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HomeMy WebLinkAboutBuilding Permit # 12/6/2016 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit os5 4C!41J5f Date Received N #: Date Issued: IMPC)RTANT: on this page -Alj) ficantaiust coinplete all �t'�Ms On 11 LOCATION ov ki Ori l v61"r, Print PROPERTY OWNER a .. Print 100 Year Structure yes MAP 001C1 7 PARCEL: UC"'ekP ZONING DISTRICT: Z _---Historic District yes Co Machine Shop Village yes 60) TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 11 New Building E One family F1 Addition n Two or more family E Industrial * Alteration No. of units: El Commercial F Repair, replacement Ll Assessory Bldg D Others: 11 Demolition Ll Other � rir/ r 1r /� -7//-/,7/'/,/-/1 e/ S d a n"d'/""/ % M 4///,/�My J/ Im to/ ilsw 1P g g/ L 4 g A IV A 1A NO /Tri 1/01 ✓ 6r. Im�-=/ �w DESCRIPTION OF WORK TO BE PERFORMED: e5 Ilentication/Ilease Type or Print Clearly fi OWNER: Name: C "Celr-He&J Phone: 1U-,41Vz)&Veyz- Address: /7y kjl0-cce4i ------ Contractor Name: Mai,,�vJAY-VL Phone: Email: WA-J' Lowt 64 �ihm\ muil( 4/,� Address: -OrkV01d, EdAluY LI 9 Supervisor's Construction License: (2, Exp. Date:_ Home Improvement License: Exp. Date: s) ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000-00 OF THE TOTAL ESTIMATED COST BASED ON 129OPER S.F. Total Project Cost: $ is-9 (01 FEE: $ - Check No.: 34, Receipt No.: 02 7 e - NOTE: Persons contracting i ith, n e ist red contractors do not have access to h aranty.fiind 4 dt ..... SiS�gnature pf..00�&,ab ge ef etORTH Town � _ : �. Andover o 11 a No. — [ * � - �` h , ver, Mass, . t)6 Coc"Ic"g WICK 0Q`��,i5 U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT .... 41 Aw..04...4,,...... .1.OA✓............. .......,.. BUILDING INSPECTOR has permission to erect.......................... bui ings on .,*. .... ..?.�(•,� ,..... Foundation . Rough to be occupied as ....kw)o .. ...... ...�. !! . ................................................ Chimney provided that the person accepting this permit shall in every respect conf m 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 CONS C I N Rough Service ,... .4- ja.,...... ""` Final BUILDING INSP TOR GAS INSPECTOR ®ccupancV_Permit Required to Occupy Building 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. Ace Howe Medics,LLC Mail-HIC registration status litips://mail.google.com/niail/ii/0/?ui=2&ik=7bb9O9ld08&view=pt... G2 . Mat Previte mat acehomemedics.com> HIC registration status 1 message Morales, Michael (SCA) <michael.moral es@state.ma.us> Mon, Nov 7, 2016 at 11:27 AM To: "mat@acehomemedics.com" <mat@acehomemedics.com> Hi Mat, As of today, your HIC registration number 153165 is currently active and does not expire until 1110512018. Regards, Mike Michael Morales Deputy Chief of Staff Office of Consumer Affairs & Business Regulation 10 Park Plaza, Suite 5170 Boston, MA 02196 Phone: 617w973.-8706 Fax: 617-973-8799 :s 1 or 1 12/6/2016 5:53 AM f'ell,978-GU4-i�47 I d:i A4nin Strccl��_� Office:97H-207-1¢32b 'rp`�`- >+'+ •€tet, Nm Ili Rending,NIA Ac ei'itx;'77R-)07-U.179 �..` �^ naill:fiaCrilu nlellll'eiie5e�.ryrrl - `9.-- 17vgrntul3rrhnrirrrd 7i+: ssryw'.are Iml mee€ics.cmtl Make turd Lira l{cichkn ��`"'�+wa 74 1Vii9mv itidgv Ita:ul HKi Lie.ft 153163 Home Medics,LLC N111111N111111AlliII)III.MA III%45 ('mwit Ilion Slater,LIF.ft1011212 C.308-380-2647 lEslinwhJAgrrclltcast J1:297213 fi€r.7v1-,mv-L• Ci;SID pLl"Filk NO: ?jfI ._til,,.;ril.capl !date:Allgtmt 7,20)6 Joh Lr,rnllnru 74 Wdlnm Ridge Itc,:ld }1 - nnrll;.!plover,10A 01945 j E3F38. % t [r,rrlierluJnk2dgrrrrrcnu,lfrrrS'rrvf:rr L4 r lis R plant n S ,,{:arl !q.C___.1 E irRcmxrsafi mpin<c the trrsn,y;sriudou t nnr iasysy uad mtr,im c;-srnts mpeef Il xvwh toaias: iSi«5k1 �£Arin .Uanun I}I'Inrrr l; , 1R•5,til'i hung ' `DR,2,Jublr flunk; ! Kh-1 1)111!,111­t to he rcplaccd'ill'slidingwind,+- �I3A-I dII hang tt—l dnnblc hwrg,ud I unit cwdosting of x picture wirlEau-a ith SlnnAing daa6ls hang• a JAIIAEJ1 I dnuW hnng 1_lnor 2I i ;till I I dunhlc hoop r �Ilf".2 double Iwng pit 3 26.1d.Inwg %VIA.3 duublt hung ik 1Sk1\I-2 dunhlo huuR �All upagings Brill Il tI*11,11111,4 and 11111INIM prr'i,ad). i 'IAll e.Llrtlor rosin Fs to IT repinceA will,tan+pusilo Ili m board and fzsiencd with phsgiiW1,hidden trim'clews 1ISrtrrior nim daail m he tlA rnsinh xnhod O)silo and cu,u".61,sill nod"e.(t­Ill,Flixlu3tt I wNI,) I -lniervIrim8Yaii robe rasht(:s�mnnd O)si�laitanlatrlr nsbe<s in rhe Ior ),nwvdedsill muWryl n,v1skirl6crlwecd h,mn•aharo Wil,'Id") A11 inFledoc casings la be rgdaced,dih p.insrd pin,will)T"011e io u+atch whcry III home l n Irrsn j� el r i r! Jl ff r in �sulrrUnn,th�h4uh,fa 1 tUcru,ndl r orf x^•r 3umeru t1/fi„ IMnr t I C usi usli alch r c nha ponseil pin u I ru!art t or taswps nrid Sill no 3np4 p aY u.+tsx and uthct<S iSl f Illcd 3)351 I pOtcl 1rp al rulmn rlr,run lrf ]dl,ildrF ml,rblsaud relnkl-!1 (ndy-iiofd Ipl ttniEh,usd) _ Ymlu Eluiidn:l,PanIII Fu Eh ( hI pv III llIIs.Itn11INSihUf1 (I i it J_I Ipill 37510(I ipiulpu L 52C�m ()pli ff r_r e�l l•li ll-{2)Ir nl,fe wlndnts WilM so sli,91,b J III 1151 1€ali s �(nrl crttry,{crostn,tl un Addlhrm! p 1}I 1, lliTri[ ,kLiR I]LIZ thuc lhcann.1211 n}cE..nhr]I sl L E .udt,rEh ringEc l.�sy+rmdnwtnd. -_4;�t1_..� W,Admin,s4 diol, �Iternosa i f f IunE nrttlln s ltt 1' �tR to ncmmn;udiE r as.xC•E indr ser c: h Icni tg I t II'rI - I t aingi pal 11,b c4 tr Yt rolly:'nA cnYyas 15 11 ft Iy/ni 111 irit -I ra,il Oihapl•nit shrug!,cal fir6 over i q 111v mr tlpmnim t v has }I b t t 1 df2) .hsy I JicrL o p I ilr m lE illi NINNS;AtY) i Ui o r _ Ym incl IdHigJ ni t9_ ,ili plltnnEs vrdnglum6e vn)4nri t... nes, k vihmy,liter aJhxsnc_t erltl , l nlaicinrcnLls f��ca.+rr�r krb)Itrn1:•+t ins1111rus�'rOb(r• ` { - ..o... mrhrr ag'isey Idldrov 4sl llinlhJus:' DaQ1„ Torn_ i[ if 1/2 ill, 113! 7, /f f !f lrr,tn,rr.r r oyr, 1 i d J nen ry let 1.11 s f 'f I If t ,Sddnr rf,.,.;mnt7 gnrrufdv<r fToar sAutw cul on, r ,fi .dymrg,rmrirr vner J,r11vs rMfrraf+ur U.rrrnr f] + uuLr Igor•n ,7r+.rk,r"r n,rl,rl,:,,ILrN "r,=r,rJl,r,lh;rc,r:fl hr NMI­,/I f'mlir)rinr^.il'r xr,nrrri<lrnn,r�vJ'rn«v.»s.ll,+„n dr>auI uaur rkr.xr nicn,rr•,,ira•rJ.p7ro±•'inrrro J�����_ IMI mrd l.lrn, Thank rnr,very much f r rh nppaaunhyI nvrrk n1 y'nur lr aw.IS'r,err vrrp grurrfid rrrrr!nr hryra m hrnhlr rnprnrfdryna r'dh aur ar.rk'rs. tirhrn•rv,n!carr n r-hrurrr ro­Ifhr injarnrnlhnr,Pl:wsr 1•t me knnry yrn,r rhurrgfos mrd how J-vu,.uuld like n,pnrrmd. Thmrkyafr mp•mr­h.ft, "arpr(lilrgr er,s J•oa. S'fn.rrrlsy ,tfnflrrn•fuMre ' ThetmK you very inucfl firr,l ono.rmisideratimf. Ifir grelelh'appreciare youl,husiness mrd lnnh jnJnrrlyd to proL4111rg you Ivilli ercrlulnnrrl qurdirr,ill a professional,near,fimefp«Ilei efficient menmer•.Our 1ltrmher due goel IVy our Complefr safisJacllnn. Atccpied:Tllc.Ibova prices,speclliralio+s anti eorrJltions arc —1,- -^ `��G 16 satlelactoty at,d arc hereby ace pW.Ac,,!roto,Mcdirs,LLC is �_,.-.,_... antharizc,l to rlo tha work as specified.Paymtnl will be afar ax ,SI�,IYilf llJ"F%��� !1€e Sigh!!€l11'C - Date ' boa „ :: .,.. • . , . Yacshi, urv 'treet' '" Bns,014 MA OZ111 * w,fnaugovId i ,Workers' Compensation lnuxanceAfdan't; olde /, txad" rsn /Elettriaaus/P1,u rabeY�:;,l.-� Vale 'n# v i2 me. Musiuess/grpnizga0 q/t 4Mdwzl); dca 0 % ,,' t.dd re5s- 1 • ,,w�rev,.r - ' :ity/s tati/zip: W l , I�'�' li J a�{ .. .,Phan #: �- zw re M an=pitiyer":Check the appnpriute boxc- frGJ I axn a employer with• 4. [ I;M tkinc al Typed project(regWr ed,):, ' cnatp loyecs(fi>ll,atuUor part- a.'" }i�vc:fired -�coittrAcodr an I 1. 6. [].1+*ctmstmetio C1 I a:=a'sole pmprietar or pi rtncv. U16d ozi thc.a c t 7:`� ctaadelirtg ; ship and have no employees Thcsc sub- "gc!actomha re' �J r.: 8: Demolition . wor4ig for me in any capacity.' tworkeis, +gip-.mica. 9. [� Htu'Iding addition [Wa workers' camp. urancrr. ' S, '[ We*re a edzporation and its , rcgtrircd,J offlcecs have exercised their 1017 Electrical repairs or adtiiriQrrs' j (� I am a homigowacr,doing all work right,df ex=ptj=per MQL' I1.Q.Lylmdbing repair ar additions myself.(No workers'.comp. (4)►.,Md.we have na. . insuranco,required j t P �•tNo vVQrlCt 12.❑ l�of repans • cam, iitsttrttace regtrireci.j 13.0 Other ay xppHc=t that checks`bax,#i must,alao fM otit:the to o*n t4 ia"w,40wicg!heir vnd w cetxtpe asat mpollay iu t{an lamea wnem who submit thia affi&vit inditadn$they,era do ws 4?kude'� Win outt{d,a catttrtcutta mmtca+dnxir a pabv davit iadit:aotfst�such. attw=wra that cbackxhta bdx must acnudhad pit addit{aissl;sherariJwt 't6� tj�diAat►b*cagttt�tCta attd�thait Wafitata'ca�p..i►ofl inf aY ssrrrsstiatt.: am.an.emiloyer that IS provging warlurs c l,com nr a fora: fvrmar'�an.: P kiumg'e`olfqd':Oy`irnplayeas,. Mew it tfcd•.pollcY,ar:d,fa¢,slt'e . :�rttsrzra,�gfi�a. , tsur�ce,.Company Nanac•' , 4licy r cyr Self ins.,Lie y _ Expicratiaii Mae: A.Site Address: ��� Qcw City/stati;/2,ip: ►ttach a copy of the workers' cbmpi nsanion.paltcp dectttrattaw page(shawingtie pLtcp number and egytratfoa dstta). ailuse to saaue.coveragc as mq*cd•und-er 19ecrib 26&gfM(3L'c. 152 can lead to thi-=p6sidan.ofc t»peoaltito of a" ine up try 51,500,00 and/or tangy-yea tmvmomprlent,,* dllguie penalties in the farm of a SATO WORK ORDM and k-f e )i up-to S210.00 a day ag#Ut the violator., r,advis«1 tdA ,a to R':cyf this star mcnt4tnal+'bc fvravaatdcrl ay tlae C? ce:of nvestigIdq'uS of the W6 frac kswrance.covdrxge verifiaad*n ," : , r do hereby Ce enalt#et ofirlwy tsar;the,btfbm #ota pmvWg4 above 13.vW and aorrec4. p cW'use oil �o'not wrl�rir are to be cd*ire r ,f)'i' only., ire th�fs: a,; pl�atd•by,'city-or town a,�clat; i"• . City"orTowni' 'Permirtll»tcetise 0 I30ng Authority (cirdt4ne): ••r .Y','Board of Renith' L Building Depn,rtm►ent 3. Chv.frpwu,9lcrk 4.Ebz�ctrtcai Inspector 5,rIumbiug Inspeamr 6. Other Cootatt7trson: Phand At: ACEHOME-02 S IMOES �® CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DDIYYYYJ 12/06/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or 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 CO Durso&Jankowski Insurance Agency PHONE 11 Saunders Street IA,G,Ne,Exy:(978)688-7000 FAX Noy:(978)688-7001 North Andover,MA 01845 E-Mal ATMA SS INSURERS AFFORDING COVERAGE NAIC q INSURERA:Utica Mutual Insurance Company INSURER£ INSURED INSURER B: Ace Home Medics LLC INSURER c 57 Harold Parker Road INSURER D Andover,MA 01810 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. ADDL SUBR POLICY EFF POLICY EXP!NSR TYPE OF INSURANCE I D POLICY NUMBER M D LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,0©0,©0© CLAIMS-MADE PREMIS Ea ocw OCCUR 46$7243 09!2712018 09!2712017 DAMAGE TO RENTED 500,00© ca $ MED EXP An one person) $ 10,0©0 PERSONAL&ADV INJURY $ 100,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 00,000 X POLICY❑Tar El LOC PRODUCTS-COMP/OP AGG S 2,000©,000 OTHER: $ AUTOMOBILE LIABILITY (Ea aaccidunBINED S1NGLE LIMIT $ ANY AUTO BODILY INJURY Per arson $ OWNESONLY SCHEDULED BODILY INJURY Per accident S AUTOAUTOS ONLY AUTOS ONLY PeAUTOS �ac£.riRdeni AMAGE S UMBRELLA LIA13 HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEO RETENTION 5 $ A WORKERS COMPENSATION X PERIIIE OTH- AND EMPLOYERS'LIABILITY 68724$ 09127/2016 09/27/2017 1,0©©,000 ANY PROPRIETOR YIN Y� N 1 A E.L.EACH ACCIDENT $ (%andataryJn NHy EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1'�$a`ODD if yes,describe under E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below u j DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) u carpentry-residential interior carpentry- 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. 384 Osgood Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved. i The ACORD name and logo are registered marks of ACORD y e'7RRIIIfIlftlYff+�ll�lJR OlNtceafCom marAClhEm&BadIeURGIChdah I:IMPROVEMEW CONTRAfnOR lstnttion. 10165 Y14W. ...; �csltattonr t #1a DBA MAT PREVITE WOMB MATTM W'PRZViTE 67 HAROLD PARKER ROAD' A40OVER.MA 01810 iredarsee"ry , r Mao achuea"department of Public Safety 90OW of Building Regulations and Standards- CB-100212 taindards- CS100212 Construction Supervisor S pnJffE A,yItM D PAPJWR:f�9F'.' ER MA 8010 ' n � Rxgiratton: Coinmisslanar aa1a�I:rt�� .r 3 u o ' E u ' u 3 3 •