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HomeMy WebLinkAboutMiscellaneous - 967 JOHNSON STREET 4/30/2018Check # lolp% 17697 Building I Spector Cw?S r Location y ti No. Date �I 7161r' / I Try TOWN OF NORTH ANDOVER � A 9 a � Certificate of Occupancy $ Buildin /Frame Permit Fee $ s.►cMust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ .3 Check # lolp% 17697 Building I Spector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING d Zn ,`,n'r.s:� ,s�X Y. z?4 = �x;,.� &s�`:. y- .w€:m' mkt Y'S fi< k '}'per•77 BUILDING PERMIT NUMBER: O DATE ISSUED: C;2 /0/-7Z0 C C SIGNATURE: Building Commissioner for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: � 91 lug -A- 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 R red Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ ECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT HistoricDistrict: Yes 0 2.1Owner of Record 0, C/ N (Print) Address for Service: C ignature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SUCTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number T)"Val IZ6®g--- Address P.u. Box 637 `p� /0 �?otYi1 `;'jdinl, MA / �% 7j6` cl-22 � Expiration Date Signature Tele e4 3.2 Registered Home Improvement Contractor Not Applicable ❑ U C/a Q Company Name Registration Number dl Roo Address �1L=apt K,,ading, MA r}€`8F4l9%�66 ��SS Expiration Date Sr nature Telephone 4/a'Ve-X— n 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 buildwel2rmit. Signed affidavit Attached Yes ..... No ....... ❑ SECTION 5 Descri tion of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: ---a9 it � A .rri.6-n �! I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be Completed by permit applicant OUSE ONLY 1. Building (a) Building Permit Fee Multi Tier 2 Electrical (b) Estimated Total Cost of Construction 3 Phunbing Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 O 0 `— Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT authorize alf, in all matters as Owner/Authorized Agent of subject property authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION to act on 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 Z� ro Lc Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2 ND 3 RD SPAN DINIENSIONS OF SILLS DIN ENSIONS OF POSTS DINIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE rA Terms and Conditions 1. Contractor is amply protected with workman's compensation, public liability and property damage insurance in connection with all work performed by it on the Purchaser's premise. 2. Contractor shall not be responsible for any damage or delay resulting from acts of God, civil commotion or disorders, strikes, fire, accidents, storms, delays or default, by carriers or suppliers, inherent defects in subject premises, or any other causes beyond its reasonable control. 3. Homeowner acknowledges code requirements of roofing nails penetrating through roof decking and will be visible on underside of some surfaces. 4. If the contract price is not paid when due, Purchases agrees to pay all costs of collection and reasonable attorney's fees. 5. Purchaser agrees to hold no retainage for work performed under this agreement. 6. All items not on the accompanying proposal ordered by the Purchaser will be added to the amount due. 7. All oral, or written agreements, statements or presentations made by or on behalf of this company are expressed or superseded by this proposal. This contract contains in writing and print the entire contract between the parties thereto. No warranties or guarantees, expressed or implied, are made by the seller except those set forth in this contract. 8. If as a result of the proposal, work is performed without a properly signed copy to Contractor, the purchaser automatically agrees to all applicable terms and conditions. 9. Contractor warrants to perform a workman -like job using materials consistent with contract requirements, however, because of material shortages substitutions may be made at the Contractor's option, provided equivalent materials are used. 10. The terms of this contract shall be governed by laws of the State of Commonwealth of application. 11. The person who signs the contract, or who accepts by verbal implications, corporate, personal, or otherwise, accepts full legal responsibility for payment of all monies due under the terms of the contract. Without offset the signer waives demand, protest, notice of presentment, notice of protest and notice on non-payment and dishonor hereof and also agrees to pay attorney's fees under the terms of the contract. 12. Contractor agrees to take every precaution to protect landscape but due to the delicate nature of some vegetation some minor damage can be expected. Contractor does not except responsibility for repair costs to any plant life that will grow back in the following year. 13. If Homeowner cancels after materials have been order, any monies paid as a deposit will not be returned to you unless we are able to cancel the materials ordered specifically for your job. 14. To cancel this transaction, mail a signed and dated copy of this cancellation notice or any other written notice, no later than midnight of three business days after the contract date. mel ingl Co rand Style (n� Deposit Amount 101© cl., ej D © 1� r'c:� �J oo o kap Terms and Conditions 1. Contractor is amply protected with workman's compensation, public liability and property damage insurance in connection with all work performed by it on the Purchaser's premise. 2. Contractor shall not be responsible for any damage or delay resulting from acts of God, civil commotion or disorders, strikes, fire, accidents, storms, delays or default, by carriers or suppliers, inherent defects in subject premises, or any other causes beyond its reasonable control. 3. Homeowner acknowledges code requirements of roofing nails penetrating through roof decking and will be visible on underside of some surfaces. 4. If the contract price is not paid when due, Purchases agrees to pay all costs of collection and reasonable attorney's fees. 5. Purchaser agrees to hold no retainage for work performed under this agreement. 6. All items not on the accompanying proposal ordered by the Purchaser will be added to the amount due. 7. All oral, or written agreements, statements or presentations made by or on behalf of this company are expressed or superceded by this proposal. This contract contains in writing and print the entire contract between the parties thereto. No warranties or guarantees, expressed or implied, are made by the seller except those set forth in this contract. 8. If as a result of the proposal, work is performed without a properly signed copy to Contractor, the purchaser automatically agrees to all applicable terms and conditions. 9. Contractor warrants to perform a workman -like job using materials consistent with contract requirements, however, because of material shortages substitutions may be made at the Contractor's option, provided equivalent materials are used. 10. The terms of this contract shall be governed by laws of the State of Commonwealth of application. 11. The person who signs the contract, or who accepts by verbal implications, corporate, personal, or otherwise, accepts full legal responsibility for payment of all monies due under the terms of the contract. Without offset the signer waives demand, protest, notice of presentment, notice of protest and notice on non-payment and dishonor hereof and also agrees to pay attorney's fees under the terms of the contract. 12. Contractor agrees to take every precaution to protect landscape but due to the delicate nature of some vegetation some minor damage can be expected. Contractor does not except responsibility for repair costs to any plant life that will grow back in the following year. 13. If Homeowner cancels after materials have been order, any monies paid as a deposit will not be returned to you unless we are able to cancel the materials ordered specifically for your job. 14. To cancel this transaction, mail a signed and dated copy of this cancellation notice or any other written notice, no later than midnight of three business days after the contract date. Signed Shingl 3o Vu- A-;, ,+zmac ) Gc— ( _rA w4 V/I/-)Y-_ mount 4 (c¢0-0 ._ 0 c) Duval Roofing P.O. Box 637 North Reading, MA 01864 978-664-2557 Steve, Enclosed is a building permit application, the town of North Andover requires your to sign in both place that I have marked. Also, 1 need to get your shingle selection in writing. There is a "Terms and Conditions" sheet in the folder he ve you with your estimate, please sign and note your shingles selection and return to me with the appficaAon so I can order materials. I� � Y Oct yc),-, el(,.)� �A 5 n� iev AS J � [Ak' f _ cel. [ a L{`f' LC. -t1 c�` (�L C� Ct ✓lam_ `<< l� (,'jeaC i l5 C C �` Vkv1 r L, C �J C - (w� X36 c, Page No. of Builders License # 58443 Home Construction Reg. # 109288 CertainTeed/Certification # 1911 J � e A- i *1 GAF Certified Master Elite i� i]n ,. TH E Ei1 �C00 �L..l�>rh COLLLCTIO t���j 9�1�3-999 ij9�aj 6G4-a55� Cwialffbed El "The Areas Oldest Roofing Company" LJ P.O. Box 637, North Reading, MA 01864 i - s 3:" PROPOSAL U MITTED TO • /� ATE { / C / ST r- 7 JC Agiq!i /l�+�Jf/ 17k7 ' CITY, STATE D ZIP CODF� l.►vPr JOB LOCATION o. We hereby submit specificationd estimates for: Recommended Optional /1 4 t to P07- (Included in price) (Not included in price) t% Rip & Remove all shingle debris from roof & job site: S 1 layer :12 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 ✓ Install ICE & WATER underlayment along horizontal eaves, valleys, sidewalls and sky -lights & chimneys r✓'` Install 30# felt underlayment between roof deck and roofing shingles ✓ Install 25yr CertainTeed/GAF/Tamko or Owens & Corning traditional 3 -tab roof shingles ❑ 30 year • Install 30yr CertainTeed/GAFITamko or Owens & Corning architectural roof shingles (� ❑ 40 year U 50 year.,. ❑ 60 year 0 Lifetime See manufacturer warranty policy for more details t+! Install new aluminum vent -pipe flange (s) I/ Chimney (s) -counter-flash and re -step existing flashing ❑ Cut & Install new lead flashing o o • Ridge-vent/exhaust vent with low profile design, hidden by shingle caps ❑ Soffit -ventilation J Roof louver -vents j Seamless style aluminum gutters - custom fabricated at job site ! ❑ downspouts ❑ aluminum leaf guards • Other Price includes all items above that are checked only / others may be priced separately upon request. Pe Prupeez hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: U Total 1 price not including options. dollars ($l ). Pay ent 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 Late charges of $50 per week for all outstanding bills due upon day of Authorized completion. Signature - Accepting proposal means agreeing to the terms of the enclosed binder Note: This proposal may be rnntrnrt Planca Ginn rrnntrnrt R rata irn tnn rnnv twhital ­ith einnnci+ .d+hriro n K--4 nn+ ­- ..d+hi.. S .+...... The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # 0 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity am em loyer providing 2 my employees working on this job. 9 .2ff4�d5o v g 730 x 35vo Company name: Address City: Phone # Insurance Co. Policv # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties af,a fine up to $1,500.00 and/or one years' imprisonment -as wett_as_civil.penaltiesin the form da.STOP WORK _ORDER.And_a.fiine of (3100.00.).altay 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 underAe pains and penalties of perjury that the information provided above is true and correct. // Signat a Date l U// Print Official use only do not write in this area to be completed by city or town official' # City or Town Permit/Ucensi ❑ Building Dept ❑Check if immediate response is required ❑ Licensing Board ❑ Selectman's Offrce 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: ,/ 7 (Location of Facility) Signaturef Permit Applicant 11O ate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 41 CA m m x CO) v m C CO) CO Z CD O CLd -00 CDa� a� o p CL Q CD o a' o CD _ CA .p CD O C2 y _ d O CA C CA d 0 CD O rF CD CD CD CA O CD 0 CCD 0 CO e+. PA! cn V J n O cn 0 :-,a- � v ==ato 0 m Sd0Sm10 y oa:o m n 0 H CD d CD C09 T Z =r -c N .0y. 7 tdim � -.-n o?m O y m ...comm $ IE m a m Ca O z is O m•e2 CD EL �m s :. m o =r? ` C93 O O CL IL yam: m y CAA CL Q Ccc c O c •� d : = VV N 'm� A l 1, � .� m . CO) CA CD � ..� :\ • °�yA:Wejr� omaCD : p_ CA CD s; m; Wim: ;w CCp '. e CD ` dmCL: 5-00 C O O O � �q (n p C/) z C37 G z W �9 G 31 y ox O rz '�7 x G CA "t1 C 5to C', a H 0 W 4 Date`.�...�° ... !!� ......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING !This certifies that. . ........ ........................ /'?.— ........ has permission to perform................ .................. wiring in the building ................................................... at . ......... .......... .. North Andover, Mass. Fee`�O �t .......... Lic.No"P�1.7�. / --- ELEcrR ICAL INSP ECTOR Check # 130V - 5224 e THE COMMOATHEALTHOFMASSACHUSETTS Office Use only DEPARTAIEWOFPUBIdCSVETY Permit No. Q5—J c BOARDOFFMEPREV=ONREGUI ONS527CNIIZI2.'00 I Occupancy &Fees Checked. APPLICATTONFOR PERMIT TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS CTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date o G Town of North Andover To the Inspector of Wires: The undersigned applies for a permit toperformthe electrical work describe be .w. Location (Street & Number) / V %j � 6 - ,f Owner or Tenant Owner's Address Is this permit in conjunction with a building Purpose of Building Yes E] No (Check Appropriate Box) Utility Authorization NoS S Existing Service g.,,� Am s o2 / D Volts p ' Overhead ®Underground � No. of Meters f New Service Amps c� / o? �3 Volts Overhead ® Underground _ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work A 7-j U/L -P No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Bumers 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 Nq, of Sounding Devices N(;of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal Other Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydr*) Massage Tubs No. of Motors Total HP OTHER- hU1[arxeCDWrage.Ptnst=totheregttiam8ofNb%actniscIsC',ffe Laws [haw aamal iabffitykoza ccPbhcyi kxkngCompleteCovcageoritsmbsWUegrmkit YESMK NO F [bavustibrmtlDdvandprocfofsametotheOffim YES ffyoubawdr d<edYES,plea9em&aletheMmofoDvetageby :}1edkingtheeppm m& box NSURANCELA— BOND F1 MHT- (Please Spa*) 6r i f} o61 �iS 6 . DatE t/� r4 JlorktoStart l iigned urxldr�ie Pfr&es of perjury. MMNAN1E 10111 L-9--figgirar-4-all Y, J L-/1-16*1 t, Exp1<atioll Eshm&dValueofElec"Wark $ Final / Ii�eNo.a 7 1-:7dicensee fLe ✓ � l �fI Signature - r,,g:�J � Ii�No 2/ �j / /� / BusinessTel.No. % -3 a, 3 %,//Ue (l ref Dr/ V-( ! �d�i �4 �(/` (d< qc?/ AIL Tel No. 92L 7 - 6 /� )WNER'SINSURANCEWAIVER;IamawamfliatlheLicmsf--doesnothavetheinsurxmoDva poritssul alequivaleMasmgtluedbyMassachu92zCremx Laws -)d thatmy sigk9me on thispeurnt application waives this reqrmenrent ?lease check one) Owner ® Agent Telephone No. PERMIT FEE $ rgna ure o caner or gen The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 Workers' Compensation insurance Affidavit Name Please Print I 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: Address City: Phone #: Insurance. Co. Policv # Company name: Address City: 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 w.ell_as_civil..penaltiesin.Shefarm-of-aSTOP WORK_ORDER..and_a fine -of _(.$1.00.00)-aday-against.me. I e understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. f I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name P.hone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing 0 Building Dept i ❑Check if immediate response is required p Licensing Board Selectman's Office Contact person: Phone #. F-1 Health Department n Other