HomeMy WebLinkAboutBuilding Permit # 7/10/2015 BUILDING PERMIT t%oRT#1
TOWN OF NORTH ANDOVER 11", e,
APPLICATION FOR PLAN EXAMINATION 4
Permit No#: Date Received
SSACHUS
Date Issued:
IMPORTANT: Applicant must complete all items on this page
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LOCATION ) (
Print
PROPERTY OWNER /�-ftj-e-- S AJ t-1) co
Print " 100 Year Structure yes no
MAP 6 PARCEL: / ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
0 New Building One family
El Addition El Two or more family 11 Industrial
El Alteration No. of units: [I Commercial
0 Repair, replacement El Assessory Bldg D Others:
El Demolition El Other
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DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
yo'
OWNER: Name: -zl A"PA e J- Phone:
Address: L <A
Contractor Name: Phone:
Email:
Address: 'T 0 &M CI )"i
Supervisor's Construction License: (2�7--, —Exp. Date: � ' ( I
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 3o ( 0 FEE: $ 2&e
Check No.: Receipt No.: o
NOTE: Persons contrac 9 1 un istered ntraetors do not have access to the guaranty fund
jre�b ,con rac
FORTH
ndover
Town of
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COCP41CHEW,CK ��•
�T� u LD LI BOARD OF HEALTH
Food/Kitchen
Septic System
PEKMI �"`
BUILDING INSPECTOR
THIS CERTIFIES THAT ... .. ... .. . . .... . ...... .
y ......................... Foundation
has permission to erect .......................... buildings on .. .. .......I.. .. ..........
� � Rough
CLI ied aS ...� ........te
.. �................ Chimney
to be occupied ® ... ...... ............
. ..... ....... .... ........ ...
provided that the person accepting this permit sh every respect conform to the terms pplication Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and PLUMBING INSPECTOR
Construction of Buildings in the Town of North Andover.
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit. Final
PERMIT EXPIRES I MONTHSELECTRICAL INSPECTOR
UNLESSTI Rough
Service
® ................................... ............ Final
....
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occum Building Rough
Final
Display in a Conspicuous lace on the remises — o of Remove FIRE DEPARTMENT
No Lathing or Dry Wall To Be Done
Burner
Until Inspected and Approvedthe Building Inspector. Street No.
Smoke Det.
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CH9MV'4EYS POE HT ED-REBURLT-CAPPED
Experts Masonry Work
Klass Toll FreeLicensed & Insured
1-800-WAIT-4-US
�..ocally�>'Vn�'d't: Opereried .r <e .i£»s c" � License#034200
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(924-8487) ;r � C?a 5' d"�'lwe c 10vie-00 � We- �1 Work Year Ror. nd
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Proposal To: James Lynch Date 418/15
Street: 268 Rae St. 978-852-7800
£s,
N. Andover, MAS
Vinyl Siding Proposal James.lynch@gmail.com
1. Remove all existing siding and corner boards 13. Removal and installation of light fixtures and
from entire house. doorbells included.New fixtures and doorbells must
2. Inspect all wood components of entire house. be provided by homeowner if wanted.
Any compromised material will not be left. Any 14. Install composite kick plates under all entry doors
existing damage or rot will be discussed, where applicable.
confirmed with homeowner and replaced at an 15. Proposal does not include any painting or staining.
additional cost of time and material. 1st 32sq/ft of Existing front entry mantel to remain.
plywood at no additional cost. 16. Building permits included
3. Install housewrap to entire house. All seams will 17. Removal of all work related debris
be taped. 18. Limited Lifetime vinyl siding warranty from
4. Install 4"vinyl traditional corners to all house MFG. , not contractor.
corners. (white or colored) 19. Contractor workmanship warranty: 10 years under
5. Install Mastic Carvedwood .044 double 4"vinyl normal weather conditions.
siding to entire house. Standard colors only. Total COSH: 1 0��.�� ,//'. .. �
6. Soffit area: Drill holes in all rafter bays for added
ventilation where or if needed. Install white vinyl Optio!mt'
perforated Invisivent soffit panels.
Gfnstall louvered or raised panel vinyl shutters.
7. Install j-channel to all areas that need to accept $ 60.O .per pair additional cost.
new white.032 seamless aluminum
vinyl siding. All j-channel will be self-flashed �'Iasfidl'all
gutters and downspouts to all existing areas.
and angle cut for clean professional appearance. $750.00 additional cost
8. Install custom bent Alcoa white aluminum trim
coverage to all fascias,rakes, applicable entry *Note's Tudor style area: Remove all existing pine
door casings,window casings and sills. trim. Install Mastic Cedar Discovery double 7"
9. Install white composite PVC 908 to garage door vinyl cedar shake panel to entire area. Remove all
frame, casing and weather bands. shingles from roof wings, counterflash with ice and
11. Install all new vinyl accessories: light blocks, water shield, install new aluminum step flashing
gable vents, split blocks, meter block etc. (Removing and install all new shingles to match.
and re-installing electrical meter by licensed
electrician and permit included in proposal) Payment schedule:
12. Install sleeve over existing AC exterior pipe. 1/3 on project start date
1/3 at project halfway point
Final balance including any extras due upon project
completion
The Commonwealth of117assachusetts
Department of Industrial Accidents
Office of Investigations
600 TMashington Street
Boston, J4IA 02111
mmv.ntass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Inforination Please.Print Legibly
Name (Busines s/Organization/lndividual): & /pL19-eA 1Z>6./',
Address: 7 :-4
City/Stale/Zip: 44vvx �^^)�"'` �yt��2s' � Phone#: 1)
Are you an employer? Check th'e•appropriate box: Type of project(required):
1.�1 am a'employer.witb`� 4. ❑ I am a general contractor and I
employees (full and/or part have hired the sub-contractors 6. ❑ New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. t �• ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their •10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions
myself. [No workers' comp, c. 152, §1(4), and we have no 12.[] Roof repairs
insurance required.] t employees. [No workers' - 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#I must also fill out the section bclow showing their workers'compensation policy information.'
t Fiomeowncrs who submit this atrrdavit indicating they are doing all work and then hire outside contractors must submit a new atGdavit indicating such.
XContraclors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy idforrnation.
I am an employer that is providing workers,compensation insurance for my employees. Below is the policy and job site
infonnafion.
Insurance Company Name: A 0--
Policy#or Self-ins. Lic. #: Expiration Dale:
Job Site Address: Lt `�> }r�' City/Stale/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)'.
Failure to secure coverage-as required under Section 25A of MGL c. 152 can lead to the imposition of cruninal penalties of a
fine up to$1,500.00 and/or one-year itnprisomnent, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement.may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby ceififj�_ aide tie pain's and penalties of peijw),that the infor•rnation proi,ided above is true and correct
S i a tore:
Date:
Phone#:
Oficial rise only. Do not write in this area, to be completed by city or towh official
City or Town: PerrnitfUcense#
Issuing Authority(circle one):
1. Board of IIealth 2.Building Department 3. City/Tbwn Clerk 4.Electrical Inspector 5..Pluutbing Inspector
6..0 tit er
Contact Person: Phone#:
OF LJAMJW INSURANCE
CERTIFICATE
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\V" Board of.Building Regulations and Standards
License: CS-069120 j
JOHN W LANZAkME
30 TEMPLE DR 1
METHUEN MA 31844
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./..D�,�'.' +i"'�• Expiration
C o7ttn7issicrc r 04/03/2017
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City/Town estate Zip
carte
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REGISTRANT RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS
NAME INDIVIDUAL NUMBER DATE
ALL UNDER ONE ROOT' LANZAFAME, 13757 166 A MERRIMACK ST 10/02/2016 Current
JOHN METHEUN, MA 01844
I
02012 Commonwealth of Massachusetts.
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