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Home My WebLink AboutBuilding Permit # 7/26/2016 BUILDING PERMIT NORTH TOWN OF NORTH ANDOVER opo{� ko'`6 6+6 { APPLICATION FOR PLAN EXAMINATION '- VL e 1 Permit NO: -� Date Received °R -�• ^' Date lssued: f/ �QSSgCHUs�t�� IMPORTANT; Ap scant must complete all items on this page _LN- �4 L- !x t a ra 017 JI a �, a w er M1 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ,New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bidg Others: Demolition Other e a qac DESCRIPTION OF � PREFORMED: h p WORK TO BE ORM ED: I Identification Please Type or Print Clearly) OWNER. Name: Phone:�� Address: 4y, leo (3V-(J-� OA 0 I� ZRiNE y e. :. ARCHITECTIENGINEER Phone: Address: Reg., No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$4000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 11 ,500,(10 . FEE: $� f 4 �1 Check No.: 1 Receipt No.: Q �� NOTE: Persons con ratting with unregistered contractors do not have access to the guaranty fund f NORT" Town of over 1z h ver, Mass LAKEn CCC MIC H[w.CK � 7 V BOARD OF HEALTH Food/Kitchen PERMIT %6 D N Septic System THIS CERTIFIES THAT .............................. ......�I�.......................I ...... BUILDING INSPECTOR�..,..................,.............. has permission to erect .... buildings on , ,,,,,,,, Rough Foundation .. ........ .............. ...... to be occupied as ........ ......—Ago...4107-4-41. Its ...�,QSLa.e.....6 .............. Chimney provided that the person accepting this permit shall in every ect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TIO Rough Service . ........ Final BUILD G I ECTO GAS INSPECTOR OccupancE Permit Required to OccupV Buildin Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Alan Bingel 978-815-8848 1 Oak Ave. North Andover, MA 01845 __.....___ Samir y�oirynnd"177d 0p'vatt,1 Kh",WPOWMA Pon 117. me won swims Am ATIONS Ile Into € .r€n +r_ € C� r,.�..._._�...� _ l ,dd ;�E Ulvr�+' t''�� !-ar3 sdE.��'{5T1tf.$ Roo. 47ncO-lana trrgan Scinu= 3r;aS;; m F1i a Coo: v I`J a t~o Yeq Ylo Yes J. rio Yrs ida Y -----1J3 Sol 13 i upon Jl�h y Gare;Fr _ __. �. ...—. _..._.,_._._.. pan �ornl lotion 5 _ ..,:: .__M _ . �,� __ ___ _ : _._._.__ __ .. t NUNS: r i i, Evk I ^j (dlt it C)I V tat (SIDING)SPECIFICATIONS r C 43 v over lady area of souse, a of:issiaooti L-- Item:'.r.ot covved er lnstai11 : Ys PFo Yes 4o _ Yes 44o 1 nyl Shu(}c-r s _ j t e'w&+i Cw.. ,er_ d reiw"A _ 4Vnticw Ma i c WFn F E 1: ':___.._._�,_.,, °) t ,i[tct C -rSs . ._.._.�. �._ Ceiling )( €r,Je I F o4t.5. ._._...._ ., _ IQ MWre Ammaihs it neMad �'� � PvC iri[;i ------------- Alt ON SMRT OF ALL Jt313&HOMEOWNEU MUST REMOVE ALL ITEMS FROM WALLS� I�cI.VES COMM refatm[#r:,errni*s:"A Imreawner owns Ilk ovn canstruc{iaq-rsleted;Frrmits'or it€c work rfesrihed under this xgras�strent,4lre homs:aaerrur Ir.here by adviser! Mal M Me am of Ti juQMent am rumpgmerd 0 Phe aontlactor,Crie IYonleoywner vifi flat 49 eEilltfid to rnafce a cttirrt to OF codec Pro-rn fte ytiaranty,iur€d csta€;IFslted by t Ghwpfcr442h.In,G.r_ U PAWFY �c . no TO TAL�i..._ Vin'I SEA •WdI€u oiSJn f�aors 2151 N.Broad iay E mchin�ge NV 1... (5......:- ,[ 1.. 5 4l t•7�{ SaWM H 83479.___.- (t G3)(f3t.:.,'4GB_.._..._,_ .trvata,brookss d.rornmm_--_ 1p'IF 2 SONO _ avow am"" Ym iiu 13u r EnaY r.ndu�f Eh Fr�n_mthon ar eny time itrEor Pa midnirght or,he thin hus€nrs tray so to my M to 4retw:dwi G•.ocrEt.,r m=A he&m Ea wrErntg M room Bre E ,iyht to rL..rk fc,rcrcd,v. C NOT SIGN THE CONTRACT IF°!H6i AIDE ANY PLANK SPACES. / IN AFNESS 4HEc o %pwNe- ? .z& - jRMW__?Mn Ma�,...,._....,.._..Y.._� dsW..., 'R- �G'rmm_........�. — .__ J ..s ..... The Commonwealth o,fMassacbu6tts De,Oartmint oflwlustrigl Accidents Of eq of.Inpesagations ' 600 Washington Street ;k Boston2i 02111 immmassgovIdia Workers'Compensation Imurance Affidavit:BuffderslCoy. actor8lBlectriclans1Plwmbers A 11cant InformationI P]ease Px ut Le ' Name(Bustnessl0rganizatioallndz`vadual): ro-AS end Address: citylstatemi): Phone FA-r()YAU1. employer?Check the apparopriate box: hype ofproject(required): employer with4. El S ane a general contractor and I Iees(full ancVorpa -Limo}." have hredtbe sub-contractors 6. ,� ani coz�strazc ion sole proprietor or parta.er listed on the attached sleet.� 7. Lf Romodeling ship and:have no employees These sub-conbsaotors have S. n bemolhion working forme in any capacity. workers°.comp.M*sauce.. 9. 11 Building addi#ors [so workers'comp.Insurance S. D We area cozporation and its xeguired,j officers have exercised their 10-0 Bleaf'rical repairs or additions 3. 1 am a homeowj.er,doing all work right of exemption perMG.Ir l LEI I'lurnMUgrepairs oar addltlons myself.[No workers'comp, c.152,§1(�),�ndwel�avesro l2.[ Raofzep$irs insurance,required.]t einployea%[N'oworkers' comp,in�rance�tegpired.� ; sy appIiosnt that checks box#I mnstaisol[autthasegtion belr st�ovthairVr©rtcera'capensafi�ori;polscyuifom�afinn: I Homeo�vtters who sal mItUs aff[davii lndiGating they a�oigg ef!vlork and then tetra outside ooniraeiors annst su i nt s ttew:aM6Yitindicftj sucb. kcontmoiers that checktws baxmust affached an.addsiiondAeetsho ringthe name ofthe sub-�ontmotars':IAd their wa*-,xe comp.pollcy i fomia&n, T ft>F2 aY12tYiiIPg WOYeYS'COnaollXOye t}tEiSj01 wffMV Be rs�hepolicy,�zcX,�ob site ; :.. IY�foriftatiAfa. _ Insurance Company Name:_ �`��(' T n f a A1C Polioy#Or el pus.laic. :_ j l3xpirodon.Date, Sob Site Address-'—L - Gty/S#selZlp.' Attacha copy of the wortsere'cornpe)asatioupolicyaeeigraiionpage(Showipgthopolicy.number and ex-pfratiou tate).:.. Failure to secure coverage as reguired.uader Section 25A,ofr,13L c.152 can lead to thi ''isnlaosif*on ofcximinal penalties of a &e up to$1,500.00 anwor o,66-year ,prisonmenf,as well.as 01V irk s forrri ofa STOP. OI QRDEIi and a iia of np to X50.00 a day:agalmt&o violator. B e advised that a copy of this Statets:entmay.be forwardod to flie office a-f Investigations of the DIS.for itisurence coverage vett cation.. XcYo tree eby cert raitr7eY a rtd.PeAlaTiles of Fer;jur,�fhatfJ'te trif-r nwationpropi6d tabove is true.and correct. S% afore: Date., hone#: 6 0'349 Official rise only. Do riot write in�"s area,to be co�ttpXetetl�y cfz�ar toWri of}ictaX, s City or 'own: . 1'ermittlLiceaise Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4 �jectrlcoi Znwr eetor S.Numblug Inspector 6.Other - Contact Person:on: �'ho 7ne#: E, .��®® CERTIFICATE OF LIABILITY INSURANCE [2725/2016 TE(MMIDDIYYYY) / THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 Ileu of such endorsement(s). PRODUCER NAME CT Linda Bogdanowicz Insurance Solutions Corporation PHONE (603)352-4600 AX No; (603)382-2034 60 Westville Rd E-MAIL ADDRESS:lindab@isc-insurance.cont INSURERS AFFORDING COVERAGE NAIC# Plaistow NH 03865 INSURERA:PeerlesS Indemnity Insurance 18333 INSURED INSURER D; Brooks Construction Co. of Lawrence Inc, INSURERC:EXcel.Bior Insurance 11045 dba Brooks 'Vinyl Siding, Doors and Windows Company INSURER D: 254 N. Broadway INSURER E: Salem NH 03079 INSURER F; COVERAGES CERTIFICATE NUMBER.CL165926838 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 TYPE OF INSURANCE ADDL 3UBR POLICY NUMBER MOIDBY EFF Mrd1Db YYYP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO A CLAIM&MADE � OCCUR PREMISES Ea ocT encs $ 100,000 CBP8945793 5/16/2016 5/16/2017 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑jE O- LOC PRODUCTS-COMPIOP AGG S 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per ac ldent Medlcal a monis $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PER ER ANY PROPRIETOWPARTNERIEXEGUTIVE Y❑ N/A E.L.EACH ACCIDENT $ 500 000 C OFFICERIMEMBER EXCLUDED? n WCB$36275 5/16/2016 5/1fi/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS beioW E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE.HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Alan Bingel THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 Oak Ave ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE -- -- Keith Maglia/LJB - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS 025(201401) ^. issa�huserf4s Department of Pubiic Safety Board of Buk ilng Regulafiansnd Standards Ucense: CSSL-099730 Con.struc;ticr� UJ:�,er:isOr Spe.Gi',alty MARK DIPRIMA 18 HAWK DRIVE SALEM NH 03079 n�-, ssicrr nr 02/2012018 . -Office of Consumer Affairs do business Regulation (-TOME IMPROVEMENT CONTRACTOR `Registratlon; 101582 Type: _. Expiration: 612912098 Supplement Card BROOKS CONST,CO.,INC.OF LAW MARK DI PRIMA 254C N. BROADWAY STE 110 4= - SALEM, NH 03079 Undersecretary