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HomeMy WebLinkAboutBuilding Permit # 12/19/2016 _ NoRry BUILDING PERMIT pR rot �1 y TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: GI Date Received cNus�-c Date Issued: 1MPORTANT:Applicant mast complete all items on thi page LOCATION _ 1 LxU Pnnt PROPERTY 01NNER Pnnt 10D Year Structure yes no PARCEL ZONING DISTRICT H�stor�c ®istnct yes no Machine Shof�,Viflage:._Y._� nfl TYpE OF [MPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building A One family ❑Addition ❑Two or more family fi Industrial El Alteration No. of units: F1Commercial epair, replacement ❑Assessory Bldg El Others: ❑ Demolition ❑ Other ❑ Se tie O We-I' 1�. ❑ Floodplain Cl Wetlartcis_ t ❑ Watershed Dstr�ct D.Water/Sewer.: . DESCRIPTION OF WORK TO BE PERFORMED; Identification-- Please Type or Print Clearly OWNER: Name: u Phone: �t�� U 7 Address: IV+ R"'7o►/�'1 c9�1► -...�-+.t_'ha11e: 51 : Contractor Name: , . . . . Address:. Q))— r7_... � -� V V� z �� Y,,L-r=7 aTC�t Supervisors Construction l cense a 7. ! cl -- Ex : tWpr - P Home Im rent Lieense 6 J _ ... Exp_ Date .[ : _ _� ARCHITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDIMG PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASEL?ON$125.00 PER S.F. '. ,rotal Project COSI: $ � U 13 FEE: $ Check No.: G Receipt No., [ NOTE: Persons ting-wkA-wnregistered contractors do not have:access to the gac army fund SVigi afioreof.A entlUvtir er Signature of coritracfor t%ORT1f owe. of � Andover jbNo. � * - h ver, Mass, d! 0 CO[MI[ML W.0 K �-4s RATEO P4R`,i+�� L) BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .... �c. .�► ...Fl.vir AterfV.......................... BUILDING INSPECTOR has permission to erect buildings on ... .. . ..� .. � /<< Foundation ................ .... .�......... Rough to be occupied as .. .... ......%j&.........Ittok.m.4)... ... , r �..� Chimney provided that the person accepting this permit shall in every respect conform to the terms f 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO RTRough Service ................ . ....., ... .. .,,................... ".. Final BUILDING INSPECTOR, 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. Arbella Protection Insurance Company A R B E L LA 1100 Crown Colony Drive COMMERCIAL PACKAGE POLICY Quincy, MA 02269-9174 RENEWAL DECLARATIONS DIRECT BILL INSURED -- ....... --- - - -- ''i?FF�Aii#CY:>EyR[i71' i..'.'.'r:i;;':Si" -':` 'i>:#'Sfi}:;;;iii ........ ......... i::_r :::::..::.;:.:. :.........:: :" Ez.':##i?P?ii:,::.:::-::.....; .;!' UM4$ :..... i�C3L1GY.1IE1f.OBER..............:...,...-..._.. :::::..,...__:-.. G1M....::...... :: ;,«::: 13E # a:.2`7.. .. D6/12/2016 06/12/201 1201 AMSTANDARD TIME 6 RICHARD FLUET CONTRACTING INC SEGREVE & HALL INS INC 102 BRIDLE PATH LN 305 NORTH MAIN ST METHUEN, MA 01844 ANDOVER, MA 01810 20 ANNUAL PREMIUM: $5,120 FORM OF BUSINESS; CORPORATION BUSINESS DESCRIPTION: CARPENTER WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS. COVERAGES PREMIUM Commercial Property Coverage $100 Commercial General Liability Coverage $4,920 Commercial Inland Marine Coverage $100 TOTAL $5,120 FORMS AND ENDORSEMENTS MADE PART OF THIS POLICY AT TIME OF ISSUE 28AP1264 01-15 OFFER OF TERRORISM 30AP1001 01-96 COMMERCIAL POLICY JACKET 30AP1078 09-14 EQUIPMENT BREAKDOWN ENDORSEMENT 31APIGOI 10-09 MAIN SAIL PROPERTY COVERAGE ENDORSEMENT CP0090 07-88 COMMERCIAL PROPERTY CONDITIONS CP0109 10-00 MA CHANGES CP0176 09-06 MA EXCL VIRUS BACTERIA IL0017 11-98 COMMON POLICY CONDITIONS 30AP1093 02-02 ASBESTOS EXCLUSION CGO062 12-02 WAR EXCLUSION CGO063 12-02 WAR EXCLUSION CG2149 09-99 TOTAL POLLUTION EXCLUSION ENDORSEMENT CG2196 03-05 SILICA OR SILICA-RELATED DUST EXCLUSION CG2426 07-04 AMENDMENT OF INSURED CONTRACT DEFINITION CG3370 03-05 SILICA OR SILICA-RELATED DUST 'EXCLUSION IL0021 04-98 NUCLEAR ENERGY LIABILI EXCLUSION AGENCY AT ANDOVER MA DATE 04/21 /16 AUTHORIZED . OUNT=1(3NATUrT PAGE 1 Arbella Protection Insurance Company 1100 Crown Colony Drive, Quincy, MA 02269-9174 ` PROTECTION INSURANCE COMPANY WORKERS COMPENSATION AND EMPLOYER'S LIABILITY POLICY INFORMATION PAGE Policy.Number' ;Transaction Effective pate Bill Type 4220051550 01 RENEWAL 03/31/2016 Direct Bill , Nameditnsuredand Mailing Address .` Agent. 28.20' RICHARD FLUET CONTRACTING INC SEGREVE &HALL INS INC 102 BRIDLE PATH LN 305 NORTH MAIN ST METHUEN,MA 01844 ANDOVER, MA 01810 Phone#978-975-1300 All workplaces are shown on an attached schedule. 2, .. Policy Period at 12:01 A.M:Standard ai Address of Named:Insured From: 03/31/2016 To: 03/31/2017 :Form cif Business.. Business D'escrlption Corporation CARPENTER 3.A. Workers Compensation Insurance: Part One of the poiicy applies to the Workers Compensation Law"of the states Iisted here: - �— Massachusetts 3.B. Employer's Liability Insurance:Part.:TWof the policy,applies to Wori:in each state'listed in Item 3;A The limits of our Liability under f?artTwo are; . Bodily Injury by Accident $500,000 Each Accident Bodily Injury by Disease $500,000 Each Employee Bodily Injury by Disease $600,000 Policy Limit 3.C. Other States Insured :Part Three of the policy.applies to the,states, if any, listed here: ConnecticutNew Hampshire Rhode Island 3 D. This policy includes these endorsements and:schedules: WC000000C WC 00 03 08 WC000406A WC 00 04 14 WC 0004228 WC 20 03 01 WC200302A WC200303D WC 20 04 03 WC 20 04 05 WC200601A WC 00 OOODC 4. The premium for this policy will be determined by our Manuals of Rules, classifications,Rates and Rating Plans. All information required�on the.attached Information:Page Extension is subject to verification anct_chan.ge by audit. Minimum Premium Total Estimated Premium – $650 $16,857 FEB .12 2016 Countersigned by Date 68 AP 1021 01 16 4220051550 01 INSURED COPY 02109/2016 Page 1 RICHARD FLUET CONTRACTING,INC 102 BRIDLE PATH LANE PROPOSAL METHUEN,MA 01844 Date Estimate# 11/2312016 669 Name/Address E.LWOOD&JUDY BENT ~ 62 BLUEBERRY BILL LANE N.ANDOVER MA.01845 Description F RONT DOOR;INSTALL NEWT HERM2%TRU S236 WITH TWO 10"SI I70SL SIDELITES WITH LOW"E"GLASS.REPLACE EXTERIOR FLUTED TRIM WITH NEW 7"PVC FLUTED TRIM.PAINT EXTERIOR OF DOOR CRANBERRY.EXTERIOR OF SIDELITES AND"PRIM WILL MATCH EXISTING PAINT COLOR. INTERIOR.OF DOOR AND SIDELITES'WILL BE WHITE.REUSE EXISTING INTERIOR TRIM IF APPROPRIATE.INSTALL NEW LARSON STORM DOOR PAID FOR BY OWNER.$4438.00 DECK;REMOVE EXISTING RAILINGS AND DECKING.INSTALL NEW AZEK 514 X 6"DECKING(SILVER OAK)WITH.BLIND FASTENING SYSTEM AND.PERIMETER BOARDS.NEW 36"HIGH AZEK PREMIER RAILINGS WITH 5.5"POST SLEEVES WITH ISLAND CAPS.NEW STAIR RAILING ON ONE SIDE LIKE EXISTING.INSTA, WIiITI AZEK 3'RTM.BOARDS AROUND'I'H EXTERIOR OF TETE FRAME,SKIRTBOARDS AND RISERS.$12,575.00 BOTH JOBS INCLUDE PERMIT AND TRASH REMOVAL. PROPOSAL IS VAIAD FOR 30 DAYS, EXTRAS OR CHANGES TO BE COMPLETED AT A RATE OF$90.001 HR!MAN. MA.LEC.#50710 H1C.#106620 FINANCE CHARGE OF 1&1/2%PER MONTH FOR UNPAID BALANCES. PAY€viENT SCHEDULE;FRONT DOOR,112 WITH ACCEP'T'ANCE,BALANCE UPON COMPLETION. DECK;$575.00 WITH ACCEPTANCE,$10,000_00 DAY WORK BEGINS,BALANCE UPON COMPLETION. p Total 0,00 Signature • .� r 1( FJ Phone# Fax# E-mail "l 978-685-70 .0 978.685-7010 RFCl02@veriznn.net OP ID:J YYYi CERTIFICATE OF LIABILITY INSURANCE D 1211612IY6 1z11s�2a1s THIS CERTIFICATE 13 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 INS1URER(5), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; If the certificate holster 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 tills certificate does not confer rlght9 to the certificate holder In lieu of such endorsement(s)- CONTACT PRODUCER NAMES Segreve&Hall Insur.Assoc.lnc PHDNE Ax 305 North Main St. c c Nn Andover,MA 01816 ADORFSS: MlChael L.3egreve CuSTOME 10 •FLUI:T•1 INSURERS AFFORDING COVSRAeE NA1C 8 INSUREb Richard Fluet Contracting Inc. INSURERA:Arbella Protection Ins.Co. 41360 102 Bridle Path Lana INSURER 13:C0MMBrCG Insurance Co. 347B4 Methuen,MA 01844 ENSURER C €NBURER D: INSURER E � INsuRP F: COVERAGES CERTIFICATE NUMBER; REVISION NUMBED: 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. APOL SUM OLIC INS TYF9OFINSURANCE POLICY NUMBER MM@D MMID� Y LIMITS GENERAL LIABILITY F-ACH OCCURRENCE S 1,000,0 A X COMMERCIAL GENERAL LIABILITY 8500034727 06/1212815 06112(269 6 PREMISES Ea a-uurrence _ $ � 100,0 CLAIMS-MADE OCCUR MED EXP An—on" 6,0® 5,0 8500034727 DOM212016 0611212017 PERSONAL&ADV INJURY s 1,000,0 GENERAL AGGREGATE $ 2,000,0 GEN'L AGGREGATE LIMIT APPLIES PSR PRODUCTS-COMPlDF AGG $ 2,fl©Dr0 X POLICY PDO- LOC $ AUTOMOBILELUL IWTY COMBINED SINGLE LIMIT $ ('wa aCClden€) ANY AUTO BODILY INJURY(Per person) S 100,0 ALL OWNED AUTOS BODILY INJURY(Per scddcnq s 300,0 X SCHEDULrO AUTOS PROPERTYAAMAGE X HIREAUTOS XV1450 12/01/2016 12101/2017 (PER ACCIDENT) $ 100,fl D X NON-OWNED:AUTOS $ s UMBRELLA LIAO OCCUR EACH OCCURRENCE 8 _ EXCESS LIARGLAIM9-MADE AGGREGATE $ DEDUCTIBLE $ �- -- RETRNTION S $ WORKER8OOMPENSATWN WCsrATu- OTH- AND EMPLOYERS'IJAMLITY � G A ANY PROPRIETORIPARTNERIEXECUTIVF YIN E.L.EACH ACCIDENT $ SOD,© OFF€OERIMEMBER ExQLUDE1 NSA' 500,C (ftlandsteryinNH) ,220051b6D 03!3112016 03/3112617 Er,L.DlSEASE-EA EMPLOYEE 5 r K 6s desuibs under �,L.DISEASE-POLICY LIMIT S 800,0 D_RRiPTION OF OPERATIONS Oe1ow DESCRIPTION OF OPERATIONS I LOOATIONS 1 VEN1CLE4(AaRch ACORD 101,A001tionel Rsmarkn SthedOrs,If mors 6peue Is raqu;red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCIZIpED POLICIES BE CANCEL46D BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BIE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover,MA 01845 AUYNORIMP REPRESENTATIVE aD 1988-2-009 ACORN CORPORATION, All rights reserved. ACORp 25(2009109) The ACORD name and logo are registered morks of ACORD ^7lc�a�»»m�r�i�err�l�a�0%l�ad�t�r��rrelC' office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR iA Registration: 10882o Type: Expiration: 7124!20.18 Private Corporation RICHARD FLUET CONTRACTING.INC. s Richard Ftuet 102 Bridle Path Lane Methuen,MA 01844 Undersecretary Massachusetts -Department of Public Safety Board of Banding.Regulations and Sta^da, VU�I�LI if ltil)n J�ni:l l'191ir' � License; CS-00710 RICHARD A FLt,*r 102 BRIDLE PAIR L �� METHUEN MA 0184410"'x i Expiration 04/22/2017 Commissioner r