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HomeMy WebLinkAboutBuilding Permit #046-2015 - 13 CLEVELAND STREET 7/10/2015 Ff� NORTFH \� tl-r � D BUILDING PERMIT OF� LED ,6�1'O TOWN OF NORTH ANDOVER I. PPLICATION FOR PLAN EXAMINATION _ _ ' " Permit No#• Date Received �,ys RATED•P��.cS Sgc►+us Date Issued: 1� IMPORTANT: Applicant must complete all items on this page LOCATION 13 Print PROPERTY OWNER q Print 100 Year Structure yes no . MAP b7 1 PARCEL:�2 ZONING DISTRICT: Historic District y s no Machine Shop Village s no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition ❑Two or more family 11 Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain Wetlands [],1/�/ate„shed District glNater/Sewof DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly 3 ^of OWNER: Name: I•-1 Phone: Address: Contractor Name: T O�-, �A el 14710” 4-:' Phone: Email: Address: Supervisor's Construction License: (� �g �2 Exp. Date: Home Improvement License: s Exp. Date: J ARCHITECT/ENGINEER Phone: i Address: Reg. No, FEE SCHEDULE:BULDING PERMIT.,$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �5 <� bb FEE: $ •� Check No.: Receipt No.: NOTE: Persons contracting with or tered c retract s do not have access to the guaranty fund Location w No. Date NORTH TOWN OF NORTH ANDOVER n Certificate of Occupancy $ Building/Frame Permit Fee $ 71 �O•�o �`�� ,ssACHU Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector s p"'` Div. Public Works Location 13 c/p('1414 eld � Date 1 No. !J , . ` NaRT►, TOWN OF NORTH ANDOVER ?O•,t`•o I•,M O9 Certificate of Occupancy $ Building/Frame Permit Fee $ 'SS,cH�SE< Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ ----�— Water Connection Fee $ TOTAL / Building Inspector • n 0 612/01/98 09:57 25•00PAMDiv. Public Works . n �� Location '`` No. 2U�� Date . - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#-1q Building Inspector r �i i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swiuvning Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF e U FORM PLANNING DEVELOPMENT Reviewed On Signature— COMMENTS i9natureCOMMENTS CONSERVATION Reviewed on Signature COMMENTS i ? HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes v� Planning Board Decision: Comments Conservation Decision: Comments V !!Vater & Sewer Connection/Signature � Date Driveway Permifi DPW Town Engineer: Signature: Located 384 MEIVT FIRE DE od Street � ��._..�.. ..�..�_..�� . nt bli TernpDum steronts teT tiyes L00a�te,�clat124MainSt�eet, ;gypz `` Fire`dDpepartmenttsi n`"ture%date u � �CT®M�MENTs .k-�S f – -. ,: l,..A_ — S `-+� Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICALS Movement of deter 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) LI Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 i Building Department 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign offrom Fire Departmentartment 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 Workers Comp Affidavit 46 Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 4 2012 I ECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 NORT#i Town of ? 1 E ndover oTL No. *" - � it) 20� oh ver, Mass, 1TV145 COCNIC Mf WICK PP��,�S s � , BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT a ��!!�. .............................................. BUILDING INSPECTOR .............. ..... ... . ...... .... ....... ..... has permission to erect '� ,� ,Vtl ,� ' Foundation .......................... build' son ................ . .... ............ ............ ��O, Rough tobe occupied as ............ .. ...` .......44.......................... .............................................................. Chimney that the person acce tin this ermit shall in eve respect conform to the terms of the application provided p p g p every p pp 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 MONWS ELECTRICAL INSPECTOR UNLESS CONSTRUC I S T 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. ........................................ 40b Use Period lids titled 140F Thank y(xi fm mart, ....... omplete Comm. ercia'l Roof ing All Types Of Sidinq C HE I P4 N E YZ POPINTED-REBUOLT-CAPPED ................... Expert Masonry Work Mass Toll Free t................ ... ............ Licensed & Insured 1-800-WAIT-4-US L-ocall)l Owneel& License#034200 (924-8487) lvazm oe i W­ Work 'Year Round ....... ................. J11 Proposal To: Tim Southgate Date 5/18/2015 Street: 13 Cleveland St. 978-943-0198 N.Andover, MA Roof proposal Timothy.southgate@verizon.net IKO Cambridge tsouthga@us.ibm.com 1. Extra caution will be taken to protect building 13. Building permit included. exterior,pool area and landscaping as best as 14. Contractor workmanship warranty: 10 years possible. (tarps etc.)Magnets run at final clean up. under normal wind and rain conditions. 2. Remove all shingles from entire house. Remove and dispose of old antennae. (See Garage option) Total roof cost: $ 8,900.00 3. Inspect and re-nail any loose or lifted roof boards. 0 Option: Garage: $750.00 additional cost Any compromised roof boards will be replaced at 0 Option: Chimney: Cut and grind out mortar an additional cost of$3.00 per lineal foot of 1x8 joints. Re-tuck point with adhesive based mor- Spruce. tar. Apply silicone based waterproof spray. 4. Install heavy gauge 8"white aluminum drip edge $700.00 additional cost. to all eaves and rakes. Option: Cut and install all new lead flashing 5. Install 6' of IKO Armourguard ice and water into chimney, counter flashed with ice and shield along all eaves. Install full coverage of ice water shield and sealed with clear Geo-Cel and water shield on rear lower addition. sealant. $200.00 additional cost. 6. Install synthetic underlayment to remaining sheathing up to ridge. IKO Shield Pro Plus extended MFG warranty 7. Install all new pipe boots where.applicable. A fully transferable 100% coverage against 8. Install IKO Leading Edge starter shingles to all material defects for a fully non pro rated period of eaves. 20 years. Please refer to pamphlet left in estimate 9. Install IKO Cambridge Limited Lifetime folder or go to www.iko.com. Offered to our local architectural shingles to the entire house and referrals(Tim Cresta) and included in this proposal carport. 15 year non pro-rated warranty by mfg. at no additional cost. All shingles will be installed and fastened accord- *Note*: Please be advised if applicable, valuables in ing to mfg. specs. All valleys woven. the attic should be moved or covered due to minor 10. Cut and install a new GAF Cobra ridge vent capped with color matched IKO hip and ridge debris, dust and asphalt particles that will accumulate shingles. during the stripping process. All Under One Roof not 11. Counter flash existing chimney 'lead with ice and responsible for any damage or clean up that may water shield, tie into new shingles and seal with occur in attic. black rubberized cement. (See option) Balance due upon completionno deposit required! 12. Removal of all work related debris. Planks will be References available upon request placed under dumpster to prevent any damage to Highly rated member of the accredited BBB and driveway. AnLyie's List Thank you' The Commonwealth of111assachusetts Department of Industrial flccidents Office of Investigations 600 6fashington Street Boston,MA 02111 wtvmnrass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name (Business/Organization/Individual):_ 4.1 (fVl 0�� Address: C> City/State/Zip: Vhy, `141/7M Phone#: J— VJ'3 Are you an employer? Check Ufe•nppropriate box: Type of project(required): 1.El am a'employer.with. 4. am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp, insurance. g, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their I0•❑�Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13"0�01er 2.�"rte *Any applicant that checks box#I must also Ell out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new afrdavit indicating such tContraclors that check this box must attached an additional sheet showing the name orthe sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site ircfanrratiorr. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: C 3 CZ � ►2 IVA . City/Stale/Zip: 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 MGL c. 152 can lead to the imposition of criminal penalties of a Cine up to $1,500.00 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 day against the violator. Be advised that a copy of this statement.may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ceiyify under thepain's an renalties ofpetjur),that the infor•nration provided above is true and correct Si ature: •Date: Phone#: y1 c/ If - 17 f`31 Oficial rise only. Do not write in this area,to be completed by city)or tolph offrciaL City or Town: Perrnit/License# Issuing Authority(circle one): 1.Board of IIealth Z.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.-Plumbing Inspector 6.-Other Contact Person: Phone#: CERTIFICATE OF LIABILITY INSURANCE nATE(r rDrvYVY) 1FICATE IS ISSUED AS A ti�ATTEft Of=1f�1Ft]EnfltA734"f3tiLY AND f�1tdF£R�NO RtSNTS UPON THE CEftTIFiCATE HOLDER. THIS 3MRCATE DOES NOT AFRRt&ATIVELY OR NEGATIVELY�,��OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CERi'IFICATE OF INSURANCE DOES NOT CMS'i'tttl't'E A CONTRACT BOWEEN THE iS UING INSURER(S),AUTHORIZED REPRES044TATIVE PO RANT:if the certificate holdw is an ADDI IGNAt i 1.SURf tf,the Poitc €etl must be endtxsed. H SUBROGATION IS WAIVED,ightstsubject the the =sand conditions of the Policy,certain Pollcies year requAe and endorse mereL A stateeeent on this certiftcate dose not cor►!er rights to the ate holder in�t of such ere s RMLICER CONTACT HA#AE: AVID E l.ELJ-ER INS AGt'l PROMS FAx (AC,No}: 370 F YNNWAY E4AML LYNN,MA 01901 ADDRESS: 2%,D6D iT WRER(S)A1= FVMG COVERAGE MAIC# I"SURM Al: tiCE pt,4£ItfCAAtthSURA4CE COMPANN' BRED BERRY,FRANK&.BERRY,JP04ES DBA FRANK SaNIS INSURER S II'IS€IRER G. IlMRER D: 45 WIN BROOK DRIVE tfMRER E: EPPLNG,NIH 03042 StsRER F: E4tAGfiS GER71P11�X'tEt4L3iiit3Eii: RE�itSK3l1 H5RAt3ER: TMI p AT'rNE BeBBO HAVE SNI 1A11OWFCli7'tfEFOLIGfPEMOOl DEATEte vjoT Se1S'rkWMG r 9iE0iiPIEtlfE�iT,TENrli OR C%5Hr31TS3N OF ANY CONTSACr OR OTHM goCL LW Wff"RESPECT Tp Vn4C!T�SVA'IgASUED OR WN kM+Y HAVE BEEN REDUCED S AMRVED By THEPOLICIES 1%3M d sa�TO AL17riE TErNA3 EXE Atm f:Ordltn0115 �aroca.,+ur�. /DO VOLMV E W O&M PQLJCY E"GATE LNHTs LIR TVPE OF Mtt LICE L R POLICY*49BER traWruA'YYYYt fial:Dslxvml Gd OCCURRENCE is GENERAL L1AMLI Y .,_.,.,_.:....--.—.—._ Cf NIMERCIAL GENERAL LIABiL" AMAGE To RENTED 1$ CLAWS MADE [DOCCUR. flEhSSES(Er occurren e) .ED EXP(Any one pown) $ ERSONAL&ADV f,WURY $ GEN:AGGREGATE Lihtff APPLIES PER: ENERAL AGGREGATE S POLRCY M PROJECT -3LOC ROD'UCTS-GOMPIOP AGG f$ AUTnf OBILE LIAMLM OtN31NED SKVG:E I$ ANY AUTO JMr (Ea acc ieru) { ALL OWNED AUTOS ODper iI�n) S (Per perste} SCHEDULE AUTOS DILYMURY sS �41REO aU7MS {Per acciierxi NON-OWNED AUTOS PROPERTY DAMAGE .5 Per ace derr} EACH OCCURRENCE ;$ UyF.iPltrLi.A LtAE C 0. JR I -- f fsREGATE i$ EXCESSS L C;_P%lMS MADE •�,••••••�• $ DEDUCTIBLERETENTION S $ IMC STATUTORY OTHFA; A WORKER'S COMPOISATFON AND Y EMPLOYER`SLUML1TY US-gML434-14 1tt{50114 ttlo 2oe5 1! ITS ANY pRopEAITL?fB's'AtreYifrftrL'^:xECLtT:vE I.:..1_N#A E.L EACH ACCCENT 15 100,000 OF.«ICEF1'vRwREXCLUDER'.? I....1 —`•_r-• E.L.DISEASE EA EtaiP<_OYEE!$ 104,000 ftan"Cwy n r"# ttqa-_desats uss[a3 E.L.DISEASE-POLICY LIMIT $ 500.000 flFSCRMTTON OF OPERAT%)JlS e,ata+M DESCRIPTION OF OPERA'IE{}WLt Al14#'wNEMLE 'tiF-sTFiEGit oa3'v-�IT Em TrtLS REYShCES ltd Y 65REfltt CER C eCA`t'Ci LSStT ty E2 141E CMTIFWATE V"e1.DER A C TN!G WOJtX AS COMP COVERAGE. No PAR'i IgURS ARE COMBED By nM bti ORKERS7 COMPF.`1SATION POLICY. ' CEIfTIFfCATE�Oi.EtE#t GAIdCELLATS3t3 AL1.U;sI?ER OSE ROOF S"OULD Ater OF TRE A e Desc +mEPoLMFSS BE CANCEL.LEO gef:OREIHE EXPIRATM OATS lHEREOF,NOTICE WILL W 055 Tft Tr.MPI F nR ..:......++......' .:�+..�...e...:wv s�nw...Q..�.:r x r I ` 4 Massachusetts-DsPaldtmtflt of Public Safety Board of Building Regulations and Standards collitruction surwi-v-tiitr xza, License:CS-069120 IJ JOHN W LANZAF`}ri.ME -:-._ 30 TEMPLE DR METHUEN MA 01844. N r � F i fJ5T'.rr'ii5S7t2t)G a 04/03/2017 _.._..__.. ._ �._ zip City/Town � State ' code Search Registrants Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund histo The list is current as of Wednesday, October 8, 2014. i Search Results REGISTRANT RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS g NAME INDIVIDUAL NUMBER DATE ALL UNDER ONE ROOF I_ANZAFAME, 137057 166 A MERRIMACK ST 10/02/2016 Current t JOHN METHEUN, MA 01844 ©2012 Commonwealth of Massachusetts. Mass.GovqD is a registered service mark of the Commonwealth of Massachusetts. Inrn/')nI e _......._.__.._....................._.._._. __............._ . .__.......__........... _..__