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Home My WebLink AboutBuilding Permit # 9/1/2016 BUILDING PERMIT O� NORT}� ,�KLea TOWN OF NORTH ANDOVER 3 N EXAMINATION o APPLICATION FOR PLA Permit No#• Date Received nreo.P0.�{y ss.acNuse Date Issued: MPORTANT: Applicant must complete all items on this page LOCATION � O C Print " PROPERTY OWNER_L �t Print 140 Year Structure yes o MAP PARCEL: ZONING DISTRICT:_ Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, eplac n� ❑Assessory Bldg ❑ Others ❑ Demolition i t 11Other r TlItersled a�str�ct . �❑ �eR tic ,❑.WeIJ`�, <t7 Floadplatn ❑:Wetlands �, ❑WaterlSewer.: ,. �. .. .;: �` .� ,, �...; ,� � :�. �, .F y.. DESCRIPTION OF WORK�TO BE Y i PERFORMED. 4 Identification- Please Type or rint Clearly OWNER: Name: 'ry C Phone: Address: 4 � � Contractor ame: � `t-t � hone: I' Email: G^_S- Address: Supervisor's Construction License: c_ � 3 0 Exp. Date: -c (A I b 7 Home Improvement License: Exp. Dater ARCHITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE.,BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. y Total Project Cost. $ �.� FEE: $ Check No.: Receipt No.. NOTE: Persons contracting with unregistered contractors do not have ac the guaranty fund 4 %AORTjy Towe. of 2 _ ,� 6 ndover 0 No. � = so h ver, Mass a-bW 1.2alt, Cac"Sc He W I[K AERATED S u BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT U. +� BUILDING INSPECTOR .....................�.J. .,...,......... ....,.... .l4rr:. .....................,... ... �......................... Foundation has permission to erect ...... ................... buildings on ...... . ........, ...... .. .. t Rough • T _.... to be occupied as .. ... -..,,,.,. M .. Chimney provided that the person accepting this permit shall in every res1pct conform to the term.....................s oft iplicati 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 MO S ELECTRICAL INSPECTOR UNLESS CONST3M71 T Rough Service .., .... .... .......... ...... G 1NSPE TOR Final GAS INSPECTOR Occupancy_Permit Required to Occupy Building Rough Display in a Conspicuous Place onl� Bethe Premises — Do Not Remove Final No Lathing or Dry Wall To Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. [�ED 1"AH., CONTRACT#81316 733 Turnpike Street Unit 192 Morth. Andover, MA 01845 DATE:8/30/16 Phone: 978-273-4397 E-mail: www.rdtail.com .............................. Scope of Work Address: Jerry and Jacque Margolcyz 46 Foster St North Andover,MA 01845 Thank ou for choosing Red Tail Construction---Scope of Work Agreement: Item Item Description Scope of work: I Front fascade of garage: remove existing trims, install new AZEK trims at corner boards, around $7,430.00 garage doors and around upper window;remove damaged clapboards and install new hardi- ,elank clapboard siding. Weather seal all; all debris removed from site. w,V40w JP_'LS F'<kfAv", 'Ay We Appreciate Your Business. Total All Segments : $7,430.00 Payments: Upon Start: $2,100.00 Upon Substantial Completion: $2,600.00 Upon Completion of punch-list/project: $2,730.00 Red Tail Construction., Inc. 733 Turnpike st unit 192 North Andover, MA. 01845; CS License # CS-094338; HIC #155649; Contract begin scope of work on 8-30-16; completion by 9-8-16 Approved by: Jerry Margolcyz Steve McCulloQh Red Tail Construction Inc Flee Commonwealth ofmass�chuseas F .Depagment ofindustrialAccidents I Cangreswshvet, saMe 100 d Bastap,MA 02114-2017 , lvwll.rrtas,.govldza W'otkom'Coxop6asationInsurance.A:ffldavit:��iderslCo�z�rac�oxsL�Zectriczazisl�X�n�axs, TOB,FICA]WITH THS YERMTTING AUTHOR=. Tj`YIr.��yqyy�� Applicant Woxmati„on,y�,,,,,7 p T{ N / r / Please l'xzat Le X ,S,`{fj.f.. o (J��sinei.S'doiga�ation .11�3.v;ldnd): ` 7 lil � Address 8, atY p Ave you an employer Cheekis aplirOPnate box: Type as project(rqgrrls ed): 1. I an a amployervdffi . I.. ! employees(Iull andfor part tune).* 7.. D N W roust; Dtlon 2. Iamasolo proprietorarparlnershipavdhavonoemployaesWorkh%formeiu 8. XROMOdo1lig ally capacity.[7o workers'comp.insurance,regukod.1 9, Demolition 3.E]1 am a homeov ner doing all work myself[mo workers'comp.dumauco inquired-1 t 10 n Ba#g addition 4.D I am a hameawmraud will be hiring contractors to conduetall work onanyproparty. I vrill ensure that all watraotors eitherhave workwZ cempensatian insurance or are sole 11, Electzzcal xepairs or additions proprietors-withrzoeinployces. 12: Plambing repairs or additions 5.FJ I nm agenaral o;zrltracfor and I haye hired the sub-contractors listed on the attached sheet. 13; Roofxep airs These sub-contraetarsliav�euiplaycCS andlraveworkers'comp_inscuance t ' 14.E]Other 6.F]We are a corporation.pad#q oM.9ars have exarcisedrhek right of exemption pe-r-MCL c. andwehavevq.e�nployefs.jNoworkers'camp.ansuranceregnixed,� Any appliicantthat cheoksbox#tT must also Edt outihe sectionbelow shavingtheirworkers'sampmsaiionpolicy Womlation i Homeov,=mrs who sirlimif'�ai�affidawthxhcatingthey are doing allworkandthenhim outside contraotors mustsill}mit anew affidavit irtdicaiing such tcontmotors}batchockihisboxuws'a`[ac�tcr an additional sheetsl�awizzgtl nameofthesob-contractors andsfate etTzeror ot[hoseenti eshave employees. 1£tho sub-eoritra cors have employees,!liey must pravicletheic workers'comp.policy number. p I cz n an erriployer 17z at isrovidmgVDrrt ers'cavzpewation tnsuranee f r my MT&Yem'.Bel01v is thepolicy andjob site - TnManoe Company 11Oli.Cy4 or�elfw.lns.Y,1 .#: S l 2— Expiration Date: 1 sob Me l ddzess: `1 i b �`i � ' " ` tCity/tatep: (l"v Y-70 Attach.a eopy ofth.eworke's' cbmpeusa jon policy declaration.page(showing the policynumbex and expiration.date). Failure to SCoura coverage as requixed imderMGL c. 152, §25A is a criminal violation pu ishable by a fico lip to$1,500.00 and/or one-year ivxprisonmant,as well as czvilpanaltxes inthe torxu.of a STOP WORK ORDI R and afin.e of-up to$7,50-0 0 a day against tho violator_A.copy of this statezn t may bo:C01varded to ffie Ofco oflnvestigatians ofthe-MA dor inmixanca cove.rage verifloatiola.. Acro hereby certify uxsd-er tree-P imaffies afperjzzry that the informadonirrovicle�ah vie as ru Fa coir tet. L Si ate: / Dato: , 7ZI Phone#. Of,ficial uge only. Jl o notwrite in this area,iO he corrz�rlefed by city or z`apprz of,ficial, City or Town l'exmitlLicense# fssuing AAut orhy-(circle one): i 1.Board.ox Heaiffa 2.Bnildi ngDeparbneut S.CW/Town Clerk 4.Electrical Inspector 5.Plumbi ghispector S.Other Contact Person: 3?73 an e#: CERTIFICATE OF LIABILITY -INSURANCEDATE(MMIn❑YYY) T TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. S 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 DKERODUCERL AND THE CEETIFLQTE 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such Endorsement(s). PRODUCER CONTACT NAME: STARKWEA7'HER 8c SI IE:PLEY PHONE FFAX60 CATAMORl,131.VD (AIC,No,Ext): o): E-MAIL EAS'I'PROVIDENC E,Rl 02914 ADDRESS: 22111 IX INSURER(S)AFFORDING COVERAGE MAIC# INSURED INSURER A: TRAVELERS INDFMNI1 Y COMPANY OI°AMERICA RVI)TAI1.CONS-I'RUCIION INC' INSURER B: INSURER C: 733'1'URNPIi<l:S'1'UNIT 192 INSURER D: INSURER NORTH ANDOVER,MA 0184S INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S 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 15 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADA SUB POLICY EFF DATE POLICY EXP OATS LTR TYPE OF INSURANCE L R POLICY NUMBER (MM%DDWYYYY) (MMWDD%YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LABILITY S CLAIMS MADE OCCUR. DAMAGE TO RENTED $ REMISES(Ea occurrence) ED EXP(Any one person) S GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY 5 GENERAL AGGREGATE 5 POLICY PROJECT❑LOC PRODUCTS-COMPIOP AGG 5 AUTOMOBILE LIABILITY COMBINED SINGLE 5 ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY � � 5 NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMS.MAOE AGGREGATE $ DEDUCTIBLE ;$ RETENTION S $ A WORKER'S COMPENSATION AND we STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-9F557612-16 03/19/2016 03/19/2017 LIMITS ANY PROPERITORMARTNERIEXECUTIVE N NIA E.L EACH ACCIDENT 5 OFFICERIMEMBER EXCLUDED? 500,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE',$ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIRESTRICTIONS!SPECIAL ITEMS THIS ItEPLAUFS ANY PRIOR C'fiR I'IFIC'A I li ISSiJI'D'€'b TElli('lilt'I'lI 1C'A'ffi HOLDER AFFE I'ING WORK1iR%(COMP COVERAGE, CERTIFICATE HOLDER CANCELLATION Jerry Mal' OIC Z SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED y y BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 46 Foster St IN ACCORDANCE WITH THE POLICY PROVISIONS, North Andover, MA 0 1845 AUTHORIZED REPRESENT ACORD 25(2010!06) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. c rt1,s SF�s uepameni ai public �are;y I > 3_ 114inq Regulations and Standards L"Cense: tS-094338. :rU-C on St:pervi§or S-fEPHEN A'MCCULLOUGn 733 TURNPIKE ST U-1,92- NORTy ANDOVER M,4 01" '. �orlm,_S;,,e_ irxpiration: 09108/201i - - �rz� (I,aTi�nrane<ea�a�C�/�p,�Arzc�uJeL�S,: Office of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR egistration:- i66649 Type: xpiration;; I302f17; Individual . STEPHEN MC CULLA, STEPHEN MC CULL66GH 733 TURNPIKE STREE=T KD ANDOVER, MA 01849 [tndersecretary