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HomeMy WebLinkAboutBuilding Permit # 6/17/2016 BUILDING ING PER IT OO°T b��o TOWN OF NORTH ANDOVER 4�1 APPLICATION FOR PLAN EXAMINATION ® Permit No#: Date Received `��ADRA rED .If. Ss�cHO5 Date Issued: IM OI2TA1®NT: Applicant must complete all items on this page " LOCATION ��� - f PROPERTY OWNER Zl (G)I-C-il Print — U Print 100 Year Structure yes UnoMAP PARCEL: ZONING DISTRICT: Historic District yesMachine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial iP�Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other t ��.,Se tCc�� ❑hlNell��� r� ,� ;� ❑ Flood lain � h❑Wetlands �� � �� ❑;�1/Uatershed District , ..'�`,��`i�'.h�� ,: .i1�i,.X�.n..;ra #�. a r -.�,�'",�r .,Eta-.: �:/�f •t'c l�_ k ,y.�" to,�:-.h^�r i�� � lam.y '�f (p�r, �.. :' �k``�" r �z* re���+`�� J,z J.! h.a �^r rrr�:.y f Y�`��r�u�rE^c .9fi' "�y z r.� r'.:�si � fair r�`1`�a !''` '�rr� �,.�y�..�,9�Y����� �.��'Y rT,f, r� ,� ✓ H ��Water/Sewerc,,,�-.,. ''�,l .,,!.,,.�'f„��k ��r"J,i�''��r �i�l�`�"��, �a%�1'r�.r.„:�fi, ���z^a,,.,.�:.:�J`�r�`�,m��;;t� � r�,;.''r�.�'�,,,r� r�.Cr,✓ftp ,„�'�,Ff, .�rJx��. DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: e-n Phone: Address: fit' i'"-)I'LL- ST Contractor Name: �� vl° �� Phone: 1'9`IY- Email19 <,. Address: j �� 1� °'C ;ter tf�t) Supervisor's Construction License: � � ( Exp. Date: Home Improvement License: l ;7� c y Exp. Date- ARCH ITECT/ENGI NEER ate:ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$9200 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ c��� �' I ' FEE: $ Check No.: b 1 Receipt No.: NOTE: Persons contracting with, unregi erect contractors do not have,;,,access the gigarantv fund NORT#1 Town of Andover ® • ^ R+ ® �Q LA14Q h ver, Liss' . 117 COCNIc"t—cm ��q0 � RATED p.P U BOARD OF HEALTH DFood/Kitchen PErx Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ..............N11T ... ........... .. ...... .................................................................... has permission to erect .......................... buildin son .. .: . ...... ........... .......... Foundation ® Rough tobe occupied as ........... ........... . ....... ........... .............................................................................. Chimney provided that the person accepting his 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 CONST ION Rough Service .. ...... Final !!TWiB0UiL4DING CT 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. 6/17/2016 Community Software Consortium 4 ea sors North Andover Board of Assesp Ac Parcel ID: 210/057.0-0021-0000.0 FY: 2016 Community: North Andover e mary Locan: 73 BRADSTREET ROAD Photo(Click on Photo to Enlarg I Gal CKynertioName: PATRICIA A.GLYNN REVOCABLE TRST Owner Nante2: C/O PATRICIA A.GLYNN IRREVOCABLE TRUST Owner Address: 73 BRADSTREET ROAD City: NORTH ANDOVER State: MA Zip: 01845 Ah]Wo( '? Neighborhood: 6 Land Area: 0.46 acres lro�lr "i r, Use Code: 101-SNGL-FAM-RES Total Finished Area: 2001 sqft Tax Class: T Pct-Exempt-Land: 0 Pct-Exempt-Bidg: 0 73 BRADSTREET ROAD Sewer: Road Type: T Sketch(Click on Sketch to Enlarg�) HiS(01 Y Water: Road Condition: P V�H�,(oj y TotalValue: 418,500 398,100 -h A(m Asz „mwnts Con 'm rPM Yom, Previom Yom. Building Value: 222,100 208,600 Land Value: 196,400 189,500 Market Land Value: 196,400 Chapter Land Value: ta�wASak! Sale Price: I Sale Date: 0612312014 Arms Length Sale Code: A-NO-FAMILY Grantor: GLYNN Cert Dcx-- Book- 13888 Page: 0254 Copyright 02015 Corn ITI unity SORMIre Consortium,All Rights Reserved http://epas.csc-ma.us/PublicAccess/Pages/ParcelSummary.aspx?MeriulD=3&LinkID=181009&Comt-ncode=210 1/1 tt sa° ��is3 iso1 fit/ r{ tut'(uis � � a�CP P'W �tAz�7t�F���c.�f��u, � � �i � 1 "I`grpes Of ''. 3#`.�Y's �,>}tt'�€ �;U u'�' t z [3�„�jt3 3 ..14 (t:'�rT."�I�,n—, f.,:�..s'3�t��.J' E pert Masonry Work Mass Toll Free Licensed & Insured 1-800-WAIT-4-US License#034200 (324-8487) [�"Std Com, r �c�v v� ���>� s� e�.� X1#1€ look Year Rr uncl i Proposal To: Pat Glenn P Date 2/9/16 Street: 73 Bradstreet Rd. 978-682-2688 N.Andover, MA 978-764-6692 Vinyl Siding Proposal L Remove all existing siding and corner boards 11. Install all new vinyl accessories: light blocks, from entire house and garage. gable vents, dryer vent, split blocks,meter block etc. 2. Remove all shutters. 12. Removing and re-installing electrical meter by 3. Inspect all wood components of entire house. licensed electrician all included in proposal. Any compromised material will not be left. Any 13. Removal and installation of light fixtures and existing damage or rot will be discussed, doorbells included. New fixtures and doorbells must confirmed with homeowner and replaced at an be provided by homeowner if wanted. additional cost of time and material. 1 st 32sq/ft of 14. Install composite kick plates under all entry doors sheathing boards. at no additional cost. where applicable. 4. Install 3/8" solid Styrofoam insulation board to 15. Proposal does not include any painting or staining. entire house. All seams will be taped. No generic 16. Building and electrical permits included Mfg. 17. Removal of all work related debris 5. Install double 7” Cedar Impression corners to all 18. Limited Lifetime vinyl siding warranty from outside corners. Color Sable Brown MFG. , not contractor. 6. Install double 7" Cedar Impression vinyl siding 19. Contractor workmanship warranty: 10 years under panels to entire house and garage. Color Sable normal weather conditions. Brown. Total cost: $ 31,400.00 7. Soffit area: Drill holes in all rafter bays for added ventilation where needed. Install vinyl perforated ' Option: Install all new vinyl louvered or raised Invisivent soffit panels for excellent attic airflow. panel shutters to all existing areas. $60.00 per 8. Install j-channel to all areas that need to accept pair installed additional cost. vinyl siding. All j-channel will be self-flashed and angle cut for clean professional appearance. 9. Install custom bent Alcoa aluminum trim coverage to all fascias,rakes, window casings and sills. Finish aesthetic appearance to match Payment schedule: new and existing windows as close as possible. 1/3 on project start date 1/3 at project halfway point 10. Install all new composite jambs, casing and weather bands around garage doors. Final balance including any extras due upon project completion Acceptance of Proposal—The above prices, specific itions and conditions are satisfactory and are herby accepted. You are authorized to do the work as specif ed. Payment will be made as outlined above. Date of Acceptance: Signature: The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass:.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information l� /J Please Print L ib Name (Business/Organization/Individual): A > f��1'�"�'l d° Address: aKJt cr� ��`11✓��� _ f3 City/State/Zip: Phone#: Are you am employe'!Check the appropriate box: Type of project(required): 1.0 1 am a employer with employers(full and/or part-time).* 7. New construction 2.n-1 am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.[No workers'comp.insurance required.] 3.01 am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. El Demolition 10 Q Building addition 4.0 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that al)contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.D Plumbing repairs or additions 50 1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.DRoof repairs These sub-contractors have employees and have workers'comp_insurance.t 14E)Other 6.O We arc a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 'Any applicant that chocks box kl 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. (Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employers,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy-anrijob site information Insurance Company Name: Aon ekn,u 1yw, �J /� i Policy#or Self-ins.Lic.#: A'JC' —4G c`u �O© � r-201 6 Expiration Date: ( `a' r� r Job Site Address: J ��� � s� City/State/Zip: �f - 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 DIA for insurance coverage verification. I do hereby certify undP7 the pains and penalties of perjury that the information provided above is true and correct. Siznatwe: I Date: i 5_I Z®i �- Phone# O,,icial use only. Do not write in this area,to be completed by city or town oJjieiai 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#: WORKERS COMPENSATION AND EMPLOY RS LIABILITY INSURANCE PO INFORMATION PAGE POLICY A.I.M. Mutual insure co Company 54 Thlyd Avenue, SuriingMli ME Ssacht,!Wts 01803.0970 (800) $76-2 es NCCI NO 26158 POLICY NO. AWC-400.7009484-20A PRIOR N0, ��WG4002014� ITEM 1. Tho Insured; All Under One Roof DBA: Melling address: C/O John Lantafame 30 Temple Drive PEIN;e0-ee*8261 Methuen,MA 01844 Legal Entity Type: Sole Proprietor Other workplaces not shown above: See Location 2. Tho polloy perlod is from ,11108/2015 to 11/09/2016 12:01 a.m. ing 3. A. Workers Compensation insurance:Part One of the policy states listed here; MA 14110s to the rWo kers Compensation Lad time at the Insured's w of iheCesa. B. Employers'Liability Insurance;Part Two of the policy Applies to work In each state listed in item 3,A. The limits of liability under pert Two are: Bodily Injun by Accident $ Bodily Injur3 by Disease $ 100 000 each accident BodilyInjut) b Disease $ "'` � ��policy limit 1 Y 0 o each employee O Other states Insurance: Coverage Replaced by Endomorr ant WG to 00 00 B D. This Policy Includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals 1 It RUI8t3,Classifiaatlons,Rates and Rating pians, All Information required below is subject to verification and chef go by audit, —�lessificet ons """ ��••- _, -Min u as�"'is"-"" '"" Code l:stimaf d , Pouf 00 Eslimatad No, Total An ual Annual ^--• - ,,,,,_„____�,,,_�_. Remuner tion Remuneration Premium INTRA 174366 I I INTER t jj SER CLASS CODE 6CHEOUIE Minimum Premium 3ftV To�ai Est►mated Annusi Premium ----.._......... i� GOV GOV pe osit Premum STATE CLASS no Mme? 5474 St to AsseasmentslSUrcharges --^-_�— $1 ,00 X 5 7500% $1 This policy,Including all endorsements,is hereby countersigned by ^� �.� �a u or s pnature """• „10105Q1$ MIT— Service4Trrd Atvenue P rry Insurance Agency L{.O Burlington MA 01803 5 2 Chlckedng Rd, Rt 126 N rth Andover,MA 01646 WO 00 00 01 A(7-11) incluusad it t It*permission. tel of the National Council on compensation Insurance, , usod with It*permteston. WORKERS COMPENSATION AND EMPLOYE RS LIABILITY INSURANCE POLICY INFORMATION PAGE AIM, Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803.0974 (800) 878-2-POS Nccl rte 26158 POLICY NO. AWC-400-7009484-2015A PRIOR IV(7, 'AWG400.700940 -f 4A ITEM 1. The Insured: Ali Under One Roof DBA: Melling address: CIO John Lenzafame FEIN:**-***8251 30 Temple Drive Methuen,MA 01844 Legal Entity Type: Sole Proprietor Other workplaces not shown above: See Location 2. The policy period is from 11!0912016 to 11/09/2016 12;01 a.m,standard time at the insured's mailing address. 3. A. Workers Compensation Insurance:Part Ohe of the policy applies to the Workers Compensation Law of the states listed here: MA S. Employers'Liability Insuranoo: Part Two of the policy applies to work in each state listed In Item 3.A. The limits or liability under Part Two are: Bodily InJuq by Accident $ 100,000 each accident Bodily Injuryby Disease 3 """"" "$��j'W policy limit Bodily Inju by Disease S 100,000 each employee C Other States Insurance: Coverage Replaced by EndoraorrontW020 0300 B D. This Policy Includes these Endorsements and Schedules: 5FEE SCHEDULE 4. The premium for this policy will be determined by our Manuals 11 Rules,Classifications,Rates and Rating Plans. All information required below is subject to verification and chai ge by audit. Classifications - "' _.F=rem u Basis -- ..—..-..._.._...�....._.,. Code Estimal d , Pers,00 Estimated No. TatalAn ual Annual Remuner,tion Remuneration Premium I INTRA 174366 INTER SEE;CLAS3 CODE SCHEDULE , Minimum Premium 91iibD To al Estimated Annual Premium - GOV GOV De osit Premium STATE Comp,$$ M —. 5414 Sh to Assessments/Surcharges $1 AO x 5 7500% $1 This policy,including all endorsements,is hereby countersigned by .-a— 10/05/2015 Authorlwdaignalurd Maw— Service Tird Avenue Office; P rry Insurance Agency LLC Th5 2 Checkering Rd, Rt 125 Burlington MA 01803 N rth Andover,MA 01646 We 00 00 01 A(7-11) Includes copyrightedmatsrlsi of the Nsuonai usod Council on Compensation Insurance, with its permission, it roassachusetts Bo.-rd ol Buiiding Rog iimion License, CS-069120 , JOHN W LANZAPkME 30 TEMPLE DR : r METHUEN MA 01844', oms7iis s i o ri er 04/03/2017 Click on the registration numt.er to view complaint history. You Can also-view 2rbit[�tion and G aranty fund history. The list is current as of Wednesday, October•8, 2014•. Search Results REGISTRANT RESPONS11BLE REGIS-MAT= ET�I�IRd�iiltJl i STATUS A13 - SS DA'� NAME INDWIDUAL NUMBER A LL UMER ONF-RooF LANZAFAME, !WQfa 166 A MERRIMACK ST 10/02/2016 Current JOHN METHEtJN.,MA 01844 ®2012 Commonwealth of Massachus6EtS. Mass.Gove is a registered service mark of the Commonwealth o Massochusetts.. ,n�n�-inrd