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Home My WebLink AboutBuilding Permit # 6/8/2016 BUILDING PERMIT °HD �p- ,c4L16 •' TOWN OF NORTH ANDOVER ®� �`.,`.- �6 0 APPLICATION FOR PLAN EXAMINATION Permit N®#: Date Received ��AD�ATED PYp�QS Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION v L Print PROPERTY OWNER Print 100 Year Structure y:ey9es Ono MAP PARCEL: ZONING DISTRICT: Historic District Machine Shop Village TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other b Septic ❑Well ❑ Floodplair, ❑Wetlands ❑ Watershed Distract ❑Water, ewer' � �. h n, DESCRIPTION OF WgRK TO BE PERFORMED: I I entification- Please Type or Print Clearly OWNER: Name: Phone: '� J Address: c� r Contractor NaW: V' k- Phone: ? � �'��'�2-- Email: Address: l'c� ; s a,� lA 2J,1 Supervisor's Construction License: (7 0 � J-9-/ Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 141�, uov.0 o FEE: $ $" 1-7- Check No.: 6 Receipt No.: - NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund -, - --- -- -- -- -- -- ---- - -- -- ------- of -- --- -- -- -- SipInature of contractor - - - ---- - IAORTH Town of *' ndover 2, h ver Mass, COC .LAPIS acnewoca 1' RArE D J"IF U BOARD OF HEALTH Food/Kitchen PERamm -IT T LD Septic System THIS CERTIFIES THAT .. ... 0BUILDING INSPECTOR has permission to erectg .......................'........ Foundation .......................... buildings ... ..� ...A.Imao_ %* Rough R.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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Ak UNLESS CONSgTION Rough Service .... ... . ........ .... Final BUILDING SPEC R GAS INSPECTOR Occupancy Permit Required to Occupy BuRough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathingor Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. REQUIRED BIDDER:FILL IN ALL YELLOW BOXES Property: Royal Crest Estates(North Andover) B S M Restoration and Contracting Project: 18122-2016 Building Envelope Work Paul Bruno Bid DUE Date: 03/2321116 by 5d)Opm pbruno@bandnvestoration.com 64 5614+998 IDescMffion ua 'qUoM Unit Cost Tow Anti rated Start Date JAnticipailedouration FLaldne I IBLdkrmg 1 ThtuArien Fleshing i IS 50,000.00 50.000.00 611116 620116 Tentative 2 SWdrng2Ttvurva11Flastdng 1 LS 50.000.00 50.000.001 519116 5WI6JTenLafivs 3 Brtldergt6TtutrirraDFlasteng 1 IS KOWA 5D,ODD.00 414116 421116 4 Building;27ThruwallFlasifrgq 1 LS 50,0()0,00 50,000.00 329116 4115116 FIRST BUILDING 5 BuTdug4DTiuuwall Flashing 1 LS 50.000.00 50.0D0.00 42516 512216 6 Tbtuwali Permits&Fees 1 IS 3.000.00 3.000.00 Through-wa0Flashing CostTatel 263,0 ,..00 Repohtkv ...` .". Buldrrtg 16 grind and Repaint ALS 145.000.00 14SAMOD 5!25116 fi29i16 2 `- BWdIng 27 Grand and Repo➢d 1LS 145.000.OD 14SAMOD 411816 5MI FlRSTBUILDING dmg S-.:. Bul40 Grind and Repaint i LS 145.000.00 145,000.00 714!16 amne 7 lGnnd.-M RepDird PefmdsB Fees i LS 5,220.00 5,220.00 Repoirdkrg Cosmtal 436,000.00 nItPrieing 1 Billed Mason 1 HR 7200 7200 2 General Labor ,1 HR 1 50.00 50.00 3 EEdador Drywall Replacement i SF 25.00 25.00 4 Me"Percentage for Overhead 11.5 15.00 15AO 5 MadwpPercentageforPmtit 1 LS 15.00 15A0 Unitpdcum Costutal 1770 d Summary Base Bb Total 688.000.00 Additfonal IntomraUon Did you provide 6feAnticipatedStart Date and Durations asREQUIRED? as Bidder Qualifircafum Notes (OPTIONAL.) '.. PRINTNAME: Paul Bamo in order feryourbid to be accepledyou must complete ftffs Did form,pant d. '''..... sign,and date LL It must Oren be scarmed and emaled back.by the DUE '.. TITLE: President date and Erne to the folawingAimwProject Representafry afema addresses: SIGN&DATE: • t ! REQUIRED BIDDER:FILL IN ALL YELLOW BOXES .Property: Royal Crest Estates iNM7Ah ndover) B B M Restoration and Contracting project: 16122-2016 Building Envelope work Paul Bnmo Bid DUE Date: 03232016 by Mpm pbmno@bandnvesWration.com 61 561-8986 on Qua - UoM Unit Total Cost Ano ated Start Date Anticipated Duration Througt,.vxa l Flashing 1 BtaWmg 1 TlBuwaD FL3shing 1 lS 50.000.00 50,0DOMI 611116 620116 Tentative 2 lkaldmg27tau-waB Flashing 1 LS 50.000.00 50000.00 1 519116 526/18 Tantafive 3 Building 16ThruwallFlastdng 1LS 50.OD0.00 50,000.00 414N6 421116 4 Buiding 27 Tbnrual Aadit 1LS 2911 50.000.00 50,ODO.00 36 4115116 FIRSTBUILDING 5 Bu7dvg40TMmval1Flasing 1 LS 50.000.00 5D.000.00 425116 5112!16 6 Thru-wall Permis 8 Fees 7 IS 3,000.00 3.000.00 tl Ff d*W CostT0w 263,000.00 RepoirNng "= PGIdind g 16 Grind and Repomt 1 LS 145.000.00 145,D009D 545116 609!16 '2 g27f rindand Repomt 1 LS 155.000.00 145,000.00 411BN6 503/1 FlRSTBUILDING 3 901 Will Grind and Repoatt i lS 195,000.00 145,000.00 714!16 am( 7 and Repaint Permits 8 Fees i LS 5,220.00 4220.00 Repoirdtng CostTotat 436,000.00 unjtpdchw 1 Sidled Mason 1 HR 72-W 7200 2 General Labor IHR 5090 50AD 3 EAeriorDrywall Replacement ,SF 25.00 25.00 4 6tark-up Peroertiage for Overhead 1 tS 15.00 15.00 5 Mark-pPeroentagefor PmOt 1 IS 15.00 1590 UnRPrieing Cost Total 1779O BId Summary Base Btd Tolai 686 OW Additional bdormaflon Did you pro Klett()MficipatedStartDateaMOuratiorsasREQUIRED? es Bidder Qualification Notes (OP71ONAL) PRINTNAME. Pau]DAVID In order foryotrfud tab&accepted you must complete Ods bid form,print it sign and date it It must then be warmed and emailed bark,by the DUE TITLE: President date and time to the lolowingAunw Project Repmsentaf WSfemal f addresses: SIGN E DATE: If A�= =`_:.'�': �l:•f E t :ff ___t5._= ,— c,. tJ . The Commonwealth o,f Massq, husells 4 Depowi tent of1ndastriaZ.A.ccidenfs ah d X Congress Street,Suite 100 Boston,MM 02114-2 017 ;� .:•.: 4J4�,. www.mass.govIdza Wool<ers'Compensation insurance Affidavit:Builders/Contractors/Electricians/PZumberes. TO BE FILED WITH THG PFPdMTTING AUTJIOPJTY- Applicant Information Please Print Ledb Name(Business/Organization&dividnal): Address: � On v`r S r,,L City/State/Zip: V1 Phone#: Are yoa an employer?Checkt&app opriaiebox: Type of project()required): LHI am a employer with_ employees(full and/oz part time). 7. E]New construction 2.Q I am a sole proprietor or partnership and have no employees workil g for me in 8. [1 Remo defuig any capacity.[No workers'comp.insurance required.] • 9. El Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp-insurance required.]t 10F]Building addition 4.❑I 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.F]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.Q We are a corporation and ifs ofeers have exercised their right of exemption per MGL c. 14•�OtheT 01 152,§1(4),and we have no-employees.[No workers'comp.insurance required.] *Any applicant that checks box41 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit 1*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 fiaye employees,they mist provide their woriceis'camp.policy number. Z am an employer that is pI'6v1d1hg worIierscompensatlon insurance for my employees.'Below is the policy and jolt slte information. Insurance Company Name: /a C G r 1^ Policy#Z or Self-ins,Lic.#:=A /J P19 U 2 ExpirationDate: /0 3obSitaAddress: City/State/Zip: Attach a copy of the wor rs'compensation policy declaration page(showing tb e policy number and expiration elate). 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. I do hereby cert' rade)' lie pat, s -ndpenalties afper;jury that the information provided above is true and correct. Signature: Date Phone ff: 7 e '� Qfj`icial use only. -Do not write in this area,to he completed by city or toren official. City or Town: Permit(License# Issuing Authority(circle one): 1.Board.ofHealth 2.BuildingDepartment 3.City/Town Clerk 4.Electrical Inspector 5.PlumbingfnSpector 6.Other Contact Person: Phone##: AC" CERTIFICATE OF LIABILITY INSURANCE4DATE/4/0�6 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 BELO}IV. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPO TANT: 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 endorsement(s). PRODUCER NNAMEACT Jean Sullivan, CIC, AIS Burgin, Platner, Hurley Insurance Agency, LLC PHONE , (617)472-3000 FAX (617)472-7248 14 Franklin St. E'"IAIRLE s s,,jas@bphins.com INSURERS AFFORDING COVERAGE NAIC# Quincy MA 02169 INSURER A-Hanover Insurance Company 22292 INSURED INsunFna.-Safety Indemnity Insurance Co 33618 B & M Restoration & Contracting, Inc. INSURERCAcadla Insurance Company 218 Paris St INSURER D: INSURER E: East oston MA 02128 INSURER F: COVE GES CERTIFICATE NUMBER:Kaster Cert 2016-17 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. ILTR R TYPE OF INSURANCE ADD UBR POLICYNUMBER MMDD MM1DD P LIMITS LT GENERAL LIABILITY y N EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 500 000 R COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ r A CLAIMS-MADE ®OCCUR ZIFN8997647 /17/2016 /17/2017 MED EXP(Any oneperson) $ 10,0901 PERSONAL&ADV INJURY $ 2,000,000I GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 X POLICY PRO LOC $ AUTpMOBILE LIABILITYy y (Eaacciden SINGLE LIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALLOWNED x SCHEDULED 208157 1/6/2015 11/6/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ HIRED AUTOS x AUTOS D Per accident PIP-Basic $ 8,000 X UMBRELLA LIAB x OCCUR y N EACH OCCURRENCE $ 5,000,000 A EXCESS UAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED X I RETENTION$ C 9055121 /17/2016 /17/2017 $ (,` WOgKERS COMPENSATION N % WC STATU- 0TH- TORY LIMITS FR AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) C-20-20-003740-03 /10/2015 /10/2016 E.L DISEASE-EA EMPLOYE1$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Contract # 18122-422094-CPe-00002; Property Name- Royal Crest Estates(North Andover); AIMCO North Andover LLC is additional insured per written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AIMCO North Andover LLC ACCORDANCE WITH THE POLICY PROVISIONS. 50 Royal Crest Drive North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-065281 Construction'Supervisor PAUL BRUNO 1 109 CHESTNUT STR I LYNNFIELD MA T 019 O Fra ` Expiratio Commissioner. n: , 09128/2017to