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HomeMy WebLinkAboutBuilding Permit #Exception - 1402 BASSWOOD CIRCLE 5/1/2018 (5) NORTFi OF�i�ac ibati BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATIOP4 - e o � Permit NO: Date Received—jzok Date Issued: us IMPORTANT:Applicant must complete lete all items on this age LOCATION 1—LQ 2 t'� &)ood Ctrdf- I I• Airl"tr ►' Jr, ors-,yr Print PROPERTY OWNER 0-&4, c,R �)oorlarl Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑One family ❑Addition ❑Two or more family 0 Industrial ❑Meration No. of units: ❑Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic ❑Well ❑ Floodplain ❑Wetlands 0 Watershed District C7 Water/Sewer Rtob-4 ev sb,n F )(/o' deck c4nd keplact.-Ut Atte de,cle w�1r' d ,Y/U' UrJ��� 01 A 1 421.5f r A7 Pt 00-519 r 1 K deCklinC4 coti6tidr—ads +G cede PC, IdentificationPlease Type or Print Clearly) OWNER: Name: +rI c. C.,r-1 Phone: Address: CONTRACTOR Name: ?k135J-9131 Phone: Address: 13 Li b*l j S+ TaSw/cb M&. of 43�- Supervisor's Construction License: CS Exp. Date: -l09�� Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1000, o� FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ', Signature of Agent/Owner Signature of contractor SPS Oakridge Village Maplewood Reserve Condominium Trust I Proposal#:5443026 Proposal for Services - Small Project Contract Property Information Owner/Managing Agent Property Name: Oakridge Village Contact Name: Tonya Petone Maplewood Reserve Condominium Trust Address: Harvest Drive,Turnpike Company Name: Mediate Management Inc. Street City, State,Zip: North Andover MA, Address: 180 Lincoln Street, Suite 3 01845 Contact at Property: City, State,Zip: Boston MA,02111 Contact Phone: (617)316-3333 Contact Fax: Contact Email: tonya@mediatemanagement.com Project Description: Remove and replace decks at 5 locations. Notes & Miscellaneous Items: • Price to include labor and materials. Description of Work Price 1. Remove and replace 5 decks.The units included are 601 Alder Way, 1506 L $45,000.00 1401,1402 and 1502 Basswood Circle.Decks to include PVC decking and PVC railings. Total Price for work to be performed: $45,000.00 Acceptance of Proposal The undersigned,as authorized representative(s)of the property listed,have read e term tated herein and accept the terms as written. 4��i* 11/10/16 SIGNATURE DATE SIG URE DATE Chuck Huntl Vice President Tenpa PuMft ffGSI�,� Y ho w NAME TITLE NAME TITLE Schemecker Property Services 1 283 Second Avenue,Waltham MA 02451 1 800.424.2468 1 spsinconline.com Page 1 of 1 AC40® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ♦�,,,,,�� 11/10/2016 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 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 CONTACT Claire Boutilier NAME: Cleary Insurance Inc PHONE (617)723-0700 aC No:(617)723-7275 226 Causeway Street ADDRESS:cboutilier@clearyinsurance.com INSURERS AFFORDING COVERAGE NAIC# Boston MA 02114-2155 INSURERA:Continental Western Insurance 10804 INSURED INSURER B:Acadia Insurance Company 31325 Schernecker Property Services, Inc. INSURERC: 283 Second Avenue INSURER D: INSURER E: Waltham MA 02451 INSURER F: COVERAGES CERTIFICATE NUMBER-2015-16 Liability 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD MM/DD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE �OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ X CPA 0183614-19 12/31/2015 12/31/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ POLICY a 2,000,000 OTHER: $ AUTOMOBILE LIABILITY CEa acciOMBINEDdent SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS X AUTOS MAA 0183615-19 12/31/2015 12/31/2016 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per a.dZI $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION CUA 0183616-19 12/31/2015 12/31/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY OFFICER/MEIMBER EXCLUDED?ECUTIVE N N/A E.L.EACH ACCIDENT $ 1,000,000 B (Mandatory in NH) WCA 5074780-13 12/31/2015 12/31/2016 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If SCyes,describe under Excludes MA RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached ff more space Is required) The Town of North Andover is included as an additional insured for general liability per insurance coverage form CLCG0492 (02/12) when required by written contract. CERTIFICATE HOLDER CANCELLATION 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. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE John Bernardin/CTB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 onl4n1) Client#: 1025557 SCHERPRO DATE(MM/DDIY" ACORD.- CERTIFICATE OF LIABILITY INSURANCE 11/11/2016 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 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 NAME: Kathy Wagner USI Insurance Solutions,LLC PHONE 413 750 4222 F 6105379481 A/C,No,Et): A/C,No: 123 Interstate Drive E-MAIL ADDRESS: Kathyag Wner usi.biz West Springfield,MA 01089-3600 INSURER(S)AFFORDING COVERAGE NAIC# 855 874-0123 INSURER A:ABC Mass Workers Comp Self-Insu 99999 INSURED INSURER 5: Schernecker Property Services, INSURER C: 283 Second Avenue INSURER D Waltham,MA 02451 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 CONTRACTOR 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 TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMBS LTR INSR WVO POLICY NUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE E OCCUR PREMISES Ea occurrence $ _ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY❑JECT [:]LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOSAUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION ABCMA12000116 1/01/2016 01/01/2017 X PERTUTE ER" AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEYIN E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Massachusetts Workers Compensation Coverage CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE Gam.. ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S19266164/M17054616 PZBZP ,y�` ��1�8l(J(J47'7.-97I,(d'J7.LlJC'.CLL/A1 O��//'GCl4:JLL'C17A.G�G'�irQ, . ffice of Consumer Affairs&Business Regulation OME IMPROV,�NT CONTRACTOR Regis tratiop '` 123615; Type: Expire nig/{q/201 Supplement Card -Schernecker Properly Sen+ices, Inc: KEVIN WINTER 283 Second Avenue '�� . ;,. i Waltham, MA 02451 Undersecretary l Massachusetts Department of Public Safety Board of Building Regulations and Standards License: S- ConstructionnSupervisor KEVIN WINTER 13 LIBERTY STREET« �' s IPSWICH MA 01938, \ t Expiration: Commissioner 03110/2019 i IIS Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ 'I'YPB 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 v U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on t I S Si nature ` COMMENTS 4r HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments &Onservation Decision: Comments d tater & 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 signatureldate COMMENT _, 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 droprequires approval of Electrical Inspector Yes No DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email } ate Time Contact Name Doc.Suilding Permit Revised 2014