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HomeMy WebLinkAboutBuilding Permit # 9/13/2016 %AORT"l .1 41 BUILDING PERMIT TOWN OF NORTH ANDOVER 10 APPLICATION FOR PLAN EXAMINATION oeHiaHe Date Received Permit No#:-�/:.7 S CHUS e Date lssued-­, & RTANT: Applicant MUSt complete all items on this page _J LOCATION P V0 WN Yl/) PROPERTY OWNER Print100 Year Structure MAP PARCEL: ZONING DISTRICT:___._Historic District no Machine Shop Village y s no ,F TYPE OF IMPROVEMENT PROPOSED USE Residential Non-- Residential ri New Building 0 one family Industrial [I Addition Li Two or more family o Commercial N o. of units: D Alteration -- [I Others: E Assessory Bldg 44-<e­pair, replacement El Other F1 Demolition -7777 7 Wa. n c Floodplain [i Wetlands t shed"Dist t Se tic 111Well; 6 0 FIbb &"/s bt WORK TO BE PERFORMED: I)ErCRIPTgg I�N OF Identl*f1cation- Please Type or Print Clearly Phone: _2 OWName:NER. —41 Phon .—M Address: Phone: Contractor. arge: v) Email: 4 Address:- Supervisor's Construction License: Exp. Date:_ Home Improvement License: q----Exp. Date: ARCH ITECTIENGI NEER P e 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. Zfi Cast. $ 70 61, 6V FEE: $ Total Project Cos . _-L–L-4 In --,.---Receipt No.:__ Check No.-.----.— NOTE: Persons contracting with, u gistered contractors do not have access toIthe aranty fund .................... 4 �y )RT" q Town of 6 ndover 0 �+ L., m- %6 h ver, Mass, 1�► COCMI:A"K EweC�( h' IPAro P.ea,�,�5 S U BOARD OF HEALTH Food/Kitchen PERMIT . .. D Septic System THIS CERTIFIES THAT .............Z'N'sm'....... .Ic6 . ",.� . BUILDING INSPECTOR ............... ........ ............................ has permission to erect .....:.................... buildin son 1 .. �&4.. Foundation ` t Rough to be occupied as .......�,. chimney ......... ..... ....... .......................................................................... provided that the person acceptin this permit shall in 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 UNLESS CONST CTI T Rough Service .. . ... ...... ................ Final B ING I SPECTOR GAS INSPECTOR y lld�ln� ccupcarac Permit Ike uared t® ®ccu� Bu Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Udall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. D.G. Contracting Inc. Decks ,Excavation work Commercial fit ups* Dumpsters * Man lift work * Tree pruning Sport court Installations 7 OV0 C,ulez!!4' Przsidev't 428 Pleasant. st. N Andover 61x.01845 Office 978 689 4797 - Fax 978 686 6337 - Cal l Cel{978$15 7745 bIa. License # 061821 * insured * Home improvensent # 120199 Dg,buildingkiol. colli ,Tim Lappas 133 Main st N andover Alpine realty September 12, 2016 Install vinyl siding over existing siding and 3/8 fan fold. Estimated price $22, 700. 00 X.._ -._ _ _ .. _.__...__-. Date OP ID:GOGL ,a►��R®A TE(MMIDOff" CERTIFICATE OF LIABILITY INSURANCE DA08/24/2016 aer2ar2x1s 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 policylies)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 CONTR T Macdonald&Pangione Insurance Phone. 878-888-6921 PHMNE Hannah Courtemanche,AAI,CISRAx 104 Main Street Fax: 978-688-5350 sMg-N. I,978 868-682_1_ ��No;978-688-5350 North Andover,MA 01845 £-MAIL hannah m Ins.ne# Donald Schemack ADDRESS: p _- PRODUCER DGCON-1 CUSTOMER ID 0: mm,� T_,_ _ tNSURER�5)AFFORDING COVERAGE NAIC q INSURED D G Contracting,Inc ID 646648 INSURER A:Travelers Prop&Casualty CL 25674 428 Pleasant St INSURER B.Safety Insurance Company 39454 North Andover,MA 01845 - —--- wsNRERc:National Liability&Fire Ins INSURER D: INSURER E; ENSURER F: 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. ILTR TYPE OF INSURANCE D L B POLICY NUMBER MMIDR EFFPOLICY Mw0g EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY 680-1553R18 0511712016 0511712017 PREMISES Ea occurrence) $ _____300,000 CLAIMS-MADE= L_"_J OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 11000,00 _ GENERAL AGGREGATE $ 2,000,00 GENT.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ .2,000,00 POLICY[E PRO- JFQT L1 LOC1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ),00x,00 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ _ ALL OWNED AUTOS BODILY INJURY(Per accident) $ B X SCHEDULEDAUTOS 3116538 0711212016 07112!2017 (P08�dRTnt}AMAGE X HIREDAUTOS $ X NON-OWNED AUTOS $ X UMBRELI.ALIAB X OCCUR EACH CURRENCE $ 1,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,x00,00 A --� CUP-0090153321 0511712016 0511712017 -- DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY TO LIMEYS ER _ C ANY PROPRIET R EXCLUDED?ECUTIVE YIN NIA V9WC704542 03/3112016 03131/2017 E.L.EACH ACCIDENT $ 1,000,00 OFF(Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 if yes,descr be under -- — DESCRIPTION OF OPERATIONS below i E.L.DISEASE-POLICY LIMIT S 1,000,00 A Property 680-1553R18 05117/2016 05/1712017 LsdlRent 20,00 Equip DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Fax: 978-688-9542 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Building Dept ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street AUTHORIZED REPRESENTATIVE North Andover,MA 01845 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD ne Commonivealth of mawsachusetts Department ofXndustrIalAccldents -_ __ N I Com-Fe ystreet, Suite x'00 s� RO,yto12,.A 02114-2017 , w-PPiP.mass go-P1d!a W,011:-keve CoxapensatioaxTwurauceA- TO BE FffW-WMEE THE TEM'gUTJNG AUTB:ORT'y Apphcantaxmatiox Please Pry Le N,gM(. (3 za ess/[3rganizat%nnrCvdiriduai): [' (�`1 (4c���}� ,� �r— Cztylstatef xp: (gbve r ma JOYS— 'hone k Areyeu an emplayer? MBOkfe a s ixopxza Typo of project(yggWte€1): 1- am a employer�vitb�_..:.....,employees(fiill andlorgartMane). 7-- New coaisf mrtzon Iamasoloyopdotorarparinershipandhave,monpioyeesv�nrTcing-Ormein $. �Rel�oc��e�bg any capacity.PTO workers'cazap.insurance re[iuized-J 9 �Demol7tlorL 3�lain ahomaownerdohgaR-wu mysel� No�ozkers'camp_dnsarauoeracp�ued] 10 addMOR 4.FJ lam ahnmeownezac will beliiring casd[actorsto conductall vrorkonmyproporty. Iv1i11 11. Electrical re ain or.addifiaus snsnra#hat all cozztra ciazs eitherhaye wozkers'compensation.insurance()rare sole I�l p proprietary Vitt zro ein,'playses. 11 Q PJ.uznbing repairs ox addii;iorzs d,��am agenezal co�,hactor and�baye fired Phe sub-car?traatazslisted authe attarhedsheet. 13.'QRoaf repairs lhesostib-ca�izactarsliave�ix�pToyeesaudlrarevvoz3rers'anmp_msivance,� 14.a0th6S A'�./ b.FJ We,are a cozporatinn-pnd ifs o vers laaFe e ercisediheit riglrt o 'exempiian per l C is n. IS2,§l{4},andwetraYer}q.e�xaplayees,jNov,�orkers'comp.insnraacasecprired.] s. .. AiryapPliaantthatchacl sb�x#1masta1sn Ontdxeseetionbelow8hov&gfhticworleers'oomponseEonpc)EoyE nunation iHorneuw=rswho s-obx_it��a" davit�catingtheyaredoingaltv�orIcandthenhireorrisideecazfractorsmustsiy�mitazAevuaffirtav�indiaatzuginch �o efQ� e {t bowzr:us a��tachedanadditionalsheetshowingtb nameot:tie sub-ouniraotozsandstateWfietberozuotihoseOaatieshave ,. • Fp y employees, I-t'-tho sub-con racforsLa�e employees,�ieymustpravidethair Frorkers'coin olio nv3mbex re ara eraiproyert7zat sp�ovzc�cng�vorkers'c©rzzperasa olz irasuz�arzcefbrzaay err �oyees:'Bero7v is thepoZicy azadjo site irafozraaadom ` lIn Jumanne Compaaay NamO: Policy#or Self-Ins.1i C;. i C 7 �! r7~ y L pirationDate: � 7 lab Site Address: City/Statc&p: - ttach a copy ocl�ers'caax�peMatioazpoRaydeclarationpage(showingthepollcynnm-the MM expiratzoai[late). Faftureto secure coverage as zequiredunderMGl.m 152, §25A is a orhnjnal violation.p-r Lbhable by a fiuo up to X1,500.00 and/or arta-year h3apr�bonznent;as WeJl as c%vil penalizes the fozm 0f a STOP WORK�3RDBR and a�tne ofnp to$250.00 a day against tbo-' iolatOr-A,copy a£tbis statement may be forwarded to the Oflica of fnvostlgat6m of thoDlk#'ox inmraum coverage verification_ Iclo hereby offfify UYI&t'Aze p avdpe alffes ofperjzcry t aai the inlorrrtcctioaxproi ided above is due�d��I act, Date- (o Phone# Officiaz zis'e ora%y. -Do not-write iia Phis area,to die completed by city Or town officz-aL• Cty or Tom: Pe1ranilLzeense# lssniug A or�iy(P-irele 011e): 1.Yaaxd.ozlffealth2,.-13uffdingDeparbn.eait 3.City/Tmm Clerk 4. + eetrzcaI Zvi Pectar S.Numbinglaspector 6.Other CoWtact:Pexsort: )?hone#: IJOE v DR rylaVfOlT Q F ��f�1 w AMYEW ,. igr` q . z . / 8 42B PL AS �,` AMT'ST NANDOVEIt,MA 01845.2929 �U609�T9.2A15Rnv€�1.9C 9009 �' ,; ,, '� � �, �/ d�'i�W"1°�i� r,NInA�������Ak�1;�D�hV"d�� r '�'���w�d'&�'�tl✓�����R4"�"i�N, 6 + VE,1m r °� . D � J ,. T� JML1LMJ , r AVID GULEZIAN 428,4WILEASANT,ST 1,vkT r 9 kt b O"j 4 c8_001821 DAVID P GULEZIAN 428 PLEASANT ST f j ' / f�4 NORTH ANDOVER 7,cpVP �Mur ° "Ioinnoil