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HomeMy WebLinkAboutBuilding Permit #487-16 - 14 WRIGHT AVENUE 10/15/2015 NORT44 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION V Permit NO: Date Received Date Issued: ACHUS IlVIP ANT:Applicant must complete all items on this page LOCATION: 1 q 0rl k4- Ave, r}Y ►t I�� .,O Print o-� PROPERTY OWNER_-_ _ . e�"l. Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes 6no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building *,One family ❑Addition ❑ Two or more family ❑ Industrial I-Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other El Septic '❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer �l#est 4F &-�-r &6—m 9/P' 70 6*64e Identification Please Type or Print Clearly) OWNER: Name: Phone: 97 g $SoZ�/ ff. Address: CONTRACTOR Name: Phone: Q2akg ' t Address: Supervisor's Construction License: Exp. Date. U — c Home Improvement License: t Exp, Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATEQ" j�iON'$125A0 PER S.F. Total Project Cost: $ at 5b FEE: $ (6? Check No.: Receipt No.: NOTE: Persons coMPavtW with unre istere contractors do not have access to the guarantyfund Signature of AgentlOwner ::Signature of contractorIle Location// No. Date J . - TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee $� Foundation Permit Fee Other Permit Fee $ TOTAL $ Check# l Building Inspector t.. NORTH Town of �._ � E ,; Andover o No. - * •t ver, Mass, Itca)? Vo C OC NIC Nl WI ) I ICK ,, . 'x,95 R�rED �PN��S U BOARD OF HEALTH Food/Kitchen .PER Septic System T M LD4 THIS CERTIFIES THAT � �.. :G ,�� ......... BUILDING INSPECTOR Foundation has permission to er t .......................... uildings on .....I.... .......�.C.!✓ ►. ....... ............. to be occupied as .. ... . .!QN� . ..... .. . ..... ...... �.....,�......�t,. Chimney provided that the person acceptin his permit sh in every respect conform to the terms of the app ' tion 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 CONSTRUCTIO AR 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. X U )-S O 11 Q d47 X t Boor Cb Ndi-rio-ri J;� Aa w v-►,&aT v4ue N ,4.•�c�oveyg 4� WNy ( 7 „► $,Jdavv� WIt4 a � Ell ' liv—d .10 r4ot17jS f*1N dJdW��f of ? piyNI1S1X-9 coa�Z�a$ c�aM L 0 a�b lye►�►M h� � Lc1L 112N co door CONTRACT ROBERT BOHONDONEY CONSTRUCTION CO. 12 HALL STREET METHUEN, MA 01844 978-685-0970(office)/978-685-8262 (fax) Fully Insured Construction Supervisor License#979 Exp 4/21/2016 Home Improvement Contractor#114238 Exp 8/16/2017 bohondoneyconstruction @yahoo.com Customer Name: Andy Dugerian Property Address: 14 Wright Ave, North Andover, MA 01845 Contract Type: Repairs Date: October 12,2015 Scope of Services: Repairs 1. Supply local building permit. $250.00 2. Supply workers compensation and liability insurance certificate. 3. Roof—approx 22sq $8,850.00 1. Strip existing roofing to bare sheathing. 2. Supply and install 6ft of ice and water barrier at all lower roof edges. 3. Supply and install synthetic shingle base on all remaining roof areas. 4. Supply and install new aluminum drip edge at all roof edges. 5. Supply and install new 30yr architectural shingles on entire building. 6. Supply and install continuous ridge vent on entire peak. 7. Re-lead, re-point and cap existing chimney. 8. Provide job site clean-up and safe work zone. 4. Insulate attic to meet MA State Code(1138)—existing is approx R13. $1,400.00 .5. Remove section A of roof and re-frame. $2,800.00 6. Remove section B of roof—frame gable end with vinyl siding and gable louver. $4,000.00 7. Venting $4,300.00 a. Remove existing aluminum facia trim—vinyl sophits and wood sophits. b. Install new insulation baffles at eaves. c. Install new fully vented vinyl sophits. d. Install new aluminum facia trim. e. Install new attic vent through roof and outlet for power. I Page 1 of 2 I 8. Provide job-site clean-up and safe work zone. 9. Dispose of all construction debris from site. $450.00 TOTAL CONTRACT AMOUNT: $22,050.00 Payment Terms: Deposit amount of$7,350.00 to begin project,progress payment of $7,350.00 at inspection of roof frame and balance of contract in the amount of$7,350.00 at completion. Customer Signature: e4 Date: Contractor Signature: Date: Page 2 of 2 The Commonwealth of Massachusetts Department of Industrial Accidents X Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMUTING AUTHORITY. Aimlicant Information lease Print LeLdbl Name(Business/Organization/Individual): Address: 15 U� oaj� 1 6 City/State/Zip: MT vl U,Q.1 A NA M0 Phone#: q�b Are you an employer?Check the appropriate box: Type of project(required): LE I am a employer with `J employees(M and/or part-time).* 7. ❑New construction 2.[]I am a sole proprietor or partnership and have no employees working for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 3.FJ I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9• ❑Demolition 10[:]Building addition 4.a I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions proprietors with no employees. 12.n Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp,insurance.: 6.0 We are a corporation and its officers have exercised their right of'exemption per MGL c. 14.Q Other 152,§I(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also till 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 affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing iporkers'compensation Insurance for my employees. Belmp Is the policy and job site Information. Insurance Company Name:PR VV �U+Uod �Y'��- 1.� Policy#or Self-ins.Lie.#: ftA2,gWC0aq as V s Expiration Date: lob Site Address: i City/State/Zip: Attach a copy of the workers'colftpensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enalties of perjury that the information provided above is true and correct Si atureDate: ) Phone#• 61, Official use only. Do not write in this area,to be completed by city or tmvn official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACORLY CERTIFICATE OF LIABILITY INSURANCE 7(MMMENYM) .--" 10/14/15 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(es) 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 endorsemen s. PRODUCER CONTACT NAME: Bates Insurance Agency Inc. PHONE FAX 781) 395-9454 92 High Street, Suite Bl E-MAIL (781) 396-4985 N . 1 Medford, MA 02155 ADDRESS: Andrea@Bateslns.com INSURE S AFFORDING COVERAGE NAIC# INSURER A:RCA-Essex Ins Co INSURED INSURER B:A.I.M. Mutual Ins. Co. Robert Bohondoney INSURER C: Bohondoney Construction INSURER D: 12 Hall St INSURER E: Methuen, MA 01844 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 OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DDIY MMIDDIYYYY LIMITS A GENERALLIABILITY 2CM7759-15 2/3/15 2/3/16 EACH OCCURRENCE $ 1,000,000 XCOMMERCIAL GENERAL LIABIUTY DAMAGE TO RENTED $ 100,000 CLAIMS-MADE a OCCUR MED EXP(Anyone persm) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGR EGA TE L IMI T APP LIE S PE R PRODUCTS-COMP/OPAGG $ 1,000,000 17 POLICY 7 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT O,accident $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED er accident HIRED AUTOS AUTOS $ UMBRELLA VAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B YORKERS COMPENSATION AWC40070243322015 8/9/15 8/9/16WC STAI.TU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT _$11000,000 OFFICERWEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 Ifyyes,describe under DESCRIPTIONOFOPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VE 4CLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is regdred) 14 Wright Ave North Andover, MA 01845 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 © 1988,20 ORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: i Massachusetts .. Department of Public Safety �J Board of Building Regulations and Standards rnnairur[init `iuncr�i„�r .;cense: CS-000979 ROBERT A BOHQXDONEY 12 HALL ST METHUEN MA 01844 l Cxpiration Commissioner 04/21/2016 office of cons” �_.. MME IMP mer Arfairs&gus sS e�.,,..,%,.;, RegistratioROVEMENTCONTRgCTpRgulfltion --;expiration; 114238 8116/2017 Type; ROB ERTBOHONDONEY DBA CONST CO ROBERT BOHONDONEV 12 HALL ST METHUEN,MA 01844 Undersecret_y