HomeMy WebLinkAboutBuilding Permit #014 - Exception 7/13/2006 t NORTH 1
p tt� o ti
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p TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
9
�,SSAC Hust41'
Permit NO:
Date Received: ► a`r
Date Issued: "
IMPORTANT: Applicant must complete all items on this page
LOCATION ( �
PROPERTY OWNER I`�1'�S�►'1G Pry, ,-f-I�► t7P n '
n
MAP NO.: V?.—I PARCEL: —7 7 ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
i
❑New Building ❑ One family
❑ Addition ❑wTwo or more family ❑ Industrial
❑ Alteratio No. of units:
Repai replacement ❑ Assessory Bldg ❑ Commercial
❑ Demolitl
❑ Moving(relocation) ❑ Other El Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
`I 20\a
Identification Please Type or Print Clearly)
OWNER: Name: c�St'1nG Me I Phone �i-7k-���
Address: AQ "
� g�S64- 576
CONTRACTOR Name: Phone• 4?-7 --
Address: � G c'ee n w�c �F
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE.BOLDING PERMIT:$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST PASED ON$125.00 PER S.F.
Total Project Cost :$ l 'q , `�r� - x10.00=FEE:$ j
Chcck No.:
o Receipt No.:
Page I of 4
Location 3� �qv K.�-ti eat
No. D 1 ` 01 Date
�oRTM. TOWN OF NORTH ANDOVER
0 s
Certificate of Occupancy $
�' b'••°.e�� Building/Frame Permit Fee $
,SJAC14USE
_ Other Permit Fee
TOTAL $ �r
Check # 1350 ?
"
19500 l�
Building Inspector
TYPE OF SEWARGE DISPOSAL
Tanning/Massage/Body Art ❑ Swimming Pools 11Public Sewer 11
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Permanent Dumpster on Site ❑
Private(septic tank,etc. ❑ Electric Meter location to
project
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of Contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ 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
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
Temp Dumpster on site ye no__X Fire Department signature/date .
Building Permit Approved and Issued by:
Pau 2 of 4
Building Setback
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 DATA—(For department use)
f
I
G
i
Page 3 of 4
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORMOS
Crewed JMC.Jan.2006
r
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 n Permits
I ❑ 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
❑ 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
❑ 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:INSPEC'rIONAL SERVICES DEPARTMENTMFORN105
Page 4 of
NORTH
Town o , t RAndover
No. pJot
o _ LAE dover, Mass.,
OC HICHEWICK
AGDRATED
'9S BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
• BUILDING INSPECTOR
.
THIS CERTIFIES THAT..........�..r.I....s... t�. .............�................ ......1.I\.R►N ................................................ Foundation
has permission to erect............. .......................... buildings on . ..........�� I.. .h.............................. Rough
to be occupied as....[ ....... ...�i/ �,.I �. .. Chimney
provided that the person accepting is permit shall 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
14Final
�� PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCS Service
T Rough
............ R................................................................................
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.
FROM : KIMBLY FAX NO. : 6033624679 Jul. 07 2006 11:50PM P4
HOME IMPROVEMENT CONTRACT"
Sold,Furnished and Installed by:
Branch Name- 5i �) Date: "7 6 THD At-Home Services,[Tic,
dNa The Home Depot At-Home Services
`� f J 345A Greenwood Street,Worcester,MA 01607
Branch Number. �✓ I Job#:� ( Toll Free(800)657-5182; Fax:508-756-2859 LA3
Fodeml ID 9 75-2699460 MIS Lic 9 C 02439 RI Cont.UOB 16427
CT Nt;9 565522; MA Homc IrpmvnmentnContractor Rea.#12699.1(99
Installation Address: � N .- A ft d `q 4- b�"t '
City State Zip
tett e• I,ant 4 '. of Driver's I ac.p&lis .MuNr.. Worn Phone: Hume Phone:
1 11 ) RAI I
( ) )
flome Address:
(If different from Installation Address) City tate Zip
E-mail Address(to receive updates and promotions from The Home Depot):/ �C"Oce �t/�• Y
Pro'ectInformation: VWe/Yati("Purchaser"),the owners of the property located at the above installation address,offer to
.contract wi Home Depot U.S.A.,ins.(°.`borne Depot")to futuish,deliver and arrange for the installation of all materials as
described on the attached Spec Sheet#: inewpomted 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 perfolma.its obligations clue to a structural problem with the home,ptiiaiug errors or because work acquired to
complete the Sob was not included in the Spee Sheet or Contract.
DEPOSIT PAYMENT OPTIONS
(Su>7j act[o flintl vebfirAtlaa xndlor crtxfit a�rmral J
1. (,`beck,C„whicrs Cbock or US Posed Service Money Ordor
CONTRACT AMOUNT $ 3a (Mark payable to The home Depot).
"LESS DEPOSIT" S 'I b 2. Credit Card•and/or other payrsxal options-Cello'O:re Below
.. Visa i4fasteiCsrd Discover Animi.11\press
.. BALANCE DUE �..�� T".re Home Improve Lww 7hc iicmc lk�oc Cratit Card
ON COMPLETION $'' ��VV
New Accnn F.sratd ecoiurt (HIL do IMCC flNLk)
*Minimum 25%of Contract Amount due upon execution
f this t
j ry�
AvaiMbie Credit:S W (HIL&BDCC ONLY)
con"c.. .
..._._
Indicate Payment Idlethod For Name as it appem on card:
BALANCIE DUE ON COMPLETION: 08y tory/our signatprnbelow,I/Wo agree to allow Homo Depot to charge the above
rotor: d credit card for the dcpo it indica
f ,C old,x'a 9,pature Date
l
HIL or"CC Authorisation Codes
Deposit Final Payment
# dp # t OO
Purchaser agrees that,immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate
and pay nay balance due, purchaser also agrees to be jointly and severally obligated and liable hereunder.
�Wire A+ men:This agreement and its attar is including any financing agreement,contain the complete agreement
ween a parties and can not be amended oorrinodi I rileting in a .ratreagree signed by b h parties.
�a,. ]/CI i' Fes 1 TICE TOM "T �j
b
Do not slot this contract before you read it You are entitled to a completely frilled-in copy of the eontrwct at the time you sign. Keep
it.to protect your rights Do not sign a Canplefion Certificate before this project is compMe Law prohibits home repair
contractors from requesting or accepting a Completion CertiGcatt signed Ay tht mvncr peter to.the actual completion of the work to
be performed under the contrack -
Yort may cancel this transaction at any time or to midnight of me third business day atter the date of this contract See Notice of
Caneeaa[feon for an explanation of this There will
a service charge equal to 25%of the contract arreuuat if the job is
cancelled by Purchaser AFT OR the third business day.
BY MYIOUR 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,I/WE UNDERSTAND THAT'fill: AGRIMMKIY'f IS SLJBIFI:T '1"0 REVIEW OF MY/OI1R
CREDIT HISTORY AND UW8 AUTHO'RI'1.13 HOME DIiPOT TO VLA1171'AND REVIEW MY/OUR(;RuDiT RHco1(1)WITH AN
INDEPENDENT CREDff
Prr
ARRI.HASR THEM FROM ALL LIARIIITY INCURRED FROM
OINA?VFRTTNTOMIS O O TSIGD
THIS CONTRA IIF'TiERE AItls ANY BLANK SPACES.
SU13MTTED BY: Date; 7
ACCEPTED l3'Y: Date:
m� Date:_cam 6
H.&C W6._
N(rr":ADDITIONAL TERMS,CONDMONS AND WARRANTLFS ARE STAT10)ON Ti IK REVE&4E MOR AND ARE PART OF THIS CONTRACT
• nitre-Btmch File Yd1em-Cmmtrxr Pine-Sd rtC,pppiltaet
1205 C-SC
ta:�•_
AT-HOME Installed
_r � Siding g and Windows
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registr
.—i—
.....__._...._126893
Ezpiratfon 913/2006
Type Supplement Card
THE Home Depot i1t HGrtiC
9ZINROEUN
q LLERfi4-l?KWY#20
3200 COBB GA
RLTANTA,GA 30339
Administrator
Proudly sold,furnished and installed by RMA Home Services,Inc.,a Home Depot authorized contractor.
345 Greenwood St.Unit 2•Worcester,MA 01607.508-756-6686•Fax 508-756-2859•Toll Free 800-657-5182