HomeMy WebLinkAboutBuilding Permit # 5/8/2015 (2) i
i
V%OR'ry
"
BUILDING PERMIT
TOWN OF NORTH ANDOVER a � o
APPLICATION FOR PLAN EXAMINATI„
Permit NO: Date Received /°
Date Issued: G SsgCHU
PORTANT: LA2, phcant must complete all items on this page
LOCATION-- �4 :2
PROPERTYC7WNER. „ Tint
r Print
MAP NO:1-��PARCEL:696 ZONING DISTRICT:-----Historic District yeso
Machine Slop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
U New Building family
Ll Addition U Two or more family U Industrial
U Alteration No. of units: U Commercial
?KlRepair, replacement u Assessory Bldg u Others:
U Demolition U Other
Ll Septic u Well u Floodplain U Wetlands u Watershed District
U Water/Sewer
g6
A ..w _. ... � ..
/ Identification Please Type or Print Clearly)
OWNER: Name: V, i-7 I w .t /Lr- 11 / Phone: ,,
Address:
CONTRACTOR Name: Phone:
Address: ..
12Date,Supervisor's Construction License: � Exp. IV
Home Improvement License: Exp. Date:„
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDIMG PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED DH$125 00 AER S,F,
Total Project Cost $ � .,�°° FEE: $
Cheek No.: t
-- - � Receipt No.: 7 L4q
NOTE: Persons contracting with nregistered contractors do not have access to the guaranty fund
�
Signature ofAgent/Qwner � ...Signature of contract�� P,
,,��'�
Plans Submitted C Plans Waived ❑ Certified Plot Plan t] � Stamped Plans ❑
F
YPE OF SEWERAGE DISPOSAL
blic Sewer ❑ Ta ning/Massage/Body Art ❑ Swimming Pools 11ell ❑ Tobacco Sales
❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Diunpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF o U FORM
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS ice'
/`1'r,ONSERVATION Reviewed on - Signature
�-- c v"�- (�1 l Jv 1 .,, -Pn Q L
COMMENTS � ti '�1`�,,e� �� �`�.� ,� �� �„ �; ..
HEALTH Reviewed on, i Signature r"V
i
COMMENTS ,
� , ❑ ` �, .❑4�
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
x
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/Signature & Date Driveway Permit
]DPS'Town Engineer: Signature:
Located 384 Osgood Street
4 r
i
FIRE DEPAI�lTMENrT r Tem D
um sier onsite,
' ��J�per/,,�/f p/�r%f; / rat'l��Gild��(11 �� rr r F' p
Located`sti/%124'
1 1 !7 / -frr%�%%.i rri et r i r'� 1 r� s f,„ r r✓r r� % /�%/i ����%r/�a,;
Fire De artment s ;!, ,i /„i,,r,❑ %,,
i nature
yrs rr r pl,,r �i o////r �•`� i; ra� r r / „,%G.' r/,.r7 / r i/ it r////�'��i///r�/�����//i 1�����%����lr i.///ri�"l�❑�i"c;
77711 "'777"
77777;
COMMENTSn '
rri� / /r ,
own of 1-adover
An
® �" M
® 81J."
11 � ver, Mass
O LAKE 1
COCKI[NEW.CK
x.95 RATED
USmoak, BOARD OF HEALTH
PERMIT
Food/Kitchen
I %% L &W Septic System
THIS CERTIFIES THAT ....................
HAT .w , ,A r®iJ® BUILDING INSPECTOR
.....U. .................. ............................... ........................
has permission to erect .......................... buildings on ...... ... .......Ca.ri`, .
Foundation
.. . . .. ... .................
. * Rough
to be occupied as ........... .'A ... .�....�. ..�01 4.... ..... Chimney
provided that the person accepting this permit shall in every respect conform to t terms of the application
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Final
Construction of Buildings in the Town of North Andover. w�ct foltq It's
, st k PLUMBING INSPECTOR
1
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMITI IN 6 MONTHS ELECTRICAL INSPECTOR
-UNLESS5jftRTS Rough
Service
BUILDING.INSPECTOR. Final
GAS INSPECTOR
ccupancV Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
Massachusetts glome Improvement Sample Contract
This form satisfies all basic requirements ofthe state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard
language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A
Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the
Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website.
Homeowner Information Contractor Information
kLm
CompanyName
Adddrress onotuseaP st tBoxaddres Conpt6/Salespe mOwnerNaeCity own to Zip Code N gusiness Add (must'nclu e a street address)
D 'me Phone Evening Phone Ci /room State Zip Code
ailingAddress(It bifferent frob ab e) IB sin honeremen(ContractorReg.Wenu,=
er ployer or S.S.Number
Erp'vatbmdate
Lor requires that most hImprovement contractorsvnlld reehtrution numb
The Contractor agrees to do the following work for the Homeowner:
(Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.)
I
Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will
and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise
(Owners who secure their own permits will be '
excluded from the Guaranty Fund provisions of 1 .when contractor will begin.contracted work-
MGL
ork
MGL chapter 142A.)
e when contracted work will be substantially completed.
Total Contract Price and Payment Schedule
The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of. (*)
/+ Payments will be made according to the following schedule:
upon signing contract(not to exceed 1/3 of th7WF;
or the cost of special order items,whichever is greater)
( A� by / / or upon completion of QoJ 1 1 j
g by / / or upon completion of i�
$ upon completion of the contract. (Law forbids demanding full payment until contr is completed to both party's satisfaction)
The following material/equipmentmust bespecial $ to be paid for
ordered before the contracted work begins in order
to meet the completion schedule.(0) $ to be paid for
NOTES:('t)Including all finance charges('r*)Law requires that any deposit or down-payment required by the contractor before work begins may
not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
Express Warranty Is an express warranty being provided by the contractor? ❑No❑'Yes tall terms of-the warranty must be attached to the contract)
Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third
party/subcontractor utilized by the contractor. Tlrp goonntractor h r jgre to be solely responsible for all payments to all subcontractors for
materials and labor under this agreement d✓
ContractAcceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the
contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices
carefully before signing this contract.
• Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear.
• Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and
subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor
registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757.
• Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to
see a copy of a"proof of insurance"document.
• Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of tate Consumer
Guide to the Home Improvement Contractor Law.
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the
contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the
third business day following the signing of this agreement. Seethe attached notice of cancellation form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLAND SPACES!!!
Two identical copies ofthe contractmustbe completed and signed.Owcopyshouldgoto mmemvncr.The other copy should be kept by the contractor.
MA 1)-4
Homeowner's Signature ontractor's ignature
Date Date
E
I
f I,
f k
717
u
hV . 41 LAI
����i tit� �$rJ ro#' +:..-✓ �
rv-�i - e
0
rT I
III r
i _<
g
i�Xl
�
TO
Or 4-1
iv-
_� - �' - �-
-r
�� .. AV-
The Common-wealth of Massachusetts
Departfnetit of Industrial Accidents
�{zi
� � Office ofimlesti.0atiens
lr
' 600 Washington Street, 7'Floor
Boston,Mass. 02111
Workers' Compensation Insurance Affidavit:BuildingtPlumbing/Electrical Contractors
Applicant information: Please PRINT leuibly
name:
address:
cityaZ r,4& ( dc
state: � zi : ` • hone# m
work site location Milt address):
I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel
I am a sole proprietor and have no one working in any capacity. ❑Building Addition
❑ I am an employer providing workers'compensation for my employees working on this job.
company name:
address:
city: phone#•
insurance co. policy#
❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers'compensation polices:
company name:
address-
city: phone#:
insurance co. policy# �I
company name:
address:
city: phone#:
insurance co. policy#
Attach additional sheet if necessary
Failure to secure coverage as required under Section 25A of 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 penalties in the form of a STOP WORK ORDER and a fine of$100,00 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 liereb certify ander it:e pains and penaltie ofperjnry that the information provided above is true and correct.
Signatur Date
Print name a 61 t` • Y Phone#
official use only do not write in this area to be completed by city or town official
city or town: permittlicense# ❑Building Department
❑Licensing Board
❑check if immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phone#; ❑Other
(revised Sept.2003)
���e (�,aoxo7paazu:ealt�a��G��l{lrrr�¢c�rrtell�
Office of Consumer Affairs&Business Regulation
rOME.IMPROVEM�►JT CONTRACTOR
FAegistration: 444863 Type:
xpiration: 3/22t2Q17 Individual
,JAMES MEALEY - =-
JAMES MEALEY
32 HILL DALE AVE.
MIDDLETON,MA(11949 Undersecretary
} Massachusetts-Department of Public Safety
t Board of Building Regulations and Standarids
�'----
-
+LrtrrsTi ue.teErii�ii;ser+�>ur
License: CS-066660
(�CS
JAMES J MEAW `
32 HILLDALE ASE _
MIDDLETbN MA 019
,V I
Expiration
Commissioner 01/17/2017
Deems, Maura
From: Enright,Jean
Sent: Thursday, May 07, 2015 2:00 PM
To: Deems, Maura
Subject: RE: Replacement of Deck at 49 Carlton Lane
Thanks, but no I do not have to approve.
Sincerely,
Jean Enright
Assistant Director
Community and Economic Development
Town of North Andover
1600 Osgood Street,Suite 2035
North Andover,MA 01845
Phone 978.688.9533
Fax 978.688.9542
Email: jenright@townofnorthandover.com
Web: www.TownofNorthAndover.com
From: Deems, Maura
Sent: Thursday, May 07, 2015 12:27 PM
To: Enright, Jean
Subject: Replacement of Deck at 49 Carlton Lane
Jean,
We have a permit for a deck replacement at the above address.
Health and Conservation have signed off on the application.
Do you want to review the application?
Let me know.
Thanks,
Maura
Maura Deems
Building Department Assistant
Town of North Andover
1600 Osgood Street Bldg. 20 Suite 2035