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Home My WebLink AboutMiscellaneous - 1289 SALEM STREET 4/30/2018 gg SALEM STREET 2101106 0.0 T_ . _ _ -� - - - I� Location No. �/ / Date NORTH TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ Eta' Building/Frame Permit Fee $ ACMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �' Check # /v C�l 14171 1 4 1 7 1 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING a u„ BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissionerfl for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 12 e? 7 f9 evW41*� 122, Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Cso Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re gwred Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record / Name(Print) Address for Service: ('N Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ - 1040 �/ 2 I:;icenssed Construction Supervisor: f �q ( e- /a- e 2- O /a-S � G�h—'U 11 5- l .0 E� License Number M" Address tl Expiration Date Signature. Telephone 3.2 Registered Home Improvement Contra nr Not Applicable 0 C� / Company Name 12— L ry M /"` Registration Number rM Address r Expiration Date 1/ Signature Telephone G SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Descri tion of Proposed Work check ali applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: s SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OGIAL USE t ENLY > "' Completed by permit applicant ti. 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of ,�--�, Construction 3 Plumbing Building Permit fee(a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number -T SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A I ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3KD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE roo��r • ' Free Estimates Page of 105 Haverhill Street Fully Insured Methuen, MA 01844 THOMPSON'S ROOFING (978) 691-1355 Shingles — Slate'— Rubber Roof Single Ply— Copper Work PPCPOSAL SUBMITTED TO PHONE pgTE Mike Gueli E,-%-00 STREET JOB NAME 1289 Salem Street CITY,STATE AND ZIP CODE JOB LOCATION North Andover MA 01845 ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: Strip of E all roof shi.nyl.es on house _inc garige loose plywood and if .any need replacement it will be $35 . 00 a shut installed! Install aluminum drip edge around .cool line 'pply ice and water shield-3 ft . up all along edges Appiy .151b. felt paper .on rest of .roof area Reshingle with a 25 year ; 3 ta;b shingle your ch'oic.: c:;` :�o!.ur- lnstall new flanges a.rounO soil pipe i.a a ridge vent on Douse only Remove all work related debris 25 year warranty on material tv year guarantee on labor construction lic . #060112 ;or,vement #128612n�.. Option : If you decide to have a 25 yeer Arcnitect shingle it will ba� $400 . 00 more ( four hundred dollars ) CroOge hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: Four thousand f i.ve hundred 4 i1� QE) Payment to be made as follows: dollars($ ) M raterial is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications involving Authorized/ f Y extra costs will be executed only upon written orders,and will become an extra charge over and Signatur9' 1( above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado and other necessary insurance. Our workers are fully Note:This proposal may be �covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. cceptance of propozat—The above prices,specifications and /..' conditions are satisfactory and are hereby accepted.You are authorized to do the wc.k as specified.Payment will be made as outlined above. Signature -. V Date of Acceptance: Signature ° - IFICATE OF LIABILITY INSURANCE DATE 05.08.00 (w/CDJ'7Y) I PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER PELHAM :NSURANCE SVCS INC THE COVERAGE AFFORDED BY THE POLICIES BELOW. ^? BRIDGE STREET INSURERS AFFORDING COVERAGE PELHAM NH 03076 INSURER A: The Maryland 7SURED INSURER B: Liberty Mutual Thomas Doyle INSURER C: DBA Thompsons Construction 8 Roofing 8 West St. INSURER D. Salem NH 03019 INSURER E: COVERAGES ( THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N'T 'THSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS :RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL_ THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION 'R TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1.000.000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 300,000 [ ] CLAIMS MADE [X] OCCUR SCP 34865353 04.15.00 04.15.01 MED EXP (Any one person) $ 10.000 PERSONAL & ADV INJURY $1,000,000 iGENERAL AGGREGATE $2.00^.0^0 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2.000.000 [ ]POLICY [ ]PROJECT [ ]LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ] ANY AUTO (Each accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ 1 HIRED AUTOS BODILY INJURY I VON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE [ j (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY; AGG $ EXCESS LIABILITY EACH OCCURRENCE $ [ ] OCCUR [ ] CLAIMS MADE AGGREGATE $ $ [ 1 DEDUCTIBLE $ j RETENTION $ $ WORKER'S COMPENSATION AND [ ) WC STATUTORY [ ] OTHER B EMPLOYER'S LIABILITY WC2.31S-314995.019 04-21.00 04.21.01 E.L. EACH ACCIDENT $ 100,000 ' E.L. DISEASE-EA EMPLOYEE $ 100.000 E.L. DISEASE-POLICY LIMIT $ 500.900 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Roofing. CERTIFICATE HOLDER [ ]ADDITIONAL INSURED: INSURED LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPJRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR. Don Foss TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED 9 Gumpus Pond Rd. TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Pelham NH 03076 REPRESENTATIVES. AUTHORIZ 0 REPRESENTATIVE . Page 1 2 ti AORTH Town of Andover 0 No. y z� ori dower, Mass., T O LA COCHICHEW1 V ORATED 17`7 H 4` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System M BUILDING INSPECTOR THISCERTIFIES THAT.......►. ` 1 Gkl•••�..... ... �........ ............ ........................................................................... Foundation oft has permission to erect...Q..�...P...... buildtyson �. �... Rough ........ ....... ......................to be occupied as..........................................�0� w � ........................................................ Chimney .................. ......... .....,.. provided that the person accepting this permit shall in every respect conform to t 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. M '0 (o a P / Q � PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. f ® Rough PERMIT EXPIRES IN 6 MONTHS 43 Final UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR Rough 111100 .............M....... ........... ..... ........ .. BUILDING INSPECTOR Sere 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.