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Home My WebLink AboutBuilding Permit #265 - Exception 10/5/2006 V/ TOWN OF NORTH ANDOVER / NORTFf q "'VVV APPLICATION FOR PLAN EXAMINATION o ,,,.•o ,6 ti t o p T/^ F- o`J�-d tP Permit NO: Date Received + 0 _ Date Issued: 10.- S-d�0 gACHUgE IMPORTANT: Applicant must complete all items on this page LOCATION % )5:�4', typo 8 5-�- Print PROPERTY OWNER Fe�e el e- / Print MAP NO.: PARCEL: 2j 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 K.Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑ Commercial ❑ Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identi cation Please Type or Print Clearly) OWNER: Name: �� /Cidj.e /� Phone: Address: CONTRACTOR Name: 1�►-� >v�� Phone: Address: k-"C,0 Supervisor's Construction License: Exp. Date: Home Improvement License: l a-� ?j Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$1'25.00 PER S.P. Total Project Cost :$ S 15F�/z x12.00=FEE:$ /o Check No.: /,,�& 70 Receipt No.: l 7 � Page Iof4 1i TYPE OF SEWERAGE DISPOSAL 7� Swimming Pools !J Tanning/Massage/Body Art ,� Public Sewer ❑ Well ❑ Tobacco Sales Food Packaging/Sales V 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 4191!!�� i Plans Submitted ❑ Plans Waived U Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM i DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ F1 ❑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: Continents Water&Sewer connection/Signature&Date Driveway Permit Temp Dumpster on site yes-�--no_ Fire Department signature/date �ioav 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) Page 3 o1'4 D,tc:INSPECTIONAL SERVICES DEPARTM ENT:BI'FORM 05 C'reated.IMC.Jan.2000 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 j ❑ 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) j ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application j ❑ 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:INSPECTIONAL SERVICES DEPARTMF.NT:BPFORN105 I Pape 4 44 ,t.%ORTH Town of us �O �t�-'- LAS _ o dover, 1VMass.,10i COCNICMEWICK ADRAT E D 7`S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System " BUILDING INSPECTOR THIS CERTIFIES THAT.............. .......r...f...t.r% '......... ..... ......... ....................................................................... Foundation has permission to erect........................................ buildings on .?.....F1.0p.#1.. .. ................................ ....... Rough to be occupied as......S� .. ..40re g....5Chimney ............. ................ .......................................................... provided that the person ecce ting this permit shall in e ry respect conform toierms 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS N ARTS Rough ................................................... Service BUILDING INSPECTOR 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. MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CCONFERS 7-11 MARSH USA,INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE ATTN:BRENDA BOOKER (404)995-2594 POLICY.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE MAYA MCC LU R E(404)995-3206 OR AFFORDED BY THE POLICIES DESCRI BED HEREIN. TAMI ROUSE(404)995-3430 FAX(404)760-5663 3475 PIEDMONT ROAD,SUITE 1200 COMPANIES AFFORDING COVERAGE ATLANTA.GA 30305 COMPANY 100492-IPUSA-GWA-03/04 A STEADFAST INSURANCE COMPANY INSURED COMPANY THD AT-HOME SERVICES INC. B ZURICH AMERICAN INSURANCE COMPANY DBA THE HOME DEPOT AT-HOME SERVICES.INC. HOME DEPOT USA.INC. COMPANY 2455 PACES FERRY ROAD NW BUILDING C-8 C NEW HAMPSHIRE INS COMPANY ATLANTA,.GA 30339 COMPANY D AMERICAN HOME ASSURANCE COMPANY COVERAGES This certificate supersedes and replaces an y' y previous! Issued certificate forth policy period noted below. 3 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER DATE(MM/DD/YY) DATE IMMIDD/YY) LIMITS A GENERAL LIABILITY IPR 3757 608-01 03/01/06 03!01/07 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' GENERAL AGGREGATE $ 4.000.000 CLAIMS MADE PRODUCTS-COMPXJP AGG $ 4,000.000 OCCUR 'OF SIR: PERSONAL&ADV INJURY $ 4,000.000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 4,000.000 FIRE DAMAGE(Any one fire) $ 1.000,000 B AUTOMOBILE LIABILITYMED EXP An one rson $ EXCLUDED BAP 2938863-03 AOS 03/01/06 03/01/07 X ANY AUTO COMBINED SINGLE LIMIT $ 1.000.000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $(Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ X ELF-INSUREDAUTO T HYSICAL DAMAGE PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY ACCIDENEj OTHER THAN AUTO ONLY. EACH ACCIDEN EXCESS LIABILITY AGGREGAT EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM G WORKERS COMPENSATION AND 6610998(AZ.ID,MD,VA) EMPLOYER5 LIABILITY 03/01106 03(01107 X OC STA LIMTS E C 6610995(AOS) 03/01/06 03/01707 EL EACH ACCIDENT G THE PROPRIETOR/ X INCL 6611326(OR)EPARTNERS/EXECUTNE03/01/06 03/01/07 EL DISEASE-POLICY LIMIT OFFICERS ARE EXCL 6610999(NY.WD 03/01/06 03/01/07 WORKERS EL DISEASE-EACH EMPLOYEEI$ 1.000,000 E COMPENSATION CONTINUED 6610997(FL) 03/01106 03/01/07 D 6610996(CA) 03/01/06 03/01/07 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL,� 0 DAYS WRITTEN NOTICE TO THE FOR INSURANCE PURPOSES ONLY CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILrrY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Walter Gilstrap ;tom f? MM1(3102) VALID AS OF: 02/27/06 AT_-_HOME onstal0ed Siding and Windows Board of Building Regulations and Standards License or registration valid for individul use only W 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 Type: Supplement Card Boston,Ma.02108 THE Home Depot At-Home Servic STJNROEUN CHHOUY 3200 COBB GALLERIA PKWY#20 � 1 % AtIANTA,GA 30339 Administrator Not valid without signature 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 Oct 03 06 06:43a tim saari 16038863430 p.6 HOME IMPROVEMENT CONTRACT / Said,Furnished and Installed by: Branch Name: &I�Qr�7 . Date: !� THD At-Home Services,Inc. dibla The Home Depot At-Home Services v� 345A Greenwood Street,Worcester,NIA 01607 Branch Number: Job#: r,J! �p Toll Free (800) 657-5182: Fax: 508-756-2859 Federal.Ill 4 75-2698460 NSE Lic U C 02439 Rl Cont.Lica 16427 `/ ,C/T�Lic#565522: MIP,Horne improvement Contractor Reg.q126893 Installation Address: 't°(–r7�C1Cr S /(/� L)(ltnr- 14 City State "Lip Purehase s: Last 4 Digits of Driver's Lie.#&Exp.MwYr: Work Phone: 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 property located at the above installation address. offer to contract with Home Depot U.S A., Inc. (" gm��l �kgfu�ttsh, de iver and arrange for the installation of all materials as described on the attached Spec Sheet#_ y�" �"y incorporated 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 the home,pricing errors or because work required to complete the job was not included in the Spec-Sheet or Contract. DEPOSIT PAVNIE•NT OPTIONS ;Subject to fund verf1 cation atkor c:edit'approvd, CONTRACT AMOUNT T L Check,Cashiers Check or US Postal Service Money Order l �! (Made payable to The Hone Depot}. "LESS DEPOSIT $ f i ce '! 2. Credit Card'anchor other payment options-Circle one nclow Visa MasterCa:c Discover American Exprr BALANCE DUE The Home Depat Hone Improvement Loan .:can Hone. a nt Credit Cat ON COMPLETION $ 1 New Account I I Existing Account (HIL&I10CC ONLY) *Minimum 25%of Contract Amount due upon Available Credit X .4/C�) execution of this contract. ��r� (HIL&IWCJ.ONI l') Accu: exp Datc:.Of �� Name as it appearson card: Indicate Payment Method For QP#01ffsignature Belo , c gree to allow Home epotto BALANCE DUE ON COMPLETION: cha the e9vereferent credit r the dep sit kdicattid.—JCf ardho_der's Si lure Date HIL or HDCC Authorization Codes Deposit Final Payment SUBMITTED BY: / onsultant Date: ACCEPTED BY.. Homeoti ner Dale. Homeowner Dale: NOTICE:ADDITIONAL TER141S AND CONDITIONS ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT 4-07-06 C-SC White—Branch File Yellow—Customer Pink—Sales Consultant