Loading...
HomeMy WebLinkAboutMiscellaneous - 18 JOHNNY CAKE STREET 4/30/2018 (2)_ Location Ig i No. Date °� Q NORTH TOWN OF NORTH ANDOVER Oi �•o ,•,h00 9 Certificate of Occupancy $ MU Building/Frame Permit Fee $ ACS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ %/7,0 ,.•- Check # V / y4) YL{ i 1739 lam" /U.` � Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: _ 9 _a C SIGNATURE: 6"0— -- Building Commissioneffl for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Addr f �fJ IV 1�7 '� �' 1.2 Assessors Map and Parcel Number: (o°i � a o a Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public 0 Private 0 Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Munici al ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record �t� 2 teq i�( PSS 1 J 4 w Name (p.�t� � Address for Service 9C", Signature Telephone 2.2 &, ner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: e k �d�� J Licensed ConstructiA Supervisor: r -7 Address V Ae4u<,>, KA 6c0 Signature Telephone Not Applicable ❑ O r License Number 2,,1?) c/ Expiration Date 3.2 Qistered Home Improvement Contractor �o A Not Applicable 0 / l 7 3-31 Company Name i n / ` 91-7 Registration Number / Addres Expiration Date Signature Telephone 00 M X Z O m V D O Z M 90 mn r v M _r Z 0 SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 4 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 ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 1 � �c-ct�, J wOS-iwl- 101 s 6i/Z'Ak 6,,� X YWA (6'�'J<to ur I/j Cait.'J /t SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be(1lFFICIAL-USE Completed by permit applicant 0NLY- 1. Building\� of., -(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 SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , 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 1, 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/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMERS 1 ST2 ND 3 SPAN DIMENSIONS OF SILLS DUVIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE . FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained.. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT � r o- (-" ` �J J , PHONE I i7(� 59 y b 0/ cf c( LOCATION: Assessor's Map Number / PARCEL a SUBDIVISION J LOT (S) STREET_/e d � C #4e T. NUMBER *****************************************OFFICIAL USE ONLY**************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH TH COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED l7� L[�r (`/, b�' �-� �-► �L x ; ti..v....� :✓L J.-.-,_�,� � a � � C7 c5'•---.•.'� . 4i ��Z IL, Y o� riv�II� /'�� � . ��t�'w+_P • "`-��.. I" _. F --tom r Q,$' PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm C�eAV y,�, Ise- Y2- V) — 41 tc �,0- S£56N89 JNINNVld Ob96-889 HETVBH 0£56-889 NOIIVAAMN00 9l W889 0N14'IlfI8 Ib96-889 SIV3ddV 30 GHVO8 �ltnbut puu lsaralut .moX joj noxi ,r t i r' t /t / :fttnbul ( oumu uuld alts ro uoislntpgns `aaqul:nu laozud puu duuz xul 'ssatppu :-2•a `olgtssod su uorluuuopt gonw su opnloui osu j& :uoilsanb ut �IjodWd \� J A?IIII�NI :ssatppv :jogwnu xu j :j;)quinu auOgd `V :aumN j `` :aanQ NOIJLVNHOdNI 13 VVZNO3 al 4sod su uoos su paipuuu a4•.,IItm uotluumpi .toj sisonbaa IId 'asuodsat idutozd puu alumaou Wojnsua of Xja.iijuo sli ut uuoj*•%pogonjju oqj Ino IIID asuald •saznp000td uopnotlddu pmog,2utuunld puu `s2upoow pun suoilou ptnog 2umunld ` oZ ui lu;)wdolanap mau uo uorInuUOJUI aplAotd uua jouunld atl,L •aaunasrssn aJnipaulurt tnoild of olqultunuun st nuuuld umo,L oql ji �woj sigl osn osuald H2[NNV'Id NMO L isalflbau NOIZVNHOINI US6-889 (SG6) ouizzed aiin j S£S6-889 (8G6) d zauuLId UtAOJ, uzoa•.zaAOPUL' I}.iOUJouUMOI-M--MMlq StSIO S4jasntlapsSeW 'aanopud WON PZ)JIS saizI?uD LZ �t * uotSIAla Sa�TAJaS pu>, }uauidoIanaa AItuntuuio: y :* r r0 . . JualujjLdaa Su'uuvld alll Jo az)iJ30 O ►+taoµ IaAopuV DIJON Jo utAO L North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed/of in: (Location of Facility) Sign ure of ermit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector t Board of Building Regulations and Standards ''1 Y HOME IMPROVEMENT COhi s RACTOR Registration: 117359 c Expiration: 9/26/2004 Type: DBA JONES & CO BRADLEY JONES 97 DRUID HILL RDS i': ETHUEN, MA 01844 adminlrtrnrnr �..,, etY• ,,,,,. ,rr/�l: .i . ea'Jrsrl � .: r: BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR k Number: CS 036863 Birthdate: 06104;1c M Expires: U6104i2004 Tr. no: 24694 Restricted: 00 BRADLEY J JONES R97 DRUID HILL RD IETHUEN, MA 01£14 Adm.niStrator A 0 Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print G,� ' 1 Citi 4-hrt- 6av�f_ M"�" Phone # I am a homeowner performing all work myself. aI am a sole proprietor and have no one working in any capacity M --I am an employer providing workers' compensation for my employees working on this job. Company name: Address 9-7 l I I Y2J City' w`e i►'1ua_ Phone #: Z17 �'/t^17�r/L/-Pi2a • ..1-�S Gtd.r'"u�� . Company name: Address City Phone #: 0. S-- 3 J S - 3 3 'S 0 z; G 'yq Insurance Co Poles # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to $1,500.00 and/or one years' imprisonment.as.well_as_civil.penaftiesin.ihefnrmnf-aSTOP WORK.ORDFR..and_a.fine.of.(.$100.00)_aiiay.against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify undue the pains and Print of peguQ/ that the information provided above is true and correct. J 'hone #/ 5 7J 9 V,1/9 G &/ Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required I] Licensing Board F-1 Selectman's Office Contact person: Phone #. ❑ Health Department r-, Other Jones & Co. General Contractors 97 Druid Hill Rd. Methuen Mass. 01 844 Tel 1978 688 7307 NAME/ADDRESS Mr & Mrs Brian Lessard 18 Johnnycake Rd. N Andover Ma. 01845 Estimate DATE ESTIMATE NO. 3/4/2004 128 SIGNATURE Page 1 TERMS PROJECT DESCRIPTION RATE TOTAL Description of work as described and based on floor plan provided by customer. Scope of work We will hange 6mil polyplastic betwen the foundation and studs to stop possible moisture from comming through to the drywall and insulation ( this is to stop humidity type moisture only ) We will frame off the basement as shown with 2 x 4's KD set on a pressure treated plate, 3 1/2" R 13 insulation and covered with 1/2 " drywall hunge , hunge , taped, primed, The ceiling will be 2 x 2 non dirctional fissured pattern with white grid. Trim includes wood baseboard as needed, trim around the basement window, closet doors 6 panel masionite bifold 5 ft lunit , 6 ft lunit Thanks Brad TOTAL SIGNATURE Page 1 Jones & Co. General Contractors 97 Druid Hill Rd. Methuen Mass. 01844 Tel 1978 688 7307 NAME/ADDRESS Mr & Mrs Brian Lessard 18 Johnnycake Rd. N Andover Ma. 01845 Estimate DATE ESTIMATE NO. 3/4/2004 128 SIGNATURE Page 2 TERMS PROJECT DESCRIPTION RATE TOTAL 3 ft 1 unit door to the furnace rm , railing the wall along the stairway will be closed i►p to expose about 5 treads and trimmed with post, rails, spindles, and skirt boards , each closet will be set up with 1 wiremold shelf/pole set up Note no work will be done to finish the furnace area. Note all trimwork is based on paint grade not stai grade Note no painting cost has been included in this contract Electrical Our electrician will add circiuts to your existing panel as needed for basic 12 receptacles ceiling lights are to be 2 x 2 flouresant 4 units in the main rm 1 fixture over the treadmill, 1 fixture in the 3 closets, 2 cable, 1 telephone Alotment for all electrical work is 1,400.00 Heating Based on installing another zone to the existing furnace with its own thermostat Alotment $1600.00 Should your furnace not be large enough to support the additional zone the money alotted can be used towards another heat source option. Flooring quarry tile floor 185 sq ft 6 x 6 material alotment $ 2.75 per sq ft Carpet based on other side and the stairs ( aprox 454yrds ) $ 1042.00 total installed cost Thanks Brad TOTAL SIGNATURE Page 2 r i Jones & Co. General Contractors 97 Druid Hill Rd. Methuen Mass. 01844 Tel 1978 688 7307 NAME/ADDRESS Mr & Mrs Brian Lessard 18 Johnnycake Rd. N Andover Ma. 01845 Estimate DATE ESTIMATE NO. 3/4/2004 128 SIGNATURE Page 3 TERMS PROJECT DESCRIPTION RATE TOTAL Custom cabinet work to simple in design an all paint grade materials bench seat in the tile area wirh storage under the seat a laminated countertop in the corner at desk height for a future computer, with a keyboard tray and file draw to 1 side a table height countertop with storage shelves on the TV side. Cabinetry built and installed allotment $ 2,000.00 Includes materials, labor, and debri removal Permit fee is expected to be 215.00 Total cost of this contract at this time is 17,215.00 Terms The basment will need to be empty so we can move freely through the work area. Deposit when we start $6,000.00 drywalled /primed 6,000.00 trim , cabinetry, ceiling, heat 3,000.00 Balance upon completion 2,000.00 Please read through if you have any question that I need to address and alter let me know it has been a while since we talked thankyou Brian & Chris Upon reading sign both copies , keep one for your records and return one back to me. X X Thanks Brad TOTAL $0.00 SIGNATURE Page 3 n vs W s.: 9 O FM4 uj C" z a Mo a a w o � N O = w aob U 79 w w Q. �°° a°4 '� w W �' r�° u u. a°' C 0 m 0 o cn 9 O FM4 uj C" z M 0 W a 0 K1 —1 LIM I �c ,C 'E40 CD 03 m m it t CD 3 :01% � � a) L C.3 o a CM< ca s c as c Z CD CL �..� y C C ev H c W O uj N N W W 19 W CA Mo o � N O = CL C CL C 0 0 1 m = ;= O ;w c O o =0i 00 cm -tg 04: ;m= ro- (A CO m 3 m N ma vi A 1 O mo CLU L; c m y m D OC scm -o ti � JZi o.=r CSN O _ CL C Q L m m r,-,, oz No 1=- o vi CL m W— z '44 CLM Z E v� °c$� m Ow g CO) CL m m O fl O =2C.=mom M 0 W a 0 K1 —1 LIM I �c ,C 'E40 CD 03 m m it t CD 3 :01% � � a) L C.3 o a CM< ca s c as c Z CD CL �..� y C C ev H c W O uj N N W W 19 W CA Date ... . ..//!.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............... GSf f..'Z.... T ....... Acs.. has permission to perform ........ ✓✓. ..................................... wir}ng in the building of +"�s g dc%� ................................................................................... ..:.... 6 �..y..c....p........... fi......... , North Andover S. FeeV ..... Lic. NZ5W . .........eir�a��... ELECTRICTOR Check # d �� 53u5 Date..................... TOWN OF NORTH ANDOVER A PERMIT FOR GAS INSTALLATION s This certifies that ........................ ................ . has permission for gas installation ............................ in the buildings of ......................................... at ....................................... North Andover, Mass. Fee......... Lic. No........... .......................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File TBE C0AW0A'WEALTHOFVIASSACHUSETTS Office Use only DEPARTA1W0FPUBUCSAFE7Y Permit No. J761,5 BOARDOFFmEPREVEMONRWUTAHONS527CM]2.M, #1" Occupancy & Fees Checked PLICATIONFOR PERMIT TO PERFORM EL' =CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below 11 Location (Street 1 Owner or Tenant Owner's Address I'I Is this permit in conjunction with a building permit: Yes rM No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service _P 2 O d Amps 1/01,09 Volts Overhead M Underground No. of Meters New Service Amps Volts Overhead r --J Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work L,.J 1 /L *,L, �t- U GJ -1 !"y%�t► No. of Lightipg Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above 1:1round Below Generators KVA round No. of RecelAacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners No. of Ranges No. of Air Cond. Total FIRE ALARMS No. of Zones Tons No. of Disposals No. of Heat Total Total No. of Detection and -� Pumps Tons KW Initiating Devices No. of Dishwashers Space Area Heating KW Np. of Sounding Devices Na;:bf Self Contained Delection/Sounding Devices No. of Dryers Heating Devices KW Local Municipal Othe Connecrions No. of Wate. aters KW No. of No. of Signs Bailasis No. Hydro Mgssage Tubs No. of Motors Total HP THER- nanoeCoverage RmanttotbetegtmmentscfN4a%adn9�mCtnerlLaws awaamentliaMtykaranceFbkyinckxki,a,GDnipletel2yaftomCDwworltsabsmnuapvalat YES © NO av ahnitmdvalidpmofofsametothe0ffiM YES r7 —— F3whavedeed®BYES, pleaseindicalB(hetArofeoverageby krgdle box 1III1 SURANCEE BOND OrI;`-IQIZ (Please SpaeafY) ExpnmonD& ` Estun&dVahleofE1"icalWork $ xktoStart — C/ - � 1 nedundertf ePa&esofMury:�— :MNAME Rough / Flnal q / G LicenseNo. % � � /S Licff&No S/'r BttimmTel NO. 4? 771 ' y7 %� AIL Tel No. NER'S INSURANCE WAIVER; I am aware that dr-Licermdoes riot have theinsr==covetageorits a1smalequivalentas tagnedbyMassachusen General Laws that my sig iahue on thispemtit application waives this mgir -o t ;ase check one) Owner ® Agent ® Telephone No. PERiVIIT FEE $ �p igna ure oT Owner or gen The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation insurance Affidavit I Name Please Print Name: Location: Clty Phone # F1 I am a homeowner performing all work myself. 0 .- I am a sole proprietor and have no one working in any capacity F7 I am an employer providing workers' compensation for my employees working on this job. Comr)anv name: 4 Address City: Phone # 4 Insurance. Co. Policv # Company name: Address ,:. City: Phone #: Insurance Co. Policy Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500,00 to and/or one years' imprisonment -as Well_as_civil.penattiesin.thefnrm ofa..STOP WORKORDER.and a.fine_of_(.$1.A0.OD)arlayagainsLme. understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official - City or Town Permit/Licensin � ❑Check if immediate response is required Building Dept I] Licensing Board E] Selectman's Office Contact person: Phone #: E] Health Department ❑ Other