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HomeMy WebLinkAboutBuilding Permit # 11/8/2016 tiSORTpy BUILDING PERMIT TOWN OF NORTH ANDOVER 0 � - ..... APPLICATION FOR PLAN EXAMINATION PermitNo,#46_1 °; Date Received �acus� Date Issued IMPORTANT:Applicant in-ust complete all items on this page LO' ATIC?N _ Print PROPERTY OWNERr„ Prim 100 Year SthJctur® yes no MAP . PARCEL. ZONING,DISTRICT: Historic District yes no Machine Shop Village Y,�p no TYPE OF IMPROVEMENT PROPOSED USE _-..... Residential Non- Residential 0 New Building 0 One family _ 0 Addition 0 Two or more family 0 Industrial ❑Alteration No. of units: 0 Corr"mercial 0 Repair, replacement 0 Assessory Bldg E?"Others: 0 Demolition 0 Other 0 Septic 0 Well 0 Floodplain D Wetlands 0 Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Icie titicatYonClearly'ase Type az ]hint OWNER: Name � � �. Phone: r � Address: Contractor Name` Phone: Ln . -,-' mm Address:� . ., Supervisors Construction Licenser " . w. Exp. Date: Horne Imp rovement License: � Exp,. Date � C - -_ " ARCHITECT/ENGINEER Phone: Address: Reg. leo. FEE SCHEDULE.,BULDING PERMIT. $12.00 PER$1000.00 OF THE TOTAL.ESTIMATED COST BASED ON$125.00 PER S.F. ° Total Project Cost: $ FEE: $ -- Check No.: Receipt No., _ �^ � °� ._ O'IRQ Personscorzt�ccctan with uazre asterec�caxztz+crctc�rs' coo ,.. s.�to tile sic nd ccvc 10 Si Mature of.A ent/ainrner _ _. ._..__ Si nature Of contractor > ....._. g .. _.__._. .. ------------_..­...............I.,-----------...... ----------------- T NORTH own o Andover r 0 to No. C' h ver, Mass, �� 0� ��� COC HIC"IWICKKK U BOARD OF HEALTH Food/Kitchen PER T LD Septic System THIS CERTIFIES THAT . ...................... BUILDING INSPECTOR.... to I Foundation has permission to erect................0..... buildU* Wson ..... ...... Rough to be occupied as ­5w.. Tly .....i.. ............................................................... Chimney provided that the person accepting this fermli 4sha ievery 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 CONST TION SRough i6e rvice .. .. .. .. ... .... Final BUILDING INSPE GAS INSPECTOR Occupancy 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. Fully Licensed and Insured Member of MA Better Business Bureau Member of NH Better Business,Bureau GAF Cert.ME#20212 1propoal HIC Reg#166661 Owens Corning Preferred Contractor#212828 MA CSL#104728 OSHA 30[lour Construction Safety Training EPA Lead Safe Certified BBBa-MEG T- General Contracting, LLC 51 S. Broadway#2214 - Salem, NH 03079 (603)8900084 10 Stevens Street#141 Andover, MA 01810 d (978)4750095 PRO SUBMITTED To PTIONE DATE < A.........L, STREET E-MAIL iz, CITY,STATE,AND ZIP CODE. JOB LOCATION Comple,tply protect the home with tarps to catch falling debris. Respect and protect shrubbery and flower beds. S�tn,�, W layers of roofing material down to the bare roof deck. Inspect the roof deck for structural defects. he condition etprffi 0 of the underlying plywood or boards, and repair and replace as necessary*. fq,�t insp8� f:r6of ridge for proper 11/2" spacing on either side of ridge for maximum exhaust ventilation. Cut in if necessary. I n sta,1, 1 JULwLJLLv1-drip edge at roof eaves. "ne :heavy gaugeLL2J_.�,_ (color)_�/- -S Install U ­A=-L-11L161 ice and water shield to meet manufacturer's specifications (i.e. 6 feet from roof edge, 3 feet centered in 'valleys, around all skylights, chimney bases, roof penetrations and at all sidowall transitions). "V" f-, Install breathable roof deck protection to remainder of the roof deck. Install new heavy gauge 4,�-21 , (color) J ALLII,,,.,Lw,FaV°°t drip edge at roof rakes. Install Pax starter strip at roof eaves and rakes. y- Y (color) Install—L-A ev o desired c o I o r.--L LIA(1`14111,11 �itions). Inst6l] new flashings to meet manufacturer's specifications. (Le. sidewalls, chimneys, skylights and roofs)enetr`c� Install 1,61" (feet) of iax(,mu ntilation. rT jC��riclge vent at roof ridge to allow Hand nail to ensure proper fastening. .......... Install distinctive hip and ridge cap. Hand nail to ensure proper fastening. (feet) of L Thoroughly clean up and dispose of all roofing debris on property. Magnetically sweep property for nails. Notes: A- 1 1-121/1 I'll--1 Edmunds General Contracting will: • Obtain all necessary construction..related permits to complete this project. • Perform work as efficiently as possible without sacrificing quality. • Furnish and install all necessary materials to complete the project. • Provide a thorough clean-up and disposal of all debris generated during project. Edmunds General Contracting LLC agrees to commence work on/or about and described work will be completed in about _ mo days. ) Product Upgrade 1: (- b4 ........ Product Upgrade The Commonwealth ofMassachusetts ,Department oflndustrlalAceldeuts 1 Congress Street,Suite 100 L'ostar, 02114--2017 www mass.go-vldia b Af 541 yVa kers'Compensationb1surance Affidavit Builders/Contiactors(;le0rScia:os/k'Xumbexs. X0 BF,T1LFD-v8UHTM pLi It1YM"l MG.A'C1` jXOSZITY. f'Zease J�x3nt Le 'bl AlicantZnfoxzraation 0 Namo(]3usivess/(7rganizationftdivid2tal): �w -61-4 4" _ ° xr,r—.... phone City/State/Zip: ���-- _ __ . — l.ype of project(required.); AX e yo n employer?Checictlze appropxaate box: 1,� a employer with _employees(hill and/or parE titno).* 7, E]NdWId nstriicflon 2.�1 am a sole proprietor or partnership and have no employees rf✓azking for me in 8. Romo d liiig any capacity.[No Workers'comp.insurance required.] 9. l7eazlalitian 3.F I am a homeowner doing all Work myself[No workers'comp.insurance required.]C 10E]Building addition 4.F]I aur a�homeowrrer andwall be hiring contractors to conduct all work on my property. 'will 11.F j��ectrical repalSs of add tigAs ensuretllat all contractors either have workers'compensation insurance or are sole J�A 4 � . . aXxs or additions Llfffhing rep proprietors withntz enplayees. 5.F-1I am a general contractor anl'havo hired the sub-eonfractozs listed onthe attached sheet. 13.n Ecrofxcair s These sub-eontractozsatihave erazployees and have workers'comp.insurances t id.,n Other -- �We are a carporori and its,oidcdrs have exercised their right of exemption per MGL c. d. 152,§1(4),and'we have no ernployces.[No workers'comp.insurance required.] n POE Y 0 %Airy applicant that checks bb-k 41jdav tairzdicaturg they are,doing all work and then hire outside ccontracto---jc­io��showing their workers' rs zest submouj�Ed se l a ew affidavit indicat szg such I ljomeowners who submit t...... �Cantractozs that check thi§fiox zbust atfaclied'an additional sheetshowing tbo name of the sub-contractors and statewhetlzer of riot those.entities, ave employees. `Iftbe suh-contractozs have enxplayces,they must provide their workers'comp.polioy number. --" f ai'n an emp%yer tliat is providingxvorfrers'cornpensatiorr.znszrsRaxare f or'my ernpioyees, Jaela7v is the policy orad j ah site information, - fnsurance, Company Narnc: Policy ff or Self"-ins. ic.ffi_��.�-- - — I�xpiratianDtez lob Site Address:_ . fir City/state/Zip;. ° AttachacopyofLiteworlrexs' coxzxpexrsationpolicydeelarationpage(sbowingthepolicynurabe ran lexpirationdate). ol ation punishable by a fiAb UP to$1,5 Failure:to sccuxo coverage as required under MOL enalties�n�l>_a forma of criminal2 SA is a OPfWOR Eli'a�a line ofuii to $250'0.00 a and/or one-year'imprisonment,as well as ry p clay against the violator.A copy of this statement may be forwarded to the Office of Trrvestigations of the MA.fox insurance- Coverage verification. / t pains and penalties ofper ur_y Haat the information provided aho,Ve is true ar-d,carre f do hereby cercz Si n_.ag ture: __"� � Phones#: Official rase onry. 7�a not-Write in t12is area,to he completed ny city ortvrvn vfficia7 City or Town: Issuing Antlzoxity(cixele one). ' ctor ',Pluzxxloing inspector t.Board ofl_[ealth 2.Building IJepartment 3,City/Town Clerk 4..ft lect]rical.) p e. 6.Otla.er :phone Contact --- 11/8/2016 Details Tile Ofiiclal Vebsite of the ExecUtive Office of Pub"c Safety and Secu`€ty(EVFSJ, 1iass.GOv;Home State Acendes Demographic Information Full Name: DAVID C EDMUNDS er Name: an License ress norma [on ity: SALEM tate: NH ipcode: 03079 o nt : U 'ted tater icense inTormation License No: CS-104728 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 10/712016 Issue Date'. Expiration Date: 10/3/2017 License Status: Active Today's Date: 11/8/2016 Secondary License Type: Ding Business As: atus Change R as : License ftriewal rerequisi a nor a ion No Prere uisite Information Close Window O 2011 Commonwealth of Massachusetts Site Policies Contact Us http://elicense.chs.state.ma.usA/erification/Details.aspx?agency_id=1&license_id-293654& 1/1 f• Convenient. tPayment Along with traditional methods of payment such as cash or check, Edmunds General Contracting, LLC has joined with EnerBank, USA Express Loans to offer a 12 month, 0% interest free loan program. To take advantage of this program, call the toll free number 1-866-405-7600 today to complete the pre-approval process. To complete the over-the-phone application please follow the simple steps outlined using the following information: o DIAL toil free. 1-866405-7600 o Our Company dame: Edmunds General Contracting, LLC o Project Type: roof replacement, addition, siding replacement, bathroom remodeling, etc o Dealer ID Number: 80671 o Total Cost of Project: see our proposal for the total cost of your project o Promotional Code: 821177 For your convenience Edmunds General Contracting, LLC also accepts all major credit cards including: o VISA o MASTER CARD I i o AMERICAN EXPRESS i o DISCOVER i Y t:13MUM-7 UY 113. Mk CERTIFICATE OF LIABILITY Y INS NCE0610912r, " Q�iQQ1 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. -FHIS 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 BETVVEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: it 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 Ileu of such endorsement(s). PRODUCER NRINN6;CT James ASanto Planrightinsurance-Sateen PHONE G03-880-6439 A1C Nn: 6Q3-890-652;1 224 Main Street Sulte 3C Arc No.Ext Salem,NH 03079 E4 MIL ADDRESS:'arrlie santairtsurance.com James A Santo INSURER(S)AFFORDING COVERAGE NAIL 4 INSUIMRA:St Paul Surplus Unes Ins Co _ - INSURED Edmunds General INSURER IS.UbertY Mutual Insurance Co Contracting,LLC INSURER 0:Essex Insurance Company P©Box 2214 Salem, MH 03079 INSURER D: INSURER E., INSURER F, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW'HAVE SEEN 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 SY P041D CLAIMS. IENTR TYPEoPINSURANCE k DL5 P01-10y EFF POLI LIMITS EXP POLICY NUMBER rMMIDDIYYYY {MMl0 A X I COMMERCIAL GETIERAL LIABILITY ` I EAC€-€OCCURRENCE I S 7,O00,Q0( ! S197699 1//1112013 111 112014 D A ET TE I S a��00( OCCUR i I I PREMISES(Ea occurrence} , CLAIMS-MADE E -- MED EXP(Anyone erson) I S PERSONAL&ADVtNJURY If GEN'L AGGREGATE LIMIT APPLIES PER: GENEFL4L AGGREGATE I S 2,000,00( } POLICY JPRO LOC PRODUCTS-COMPIOPAGO 3 r00fl,DQl ' I OTHER: — 'AUTOMOBILE LIABILITY 's'OMBINEB S€NGLE LIMIT _ �;�} i Ea acecdent I ANY AUTO BODILY INJURY(Par Qerscrn) S ALLOWNED SCHEDULED I i BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED j Pero C�ei€IOAMAGE HIRED AUTOS AUTOS € S �( UMBRELLA LIAR X OCCUR T EACH OCCURRENCE Is 9,OOO,OO! EXCESSLIAt3 ��CLAIMS-fdADE UBVV4880813 � 1210212013' 1x10212094 AGGREGATE S 1a000,801 DED � RETENTIONS g01000 ( 5 VJORKERSCAMPEN5ATION &ATIJ€E ERH AND EMPLOYERS'LIABILITY B ANY PROPRIETORIPART€SERrEJCECUTIVE Y® NIR WC6-31S-602821-014 04103/2014 0410312016 E.LEACHACCIDENT $ 60(!,00( OFFiCERIMEMBER EXCLUDED? I3A: NH E,L,DISEASE-1=A EMPLOYEE $ SWIM)( (Mandatory In NK) I I€yas,describe under if nas PT10N OF OPERATIONS be€o4u 1 E:L.DISEASE-POLICY LIMIT S ©(),(I0( o f ON gESCRtP OP OPERATIONS r LOCATIONS!VEHICLES (ACORt7101,A01Ua„al Remarks Schedule,may be attached If mors space Is required) �mP ccs a�rac�2. CERTIFICATES OF INSURANCE ARE,PRODUCED UPON REQUEST AND DELIVERED DIRECTLY TO THE CUSTOMER i - l 1a F l=l'IQI {3R CAN{'si i-AI®N e SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE YOUR NAME AND ADDRESS THE EXPIRAlDATETHEREOF, MLL BE DELIVERED IN wl POLICY PRINTED HERE AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2094101) The ACORD name and loge are registered marks of ACORD -rom:Nicole Boudreau FaxID:Santo Insruance Page 2 of 4 Date:11f712016 12:45 PM Page:2 of 4 EDMUN-1 OP ID: NB ACORQ^ DATE(MMIDD{YYYY) CERTIFICATE OF LIABILITY INSURANCE F04/06/2016 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. 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 Ileu of such endorsemerlt(s). PRODUCER NAME:CONTACT James A Santo Ptanright Insurance-Salem PHONE AX 224 Main Street Suite 2A AAIC,No.Ext) 603-890-6439 Alc No):603-890-6521 Salem,NH 03078 nDRIEss:-am ie@_santoinsurance.com James A Santa INSURER(S)AFFORDING COVERAGE NAIC f! INSURER A:St Paul Surplus Lines Ins Co INSURED Edmunds General -INSURERS:Liberty Mutual Insurance CO Contracting, LLC INSURER C: PO Bax 2214 Salem, NH 03079 INSURER D: INSURER 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 NAME=D 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. INSRADOL SUBR PDL C POLICY EXP LIMITS LTR TYPE OF INSURANCE €NSD WVD POLICY NUMBER MMIDD)YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE TOCCUR W5264625 11111!2015 11177!2016 PREMISES Ea occurrence) $ 50,000 MED EYP(Any one person) $ 5,000 PERSONAL&ADV/NJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑PTCI' �LOC PRODUCTS-COMP70PAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea acddant ANY AUTO BODILY INJURY(Par person) s ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS $ NON-OWNED PROPERTY dDAMAGE HIREDAUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONX AND EMPLOYERS'LIABILITY STATUTE ER 13 ANY PROPRIETORIPARTNERlEXECUIIVE v r N WC5.31 S-602821.015 0410312016 04/03/2017 E.L,EACH ACCIDENT $ 500,000 OFF500,000 ICERIMEMBER EXCLUDED? T NIA 3ANH H (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes.describe under 500 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ r DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Dave Edmunds is excluded from work comp coverage fax#978-688-9542 CERTIFICATE 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. Town of North Andover, MA 120 Main Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014109) The ACORD name and logo are registered marks of ACORD I Massacr} se ms's Departrnent of PubSafety i a Bcard of Building Requiations arid..Sranda ds :cerise: CS-104728 :—S&`` ` v� DAVID C EDMUNDS P_0.BOX 229 y y A y y\ yVv�� \yv� v \vyyA��w�AAywv wA SALEM NH 0307 M- 0W mg VA�y�VVOO�A�A� `� vVW, w vi r#'iisslone 901tD312�397 p a ` use s Department of Public S r i' f.b-if'i a Regulations and Of-rice oS'Consumer Affairs&Business Regaii:aticaa; License: - 290 OME 1MPi;.OVE ENT CONTRACTOR <k E Construction ir ` � egis 's€sr: iGG6G1 Type: � x ire iii 612112016 Corporation v� GREGORY J B C ANA V - ' :FAITH ROAD EDMUNDS GENERAL CONTRACTING,LLC. WINDHAM NH E33027 DAVID EDMUNDS 18 ASHFORD RD HAMPSTEAD,NH 03841 Undersecietary �� � Eft -a Expfl ion_ x .mss-crier 1112912 7