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HomeMy WebLinkAboutBuilding Permit #306 - 148 MAIN STREET 10/9/2009 C TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION i f Permit NO: Date Received v Date Issued: IMPORTANT:Applicant must complete all items on this page LocATION ,, }Vrn li'0Css CY1tLn . Pn PROPERTY OWNER, ^ J�CZCf'1C1 +� 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 Industrial tion No. of units: Commercial Repair replacement Assessory Bldg Others: emolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: �rov�c�ed . Identific tion Please Type or Print Clearly) OWNER: Name: j-� ct( — -(USA Phone:Ckn� -0-17S •ui= Address: Vk% moan t`Nn '�- CONTRACTOR' Name: Phone: Address:: '� X Cc�tcer OI�SI Supervisor's Construction License; �.`J �.9 Q Q Exp. Date: "g1 u3(4)aQ1,© Home Improvement License: la' S;QkQQ Exp. Date: m ARCHITECT/ENGINEERsZira.. Phone: 0011 - yAU; - LAY&p Address: SIC! A ErX� CAS. n-A Reg. No. 3394 Cl FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ,810M-np FEE: $ ��.00 Check No.: `/' 7 e Receipt No.: NOTE: Persons contracting with unregistered contractors do not hav d Signatureq of Agent/Owner Signature of contracto Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL [ L d� . . 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 - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Si nature '11.. COMMENTS I � , R HEALTH • Reviewed on - 'Signature' COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments -r Water & Sewer Con nection/Signature'& bate Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood $treet FIRE DEPARTMENT t Temp Dumpster on site yes no M Located at 124 Main Street Fire Department signature/date COMMENTS 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 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 NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 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 NOTE: 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/Crossection/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 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 ❑ 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 ❑ 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 2008 Location �� No. Date NORTH TOWN OF NORTH ANDOVER 3?O�?•`•o,•1hOG f' 9 • Certificate of Occupancy $ +S' "•,..a.''``' �s Et'n CM Building/Frame Permit Fee $ s� us Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #J/ :�R G Building Inspector IIII A . , Lill Lilill, A � ,�-� �.:�.�.� � � � i -,s ��� .. -- ����� --- �,�,' __ � �� � .. ,�` _ -- � ...._ - -_. _.� �- w,,.. �r E F 1 � � � � � � / i�rr �� r �11 1 1 1 ". �. i rr' r' .".".i, t ��.a;.. NORTfi Town of 4 over Orw•Fx+v- 1'`x'14'` ,I/ter [ No. - �` CN dover, Mass., 1 ' T O '— LAKE �• COCMICKEWICK y ADRATED 1S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT �4 - ........... ... ....!!`.... ............. ..... ............................................. "" Foundation has permission to are ...................... buildings on ..... 0......`.•.x.14...... . ...... ...................................... Rough to be occupied as.... .... r...... .......rw �...... s a Chimney provided that the person accepting this permit shall in every respect confor to the terms t application on file in Final 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 CONS STARTS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. 10/06/2009 08:04 9782784008 GREAT NORTH PAGE 01/01 PROPOSAL �,. PO Box 27 M Andover, MA 01810 Phone: 978-882-1638 Fax: 978824-9420 Szekely ICunzrruc[lon DATE: Oct. 5, 2009 TO: Sutton Pond Condominium JOB Footing repair to rear deck Association 148 Main Street North Andover, MA 01845 We hereby submit specifications and esilmates for. Labor and materials to repair/replace damaged footings at rear deck. All work to be performed per plans/contract provided by Gelinos Engineering. By Signing this proposal Szekely Construction Inc is authorized to act as agent for condo association, pull the permit,and perform the wrxk at quoted price. A finance charge of 1 112%.which is an annual percentage rate of 18%.wm be added to all balances past due after 30 days,plus any collection and legal fees. WE PROPOSE hereby to furnish labor for the sum of: $8,000.00 (Eight Thousand and 00/100 Dollars) Payable as follows: 50%at signature of contract 5076 upon completion of work All work to be completed in a workmanlike manner according to Standard practices. Any alteration or deliatfon from above spedfications involving extra costs will be executed only upon written orders,and YM become an extra charge over and above the esfimote.All agreements contingent upon weather,accidents or delays beyond our control. owner to carry 00-1 fire,tornado and other necessary insurance.Our worker's are fully covered Sean Szekely by Workmen's Compensation InsunSnoe ACCE N=PROPOSAL-The prices,specifications and conditions are satisfactory and ore hereby accepted. You aro authorized to do the work as specified. Payment will be made as outlined above. ATE ACORD�, CERTIFICATE OF LIABILITY INSURANCE 10/06/2 09) PRODUCER (6 )432-3666 FAX (603)432-6076 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lake de Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE One 'Wall Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1ham, NH 03087 _ INSURERS AFFORDING COVERAGE NAIC# INSURED Szekely Construction, Inc. INSURERA: Peerless Insurance 24198 PO BOX 27 INSURER B: Andover, MA 01810 INSURER C: INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONI TR NRR LIMITS GENERAL LIABILITY CBP8280828 04/22/2009 04/22/2010 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY BA8278174 05/01/2009 05/01/2010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,00 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ A X HIRED AUTOS BODILY INJURY $ X NON-OW NEO AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR a CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC8480730 08/07/2009 08/07/2010 X I WC STATU- I OTH- TORY I IMITS FR EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER' i DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Covering work performed by the Named Insured during the policy period. Sutton Pond Condo Trust is Additional Insured per written contract with respect to Insured's work only and with exception to he Worker's Compensation policy. CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Sutton Pond Condo Trust BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 148 Main Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Edwin Duvall LYNN ,&x "J.4— ACORD 25(2001/08) FAX: (978)278-4006 CACORD CORPORATION 1988 R Gelinas 5hdural �nglneerinq I LC Phone 978.465.6436 Daniel L. Gelinas, P.E. Fax 978.465.5160 579A North End Blvd. Salisbury, MA 01952-1738 danlgelinas@comcast.net August 25, 2009 Mark Rae, Belford Construction Inc 283 Washington St Groveland MA 01834-1008 Subject: 148 Main St N. Andover Rear Decks Reference drawings SG-1, SG-2, SG-3 Dear Mr. Rae: Per your request Gelinas Structural Engineering LLC (GSE) met with you on 8.13.09 at the above address. The purpose of this meeting was to provide limited structural observations and assist the Condominium Association to repair the corroded concrete pier supporting the rear deck. The following are GSE's recommendations: Recommendations: 1. Project to be handled in two phases. 2. Phase one is to shore the deck first floor to grade/basement as shown enclosed drawings SG-1, SG-2, SG-3 3. Then Contractor to excavate/expose pier to bottom of footing/so as GSE can assess the condition of both piers and recommend a repair which will be Phase 2 4. Phase 2, GSE repair recommendation 5. Note, to move forward with Phase 2 GSE requires a signed contract(enclosed) Discussion: 1) Pier one is severely corroded. Pier 2 is cracked. GSE recommends shoring, excavating to expose footing/pier at both piers 1 &2 for Phase two GSE recommendations 2) Tenant indicates: a. Two years ago+/- both piers where repaired b. Water issues are ongoing here; water occasionally is a cause of concern in the decking area, in the basement area, etc. 3) Thus GSE recommends the Condo Association address this with the proper professionals Please call with any questions. Very ruly ours, �s� C, Y' DAN l al Q GS:, iNAS tr Daniel U. Gelinas, P.E U s T O(--URAL C letter 8-22-09 09104 Shoring Phase.doc , ss�C�>Jr1Yr� �� i f ':. •. T +. .3 9 �`^� :.r. y9< €r ' �n iEj�.�a :' IN wg �' 3 '• icy #'�qa ` `' i �` . «.ez 'a* ` , S .r� ,: t Y �, w 3 `R "w We y a _ X f�3 z FLW%:., s r .h z a � Wj tai aw M 4. CS `�• zn t --� NNI V ZO0> p C', C)rnt 2 ID ,:t)r__ p yFFR C��p cn m ° _a)(1 Sil kLl-r-r a GEUNAS STRUCTURAL ENGfNEERING Ue Z o Daniel L. Gelinas, P.E. Go�lp� 4 p ) - --- - -- 579A North End Blvd. -� 10> HAI '�;r Salisbury, MA 01952-1738 Phone 978.465.6436 (Fax 5160) HA 00 - ? co - w ui r x -- amNIi Ico I � " < co 6 o co 2x 4- 15 cn o cly ckA OF Massy l y S V tJ - � t C', G g� DANIEL L R� — ` '' � ` • GELINAS 0 STRU (::��_� I�1't.SRAL � No.33994 '2�9A �� LL 1 a _ I�bL <�z 00 �rz- �"I Boob 51 12,�I 2 k(40 t), Ss �- HAl `' j ,+ JOB NO. -. SHEET NO. LTCAIPE co 0/ Ul) ILL M 70 0 CIO M --- - IT - Q1 L _ Q 2—ML � _ N .ar T . J ti CO C - Z m -�N OF cy �O DANIEL L. m c��INAS No.33 — 7:3- '-2'-2 oo 00 JOB NO U - Z-x _ _ . ---- SHEET NO Rli - �' �, o Massachusetts - Department of Public Safct'N Board of Building Regulations and Standards Construction Supervisor License License: CS 69055 Restricted to: 00 SEAN P SZEKELY PO BOX 27 ANDOVER, MA 01810 Expiration: 8/26/2010 ( lilt] i"i"ller Tr#: 2459 ✓`LP. LnlYY�9/II.141" l J._l" JCZGJZ[ldP.l�4 \ Board of Building Regulatio s and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 128900 Board of Building Regulations and Standards Expiration: 6/4/2011 Tr# 285168 One Ashburton Place Rim 1301 Type: Private Corporation Boston,Ma.02108 Szekely Construction Inc. Sean Szekely 3 DEERBERRY LANE �•t,�,�a ..` ANDOVER,Ma 01810 Administrator Not valid without signature • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name (Business/Organization/Individual): . Address:_ QAX City/State/Zip: R( \ MfN CA%10 Phone #:—q 4193.3193 Are you an employer? Check the appropriate bog: Type of project(required): I. I am a employer with 5 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ 7•�K Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.F] Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *::.y-FF--­that checks box#1 must also fill 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 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 information. ` Insurance Company Name: QY 1ttS M nC k_ Policy#or Self-ins.Lic.#: Vy,' VA 01 M) Expiration Date: Job Site Address: VA446 Majc Ci /State/Zi ri p 1JP�� mA old 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 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. 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 cert' �al penalti�offperjurythat the information provided above is true and correct Signature: nDate: is 6)CrA Phone#: (4@Z)- 2ACA3 Official use only. Do not write in this area,to be completed by city or town 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#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apaftfnents and who resides therein, or the occupant of the dwelling house of another who'trhp'loys her§bns to do`Aaintenance,cLstruction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employirientrbe deemed to be an employer." s MGL chapter 152,y,§25.C(6.)also states that"every state or local licensing agency shall withhold the issuance or renewal of a licdn or'permifto opet'at`e a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall , enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance-"' requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability.Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit f6ryou to fill out in the event the Office of Investigations ias to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,;an applicant • that'nid"s subf iiVimiltipl6•petmitllicense applications in any given year,need only subniittone affidavit indicating current . policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. - - The Department's address,telephone and fax number: j The Commonwealth of Massachusetts Department of Industrial Accidents; Office of Investigations 600 Washington Street Boston, MA 0.2111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-72.7-7749 Revised 5-26-05 wwvw.mass.govfdia