and windows
• All overhang and eaves will be dressed with soffit panel
• All trims will be wrapped with aluminum coil stock
• We will install new vinyl comer,j-channels and casements throughout
• The soffit and face boards will be done to match the windows
• You may choose to have the vinyl match the color of the soffit
• You may choose to have us install vinyl shutters(this is an option and is not included in estimate)
• Foundation will not be covered
• Job will be started and completed without any interruption
• Vinyl permits vary from town to town and are not included in this estimate
• COLOR:
Please initial options you are choosing below. /
Cost for Labor&Material for Vinyl Siding: 71,5 4'e, W.$12,750.00
Payment Terms: 1/3 deposit upon signing contract $ ZJ x,1/3 work in progress $ and 1/3 upon completion$
Please make payments to Alpine Property Services Company Inc.
Total Amount Agreed To Be Paid: $ IC2750-LO
The following schedule will be adhered to unless circumstances beyond Olympic's control arise:
Work Scheduled to Begin: TBD Expected Date of Completion: TBD
Warranty: Olympic Painting&Roofing Company,Inc.guarantees all work performed for a period of one year. If any problems occur,we
will cover the cost of all labor and material to correct the problem to meet the customer's satisfaction. The vinyl siding material will have a
lifetime warranty from the manufacturer.
Do not sign this contract if there are any blank spaces.
(addi 'onal provisions follow and are incorporated herein by this reference)
Pro ctrvigeLnvbnors, r ZL� I 'r ARuss Quartarone
Alpine Property Ser ompany Inc., Homeowner
d/b/a Olympic by(Name)
Tel: (800) 535-4312 • Fax: (978) 535-2008 • 515 Lowell Street Peabody,MA 01960
1-888-5 OLYMPIC • www OlympicContractors.com
15 Tanguay Avenue 1 Rockland Cemetery Road
Nashua,NH 03063 — • North Scituate,RI 02857
✓lie loanvmaruuea/.� o�✓�.aaaae/%uael�
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registratotr=:1;54326
�Exphrat+on 2127/2009 Tr# 254379
Type—Private Corporation
ALPINE PROPERTJ'SEft�lIGES CO,INC.
..
STARROS MOUTSOl7L�S f :'
11 WILSON STREET�:;.4�=
SALEM,MA 01970 Administrator
!V/ass;�chuserrs_pf
Bard W, parr
Buildin., 'Hent of Pu
Construction SnperRe.ulations andnhc Sai:ctt
License: CS sor S St
RestrictedSL 101003 Pecialt ense ds,
to. .RF,WS Y License
STAVROS MO
11 WILSONST
OVLAS
SALEM, AWA 0T REST
970
�,•n+friss
„ne i Expiration. 12/14/2011
X2011
Tr#. 101003'