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HomeMy WebLinkAboutBuilding Permit # 9/13/2016 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION V� ; Permit:NO: Date Received I g CHU`^'���5 Date Issued: i �4SSAC IMPORTANT: Applicant must complete all items on this page LOC,4TtONIYXIGreene Street PROF�ERTI' OBER Aratlrc l�lark�� F Prat I�IAP NO �'ARCEL,��....-ZONING DtST�IOT��Itst C����� yep nor TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ® One family ❑Addition ❑ Two or more family ❑ Industrial E.Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg 11 Others: ❑ Demolition ❑ Other ❑Spttc ❑lett f=todPlat O Wd �elstrrct' crawlspace insulation Identification Please Type or Print Clearly) OWNER: Name: Anthony Moreschi Phone: 202-329-8702 Address- 95 Greene St. North Andover, MA 01845 CONI RAAfTR dose ARyrt lern�� ailr �laort �` f8 � A Shcltun Relillsr lilt SuUt�tl'8 Gortrto �l Lnse I DIt cs-tl��'I tl2t �"t�` ARCH ITECTIENGINEER 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: $ 2,788.47 FEE: $ . Check No.:. I l- Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access t the uaranty fund SEgnatureifAgetf3yver. ee. ached. Sic; #urs oftractQr - �ORTf Town of � tT, 6 ndover p cn O -LAK! h ver, Mass, 'Q COCKtC nlwK.t y1' AQ�RTE P p,Ps`�,��j S U BOARD OF HEALTH Food/Kitchen PER - LD Septic System • THIS CERTIFIES THAT ........ . ......aC'CS BUILDING INSPECTOR YYC Foundation has permission to erect .. buildings on ..... .. Rough to be occupied as ......CrAW6? ...... .1[`�, R................................................. ch mney provided that the person acceptin thismit shall in eve respect conform to the terms of the application g p every p pp 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 LESS CS TI Rough Service .. ..... ... ...... ... PW . Final BUILDINANS­*' PECTOR 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 DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. F4de+at@l06OiAd6tQ ti$C�Et tuering Rt � Qoko$fob � A Hitap of7hleistb l3tgioeerlag 6Ate=RWN0i1M C=pmAamK, ctry`h�►cooao CONTRACT ...... -�FAX40i423.1284 `rFri PROGRAM Pop4 CA1A-M +1 ► CUl700iR _ N PMN "B WAMN WOaxaatMia Anthony Matasots) tTOQ t)9104!?A16 434824 0011o(d 6aalaa6 eaiaElr ;"'�� r oarata otaatr 950wm avel a! > 95L9teatttsSlt t Gawn enr.eM1B W 'n? am nl7n kw MA Andover,MAOl i North Andmi;MA 01845 JOB DnQUPn0N A5F30NR-Pmpasat fartblscs;atdaryeor. _ WAS AIR SPAL1MViovtdelaharandwatorfabtosesle=ofymbmeagainstThissorkvdllbe pertbrmedtoaoncodcsbhrhot®eoffaltoolsend apAaattofeatstaam*ThatyourhomewilltoleftcathabedlthDAlovetof alrexchaa8pand kdoaralrqueMy.Matedalatotouaediosealyourhoutcamtnctadacatdks,Mme and other praduote. P&MY asses Ibrsealrnglnalodoarrlwbptoeltbs, notaa►mV add=d.)ThrivAll v*q*o(I2)w1kftho1M A r4ftlfon In QuV9W pcewtode(ofm)ofstrWtrafionmill oew,big the salml numberofattn Isnot Rsrenfeed. At the compWian of tho vrcalbecludion swrk,and at no sdMIDmI ooaf loft homema,a MW blower door eadkroomkolon aattary aa*dsxill becendaated by thembconiraclarto can tbosaWof the Indoor elrVANy.NOTE 1 OD11LD KM AMM ALLATTiC ARMSOUS TORVAC QONI'RACrORSWORK1HbtirHlLE WB WEROTHl1Rtd $1,0211110 AMMALINQProvidctaborandtmtakbtoowl arcasofyourbemosad stviestoild,newatrl a am Thismaritcdlibe prrlhrmedin owwd with tho smaoirVoolai tanlsaoddleffitoallatestataesmma Chet your domomill be teal w1h a heafibad levet of atrexche pmdltdooratrginlby.MatcrWstobewed lead your homecanrncludacsismtLamseadoft pmdada Prknary Mesar atlimbntamm%atluMIgMsandotber whewed tucasNndousom[tot g:neral�y addrea d)Thlsv6illregtW(12)vm*faSboumArodaattonInaftfbetparmlmAv(aths)ofetrlallrttat{o URI oaatr.but the uctwl member ofclhs is not p antad. At the o mptottca of tho watherWion vwrk,sad at no art 1oasl coat W rho hemeoamer,a Mal Vow door andfaraombolon raft aQalyarswitibocomWvdby the asd►oonlra�ctotto cnasetbasrfbty oftho tndaornir cpmtfty. $1.020AO DRYER NIM BR VE avow. $OAO A'lT1CACM Pmvldotabor awl matertalsto vvoalhemlp tho pertmeter of(4)stdo hatch vaifh Qom. $100.00 flASI1Ml�lf A�Provtdo�boraad mata€als to iaadalo the rode a8t6e basantenl door uilh 2�rlgWThatraarz board aadseai tba doofsadgp cvfth ctt�thcrs<rlpgiugto toetrlct aIr IaokegA $73.91 CRAWLVACIL-Ptovldo laborandmakdats to two(166spara fed of;will polyetbylanoovcr opoa Vomdin dedS*cd exavdspeoekarthoa tosa�sent arena $129.36 CRAWLSPACL:Prov[datdw and ma uMsto Install(96)sp o fat of Rr10 tUdThermax laadatton to than wA;n— partmetcrmull up to MOM and COW the bandjoist. $3$3.10 H[��est[tayplya0apptiasli�oltg toiaaattvastolhboatttraal. Yomallia*WNWtheft wow.ire*. fnrellglbtemea¢n�t7af��Qasotli:rs7595[aoantiva�net to ra<ead12,040 pert�leodaryeae,tmdao iaanliva of 10096 fiutbe Alr&sltrtgmessruastV to tbplrtat x680 andon a0lanal$340 if saving asojuSAMedby lbawaor. 0 i R RM gaglueeft F4 olni(t Wr Resuft F4 Qaatranior Ra�urntton Ko 6188 A dlviden ofIblelseh lbglueeriug VAQcnb*t rRsgtn m ton No ISO RISZ CaMpnyAddNU Ctly,WAQ6W �ot.ua.txaa trAx�ai.lxs-ia CONTRACT pop 2 PROGRAM �+ ,, CMA-10 E9t1< QUif�hme VHOlnf SAW CAZW MWOWN AalhonyMomchl (�02S g= t'fMW2016 4MW 00003 iriNVfOa D�1 �gltlq 6�tBaT 95GUne8fto 9s(keene1`l ut Notch Andover,MA{!1845 1Wh Andover,MA 01845 JOB DRSCRIMON For MeWNYandhcaithafyasrhomdstndooratrgaelhy,viewillbotondootbgablawdeer dWalcof1hoavailablealrifowia your home bMh Bofaratho%ork is6om,and after lhov►calhcrtralton me*itoomptato.%VcvAil 00 a W amwent or the combuglon wrdy ofyow heatingayatem and vater heeler.This has u vatae of$90 and b el no cost toyon Total ellaveVo ualhccfratEon l000ative t3b),1 It s;9oaa Total: $21788A7 Program htcenuve: $8,vrse Customer Total: $81087 tYHAQRaB N6R W YTa`FiRllfs8118�i1rteE8�CO�f91�r9 QIACAORaRtbQllYtfil A8QiY8aVaRG+IRA'l901f��'Cli1i18 81fA1 oP "'Six Hundred Ton&871100 tlollam $57087 0o slax�xlecaaitTiaarlFTxasuHis at�ocs6 TOM�A K==Q4ftWA0T1Ww /W900"OlumomwMIM mvjqc el oO e CASE# SIDING ;B CBRIC11" .j)CB/VINYI.�ALUM/A,(i ROOF ARCH -TAB/ COLOR Rl� , , VENTS BATH FLAPPER x�(�640 RIDG- ROOFxL!0-GA13LEx,.9 OK FOR WORK Y r 14 SOFFIT: NONE 01, ALUM I VINYL DEPTH COLOR 11 1,1. STYLE 16" VS I W 1,If/l ill cw rr-.5, VW4 vamomman,"roo, cc c e,,ss HA c,- ILS It 4 Y, Ile, fZ/9 �-o ceflj�wq J 0 FLAT OKNEEWALL [DWALLS 0 AIR SEALING L^iADDVENTS 0 MAKE ACCESS D SLOPE DKWFLOOR DKWSLOPE 0 SILLS EXISTING ACCESS RISE60 Shawmut Road,Unit 21 Canton,MA 0202111339-502-6336 ENGINEERING; wwwXISEengineering.tom OWNER AUTHORIZATION FORM I Anthony Moreschi (Owner's Game) owner of the property located at: 95 Greene Street (Property Address) North Andover, MA 01845 (Property Address) hereby authorize , (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property.This form is only valid with a signed contract. � s ignature Date EC � MAY 2 7 2016 The Co n- oulvealth ref Massachusetts Department of Industrial_-kedde-its 3rzce of;uvesti, do s 600 Washi-tgron St. Boston,-PyLk 02111 .7nnss.zoti%ria Worker's Compensation Insurance Af-fridaldt: Builders/C on_ractorsiTlectricians/Plumbers Application T_nforrrration—Please Print.Legibly I4ame {gusizessidr an=za on ndividaai/C7�vner:�i itGi: l� TG�cdefhbs u- Qn Arldress= a-,-� A. S --t W A sal 0ty/5tatetZ1p:Bt J;S(-ICA -1-AA.c:i t r Phone r z e you an eraployer? --k-re you the homeowner? Greek the appropriate number- z 1. I am an em-13loverwith number- J2' (xull andinr part-time. am a sole proprietor or partnership &-lime no employees worldna for tae in an,:capaeiL. ;. I am a home-ov.mer doing all .'ori;`myself. (ivo workeers compensation insurance required.) 4. r am a general contractor res I have hired the sub-contractors listed on the attached sheet. € (These contractors have tiYorlters comp.insurance and I have attached a cov of'their ins.) 4. We are a corporation ane its officers have exercised their ri ht of exemption per NIGT.L-J32ys i ' (.a),Mrd-we have no employ em(11-Nio workers comp.insurance required.) r a n appiiasnt that,Checks Eos-r mast,a€so fM out the section beros showing"heir workers-cot=.np.policy information. = Rlotrawwv r-z Syne$LLilm?[C t5 refit�:1'v i[In:?€c:LEi nw:they are 46rig all ml-ane:a»rs Sul'.: n Cnni:,actors that check this pot must aitacn.aa addr5onni sheet shotisii;s:t€te name of the sob-con-mmlors ural thcirworkers' compensation policy informalon_ 'type of project(required). Checit:rpproprinte�–. 1 6- Neil. Construction :, _RemodeHn—8._D-Molition 9. Buildinz a��?dxt on 10. lectricttl i . Plumb. 12. Roof�3 �i3the, rsc'_1aA6;.. n Jam an emptaver that is prcridi"g n°or€tors'cu:npcnsation insurance for n1V^_tni)noV ees. Berm1 is the ooticy&job site info. Insurance ca pang-Name: Policy>`=or self-Ins-Lie. Eipiration Date: job Site Address: Bach a copy of woriter`s eorint nsaiian policy Fieclarrttivn pawn(sha��ist�tale palica zumper artlehun of c [late. hailure to se-mr:coverag4 as requirea under Secdoa 35 A of it�lFLc_ i 3?can lead to the hwosit ati of Amina! ceaai:ias of a'erne up to S1s�0(}.'JO ardr or onu year irnprisnart:.ri ,as et e as civil penal;les in the form of a -'TO-'P �VORi-ORDER airml a fiae of up to S250.00 a d;v against the Aolation. Be advised that a copy of this sraaerneat tna;he,forwarded to the O�Le c)Ea��estisatioris of rlte iDi A for insuranc4:overawe Izn icatioa. do€terzby cel i ladder;hz pains arta nz aloes df otdi t :hat the ir�fa��nLLiian provided goo a is Erece and vnrrzct. Of rciat use ordv: Da not.rite in this a=7 to be completed by cit.-y or tovia official- Ci f ficial- 1 Ci Cor Toeno�: Partain.'Ucem-- . iss€zir,- '!udlzori y (check oi7e) - � t. Board;of�iealth Building Dept- s�C.im'Tovm Ciera –'._Eleadcal Lisp. a_ Plumb&vias o—tither__ i I Contact Person- (print) Y Phone1 CERTIFICATE OF LIABILITY INSURANCE y DATE______ DIYYYY, fi1'13121312016 PHIS 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 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). ODUCER CONTACT NAME: tomatic Data Processing Insurance Agency,Inc PHONE FAX LDP Boplevardc No Ext: Arc No E-MAIL seland,NJ 07068 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC q _ INSURERA:5Star V3 AAIC American Alternative Insuran 'URE° Merrimack Valley Insulation Corp INSURER B: 23a Sullivan Rd INSURER C: North Billerica, MA 01862 INSURER D: ��.. INSURER E. INSURER F: )VERAGES CERTIFICATE NUMBER: REVISION NUMBER: PHIS 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. R TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY—EXP LIMITS Z S POLICY NUMBER MMIDDIYYYY MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL UABILTIY DAMA _. PREMISES Ea occurranc $ CLAIMS-MADE 1:1 OCCUR MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY jE T TOC $ AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT �Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED P BODILY INJURY(Per accident) $ AUTOS AUTOS } PION-OWNED PROPERTYDAMAGE $ HIRED AUTOS AUTOS Peraccident UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ r,E—D—F I RETENTION$ $ WORKERS COMPENSATION X WC STATLI- OTH- AND EMPLOYERS'LIABILITY TORYLIMTS ER ANY PROPRIETOR7PARTNERIEXECIITIVE Y1 N V9WC749118 5118/2016 6/48/2017 El,EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? --°-- (Mandatory in NH) E,L.DISEASE-EA EMPLOYEE $ 1,000,00 Ifes,descdbe under Tmm"m ❑ESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $ 1,000,00 .SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is required) ERTIFICATE 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 ©1988-2010 ACORD CORPORATION. All rights reserved. CORD 25(2010105) The ACORD dame and logo are registered marks of ACORD Office oConsLllxlerA fairs and B' Usiness Regulation 10 Park Plazg-Suite 5170 Boston,Massachl.lsetts 0-9116 Horne III1lJI04ieI71elkt Cow rCt07le StraticIl ReDistration: iscism TYPe: Corporation MERRMACK VALLEY INSULATION! CORP Expiration: 1112412016 :-rc 260324 JOSEPH RYAN! 23 A SULLIVAN RD BILLERICA, Pt/1A 05862 U ltcintr. dt)t rss rntl return c trJ.,,or,,reason for chano il- ReneK•aImplovmetlk Lost Card OrGce nfConsumcr_1lftirs3 uusine.s Regulation License or re++ lA�1P1pROVEPrEidTC()h1-,Rr o zr3tiontiolidfvriudivitiuluseoniv ,r eglstration- 1805506 tC'01Z before tite e.iairntinn date. If found return to_ Type: 0'Ii =srai�tlon. itf24f2418 cc of Consumer AfElirs and Business ReSuiasinn ..r. Corpomiton 10 Park P13z3- SuitcS170 MERrRMAC.ICVALLEY Ir.SULfiTIONCORP Boston. L� 02116 JOSEPH RYAiI 23 A SULLIVAN RD r- rpt 13dLLERICA,ielA 01862 NUT Valid rtittlaut signnturr 41 � rho :a"t oS C tllSE ' �vGa,t^..t v. ,./•+.ti�i .. Y ", lc.tivi 411+.3 54xMf,u_,.._e.l SO:CS-075549 -A 20EI�I n.SA Rail Dr,.-Apt 2{i1 L,ynnfield Kk 0040 _ Cc ,•,.., .Q.;ar 0210412017 -