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HomeMy WebLinkAboutBuilding Permit # 8/27/2015 TH BUILDING PERMIT o� t'°D , �w TOWN OF NORTH a� -446 \/ 0 APPLICATION FOR PLAN EXAMINATION ~ Permit No :"" Date Received gRareo nP �(� SSACyUs�� Date Issued: — a 2, ==! ( , IMPORTANT:Applicant must complete all items on this page e h 1 1 rubam'mina!wii i r�i u�0iom� our9V"UI v� a w��itli t su .ami i �O�Nrmo f nl nmo:i. v TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building eOne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 4r uy� �,fi 5~VV1W4;�v�j( doim,nlpauU�NP1Y'lr ��siuurr,� tt¢rrofPur' �resrr�nw )�I�I�Ni%iA�mU Od1��JWU j!mW �wrv�,rt��iloi)"I'Vlln'➢���'"'IcU+,, J i`( iiiii� "lh�014� Ptitt�M�9(�{iyp��iM `"''f'Ul/ipP�ri/(r/�'nnaVN"°IfUir�( �/J'J� ,, �i! is r� ���� �e � � �l �� I�, �✓d m p '"� ,.�� ���a�ds' � �� �'� m IJV6�s'k�Yl� ��'l 1 DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: tom°► y- LJ Oi-s .Q Phone: '�'): ,_ �Y3 Address: ° i l� s i I ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASEa ON$125.00 PER S.F. V Total Project Cost: $ uC� FEE: $ Check No.: Receipt No.: u NOTE: Persons contracting with nregistered contractors do not have access to tl guaranty fund ( •1%�/moi/� a,/moi/r ri��%/� AID t%®RTH wn '� E. :..'.., C& ver ncto ® ® n _ h ver, Mass, o COCHIC"RWICK �1 AMPNOOL U BOARD OF HEALTH TU Food/Kitchen Septic System THIS CERTIFIES THATP E �R =MM M0Tm LD BUILDING INSPECTOR .. . . Foundation has permission to erect .......................... buildings o ........ .. ...... ... ..... . ... . . i� Rough to be occupied as .............5.r\L'C� . .. 7Ir ....................................................... Chimney provided that the person accepting th permit shall in every respect nform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 eMON ELECTRICAL INSPECTOR LES L Rough Service .......... ..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — ®o Not Remove Final No Lathing or all To Be ®one FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. C rntwercl l Roofing All Types Of irn 'iulti Y of ro irrr-rur�i�-' - rpr(C Masonry Work Mass loll Free Licensed & Irisured La edl C)wrrt ul.{ Opr aged 5W ce J 976 �-X300-�ftt�6 6".��._ ��, Licer7se X034200 (924-8487) :C x C.x€Z �c/`_-Pw c,ye ,e-04' We- Work Year Hound ' j a ,.�f l s s � r ',•' r !T� r z , JF ?� Proposal To: Matt Wolstromer Date 5/26/2014 Street: 73 forest St. 978-683-5113 ra North Andover, M.A Roof proposal jimwolstromer@verizon.net Certainteed Landmark 1. Extra caution will be taken to protect house and 11. Removal of all work related debris. Planks will be landscaping as best as possible. (tarps etc.) placed under dumpster to prevent any damage to Magnets run at final clean up. driveway. _Ij 2. Remove all shingles from entire house. 12. Building permit included. 5 3. Inspect and re-nail any loose or lifted plywood. 13.Contractor workmanship warranty: 10 years under Any compromised plywood will be replaced at an normal wind and rain conditions. additional cost of$70.00 per sheet of 1/2" CDX 4. Install heavy gauge 8"white aluminum drip edge Total roof cost: $ 89800.00 to all eaves and rakes. 5. Install 6' of WR Grace ice and water shield along Certairit ed Pro upgrade: $700.00 ' all eaves. Opti n: nstall 1) I omen 2 60HT �rmo/ 6. Install Certainteed Diamond Deck synthetic humi ` tat conti led Powe ent. $3 .00 underlayment to remaining sheathing up to ridge. addi ' al cost. ( clectricapok u i luded) 7. Install all new pipe boots. o 8. Install Certainteed Swift Start starter shingles to Certainteed 3Star extended direct MFG warranty all eaves. A fully transferable 100% coverage against 9. Install Certainteed Landmark Limited Lifetime material defects for a fully non pro rated period of architectural shingles to entire house. 10 year material MFG. warranty. (See extended 20 years. Please refer to pamphlet left in estimate warranty) All shingles will be installed and folder. Offered to urrr• lut�.rl referrals and included in this proposal at iru additional cost. fastened according to mfg. specs. 10. Cut and install new GAF Cobra ridge vent and cap Balance due ur)on c{ ii valet with color matched Certainteed Shadow hip and -- ridge shingles. (MA code) References available rrj:xorz remicst -j-I- Hij4hly rated o " fl�e ,,r'.,eredited BBB and Anaie's List _ g ry p (j Thank you! Acceptance of Proposal—The above prices, specifics ons and conditions a!,. �[isf iclory and are herby accepted. You are authorized to do the work as specified. Payment will be ii,, c -3 ouciin�:d above. Date of Acceptance: Signature:-- - --- The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 IVwww.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE F1LED WITH THE PERMITTING AUTHORITY. Aunlicant Information Please Print Legibly Name(Business/Organization/Individual): Address: City/State/Zip: Phone#: `l Y-7 .3 Are you an employer?Check the appropriate boa: Type of project(required): 1. a employer with--5 employoes(full and/or part-time).* 7. D New construction 2.®l am a sole proprietor or partnership and have no employees working for me in 8. ®Remodeling any capacity.[No workers'comp.insurance required.] 3.[D 1 am a homeowner doing all work myself.[No workers'comp,insurance required.)r 1 ❑BuithDemolition a 10 D Building addition 4.[:]l am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions j 5 J41 am a general contractor and I have hived the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.$ 13 .[__1 Roof repairs 6.[:]We are a corporation and its officers have exercised their right of exemption per MGL c. 1 . er f 4 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A f-� A dlym Policy#or Self-ins.Lic.#: � � - ��J �a y S Expiration Date: I ' .2_6J) Job Site Address:— ",23f' ' City/State/Zip: workers'Attach a copy of therkers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under thepa' and penalties of perjury that the information provided above is true and correct Si ature: Date: i a Phone#: Official use only. Do not write in this area,to be completed by city or town offciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �y C �� F ILOW ON ` AICA DATE'm;;:s� �i:t. _ �N• Y.4v!{ •wua.w.w.W.uW...••o.�v-..•wr,.r+w.�.M•.MY•iMt91NY•,1•w_.M..�.�o.tF•Iwo/�•�w.�r.wwe.....'M..�_..w.v.Yti+-.••.wwn.wM.w•wv—+..wwr.w�w._.Nwt.T.c4�._,.rwrr.r ...M_._+h-'�+:>.ifi:':nn.. :"l 71MYE M 10120 AS A MMER 0.7 WFOW RON CNIg AMD C51�MRS VO M-SWTSa t FMJ THE CERTMICATE HOLDER. TM$ M"YtFIC.An cuts uoT mr-num my m amAwymyAmem erma ;Ea '0Co"MEi..MOZ f�t~GE'3i§>�t" SY THE POLICIC-6 P-SLOW. T s (,.tcRT mtm of if sUFzA `r c ,� noT ecim r aE J�. FIR* Asir sLmito Tim iSwim-a titMUNER S1. At3nioptr a, * PaTAINT!ff Ow t wU'n�a Pth4 1*an dII�f131Tt;0 Ems`'+ MD.b-m ov � 'i mag� tb u9Cfo.wen-9. If SUMP..DWRO"`J Pv LJA 0, aub§nI is ZLe Iftivi$and ttt't9tl ltlj w of IN pall y,tom-1.1a fIT'iHtb--.s wmr 4-GYfI:ha an calmo m t. A Sftr zltf w;trds casli rixtMo i'tws n-W confoy tights to 4;;J IF25t1t481:L*Qtt�jt3Y�}P1 '. t��P� r «�.~g9YII�ti& - �is�3 fti _.__ ..i�, na' i918►b7-tS3.d� Etas t*.bt1Y� Q,�fl 9 x� t 8 ._ _...,._ �,_.. .. ........ ... _._. .. /�ntl avot,MA 61 �' Mvtum9 is uiencu Company ?. 1 ti f 2ati,;� S:iA OittIIO ��sTftY•5_.v,�,41,;,� �Ll _�PA*;� Tj>u$ is Tp CFRYIFY Tt 4T I'"v -,ottcfes OF%W3'RP XF_LISIM MUM',RAVE ME91 MWU)TO THIF ClaWR D NAMM AIME FOP THF, POLICY LWDRCATISO NoTtAX14STfaDdQltht'; ANY RIiSTTf:ItMEWI TlEftt."l {3R C,MUITt N OF A%Y Gt>MP ACT OR OTHER DOCUMBIT tPJ171t RESPECT TO Vvt'llro-i TH". CERTIFiai hAY BE ISSUED OR MANY PIMMU, THE WSUW4W/.VMtWZD OV TyAt: nLtCMSS VESCt;tOS O HEVI.ZN is $UOJECT TO r\LL THE Tt:>"MI., L3trLiP.,�iA pzumcaair I vs L S3SY6I t�4 t1rCEw.6 t 51S L iY llt1`J!E i'E E Y1G �t3Y 8sA33}i:E/L h5. 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Y :T?iL U&B AMV TOME Ci-MME>S iOc 4'13i..tCCi:'jp,CE M;GrELL D t P UM M*M'I= DATE TML:M!, t wjCIc E2 OVLttil�:E��i fi; i,,,i, ALTT}��t�`t�siSL4'TT A'tTL•� �ter_._ �,-,..... -••J•., �� I r. t♦ Massachusetts -Department of Pudic Safety Board of Building Regulations and Standards - License: CS-0601120 40 30 TEMBLE DR S ` ki Lit M[EETHUEN MA 8184 f F3 Expiration Commissioner 0"312017 aE:E111:f1 ftLS�Ic7l1 alI4J1 '.,'',, Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list icurrent as of Wednesday, October $, 2014. Search Results REG,-I]RA SIT RESPONSIBLE REGISTRATION EXPIRATION INDIViC�tt;AL NUMBER ADDRESS DATE STATt1: All UNDER ONE R00i= L.ANZAEAME, 137057 166 A MERRIMACK ST 10102/2016 Current JOHN METHEUN. MA 01844 �-- ©2012 Commonwealth of Massachusetts. Mass.Gov®is a registered service mark of the Commonwealth of Massachusetts. l_