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HomeMy WebLinkAboutBuilding Permit #119 - 149-151 Pleasant Street 8/15/2007 f NORTH BUILDING PERMITL TOWN OF NORTH ANDOVER ° ; p APPLICATION FOR PLAN EXAMINATION r` Permit NO: t A Date Received • "9 « Date Issued:_�f �9SSACHUS�t�� IMPORTANT: Applicant must complete all items on this page Rm TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building �1 Owe family [_7 Addition !Ifwo or more family J Industrial Iteration No. of units: �:, Commercial Repair, replacement 0 Assessory Bldg E Others: Demolition ❑ Other DESCRIPTION OF WORK TO BE PREFORMED. fl - [_5 u-� � �k� r _ nnIdentification Please Type or Print Clearly) OWNER: Name: Lvc� C L ;i)-QDiCULCj Tw ,,;� �� Phone: ` Address: q0 vvr�.�c `tau,• avK It 3I 13vC-tS1�11 6 �• IF" k ARCHITECT/ENGINEER /V� Phone: tv 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: $ /_?'4 D DLA FEE: $ Check No.: 9 Receipt No.: NOTE: Persons contract* ith nregiste ed contractors do not have access to th guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer .FI: Tanning/Massage/Body Art - 1I Swimming Pools _! Well [_ - Tobacco Sales -_j Food Packaging/Sales ❑ Private(septic tank,etc. L Permanent Dumpster on Site I 1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit Located at 384 Osgood Street c a A � ,iN 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 2007 Location/Y7- NO. ocation/�Y 7� � r No. Date N��TM TOWN OF NORTH ANDOVER f Certificate of Occupancy $ s' MUs Building/Frame Permit Fee Foundation Permit Fee $;' 1` Other Permit Fee $ TOTAL $ Check # 20494 - Building Inspector 07/23/2007 14:15 It$1bljjzboo e.m. snow, THE SIDING COMPANY 971 MAIN S1'RF.FI WALTHAW MA 11-7451 TO (9R1)899.4946 rax(70 1)st9.1•?6.55 Email:tm.nnwincfriat n;ann Proposal Suhmille. I o: PhoneDete Yvonne Shagoliry T:509-358-2786 F:508-358-9944 7/23/07 Street Job Name 131.Buckskin Rd City State&.Zip Job Location Wcston,MA 02493-1131_ 149.151 Pkaaaat Street North Andover Architect Job Phone 1)ou Snow Reg� lob# We hereby qubmil Rprcitications and estimates for! Strip existing siding ?1„..Q1 Q Install solid vinyl siding on entire house—Certainteed Mallastreet 4"or Mastic Carvedwood 4"COLOR: Install 7'yvek paper ander all siding Install white vinyl 11041111,aluminum fascia and gutters on entire house Install new white aluminum downspouts Custom cover all window&door casings with white aluminum Cover rake hoards with miscellaneous trim with white aluminum _ Install new vinyl shatters where shutters are pre-exits ing COLOR-J,�Ak Rro cvl) 4 Clean and remove debris caused by ut f* "You may cancel this agreement if it has been consummated by a party thereto at a place other than the address of the seller which may be hie main office or branch thereof,by a written notice directed to the seller at his main or branch office by ordinary mail posted, by telegram sent or by dclivery_not later than midnight of the third business day f011OwiM the signing of this agreement." We Propose hereby to furnish material and labor- comp a in accordwith above specifications, for the 4,4 SU m of: 01-9 polls - Payment to be made aR fi,llowc: D©� In full on day work iq completed. Alt material iy 81Z� rii 111)be n;p►xified.All work to be completed in a workmanlike maaim Authorized according in etTntlnrd practirca.Any alteration tK deviation from above specifications involving extra Signature ca.+s Will i.e ex—I'M+only ulrv,wrinen orricn.and will beamre an extra charge over and above the estimate.All agrcemr,t%contingent uprm strikos,amideras ordelays beyond our control.Owner to carry rtrr.tomatio en4+Khrr necrssary imurence.Homeowner will be responsible for all faulty Nate:This proposal may be withdrawn d"trical wiring aur fixtures.Cordrataor,ua responsible for mold. Contactor not re"ible for lead by us if not accepted within��dayS. puin,removal.Our workers are fully covered by Workmen's Compensetinn Insurance.The homeowner has the right to arbitrate tltspvtrs through a private prugtsm approved by Secretary of Consomer r Alain,Conyuctox i8 moisternl. Acceptance of Proporsnl- The above price-,specification and conditions are satisfacto And are hereby acerpted. You are authorized to do the work as specified. Payment will be Made as nullified"N'Ve. 79�;Z__L/`L bate of Acceptance _ Signature I-e u() e d,\n �0 r �v�J'e y f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): L m ' bn0(,) v) c Address-- iWjyo, (n A Phone. : 4SVCity/State/Zp an employer? Check the appropriate box: Type of project(required): lA m a employer with 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. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. Buil addition [No workers' comp. insurance comp. insurance.$ E] required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions. officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ g ep myself [No workers' comp. right of exemption per MGL 12.❑ oof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.Irl Other /l comp. insurance required.] •Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. r I iomcowners 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. hisurance Company Name: T� y L. IJ J7 t lYl N I lU . Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address _Ig_- w ) P(. $/7tv j �j� City/State/Zip: A)O p0C24 ��- 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 ascivil 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 certify under the pains and penalties of perjury that the information provided above is true and correct. { >rtatwe ------ - ._.._� --------- Date: q_ —. Phone#:. -- --- - - -----� To� --- Officio/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#: DATE(MM/DDIYYYY) M CERTIFICATE OF LIABILITY INSURANCE 05/08/2007 PRODUCER. (800)333-7234 FAX (508)653-8089 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 233 West Central Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Natick, MA 01760 Commercial Lines ext 3389 INSURERS AFFORDING COVERAGE NAIC# INSURED E.M. Snow Inc. INSURERA: Travelers Indemnity Co 25658 971 Main Street INSURER B: Waltham, MA 02451 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'NSRTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE a OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY f7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ ANY AUTO (Ea accident) ALL OWNED AUTOS - BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ N- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ . RETENTION $ $ WORKERS COMPENSATION AND UB7523AO48 05/06/2007 05/06/2008 X WCSTATU- OTH- EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 100,000 tt yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS I CERTIFICATE HOLDER CANCELLATION j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL i 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, E.M. Snow, Inc. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 971 Main Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Waltham, MA 02451 AUTHORIZED REPRESENTATIVE e Stace Brice CMH2 ACORD 25(2001108) ©ACORD CORPORATION 1988 _ :"l�te �Jo�icrcvnuieal�t uf�.:GtaiNcclKldg�jd BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 069399 Birthdate: 08/03/1961 Expires: 08/03/2008 Tr. no: 508.0 Restricted: 00 DOUGLAS E SNOW 28 COUNTRY CORNORS RD WAYLAND, MA 01778 Commissioner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTORS ti Registration: 133724A Expiration: 8/2/2007 `fl Type: DBA h{A D.E. SNOW INC. DOUGLAS SNOW 28•CROUNTRY CORNER RD. WAYLAND, MA 01778 Administrator i. DATE: 8/14/07 ` TO: TOWN OF NORTH ANDOVER Robert Macleod hereby has my permission to work with the Town of North Andover on my behalf to obtain permits and complete any necessary paperwork for the following `! project addresses: 149-151 Pleasant Street 333-335 Sutton Street 343-345 Sutton Street Thank you. Sincerely, Douglas Snow NpRTIy Town of � s . ¢ Andover No. _ LAKE o dover, Mass., I� COCHICHEWIC. %ds RATED PPS` 1 E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT...... &.U..J....... ... ....... ....�... .....lq..................... ................................. Foundation has permission to erect................. ......a.............. buildings on .... .......1..r.1........10..A o..Otorwl.T...S.T• Rough to be occupied as G. 3..tal �(�........�'.d., ... chimney provided that the persona opting this per%--1,s--h--a--1F1in-every respect conform�ms of the 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 jqq Final PERMIT EMPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TS 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 BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.