Loading...
HomeMy WebLinkAboutBuilding Permit # 9/29/2016 tkORT111 ' BUILDING PERMIT ',LED li N fy TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date Issued: L PORTANT: Applicant must complete all items on this pale ...... OROR—_ LOCATION >61 P .nt PROPERTY OWNER 1� //7),0 Ar- Print 100 Year Structure yes Cn o MAP '56 PARCEL. Print ZONING DISTRICT:--------, Historic District yes no Machine Shop Village yes no - ---- -__---- .......------ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 11 New Building /One family Li Addition r]Two or more family 0 Industrial El Alteration No. of units: El Commercial —-—--------- 0 Repair, replacement U Assessory Bldg Cl Others: El Demolition E Other DESCRIPTION OF WORK TO 1131� PE 'ORMED� Pla'r_ "C'y Identification- Please Type or Print Clearly OWNER: Name: w i two� - 6 Phone: Address: a.-,5 /7-7 1--,-2 ------------------ Contractor Name: Phone: Email: o Ae a a d Address: 2r Z> *—? c- Supervisor's Construction License: J '9 Exp. Date:. HomeImprovement. = =_ t � ARCH ITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. ku Total Project Cost: $ 6V) c,u FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contra - ors d zothave Ss 0 the guaranty fund ,7 LO f `AORTli n of z �. Andover o Noy -v 1 �7/,,�`SQ�R.tiTEriO ►'C4FAV,� �S Lvjw 29, 2AIP 0CLKv ver, Mass [pNIClWU BOARD OF HEALTH Food/Kitchen PERMIT. T LD Septic System R • ; � BUILDING INSPECTOR THIS CERTIFIES THAT ...,... .. .. ...,. ...... ....... ................... •�,���• ...clom��#4 Foundation has permission to erect .....buildings on .. .... .• •• .. ug 1 .... ...... ..... ...%A6 . ..................... Chimney to be occupied as ..aM+�3 .. ...r' . ............. '' ''- rovided that the person accepting this permit all in every respect conform to the terms ole application Final p p Iteration and on file in this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Construction of Buildings in the Town of North Ando verY��C� ` Wj v,.5 PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS C®NSTR NT7k�mv Rough Service ... .... .... ..�... Final BUILDING INSPECTOR GAS INSPECTOR oceupancV Permit Required to Occupy 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. i \tel { CUSTOM BUI'[ LD ) NG Y 1ZEMODELfNG i i This agreement made this 2211 day of July,year T ko thousand and Sixteen by and between Cote and Foster Contracting, Inc.hereinafter called the Contractor and Rhea Simon-Skoler,hereinafter called the Owner,witnesses that the Owner intends to repair& replace windows and exterior trim at the address of 64 Phillips Common,North Andover, MA. Now,therefore,the Contractor and the Owner,for consideration hereinafter named,agree as follows: i ARTICLE 1 The Contractor agrees to provide all the labpr and materials to do all things necessary for the proper construction and completion of the work shown and described on drawings. The drawings and specifications are the basis of the contract. ARTICLE 2 I In consideration of the performance of the contract,the Owner agrees to pay the Contractor,in current funds as compensation for hi services hereunder$40,809.00 to be paid as follows: i Payment 1 -$15000.00 at signing of contract to order the windows Payment 2 -$15,000.00 at start of world Payment 3 -$5,000.00 at completion of windows Payment 4-$5,809.00 at completion of trim repairs ARTICLE 3 Final payment o6 contract amount as agreed above to be paid within ten(t 0)days of project completion or occupancy.'' If final payment has not been made within this time a 10%charge per month on the balance due willbelicharged. All minor punchlist items will be complete as part of the one year warranty on the finish product. Failure to pay balance within in ty(90}days ay'result in legal action. an, Initials: 20 Aegean Drive'• Unit 15 •':1V1'ethuen,MA 01844 Tel:978-682-6518 • Fax:978-682-1221 www.coteandfoster.com l ARTICLE Additional work above and beyond the contract agreement: All additional work done to be quoted at the time the client requests the work. The work will be done and billable at its completion. The client has ten(10)days to pay the additional cost after he or she has been billed for it,. Initials: In witness whereof they have executed this',agreement the day and year first above written. li Rhea Simon-Skoler,Owner Steven M.Cote DSA Cote&Foster i i i The Connnolliveaftil of M,088acluffseus Depfl;,jj)jejij of.TtIdustrial A ecidefdS Offlee Of 1191resd9fitioNs -eet 600 WflshifigrlM SO MA 02111 V. Workers' CoIrflpensation Insurance Affidavit. lmr Builders/ContTnetors/FBef-triciOus/inpube ' please prt Le *b J\Tarne(Business/organization&dividual):_ 7-6 0 C 6 LC rj I\r Ab Address: 4 0 City/StateIzip TY11(A( .,.MPhone ff-------- A i ct(required): Type of project ployer?Chech the Appropriate box: e 0'pr _tor and 0 FAre you u laIlIn e 7 r I outra ew r 6. 0 New cOnstructiOu 11, am a general contractor and I general I T Oyer c�the su�.C�n ac aIs Rom _M 1.0 am a employer With have hired the sub-contractors Culp 0 0( employees(full landlor part-time).* 7, Remodeling UU ligpd on the attached sheet. s(f em Yee' I a sale proprietor or partner- 0 em These sub-contractors have , 0(Demolition sale proprietor a 011 2.0 ,rn a ship 1 0 ju hip and have no employees employees and have workers' 9. Building addition ,,Working for me in any Capacity. i I , COMP,insurance. 100 Electrical repairs or additions [No Workers,COMP.insurance 5. We area corporation and its repairs or additions required.] officers have e3cercised their 11. Plumbing 3. 1 am a homeowner doing all work right of exemption per MOL 12.n Roof repairs myself.[No workers'comp. c. 152,1]1(4),and we have no 13.[] insurance required.]t employees.[No workers' ptlier COMP.insurance required.] 01111 out the sectionliclaw showing their 5Viitker-q'compensation policy information- ilitity applicant that checks box#1 must also al)Nvoric and thert hixc Oluside contractors must stibruit a nexv affidavit % csull. t l4ameowiters who subutit Otis affidavit indicating they are doing tois and stale NvIledIcy or not those entits have lConuuetars that checit this box must allRellcd an additional sheet sh6xting the game offila subcontrIle employees. If the sub-coametors have employ—,they must provide their Workerscomp,policy number. es. Below is thepolicy andjob site con1pe I am apt empfoya"filat is 00111diplg 100ricars' �nsatjan j,1511rancefol.pply einploy,p M rY2 1,/,1 e b U,5 rr-. Insurance Company Name" Expiration Date: Policy#or Self-ins.Lic. 9 t2 M PC C"ity/State/_7ip-/\(d 47—W- Job Site Address: 6 )�� - k/01 compensation policy declaration page showing the policy number and e*raltlOn date). Attach a copy Of the wOrl"ers' lead to the imposition of criminal penalties of a cure coverage as required under Section 25A of MGL c. 152 can Failure to se civil penalties in the foro,of a STOP ORDER and fine up to$1,500.00 and/or one-year imprisonment,as as well rwarded WORK to the Office Of a fineof up to$9.50.00 a day against the violator. Be advised that a copy of this statement may be fa Invesfi- flons of the DIA for insurance coverage verification. Ma at tile illf0j,111adan provided above is trija and carred. I do jjepgkV eardj5v under jilepaills andpenaldes Of leer fit Date: L Phone 9: Official 11.3a only. Do not Write in this area,to be colliplefed by eftY 0Y fOU'll Offic! Per"AtiLicense City or Town' Issuing Authority(circle one). Plumbing Inspector 1.Board of Health 2.Bading Department 3.City/Town Clerk 4.Eleetriefli IMPECtOF G.Other Phone#: Contact Ferson i g �+ oATE(MMIDDIYYYY) CERTI IC A-g' F L®t A 1L8 Ti lE INSURANCE 12/21/2015 THIS CERTIFICATE IS ISSUED AS A MATTER'1OF INFORMA'T'ION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY! AMEND, EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE1 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(!")frust be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the pol[cy,certain pol[cies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(sj. PRODUCER A COME:NTAC 'Victoria LoWeS, CISR MTM Insurance Associates PHONE . (978)6815700 Armee Na:19fB)681-5777 EMAIL 1320 Osgood Street uRrzss:vickiel@mtminsure.com I INSURERS AFFORDING COVERAGE NAI C# North Andover MA 01845 INSURER1A:State Auto Insurance INSURED INSURERIB:National Liability & Fire Ins. Co i Cote & Foster Contracting, Ina INS URERIC: 20 Aegean Drive IN5URERID: Unit 15 tNSL�RER�E: Methuen MA 01844 1 INSURERIF: a COVERAGES CERTIFICATE NUM BER•] 5-16 16-17 W'C REVISIONN NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED;BELOW HAVE BEE THIS 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 CERTIFICATE MAY BE ISSUED OR MAY PER7AiN,jTHE INSURANCE AFFORDED BY HE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BE EN REDUCED BY PAID CLAIMS. WSR pOLICY:EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE L R POLICY NUMBER MMIODfYYYY MMIDDfYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA AGET RENTEO 100,000 A CLAIMS-MADE51 OCCUR PREMISES Ea occurrence 5 PBP2747539 '2/31/2015 12/31/2016 MED EXP(Any one persan) S 10,000 PERSONAL&ADVINJURY 5 ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMPIOPAGG S 2,000,000 X POLICY❑JECI El LOC ! S i OTHER: COMBINED SINGLE LIMIT 5 1,000,000 AUTOMOBILE LIABILITY Ea accident BODILY INJURY(Per person) $ 20,000 ANY AUTO p' &— M SCWEOULEO UM2370166 03 _ ]�2/31/M5 12/31/2016 BODILY INJURY(Per accident) S 90,U00 AUTOS ' PROPERTY DAMAGE S NON-OWNED Per accident X. AUTO5 Medical a mentsS 5,000 OCCUREACH OCCURRENCECLAIMS-MAD>= - AGGREGATE S ENTIONS WORKERSCOMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY YIN E.L. ACH ACCIDENT �$ 510 ANY PROPRIETORIPARTNERJUEcunVE OFFICERIMEMBER EXCLUU£D? -1 N 1 p' i B' (Mandatory in NH) V9WC709549 6/20/2016 6/20/2017 ISEASE-EA EMPLOIf es,describe under E:L.D]SEASE-POLICYLI O SCRIPTION OF OPERATIONS below f j 1 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder as listed balowr This certificate of insurance represents coverage currentlq in affect and may or may not be in complia»aa with any written contract. 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 ACCORDANCE WITH THE POLICY PROVISIONS. 384 Osgood Street 3QOrtP1 Andover, MPi 03845 AUTHORIkED REPRESENTATIVE i P MacDonald CPCU, CIC fdL�°l9`Y ©9988-2074 ACORD CORPORATION. All rights reserved. ACORD 26(2074101) The ACORD name and logo are registered marks of ACORD INS025 onuntl r ass'acliusetts -Depart[ment of Public Safety l Board of Building R9 uia.tans and 5ta ;:aids License:CS..0851T3 iri , v T FOSOR WILLIAM 65 COAD DR DRACUT MA 01126 Expiration .. 11Ii0l20i6 Co¢nmissioner r f�r+�ana��ra��enPrrf/�o� J,-_\.Qft'ice of Consumer Affairs&BusinessRegulation TOME IMPROVEMENT CONTRACTOR w jRegistration: 107602: Type: Expiration: 815120 f8 Supplement Card >. COTE&FOSTER CONT, WILLIAM FOSTER 20 Aegean Dr Unit 15 Methuen,MA 01844 Undersecretary