HomeMy WebLinkAboutBuilding Permit # 12/6/2016 txORTH
.z hBUILDING PERMIT .ar rt6 <
TOWN OF NORTH ANDOVER a
APPLICATION FOR PLAN EXAMINATION
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Permit IVo Q - / Date Received �" 'yy �,�o P¢ �`
ace�us
Date Issued: I- �_ _.
LAPORTANT: must complete all items on this page
LOCATION
Forint
PROOF
RTY COWVNER '
Forint 100 Year Structure yesn
ZONING DISTRICT: -_ Historic District yes no
MAP PARC EL C
Machine Shop1/tllageT yds o
TYPE OF IMPROVEMENT PROPOSED USE
__._ Residential Non- Residential
U New Building —^ Ione fiamily —
U Addition d Two or more family ❑ Industrial
No. of units: C7 Commercial
ATferation �
Repair, replacement - CI Assessory Bldg F1 Others:
❑ Demolition f.7 Other _.
Septic D Well ❑ Floodplain. D Wetlands [I Watershed .. is rte
❑Water/.Sewer
DESCRIPTION OF W FtK TO BE PERFORMED:
_24 L7yt
' c-
Identification Please Tyle or Print Clearly
OWNER: Name: Phone: _ -
.
Address;
Contractor Name: _ Phone: 71-/- X 74
Address: " 2. Y-
Supervisor's Construction License: . Z0,57— Exp. Date`.
Flame Improvement License — � �_ E?�17 Date /"cf,! =_----
ARCHITECT/ENGINEER Ph° e:
Address:_ Reg. No..
FEE SCHEDULE,BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
otai Project OO t; $ / FEE: $
v
Check No.: / _Receipt No. t NOTE: Persons contracting with unregistered contractors do not have:access to the guaranty fund
Cig' "t' e of Fuger tLOwner Signature of contractor .,
NORTH
To �.wn of ? .. : .. Andover
No. -
h , ver, Mass, / d/
CoC.RCR.W.[R V
Ab
Are
s U
BOARD OF HEALTH
Food/Kltchen
PERMIT ::T LD Septic System
THIS CERTIFIES THAT .... �.......,i�..�..1..'.!.��(iA..�... ...................................................... BUILDING INSPECTOR
has permission to erect ..........................buildings on .......�.d.........C. ., '`L...... Foundation
//�� Rough
to be occupied as �. . ....�: .. ,. � � !�►.�, 4r.. !..�• 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 provisioni 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 CONSTRUCTIO TARTS Rough
Service
......... . ..... ...... ..................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Miall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
Mark H [fida
From: @co oaoLneQ
Smmu'' ."es"" ^,,,~.~,. 2,. ^, _ .: _ P_ .
To: 'Mark \�m�; 'Hamboyon. DoniaD- BOSTON MA� 'Ellen M. Ho�yen
Subject: RE: questions comments 11-28-16meeting
hiden and ellen
nice join gettin�,),everything cleared out'vem nice!!
tu-,dow is a recap of pricing so we are. all on the sarne page- i air ordering windows I.oda V.. will have you guys look at the
ucknowieJCementwheni �etitfromharveys5oyoucanhaveMnu| apprnvaLpiease \etmeknovvifiheneoreany
chanOesurimissedanythingnrifYOU have any questions atall
thank you for the deposit, $1O'000.0O#1127
� PRI(JNG RECAP
w
1,7,8O0,00 masLer6adh
w I9,50UQ guest bath
m 12,750�00 windows
�
2950,00 crown molding
w 3250-00 add 13recessed 'mb=S,dens rm=4,medrm=4includes 1switch- owners Losupply Hf,?,6tsand
switches
� 300�00 add outlets- l |nm6corner arid 1inmedroom corner
w I500,00 rem*ve3bedroom ceilings, board and p(astersmonth
* 3,OOO�UO replace casings with 1Sinthmerooms and jus\theonevvindom/inihesparebed/oom' inu|u�es
|abor20O0.U0and materials approx1,00O.O0
� 3,4000O
painting 3 roorris inc ceilings,walls,trim, and one side(inside) of doors and no painting in closees
r 150.00 add back|nlighted mirror with out|ets' mayneed extra line frombasement
� l250,08 supply ind install metal stair pulldown staircase in hallway next to�west bath door
*
119PP-00tile one wall in nnaster bath.. asrecluL-sted., owners to supply tiles and grout
�68,75O,OO
p haseboardheatTGD.. will flet pricing toyou assoon auplumber lets meknow
1
finalize scopeof work and pricinf..;
2order windmws
� l supp!y all 8ghtin0fixCuresand allp|umbin�fixturesunyitef*re\ i � � plumber
� 4, provide sample orpidureofnmmm/indmmand door casing
FLOW CHART
' 1$2Weeks
� prep, disconnectasneeded, anddemoasperp\an� andfiumeb h 0'
* e|ecL/ira| and plumbing rough and inspecd*ns'
| m ovvnoryconhrme|ectrica| |oca\ions |mportant
3rd and 4th
16, electrical and plumbing could run into this time frame a bit �
* omofirrmmarble pieces set Lmgo.. temmp|ate, etc 2n6-3rd voaek \\ I~
� m
frame for windows
,
w lnsubteboard and plaster
5d` / \
a frame' and insto|| windows arid doors ifthey are neady'
01
v
marble install \
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We Commonwealth of Massachusetts
Department o ffndlistrzalAccidents
We I
Z Congress Sireet,Su .00
'd $ 11oston, A 02114.2017
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-X0 f3F x+ILED 4VC71 PI RI1drI T 4�1 ATJ C C(7 I X, .Please print Lef"M
12i ILI ant Cnfoxmatian --
atrizatianll'ndividuat}:___�_
Namo (Businessloig
AddTcss: 7-
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City/State%ftp:_ / _ _ - -= - — ,ye apxoject( eruixeti);� ,
,Axeyouanernployez`?Gtech he RPP
ropziateboxa
7. (j N nonstr6dtion
employees(11111 andlor part time)
I am a emplayor with,- _--• g• El'I..:exnodel3ng
2. I am.a sole proprietor or parnorslrip and hays no amptoyoes Mark ng foz me ur uir9. I1 DenlolitioTl
any capacity-[No workers'comp.iusuraaco sqed.] I
arkers'camp. "I 10 El 3Lilding additon
3.]I auahomeowner doingallworkraysrlf.[Now
will
d.-- Iamabomeownerandwill.behiringcoutractorstoaensatio,ll uranceork myproperty- 11.� lent:TLC'�lxEp�?xsoY Ldditlotls
Erin xe sox ar3ciitaaxrs
1 onsvrctllat all contrarci�or's eithrr have workers'compensation insurance orate sole 12� a Pz n. p
proprietors with employees•
S. o general cantraatar and I;havehired-c sub-contractors listed oathe attached sheat.
oyeos andhaveworkers'comp.insruance 14.
These sub carilractors have oanpl [�Other
6.E]We are acoandratihav6no' oyeQ�v[g worker�camp.�Qurance e�gnired MGLa�— —�
152,§1(4), p
— .
are doing all work andthen hiro outside contractor must subrai a n o Se fie b e h
*Any app]icaz�tlhat checks bhiclkl must also ill outthe seefionbelow showingtheirwoikers'campensatlonpalicy iaformation.
i 1-lomeowners vtho submit tins p Cdavit indicating they g the name of the subcontractors and state whether
Cantracfars that cliecktbis boxnusl attapot tho
ched an additionat shoetshaw%ng
employees. If the sub ccm{ractors have employees they muss:provide
the
workers'comp_po7icy numberi��—
Zo er t7aat is providing�varlcers'carnpensallon insurancefor my erazployees. i3elorsr is the paZrey and%ala site
I"am aro ern y
information. — --
htstitrance C0xn:Z3any1`Taxn•e:_ - pvatzonDate'. C rt
Policy 0.ox Sell ins.S ic.#: _ _ - _._. fI' u"✓""
City/State/Zip:_ --
"� the •nZic ntuxxbex azicY e�piratxon.date}.
;fob Site Ad(lress:._.� '�"�-- — -__ p g'(
Attach a cagy ofthewcrxl�exs' compensaiionpo7icy dedaxation a e showing • � y
al
:Cisilureto sec>zye coverage asxegzxixedimdorM 7tiesLrnthe oxm afaSimishablo by a-.HfLbUP to$1,500-00
ZOP��/JOJ?Z C rJ], and f�.nc Cu�to �254.U0 a
and/or one-year iMPT sonweut,as well as civil peva
day against the v%alator.A copy ofthis ataEcmoDt may be fol-warded to the Oft ine oflnvestxgatiox�s of the DSA foxirusuranc�
cayexage Vexication. -- --
__ —
under'tlzepains anrlpenalties afperjury tlxat tlxe infarmatianpr ovrded afanve is true a'dcarrect
X do ltere/ry cerfify e�
= ---_ - -- Date:
Do notwin
rite tharea,rea,to he completed by city ar'town official
offcial use only.
errni JICense
City or 7bw11:
Issuing Aulho3`zty(circle cue):
l..f3aaxcl afZxeaXLh 2,[3xxixduzg C7eparixrrent 3,City/Town C;lexls 4,Electxzcal Inspecttrr 5_l'luxribing Xns ectnx
6.Other
Cola:`_�_______—�--_--__—_---�._----._—
ACOR ® CERTIFICATE OF LIABILITY INSURANCE D 1Dl
12/0612016
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(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 lieu of such endorsement(s).
CONTACT Maureen Pollman
PRODUCER Brownson Insurance Agency FAX
139 Albion St.
PHO 781 245-2292 .781 245-3826
P.0, Box 349 eDMR=' m0 brownsoninsurance.cOm
Wakefield MA 01880 NSURER S AFFORD NO COVERAGE NAC#
INSURER A:Hafford Underwriters Insurance CO.
INSURED SURE
T&M Finish Inc. Ns E c:
52 Lake Street INSURER D
Wakefield MA 01880- wsu E:
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,
i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
i INSR ADDL SUER POLICY EFF POLICY EXP LIMITS
TYPE OF INSURANCE
COMMERCIAL GENERAL LIA9lLITY EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE OCCUR
MED EXP An one arson $
PERSONAL A ADV INJURY
GENERAL AGGREGATE $
GENE AGGREGATE LIMIT APPLIES PER:
L]PRI- LOC PRODUCTS-COMNOP AGG
POLICY JECT $
OTHER
COMBINED SINGLE LIMIT $
AUTOMOBILE LIABILITY
BODILY INJURY(Per person) $
ANY AUTO
ALL OWNED SCHEDULED BODILY INJURY(Per aWdent) $
AUTOS AUTOS PROPERTY DAMAGE
NON-OWNED $
HIRED AUTOS AUTOS
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAR CLAIMS-MADE AGGREGATE
E
A WORKERS COMPENSATION 6S60UB-9F53696-9-16 3/0212016 3102/2017 X PER oTH-
AND EMPLOYERS'LIABILITYYE.L.EACH ACCIDENT 100 000
ANY PROPRIETORIPARTNEWEXECUTNE �WA
A
OFFICERIMEMBER EXCLUDED? E.L,DISEASE_FA EMPLOYEE $ 100 000
(Mandatery in NH) 500 000
Ifyes,descriha Under E.L.DISEASE-POLICY LIMff
Coverage under Workers'
Compensation is excluded for
Mark Halliday, President.
DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(ACORD 161,Additional Remarks Schedule,may be attached If more space is required)
Carpentry operations. Hartford Underwriters Insurance Company will issue the Workers'Compensation Certificate. 12106116.
Project: Denis Hamboyan,50 Mcambell Rd.,North Andover MA. (2)bathroom remodels.
CERTIFICATE HOLDER CANCELLATION Al 098313
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of North Andover THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Building Inspector
120 Main Street AUTHORIZED REPRESENTATIVE
North Andover MA 0 1845-
Fax:(978)688-9542 O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
' ViL6 l(�f)'/�lAlzo4llceeUfC�Q����CIJ tC7C,�e[[aLti-,_,
Office of Consumer Affairs&Business Rppao,on'
kq,,FOPIIE IMPROVEMENT CONTRACTORType:g�stration 184222iratinn:>- k214 12017, LLC
BUILDERS,LLC.
;MARK HALLIDAY
52 LAKE STREET s —
WAKEFIE;LD, MA 01880 Undersecretary
Massachusetts Department of Public Safety
vrBoard of Building Regulations and Standards
License: CS-903435
Construction Supervisor
MARK S HALLIDAY�
52 LAKE ST
WAKEFIELD MA 01$8
�.M CA— Expiration:
Commissioner 03/12/2017