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Home My WebLink AboutBuilding Permit #332 - 16 WOODBERRY LANE 10/20/2010 NORTH BUILDING PERMIT oF��eD 'a�• TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION -2i Date Received pDRATED t'Q�`y4 Permit NO: gSsacwu5�C Date Issued: / TIdIp®RTANT:Applicant must complete all items on this page /e. SCJ d e1,p LOCATION_ Print PROPE-RTY.OWNER. • -. ti Fant ". _PARCEL: ZONING DISTRICT Historic District yes. no . MAP 210 Macgehine Shop.Villayes no TYPE OF IMPROVEMENT PROPOSED USE E Residential Non- Residential ❑ New Buildingne family El Addition ❑Two or more family 11 Industrial Alteration No. of units: ❑ Commercial ❑Assesso Bldg ❑ Others: ❑ Repair, replacement ry g � ❑ Demolition ❑ Other d.Sept'►c p Well. p Floodplain' .. VVetlarids ❑ 1Naterstied District. 0-Water/Sewer- DESCRIPTION OF WORK TO BE PERFORMED: 101 ]Identification Please Type or Print Clearly) ]I OWNER: Name: cc..J� ,4110- e, c- Phone: 2 Address: /G> /-J6 0�/Ze...� ��b� Ab> �✓ao a ,..a r. CONTRACTOR Name: Phone: 171 �f , / xy . �; I Address-, _ t .w0 � ,5 Exp:`Date: supervisor's.Construction License: G - � � `Z� !� . . . Exp. Date:: � Hbhid. mproveme�nt License: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEB SCHEDULE:BOLDING PERMIT. $12.00 PER,0$1000.00 OF 0 PER S.F. THE TOTAL ESTIMATED COST BASED ON ccs ' Total Project Cost: $ / FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unr gistered contractors do not have access to the gu my fund Signature of Agent/Owner �,/--/ Signature of contrac Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL d Public Sewer ❑ Tanning/MassageBody Art ❑ Swnnming 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 Siqnature COMMENTS HEALTH Reviewed on Signature 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 D1PW Town Engineer: Signature: Located 384 Osgood Street FIRE ®IEPARTMENT - Temp Dumpster on site yes no" Located at 124 Main Street .Fire Department signature/day#e COMMENTS. DimensiOn Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of rioter location, mist or service drop requires approval of Electrical Inspector Yes No DANGER Z®NE LITERATURE: Yes No MGL Chapter 166 Section 21A Fand G min.$100-$1000$100- 1000 fine NOTES and DATA — For department t use I ® Notified for pickup - Date Doc.Building Permit Revised 2010/October k t 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 CalculationsApplicable) If ( ❑ 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 ®°E: All durnpster permits require sign off from Fire Department prior to issuance of Bldg Permit Il=n 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 Doe:Building Permit Revised 2008 Location , (.� No. '� l� Date ��v NaRTh TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ Must< Building/Frame Permit Fee $ ' � Foundation Permit Fee V $ Other Permit Fee L $ TOTAL $ Check # — 235b Building Inspector NORTH Tomm of _ _ over VA No- LAKE O over, 1VIaSS., COCHICHEWICK Ids RATED 7 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System d� BUILDING INSPECTOR THIS CERTIFIES THAT...... . S ::....... ............... ..................... .. Foun anon ... ............................... has permission to erect........................................ buil Ings on /A...........................� ...�..,� .....Ia.ftwc'.. Rough to be occupied as rt�.14 �. �� .... Chimney ............ .. . . . . ..1 ... . .............................provided that the persong this permit shall i ery respect conform to the terms oft 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 THS ELECTRICAL INSPECTOR UNLESS CONSTRUTS Rough Service .......... ............................................................................. BUILDING INSPECTOR 7 Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Rough 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. TALOTV N Bob Talbot Owner Direct: 603-755-1535 ROOFING & CONTRACTING Main: 888-755-1535 Residential, Commercial& Condominium Roofing Solutions E-mail: bob@talbotroofing.com Mastering Home Improvements!! CUSTOMER Julie Strumpfler 8/31/10 16 Woodberry Ln. North Andover,MA 978-821-8545 DESCRIPTION OF WORK PERFORMED -Remove existing clapboard siding from entire house and dispose of properly. -Inspect all sheathing for rotted wood. If V2"plywood is needed it will be an additional charge of$2.00 per square foot -Install Tyvek Vapor barrier over all exposed plywood. -Install ''/z"insulation board over work area. -Install Certainteed Mainstreet.042 double 4"woodgrain clapboard vinyl siding to entire house.Color:310WOG Gl<±,04^/ -Install all new Value triple 4 vinyl soffit center vented.Color: W h%TF -Install all needed accessories to include J-Channel,undersill trim,aluminum starter,and outside/inside corners. -All existing trim around windows,fascia and rake boards will be wrapped in aluminum.Color: W N-iTJ -New pine trim will be installed around windows with no trim and wrapped to match other windows -New(owner furnished)light fixtures will be installed where existing -New"Mid-America"polypropylene shutters(15"open louver)will be installed to all windows.Color: BL� -Work site will be cleaned on a daily basis and gone over using a magnet to pick up all the nails. -Talbot Roofing&Contracting will furnish manufacturers Thirty year material warranty,as well as a l0 year non-prorated workmanship warranty that entitles homeowner for coverage to include all labor,materials and disposal cost. -Talbot Roofing&Contracting will supply customer with a Liability and Workers Compensation insurance certificate -Payment terms to be as follows: 1/3 Deposit&balance on completion. -Any changes to the specifications will be executed on a written change order and will become an extra charge above and beyond the original contract price. TOTAL INVESTMENT: $ 18,500.00 All'obs to be started roximatel 2-3 weeks after the signed contract and d osis J aPP Y � � deposit (Pending weather conditions) Please call me with any questiots Thank You,Rick Lundgren 978-361-6129 "ACCEPTANCE OF PROPOSAL-:Tlie.above prices,specifications and conditions are satisfactory and hereby accepted. Talbot Roofing is authorized to do the work as specified. 1,`3 deposit is due w-ith a signed copy of this contract&balance is due upon completion. Talbot Roofing Rep: 'i` ,� Date: V Z%L10 Authorized Signature: _,L - _ e% Date:. ? 'L t0 OLHA P30%K of') LST IRz VE v-p-3t-f- Talbot Roofing&Contracting,LLC 8 Joan Avenue"Hudson,NH 03051`(603)755-1535 or 888-755-1535 wvvw-talbotroofing.com 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement actor Registration Re_gmbation: 157288 Type: -Ltd L ily Corporation Elmireti= Qa0/2Q11 TO 288W RJ.TALBOT ROOFING_ &CONT ROBERT TALBOT , 8 JOAN AVE. HUDSON, NH 03051 Update Address and return card.Mark reason fva change. D Address ❑ Renewal ❑ Employment ❑ Last Card ®PSCAI a SM&OWN-00105 Massachusetts-Delru-intent of 1'ub ie 4afi�t� Board of Building Regulations and Standards Constriction Supervisor Specialty License License: CS S#. 101775 Restricted to- RF ` ROBERT TALWI 8 JOARI AVE NUDSOK NH 03M1 Expiration: 1211312012 t'..ttwii� uarr Tr=: 101775 VUL VI IV V0.V4V rim Lamb of t'F€wuaws C}1f03fDOW44 p.L AC' R'C? CERTIFICATE OF LIABILITY INSURANCE110101112010°�' `�""°°'�'�"' �� 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 BMEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy{iesj 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). CONTXCT PRODUCER NAME: Philip Latvis Jr Philip Latvis&Associates LLC PHoxE 803-753-4533 FAx 803-753 932A U Tio.Fxt) �NO). 351 Village Street E-MAIL ss: tatvisp@nationwide.com-- - — Penacook, NH 03303 PED- ER INSURERLS)AFFORDING COVERAGE _ NAIC A _ INSURED – y INSURER A:Penn America Insurance Co. 32859 Adam Lecomte INSIRtERB: FirstComp Insurance Co. - 27626 167 South Main St.,Unit 5 It SUPERC: _ Franklin,NH 03235 INSURERD: -- 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 SUB LECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -— -----'----- —— PDLICYEFF POLIC1fuMITS �LTRR TYPECFWSURANCE DL ert POLICY NUMBER IM T A GENERAL uABRnY I EACHOCCURRENCE $500,000 X COMMERCIAL GENERAL LIABILITY PACS655165 01111(201001111/2014 PREMISES Ea.oe eL__ $50,000 .ti CIAIbis4jADE A,OCCUR MED EXP(Any one persor) S5,000 — PERSONAL&AIWINJLIRY sEXCLUDED — --- - -- GENERAL AGGREGATE $1,000_,000 1 GEN'LAGGREGATE L1M.TAPPLIES PM PRODUCTS-COMPlOPAGG $1.000,000 I POLICY JFCTPRO- I LOC Is AUTOMMLELIABILnY I COMBINED SINGLE LIMIT $ — (Es amident) ANY AU70 BODILY INJURY(Perpe,sm) S - ALLOWrcEDAIfrOS BODILY INJURY(Pera t) S SCHEDULEDAUTOS -- — PROPERTY DAMAGE S HIRED AUTOS (Pe,accident) —- - -— - NON-OWNEDAUTOS IUMMMLLAL(AB O�uR EACHOCCURRENCE 'S _ '---- EXCESS UAS C1 AIMSd41ADE AGGREGATE -— S- --- DEDUCTIBLE --- RETafTION 5 ( S B WORKERSC01IMNSATION WC0104500414122120100112212011 r�srA-1► AND EMPLOYERS'LIABILITY TH AW PRCPRIETOWARTNFR �tJ iDTIVE Y 1 N N/A _E.L.EACH ACCDENT 5100,000 OFFIC:ERI EMBEREJ(CLUD5D? � - -- — (ffa,W,twyinNH) E.L.DISEASE-EA EMPLOYEE 3100,000 dew ibe Ueda DESCRIPTION OF OPERATIONS blow i E.L n wAsE-POLICY uurr s500,000 ! t DESCW PTION OF OPERATIONS/LOCATPDM I VBRCLM{Attach AD=101,Addmww Ramada Schedule,if r space IS Mq¢d* Sales of roofing and Construction Services. Adam Lecomte,Proprietor,Excluded from Workers Compensation. CERTIFICATE HOLDER CANCELLATION Talbot Roofing 8 Joan Ave. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN Hudson,NH 03051 ACCORDANCE WITH THE POLICY PROVISIONS. via fax 603-598-4482 AUTHORIZED REPRESENTATIVE Philip LaWis Jr. @ 1988-2009 ACORD CORPORATION. All fights reserved. ACORIA 26(2009109) The ACORD name and logo are registmvd marks of ACORD The Commonwealth of Massachusetts t � s Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.massg ov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/individual): �.4� VE-10/ �y/, G• p� jS , ��J�' Address: e.�, �d `e- City/State/Zip: _ llo o&1)A-) e341 Phone#: - L)�- j ��/S3�✓ Are you an employer?Check the appropria b x: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ i am a soleproprietor or partner- listed on the attached sheet,# ? F1 Remodeling r oP ship and have no employees These sub-contractors have 8. Q Demolition working for me in any capacity, workers' comp.insurance. g. Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its r 10.❑Electrical repairs or additions required.] officers have exercised their e9 ] 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.[] Plumbing repairs or additions myself.[No-workers'comp. c. 152,§i(4),and we have no 12.❑Roof rS_ b), insurance required]t -employees. [No workers' 13.❑Other A/ comp.insurance required] *Amy applicant that checks bo)!I1 mast 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 mast 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: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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 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 fo nce coverage verification. I do hereby ceilify u e p ' an naltks of rju that the information provided above is true and correct Signature: Date: /6 Phone#: Ojlieial use only. Do not write in this area,to be completed by city or town ofciat 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#: