The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 11/5/2015 O& �bRTH • tJIL I G PERMIT a ;10. y��s 646 0� TOWN O T ANDOVER0 y.:,.: APPLICATION FOR PLAN EXAMINATION ic Permit ido##: Date Received �R pRArEOW�P�"�y 14 �SSgCHUS Date Issued: IMPORTANT: Applicant must coppletq all items on this page q r yr fir, I I � Y � x TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial )&Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0,r ��4od � , ,eW 4p Wetly udsll u r , ' r DES C IPTION OFW RK TO BE PERFOR ED: 17 44, ouvl�, .,Q-Vs Identi cat' n- Please Type or Print Clearly OWNER: Name: "` Phone: Address: �o G LuA Pgvk 4ogJaLa,�,- qoft= 011 �'''��"� `�� / Ilei u r !!�'PR�"u'�'M+:A Ni4p��vul�YMimiI�IWWWh'ii�VNU11' m�V rwuwMlWVi�rtN(7uu iPlp>f➢:'N.YnrrNldryu Nl�� ,..� .... "'_,_ .n� � � e ._. .� , i dPwaaa 0 um�V�w,i ira,orJ�w�pvi Miumw',�aswns�Vnm'rtiw�ufo,..._.. �� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12,00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ �p Check No.: c ' '"" Receipt No.: DOTE: Persons contracting with unregistered contractors do not have access g a zty fund ® T Town of Andover ® ..`.. to ver Mass, COC KICMf wtCK y�' SATED BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .............................. ................... BUILDING INSPECTOR Foundation has permission to erect ....... buildings on ... �--e.. . ... .................... ..... . ... ........... .......... .............. Rough to be occupied as ..... ..... ...... r.. ... . ................... ... ... ......( .�... ...�........................ Chimney provided that the person accepting this permit shall in every respect conform 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 I 6 MONTHS ELECTRICAL INSPECTOR UNLESS Rough • Service ..................... . ........... .. .......... ................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathingor Dry Wall ToBe Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector, Burner Street No. Smoke Det. Estimate Fay Construction Date Estimate# Meetinghouse11 10/5/2015 197 Methuen, MA 01844 E-mail fayconl@comcast.net Name/Address Job location JB Doherty 44 Birch road 80 Great Pond rd. Andover,Ma.01810 N.Andover,Ma. Customer Phone Terms 978-604-0455 Due on receipt Description Qty Rate Total Fireplace and window job. Remove and save mantle---remove gas and elect from fireplace---remove venting system---remove direct vent fireplace heater unit.Exterior build out--remove and save roof materials---remove and save as much as possible of entire build out to be installed on adjacent wall. Remove all interior window trim and wall board around existing windows---install a triple 2x8 header across wall---frame for 2 new windows to be installed with equal spacing between existing windows---close off fireplace hole and install tyvec . install wall board and plaster ready for paint.Cut out and tooth in flooring at old fireplace opening-- Install full length baseboard to match.window install and siding to be completed when windows come in.2.5 week lead time after ordering(Jackson). New build out and fireplace install---remove siding---frame for new build out---install sheathing and roofing---install trim and siding---cut open wall and frame for fireplace rough opening---install a 3/4 plywood floor---insulate build out.Remove and re-route existing wiring---wire opening for unit power---install oak trim at floor---install unit---install gas and venting. Labor for completed job as discussed with permit and inspections 1 5,400.00 5,400.00 Labor for gas and venting work with permit and inspections 1 800.00 800.00 Materials for framing---siding---wall board---exterior azek trim---interior 1 1,400.00 1,400.00 primed pine trim---oak---wiring---venting and misc supplies Total $7,600.00 The Commonwealth of Massachusetts Department of lndustrialAccidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 yyp�. www.rnass.gov1dia Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE FILED WITH THE PERAUTTING AUTHORITY. AvPlicant Information Please Print Legib Name (Business/Organization/Individual): Address: City/State/Zip: �,C / l Phone#:__ c - Y Are you an employer?Check the appropriate box: 'Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.p,,1 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.r]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t [] 4.F]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12..F1 Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.# ❑ 6.F1 We are a corporation and its officers have exercised their right of exemption per MGT,c. 14. Other 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-cori`trac6rs have employees,tliey must provide their workers'comp.policy number. I am an employer that is providing wor-leers'compensation insurance for•nay employees.'Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: )V`. 0 Attach a copy of the workers' 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 WORD 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. I do hereby cert' un erthe pains penalties of per jury that the information provided above is true and correct. Signature: d � Date: Phone#' Official use only. Do not write in this area,to be completed by city or town official.. 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#: Xlu 3pN32iMb1`. `; n 133a1S QOjS32�39 OZ N ,. m' kV V S3l2�tlH7° c� n .::N111p-I�l '3l3 NdW�l3N2�(lOf J3� tl Stl 3SN3pIZ :pNIh10710� 3H� 53nssI SNt1 13 l bl:! .40 8-MNOWW 9 LOZ/L L/g0 U04eu rdxg Jauorssrwwo0 L 6 L (-, £bliIO V]k aqua tae I "Oas ag OZ AVg N S�'d Ea MOMS £99850�j :asuaorl rncrn rarin�rreeYs�n e�crrp� sc.e�uegs;oue ~ sucsae;nEa�r orae, A;a1es ailqnd d®;uaw�edaQ-s4asn nq ;o p.,L 4aesseW �� orrz��zd�zcaecclC�o Office of Con sumer Affairs&Business Regu ---__ /j/�cl�ccc�4. cc�eL7ii lation OME IMPROVEMENT CONTRACTOR I;egistration: 147062 >'Expiration: gl8�201� Type: Individual CHARLES A FAY JR. CHARLES FAY 11 MEETING HOUSE RD _ METHUEN,MA 01844 Undersecretary -