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HomeMy WebLinkAboutMiscellaneous - 36 WINDSOR LANE 4/30/2018Location No. ' -+ f Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee It {) =,- Sewer Connection Fee $ Water Connection Fee $ vv •t' 9�;" ' Building Inspector Div. Public Works O m m r F: O 'a_ N . 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T w (AT R. r a ° n a: a. •9 K ca z n Z H A °c f� v n _ Z X a m ° O T -w S fb d• O A A o s A A N ° b _ _• z y' A QG O O� A m� � OQ C s V1 d rr1 =y X °' S m o T N , r" �• A m < I Cr) S. W •� Z y =• A VT ) Q A O � A O O � � IrD 0 � A Z -� A (!1 a fo soo = A � d t' to c A o = O = iD O . m c (A x .. oMa n CLI �• H O x :nl) :o Q (A 3 m Q7 � i�/j� z o .� T m �1 T w' c° a N z T � Afa" T w (AT R. c° (D m > Z w Z1 � t0 •9 K ca z n Z w _� °c f� v n _ Z X a m ° O T 0 m z DU m Di ca M 17 Y FORM U. TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION ASSESSORS MAP ff)(p T.:> SUBDIVISION LOTS)_. PERMMAUNT ADDRTSS ASSIGNED BY D.P.W. /STREET _ , [z _W i Al RNs oiQ L-0 N E - /APPLICANT /APPLICANT L6j9R PHONE 1//DATE OF APPLICATION to ' PLANNING BOARD TOWN PLANNER TOWN USE BELOW THIS LINE DATE APPROVED DATE REJECTED CONS R ATION COMMISSION DATE APPROVED CONSERVATION ADMIN. Q DATE REJECTED BOARD OF HEALTH HEALTH aANIrARIAIT �_�T/..lar �clor ?o56- /.4AJ1:� 91Z PIPE DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT IV ll� DATE APPROVED DATE REJECTED 1IIV460 0.41 C -"o OF IS eVE2 72:�,cle. ao4,¢0 of 44fl/W /�rSpEcTb2 ?� /.u5PEc7' F.2idl&- To 7541 ,(/ SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. 0 t' DELBAR 36 Windsor Lane North Andover 3 sonotubes I stair footing pad 3 posts 1 cantilever support beam 1 header beam 1 ledger 13 joists solid blocking decking railing cap railing railing posts 4 stair stringers stair decking newel posts 5 post bases 22 joist hangers lag bolts with washers carriage bolts with washers 8d common nails for decking 16d common nails for structure poured concrete 12" dia x 4 poured concrete 1 'x4'x4' 4..x4.' 2 - 2"x l 0"x 12' 2 - 2"x 10"x 12' 2"x 10"x 12' 2"x 10"x 14' spaced 12" o.c. 2"x 10" 5/4"x6"x 12' 2"x4" spaced 4" apart 5/4"x6" 4"x4" centers and corners 2"x4" at 114 and 3/4 2"x 12" 5/4"x6"x4 4"x4" 4..x4.. 2"x 10" 4 1/2" x 5/ 16" dia 5 1/2" x 5/16" dia all wood pressure treated 40 cca all fasteners and hardware to be galvanized steel DELBAR 36 Windsor Lane North Andover MATERIALS LIST pressure treated wood 40 cca 4 4"x4"x8' 6 2"x 10"x 12' 13 2"x 10" x 14' 2 2"x l 2"x 12' 5 5/4"x6"x8' 34 5/4"x6"x 12' 1 5/4"x6"x 14' 2 2"x4"x8' 10 2"x4"x 10' 8 2"x4"x 12' hardware - galvanized steel 5 4"x4" post bases 5 5/16" bolts with washers 24 4 1/2" x 5/ 16" dia lag bolts and washers 12 5 1/2" x 5/ 16" dia carriage bolts with washers 12 4" x 5/16" dia carriage bolts with washers 22 2"x 10" joist hangers 12" dia x 12' sonotube 8d common nails for decking 16d common nails for structure ----QQQpsi concrete deep .+ 0 DELBAR 36 Windsor Lane North Andover MATER1AL5 L15T pressure treated wood 40 cca 4 4"x4"x8' 6 2"x 10"x 12' 13 2"x 10"x 14' 2 2"xITx12' 5 5/4"x6"x8' 34 5/4"x6'x 12' 1 5/4"x6'x 14 2 2"x4"x8' 10 2"x4"x 10' 8 2"x4"x 12' hardware - galvanized steel 5 4"x4" post bases 5 5/16" bolts with washers 24 4 1/2" x 5/16" dia lag bolts and washers 12 5 1/2" x 5/ 16" dia carriage bolts with washers 12 4" x 5/ 16" dia carriage bolts with washers 22 2"x 10" joist hangers 12" dia x 12* sonotube 8d common nails for decking 16d common nails for structure 6000psi concrete DELBAR 36 Windsor Lane North Andover 3 sonotubes 1 stair footing pad 3 posts 1 cantilever support beam I header beam I ledger 13 joists solid blocking decking railing cap railing railing posts 4 stair stringers stair decking newel posts 5 post bases 22 joist hangers lag bolts with washers carriage bolts with washers 5d common nails for decking 16d common nails for structure poured concrete 12" dia x 4' deep poured concrete 1 'x4'x4' 4"x4" 2 - 2"x 10"x 12' 2 - 2"x I 0"x 12' 2"x 10"x 12' 2"x 10"x 14' spaced 12" o.c. 2"x 10.. 5/4"x6"x 12' 2"x4" spaced 4" apart 5/4.'x6.' 4"x4" centers and corners 2"x4" at 114 and 3/4 2"x 12" 5/4"x6'x4' 4"x4" 4"x4" 2"x 10- 4 1/2" x 5/ 16" dia 5 1/2" x 5/ 16" dia all wood pressure treated 40 cca all fasteners and hardware to be galvanized steel Location No. Date NOR7►� Ot�,.to ,•,ti0 3?e� • OL A f A 41 11 �O+ane •�,�� ,SSACHUSEt ,- ,d� TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ i0therPermit Fee $ Sewer Connection Fee $ Water Connectio TOTAL Q4 V ��'?M 1/9b 13:46 9853 n Fee $ 3S• �uildiPPn�Dlnspector Div. 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CD CO) 0 O CD O CCD W E. I cn �7 — C E - o O N 2 cr E W t!J r Ix w too,Cc,m "7` r" C) n m T D O n C cn �' c O a eD Z O� =r -O CO N N—O• —1 TI r .Wa =r CL CL o Mn W O W y CO) o W m m C CD �, C to C C2 :5. C, O N C7 oo: ;:�.o W ' LM: n o . �. co �C? W N 0­4 Wn- UM CD CCDL W CO) O = N O. grij N �CD C/) C CA y...� W y W = N '� C to ,,,�, O o O O y��y•�� l7 W co oC°• P CD :I N CD 0CD 1V 03 CD O sv O n� C, co') O : c o o=' W o cn �7 cn 0 M n I 7 w cv O S r Ix w Pi 0 �' "7` r" C) n m T D O O o o. C cn �' c O a eD o y 0 0 c v P It Y FORM U - VERIFICATIOiN 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** (/APPLICANT : 'fir. rt l nJnP cJl �I Phone 508- fo Ta - S"d q q LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) "treet 3(,p W z"vCLS Off- 1-N - St. Number ******************** 63 vat***Official Use Only************************ RECO DAT ON �O TOWN AGENTS: /J,- Date Approved v Conserion Administrator Date Rejected Comments Town Planner Comments Fco:,., inspect -or -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Approved Date Rejected Date Approved Date Rejected Date Approved �O Date Rejected Date ,x. \3, z rr- n m mm x x m m m M m N Z S N � 4 " f f Location No. �2 3 Date 2.Q, TOWN OF NORTH ANDOVER s 799 •p Certificate of Occupancy $ ��s'•^�•'<� Building/Frame Permit Fee $ s�CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # /,I? r Iu- -Building Inspector �% �r TOWN OF NORTH ANDOVER • BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE,{{ OR DEMOLISH -A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: 4r SIGNATURE: Building Commissioner/I for of Building -s Date —G Ln SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ���� 2 4 X 16 0 - GO ^l ,� /Y o Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Rewired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 OwnerA Record �p Name (P int) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: Duval Rooft License Number P.O. Box 637 Nath Reading MA Address 01864 A, E E iration Date Signature Telephone 3.2 Registered Home Improvement Contractor„„�� Not Applicable El ElCompany D� ww 11i oft Name P.O. Box 637 20 Registration Number North Readhl& MA Address Cl' G Expiration Signature Telephone v rn O Z rn 90 O r v r r — Z^^ LI �L 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 Completed by pertnit applicant OFk'ICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) r- 001 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 '',3y0 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ��,l�G`Lc^ _ S �� ��t/�J.o� as Owner/Authorized Agent of subject property Hereby authorize to act on M belt f, in all ma rs relative to work authorized by this building permit application. S oature of Owner Date ACTION 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 ,ZQ,,J,7 j (,A,( . Print Si ature of Owner/Agent NO. OF STORIES � J� Date / SIZE BASEMENT OR SLAB SIZE OF FLOOR T114BERS iST 2 ND 3 RD SPAN DIMENSIONS OF SILLS DMIENSIONS OF POSTS DIN ENSIONS 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 ui s 0 041.1 4.4 a Y/ W W W 19 W N C4 � a 1 a � a d � v � U w a°G i:. w p°G V w" 0°4 w a�q cn cn ui s 0 041.1 4.4 a Y/ W W W 19 W N The Commonwealth of Massachusetts Department of Industrial Accidents Ofts of Invesdgadons Boston, Mass. 02111 Workers' Compensabm Insurance Aflidn4 J 117 i 9"I'MI 1971-1771= 0 I am a sole proprietor and have no one working in any capacity I am an emplayer providng for my employees working on this job. Irimmunce Co. Polcv 8 Fdkve to sordes coversps • regalrect undo► Section 2f^ or MOL 152 can lead to!M kr pmllon d alrnhal penaMlas d.a tins uP to $1,500.00 andfor one yeas' imprlscoo. t_m.wd.nAM4nwM wbmsh=.dA.S I VAOMDRDERandA fkw d.(,SIWAMAAw wkmt ma. I understand that ■ cagy d this datwrw t may be fc waded to ft Offlos d invoodgs lom d Qu DIA for comwopa veriMcdlon. I db hereby cw* wx!v ft pains and penalrlae d perjury the the kdbmwOm provi* d above k sue end camp Print Offldd use any do not write In this res to be completed by d ty or town dW City or Town PrmlN.lcanino [] Buddng Dept []Check I Immedlete response Is requked [] LkerlBft Boe/d [] Selectman's Ofte Contact person: Phone t [] Health Department 13 Other North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the pros thatsion othe debris�esult ng from this condition work shall beermit Number disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The deb's will be disposed of in: /Al of F Signature of Permit Applicant � bs-� Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NOTICE TO EMPLOYEES NOTICE TO EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that, I (we) have provided for payment to our injured employees under the above mentioned chapter by 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 DBA 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 ADDRESS 00820E W20P1G02 TO BE POSTED BY EMPLOYER Page No. i of Pages Builders License # 58443 I. Home Construction Reg. # 109288 L <'. : • tom.' -- kt.u� (781) 944-1994 (978) 064-2559 II "The Areas Oldest Roofing Company" n it P.O. Box 637, North Reading, MA 01864 I! i III PROPO L SUBMITTED TO P E-7� /'` DATE STREET - JOB NAME CITY, STALE AND ZIP CODE JOB LOCATION We hereby submit specifications and estimate,§ for: Recommended Optional j V i i ' I,— / (Included in price) (Not included in price) Rip & Remove all shingle debris from roof & job site: q , layer J 2 layers 0 3 layers or more t--""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 •sem Install ICE & WATER underlayment along horizontal eaves, valleys, sidewalls and sky -lights & chimneys , q3A oto z xm z�) pow c . \ fZ k i� »©■w 2 A #_ k k k Co/ 0 2� M■ C, k § § v_ > I z CK 3 , . \CD M K q mc. E c� 2z CD CL CL : E I I x//c ■ c °Ix k E& kR R o - .c C) /OD CD OD § E� � \ f � q § 2 E � : E Lot -"' I CERTIFIED PLOT PLAN LOCATION 3 Wl'ndsor LQr-1e. Z-/or1- -7 Andozgz-, Mass. SCALE: / ' y� / DATE: 3' 8''e3 REGISTRY: sse_x Nor- "k TITLE REFERENCE: gK 2319 Pa 299 PLAN REFERENCE: OZSZ Areo-= LJ31 4Z`-1 t -S, F:. 'ZStK. tkxtk � LIti F CERTIFIED TO: - S eQa./' Aeor ar�o� I-- I bei Lot 1'- 3 This plan was not prepared from an instrument survey. Offsets and distances shown should not be used to establish t, property lines. This plan is intended for mortgage purposes only. I certify that the structure shown on this Plan conformance with zoning setbacks in effect at the time of construction. LAUD I certify that the parcel shown is �b� located within INC. --JOB NO. a flood hazard area as depicted on HUD Flood Insurance Rate CAMERON BROS. Maps for Community No: zs0098 MALDEN, MASSACHUSETTS