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Home My WebLink AboutMiscellaneous - 164 HILLSIDE ROAD 4/30/2018 164 HILLSIDE ROAD 210/098.C-0022-0000.0 i i I f Location 4 7 No. / Date � 3 ki y N0QT1y TOWN OF NORTH ANDOVER 3?o�tf`•o ••hO�L i p Certificate of Occupancy $ }�e Building/Frame Permit Fee $ yds',"°' Foundation Permit Fee $ sACNusE Permit Fee $ �� Sewer Connection Fee $ Water Connection Fee $ W TOTAL ' $ Building Inspector - ? /UU t0: 26.00 tall) i Div. Public Works PER'lfff N0. / APPLICATION FOR PERMIT TO PILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP ;DATE BOOK ;PAGE + /"ONE —I SUB DIV. LOT NO. I V OCATION I PURPOSE NO. OF STORIES SIZE OWNER'S ADDRESS//,/ J2`�;/ BASEMENT OR SLAB L� RCHITECT'S NAME GT C( SIZE OF FLOOR TIMBERS IST 2ND 3RD C• (///}BUILDER'S NAME �� A7� ��efZ SPAN DISTANCE TO NEAREST bUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR "' GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X _ IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Yes' IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES BLDG. 008T z - PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PERISQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 - APPROVED BY AlfrACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PL S MUST BE FILED AND APPROVED BY BUILDING INSPECTOR `V/DATA FILED _ BOARD OF HEALTH SIG&AAURE OF OWNER OR AUTHORIZED AGENT I FEE 3Q� / p PERMIT`GRANTE ✓OWNER TEL.# sp` PLANNING BOARD CONTR.TEL.# t9 j CONTR.LIC.# eE BOARD OF SELECTMEN a -7o)-6 _) ( BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE 3 112 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D _ PIERS PLASTER _ DRY—WALL _— — UNFIN 3 BASEMENT AREA FULL FIN, 0'M'TAREA _ 'L 1/1 °% FIN. ATTIC AREA _ NO B MT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD"✓D _ ASBESTOS SIDING COM/ACN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING ; GABLE HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) _ FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd 11 NO HEATING RAYMOND E. DAMPROUSSE, JR. AND SONS ROOFING CO., INC. :�/� ^ ' s J-/A. CONSTRUCTION % L L y._ c!,Z..r�G=,/�N� o/ fv M BOX 431 LAWRENCE P.O. SUPERVISOR LIC. 0 046636 LAWRENCE, MA 01842 ;•, HOME IMPROVSMNT yx /6 TEL: 683-4588 REG. #101662 '3 eq c �.�. f ".r ROOFING — SIDING — INSULATION ./4, ' " '. Date (Nems) -•sj Address177 t0: UTHOD E. DAMNOQSSE, JR. AND SONS 1OOF'IN9 CO., DIC., BOX 431 LAWRENCE P.O., LAWRENCE, MASSACHUSETTS 01842 y A (we) hereby authorize the Contractor to furnish all2�2 and labor necessary to install, construct and place the y i Improvements described below in-on building located at No. � ��L S /9� Street, Af City �Y G /�/`��G�✓{2 State -4 r1 in accordance with the following specifications: ti/CL E f�f� EN i/icE 1�.4 �/ .�/C.,ciJ F C/�F/'GAGF /�/✓`� ��oA.�iJ f /�7 0�� /�/V / ��- ii47-.�? r!'J./.�l�.c �i�F C � '/ L T�/�✓ ,r3Jc /-�/'/�c.;,�iJ APi�/1 oY �FT �� i2orJ i;3 a�ir-c .i.�/'Eic .'�A.�r r i JA /�Y' �a o• -„ ;:'.� r�rl�S C /�•� y 6""4(_ T/ye5/y Lt/A!.'7-25 W/2 4 e A-Lock/.J .4e- -7 "rcLl-, L L 6 /J )7:A16' <0A/�/1 /�3 C),oc 7'0 �7 v�'1.� /CJS ?00"----01/�e2 �E_k 077/V G (flJ LZ -1 GC-f /:9J-7; Y r�,n,07 All of the above work to be done in a good and workman-like manner. All men and equipment .Inssuured. Premises to be left clean upon completion of work.C/6'jTSYs For the total sum of / 1e<_e � 7T2/Oc-)j eq 7-1,rj dollars. r Entire Sum to be paid Immediately upon completion in accordance with plan as shown below. /- Al 6-s G fl "L w n Yk � TOTAL CASH SELLING PRICE ..... . . ... S DOWN PAYMENT IN CASH . ..... ... . . .. DEFERRED BALANCE UPON COMPLETION . .. .. . ... .. . . . . . . . •S�:NG�E c.�.L.� �3� �lfy The undersigned agrees to keep property mentioned in this agreement properly Insured against loss by fire including the Contractor's interest therein. This agreement shall become binding only upon the written acceptance hereof by said Contractor, and upon such acceptance this shall constitute the entire contract and be binding upon the parties hereto, there being no covenants, promises or agreements, written or oral except as herein set forth. It is the intention of the parties hereto that this contract shall be binding upon their respective heirs,executors, administrators, successors and assigns. Customer agrees to pay a reasonable sum as attorney's fees and Court Costs if placed in hands of attorney for collection. °The owner further agrees that in event of cancellation of this contract after acceptance by the contractor and before the work is A tttliced-the-OWNER-agrees to pay 20% of the total consideration herein named as liquidated damages for breach of contract. Said contractor shall not be responsible for damage or delay due to strikes, fires, accidents, or other causes beyond his t reasonable control. We, the undersigned, certify that we are the sole owners of the property herein described on which said work or repairs are ` to be performed. IN WITNESS WHEREOF, the undersigned has (have) hereunto set his (their) hand(s) and seal(s) the day and year written above. Accepted By H band R E.DAMPHOUSSE,JR.AND SONS a INC. 1' Mail Address J (If different from above) t (Slpnsbure ane f fliciap NORTH Town of :ort Andover o - ANor� , dower, Mass., 199 11 DRATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....Vat . ... ............... ....C.................... . .... Foundation has permission to AGAM.. .0 buildings on ...... .y.... .. Cot S, C.... Rough • g to be occupied as....... . ..�.-. Z �r ...........t4llip..I�.�.C. ..... .. ... ....... Chimney Ch' e provided that the perso accepting this permit shall in eft respec conform to the terms of the application o ile 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUC O S ARTS ELECTRICAL INSPECTOR ' Rough I ' s 1 Service ' B NG INSPECT Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT Date. } o'<".ORT 4, TOWN OF NORTH ANDOVER 7 ��.^' �•OCL PERMIT FOR PLUMBING SACNusE� .� = . . . . . . . . . . . . . . . has permission to perform . �f` -'°-�^"'. !t- - --��p—'. . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . at.44'. V. . . . . . . . . . . . . . . .: . . �. . . . . , North 'Andover, Mass. u•J `� f , Fee./c . . . .Lic. Nd:: ? .. . . . . . . . . . . PLUMBING'INSPECTOR Check H L-3f� 4.1 7636 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Pri t or Type (, MA Date 200 200 4 Receipt# Permit## Building Location 1641 Owner'sName Map: Lot: Zone: Type of OccupancyGIT�- New ❑ Renovation Replacement 0 Plans Submitted: Yes 0 No 0 FIXTURES Fee: 2 m Z m Z Y O Z r W WV J W W m 2 u) J m < O F- Z z _ m ¢ ¢ mXm _ ¢ Z u Z S m m cc m W < F' m ? < N 0 S a ¢ O — cc W O W < m ¢ < W N ¢ J Z O m o LL Cr F W V 4 = 3 = a z x 3 x a o Z = a W W Y W F F 7 F o m m 7 m 1- z O O m - _ W I- O u x O < J J 4 ¢ = ¢ 4 0 < F 3 x J m m o o J 3 x r- m U. O o < 3 ¢ m o SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 6TH FLOOR / lnstallingCo�m/pa(�Name Q ✓`� Checkone: Certificate Address 7 J �� _ CSF/ 0 Corporation Estimate Value of Work: S p 0 nership Business Telephone 7 i - �7 Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a currentAility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. / Yes No ❑ If you have checked ves, pleas the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner U Agent❑ Signature of Owner or Owners Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations p ormed underAe per ed for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumb g ode d r 2 the General Laws. By— Sig ature of Licensed Plum r Title_ Be,",Type of License: Master Ll Journeyman B City/Town APPROVED OFFICE USE ONLY' LicenseNumber� / !u` c- Revised 05/171 �—' NORFOLK AND DEDHAM MUTUAL FIRE INSURANCE COMPANY SMALL CONTRACTORS POLICY RENEWAL CERTIFICATE Policy # R0617586A Named KEMMER Agent COUNTY INSURANCE AGENCY, INC. Insured ROBERTPhone (978) 774-2264 yAgent # 20622 GEORGETOWN MA 01833 j FORM OF BUSINESS: g at'`;:<<>< <><>> > ?_><>>> <>> >> >` '`` >_>>;< ' '` > ?>;<>< <«>>;> >>> ...... >» <> <> <':>_' >>> ..... ;><« <'>>'< » fir..::.:.:::;..:.:.., Policy Period: ONE YEAR from 03/01/07 to 03/01/08 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 premises. .. .;:.::: P L. P Ili lt= I U S.. :::. .(+�i,I� .: .R ... .T . ................. r.. ..... .. .... . . . .. . .... Basic Annual Endorsements- State- Tars Tota Annual Add`IiReturn $1, 160 $1, 160 Bid /Location 1 17 WESTON AVE GEORGETOWN MA 01833 Address if Different Mortgagee Information Business Description REIDENTIAL PLUMBING Prem um POLICY DEDUCTIBLE $250 BUSINESS PERSONAL PROPERTY Limit $10,000 i T 0 T A_L P R E _M_I U M ___P E R B_U I L D I N__G _ _ - $1,160.00_. EXCEPT FOR FIRE LEGAL LIABILITY, EACH PAID CLAIM FOR THE THE FOLLOWING COVERAGES REDUCES THE AMOUNT OF INSURANCE WE PROVIDE DURING THE APPLICABLE ANNUAL PERIOD. PLEASE REFER TO PARAGRAPH D.4 OF THE BUSINESS LIABILITY COVERAGE FORM. LIAB & MED EXP (OCCURRENCE/GEN AGG/PROD COMP OPS AGG) $500/ $1,000/ $1,000 Included MEDICAL EXPENSES $5 Included DAMAGE TO PREMISES RENTED TO YOU $50 Included .: ..... . ......., Premium I Premium SEE ATTACHED PAGE -mar #= TkiE POLICY 006..V .i. REQi#IAE.;;T,.+tAT OU#3NfFi; lNfwF3X A{JTiiR1Z.... E51wA1FAi'tt/ ':PREMIUM r~IA3 #VORMAILIF;l}?P1IlrS:..: 1=.YQi iCAI r:..<'.,. 1~L.:Pl#}ct�.:TO 1PII# 1 F131►1 tIA r , WE .SH{!i_1. #i>r t A!1%1 J4 f 151` :: 0; $ ..::.:.REfARDLESS: OF TfE3M _ ... ............. BOP-2 (REV.04/05) Type of Payment: DIRECT BILL 4 PAY Department of lndustrtat Acctaents Office of Investigations ' 600 Washington Street t Boston,MA 02111 www mass gov/dta Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leliibly Name (Business/Organization/Individual): ;26K l� amu!L Address: City/State/Zip: lr 1� �! Q�� Phone #: �G�" 21;2 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 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2% I am a sole proprietor or partner- listed on the attached sheet. t Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. E] Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 101-1 Electrical repairs or additions 3.❑ I 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.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractois 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. #: Expiration Date: Job Site Address: City/State/Zip: 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 STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify. er t p ins enaldes of perjury that the information provided abre . true and correctSi ature: / Date: 6Z c, 47 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 6.Other Contact Person: Phone#: Date... ...... r Of MD oTM 1ti TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACHUSEt This certifies that /:.)........ u e'0 4l has permission to perform .... ! .►-lc.. ... /%f�f�. 1.r.,r... 00�s ........ wiring in the building of............. � ......................... tt ,, ................. at.....I�.Lt....... .......5..:.......... . ...... ,North Andover,Mass. . lon Fee.7.................. Lic.No.3 .. 1 . .. .......... ELECTRICAL INSPECTOR Check # 1320 8200 � \ � Official UOnly n C,/�ommonwealt�o�/Y/adaachu�e�d y 2c� �7 Permit No.� o epartm.ent o1.}ire Service Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical.Code(MEC),527 CMR 12.00 (PLEASE PR1ArT IN INK ORT PE L INF_ORM4TION) Date: I Ct IOk City or Town of: N'dXce-- To the I spector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) Owner or Tenant A-e t it Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) a Purpose of Building A Utility Authorization No. Existing Servic Amps /aY0 Volts Overhead �' Undgrd❑ No.of Meters } New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:, AdOw� �4��.�� F4 f� Rwy r r 0 Completion of the followin, table may be waived by the Inspector of Wires. No.of Recessed Luminaires /G No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above ❑ In- ❑ o.o Emergency Lighting No.of Luminaires S Swimming Pool rnd. rnd. BitteEy Units No.of Receptacle Outlets 010 No.of Oil Burners 'VIRE-ALARMS_ ;vo..of- olws ~ No.of Detection and No.of Switches (> No.of Gas Burners Initiating Devices Tons g No.of Ranges No.of Air Cond. Total No.of Alerting Devices _ Heat Pum Number Tons KW No.of Self-Contained No.of Waste Disposers Totals .............""" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection Heating Appliances Security Systems:* No.of Dryers g pp ' No.of Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Siizns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: t,/ Attach additional detail if desired,or as required by the laspector of YVires. Estimated Value of Electrical Work: / Oa (When required by municipal policy.) Work to Start: Insp ctions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE k BOND ❑ OTHER ❑ (Specify:) 1 certify,under the ins and p allies of •uryithat thein orma ' on this application is true and complete FIRM NAME: X� * ew C + le- LIC.NO.: Licensee: war Signatur N (Ifapplicnble to ei `,i t/ cei se nukr lid;.) /� �_ _ _/ Bus.Tel.N W Address: V rr (� (j" ` '�1 Alt.Tel.No.: *Per M.G.L.c. 147,C 57-61,security work requires Departm,nt of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑owner's agent. Owner/Agent Signature _ Telephone No. PERMIT FEE: $ l� e ` J FF �s r f l s t VV \ % t "'� �.. Y • �ytlsct �ii .`s 'yf k�*- tstr� .a