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HomeMy WebLinkAboutBuilding Permit #256-13 - 147 JOHNNY CAKE STREET 10/1/2012 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page PTnt �P1ROPERTY�OWNER �TGU�. �l�k�� lW'ZL� .� - T Print f 1-q-I -ar�Old' trCo ureano 1 , lstnccoPACL20GISTRIQ77 HREMAP- NO ' . MachlneShop�Village� yes. w. y. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑AI ion No. of units: 11 Commercial epair, replacement ❑Assessory Bldg ❑ Others: 0 Demolition ❑ Other _ ❑ Septicj {1Nelll c Floodplin# ®Wetlands aWatershedDlstref+ y =Water,tsi* r`. DESCRIPTION OF WORK TO BE PERFORMED: ��►'►'►�� r--��d coo �S��ss L,�►r�f� Identification Please Type or Print Clearly) OWNER: Name: SJtUr-1-1-wvrti2 G IJ 14z z,ra.. Phone: Address: al, C ka- 4 r. 'CONTRACTOR` Name: _ __ Phone: _ w — w� r=_ _ �- _ �-F -- r�.� O Supervls.orF's�Construction?Licens0-` , ' - I Homey Improvement License:° Ezp D:ate:. ARCHITECT/ENGINEER Phone: 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: $ 00 s CSO FEE: $ Check No.: S!2 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund -. .Z- 77 � - sgftAgent/Owner A. `naturelofscontractor: __�. . F-1Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ElStamped Plans Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSA1� ; Public Sewer 1Tannipg/MassageBody 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 ❑ ❑ y i ..COMMENTS - CONSERVATION Reviewed on -.;. - Signature COMMENTS i HEALTH Reviewed on Signature COMMENTS - I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: t Comments m Conservation Decision: Comments Water & Sevier Connection/Signature & Date Driveway Permit DPW Town ]Engineer: Signature: Located 384 Osgood Street FIRE ®EPARTMEIiIT -- Temp Dumpster on site yes no Located at:124,Mam Street.. ;` - 'Fire Department signature "'ydate 4 COMMENTS ,.` .. . i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I 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.$100-$1000 fine I NOTES and DATA— (For department use ® Notified for pickup - Date f Doe.Building Permit Revised 2010 i f 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 o Building Permit Application d o Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application u Certified Surveyed Plot Plan o Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L; Licenses Li Copy Of Contract u Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) u Mass check Energy Compliance Report (If Applicable) u 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) u Building Permit Application E3 Certified Proposed Plot Plan u Photo of H.I.C. And C.S.L. Licenses L3 Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) u Copy of Contract o Mass check Energy Compliance Report u 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 2012 Location No. Date • ' TOWN OF NORTH ANDOVER � _ i' Certificate of Occupancy $ } w` Building/Frame Permit Fee $ Y �? Foundation Permit Fee $ P, Other Permit Fee $ � TOTAL $ Check# _1 25771 Building Inspector Y r 1NORT11 . . w: 1 1/. :. . . ve: r O K. h , ver, Mass, cocNlcMlWlcll �'� A0RArEO V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System �THIS CERTIFIES THAT .......s 'v BUILDING INSPECTOR Foundation has permission to erect .............. buildings on ..�......!.��. ..... . �...: '�.......... ............ R Rough to be occupied as .............. '.:��.r�..41.. . 1... 4 � .. ©C>. .........................:. 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT ARARTS 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. SEE REVERSE SIDE j � 7 }; ff % qx_ R • office of io meY i ai:s +isi.ess egn,atlo j HO.1E IMPROVEMENT ONTRACTOR ',Registration: ,�2,114187 Type: . Expiration: ;.S 02,013 DBA CR 'JLEY CONST,U&TION ===_ STEPHEN CROINLEY= 54 LONG PASTUREIRD ;F NO•.ANDOVER, Undersecretary: i Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-058114 STEPHEN CR,- LEY 54 LONGPASTURE�RD. N ANDOVER MA 0184r5� r 1w. Expiration Commissioner 02/27/2014 1 - ' ; Stephen Crowley CROWLEY CONSTRUCTION 54 Long Pasture Road North Andover,MA 01845 978-258-4932 tele/fax crowlevconstruction comcast.net Estimate Prepared For: License: MA Reg.: 114187 MA Lic: 058114 Steve and Laurie Cavazza 147 Johnnycake Lane North Andover,MA 01845 978-688-4376 We will remove entire old roof off of home;out rear of house there are vents on roof that we will close off and cut ridge vents in to the top of roof giving full ventilation at all peeks. Once vents are removed out rear of home we will need to cut plywood back to a rafter and repair all areas prior to installing new roof;we will install water and ice shield(6 ft. up)on all perimeter edges of roof;out rear of home where roof extend beyond the main roof we will also install water and ice shield on that entire area to prevent . any water back up from above;we will install black felt paper on remaining areas of roof for a vapor barrier;we will also install all new aluminum drip edge on all perimeter edges of roof;; roof area above back door where roof meets existing wall we will install all new aluminum step flashing up entire wall on both sides of roof(front&back);we will counter flash the back chimney and roll water and ice shield up back of chimney to prevent water back up. We will install a GAF lifetime architectural shingle(color black). We will also install the proper ridge and hip caps that match shingles. While removing roof we will cover in entire home(shrubs,walkways and stairs)assuring that any debris falling from roof does not damage these items. We will also cover in deck,a/c units and generator. In this area of home we will remove the roof and move it to the side preventing shingles from falling onto these areas. We will also provide a dumpster and remove all debris from job stie. r Total: $15,200 1st Payment$8,200 2nd Payment$3,500 Final Payment$3,500 As evident by the signatures below both parties have read and agree to the above estimate. Stephen Crowley is fully licensed in the State of Massachusetts. Member of the Better Business Bureau. 4 BBB, StepAn CrowleyHomeowner From:Colleen Bogac_FaxlD:9784549343 Page 1 of 1 Date:9/28/2012 01:07 PM Page:1 of 1 CROWC01 OP ID: CB ACRO CERTIFICATE OF LIABILITY INSURANCE 709128112 YY) 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(les) 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 976-459_8661: NAME: Francis Provencher Insurance R1-10 Agency, Inc. 978.454-9343; IAIc.Ne.Ext): AIC No): NO Rogers Street EMAIL Lowell,MA 01852 ADDRESS: INBURERIS)AFFCRDING COVERAGE _ NAIC_tl wsuRERA:Lloyds of London INSURED Crowley Construction General Contracting Inc. NsuRERB:Citation Insurance Company 40274 II it 54 Long Pasture Road NSLRERC N.Andover, MA 01645 I !NSLRER 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 OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED EY PAID CLAIMS. NSR TYpE OF INSURANCE LTR PCLIC`i NUMBER _ DD"Yyy} IMMIDDIYYYY) LIMITS GENERAL LIABILITY _1 els Ci^CL FFED,IE ,$ 1,000,000 A NERC!ALGENERAL LIA_IL!T'r LGL1020677 02!03!12 02103/13 Fkltrni�Es(=ancair e)�3 100,000 CLA P,iS-MADE OCCUR MED EXP iA'iy ons person; 1,000 I PERSONAL sACV IN!URY $ 1,000,000 �—I NFo.41 a,GRFGAT I 2,000,000 GEM'L4,C--REGATELIMIT APPLIESPER: PP ".T -CGP�F;CFA;,•G I$ 1,000,000 h POLICY JEST L``i_ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT �E=er:.i�eri $ BAN'(AUTJ BCZQXX 09112111 09/12112 DOD!LYINJUPY,Peroersor) $ 100,000 ALL OWNED SCHEDULED AUTOS X TOS BODIL'T 11 JURY iper (cicem) $ NDN-OWNED 300,000 X 4U HIREC AU70S X ,qt IT05 PPOPERT' AMAGE 100.000 °erau:icent) $ $ HUMBRELLA LIAR rCCUR EACH OCC,_RREI,--E. $ � EXCESS LIAB I — CLAIMS-NAGE i Ar=;,;r-SATE $ DEC) ETENT ON S $. WORKERS COMPENSATION i r AND EMPLOYERS'LIABILITY YIN T"IPY Ii,1IT" F PR ARTN DrFI^CFIFIFFONICOFIP7`LUDED7ECLTIL'E NIA! FL. AcHA :IDEE141-1-1 T❑ '$ F� (Mandatory In NH) 1!yes drs-nte�n7er L ub A E E.A U LCYEE $ _ J ERA .0 E L.DISEASE-P_OL CY-!,M!T !$ � I I I i � I DESCRIPTION OF OPERATIONS I LOCATIONS('VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if mare apace is required) CARPENTRY-RESIDENTIAL NOT EXCEEDING 3 STORIES —CERTIFICATE FOR WORKERS'COMP COVERAGE WILL BE ISSUED DIRECTLY FROM THE COMPANY WITHIN 2 BUSINESS DAYS" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of N.Andover ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: Building Dept. 1600 Osgood St. AUTHORIZED REPRESENTATIV5 N.Andover, MA 01845 ©1988-2010 ACORD CORPORATION. All rights reserved, ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD ..Rightfax C3-2 100112012 5 ;22 ; 33 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MhVDDlYYYY) T IFICATE 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 D THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADD';TIONAL INSURED,the policy(ies)must be endorsed. 11 SUBROGATION IS WAIVED,subject to the terms and conditions of the policy.certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such.endorsement`s . PRODUCER CONTACT NAME: RANCIS E PRO�'ENCHER INS PHONE FAX 530 ROGERS STRBE't INC.No,Ext); (AIC,Not: EMAIL LOWELL,MA 01852 ADDRESS: 26 aL INSURER(S)AFFORDING COVERAGE NAIL# INSURED INSURERA: TRA'TELERSNDEbaiIITY CC. CROWLEY CONST RT,CTION C.F.NERAL CONTRACTLVG INC INSURER B: INSURER C: 54 LONG,FAST;,TRE ROAD INSURER D:INSURER E: NORTH ANDOVER,NIA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER;-- REVISION NUMBER: W HAVE BEEN ISSUED TO THE IHSURED 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 FERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERON IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD $UB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (Mmi)D%YYYYI fMr omyYYY) LIMITS GENERAL LIABILITY --ACH OCCURRENCE is COMMERCIAL GENERAL LIABILITY CLAIMS MADE ®OCCUR. DAMAGE TO RENTED Is REMISES(Ea occurrence) MEC EXP(Any one person) is ERSONAL&ADV IIJJUR.Y $ GEN'L AGGREGATE L IMIF APPLIES PER -ErJF_RAI_AGGREGATE b POLICY ®PROJEC- ❑LOC RODUCTS•COMFiOP AGG 3 AUTOMOBILE LIABILITY CCIMBINED SINGLE ANYAUTO L'MIT(Ea accident) ALL OWNED AUTUJ BODILY INJURY g SCHEDULE AUTOS (Per Gerson) HIRED.AUTOS BODILYINJURI' S NON-01R?JED AUTOS (Per accident) PROPERTY DAMAGE S iPer accident) UMBRELLA LiABOCCUR EACH OCCURRENCE S EXCESS LAB 11 CLAIMS-MACE A77R GATS g DEDUCTIBLE g RETENTION $ S WORKER'S COMPENSATION AND a A X WC STATUTORY d OTHER EMPLOYER'S LIABILITY YIN i.'B-O'20I�I430-i2 0^.'16,/2012 011012013LIMITS t ANY CER E MSER-XCLUER/=nECUi IVE ,ylA E L.EACH ACCIDENT $ 1^0,000 FICER/MEMBER EKCLULIED° (MandaforyIn NH) E.L.DISEASE-EA.EMPLOI'EE .$ 100,000 If yas,Jesc•Iba unde, DESCRIP.ION O=OFERATIONS below E.L.DISEASE-POLICY LIMIT s 500,000 DESCRIPTION OF OPERATIONS;LOCATIONS!VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS PIPLACES ANY PPIOR CHR'a7OATE ISSUED TO IHF CERTIFICATE p✓ COQ cps}g CERTIFICATE HOLDER CANCELLATION T OW'N OF N ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ATTN BUILDING DEPT BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 1600 OSGOOD ST IN ACCORDANCE WITH THE POLICY PROVISIONS, N.ANDOVER,*rLA 01845 AUTHORIZED REPRESENT4�TdVE 1 RD 201 05j e ACCIRD name and logo are registered marks of A ORD 1988-2010 ACORD CO RPO ATION. RII rights reserved�•