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Home My WebLink AboutBuilding Permit #284-12 - 12 GILBERT STREET 10/4/2011 TOWN OF NORTH ANDOVER I APPLICATION FOR PLAN EXAMINATION Permit NO:cw/ — 2 Date Received Date Issued: ORTANT:A7nplicant must complete all items on this page LOCATION PROPERTY OWNER T)vllPrint da ()� _Unit# �7 Print -- MAP NO: / PARCEL:ZONING DISTRICT: Historic District yes no t Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential ❑ New Building N One family Non- Residential ❑Addition ❑Two or more family No. of units: 'Alteration ❑ Industrial ElRepair, replacement ❑Assessory Bldg El Commercial ❑ Demolition ❑ Other El Others: F�€Septic 41We11 i 0Floodplam, '❑Wetlands - - -- - __WNW;; er/Sewer- r` iWatershed tDistrict DESCRIPTION OF WORK TO BE PERFORMED: -- ' 1� o t �1 ` ` �1 14 G� Y (Identification Please Type or Print C early) 1[ y P` [el G�4 Mw�nv OWNER: Name: tly,i1 k Phone!aq) G Address: ,%011_ A a— CONTRACTOR NameA1, 5,.,J Phone: R-i& Address: oc3c, q, Supervisor's Construction License: I v Li 31 14 � Exp. Date: � Home Improvement License: Exp. Date: 'alt f ,�dJ3 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULD/NG PERMIT•$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F. Total Project Cost: $_ C-V CQo.. O Q FEE: 00 Check No.: NOTE: Persons contracting with unregistered contractors do no't have � 6�7 access to the guarantyfund con k tSianature of.. tracto r; Location A-M, No. z Date ,.ORTIy TOWN OF NORTH ANDOVER Olt.�•o •,�O 9 Certificate of Occupancy $ MuBuilding /Frame/Frame Permit Fee $ Sa Dv sksE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # i 24657 Building Inspector 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 ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments j Conservation Decision: Comments Water& Sewer 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 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.$10041000 fine 1 NOTES and DATA— For department use I l I I I Notified for pickup - Date I Doc:.Building Permit Revised 2011 June/mi Building Department i The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits } ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or.'Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permt , 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 i ❑ Flo or/Crossectio n/E levatio n Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check EnergyCompliance p Report (If Applicable) 1 ❑ 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) t ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And j Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: 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 clerks 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: Doc.Building Permit Revised 2008mi NORTH TOM- M Of do , dover, Mass., / O COCKIC EWICK �oRATE BOARD OF HEALTH PERMIT T D Food/Kitchen j Septic System I /�J THIS CERTIFIES THAT......... 1 .....! �f.� C. ......................:......................... BUILDING INSPECTOR.................................................................... Foundation has permission to erect........................................ buildings on ..a.7... .. ..../zqen ........................................... Rough to be occupied as...................... S�`�� IAte.....x1e:5Q./.K ........................................................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final. 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 CONSTRUCTIg5 STARTS Rough 4- •...,-............................. .......................................... Service BUIL ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIREDEPARTMENT. _ - Until Inspected and Approved by the Building Inspector. Burner - - - - - - Street No. SEE REVERSE SIDE smoke Det. From:Georgetown Insurance 978 352 7719 10/04/2011 10:05 #249 P.001 /001 T DATE(MM/DD/YYYY) AC(JRO CERTIFICATE OF LIABILITY INSURANCE 10/4/11 �...-�" 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 CERTIRCATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)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 endorsemenl(s). PRODUCER CONTACT NAME: Georgetown Insurance Agency PHONE 978 352-8000 N No: (978) 352-7719 10 West Main Street ADDRESS: info@Georgetownlnsurance.com Georget=own, MA 01833 PRODUCER 10588 INSURE S AFFORDING COVERAGE NAIC 9 INSURED INSURERA: Zurich Insurance Michael Fiori INSURER B: 23 Carol St INSURER C: Dracut', MA 01826 INSURER D: INSURER E: 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 OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIALGENERALLIABIUTY PL M"r D1EA SO(EaRoNTED e $ CLAIMS-MADE F—I OCCUR MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATELIMTAPPUESPER PRODUCTS-OOMP/OPAGG $ POLICY ,T LOC $ AUTOMOBILE LIABILITY COMBINED SINGLELIMIT $ (E a accident) ANYAUTO BODILY INJURY(Per person) $ ALL O W NE D AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ UMBRELLALIAB OCCUR EACH OCCUPRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION 4179P334 4/1/11 4/1/12 WCSTATU- oTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNEFWEXECUTIVE Y/N N/A E.L.EACH ACC!DE NT $ 100,000 OFFICEW EMBER EXCLUDED? y (Mandatory in NH) E.L.DISEASE-EAEMPLOYEE1 $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHI CUES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Operations typical of a residential carpenter Fax 978-688-9542 Sole Propietor, Michael Fiori, has not made an election for coverage under the WC policy. 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 ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street North Andover, Ma 01845 AUTHORIZED REPRESENTATIVE Margaret Smith @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The AC ORD name and logo are registered marks of ACORD 1 i f {/J/ ~. �1di5�ICIit1*�� '� i1c jZ.�Ct t,tent ut 1'ulf#u' �..'�, N y t i mBbs+i��) 1`, uilt�tYt+� Rt��tiafitrr5 ,iid St.ttrlart w. ° Qon$taction sppei9i's6r Ucense''+ LiCe649GS -..104035,' Restricted to 00 }_ z F MICHAEL �FIORI 23 CAROL ST DRACUT, MA 01826. Xirtion: 3/2s�J^014 f i Tri' '104035 , Officc 0 0 m airs on nes �n r !{ - HOME IMPROVEMENT CONTRACTOR - Registration- 162528 Expiration: .3 DBA /16/2013 Type: `r? = M C EL FIORfGONSTRUCTION r z(-- �f MICHAEL FIORI 23 CAROL ST ' DRACUT,'MA 01826 i Undersecretary ' r Windows Live Hotmail Print Message Page 1 of 2 Re ROOFING PRICE FROM MIKE FIORI 978-265- 6843 From: michael fiori (mchlfr@yahoo.com) Sent: Sun 8/28/116:51 PM j To: BP.NORRIS@HOTMAIL.COM (BP.NORRIS@HOTMAIL.COM) FIORI CONSTRUCTION 23 Carol Street Construction Lic. CS 104035 Dracut, MA 01826 Home Improvement Lic. 162527 (978) 265-6843 Fully Insured/Workmans Comp Work Submitted to: Bill Norris Job Name: Bill Address: 22 Gilbert St North Andover Phone Number: 978-807-3260 Proposed Work to Be Performed : -Remove 2 existing layers of shingles -Install new ice and water shield six feet up from the bottom of the 'roof. -The back dormer roof will have ice and watershield the entire way up -The remaining roof will be covered in tar paper. -Install new white drip edge on all roof edges. Install new 30 year architectural shingles. The color is of your choice -Install a new cobra vent of the top of the roof -Install new stink pipe boots of the roof -Dispose of all material in a legal manner -Apply for a permit prior to starting the job Total Labor and Material $4300.00 )may IT, �. receiving all roofing material and receiving a permit. Balance is due upon com letion of project. p P p J I accept de n is contract Date /6 Tha u nd ee to contact me with an uestio s. Y Yq http://co 122w.col122.mail.live.com/mail/PrintMessages.aspx?cpids=6cc4b612-d1 e 141 e0-... 10/2/2011