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Home My WebLink AboutBuilding Permit # 10/13/2016 µo�rrh BUILDING PERMIT °4 'SA 4o 16 O TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: i.`r® � Date Received ��ssAcED uS£�� Date Issued: I TM ORTANT Applicant must complete all items on this page �. '� _ ✓ ::. - mss✓ ''T!y'��.""„wc✓^e5 f✓- �' ✓ E rrc �� 3. e `� -r� tw' �.� � °� a'�v�- �"G,W J";, nuc,.�.r a,.,e., � �', �rr'�,✓G'', �� i u. �� F e ' r C amu'. F,f � �.. ti �<" �f � �" e f✓'c �r � Pint �: 7oo�'earStrucfure �'�Y s MAP PARCEL �� ZONJNG DISTRICT �" Mia hineDShop U�llage ..�Y..�. ��po .. n, r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential )(New Building ❑ One family ❑Addition [ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑llllell ❑ Floodplain C711Vetlands ❑ Watershed District D 1Naterl:5ewei' >,..:: DESCRIPTION OF WORK TO BE PERFORMED. cA obr(.k Identi ication- Please Type or Print Clearly OWNER: Name: c.' Phone: Address: `46SnL er ; Contractor arne .. Phone.. Email Address � ; 5uperv�sor'� Construction License �' _Exp Date Home Improvement License Exp. . Data . � _ .,.. ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON 925.00 PER S.F. j Total Project Cost: $ k E FEE: $_ Check No.: 144 qi Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the uaranty f d 5ignature of AgentlOwner ;Signature of coni~ractor Town of s _ �} Andover 0 `% LAM! h ver, Mass, ZOAC COC ^K WICf� �' � U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT 3t , „ 0 BUILDING INSPECTOR .. Foundation has permission to er t.......................... buildings on .. .. .. ... ...... .... .. .......... .. '. Rough to be occupied as .. A (' IR.................................................... Chimney 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 LESS CS TIS Rough J, Service ........ Final BUILDI INSP CTOR GAS INSPECTOR Occupancy Permit Required to„Occupy PuRough Display in a Conspicuous Place on the Premises - Do Not Remove Fina' No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. OIL E a n morency 23 concord st norte andover North Andover, Ma 01845 M&N Construction Enterprise Inc. Estimate # 000072 525 Essex St. Unit 1107 Date 09/29/2016 Lawrence, Ma 01841 Business /Tax # License #CS-108367 Phone: (978) 397-9803 Email: penafrankjin@yahoo.com Fax: (978) 258-8311 Description Total Wall repair $0.00 Reinforce beans and replace damage wood Replace damage plywood in the same area New porch on the left hand side $10,500.00 -restore a porch with Pretreated wood.42 inch high rails with column 4 feet below grade. -all debris will be pick up and clean. -labor guarantee is 6 years. -job cost labor and material is $10,500 with a down payment of 4,000 and rest upon completion Subtotal $10,500.00 Total $10,500.00 A Fran, klin Pena Elba n morency Page 1 of 1 Sales: 800.448.3636 Phone: 804.271.2363 NEXT GENERATION Fax: 804.743.7779 - g LET'S GET IT DONE ST ORMWATER_MANAGEMENT SOLUTIONS acfenvironmental.com Site Development and Retrofit . Low impact Development + Green Infrastructure FOCALPOENT(high flow biofiltration) - R-TANK(modular subsurface storage) - PAVE DRAIN(paving,drainage,storage) - FABCO(decentralized treatment) ._._-._------ ! �- i I a ------------- ! , I ! ' I C � I i f I ! j S I I ! I. .--- --- -- -._. — --1 -- � _ i i 33 € I [ _._. - a ! : f j I z I r �as 1 . i I ��I ��•_ � _.� . _ � ' _. --- E ------------ _ - —- — 1 --E- -� , I S- I D -- -i---- _ f , _ r , , I ASales: 800.448.3636 A1,11W17--o-dwPhone: 804.271.2363 NEXT GENERATION Fax: 804.743.7779 AGZZ�� LET'S GET IT DONE STORMWATER MANAGEMENT SOLUTIONS acfenvironmental.com Site Development and Retrofit * Low Impact Development * Green Infrastructure FOCALPOINT(high flow biofiltration) . R-TANK(modular subsurface storage) - PAVE DRAIN(paving,drainage,storage) PABCO(decentralized treatment) ---------- -------- .3.---------------- ---------- ------------------------------ -------- ............ ----------------- j;j -------- ----------- L ---------------------------- ------ ----------- --------- ------ ........... ----------- J, 1 A ---- -F ------- ----- --- - ----- - - -------------- ------ ------- -------- --- -------- _A ------ --------------- ------ ------------- A_ ---- ------------ 44 S -----------k __ ------- ----------------- ---------- -—-------------- ------------- _7 ---------E--------------....... ------- --------- -------- 1j cx ------------------ -------------F-F-_ F_ L I -------------- - .. ............ .... - ---------------------- --------- .......... -------- --------- ,. The Commonwealth of Massachusetts Department of IndustriaZAceldents M _ I Congress Sheet, Sprite 100 Boston,MA 02114-2017 www.mass gov/dia ' Wavkers'Compensation insurance Affidavit:lduilders/Contractoxslli;XectrzcianslPluWbexs. TOHEFMEII) lTIITHE 'FRMZTTING.c, lloffl� - Dlease nt L. 'bl A ' licantlnformation NaMe,(Busiaess/Orgw*ation/lndividua3): , i7s � Address: - city/state/zip: UJ,9-/t C.'. Uy Phone, Are you an employer?Clract[rite appropriate box: Type of project(Aerinireff): employeescull and/or parttime)." l. 1. �i;W C0119tractlDn 2. lain a sole proprietor or partnership and have no employees working forme in S. ❑Remodeling any capacity.[Noworkers'comp,insurance required.] 9. ❑DemolitigA 3.❑I nm a homeowner doing all workmyseli [No workers'comp.insurance required.]i 14❑Building addition ¢.❑I arty a homeowner andwilt be hiring contractors to conduct all work on my property. I will 11.❑�lecirical repairs or additiops ensure that all contractors either have workers'compensation insurance or are sole 12_ Plulribing repairs or additions proprietors with.no erripl"ogees. E] 5.1 am a general contractor and Ihavehiredthe soh-contractors listed ori the attached sheet. 13%0 Roof rel airs rs have cmployees andhVewc kere comp.insurance A These snb-contract� 1� Other 6.0 We aro a carpora#iori and its,ofhcars have exercised their right of'exemption per MGL e. 152,§1(4),acrd we lava no employees.[No workers'comp.insurance required.] *Any applicant that checks bait#1 must alsd fill out the seetionbelow showing theirwarkers'compensation policy infonnationr, tom must ali work and i Homeowners who sup b a d $ Oct aoh an additional sheetshowin$the name o£the ub contrac'te s and spate wnhether of affidavit oe.eentities have lContiactors that check „ employees. Ifthe sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer Haat is providillg'varkels'compensation insurance for my employees. Below is the policy orad jolt site information. Insurance Company Name: Expiration Date' Policy#or Self-ins.Lie.#: City/State/Zip: J'ob Site Address: Attach a copy of theroxlrers' bratio comipensation.policy declaration page(showix#g the policy number up pto$1,500-00 Failure to seGme coverage as required index MGL e.152, §25A is a criminal violation punish Y and/or ane-year impxlsonrn ent,as well as civil penalties in the farm of a e office oSTOP 0f veesgatio of the DIA fox ins IUER and a line of up to -a a day against the violator.A copy of this statement may be forwarded to coverage verification. X da hereby cerci under tla a' s.gndpenal i fperlury that the information provided above true ar?/d correct. - � Date: Si attire; 1 ` Phone#: official use only. Do not Write in this area,to be completed by city or town af�ciar City or Town: # Issuing Authority(circle one): 1..Board of Health. 2.Building Department 3.CitylTown Clerk 4.Electri:cal inspector 5.Plumbing Izzspectar 6.Other � Phone#: 3 Contact Person: 3 1 A`ORO CERTIFICATE OF LIABILITY INSURANCE �"�`"�'°°""'�' 10/12/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 NAME: Kate bawler Armand P. Michaud Insurance Ag PHo"E . (978) 685-2549 rx No: (978) 794-0822 105 Haverhill Street ADDRESS: katelawler@michaudinsurance.com Methuen, MA 01844 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Essex Insurance INSURED INSURER B:Safety Insurance Co M&N Construction Enterprise In INSURERC: Juana Vasquez INSURER D: 525 Essex St. PMB 1107 INSURER E: Lawrence, MA 01841 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. 'NSR _.,�_,_. ..__..�, ADDL SUER _,POLICY EFF POLICY IXP_.,... _,..,_,..._...., LTR TYPE OF INSURANCE 15 POLICY NUMBER MIDDIYYYY) (MMIDDfYYYYI LIMITS A GENERAL LIABILITY 3DY6888 4/2/16 4/2/17 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENE RAL LIABILITY DAMAGE TO RENTED $__501000 CLAIMS-MADE 1XI OCCUR MED EXP("one person) $ 11 000 PERSONAL&ADV INJURY $ 1,000,000 -GENERAL AGGREGATE_ $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-00MPIOPAGG S 1.000,000 X POLICY PECT F-1 RO LOC $ B AIITOMOBILELIABIUTY 62329550 3/31/16 3/31/17 COaMBINEDUSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS -- NON-OWNED PROPERTY DAMAGE HIRED AUTOS _AUTOS eraccident _ $ 100,000 UMBRELLALIAB OCCUR EACH OCCURRENCE $ IXCESSLIAB CLAIMS MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE � NIA E.L.EACHACCIDENT $ _ OFHCERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ _ If yyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Rermrks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St Suite 2043 j North Andover, MA 01845 AUTHORIZED REPRESENTATIVE V 9 Kate Lawler O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The AC ORD name and logo are registered marks of ACORD Phone: (978) 685-2549 Fax: (978) 794-0822 E-Mail: katelawler@michaudinsurance.com I �®�1 AJ YT"d+ t.13r z SS nu � € ent. Cb H ' ove r � � FRA� CS 408387 2 - I'RANKLIN PENA j renre01841x ; 135 MAY STREET APT �' Law MA � .. 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