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HomeMy WebLinkAboutBuilding Permit # 4/6/2016 - ;yoraiy BUILDING PERMIT °-.' 2QQ 6gB'o TOWN OF NORTH ANDOVER APPLICA T ION FOR PLAN EXAMINATION �= 4 Received Permit NO#' Date § t �SSACHUS�4 Date Issued:_ �- IMPORTANT:Applicant must complete all items on this page � LOCATION 'Jt y t - Prirt�T, PROPERTY OWNER k--e- ` V''L"I�"lv f - Print loo Year Structure yes j no MRP 1 PARCEL ZONING DISTRICT:_ Historic District yes {` no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family E Addition [iTwo or more family ❑Industrial ❑Alteration No.of units: ❑Commercial ❑Repair,replacement ❑Assessory Bldg ❑ Others: ❑Demolition ❑Other QESGRIPTION OF 1NORK TO BE PERFORIV�ED: , Identification-Please Type or print Clearly OWNER: Name: e c- a y Phone: CA-17S.—SU l �� Address: \} L IF- -732 Contractor Name: Phone Email: Address: ; #7-1 tel 4c, Supervisor's Construction License�1 i`--t 7 7 `K Exp. Date: r" T Home Improvement License-0- : F C tr i Exp. Date: L ; ARCH ITECTIENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDINC,PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ 3-7) FEE:$ f Check Nna_ NOTE:: Persoizs contracting wick unregistered cantractazs do not leave azccess t t#�g uurartty`fund $ � tf Town of*.. ndover No. t\A 1b Ver, Mass, hpl;i U BOARD OF HEALTH Food/Kitchen i9j' E R M IT ILD Septic System THIS CERTIFIES THAT........ BUILDING INSPECTOR ...................................... ....... .... :�1po+ Foundation has permission to erect..........................buildings on 41... ...Sk u Rough ....fZ r 0 to be occupied as......" ...... .............................. .......... ......... 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough 4— Service ........... .................................. Final BUILDING INSPECTOR GASINSPECTOR Occupancy Permit Required to Occupy Buildinz 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 Approved by the Building Inspector. Burner Street No. Smoke Det. r 01 Member of NH Better Cosiness Bureau Fully Licensed and Insured•Member of MA setter B ss 0ureau Y 1 GAF Cert ME#20212 'a11J13 $ MA Reg#166661 MA CSL#104728 a Owens Corning Preferred Contractor#212828 � EPA Lead Safe Certified � ti OSHA 30 Hour Construction Safety Training ; T` Genera(Contracting, LLC IOWA N�nl6 51 S.Broadway#2214 Salem,NH 03079 • (603)890.0084 ( 10 Stevens Street#141 Andover,MA 01810 (978)47-5-0095 PHONEGATE I Peol—Old rle-- / .^ -2 1 . 7I %JG�" �'� OTREET�.� «•. CRY,STATE,AND ZIP core - Completely protect the home with tarps to catch falling debris.Respect and protect shrubbery and flower beds. Strip off a._layers of roofing material down to the bare roof deck.Inspect the roof deck for structural defects. Determine the condition of the underlying plywood or boards,and repair and replace as necessary". Inspect roof ridge for proper 1%"spacing on either side of�idge for maximum exhaust ventilation.Cut In if necessary. Install new heavy gauge --''� '^G (color) .�l dc�rv�fAu�rP drip edge at roof eaves. nstall /Jew °"u 'i Ice and water shield to meet manufacturer's specifications(i.e.6 feet from roof edge,3 feet centered,in valleys,around all skylights,chimney bases,roof penetrations and at all sidewall transitions). Install A c- breathable roof deck protection to remainder of the roof deck. Install new heavy gauge (color) :'i jay.tvndrip edge at roof rakes. Install r1_D starter strip at roof eaves and rakes. nstall "rrl'r t i�� 1r� "'c_ desired color. 7 (color) Install new flashings to meet manufacturer's specifications.(i.e.sidewalls,chimneys,skylights and roof penetrations). Install -%L� (feet)of 6c"2 L..�Sr �L / '^)f'"`"+--ridge vent at roof ridge to allow maximum ventilation. Hand nail to ensure proper fastening. Install I (feet)of ^�"Lc-T�c,, distinctive hip and ridge cap.Hand nail to ensure proper fastening. Thoroughly clean up and dispose of all roofing debris on property.Magnetically sweep property for nails. Notes: Edmunds General Contracting will: •Obtain all necessary construction-related permits to complete this project. •Perform work as efficiently as possible without sacrificing quality. •Furnish and install all necessary materials to complete the project. •Provide a thorough clean-up and disposal of all debris generated during project. Edmunds General Contracting LLC agrees to commence work Dolor about��r=' and described work will be completed in about 8 days. 1t„ 4- L,,,cr�'1 Product Upgrade 1: Product Upgrade 2:_ gned y the contractor, nd also Contractor's employees are fully covered by workmen's compensation and liability It is further agreed that the obligationstherect shall hat this tbind and apply ract may be do their bheirs,successors aorr estates insurance. of the parties. Upon completion of the above work,all undersigned agree to execute and deliver to the contractor,their joint note in accordance with his(their)above obligations as Edmunds General Contracting LLC guarantees all workmanship performed for III requested by contractor.Upon refusal to do so,contractor may at its option declare 2`!years. the entire contract price or so much as then remains unpaid,Immediately due and '-. -.` ��y' <, __factory enhanced warranty payable.It is agreed that,if permitted by law,contractor shall be paid by the We will reg'I�stedr, ea s of material defect average and?r years of Ij owner{s)all reasonable costs,attorney fees,and expenses,in addition to the providing=Y `� -- __for; _ amount due and unpaid,that shall be Incurred in enforcing the terms and conditions workmanship defect covno eraggethrough—the additional cost Tal of the contract and/or any lien in connection herewith. 'Edmunds General Contracting LLC will provide The materiels,labor and disposal t plane up to U sq.ft.f roof docking and 20 tt sl fascia at no addlukRol Dost dYe p ML! hest crnear loot. Any additional materials including laxer and tlis'1ts,q will be replaced at per s y linear ry All material is guaranteed as specilletl.All wofkm be rAmp1sred in a wmkmadid,mare—broing to standard Edmunds General Contracting,LLC agrees to furnish the material and ,.do..Anyauerauon ord-ndlonimm adove spemvcarona mwlmnv ezla costa We be e.acmea Dory ppo written for the sum ordone and will bewoa on entre charge over and.boyo the slated contact Price,contactor is not responsiEie for labor complete in accordance with the above specifications, / aamave auebelgnwlnaa,romaaoea,hunboner,11.or mherhaaaomnpndbaurae bonny ore tomaao ana omen 1 �,U^t` a, necessary'nsuance(.anVaCte!a Iona dere!¢pl owner tl D 9 tl but nue to ma nature of the roofing of �'r {d.o ;C' dollars 4G maw,are,some damage may Dani we stern w mid" v a g na wgl no,be nem rasp bl f a 'r• G damaAe eecua comessor is m raspnaslble for any a g b m t rof propelry'nclutling p min6 court ers(Le water stalna crumbing pester exposes noil I tlA ItinA from appl'catlan of PaYmenY T res: speciosa above.arms In The—may nae1 to be covered by 1 It,owner C Vector Is net respensble for tlame8a caused by Irs dam bulltlup AO egr 1s Gon�ngent D Ik aycltle to relays beyond o mntroi. •A deposit of �"�"� (not to exceed 1/3 of the total contract)is due upon start of work.The balance of.y (off- is due when work Authorized Signature: — [ dm d General contracting LLC is completed to the satisfaction of all parties. A finance charge of 1.5%per month(18%per year)will be charged on Note: This proposal may be withdrawn by us if not accepted within —' __�^m'r.� past due accounts over 30 days days.,.._-._—,�a,�— _ 00 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES, acceptance of propo5af-The above prices specifications,and conditions are satisfactory and are hereby accepted.you are authorized to do -� the work as specified.Payment will be made as outlined above. Authorized Signature�---. Authorized Signature: — - Date of acceptance:_ .-- I Ali M1omeimprovemvnl wntrador¢sbail0e reelsarttl.Any lnauVles abeutacentaotor or spbcentallor reladnemaregletaaun sllmae ltl��emtlliamr^unapinNslons3al Melec,14Ygm ana Bwlne¢s 0.ceulatIon,to PmrN Placa.emty 9Yin.0osmn,MAp21l8lehone'.ei]i]&H)oo). Owners whe¢scare lnelr own cunsrnellort-relvtatl pvrmire ar deal wIN unragiatvren cantrectems^�nSL4ESkSlYAE2lrom guess to 61/13 Thu ownvrwll recei aa¢Ionotic py anMss nn3N bebre earl!will commanoe,ins owner nos Nrev(3 nosiness tl'o-ystoctnael drts cenlrecC ana lnwr np penalty.Cerxasponaenca shoeia 6e dl,xnatlto Eomunas[Ienaal ennlrzcnne LLe vi me above etle,eaa e� The Commonwealth ofMassachusetts Department oflndustria_lAeeidents 1 Congress Street,Suite 100 - Boston,MA 02114-2017 www.mass.gov/dia y Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TAE PERVIIT TNG AUTHORITY. A Iicant Information \ ( Please Print Le 'bl ` r Name(Business/Organization/Individual): V C,'I t�`` Address: \fie X27 1 ��`1 c v� \"t t City/State/Zip- Phone Areyan� mpleyer?Check the appropriate box: Type of project(required): l. am aemployerwith t employees(hill end/or part-time).° 7. ❑New construction 2.❑Ism a sole proprietor or partnership and have no employees working for me in S. El Remodeling any capacity.No workers'comp.insurance required.] 9, ❑Demolition 3,E]I—.home.—,doing all work myself[No workers'comp..insumnee required.]t 10 Q Building addition <1 I am a homeowner and will be hiring contractors to conduct.11 work on my property.I will ensure that all contractors either have workers'compensation insurance or are sole 1 LQ Electrical repairs or additions proprietors with no employaesPlumbing repairs or additions 5.Q I am s general contractor.;d I have hired the sub-cmrtractms listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.; 14.Q Other '.. 6.❑We area corporation and its,officers have exercised their right of'exemp tem per MGL G. 152,§1(4),and we have no employees.IN,workers'comp.insurance required.] - "Any applicant that chocks box#1 must also fill out the section below showing theirworkers'compensation pulley information. t Horrannva rswho submit thisaffidavit indicating they are doing all wrorkand thenhire outside contractors must submit a new atFdavit indicating such. tcontractorsthatcheckthisboxmuAt twghedan a dditionalsheetshowingthenameofthesub-contractors and state whether or not those entities have employees.Tithe suh-eonlractdr have employees,they must provide their workers'camp.policy number. ram all employer that is providing worlrers'cotnpensatiotn insurance for illy etnplayees.'Below is the policy andjob site Information. ( !1 ; Insurance Company Name: !— t Qi' t- �V Polley#or Self-ins.Lic.#: 7 ' G 1 Expiraflen Data: tZ fob Site Address: 7 -1 � t.} 5 - City/StatelZip: u(`'S 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$250.00 a day against the viola�r.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1. Ido hereby certi der tlae 'its i ndpenallies ofpeijury that the inforinationprovided above is true and correct. Si nature: - Date: t Phone#: Q cf? Ste_ 7 r Official use only.Do not i i it,t area,to be completed by city or toian 0 tteiaL City or Town: Permit/License# Issuing Authority(circle one): I 1.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: From:Nicole Boudreau F..ID:S.M-l—ance Page 2 of 2 Date:4/6/2016 08:41 AM Page:2 of 2 EDMUN-1 OP ID:NB ALc®KL� DATEIY CERTIFICATE OF LIABILITY INSURANCE 04/06/210612 0166 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu ofsuch ondorsement(s). PRODUCER NAME T James A Santo Planright Insurance-Salem PHONE -- 603-890-6439 FA,c,N1:603-890-6521 224 Main Street Suite 3C (A!C No Ext}' ---- -- -MAIL Salem,NH 03079 ADDRESS:lamie�santoinsurance.com James A Sant. INSURER($)AFFORDING COVERAGE _ NAIC 9- INSURER A_,St P3UU'I Surplus Lines Ins Cc _- T INSURED Edm Unds General - INSURERB:Liberty Mutual Insurance C.O. ._ Contracting,LLC INSURER C: PO Box 2214 _ INSURER o Salem,NH 03079 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR'- POYEFF POLICY�XP� LTR TYPE OF INSURANCE INSD V YNUMBER MMIDDIYYYY MMIODlYVYY I LIMBS A X COMMERCIAL GENERAL LIABILITY EA^H OCCUR 0110E £_ 1,000,000 DAMA Ero REnT'o� 50,000 _JCLAIMSMAIE JOCCUR IWS264625 11!1112015 11/1112016 pREMI.,ES(Es cccurreres} $ MEDEXP(A,,Y one Fe:aen) $ S,QO6 PERSONAL a ADV IN.UR- $ 1.000,000 000,000 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE 5 _ 2, POLICY PEC: ]LOG -LICTS COMP/OPAGG $ 2,000,06 OTHER: �F� NED SINGLE LIMIT AUrOMOBiLE LIABILITY j Itlen[}ANY AUTO YINJi1RY(Pe:pa:san) $ ALL OWNED I�ISCHEGULED Y INJURY!Per ecci&1r0 $ AUTOS �,NUT044'NEG TOS ERTY OAMAG`e ¢HIR ED AUTOS AUTOS ciderr[i $ _ �J $ UMBRELLA LIAB iOCCIIR EACH QCCIRRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE -GF-GF RETENTION$ $ MATTFSTATUTE AND EMPLOYERS'LIABILITY YIN B ANY PR OPRIETORIPARTNERre:�CunuE � WC5-315-602821-015 04/0312016 04!0312017 EL.EACH ACCIDENT $ 500,000 OPPICE2DEMBER EXCLUDED? tJ Nl Ai I3A NH EL.DISEASE-EA EMPLOYEE$ 500,600 (Mandatory in NH) - If as.—D,b—der FL.DISEASEPOLICYLIMIT $ 500,000 DESCRIPTION OF OPERATIONS beI— DESCRIPTION OF OPERATIONS I LOCATIONS f VEHCLES(ACORD tet,.........I Remarks alhldule,may be attached if more space is required) Dave Edmunds is excluded from work comp coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, N0110E WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover,MA 120 Main Street AUTHORIZED REPRESENTATIVE North Andover,MA 01845 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD �mR ua f of ConsumAffirs&Business Reg tattoo OME IMPROVEMENT CONTRACTOR10FO egistratmn 166661 Corporations I t xpiration 6121}3616 EDMUNDS GENERAL CONTRACTING,LLC. DAVID EDMUNDS 1B ASHFORD NO H 03641 Dudersecretarg HAMPSTEAD,N Reg erlt 0!an, n pub Safety _ --Massachusetts Depart d Standards Board of Building license:CS-'04728 Construction Superytsor DAVID CEDMUNDS ', P.0 .60X2203079 Y - '- SALEM NN n! EXpiratlon'� I� Vv 1010312017 ` Co'm ism stoner