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HomeMy WebLinkAboutBuilding Permit # 11/14/2016 OEM TOWN OF NORTH ANDOVER µa�Th APPLICATION FOR PLAN EXAMINATION 1a A Permit NO: 6c I "fit 7 Date Received �A4TRA nY�".�y 9SS�CKusE< Date Issued: IMPORTANT:Aeplicant must complete all items on this page LOCATION /1 Q vt=! eelkoci P .nt PROPERTY OWNER / 6 � � z':?,q Print MAP NO.: PARCEL:U I ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES D TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential 11 New Building H One family [: Addition I I Two or more family E Industrial ❑ Alteration No. of units: X_Repair, replacement ❑Assessory Bldg ❑ Commercial G Demolition Moving(relocation) I I Other 11 Others: D Foundation only DESC. TION OF WORK TBE PRE ORJMED 1�j 4-rV rr9" ✓� C lce, ��J )44,. V Z5,7 ,i l Identifications Please Type or Print Clearly OWNER: Name: Phone: Address: A2 CONTRACTOR Name: R )_P90 Phone: . 7'Y 360 '5 20 ' Address: Supervisor's Construction License: "� � Exp_ Date: 12& Re 1 7 Home Improvement License: Exp.Exp. Date: I� I ARCHITECT/ENGINEER -- Name: Phone: Address: Reg. No. — FEE SCHEDULE.,BULDING PERMIT. $12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 7 130 a " xl2.00=FEE:$ Check No.: ~ 5 9 Receipt No.. 1 I Page 17f 4 1 'T �ORTey own of � Andover ® No. P h A" ver, Mass, /top /y• 'go/(P COCNICMEwicu .AS�RATED 1''4A,`,C� 1j BOARD OF HEALTH LD Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT ....... „ ....,.,, .. ... ...... .. ....,.... . ...1911P.7%.4. ,. ,# BUILDING INSPECTOR . , .. ,. has permission to erect .................—...... buildings on ...��. ..,. �.��P� Foundation Rough ................. .e.,.,......, ...,..... .. ........................................... chimney to be occupied as ..... provided that the person accepting this permit shall in every 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ................................................................................ Fina BUILDING INSPECTOR GAS INSPECTOR Occupancly hermit Required t® Occu,2v 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. � ` NO r=-V REAIODr 56 Pleasant Street Methuen, MA 01844 Phone/Fax: 978-688-3944 Company Email: Dave@DavidReitanoRemodel.com Proposal Date: 10/26/2016 Submitted To: Mr. and Mrs. Souza 110 Waverly Road N. Andover Ma. Email — Sob Description: Roof I We hereby submit specifications and estimates for: i *Complete house and garage roofing shingles will be removed completely. All debris will be removed from jobsite. Dumpster will be supplied by contractor, location to be confirmed prior to delivery. *Complete roof will be inspected for any decay. Contractor allowed for 64 square feet of miscellaneous sheathing replacement. j * Ice and water shield will be installed on lower 6 feet of roof edge. synthetic building fabric will be installed on remaining areas of exposed sheathing. *Complete perimeter of roofs will have 8 inch aluminum drip edge installed. All flashings will be inspected and replaced where necessary. *Complete roof will be re-shingled with a Architectural style CertainTeed Land Mark asphalt type shingle; properly fastened and secured. 1 *Venting system will be a continuous vinyl ridge vent on both garage and main house. Above total price -$7900.00 1 j. �� '1'/rc' C'nrrr►rurrrll�efrltlr of 1l:Irrssrrc•/rrtsetts I)c�lxrr•tnrc�lTt of Inrlrrstrirrl.Ft c•c•irlc�rrts -- ()ffce of 1r vestrl,'afion I Cara=r ess Street, Suite 100 13osltrrr, AM 02114-2017 ���� 3l/11'11'.rrTlrS'S./,'UV/Cltfr Workers' Co lit pensatim) lrisiltrance Affidavit. 11"ildc -sK lontractors/Flectt•ici:tlislPltititIlers A � ilicattt Inft►i•niatiott 111c€tse Prirti Legilii' r1 � �ta3iiC (ISusiney;'[)€�..utiialitln'In11i�'i,itr13):��}yl L _ ___. !fit ltc/l.ip: t F� �l M4 r Are ri►u an c►Itpint'cr':('heel. tltc:€l►pr'r►pritite hom Type p of project (r c(iatt c(1}' I. 1 am tt employer w'ilh l ❑ i €11n a ;coccal cuntr,tctitr,utcl I 6. ❑ ?New consttticttun cntltlovees f 11111 and (Ii.part-timel.' h<€vc hired the pub-cunuucturti Iismed tett the imadled tihccl. ' 7. Rcntaeiilili 1-1 :1.❑ 1 am a tcslc ltt(spriclor'ur partner- g, El l)cn€(shtion spilt anal have no crnitlovices l iese salrconl€actors have ya ork int, fur ntc in any t opacity. clnplo)'ceti and have yn'utl.crs' y ❑ 13ttildin� addition cuntp. insttrrutcr.'* [No yvorkcrs' comp. irt.sariatct Iwo vlecn-ical repairs ol-od lilic,n." �. ❑ 1�'c lrfe,t c:orporaticnt and ns, re(luirccl. officcr-s have cscrefscd their ! l.❑ 1'lcntlbini?,repairs or additions i.❑ 1 aril st lu)ntcow€ter dont! €sll tirorl; ri ht elf czemltiion per N461.N461.myseIF. INoworker~' com, p. 12,El Rool-f'cpaits . , `1(4), and (+:e have Ill)ists€t1'€utce rcduircd.� ' c 1-2I i.❑Otter - ctn tlovees. iNo llvoi-kcrs' - cuntp. msur<€nc'(' reclaircd.1 "Am ulltrllcalll that rhvcks 60.E 1 1 rnua clisn fill 0111 t I I C�ecti0n beIPu shomlntt their workers-co11111cn,11{i0❑ otscl islilrlauunn. i I1r1111COM11F I5\11111$Ill)11th Ih Is grfidn'lI 1131 11i;t l l Flt',IIICV ail'dollff.:01 woll,ill Id fliell ISI Ic.olaNidc Col!€ ad 1lrs Must submil:I Slee\ irllldaPSl EI1(hw3nr11',Such {'imiachlrs 111.11 clluck Ill's hae nrllSl a€tachcd nn odd itit)nA shed slit,uiItg she 11;snu csf Ills soh-cllsurliann 1u1xt stat(7 n'Ilctlscl ur ml{tlmse cnuuc>"ZINC VIIlttimecs. I I II1c mtt1-co lada furs bare cIIII)11+L res,tll,:s plot l llros ide II1vII lit nsher I am an enrplo-Ver that is providirrl; svurhe•rs ..ompensation insurance for mY eniplupee•s. Beton,Is lire polies,and job.cite iuJrrrnurtinu. 1 . Inst€€'�€ncc(•(ttitpa€t)• lis€n)c: I`rsliry or ticlt-ins. I.ic. �I: et - ..._ I.-Apil'at€o€t [);tic: - A 7 Ul0 ('itv�'Statc'l.ip:... /V JJ,.ICer q- •Iolt Site Address (!V-_ _ __— Attadl a col►Nof the Wot ices' contl)cnsation i►ultr`'rleclaration page(Showing the policy number"Incl expiralion dale), l ailnfe to secnrcL'(taera:�c tis rcclrliral undcl Section 25A ol'MGL.C, 152 can lca(l to the imposition of criminal penalties ol'ir line 111)its 1,5(1[).{)[1 and:'uf tine-yiar in�prisonntent, as WTH tts civil IMMItics in the lolnti ()1 a ()lti)I:;IZ and a 111W (it'ill)to$250.01) a day against the violator. Be adviscel that €t cagy of this st<ttcttu;nt may 1)c litryvarded to site Oflice of In vest ic;ations of the 1)lA for instn'ance cuveraf;c verill"tion. 17ilwi c!t'err ib, trrrler it', x1101 1011! unaltic,►'nl' ►eriurr That thr inforination provided ahoty A true aur)correct. !)ale; ` Gtt1 c: -..._.._.......- — Ph(tni.r':..... ---- - - f)fTcia!use only. Do out Ivr•ite in this area, to hr'c uurplcterl 61 1'111 or tomo uJ/ii ial City or Town: Vern►illl,icensc i# Issuing Authority (cii'cle one): I. Board of l]calih ?. BuildingUcparfntcnt 3. C'it�'!"Ioysn Cie rii d. I?Icctrical ;rispcctor . l'Intnhin Insi)ccU)r 6. f)ilrcr - Cunlacli'cl'sun: Yhtnu•#1: .. .- .__—_.---- _- _ _ .---:� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYI) 09/i4/2015 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. I PORT T: If the certificate holder Is an ADDITIONAL INSURED, the Offcy{lest' must be endorsed. If SUBRWATION IS , 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(*), PRODUCERAME. GABRIELLE BERTHOLDT N ALDEN C GOODNOW JR INS AGCY INC PHONE 978-774-2620__ __. __.� - 978-774-7550 (AIG,No,Elft): _ (W.NoI� 16 PARR ST ADDREsa: GbMRRAY.GOOL)NOWINS@Gb91IL.COM P,0, BOR 297 INSURERS)A"ORDING COVERAGE NAIL N DANV&RS, bM 01923 INSURERAtACE JMRICAN INSURANCE CO rNSUHIFII ...� . INSURER e DAVID REITANO D/B/A DAVE REITANO RFMDELING AND HUILDING INSURER C: 56 PLEASANT ST _ INSURER D METHUEN, NA 01944 1MEURER E' INSURER 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. LTR TYPEOFR45URANCE ryyaR W D POLICYNUMBER {MNVOOMM) IMwDDIYYYYI GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES(Ea rimuNence) S CLAIMS•MADE ❑OCCUR MED EXP(Anyone Person) S _ PERSONAL&ADV INJURY 3 GENERAL AGGREGATE $ GENLAGOREGATE LIMIT APPLIES PER: r PRODUCTS•COMPIOP AGG 3 POLICYjF�T LOC 3 AUTOMOBILE LIABILITY CUMBINEOURML Limit (Ee tcc(denl) S ANY AUTO BODILY INJURY(Per person) $ ALL OWNED? SCHEDULED AUTOS AUTOS `BODILY INJURY(Per accidert) $ HIRED AUTOS AUTOS (PerdGCldaM) __ 5 UMBRELLA LJAa OCCUR 1 EACH OCCURRENCE S EICGEbB LIAR CLAIMS-MADE .AGGREGATE $ DED RETENTION ; S A WORKERS COMPENSATION 6962UB9s93916816 9/2/2016 9/2/2017 ? AND EMPLOYERS'LIABILITY YIN TORY LIMIT$ EH ANY PR0PRiETOWPARTNERIEXECUt1VE 11r.1-EACH ACCIDENT S 500,000 OFFICERUEMBER EXCLUDDED7 NIA _.. (Mandatory In NH) F.L DISEASE-EA EMPLOYEE ; 50D,000 If yes,descdbo undw - DESCRIPTION OFOPERATIONS balm E.L.U18"SE-POLICY LIMIT ; 500,000 DESCRIPTION OF OPEMTION5 i LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remark*SchedoW If dlDm ripaci is nquind) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 41jour, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN v ACCORDANCE VWH THE POLICY PROVISIONS, AUTFIORIZEO REP ENTATFVE r 01888-2610 ACORD CORPO ON. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered(narks of ACORD i DATE fNWDWYYYY) c CERTIFICATE OF LIABILIT1f INSURANCE11130/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT€ HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THUS 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 pollcy{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 endorsemen s. NAC PRODUCER Paychex Insurance Agency, Inc. PWNE FAX Ne: 150 Sawgrass Chive >-M tie Rochester, NY 14620 DRESS: r_- 877-266-6850 INSI)RER AFH]ROEHGGOVERAl3E NAICs INSURER A• NOR¢UARD INSURANCECOMPANY INSURED WSURM B: DAVIDREITANO IN51JItERC: _...� REMODELING AND BUILDING 56 PLEASANT ST INSURER D: METHUEN, MA 01844 INSURERE: IN5URFR F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A13OVE 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. TWS TYPEOFINBURANCE DDLI -WVD POLICYNUMBF..R ' PMMAKYF AICYIEIIP LIMrrS A 1 GENERALUABIUTY I F.ACROCCURRENCE S 1,QOD,000 X COMMERCL4LGENERALLLAB1LrTY I PR..MISEs(Eauocum3 -f `�•0� CLAIMS-MADE Fill OCCUR MEDEW(Anyone Icon} E$5,000 -- DA 8Pfi13505 t2rolrzDtS 171otnots PERSONAL&ADV INJURY ,$ INCLUDED —� - GENERAL AGGREGATE S 2,000,000 CEN'LAGGREC;AIEUMiI APPLIES PW PRODUCTS-COMPJOPAGO S 2,000.000 -- _ PRO- 1 LOC I 5 1 % POLICY 1 ED SrIGLE UMrr AUTOMOBILE LIABILITY En ua7cw 'ANY AUTO BOD€LY INJURY(Per persrnt) 3 ALLTO OVMED SCHEOUL50 BODILY INJURY(PeraWdanl) AUTOS NON-OMED I OPERTY PAMA 1= L HIRED AUTOS I AU70S eracdda 1 S I UMBRELLA LIAB 1 OCCUR EACH OCCURRENCE S EXCESS LIAB ' CLAIMS-IJIADE AGGREGR_3E S -- p1:0 1 RETENTIONS S !WORKERS COMPENSATION '��Y LATfI- ANDEMPLOYERS'LIABILITY YiH ANY PROPRIFTOTWARTNERIMOUTIVE❑ N J A E.L EACH ACC,.DENT OFFICE-IVMdMwR EXCLUDED! (Mandabry in NH) E.L.DISEASE-FA EMPLOYEE S _ Rf yyes.describe under DESCRIPTIONOFOPERATIONSbalow ------_- .......... E.LDISEASE-POLICY LIMIT S j# E # r.=croru�nnr nc noFaentut4l LacanoNs t VEHICLF.,S[AWICA ACORD 501.Additlonal Remark6 Sohedulor If more apace to requkod) - CERTIFICATE HOLDER CANCELLATION . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE +J --- - -- ------. EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WnH THE i '.�I,n 1 0 1I� POLICY PROVIS(ONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO I l uvV lll...���"'V V OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS,OR REPRESENTATIVES. A1.17HORIZFn REPRESENTATIVE Y ' ©c4J Mi 1988 2411U AC+?i7C)r-ORPORA tp . �!f rlghts rasgrved. ACORD 2.5(101MOS) The-ACORD narDe and-toga are re-gistered markt of ACPRP ulation Jl f &Business Rei Office of Consumer Affairs ACTOR pRDyBMENT CONTRA Type: ti{OM tM 108782 oration y ` s Registration private Corp .� Exprrat�on� 8l25I2018 ' i.1t1:D pgVID REITANQ k _ j David Reitano [3ndersecretarY 1, 56 pleasant 01644 S Methuen, It public Safety Massachusetts ©epa motions and Standards el Board of Building Reg ' License: CS-023365 Construction Supervisor DAVID REITANO 66 PLEASANT STREET METHUEN MA 01844 Expiration: 1210412017 Commissioner ��i