Loading...
HomeMy WebLinkAboutBuilding Permit #070-15 - 12 UPLAND STREET 7/22/2014 TOWN OF NORTH ANDOVER PPLICATION FOR PLAN EXAMINATION Permit NX r Date Received I Date Issued: �/�/ 4 IMP R ANT: Applicant must complete all items on this page LO ,aCATIONS�o`��- l ...,.,^� Paint -R, PEr S tC '` r ,� Print" n 1 OOaYear OId Structure yes, no y µ MAP fN0 PARCEL ZONLNGr DI;S,TRICT Histone District yes, no _ =s & h ; TYPE OF IMPROVEMENT, PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition i ❑Two or more family ❑ Industrial ❑Alteration: No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic; ❑,1Nell " ' 4 D Floodplain 01Netlands L ❑ 1Natersfed ®istrict "> ❑1Nate.�/Sew- e rs DESCRIPTION OF WORK TO BE PERFORMED: ��3/ovn-gin eell�las� i n ��,lls Type Identification Please T yp or Print Clearly) OWNER: Name: M5S icy tr'� Phone: `�7��9'33 - l Address: i — �x � .,,,, n ,� �:�'.• � -. � � [l' -' � '� did a CONTRACT OR' ,Name _is � _- RTZ. efalc �Rhoni ff Address OI cu Supervisor4Construction;Llcense. C�_9` fit 33 jDa Exp to _ _ — � � °� � ��Exp i°Home Irnproverp, t License: / _ _//. - -. ARCHITECT/ENGINEER Phone: I 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: $ -.��` cl - 0 0 FEE: $ 00-1 ((�) Check No.:_�� � �— Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to th ruarantyfund Si nature of°A "ent/Own : w;_.-. wig nature of'eontractor _� Plans Submitted Lj: Plans Waived ❑ Certified Plot Plan ❑ 46amped tans ❑ I Plans Submitted ❑ Plans Waived-0 ':Certified-Plot Plan ❑ Stamped Plans ❑ .TYPE Ol'SEW—ERAGE-DISPOSAL " Public Sewer ❑ Tanning/MassageBodyArt ❑. . .Swimming Pools ❑ Well Tobacco.Sales El= FoodPackagin / Sales .11Private{septis tanketc._ Pernanent D mpster onSite <: THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM - : DATE REJECTED DATE:APPR-OVED PLANNING & DEVELOPMENT' ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS c HEALTH Reviewed on Signature t, COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision: Comments Conservation Decision: :Comments Water & Sewer Con nectionlSignature& Date Driveway Permit DPW Tovy;: Engineer: Signature: Located 384 Osgood Street FIRE DEPART�Ir NT Temp Dumpster on site . yes., no Located at,124{Mair`Street *-s :N '` �` ^.� Fire Departm a t e��t signature/date C011�MENTS . . • . . . i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Totalland 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 NOTES and DATA— (For department use I El Notified for pickup - Date l I Doe.Building Permit Revised 2010 i Building Department --The foi"owing is-'a list of the required.forms to be filled out for.:the.appropriate.permit to'be obtained. Roofipg, Siding, Interior Rehabilitation Permits - o : Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H-.I.C. And/Or G.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 Permit Addition Or Decks. 1 ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract t ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And I Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ 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) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ 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) ❑ Copy of Contract ❑ Mass check Energy Compliance Report i ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cans if a variance or special permit was required the Town Clerks office must stamp tIre decision from the-Board of Appeals that the apw,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Bui?ding Permit Revised 2012 Location �.. .`.,. 07/2 2 No. - Date , o • TOWN OF NORTH ANDOVER .. Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#C �L�-. °. 1 r� 27798 Building Inspector f Restricted To: CSSL-RF-Roofing ti 'asaac fie..-s CSSL-IC-InsulationContractor a=A-= : _ v - CSSL-WS-Windows and Siding �, ,4_ _ ,,;• F CSSL-OM-Demolition :a^s, CSSL-099933 MICHAEL P FIT?,CERALD, 119 R FOSTER STREET '*f Peabody MA 01960 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS 06/19/2016 h�• 1r<� �f�� 1 Office oonsumer A��airs d" usness egu anon 10 Park Plaza - Suite 5170 i "E Boston, Massachusetts 02116 i Home Improvement Contractor Registration i Registration: 141124 Type: Supplement Card Expiration: 1/12/2016 A+M GENERAL CONTRACTING INC. MICHAEL FITZGERALD 5 SOUTH RIDGE CIRCLE LYNN, MA 01904 Update Address and return card.Mark reason for change. Address Il Renewal J Employment C Lost Cai SCA 1 E5 20At•09r11 of Consumer Affairs&Business Regulation License or registration valid for individul use only ! ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: I •�; Office of Consumer Affairs and Business Regulation Y�Vr -Registration: 141124 Type: 10 Park Plaza-Suite 5190 _ Expiration: 1/12/2016 Supplement:lard Boston,MA 02116 A+M GENERAL CONTRACTING INC. i MICHAEL FITZGERALD i 5 SOUTH RIDGE CIRCLE LYNN,MA 01904 _ Undersecretary Not veli tire V I ooRTFt Town of s _ ndover No. 0.Z a Ilk A . ver, Mass O NN COCI(NEWV �. 7,es R�1tED 11P�,�'�5 U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT Z6 =S m. !!;Wo�* BUILDING INSPECTOR y �� ........�.............. Foundation has permission to erect .......................... buildings on .............. .........�.. .... � Rough to be occupied as .................0.0•11......�SAA, .. .• .................................. 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 CONSTRUCTION ST Rough M„ R.y 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. 1 1 3 Tite Commonwealth of Massachusetts Department of Industrial Accidents } Ohre of litvestigations I Congress Street,Suite 100 Boston,MA 02114-2017 ' www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Analicant-information lease Print ibl A&M General Contracting, Inc. Name(Businessorganiiation individual►. 8t G 9 I 1 Address: 119 R Foster Street BLDG. 14 { City/State/Zip:Peabody.MA 01960 Phone#:978'741'7777 Are you an employer''Check the appropriate box: Type of project(required): I.© I am a employer with �• ❑ I am a general contractor and 1 b: Q New construction employees(full andror part-time). have hired the sub-contractors I listed on the attached sheet. 7. ❑Remodeling 2.❑ 1 am a sole proprietor or partner • ship and have no employees • These sub-contractors have g, C:]Demolition workin€ for mein any capacit< employees and have workers g 7 Building;addition (No workers' comp. insurance comp.insurance.- � required.] S. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all«•nrk officers have exercised their I I.[] Plumbing repairs or additions i myself. (No workers' comp. right of exemption per MGL 12.[3 Roof repairs insurance required.)` c. 152.§1(4).and we have no l Q ether employees. [No workers' Other— comp. insurance required.] + 'Atnv applicant that checks bot e I must also fill out the scomn helnw show mg their%wrkers'compcnsauon pohc�infurmatton 'HomemAners whey submit this alZidasit tndieating the)ace doing all a4ui,and then hire outside contractors must submit a new attidavit indicating such Contractors that check this txn mutt attached an additional sheet a tmutg the name of the sub-u-ntrac-tors and state wh ahcr or not those emit have emploNces. ll'the suh-contractors have emphnees.the%must pro%tde their wurl ers,comp poltc%number r lam an cntplgver tliat is providing workers'compensation insurance Jar mr entp/gvees. Below Is lite pal/cy and Joh site information. TGA Cross Insurance inc. Insurance t:'ompany Name: „_ _.��__._._ � __ •----- —•-- "'"" Policy or Self-ins. I.ic. F;AMWC345622 ��� — , Expiration Date:March 20 2015 . — - Job Site Address:/ 1A �'T" City•State'Zip: ad�E�� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGI.c. 152 can lead to the imposition of criminal penalties of a ' fine up to 51.500.00 and or one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a da% against the violator. Be advised that a cope of this statement may be forwarded to the Office of j investigations of the DiA for insurance coverage verification. i l.do hereby�cer�fif;j- P- 0.e pai stile perj�thatthe information provided above is true and correct. I Si at r Dal e• Phone A: ct7k - 7VI - 7777 Official use only. Do not write is oris area,to he completed by city or town official. i City or Town: Permit/License# Issuing Authority(circle one): 1.Board or Health 2. Building Department 3.Citytl'own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i i AC�' A&MGE-1 OP ID: MH CERTIFICATE OF LIABILITY INSURANCE F DATE(MMDONYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL EOR 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 pollcy(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 endorsement(s). PRODUCER 7$1-914-1000 CONTACT TGA Cross Insurance,Inc. NAME:.-_ 401 Edgewater Place,Suite 220 PHONE (FAX _ - ---- Wakefield,MA 01880 `_ No.-€ � E-MAIL John Scanlon ADDRESS:,__� u IN_SURER(S)AFFORDING COVERAGE —� i NAiC!! INSURERA:Peerless Insurance CO _INSURED A&M General Contracting,Inc. Guard Insurance Group i Norman Dube INSURER B: 119R Foster St.Bldg 14 INSURER C: Peabody,MA 01960 i INSURER D: i INSURER E: COVERAGESINsuRER F: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADAC SlIB LTR TYPE OF INSURANCE POLICY EFF POLICY EXP ENERAL LIABILITY POLICY NUMBER MM/DD/YYYY MM/DDlYYYY I LIMITS G - ± 1 A ! EACH OCCURRENCE `$ 1,000,00 X COMMERCIAL GENERAL LIABILITY iCBP8947488 I 03/20/14 03/20/15 A NT€6 s �_AJ PREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE i OCCUR I - �� MED EXP(Any one person) IS 5,000 I f PERSONAL&ADV INJURY$ 1,000,000 I GENERAL AGGREGATE i$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ,.PRODUCTS-COMPIOP AGG $ 2,000,000 J POLICYLECT PRO- ; LOC AUTOMOBILE LIABILITY I$ I ! COMBINED SINGLE LIMIT $ 1,000,00 A ANY AUTO ! i L Ea accident) OA8947688 03/20/14 ; 03/20/15 f BODILY INJURY(per arson) $ ALLOWNED ��SCHEDULED I P AUTOS AUTOS ( ;BODILY INJURY(Per accident)i$ I { X HIRED AUTOS NON-OWNED jP'RRTYDAMAGE li I AUTOS OPEI (Per accident) $ X UMBRELLA LIAR LXj OCCUR $ i A —1 EXCESS LIAR I�CLAIMS MADJ ( �CIJ8947888 I EACH OCCURRENCE 1$ 1,000,000 03/20/14 I 03/20/15 AGGREGATE i —' 4�--� $ 1,000,000 I DED X 1 RETENTION$ 10000: WORKERS COMPENSATION i $ AND EMPLOYERS'LIABILITY # 1 WC STATU- I 1OTH- BJANY PROPRIETOR/PARTNER/EXECUTIVE Yn/N IAMWC345622 I—X--I�-�YIIMITOFFICER/MEMBES I I ER andaoryInNHREXCLUDED? J NIAI 03/20/14 I 03/20/1$ E.L.EACH ACCIDENT 1500,000 andatory In NH) — `es,tlesuibe underiE.L.DISEASE•EA EMPLOYEE;$ 500,000 ESCRIPTION OF OPERATIONS below w E.L DISEASE-POLICY LIMIT $ 500,000 I I ; I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is(required) CERTIFICATE HOLDER CANCELLATION TOWNAN1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. I North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ACORD 25 ©1988-2010 ACORD CORPORATION. All rights reserved. 2010/OS 1 ( ) The ACORD name and logo are registered marks of ACORD A&M General Contracting Inc. 119 R. Foster St. Peabody, Ma. 01960 1(978)532-8052 Fax (978)532-1033 Jan. 1, 2014 To whom it may concern, Neil Moore has authorization from 1/01/2014 until 12/31.2014 to pull permits for this company using my Licenses. Any questions, feel free to call our office at number listed above. Sincerely, Michael Fitzgerald Signed thes,-.�2- day of -3v12014 Nota expire date 04/01/2020 Job Number 4943 DATE 7/15/2014 client Jessica Erb address 12 Upland st 2nd eHy/town North Andover 978-933-1743 1-WEATHERSTRIPPING/CAULKING contractor QUANTITY A&(1t Door Kits Q-Lon or Equiv. QUANTITY TOTAL0-00AUDITOR NOTES Door Sweeps(Regular) 0.00 0.00 Door Sweeps(Automatic) 0.00 Reglaze Windows/In.inch Window.Weathstr Schlegel per side 0.00 000 Recessed light cover per SWS. Not a tenmat cover 0.00 attic sealing 2 part foam attic sealing 1 part foam 0.00 basement and living space air sealing part art 0.5 0.35.0 .00 SUBTOTALS 35.00 2A.INFILTRATION/INSULATION Domestic pipe Hot Water Tank 1st 6' AUDITOR NOTES. Sill Two Part Foam w/Fiberglass Batt 0.00 1"T-max on foam 0.00 only boardP ' enmeter per IECC&SWS sq.ft. 0.00 2"T-max only foam boardPerimeter per IECC&SWS sq.ft. 0.00 Drape DOOR R-5 or T-max only Tape Joints(Aluma Grip0.00 only)Per hr. 0.00 Duct Ins w/Tape sq.ft.R-5 conditioned space Duct Ins w/Tape sq.ft R-8 unconditioned crawl/garage/attic 0.00 Hydronic pipe insulation to 1"R-5 Hydronic pipe ins.1.25"-2"R-5 0.00 Steampipe Ins. 1.25"-2"iron pipe R-5 0.00 0.00Steampipe Ins.2.5'!-3"iron pipe R-5 Air Conditioner Meeting Rail 0.00 Air Conditioner Cover 0,00 Air Conditioner Cover Special Order 0.00 0.00 SUBTOTALS "- 0.00 28.INSULATION Open Unrestricted R 49 0.00 AUDITOR(VOTES Open Unrestricted R 38 0.00 Open Unrestricted R 30 Open Unrestricted R 20 0.00 Open Unrestricted R 10 0.000� Restrict FL/Sloped R 38 Restrict FL/Sloped R 30 0.00 Restricted FUSloped R 20 0.00 Restrict FL/Sloped R 10 0.00 R-19 FGB open rafters/walls/kneewalls 0.00 R-11 FGB open rafters/walis/kneewalls 0.00 Attic Stairs(stairwell&common wall) 0.00 Cover Pull Down Stairs Thermadome up to R49 per SWS 0.00 Site built pull down stairs 2"foam box 0.00 0.00