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HomeMy WebLinkAboutMiscellaneous - 1160 GREAT POND ROAD 4/30/2018 (13) f r "'! n f 1 I 1 iw: li Ii. Y r 1 !a. h.v., r,, 5, Q �A A - t I -��:;:�� ;�� .,1 ! t +1 ! t j + I. 1 f t 1 ,:+ NY •i" N lit, it ili, 1. ito;��on�il �&All', , �, ��, ,AXAMNS 1. �. , No 7m;WE S p 1 1. L.,, t 'I r ,! ?t 4 R1.J ! 1 ,t�'- ".::.", . .. . ,,,,,,, "I �'""of. A W, ,,,!,, my 1 121vcoll�::��,o�,�!*"��i��,-,-��,��!: - - � ,:-� . ,- " �,, ,, , � ,�,-��: AlA .y': IL I ..f�" - fy F ,i Y 1 .1 I,f it i t. _ 1-1 D t .l• I 'L 1 �.ili _ 1 43" r` ! i V S 1 :, '�.l M .. ll� F I f - t a f •1 N ` + ;i 1' iliox fso 1 1 t + i.�, t .ly '�� r. ✓ P ! II it t, ' 4 ,f.d: p.S ;i st'i i f,.. I ,!!, t - i; 'f' J t 4',. I n. �:YI .i alanjS J, i 1 yr` 1 I.a..sl:.l !:, { -Lr .7 u F s ,! �- �ttj , _ s .k - +i' .t� - _ :it •s "t FI.t• tbyl! - r 1 �� Y t, ry TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION /�G�GI �� G�OGI 7 Print PROPERTY OWNER Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ®'Septic Well ❑Floodplain 0 Wetlands ❑ 'Watershed District q Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Print Clearly) ' OWNER: Name: O Phone: Address: CONTRACTOR Name: ���1''�� �Q �'/J� Phone: , 2 ���,•G Address: Supervisor's Construction License: 7�'��2 Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$$12.00 PER$9000.00 OF THE TOTAL ESTIMATED/coST BASED ON$125.00 PER S.F. Total Project Cost: $ �1 , (�� �„ Z6 FEE: $�, '`� Check No.: 012 Receipt No.:oP-(/37:31 C/ NOTE: Persons contracting with unregiste ed contractors do not have access to the guaran and `Signature_of Agent/Owner : Signature of contractor ; �G� 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 o Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o 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 o Certified Proposed Plot Plan o 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: Doc.Building Permit Revised 2008mi 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 i ----------------- ----------- i ❑ Notified for pickup - Date �I Doc:.Building Permit Revised 2011 June/mi guaran �_.._. •_:.�:rvl ICI ." .-. - .- S,ignature of.contractor: - J Plans Waived ❑ Certified plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ GE DISPOSAL in Pools TYPE OF SEWERA ❑ swimming ElTanninglMassageBodY ArtEl � Public Sewer Food Packaging/Sales ❑ Tobacco Sales ❑ Well ❑ Permanent Dumpster on site Private(septic tank,etc. THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF , U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS Si nature CONSERVATION Reviewed on COMMENTS Si nature HEALTH Reviewed on I COMMENTS Zoning Decision/receipt submitted yes Zoning Board of Appeals:Variance, Petition No: NComments Planning Board Decision: In Comments the Conservation Decision: Drivewa Permit mu Water & Sewer Connection/Sicinature&Date DPW Town Engineer: Signature: Located 384 Osgood Street no FIRE DEPARTMENT -Temp Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS - - - - - - - - - -- -- - -- - - - -- -- --- Location No. _ /�'' Date Na^T� TOWN OF NORTH ANDOVER 3? � • OL F p t • s ; . Certificate of Occupancy $ �7s''•e''t�' Building/Frame/Frame Permit Fee $ `'�J_ s�CMusa 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Z_.-- 2 �� � i4 Building Inspector IAORTH Town of ? Andover ., O _ o , over, Mass.tmLAK , COCHICHE W ICK �70 RATED P'Pa„��� 7 V BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System • • BUILDING INSPECTOR THIS CERTIFIES THAT..... 0 �� � �. . ��11.�. d� i...... .. . .. ..... ..... N .................. Foundation i has permission to erect.... ........ buildings on .........I.I��. .. 1N .... Rough ... ... 40 be occupied as �respect � .dl/....Ir ...... /4.j.•� ney provided that the personAceouptin , k.. permit s*'Ii conform to the terms of he application file in Final this office, and to the provisions 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 CONSTRUCTIO ST Rough 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. -�omt.»ianu�eal���.�.aQod��aelta � Office of Consumer Affairs&B smess Regulafion tdO11A fM�12OVEIIAENT co Registration: 116404 Expiration 012 DBA. ST P,&SON C ( I IVELL MA 61'86'� I Jul 11 2011 9:51AM BROOKS SCHOOLFacibbes 9787256295 page 2 PROPOS: STAMP! SCS N. ONSTRO O'TIOl 37 Ru nford- (0 x:937j' 155 June 1,2011 Submitted to: Ery,M � All N:.•,�,N�,q r.w J n ' ra L..� �.� ° ",�.a 4 t?1� '� �" t u :Y> ' e hereby Propose to furnish materials and labor necessary for the completion of 1. Frame 58'X P over with soffit vents and.rubber. 2. Install 116 feet of gutters and down pipes. 3. Remove four dormers off roof and two ridge vents and plywood in holes. 4. Remove and install 6 square of siding on walls. 5. Remove existing roof and replace rotted boards as needed. 6. Install Hicks vented drip edge. 7. Install 100 percent ice and water shield on roof. 8. Install new step flashing on all walls. 9. Install 30 year architect shingles. 10. Cut in ridge vent and install cobra ridge vent. 11.Removal of all debris. WE PROPOSE hereby to fiunish material and labor,complete in accordance with above specifications.For the sum of$26,220.00 Twenty Sig Thousand Two Hundred and Twenty Dollars 00/100 a ent to be made as follows: Please make checkga able to: AnthonyR Stam Start Completed 26,220.00 Total: Contractor's registration#116404 All material is guaranteed to be as specified. All work to be completed in a substantial workmanlike manner according t specifications submitted,per standard practices. Any alteration or deviation from above specifications involving extra costs will e executed only upon written orders and will became an extra charge over and above the estimate. CCEPTANCE OF PROPOSAL: p ,specifications and conditions are satistatwy and are hereby accepted You are authorized to do the work as specified. �. SIGNATURE: DATE CONTRACTORS SIGNATURE: DATE Jul 11 2011 9:51 AM BROOKS SCHOOLFacilities 9787256295 page 3 •PRMS L f STAMP' & SUET C()1I FRIUCTION :37tutnfOd; t>lteet . -U . tkl 0,1852 75 :937=- $5. une 14,2011 ubmitted to: 0. We hereby propose to furnish materials and labor necessary for the completion of- 1. £1. Remove existing sheet rock on outside wall and insulate as per discussion. (l 9t and 2"d floors) 2. Install new R1 insulation in walls. 3, Install new sheet rock. 4. Tape and mud all sheet rock seams and inside corners. 5. Prime and paint walls color to match existing walls. 6. Removal of all debris. E PROPOSE hereby to furnish material and labor,complete in accordance with above specifications. For the sum of$9,300.00 Nine Thousand Three Hundred Dollars&00/100. Payment to be made as follows: Please make check payable to: Anthony R. Stamp Start Completed 9,300.00 Total Contractor's registration#116404 All material is guaranteed to be as specified. All work to be completed in a substantial workmanlike manner according t pecifications submitted,per standard practices. Any alteration or deviation from above specifications involving extra costs will e executed only upon written orders and will become an extra charge over and above the estimate. ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the worm as specified. IGNATURE: L! L ATE ONTRACTORS SIGNATURE:, DATE Mu%%aciawws- Mpartm nt Eel'Public Safet} Board 4 Bitiklin_Remdations and Standards Construction Supervisor License Farre to possess a current edition of the Massachusdb State BMldiag Code License: CS 79M is cause for revocation of this license. PRICE PETERSEN Befgerta WWW.Mass.CovMPS 61 FARM POND RD DRAG T,MA 01826 Expiration: 8118!3012 t bnxni.�i+.ner Frg: 31511 J1l< �fnarrrtorruccrtt/r!/^lfr;;rr�/rn r/t; License or registration valid for iadividni use only OMet of Consumer Affairs&Busidess Regulation before the expiration date. H found return to: 1M E pROVMNT CONTRACTOR Office of Consumer Affairs and Business Regulation btratlon: 133364 Type: ration: 6/11/2013 Ltd Liability Cotpor 10 Park Plaza-Suite 5170 Boston,MA 02116 Commercial Contrwas8li od LIC. PRICE PETERSEN 61 FARM POND RD DRACUT,MA 01826 undersecretary Not valid without signature " VDAC CNA WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (GS59UB-4193P65-4-11 ) RENEWAL OF (GS59UB-4193P65-4:-10) INSURER: CONTINENTAL CASUALTY COMPANY 1. NCCI CO CODE: 80381 INSURED: PRODUCER: - - -wSTAMP, ANTHONY-DBA - .- BYE TTE INS-AGCY INC STAMP & SON CONSTRUCTION 853 MAIN STREET 37 RUMFORD STREET TEWKSBURY MA 01876 LOWELL MA .01852 Insured is AN INDIVIDUAL Other work places and Identification numbers are shown in the schedule(s) attached. 2. The policy period is from 04-16-11 to 04-16-12 12:01 A.M. at the Insured's mailing address.. 3. A. WORKERS COMPENSATION.INSURANCE:_ Part One of the policy applies to the Workers Compensation Law of the state(s),Ilsted here: MA m� B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in ' Item 3.A. The limits of our liability under Part Two are: o Bodily Injury by Accident: $. 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit o_ Bodily Injury by Disease: $ 100000 Each Employee -- C. OTHER STATES INSURANCE: Part Three of.the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20--03 06A D. This policy includes these endorsements and schedules: o SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 0 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 03-08-11 WC ST ASSIGN: MA OFFICE: CNA 04J PRODUCER: BYETTE INS AGCY INC , 25GSF 002507 r NORFOLK& DEDHAM MUTUAL FIRE INSURANCE COMPANY SPECIAL BUSINESSOWNERS POLICY RENEWAL DECLARATIONS Policy# R0639424A Named ANTHONY STAMP Agent BYETTE INS. AGENCY, INC. Insured 37 RUMFORD STREET LOWELL MA 01852 Phone (978)851-6678 Agent# 20434 FORM OF BUSINESS: Policy Period: 1 YEAR from 07/14/11 to 07/14/12 This declarations page together with the policy jacket, the policy form and any endorsements, completes this policy. Coverage begins at 12:01 A.M. Standard Time at the covered residence premises. ,,,x. Basic Annual Endorsements State Taxes Total Annual Additional Return Premium P or Fees Premium -.Premium .- $1,699 $201 $1,900 '11.7 „.-.�r; ": t n .<,�rar `rvvQ•.4," .`' ;a -"'X't ,r` .t� ' 1 k s -.;x ` ✓,`. Building/Location 1 37 RUMFORD STREET LOWELL MA 01852 Address if Different Mortgagee Information Business Description CONTRACTOR-CARPENTER-RESIDENTIAL/L " , .. ._� ., . .. . „._ rte, x.,. ., •�. v. -... Premium POLICY DEDUCTIBLE $250 OPT.COV./EXT.BLDG GLASS DEDUCTIBLE $500 BUILDING (COV A) Limit ACV OPTION (Yes I No) NO AUTOMATIC INCREASE (%) 8% Included BUSINESS PERSONAL PROPERTY Limit $10,000 Included .t '`"` ;a , zk. £ > ,"T'"' x E r, � '�Cx-,� +,y , S �'::b5 „ A'{ Y.S o-z>•. '` '�..0 Premium OUTDOOR SIGNS Limit EMPLOYEE DISHONESTY Limit MONEY&SECURITIES Limit ACCOUNTS RECEIVABLES Limit VALUABLE PAPERS Limit FORGERY&ALTERATION Limit TOTAL PREMIUM PER BUILDING $1,900 EXCEPT FOR FIRE LEGAL LIABILITY, EACH PAID CLAIM FOR THE FOLLOWING COVERAGES REDUCES THE AMOUNT OF INSURANCE WE PROVIDE DURING THE APPLICABLE ANNUAL PERIOD. PLEASE REFER TO PARAGRAPH DA OF THE BUSINESS LIABILITY COVERAGE FROM , LIABILITY&MEDICAL EXPENSES OCCURENCE $1,000,000 Included GENERAL AGGREGATE $2,000,000 Included PRODUCTS COMPLETED OPERATIONS AGGREGATE $2,000,000 Included MEDICAL EXPENSES $5,000 Included DAMAGE TO PREMISES RENTED TO YOU $100,000 Included v Premium SEE ATTACHED PAGE �}�Y�1'+���'{�/�11� ■y,����� --'oyuAf ��i•��7 V`F� jam. �"�Z������ � � „T'"5 5 Tl,�/�I�, y��.. N.4 �. S 1 c..,f-. ':JNll#IM l{+UI �/"Apkl NO ��� 1+� � ��� S•'iS�^��Q'CLY�,�°v' •Zr�.' �S t'i � swe 'TZiRClYIi�" �i� �', ,„\ � r� � .� ��� ,. iy.S r x x""'� '• t• � �o;.r�� e>a'.-�s r'r�s BOP-1 f DIRECT BILL NON EFT 10 AGENT COPY innv nA/n41 Tema of Pavmanf- ............