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HomeMy WebLinkAboutBuilding Permit # 12/6/2016 t4oRr 6A BUILDING PERMIT of TOWN OF NORTH ANDOVER Q ; APPLICATION FOR PLAN EXAMINATION q Permit No#: o l Date Received RSSgCHU5�i Date Issued: LWORTANT:Applicant must complete all items on this'page E_Q:CATIQN h Pr€nt PROPERTY OWNER _ - - - Print I Qo Year S#r &re yes no MAP 1. PARCEL: e QNING DISTRICT Historic District yes ro° Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building a One family 11 Addition 11 Two or more family Li Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement E Assessory Bldg ❑ Others: ❑ Demolition ❑ Other - 0 Septie 0 Well 0 Floodplain 0 Wetlands ❑ Watershed District Water{-Sewer DESCRIPTION OF WORE{TO BE PERFORMED: dentifi tion- Please Type or Print Clearly' `�1 -L , OWNER: Name: ; ,l = Phone: Address: ; Contractor Name: �� P:_hone: 1 kor Address:_ � 5 Supervisor's Construetiori License "_ Exp. Date,:- . Home IM roverrient License: . Exp. Date?. 3V , Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Ijr bF SEWERAGE DSSPOSAL Public Server ❑ Tan ingfMassage/Body Art F1Sw ing Roots Ll well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF U FORM PLANNING & DEVELOPMENT Reviewed On Signature .COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on c Signa.�Ure--)- COMMENTS Zoning Board of Appeals: Variance, Petition leo: Zoning Decisionfreceipt submitted yes Planning Board Decision. Comments IA®RT�-j own of 2 o ndov( �. - � . No. o� - -�. _ y( h ver, Mass, T OCOC LAKE KlC Hl wl{R � `.gSa�flTEp P4�`�.�y V Food/Kit PERMIT T LD Septic Sy THIS CERTIFIES THAT .... eic......40.C.M.0.�w ..... .�. ... ! ....... has permission to erect .......................... buildings on ......ASIM........e.r.4 _.....Sr*..= Foundati �.,L i Rough to be occupied as ... ,. !,f.s.l .....;Rh..... .!t.a....�....�h........�!.� �. 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. VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTZAR Rough Service ....... .. .............................................. Final BUILDING INSPECTOR Occupancy Permit Required to Occupy Buildin-e Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner Street Nc Smoke D rV 151 Tyler St. Methuen,NU 01844 RR n soon Nip 95 go Is U5 O.M I Phone(617)599-2624 demmonse@hotxnall.com 3 1 W 1HOME X11 - V - J December 4,2016 Ensminger Residence Re-252 Gray St.North Andover,Ma. Third Floor Enclosed is our agreement for the above referenced project. My price is based upon our discussion of how you would life you t and bathroom finished. Base Bid$13,350 Scone of work • Frame walls and strap the ceiling in designated third floor area. • Insulate third floor to code. • Demo and make safe existing wiring • Furnish and install new circuits,receptacles to code for the third floor. • Furnish and install new recessed lights. • Finish walls with blue board and plaster. • Install half bathroom where pre installed bathroom plumbing was. • Painting and carpet is the home owner's responsibility. Qualifications • This agreement applies to the third floor project as discussed, • All materials supplied by contractor unless stated otherwise. • All work to be completed during normal working hours. • Proposal is valid for 30 days. • All work to be done in accordance with current codes Exclusions; 0 Anv work over and above this proposal will be completed at an additional price. 7We Commonwealth of'Massachusetts De,pa tment of j-ndUS&iajAceide S y T Congress street, xS`d to 100 Boston,YM02 �2017 rass:go-Pldia 5 iyc Wc� kers' Co-apensalionbsxxraned Afl"xdwdt:Bui�dexig/Couto aetaxSlE ec iciansl�� nbers. To BE QED Wl -U TBN 'ERMIT'J�Na.A•UTROZtr Y- Please S'xlnt Le bl A ' lx:ant fufoxmation Namo(BusMess/(rgaixzajiC)D& iv dudy Ad&css: f � Pnolt; City/statelZip. 1►�n 0i Axe you an empToyex?Checl f3ie apprnpria#e box' Type ofprojeet(xe(laixecl)' 4 ' withp em loyees(full aud/orpart time).* 7. ElNG`PV co775trUct Oil j.❑ am&employer 2_�jlamasaleprnprietororpar€nershipaudhaverroemployees Worlffngfor znein $. �Re3�lodaiig "�any capacity.[NW norkev,comp.insurance required.] 9. Q Demolition 3.olamahomcowne,r doingallworkmyse7£[Noworkers'comp.insarancerecluired.7 s 10❑Building additiOn 4.❑I am ahameawner and will bo hiring contractors to conduct all work on my property. I will 11.[ Eleo ical Teppjts or additigPB ensure that Acontractors 41erhave workers'compensation insurance or are sale � '�.pli�mbixrg xepails ax additlol3S proprietors witana employees. 5.[]1 am a general cont-ctpx andlhave hired.the sub-cont<actars lined onthe attached sheet. 13•.L]Roof xepait's' These suh-oon#ractors have employees andbaveworkers'camp.insurance 14. Other 5,❑We sre a ao oration and its,offcens have exercised their right of exemption per MGL c. F 152,§1(4},and wa haYe na empldyees.[To workers'comp.insurance regraired 7 a lrcanfifhatehecksbbx l mnstalso'fdl ouEthesectionbelowshowing-their-Workers'campersation.polieyinforraation` *�Y PP JIemcowners svha submit#his ai davit indicating the on dhmtgshowing tlrs nam a suh contracto s and sta ewhether ornotthosaentiti have tF. Contractors that el5eckttitis l]ax Arun attached an additional olr number employees. If the sub-coniiaetors have employees,they mustprnvide#heiz workers'comp.p GY ,am an ,,Iyer t1latis-providing-varkets,c0n2'p6nsati0n insurancefor my empZ�yees. Selayv is po2icy wzdfo�site information. xnsurancc COMPaUY Name: Expiration Date= Policy# or Self irw.Lie. :. City/State/zip: ALtach a copy of e�vorkexs' tarnpegsationpoliey declaxatiorzpage{sSxo�vzugt�epolicy7aunamishable�beaa e p jiration date). ob Site Address: UP to$11,500-00 Failuro to sccuxe coverage as requixed,urdez penalties the f zm of S TOl'WORTS ORDER and dna of up to 250.00 a and/or ane year impxisonment,as well as civil P day against the violator.A copy of this statemerxt xray be forwarded to the Office of 7nvestigatians of the JC A for insuz attcc 12/05/2016 12: 39 978-777-9804 JOHN J DOYLE INS PAGE 01/01 DEMOERI OP ID: DR DATE(MruUDDIYYYY) �'ORC�• CERTIFICATE 4F LIABILITY INSURANCE 05/1212016 THIS CERTIFICATE is IaSUED AS A MATTETE HOLDER.1HIS OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDEDF INFORMATION ONLY AND CONFERS NO RIGHT5 UPON THE ABY THE POLICIES CERTIFICATE DOES NOT AFFIRMATIVE BELOW, 'PHIS CERTIFICATE O AND THE CERTIFICATE NOT Q DER UTE A CONTRACT BETWEEN THE ISSUING INSURER(&), AUTHORIZED REPRESENTATIVE OR PRODUCER, IMPORTANT: If the certificate holder is E rI ADDITIONAL INSURED,the Poli0009) must be endorsed. If SUBROGATION 18 WAIVED,subject to the terms and conditions of the policy,Certain pollc[es may require an endorsement. A statement on this pertlticitte does not confer rights to the certificate holder in 11ev of such endorsements . CONTACT Kevin C Lawrence PRODUCER NAMES "' FA 878-777-98D4 PHONE � WC,Na lohn J Doyle Insuran4e Agency A878-777.8344 C�_f's 19 ConstitUtlon Lane Ste 7 IIIIAIL )anvers,MA 01923 RAD�IESS: (evin C Lawrence INWRER(3)AFFORDINO C0V6RA0F_ NAID k INEIiRER A, Safety insurance _39454 ENEIVRED Eric Dernrr7oAs�T INSURER e 151 Tyler Street INSURER C Methuen,MA 01844 INSURVI.D: -- INSURER F: {N$URERF I COVERAGE S CERTIFICATE NUMBER: REVISlOP!NUMBER: THIS IS 70 CERTIFY THAT THE POLICIES OF ANY REQUIREMEIITNTERM OCE FR CONDITION OF ICY PERIOD ANY CONTHAVE BEEN ERACT OR OTHER DOCUMENT WffH RESPECT TOD 70 THE INSURED NAMED ABOVE FOR THE LWHICH THIS INDICATED. NOTWITHSTANDING DE STAN© CERTIFICATE MAY 0E ISSUED OR MAY PERTAIN, THF INSURANCE AFFORDED 6Y THE POLICIES DESCRIBED HEREIN l5 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS. uMiTE) i TYPE OF INSURAN99' POLICY NUM@ER MM DDfYYPQ YY NEM OU YYY 1 I]OO 000 EACH OCCURRENCE $ ' A �( COMMERCIAL GEBNERAL LIABILITY 0212712(11 ti 021271201 CLAIMS-MADE CI OCCUR BMA0023240 P1�M. ISE3.( a autlrr9 ea 10,000 MED EXP(Any one personl S - — PERSONALS ADV INJURY 3 _ —. GENUPAL AGGREGATE s 1,800,00 GEN'L AGGREGATE LIMIT APPLIES PFR, PRODUCTS-COMPIOP AGG S POLICY El,PICC L�LOC S OTHER. (rOMBINED SINGLE LIMIT $ AUTOMQU14F-)EARILIYY (E.I" BODILY INJURY(P0f pr�renn) S ANY AUTO BODILY INJURY(Per sodden!) S _ ALL OWNED SCMEDULED AUTOS AUTOS PRD RTYDA AGE S NON-OWNED Par aecEdont HIRED AUTOS AUTOS S EACH OCCURRENCE S — UMBRELLA LIAO OCCUR AGGREGATE EX(BS9 LIAB CLAIMS-MADE DED RI:rENT14NS PEN oTst- Yy4RK2RU COMAHNSATION _ STAT VSE .. ER AND I_MPLOYERB'LIAMMITY YIN E,L,EACH ACCIDENT $ ANY PROPRIETORIPARTNER10)fECUTNEE fel N 1 A E,I„DIStA$8•EA EMPLOYP-6 S OPKERIMEMBER EXCLUDED? u (Mondat6ry In NH) E.L.DISEASE POLICY LIMIT IIyyaCRaezOiNe aOnFdOrERATIOpSIPaTIzePNS $ baiow DESCRIPTION Of OPERATIONS 1 LOCATIONS f VEHICLES (ACORD 101,AddlUonot Ronl7rkA Eohoduio,ms,y Ho attaeho if mora ep000 le requlree) s «��zrc%�rretfa mjxo;rtueatC� ,._ Office of Consumer Affairs&Business Regulation y OME IMPROVEMENT CONTRACTOR pe: Registration: %;3,78177 ._��.. Expiration -3120!2018 Individual - ` ERIC W.DEMMONS ERIC DEMMON 151 TYLER ST METHUEN,MA 01844 Undersecretary Massachusetts Department of Public safety Board of Building Regulations and Standards License: CS-101978 Construction Supervisor ERIC W DEMMONS 151 TYLER STREET j METHUEN MA 01844 3 Expiration; Commissioner 06/14/2018