Loading...
HomeMy WebLinkAboutBuilding Permit # 12/9/2016 AO R Tk BUILDING PERMIT oF�SLEp 6'q� TOWN OF NORTH ANDOVER o :•.a.-, APPLICATION FOR PLAN EXAMINATION �q �M y '] Date Received i a / QRnrso�4� (`• Permit No#: / �ssacwus�c . . Date Issued: 1�---�- � _ �C4%' tpZpORTANT:Applicant must complete all items onthis page LOCATION .. ;Print .... PROPERTY OWNER ' Prrnt 100 Year Structure yes MAPPARCEL ZbNING 018TRICT :_' HEstorrc D�strtct" ', yes Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ New wilding )(One family ❑Addition ❑ Two or more family ❑ Industrial Iteration No. of units: El Commercial ❑ Repair, replacement 0 Assessory Bldg ❑ Others: ❑ Demolition ❑ Other [I Septic 0 Well El I=loodplain 11Wet1:66,ds ❑ Watershed District ........ .:. 0 Water/Sewer.... _ _ DESCRIPTION OF WORK TO DE PERFORMED: s Identification- Please Type or Print Clearly OWNER: Name: � ��' Phone: Address: Contractor Name: . kalle2 Phone_ re Addss. S P ervisor's Constructia'n License:^ - fir, , Exp. Date: . Home Improvement LicenseExp:. Date . � ARCHITECTIENGI NEER Phone: Address: Reg. Ido. J- - FEE SCHEDULE_BULDING PERMIT;$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$925.00 PER S.F. notal Project Cost: $ FEE: $ Check No.: Receipt No,_ - NOTE: Persons' eoY ac 'ng�vith unregi �ererl contractors do net have access to the gxcaranty fund Signature of Age 0. ! SEgnature of cai7fractar ........... ........... ..........................- ............-------- Town of t4o Andover ® � j%147 No. 22- ver, Mass, a All U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .......I k"Ite........ ........... BUILDING INSPECTOR has permission to erect r %?VfV41 ..(* W 40 Foundation .......................... buildings on ..j ........a.. # .. .......... ............. a .. fte Rough to be occupied as ......... 0......45.=...................... 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 UNLESS CONSTRUCTI TAATS Rough Service ......... ... .... 1A .... I .............. BUILDING.INSPECTOR Final 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. NORTH SHORT~BUILDING SERVICES LLC 1 Westward Circle North Reading, MA 01864 1-800-564-4016 Licensed: CS-060149, HIC-165538, RRP Lead Certified PROPOSAL ` Revised: November 26,.2016 October 28;2016 a y r Mike Luzzo 5 Stonewedge Circle North Andover, MA 01810 Email: Michael.a.iuz7o imr,corn 617-947-6234 We herebysubrniL specificatiojis and estimate for, Finished Basement Room. SCOPE OF WORK: a Framing—interior partition walls and closets per home owner's layout. 0 Frame in under stairway for door. r Electrical—Install plugs and switches to Massachusetts code, install ten recessed lights, install fluorescent lights in closets in finished rooln and under stairway closet. 0 Install insulation to Massachusetts code. ® Install%z" blue board on walls and skim coat plaster; smooth finish. 0 Install doors,trim and baseboard in finished room and under stairway. * Install acoustical ceiling in finished room. e Apply two finished coats of paint on walls,doors,trim and base board. ® Install existing HVAC lines in acoustical ceiling. Install closet shelfing in finished room closet and in closet under stairs. Install flooring in finished room,flooring to be supplied by home owner. Contractor to obtain all necessary permits- * Contractor to dispose of all debris. Total: $2p,Ql�MOO We hereby propose all materials and labor—complete in accordance with the above specifications,for the sum of: $ 20,000 Twen 11housand Dollars Payment to be made as follows: 1. 50%at midpoint. 2. 50%upon job completion. Acceptance of proposal—The above prices,specifications,and conditions are satisfactory and hereby accepted_You are authorized doth work as specified. Payment will be made as outlined above_ Da f acceptant • 7 1 (Customer's Signature) .7 (Contractor's Signature) Ail work is 100%guaranteed for one year on all craftsmanship.All other warrantees are through the manufacturer.All warrantees will be null and void if job is not paid in full. Thank you for letting us serve you! North Shore Building Services LLC t 17 Mqd oo-� � �J 9 FT? eI a�S" DATE(MMlDDrem) CERTIFICATE OF LIABILITY INSURANCE 11/29/2016 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 lieu of such endorsement(s). PRODUCER CONTACT House NAME: _. Linnane Insurance Agency, Inc. PHONE CNE Ext): (978)664-2000 u AICNc:c97e)ssa-oleo 280 Main St:. #101 E-MAIL ADDRESS: .....___.._..,._ INSURER[S)AFFORgING COVERAGE NAIC L# N. Reading MA 01864 INSURER A:Commerce Group CIG001 INSURED INSURER B: NORTHSHORE BUILDING SERVICES LLC INSURER C: PO BOX 663 INSURER D: ._..... _`_.....,._ INSURER E: _ N Reading MA 01864 INSURERF: M COVERAGES CERTIFICATE NUMBER:CL1510601069 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, TERN! 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. -"'" —--"" D©L S11BR -- -- _ POLICY EFF_,. POLICY EXP TN-ILTR TYPE OF INSURANCEINSD WVD POLICY NUMBER jMMJDDlYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _$ 1,000,000 DAMAG T RENTED ..,_, A CLAIMS-MADE F_-1 OCCUR PREMISES Ee owurrenoa $ 100,000 BGRJHH 8/28/2016 8/28/2017 MEG EXP(Any one person) $ 5,000 W PERSONAL&ADV 1WURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL.AGGREGATE $ 2,000,000 POLICY❑PRO F-1LOC PRODUCTS-COMPIOPAGG $ 2,000,000 JE $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ _ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUREACH OCCURRENCE $_ EXCESS LIAB _CLAIMS-MADE AGGREGATE ...,_ $ DER F RETENTION$ $ WORKERS COMPENSATION PER OTB, AND EMPLOYERS'LIABILITY YIN ................STATUTE ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ _ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT i$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Add€tional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION bleathe@townofnorthandover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept ACCORDANCE WITH THE POLICY PROVISIONS, 1600 Osgood St Bldg 20 Ste2035 North Andover, MA 01845 AUTHORIZED REPRESENTATIVE M Linnane/LINRPI ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025I2m401i 0 MI DATE(MDDIYYYY) A�" CERTIFICATE 4F LIABILITY INSURANCE 12/02/2016 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 lieu of such endorsement(s). PRODUCER CONTACT NAME: Town of Andover BYE TTE INSURANCE AGENCY INC. PAHICNro Ex • (978)851-6678 [arc,Ng ADDRESS: nicole@akfowle6ns.com 200 Park St. INSURER(S)AFFORDING COVERAGE _ NAIGN North Reading MA 01864 INSURERA: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER 0: BARBAGALLO PETER DBA NORTH SHORE BUILDING SERVICES INSURERC: INSURER D• _ PO BOX 663 INSURER E: NORTH READING MA 01864 INSURER F: COVERAGES CERTIFICATE NUMBER: 108124 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. I TYPE OF INSURANCE ADDL SUER .W-�- POLICY EFF POLICY EXP LIMITS LTR p POLICYNUMBER MMIDD MMIDD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO CLAIMS-MADE 1-1OCCURPREM SES EaENTEoccu O nce $ MED EXP(Any one person) $ NIA PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO LOC PRODUCTS-COMPIOP AGG $ JECT _ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED NIA BODILY INJURY(Paracrident) $ AUTOS AUTOS .__............__._ NON-OWNED PROPERTY DAMAGE $ HtREDAUT05 AUTOS SPeraccident ................__ UMBRELLALIAB OCCUR EACH OCCURRENCE _$ EXCESS UAB HCLAIMS-MADE NIA AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANYPROPRIETORIPARTNERlEXECUTIVE --N E.L.EACH ACCIDENT $ 100,000 A OFFICERIMEMBEREXCLUDED? NIA NIA NIA 6S62UB2E30048516 07/02/2016 07/02/2017 --_.....,..._._....__._ —_ __................__.____. (Mandatory in NH) E.L,DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under ------ ...._,_�..m DESCRIPTION OF OPERATIONS below E,L,DISEASE-POLICY LIMIT $ 500,000 NIA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govllwdlworkers-compensation/investigations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main St. AUTHORIZED REPRESENTATIVE North Andover MA 01845 Daniel M.Cro ey,CPCU,Vice President—Residual Market—WCRIBMA O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD no Common-wealth of Massachusedts Department of IndustrialAccideals M - r Congress Sheet, 8to 100 Boston,MA 02114-2017 r A` fPWV.mass:gov1dia � 'WoVke& Compensationlusurance.A-0da-v:it:Baiicierc�lCG c Os Y tricxausl r hers. TO BE ULED W TBI BERMC� cease Pxlut Le 'TDI A ]ICaIIf ,.e«OILrtatTOIx Naine(Business/Orgataizationllndividual): Adxess: .;gyp Citylstatelzip: p Type of prosect()reged); ,�•e ynn an exnpIoyerY Ghac�tfie a xo xiate/sox: I.❑I 7. []Ned am.a employer with employees(full and/or part time). constXi�'afion 2.❑I aur a sale proprietor or parkrership and have no employees Working farms in $. Re7r o deii tig arty capacity.RToyrozkers'comp.iusurauce required] 9. DeinolitloA 3-Q I am a homeowner doing all wozk myself o workers'courp,insurancerequired.] 10 L_1 Building addifion 4.�I ane abnrneowner and will be hiring coufractozs to conduct a1I work DUMY property. I will Il.[�Eecfxicalx�paixs or additions e,nsurethat all contractors eithsrhaveworlcers'compez}saEion insurance or are sola L E :P b g XepaiYS DIG add7fi€a `. proprietors wlthnn employees. 5,;N1 am a general confxactp j and Ihsvohiod the sub-cos�zacfors listed onthe attached sheet. 7 3'.[�Roo£repaits These sub contractors have employees and hays workers'comp.insuzanca 14 fifer g,❑We are a corporation.and its officers have exercisedtheir right of bxemptlun per MGL a. VG haYe na employees.INa workers'comp.insurance required] zAzsyapplicantthatchecks6b #1lxiiast Sdcfill i nogt> Yarn ingbelow anwokandthenbireoutsidecmontraotsmust submita ewe£ davitindicafia3gsuch i IIo€neowmers Who submit this aid davi Contractors that checlz#lzis lank const attached.brr addddr'tion-t e their he na rs'�amp policy numberaard sEate whether ornotthase.entities have employees. T£-the sub-coniractors havo enploytes, y t e a rra xe employer Haut is providing�varkeag'cor�aPensatiora insanmee f Baor my MPloyees. 13araxv is the policy grad jai site P information. Iipsuranne Col�apanyNa�n.e: �� G�U Policy#or,s°elf-Ins.Lxc.#:. J lob Site Address: S '1 G'GC City/Statelzip: (�, . G 1✓L'�° �J/ lJ���v Attach a co ;y-Of the Y[rorkexS' compensatlo policy dec,aratiozrpage(sho�vioxgthe po�cyxanmbex and�e by a fifib UP�$10500 40) Failure to secure eovexage as xequu'ed undex MOLxraTfjes ino. s the taxm of§25A is a aTOP WORD ORDER al-violation Iand floe of p fio $250.0Q a and/or one-year imprisonment,as well as civil p be day agaivs-t'�I-a violator.A Dopy oftllis stataXa.ent may i:'ox4varded to the O�.ca ot'Suvestigatiox�s o£#Ii.e DIA foxixls�'aztce covexage VerWGaflon_ do riere7�y cerf rarxd tliepairas and penaltieg ofperjaa Haat tlae irtfarmationProvided wove is true ar? Date: Si atuxe: Phone 4: Official rage arzly. Do not-Write in this area,to he cortnpleted by city ol'to-lvrz Off elul Permit/License# City or TO-WR: Iss iugAuffioyit=y(circle one): ' ector 5.1'juwbiugInspector .)Board of Ifealth 2.BuildingDepaltment 3.City/TO'"U Clerk �.E7ectx ccaXlr3ssp 6.Other Phone : Contact Be3rson. C60 w wAl?, 0/1)Q1&'1j1jaCktj0111j' Office of Consumer Affairs and Business Regulation �-,,��` 10 Parr Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 165538 Type: Corporation Expiration: 2/1/2018 Tr# 419291 C.J. & B CONSTRUCTION CORP. PETER BARBAGALLO P.O. BOX 663 NO.READING, MA 41864 m Update Address and return card.Mark reason for change. Address ❑ Renewat Employment Lost Card SCA 1 20M-05111 of Consumer Affairs&Business Regulation License or registration valid for individul use only WW HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Type; Office of Consumer Affairs and Business Regulation ,��7Registration: .155538 10 Park Plaza-Suite 5170 Expiration: 21112018. Corporation >' Boston,MA 02116 C.J.&8 CONSTRUCTION CORP.. : PETER BARBAGALLO 1 WESTWARD CIRCLE NO.READING,MA 01864 Undersecretary Not valid without signature i Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-060149 Construction Supervisor PETER J BARBAGALLO 1 WESTWARD CIR N READING MA 01864 Expiration: Commissioner 10/31/2018