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Home My WebLink AboutBuilding Permit # 5/4/2016 %A0RTB BUILDING PERMIT 0. ,ED TOWN OF NORTH ANDOVER �� h� 46 APPLICATION FOR PLAN EXAMINATION ® '_ _ Date Received RarEo �� Permit NO#: �SSa9C HU$ Date Issued: MPOVRTANT: Applicant must complete all items on this page LOCATION /2 Print PROPERTY OWNER � � � Print 100 Year Structure yes nJo MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑iTwo or more family ❑ Industrial ❑AI tion No. of units: �14 ❑ Commercial AfRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic, ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed Disfrrct ❑1lVaferlSewer, �Y DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: e.�' ��'�' � / -(T_ Phone: � � �� Address: Contractor Name: �.� �� °�- Phone: f Email: ; 4Z--4- , Address: A Supervisor's Construction License.-6%3o , Exp. Date: 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: $ FEE: $ " Check No.: Receipt No.: NOTE: Persons contracting with unregistered ontractor not ve ' cess to the guaranty fund NORTH own O'n nuuver v - L ® %MOP2A I _ i - o . �.K. h ver, ass, 1"4 4 . COCHICKIWICK 1' �,9 °Rareo PPp��S S U BOARD OF HEALTH ERM� � IT IF L � Food/Kitchen Septic System THIS CERTIFIES THAT ,� ' BUILDING INSPECTOR ..... 2rvflu ............ .... ..Mt. ....... ......... .................. . ..... ...... .. .. .. ® Foundation has permission to erect ........ ................ buildings on .. ..... ... .. .....:. ......®.......:s. Rough tobe occupied as ... .... cc . .................. ... ....... ...l. ... . ......... ................................................. Chimney provided that the pers. on aepting 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 PERMITI MONTHS ELECTRICAL INSPECTOR UNLESS CONS TIO Rough Service .. . .. ... ..... . ....VMS ... ......... Fina BUILDIP CTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMEr Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 01 tAORttyeaTH 0 )0 .. , Town of North Andover Machine Shop Village Neighborhood Conservation District Commission 1600 Osgood Street North Andover, MA 01845 Apphcation For EXCLUSION From Certificate to Alter Certain alterations are excluded from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicants for exempt projects must fill out the form below and submit to the Commission Chairperson(contact info below), Date: � Y 1'no'- /(" Contact Name &Address: 0 ` vii 92K - ,,;-Y 6OCJ DK 'E�K L)yt-, b'�- a Project Address: /<9 V 2-0 Project Description (attach additional pages,if needed): e '4 yZ6?U U— (9 /1 YuW W 4 AWS K/ JA) 1n-ti t V)+-4 Yk om Qrlu a") Exclusion From Review Requested For: 1. Interior Alterations existing conditions including materials, design and dimensions. El 2. Storm windows and doors,screen windows and doors. LJ 9.Replacement of existing substitute doors,substitute siding or substitute LJ 3.Removal,replacement or installation of windows with new materials that are gutters and downspouts. substantially similar to the existing condition. 13 4.Removal,replacement or installation of window and door shutters. 10.Replacement of original fabric windows or doors with substitute El 5,Accessory buildings of less than 100 windows or doors that maintain the square feet of floor area. architectural integrity with respect to form,fit and function of the original El 6.Removal of substitute siding. windows or doors. El 7.Alterations not visible from a public Ll 11.Reconstruction,substantially similar in way, exterior design,of a building,damaged or destroyed by fire,storm or other disaster, U 8. Ordinary maintenance and repair of provided such reconstruction is begun architectural features that match the within one year thereafter. MSV NCDC Page 1 Current Chair:Liz Fennessy,77 Ora Street,lizettafennessy@valioo.com,978-688-2915 NORTH o4�t�co �a'�HQ Town of North Andover Machine Shop Village Neighborhood Conservation District Commission 1600 Osgood Street North Andover, MA 01845 SACNUy Application For EXCLUSION From Certificate to Ater For Items 9,16 or 11,provide the following documentation: vK Photos/drawings of existing doors, windows or siding, as applicableC.Y �DescriptionlCatalog Cuts of proposed materials to be used for doors, windows or siding Plan and elevation of reconstruction for Item I1 Determination: k roject is determined to be mpt ®not exempt front review by the Machine Shop Village Neighborhood Conservation District Commission. Projects that are not exempt must complete the Application for Certificate to Alter, available front.the Building Department and be reviewed by the Commission. Determination made by: Signature Z4 Z-eA, V)q Neighborhood Conservation District Commission Date MSV NCDC Page 2 Current Chair;Liz Fennessy,77 Elm Street,lizettafennessy@yahoo.com,978-688-2915 FIRST ENVIRONMENTAL CONTRACTORS, INC. 4 BOSTON ROAD SOUTHBOROUGH, MA. 01772 PH 978.549.2200 E MAIL GARY.ONEILL1010kGMAIL.COM MARCH 2, 2016 STEVE KIMBALL 5712 TIMER LAKE CIR. SARASOTA, FL. 34243 CONTRACT FOR WINDOW REPLACEMENTS AT 18 & 20 BIXBY AVE. NORTH ANDOVER, MA. 01845 REMOVE AND REPLACE 14 LEAD BASED WINDOWS INSTALL NEW WHITE VINYL REPLACEMENT WINDOWS WITH 6/6 INTERNAL GRIDS AND SCREENS. WINDOWS MEET STATE ENERGY CODE COST $6300.00 DEPOSIT TO ORDER WINDOWS $2,000.00 BALANCE UPON COMPLETION $4,300.00 SCOPE OF WORK AND TERMS OF PAYMENT AGREED � Aze- F I R T E V A ONM AL STEVEN KIMBALL CONTRACTORS, INC. The Commonwealth of Massachusetts Department oflndustvialAceldents 1 Congre-ss Street,Suite 100 - Boston,NM 02114-2017 www.mass.gov/dia ,�. Workers'Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE MED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organizationthdividual): 4 � /`– �2— Address: City/State/Zip: C��J� � 1 Phone#: Areyoa an employer?Check&e appzoprlate box: Type of project(required): 1.Q I am a employer with employees(full and/or part-time).* 7. Q New construction 2.�lam a sole proprietor or partnership and have no employees working forme in 8. [1 Remodeling any capacity.[No workers'comp.insurance required.] E!Demolition 3.Q I am a homeowner doing all work myself[No workers'comp..insurance required.]t 10 (]Building addition 4.F1I 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.C]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am a general contractor andI have hired the sub-contractors listed on the attached sheet. These sub-contractors have e*9l ees and have workers'comp.insurance.t 13.EJ Roof repairs 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have nc,etngloyees.[No workers'comp.insurance required.] ,r: *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information T homeowners who submit#his 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-coriiractors fiavo employees,they must provide their workers'comp.policy number.' I r M an employer that is providiizg tvorltet s'compensation insurance for my employees.'Below is the policy and job site information. Insurance Company Name: `/ — Policy#or Self-ins,I ic.#:_ �' ly� � �o7/xpirationDate: —� Job Site Address:/ ' / City/State/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 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DfA for insurance coverage verification. Ido hereby certifyan er tlzepa'ns andpenalties oyF_per' ry that the informallonprovidedabove is true and correct, sign 0: Date: Phone# Official use only. Do not write in this area,to be completed by city or town official.. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: AICIMM1II�DIYYYYj CERTIFICATEIJ F LIABILITY IN N U 10101/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUtTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED' REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder is an ADDITIONAL INSURED the policy(les)must be endorsed. If SUBROGATION IS WAIVED subject to the terms and conditions of.the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemengs). PRODUCER 01907-001 Choice Insurance Agency Inc o.as1, (978)343-4853 � •No.: 376 Summer Street Fitchburg,MA 01420 AM Ss; A.I.M.Mutual Insurance Company INSURED First Environmental Contractors Inc P 0 Box 88 Southborough; MA. 01772' INSURER E .COVERAGES - `CER.T1PIGATEN'MISER, -,.:..-. ... .:: ._:..:,. REVISION F4UMBERy_.:......... ..._, _ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEb BELOW HAVE BEEN ISSUED TO`THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT„TERM CONDITION F ANY.CONTRAC,T OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ERTIFiCAIE MA r'^B$`1SSUED"bR''MAY-PERTAIIJ fHL'INSNCE ]iFFORDd BY CNE PDttCiES OESCRiBED'HEREiN IS $LIOJECT"TO"fit["Ti1E'PERMS, EXCLUSIONS �gAND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILT TYPE OF INSURANCE I POLICYNUM9eR M99S LIMITS GENERAL LIABILITY - EACH OCCURRENCE 6 COMMERCIAL GENERAL LIABILITY I DAMAGE TO RENTED 8 CLAIMS-MADE 7OCCUtt ourrenral MED EXP(Any one person) $ PERSONAL a ADV INJURY 9 GENERALAGGREGATE S EN'LAGGREGATE LIMITABPLIESPER' PRODUCTS-COMPIOPAGO $ O11CY• RO• OC AUTOMOBILE LIA8I4ITY13 SINGLE L S ANY AUTO ALL OWNED ACHEOULED BODILY INJURY(Per person) $ LITOS BODILY INJURY(Par accldenl) S HIREDAUTOS NON-OWNED O D A E AUTOS -[Per nooldentl S b UMBRELLALIAB OCCUR. EACH OCCURRENCE ¢. E)<CESB LIAR. CLAIMS MADE AGGREGATE S DED RETENTION$ 8 'rS �1� 51PPNIT14f4r x A " — N/A - E,LEACH ACCIDENT S 100,000.00MendatprylnNN) L" J AWC400.7019883.2016A 9/29/2016 912912016 D CR0A oSPERATIO S below E,L.DISEASE=EA EMPLOYEE400,000.00 E.L.DISEASE-POLICY LIMIT S 500,000.00 OESCRIPi1.QN0FQPEgyT14N.8'CLO AfibNe:dVE.I LBerlAfiaahAC0A6"b1;AddltCSnelRem3�Yke'8oH8d Is,if more space I&required) t CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED.REPRESENTATIVE, r•..- O 1988.20 AC RD CORPOR—A-TOW-Ali7ghts reserved. ACORD 25(2010!06) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza, Suite 5170 Boston, Massachusetts 02116 Home Improvement C r for Registration Registraton: 118004 Type: Individual Expiration: 1/13/2017 TO 262432 GARY P. OWEILL n Jw _ GARY OWEILL m - , > P.O. BOX'88 SOUTH BOROUGH, MA 01772 µr _ eq g✓¢; Update Address and,return card.Mark reason for change. SCA 1 Q zone=os/» (],Addr o Renewal E] Employment n Lost Card V)Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration datL If found return to: eglatratlon: x '8004 type; ! Office of Consumer AtYairs and Business Regulation Exolmtlon-,:=-3 b.Z7 Individual IO Park Plaza Sugte 5170 (qt y Boston.MA 02116 GARY P.OWEILL GARY OWEILL ,A` • ' 4 BOSTON RD '`• SOUTH BOROUGH,MA 0I7� Undersecretary. Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-057877 Construction Supervisor GARY P ONEILL 4 BOSTON ROAD � sOUTHBOROUGH M' ,.k_. ,t�'/►L � Expiration! Commissioner 1D1D412017