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HomeMy WebLinkAboutMiscellaneous - 32 PADDOCK LANE 4/30/2018 32 PADDOCK LANE 210/107.D-0097-0000.0 r ! : 3331 + TOWN OF NORTH ANDOVER •40MMEk. S PERMIT FOR PLUMBING ,SSACMUS� ` This certifies that fh%'un. . J�o�.f ... . . . . . . . . . . has permission to perform . . . PC . . . . . . . . . . . . plumbing in the buildings of at. . -;J Andover, Mass. i Fee. 3J!.'. .Lic. No. . . . . . . . . . . . . . . . . . . . PLUMBING INSPE OR lv?J 413 06/24/97 08:44 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 PLUMBING 3�` Lx (print or Type) :. 6&�� , Mass. Date ���—,F'719- Permit# A/ Owner's Name Building Local Type -2 Z — Type of Occupancy, New ❑ Renovation ❑ Replacemert Ei--� Plans Submitted: Yes O No O ' FIXTURES Z q - z Y ►- y H q N q O z W W V3 0 ¢ mU. — a OJ W q Y a < <q ¢ m N Q >- < f' q Z D < N Z d d 6 w V = O O ¢ < W Q < W q ¢ J O C O W ¢ N W Z < S = a X = Y 4' O N _2 z W (- O V 2 3 X J m N O O J 3 = r• q W d 7 0 < 3 Q O7 O Si�T;-65ikT. BASEMENT IST FLOOR 2NO FLOOR 2R0 FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Check.one: Certificate Installing Company Name ©orporatlon Address Jr- c5 ❑ Partnership 3usiness Telephone _ o3 1] Firm/Co. Name of Ucensed Plumber INSURANCE COVERAGE: its substantial equivalent which meets the requirements of MGL Ch 142. 1 have a current liability insurance policy 0.1 Yes Er' No r: if you have checked ye please indicate the type coverage by checking the appropriate box. A liability Insurance policy G Other type of Indemnity ❑ Bond ❑ 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. Check one: Owner ❑ Agent❑ S gnalure of Gruner or Owner's Agent 16 1 hereby certify that all of the details and information 1 have submitted(o(entered)H above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Plumbing Code Chapter 142 of the General Laws. By - Title - Type of License Master r`;p Journeyman❑ City/Town _-- APPRO'YED(OFF1 1,E USE ONLY License Number Location No. 10 Date f&-OV MGRTh TOWN OF NORTH ANDOVER r�� 9 0" Certificate of Occupancy $ 0. �'�s''••°';<� Building/Frame Permit Fee $ At Nus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ !� Check #61 7 / Building Inspel. v 1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED-,?3 r _ SIGNATURE: 4J44� Building Commissioner/I for of Buildings Date —U Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 32 Pfd i)DacCf [.rJ r� (� / () -7 C7 Nd Wra- J Map Number Parcel Number 1.3 7-oning Information: 1.4 Property Dimensions: Zoning DiAr ct Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: D Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT i s Ur!C 1,01Ci: es O rn 2.1 Owner of Record 4(f v t tj u FGY . 3 2 PA#t7,PC1C tc (,AJ r No. n* Name(Print) Address for Service: � -7S - 5-57 - 717 ( Signature Telephone 2.2 Owner of Record: Name Print Address for Service: y J(tt- lh z C� rn Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 LiZ1,T7 Construction Supervisor: Not Applicable ❑ at Licensed nstruction Supervisor: YY!! �N, 'Vyeo ,�/ O License Number Addr /�'�� ((// Expiration Date r Signature Telep one r :;giste Home Improvement Contractor Not Applicable El Duval Rooft 1 P-0 Box 637 Com n ame North , F Registration Number r Address Expiration Date 21-Y ^z G) Signature Telephone a 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 buildiN 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: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 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 cv 5 Fire Protection 6 Total 1+2+3+4+5 3 7 Check Number G SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUELDING PERMIT I, k4 ly -D,,f-PY as Owner/Authorized Agent of subject property Hereby authorize "D'J v 4 L 9-0,F r pt!— to act on My behalf,in all matters relative to work authorized by this building permit application. /fn—� e,/L?/r-'( -Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, D n1 Rwfing as Owner/Authorized Agent of subject property P. Mox 637 Hereby declare that the statements and informati or Implication are true and accurate,to the best of my knowledge h and belief 01864 .� P ' e ✓ r a e of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DRvIENSIONS 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 Z N The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity �I am an employer providing workers'compensation for my employees working on this job. Company name: Addres Zj'� Ci :/\, Phone#: ?E `SSS Insurance Co. Polic # 2e, v� 7-36 1C,5-3< Company name: Address Citi Phone#: Insurance Co. Policv# 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_viten as_civil..penaltiesin the form ofa..STOP WORK ORDER..and..a.fine.of(.$100.D0)._a day 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 under tha pains and penalties of perjury that the information provided above is true and correct. Sign to � Date !�O A� Phone#72& � � � Print na CJv ��o�S 5 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 E] Licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department Other 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: 6LJ (LocatioK of Facility) Signature of Permit Applicant D to NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NOTICE N - NOTICE TO a TO EMPLOYEES EMPLOYEES 7 �W � v 0,4� Sv8 The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-7274900 — http://www.mass.gov/dia As required by Massachusetts General Law,Chapter 152,Sections 21,22&30, this will give you notice that w a d payment t4 our injured employees to under the above mentioned chapter b I (we) e) h ve provide for p ym � p yees p y insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY ONE TOWER SQUARE HARTFORD CT 06183 ADDRESS OF INSURANCE COMPANY (7PJUB-73OK535-4-04) 02-17-04 TO 02-17-05 POLICY NUMBER EFFECTIVE DATES � ARGEROS INS AGCY INC 360 MAIN STREET °�:.. READING MA 01867 ^_= NAME OF INSURANCE AGENT ADDRESS PHONE# DUVAL, KENNETH P DSA 184 PARK STREET DUVAL ROOFING NORTH READING MA 01864 EMPLOYER ADDRESS -= EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL. TREATMENT ^= The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably •- connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL T ADDRESS DOWN W20PIG02 TO BE POSTED EBY EMPLOYER 0— BOARD BOARD OF BUILDINREGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 058443 I Birthdate: 12/10/1966 I Expires: 12/10/2005 Tr.no: 10052 Restricted: 00 =NNETH P DUVAL J BOX 190/72 NORTH ST ,rtr READING, MA 01864 Administrator ✓�ze toorrmmtaozuse� �✓�,�,1 l Boas of Building Regulat:ons and Standards HOME IMPROVEMENT CONTRACTOR =F,cgistrati+�n: 10988 Expirateon: 9/9!2004 Type: DL'A ,IU`./AL ROOFING i'.C*anneth Duva! I,(;(30X 190/72 PJORTH ST N.F.t ADING,MA 0 18e Administrator a Page No. of Pages Builders License # 58443 Horne Construction Reg. # 109288 CertainTeed/Certification # 1911 u �� GAF Certified Master Elite IAL II THE Roofin i' REFI G CO LECTIO a (781) 944-1994 (978) 664-4557 e ainTeed C- The Areas Oldest Roofing Companv" P.O. Box 637, North Reading, MA 01864 7. PR PO SU DATE 917/ �I ET 3 _ `�,ff/S�/l71 CITY,STATE D ZIP COD JOB LOCATION ((//(�� 3 t rt tt0✓Pt We hereby submit specifications and estimates for: Recommended Optional k7,1 4,r(7 c)(3 (Included in price) (Not included in price) ✓ Rip& Remove all shingle debris from roof&job site_ �d 1 layer 0 2 layers U3 layers or more ✓� Repair/or Replace any roof decking; not to exceed 50sq.ft. +� Install 8"aluminum drip-edge/and rake-edge along entire perimeter. Choice of mill,white or brown Install ICE&WATER underla ment along horizontal eaves, valleys, sidewalls and sky-lights&chimneys W' Install 30#felt underlayment between roof deck and roofing shingles • Install 25yr CertainTeed/GAF/Tamko or Owens&Corning traditional 3-tab roof shingles 0 30 year rf Install 30yr CertainTeed/GAF/Tamko or Owens&Corning architectural roof shingles 0 40 year V 50 year 0 60 year 0 Lifetime See manufacturer warranty policy for more details Install new aluminum vent-pipe flange(s) ✓ Chimney(s)-counter-flash and re-step existing flashing 0 Cut& Install new lead flashing ,{ Ridge-vent/exhaust vent with low profile design, hidden by shingle caps - -----— - —-. -- -- -- --- - - t j 0 Soffit-ventilation Roof louver-vents • Seamless style aluminum gutters-custom fabricated at job site 0 downspouts ❑aluminum leaf guards ✓ Other h1< 't' I/1 r�(f_ &PF t��q r o Ci.l / n j rr�a'A4 a yp j T I.cl PWo f I J --- l u r4'A cl—— ----- ---- -- —--- ._ I i Price includes all items above that are checked only/others may be priced separately upon request. I� We Propose hereby to furnish material and labor-complete in accordance with above specifications,fo/ he sum of: -- O - - — - Total price not.including options. dollars($ / S Pa ment to be made as follows: 30%deposit required before ordering materials. Balance due in full upon day of completion. Please make all payments out to Kenneth Duval, mailed to: P.O. Box 637, No. Reading, MA 01864 I, Late charges of$50 per week for all outstanding bills due upon day of Authorized completion. Signature L- Accepting proposal means agreeing to the terms of the enclosed binder Note:This proposal may be tract. Please sign contract&return top copy(white)with deposit. withdrawn by us if not accepted within days j; F NORTH own of s 4Andover No. LA E dover, Mass., TCOCHICHEM yA ADRATED P'P�` �y `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System WJ� P BUILDING INSPECTOR THIS CERTIFIES THAT........................................ ... ...... ............................ .............. ........... Foundation has permission to erect............................... ....... buil ' as on . ....... .. Rough to be occupied a Chimney �. provided that the person accepting thi permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of t 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 UNLESS CONSTRUCTT ELECTRICAL INSPECTOR qj,{,� Rough .................................................................. ......... ............................. ........ Service BUILDING INSPECTOR 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 Until Inspected and Approved by the Building Inspector. Burner DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det.