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HomeMy WebLinkAboutBuilding Permit #261 - 109 Davis Street 10/5/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION N CCry Permit NO: Date Received�D Date Issued: �gsSgcNus���� IMPORTANT: Applicant must complete all items on this page LOCATION 10 q d t., fnS Print PROPERTY OWNER 1- a e, t V j- Print MAP NO.: © PARCEL: Q ZONING DISTRICT: �r- TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑Repair,replacement ❑Assessory Bldg ❑Commercial C�.PSemolition ❑Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name:Ks,j� tLi I N u z 4- Phone: 17Q R72-7R,73 Address: 160 PleaSdidf- SF - /Uo1fh Lhjouer (t kJ rick 1' S t CONTRACTOR Name: G6 41 020 h e,&S Phone: 9 2k 6k 7 ;�7k Address: 166 Pl Gas d n j fit- N S A ft�lj cjy.p r Supervisor's Construction License: X'-S G 20&,5`! / Exp. Date: ( - 1 -0 Home Improvement License: 1 0 3 -71 Z Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ .� ;O 0 FEE:$ ---- Check No.: 6�4-o2 Receipt No.: Page lof4 Location No. Date NORTH TOWN OF NORTH ANDOVER 0? �. • pw 9 � y + Certificate of Occupancy $ Building/Frame Permit Fee $ 2 sACMUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 19652 G —Building Inskfector TYPE OF SEWERAGE DISPOSAL Swimming Pools 11ElTanning/Massage/Body Art E] g Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contractingwith unregistered contra do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor oz Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ r COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Sianature&Date Driveway Permit I Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTM ENT:BPFORM05 Created JMC.Jan.2006 I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. j One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 F �•1ORTIy Town of No. 77 o o dover, Mass., COC MIC ME WICK ��" �d ORATED S BOARD OF HEALTH PERMIT ' T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ ....................... ... � � Foundation has permission to erect..... buildi son . p g ......�.a..7......... ...�..+�.��......s/..-. Rough to be occupied as................. .. /! 0....... fel-Idle#%d6m ...................................................................... Chimney provided that the person ac ting this permit shall in every respect to the terms of the application on file in Final 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 66)' 000- PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI ELECTRICAL INSPECTOR S Rough .................... ......... ............... .... Service B LDIN R Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RouFinagh No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. Town of North Andover t%ORT}i Building Departmento� h�t6 00� 27 Charles Street w North Andover,Massachusetts 01845 41 (978)688-9545 Fax(978) 688-9542 T O94[O[MiCM KK y1' T Building Demolition Affidavit DATE q - 1 ?- - 06 -I- OWNERS NAME&ADDRESS j�_ S T �� 1��, 1 Ir U s f_%h L-e,cll.S 1(00 PIe-a!E2C3 n"( CfirP-efi lJc r i-k � Y1C� r PROPERTY LOCATION DESCRIPTION ( o Yh Mo r G c u S o u C CONTRACTORS NAME&ADDRESS L 2u a Ccj m ao-n t e S 11'0 l�� -n fi S� n►v rk h {�►1ca�a crp r M'19 o Z '� 3' DEPARTMENT SIGN-OFFS IJ D.P.W./WA R `I �3 DBEWER GAS rl Var ELEC ;k-/ S e o< c o 0 TELEPHONE N �- CABLE TAXES A POLICE t FIRE V13 0 v� XPi P�i•�-,�� _- e� EXTERMINATOR See c.e Gt e o� Lt P t G� DUMPSTER-ON FF STREET DIG SAFE NUMBER Z Q 0 b — 4 00 ► 3 -72— BLDG. 72— BLDG. INSPECTOR DATE RECD ANTE X Pest Control Co. LLC 4 SUNRISE TERRACE • PLAISTOW, NH 03865 (603) 382-1776 • (978) 372-9929 PEST CONTROL SERVICE AGREEMENT DTE OF AGREEMENT NAME �\ KSS NAME S J eGt / ADDRESS ADDR 4 cl - CI ZIP • CITY isq .. ZIP G N O `� Q` t� PHONE2ND PH N PHONE 2ND PHONE RIPTION S RU T RE(S)COVERED 976 ?5- 1. THE COMPANY AGREES TO PROVIDE PEST CONTROL SERVICES AT THE SERVICE ADDRESS INDICATED ABOVE. 2. THE COMPANY WILL PROVIDE PEST CONTROL SERVICE TO CONTROL THE PEST(S) CHECKED BELOW. EXTRA SERVICE FOR THE PEST(S)CHECKED BELOW WILL BE PROVIDED AT NO ADDITIONAL COST TO THE CUSTOMER. 3. CUSTOMER AGREES TO MAKE THE PLACE OF SERVICE AVAILABLE FOR TREATMENT AND/OR INSPECTION AS OFTEN AS NECESSARY TO CONTROL PEST(S) CHECKED BELOW. 4. THIS AGREEMENT WILL BE FOR AN INITIAL PERIOD OF�_MONTHS. 5. AFTER THE INITIAL MONTHS,THIS AGREEMENT MAY BE CANCELLED BY EITHER PARTY BY GIVING THIIRTY(30) DAYS WRITTEN NOTICE TO THE OTHER PARTY. 6. THIS AGREEMENT DOES NOT PROVIDE FOR THE REPAIR OF PRESENT OR FUTURE DAMAGES TO THE SERVICE ADDRESS, NOR DOES IT PROVIDE REIMBURSEMENT FOR REPAIR EXPENSES ALLEGEDLY ARISING FROM PEST INFESTATIONS. 7. IN ENTERING INTO THIS AGREEMENT CUSTOMER WAIVES ALLCLAIMS FOR DAMAGES TO PROPERTY OR PERSONS WHICH MAY RESULT INDIRECTLY FROM WORK PERFORMED BY THE COMPANY, WITH THE EXCEPTION OF GROSS NEGLIGENCE ON THE PART OF THE COMPANY. 8. THIS AGREEMENT DOES NOT INCLUDE SERVICE FOR TERMITES OR OTHER WOOD INSECTS, NOR DOES IT PROVIDE FOR DAMAGES ARISING FROM INFESTATION OF SAME. TO BE CONTROLLED ❑ CARPENTER ANTS ❑ SILVERFISH ❑ HOUSE CRICKETS ❑ HOUSE ANTS LA31RATS ❑ CLOTHES MOTHS ❑ FLEASICE ❑ PANTRY PESTS (SPECIFY) ❑ INDOOR SPIDER CONTROL ❑ GERMAN COCKROACHES O ❑ CARPET BEETLES ❑ BEES ❑ ❑ TICKS (INDOOR) ❑ WASPS ❑ MATERIALS USED METHOD OF APPLICATION MAX FORCE FC 64248-14 CONTRACT BLOX 12455-79 t 00An 1 A TERMIDOR SC 7969-210 FICIAM-D 45639-3 DEMON EC 100-1004 SUSPEND SC 432-763 KICKER EC 432-1145 Ger' 5 /Cef ULDBP100 499-452 i APPLICA OR' N CH IAN SIGNATURE CUSTOMER SIGNATURE TOTAL FEE FEE IS FOR AMOUNT OF PAYMENT PAYM NTS TO BE MADE OUNT PAID TODAY 1 NE TIME ❑QUARTERLY -� MONTHS C/1 U MONTHLY ❑ANNUALLY YOU,THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. A TH IZED COMPA SI NATURE DATE CUSTOMER SIGNATURE DATE nab u r uo uo: toa P. t John James Excavating 5 Diane Lane Sandown, NH 03873 (978)3754298 Levis Companies, Inc. Demolition and removal of building ( North Andover, MA) Total: $5,200.00 10 q n OL C' nationalgrid Robed C.Pendrake SupeWisor of Support Services September 28,2006 Levis Companies,Inc Joe Levis 160 Pleasant Street North Andover,MA 01845 RE; Service removal for building demolition at 109 Davis Street, North Andover,MA. Dear Mr. Levis: This letter is to confirm that the electrical services and meter(s)were removed from 109 Davis Street,North Andover,MA on September 20,2006. If you have any questions or need further assistance,please feel free to contact me at 978-725-1320. Sincerely, %R &'.t6 C. )00- Robert C. Pendrake Supervisor of Support Services RCP/cmc 1101 Turnpike Street North Andover,RAA 01645 978-725-1320 ** TOTAL PAGE.02 ** The Commonwealth of Massachusetts usetts ° Department of Fire Services Office of the State Fire Marshal P.0.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover permit No (City of Town) (If Applicable) Dig Safe Num er In accordance with the provisions of M.G.L.l 4 8 Chapter_LfL as provided in section—U-1—OR 34 Start Date This Permit is granted to: �I V6 7— /7-- r •Full name of person,Finn or Corporation Permissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be 25 ' from structure if unable to Place with required Restrictions: clearance dumpster must be covered with plywood or tarp end of work day at _ D '0 (Give location by street and no.,or describe in such manner as to prove adequate identification of location) Fee Paid$ 50.00 � � Fire Chief This Permit will expire j -06 (Signature of offical granting permit) Offical granting permit (Title) TPIC PERMIT MI ICT RP rr)M.gPIrI 1()l ICI V Pr1CTi=n I MON TNF PPFMICFC N° FD 4735 Date ............................. r10RT/y O °° TOWN OF NORTH ANDOVER � F p s RECEIPT SSgCHUS�t i This certifies that has paid....z.-d..-...v 0 .......................................................................... . ....... ........ ..................... Received by.. �r �. ................. Department.......... /T� .......................................................... WHITE: Applicant/ PP CANARY:Department PINK:Treasurer