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HomeMy WebLinkAboutBuilding Permit #392-2016 - 2241 TURNPIKE STREET 9/28/2015 U C'An`NED g�3a//.s' TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: zJly` Date Received Date Issued: l IMPORTANT: Applicant must complete all items on this age r x SPririt „ PROPERTY OWNER DAN A i_Q_ _. Prnt� 100 Ye r Old Structure�6 ye's no MAP NQ: PARCEL'-: ZONING.DCSTRICT —I HDistrict yes no .. � �Machirie�ShgprV[Ilage _ye ro _ TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more fa ily El Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic : 0�1Nell ❑`Floodplain 1Netlarids' ❑ Watershed®istnctj- ❑W. ter/Sewer_ - - n DESCRIPTION OF WORK TO BE PERFORMED: r Identification—Please Type or Print Clearly) OWNER: Name: ' ),o A." —J19-K 1vSoe-1 Phone: 3 Y Address: G 2 g l TV Vim— s - CO_ NTRACTOR fName = Phone- lSg Adtl ress:,_ _ _ T r. � 4 s} Supervisor's Constructon<`Llcense j-0 _ � - - - � — - - - — ' Home lmprovernent License:` Exp Date:" 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: $ i� 4�- 0� iFEE: $(fq 22 Check No.: I - Receipt No.: NOTE: Persons contractin with unre ' ter o tractors do not have access to the guaranty fund S Hato of:'Agent%Owne -� re ofcontracto , . 1`;�. s _ u.. Plans Submitted Lj Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 1 -Plans-Submitted ❑ Plans tli7aived .Certified.-Plot Plan ❑ . Stamped Plans ❑ -TI'PE OF::.SEWERAGEDiSP_OSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑. . Swimming Pools ❑ Well ❑ Tobacco Sales 0 _ Food Packaging/Sales ❑ Private(septic tank,etc._ . -Permanent Dufnpster on site - THE-FOLLOWING SECTIONS FOR OFFICE USE ONLY li INTERDEPARTMENTAL SIGN OFF U FORM DATE. REJECTED . :_ DATE APPROVED PLANNING & DEVELOPMENT - ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature r COMMENTS HEALTH Reviewed on Signature 1 COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: -Comments Water& Seder Connection/Signature&.Date Driveway Permit DPW Tovv;2 Engineer: Signature: _ Located 384 Osgood Street FIRE DEPART�i NT ,Temp Dumpster on . yes no Located at-.124 Mair, Street.- :"W Fire ®epartme°pit signature date COMMENTS y Dimension (Number of Stories: Total square feet of floor area based on Exterior dimensions. Total land area; sq. ft.: - ELECTRICAL: Movement'of.Meter.location, rhast or service Top requires approval of Electrical Inspector Yes No DANGER ZONE_LITERATURE: Yes No MGL-.Chapter166.Section 21A-F and G min.$100=$1000..fine NOTES and DATA— (For department use II ® Notified for pickup - Date I Doc.Building Permit Revised 2010 Building Department The foli wing is a=list of the.required:forms to be filled out-for.the appropriate.permit to`.be obtained. Roofii,g, Siding, Interior Rehabilitation Permits B,ailding Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L: Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products (VOTE: 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 (VOTE: 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 apur?al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Bui?ding Permit Revised 2012 ALS Location No. Date r , TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ � i � . Foundation Permit Fee Other Permit Fee $ j - rED xTOTAL $ y�. L - 0L Check# 16q, a• i {; r� Building Inspector .� G NORTH own of h ver, Mass o 9 C0CM1C"1W.0 RATED V BOARD OF HEALTH Food/Kitchen PERMIT T LD--��� Septic System THIS CERTIFIES THAT ...�Y.1.✓L�... u''�u�;s, !! ........:............................................ BUILDING INSPECTOR .................. .. ........... has permission to erect buildings on ....( �. S,�' Foundation p .......................... .v«/.��....S.Y .................. Rough tobe occupied as .................... ........................................................... Chimney provided that the person accepting this permit shall in every r ect 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR OW • UNLESS CONSTRUCTIO T 7TS 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. r; PROPOSAL/ESTIMATE ,�.. 170 Main St,North Reading MA,01864 W INTER' HILL 781-321-5185 Claudio Araujo—License CS 105185 'WER.AL C<Y"TrdAC'r`OK. 1"C. www.winterhillgc.com DONNA JAHNSON Emaii:donnahvac@yahoo.com 2241 Turnpike St—North Andover-MA Phone: 781-334-7068 Date: 09/26/2015 Job Location: Shingle Roof Tear Off: The following paragraphs describe the work that will be performed. •' Remove existing shingle roof on the entire house • Install an 8 inch drip edge on all leading edges(Color:_) • Install 12 feet of ice&water shield on front leading edges&valleys • Hurricane Nailing:6 Nails per Shingle • Install starter strip on all leading edges. • Install shingle mate felt paper on all areas not covered by ice&water shield • Install New Ridge Vent • Install new vent pipe flanges • Replace any rotten or damaged roof decking ledger board{we alto N 32 ft.at no charged ;thereafter) • Replace any rotten or damaged fascia or rake boards at$WN/ft. • Install new GAF Timberline High Definition ArchitectF re Shingles • Remove existing lead flashing on chimney,install Ice&ihiater Shield,step flashing,and grind New Lead Flashing into Chimney • Warranty included in contract •{x)Gold 1 '111 dge " • Shingle Color= WILLIAMSBURG SLATE • All debris will be removedffrom the-piaperty • Replace skylight top cover with not charge-t customer will provide the material). Cost for Labor&Material for New Shmgle;Roof: $ 18.400.00 Payment Terms: C 113 deposit due upon signing contract 113 payment due upon start of job: $ 113 payment due upon completion of job: $ Total Amount Agreed To Be Paid: $ Work Scheduled to Begin: TBD Job expected to be completed within 60 days of actual start date. Warranty:GAF.guarantees all material and labor.for lifetime for any defect problem. 15Claudio Araujo,Project Manager tonna Jahnson Winter Hill General Contractor,Inc. Date Home Owner Date 09/21/2015 9:22 AM FAX 2 0003/0003 fs Pot ,-I Cost for Labor&Material for New Shin&Roof: $ 13,200.00 Cost for Labor&Material for Siding replacement $ 7„200.00 Cost for Labor&Material for 60 feet gutter installation: $ 950.00 't Payment Terms: � 113 deposit due upon signing contract $ '!q 113 payment duo upon start of job: $ f4, 3 113 payment due upon completion of job: $ Total Amount Agreed To Be Pald: Work Scheduled to Begin: _ " 6FCr k-0_ ;Ut 2c57� Warranty:GAF.guarantees all material for Ilfotlme and work performed for a period of ton(15)years.If any problems occur we will cover the cost of ail labor and material to correct the problem and moot the customor's satisfaction. S4Q !C Claudio Araujo,Project Manager Winter Hill General Contractor,Inc. Date Home Owner Date Amm 1�' Flebricina Payment types accepted: + Avalla e The law requires the following FOURTFRN items to he included In any contract between a homeowner rind a registered home improvement contractor for home improvement work subject to MGL c.142A: 1.The conlplule arfecmcnl between the toninwtor and the owner Lind a clear descripliun urany other documents which are part of the agreement. 2.The full names,fadcral I.D.number(if applicable).addresses(NOT PO.Box numbcrs�of the parties,the contractors registration number,the nume(s)of the salesperson(s)involved,if uny and the date the contract was executed by the parties. 3,The date on which the work:s scheduled to begin and the date the work is scheduled to he substantially completed, 4.A detailed description of the work to be done and the materials to be used. S.The total amount agreed to be paid for the work to be performed under the contract. 6.A time schedule orpayrmnts to be made under the contract and thu amount ofeach payment stated in dollars,including any linunce charges.Any deposit required to be paid in advance of the sturt of the work SHALL NOT exceed one-third of the total contract price or the actual cost of any material or equipment of a special order or custom made nature,which must be ordered in advance of the Start of the work to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of all panics, 7 All parties must sign lite contract 8.A clear and conspicuous notice stating: a.That all]ionic improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subwrttmctar relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaa,Suite 5170 Boston,MA 02116 Phon¢:(617)973.970D h,The contractor's registration number must be on the first page of the contract, c.The homeowner's three day cancellation rights under MGL c 93 s 48;MCL c 140D s 10 or MGL c 255D s 14 as may be applicable, d All warranties on the owners rights under the provisions of and MGI.C,142A, e.In len point bold type Lir larger,directly above the space provided ibr the signature,the following statement; DO NOT SIGN THIS CONTRACT 1F THERE ARE ANY BLANK SPACES, f,Whethcr any lien or security interest is on the residence tis a Consequence orthe Contnut. The Commonwealth of Massachusetts Department of IndustrialAccidents -- hA == f d 1 Congress Street, Suite 100 Boston,MA 02114-2017 yy.yt www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNUTTING AUTHORITY. Applicant Information gg � � I Please Print Legibly Name (Business/Organization/Individual): (/0 I 9—SK— 411 / �^ Address:- City/State/Zip: Phone#: `W1 3 21 Are you an employer?Check the appropriate box: Type Of project(required): 1 am a employer with employees(full and/or part-time).* 7. Q New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t ❑4.F]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions pro piietors with no employees. 12.E]Plumbing repairs or additions 5. t t l I am a generacontractor and I hhid thesub-contractors lid the attachedheet have hired su -conracors steon e s . ❑ 13.❑Roof repairs • These sub-contractors have employees and have workers'comp.instuance.T 6. We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] *Any applicant 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 state whether or not those entities have employees. If the sub-coritraciors have employees,'Iiey 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. Insurance Company Name: C� /< Policy#or Self-ins.Lie.#: VC-1-V'1`0 ' 'S'O'�)i Expiration Date: Job Site Address: tL�� fi V p c City/State/Zip: AA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify Xndth;pai and penalties of perjury that the information provided abboove is true and correct. Signature: Date: -- d / Phone#: l q q 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"liire, 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 apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate 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=contractor(s)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-insur6d 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 for you to fill out in the event the Office of Investigations has 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 must submit multiple permit/license applications in any given year,need only submit one 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 Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel.#617-727-4900 ext. 7406 or 1-877-NIASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia ----MON WINTE-2 OP ID:JJ ACORO, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `64�� 03/18/2015 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 51 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Bradly S.Michals Insurance PHONE Crown Insurance Agency,Inc. FAX Agency,Inc. A/c No E.11:617-924-1100 AIC,No): 617-926-2162 85 Main Street E-MAIL Watertown,MA 02472 ADDRESS: Crown Insurance Agency,Inc. INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Acadia Insurance Company INSURED Winter Hill General Contractor INSURER B:Essex Insurance Company Claudio Mcuhna Araujo INSURERC:Arbella Insurance Co. 17000 170 Main St North Reading,MA 01864 INSURER D: INSURER E: 1 ±t INSURER F i 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 s' 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 TYPE OF INSURANCE DDL U POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FRIOCCUR 30X7960 02/13/2015 02/13/2016 DAMAGE TO RENTEIY_ PREMISES Ea occurrence $ 100,00 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY FI JECT —1PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 + OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident C ANY AUTO 1020001551 04/09/2015 04/09/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident UMBRELLA LIAROCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITYSTATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC-20-20-003174-01 03/26/2015 03/26/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N❑N/A (Mandatoryin NH) E.L.DISEASE-EA EMPLOYE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Operations of The Named Insured CERTIFICATE HOLDER CANCELLATION XXXXXXX SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FOR BIDDING ONLY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR BIDDING ONLY ACCORDANCE WITH THE POLICY PROVISIONS. FOR BIDDING ONLY FOR BIDDING ONLY AUTHORIZED REPRESENTATIVE FOR BIDDING ONLY FOR BIDDIN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD j Office of Consumer.Affairs:&Business Regulation OME IMPROVEMENT CONTRACTOR egistration 168583 Type: Expiration: 3/8/2017 + Corporation WINTER HILL GENERALyCONTRACTOR;INC.., N #� GLAUDIO ARAUJO .s ! 170 MAIN ST NORTH READING, MA 01889 '- 1 _.Undersecretary i Massachusetts -Department of Public Safety a Board of Building Regulations and Standards �.I/ti\tl Vl.11l'III JII neI YI,1111 _ License: CS-105185 0"VNgLT I Y ClaudioMAraujo- 163 Hancock StreQ-N Everett MA 021 r y! ` C� 5 Expiration Commissioner 07/13/2017