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HomeMy WebLinkAboutBuilding Permit #639-2017 - 106 BOSTON STREET 12/13/2016 OF N%oT a I IYMe �} ,( BUILDING PERMIT 3� b�;i,• ,`_h'•�6 °0 4 fo TOWN OF NORTH ANDOVER ° �1 ,� APPLICATION FOR PLAN EXAMINATION Permit NO: - 1K ey � Date Received � , <�;K:.... • ATED Date Issued: ��SSACHUS IMP RTANT:Applicant must complete all items on this page LOCATION � ��CO _ _R os 46 In S� Print , PROPERTY OWNER Print MAP N4' (PARCEL: _ZONING DISTRICT: Historic Districty s no Machine Shop Village s no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building C�-One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial kRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ❑ Septic ❑Well _, Floodplain ❑Wetlands ❑ Watershed District 1 Water/Sewer R Adz I I �L a1 Y- r 4194 Identification Please Type or Print Clearly) OWNER: Name: n�,h Z-7-1 Phone: Address: D CONTRACTOR Name: • Phone: 17 Li2 51� 1 , IdICE) Address: CZ Le Supervisor's Constructi n Licens Exp. Date: Home Improvement License: C g q go 9 Exp. Date: 114, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1; ,1,)6 6 "no FEE: $ 13 a�-- Check No.: '3(001 Receipt No.: 3 t33� NOTE: Persons contracting with unregistered contractors do not have access to the guar ty fund gnature of Agent/Owner Signature of contract i Location A1)510A/ No. (0 39 - 9-01-7 _ Date 1 A• /3• • • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ '®. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 1 Building Inspector Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ i TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL. SIGN OFF - U FORM I PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I I CONSERVATION Reviewed on Signature I COMMENTS i -, HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision.- Comments Conservation Decision: Comments Water & Seeder Connection/Signature Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS ` -imension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, roast or service dropjrequires approval of Electrical Inspector Yes No DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use) I I ❑ Notified for pickup Call Email ate Time Contact Name Doc.Building Permit Revised 2014 r Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. I Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit 1 o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ' o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ,I o Building Permit Application o Certified Proposed Plot Plan D Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerics office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. one copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 NORTH Town of O - y, f* OM iVol ver, Mass, oLoo A- COCNIc Ht WICK 1• 7� RATEO S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System . ..y!� f, ........................................ BUILDING INSPECTOR THIS CERTIFIES THAT .....�.��........�....�..�. ............. t.010.....6.0wrivev.......�� ...... Foundation has permission to erect ............�.......... buildings on .. . .....� Rough tobe occupied as ....... ........•............................................................................................................... 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 CONSTRUCT STAR 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 Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 01/11/2012 04:08 9786551128 EZZI PAGE 01101 Proposal Kaz Construction 112 Bayberry Lane Londonderry, NH 978-455-7317 ,K, pzConstru ion(&c*mcast.net Proposal submitted to: John E,zzi Job name:Fire Damage Repairs Ref#• 0158 Address: 106 Boston St.N.Andover MA Proposal#0158 Proposal valid till date 912/31/2016 Number of pages 1 We hereby submit specifications and details for: Replace damaged rafters Replace damaged ridge Replace damaged plywood Strip and reroof as needed Install ridge vent on main roof Install springboard for collar tie Rebuild damaged soffit and replace Replace damaged siding To provide insurance policies and workman comp to John Ezzi All work needed structurally in the attic,area(rafters, floor joists etc)to the approval of Building inspector All necessary permits included Removal and disposal of all debris induded We hereby propose to furnish material and labor to complete the job as per the above Specifications for a sum of: Eleven thousand US Dollars,$11,000.00 Dollars.Payment schedule of$3,700.00 and the amount of$3,700.00 4 days after work begins and balance of$3,600.00 upon completion. Authorized 5ionatory: Name:Jarret Kazanjian Signature: Acceptance of Proposal I/We have reviewed your proposal and hereby indicate our acceptance of the same,as per the details,specifications and amounts mentioned In the proposal form.I/We agrea to the proposed terms of payment and will release Mhas per agreed herein. Authorized Signatory: Signature: Date !2 t L ® DATE(M Id/DDlYYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 12/1212016 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 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 lieu of such endorsement(s)- PRODUCER ndorsements .PRODUCER CONTACT NAME: Sarah Willson HOLondonderry office fpAIC N Ext: (603)437-1992 Arc No): (603)4374846 Brownell Insurance Center, Inc. E-MAI ADDLRESS: Sarah @brownellinsuran ce_com 5 Nashua Rd. I NSURER S AFFORDING COVERAGE MAIC# Londonderry NH 03038 INSURER A: Maine Mutual Group 15997 INSURED - INSURER B: Travelers A/R 000000 KAZ Construction INSURER C: 112 Bayberry Ln INSURER D: INSURER E: Londonderry NH 03053 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICES 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. INSR TY ADDLSUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MMIDDIYYYY (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 CLAIMS MADE OCCUR PREMISES Ea occurrenceUArVAGIz 10 REN I $ 250000 MED EXP(Anyone person) $ 10000 A N N SC12399476 10/27/2016 10/27/2017 PERSONALRADVINJURY $ 1000000 GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 X POLICY F—]JJEECT LOC PRODUCTS-COMP/OPAGG $ 2000000 OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGL LIMIT $ 1400000 Ea accdent ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED BODILY INJURYPid N N KA12399476 10/27/2016 10/27/2017 er accent AUTOS ONLY X AUTOS ( ) $ HIRED NON-OWTJED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per M&nt $ $ UMBRELLA.LIAR OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X PPEZ-- 0—TTH- ANDEMPLOYERS'LIABILITY Y/N B OFFICERf EATUTE I I ER ANY IMBEREXCLUD D0 ECUTIVE F N/A N UB-2E921382 10/27/2016 10/27/2017 E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 Ifyes,describe under DESCRIPTION OF OPERATIONS below I E-L-DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Work Comp 3A states: MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover, MA ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street AUTHORIZED REPRESENTATIVE North Andover MA 01845 f Fax:9786889542 Email: ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD .w .,;x"73� _.:.. -awl .. :i ��.«s.'_`:� Lw:= .CS-1 23'9e�` LOW AVE CRAZVtM,A 014 • �t�r�trrr��a�ft�na►r �;��� Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA—(For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2012 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMENTS CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS i