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HomeMy WebLinkAboutBuilding Permit #546-15 - 23 SECOND STREET 12/12/2014ff� Permit No#: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial aeration No. of units: en-e'ommercial Z?Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer DESCRIPTION OF WOR TO BE PERFORMED: \ �.. V7 cc L L 0 Identification - Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name'. Phone: 0 11) civ Ct n Cl Address: �Z �� c,r. ����� �' G► I� Supervisor's Construction License: C S C�� wU �%� Exp. Date: V /7 2cil Home Improvement 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: $ �, tby' FEE: $ Check No.: 01- 'TZ Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund -__ . - - - - t _ - g - - - - - - _., _.__ ..2, Signature of Agent/Owner'`%�11 ,'!�,dha� Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS r 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 ~. DPW Town Engineer: Signature: Located 384 -FIRE DEPARTMENT - Temp Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS Street 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 tinT;=c nnrl nATA — IFnr department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 a Workers Comp Affidavit o 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 o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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 o Workers Comp Affidavit o 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: Building Permit Revised 2014 Location 1— Z j No. — 9— Date ( ( 4 Check #�� TOWN OF NORTH ANDOVER' Certificate of Occupancy $ Building/Frame Permit Fee $Z Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �I t Building Inspector & Business Regulation 011�iP IMPROVEMENTONTRACTOR~ h iregist ation: 1:: fiz2 Type: zpirution: 12/27;2015 Individual C�iT.J D•.*'.VID DONOVAN DAVID DONOVAN 46 PLAIN RD Undersecretary FEAR Massachusetts - Department of ?ubiic Safety Board of Building Regula-- ons and Standards C,snctrPu'tir�n Su,�crii�ot. License: CS -076045 ,`' DA VID G DONOVAN 60 TEN NEY ROAD = f wESTFORD' �-OI886 vommissioner=xo,ratPon 04/17/2015 im A r x at7nr 1 M �``Y�ni�rr� Q l�-Cs� �� T TOWN OF NORTH ANDOVER Office of the Building Department Community Development and Services 1600 Osgood Street North Andover, Massachusetts 01845 November 24, 2014 June Thornton 22 School Street North Andover MA 01845 19 Sec&id'Street'o Telephone (978) 688-9545 FAX (978) 688-9542 On November 24th, 2014 the Building, Electrical, and Plumbing Inspectors walked through 19 Second Street. The following lists of violations were observed: The roofs of all four (4) units need structural repairs and new shingles (NOT 3 TAB) on the front, rear, and rear additions. Numerous holes and deterioration was observed. O All four (4) chimneys need rebuilding/repointing from the roof up with new flashing. Heavy tar was observed around chimneys covering existing flashing. Holes were observed in the chimney around flue pipe. Chimney appears to be an unlined brick structure with two (2) gas appliances vented into it. The chimney will not be adequate if updating to new energy efficient appliances. Defective wiring was observed, extension cords were prominent in several areas, water was observed in light fixtures. Wiring needs evaluation and updating. Heating was nonexistent on second floor. No heat source was observed in bedrooms or bathroom. Present heat source is a single floor furnace. No heat source was observed in kitchen area. Brian Leathe Local Building Inspector. C" U) 10 � Z CD O C r CL D c. O 00 D as (DD O Go w CDO �i CD Lwk �G F 0) O CD CD CO) C/�D VI O O CCD O CD o��O a N= C.r`� o m 0 O 0� CL C � m = -1. = Z 0 �_, =M mo N O 7 y rt am N T OO rt v- O MR % CD W n O y p SD CD Q a) y e n �. Q ca cn o c CDCD CD z� y� in Cl) Cl) o 0CD , a o s � _ X n O = :� ''zA � v n ; v' cn O' Q — o CD poM y ��CD QCD � Z N � W g _CD o �c r=� O O Z O —� —1 c _ an cn O cnCD CD 3 rt W y CD c - r= cCDi (n ^� t'J O9 .4D� Z -0 m su 0 o 0 Oaa)) o Q� 0 U r v 3 O N rD K W N K Z O T v A c T O N rD Z7 O 00 S _TI 7 .Z7 O 04 S TI 3 N O M S O 7 N M ° m n N O Q T m m -I Dr H v m -�I m r mC LALAm 0 W z M 0 W C v C Z v m 0 rD 3 rD 3 W O z v O '^ O m 2 m �I 12/15/2014 10:57:05 AM PST (GMT -8) FROM: 100005 -TO: 19786889542 Page: 2 of 2 ACCW" CERTIFICATE OF LIABILITY INSURANCE 16.. DATE (MM/DD/YYYY) 1 211 5/2 01 4 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 certificate holder in lieu of such endorsement(s). PRODUCER PANTANO INSURANCE AGENCY INC 220 BROADWAY SUITE 202 LYNNFIELD, MA 01940 CONTACT NAME: PHONE FAX Eat A/c N° I as ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: LM Insurance Corporation 33600 INSURED DAVID DONOVAN INSURER B : EACH OCCURRENCE $ 46 PLAIN STREET INSURERC: INSURERD: WESTFORD MA 01886 INSURERE: INSURER F: AG TO RENTED REMISES Ea occurrence $ COVERAGES CFRTIFICATF MIIMRFR• ooaaaao-7 RFVISiInkl NIIMRFR- 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR AG TO RENTED REMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ nGEN IRI - POLICY PRO ❑LOCPRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A WC5-31 S-391225-014 7/26/2014 7/26/2015STATUTE ETH E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYE $ 100000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This certificate cancels and supersedes all previously issued certificates, only as they relate to workers compensation coverage. THE WORKERS' COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR DAVID DONOVAN Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. CERTIFICATE HOLDER CANCFI I ATInNi TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 23 SECOND ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LM Insurance Corporation © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 22666527 Oidi Dangas 12/15/2014 1:54:30 PM (EST) Page L of 1 DIp Construe 48 Old Candia Roar Candia, N.H. 03039 603-370-2237 PROPQSALSUBMITTE TO -Tk PHONE P310 DATE ST 3zs �� JOB NAME CITY, STATE ND ZIP CODE f ove< A JOB LOCATION ARCHITECT DATE OF PLANS JOB PI 10NE ACC>R" CERTIFICATE OF LIABILITY INSURANCE TE (MM/DD/YYYY) DA04/09/2014 TYPE OF INSURANCE IN RRL 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 certificate holder in lieu of such endorsement(s). PRODUCER 02916-001 Pantano Vonkahle Insurance 220 Broadway #220 Lynnfield, MA 01940 CQNTACT N ME: v PH/C. No. Ext): (781)581-3100 _ FAX No.: _ ADDRESS: INSURERLS) AFFORDING COVERAGE _ _ NAIC # INSURERA: A.I.M. Mutual Insurance Company 26158 INSURED Ama Siding Inc INSURER B: EACH OCCURRENCE $ DAMAGE TO RENTED $ PREMISES Ea occurrence 23 Second Street North Andover, MA 01845 INSURER C: INSURER D: EN'L AGGREGATE LIMIT APPLIES PER: OLICY-- I PRODUCTS - COMP/OP AG, $ -- INSURER E LIABILITY _ 1 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS L,UVtKAt3rb CEKtIFICATE NUMBER[ RFVICInN AIIIIIIIRCo• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVF BEEN ISSUED _rvT'rIc iNSUKED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N^T•NITHSTANDING ANY REQUiKEMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 REDUCEDBY PAID CLAIMS. ILTR TYPE OF INSURANCE IN RRL W POLICY NUMBER MM/DDY/YYYY MM/DD/YYW LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F–� OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED $ PREMISES Ea occurrence _ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: OLICY-- I PRODUCTS - COMP/OP AG, $ AUTOMOBILE LIABILITY _ 1 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS ( ! COMBINED SIfi LE LIMIT—� (Ea accidsnt) $ BODILY INJURY (Per person) -t $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS MADEAGGREGATE EACH OCCURRENCE $ $ 1 $ RETENTION $ A _._ pRDDEDg pM AND EMPLt�YER8€LIABILITY AN yPRo PRIETOWPARTNER/EXECUTIVE Y / N oFFICER/M X L N (Mandatory In NH)) 699COfION �f OPERATIONS below N/A VWC-100-6018436-2014A 3/26/2014 3/26/2015 C g TU X TRY LAMITS ER E.L. EACH ACCIDENT - $ 1,000,000.00 E.L. DISEASE - EA EMPLOYEE $ 1,000,000.00 E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) --M r C i JLurrc CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED woRE- THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE _ ©1988-2010 ACORD CORPORATION. All rights reserved. % IV/VJI I ne A%,umw name ano logo are reglsterea marKS of ACORD I I• � �.:�MI .IIS i�]���j �ro�og�r DI? Construction 48 Old Candia Road Candia, N.A. 03034 603-370-2237 DATE zs JOB NAME ICI TYAT NO ZIP CODS JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby sttbmil speeffications and estimates for r�nr�_U.r_....r..■ _ 1^r - - .rte e ropn$e. hereby to furnish material and labor - complete in accordance with above speciflcations, for the sum of, dollars ( $ / Payment to be madetas follows. Z ,, All rrlalerlal la gu#r�.iiteed to be.es specified. An work to be eompfeled in a workrnarJtkg manner according Ia. alenda d poicliow. Any anera(ron o- diKaaon from above spmll-cations invdvino Authorized / �/''� extra cools will he a mAcd only upon wrilten•arde,a and win bemm an extra chalge oval and Signature_ f_ ,_Q,� f V . abo.e t e 9871rnare. An agrgemants coniingent of»ac n sfrlkac, oldw tc of daloys 49yor'a our oontrol,�nlir to carry tiro; tornado and 01116, necessary InsuranCC. Our workors are fully Ngte:TblS proposal mW be LOYarsO'IPjLWorkmOnS Compenaatlon Inauramm withdrawn by us d not accepted within days. 9rceptatice of propolat - The above pncf;s, speciffcstlons and ^ condittons.are'salistactory and are hereby accepted. Youare authorized to do the Signature work as specified. Payment will Do made as outfiried above. Dale of Acceptance; Signature, Propoot D/P Construction 48 Old Candia Road Candia, N.H. 03034 603-370-2237 JOS NAME DATE CITY, STATE AND ZIP CODE JOG LOCATION . ve) 209t— ARCHITECT DATE OF PIANS JOS PHONE We hereby submit sptii;M ations and estimates for: We Vroyege hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: ��4dollars $ �/ Payment to be madetas follows AU hteteriel is Wereroeed 10 be as spedlied. Ag work to be completed in 0 wodtmanilka manner neoording to, standard praCtle". Any elteratlon or deviation from above epevifiCPGOrs involving Authorized Signature V extra costs will be executed only upon written orders. and wig become an extra Charge oval and _ above the estimate. All agreements Contingent upon aKhot, eccldent5 or delays beyond our Nola; Tbls proposal may be control. Owner to Carry tiro, tornado one orber necessary Insurance, Our wamar5 are tally withdrawn by us If not accepted within days, covered by Workman's Compensation truurance. 9Cfeptattre .of The above prices, 9oeelicadons and condiliona are aatisf>;tctory and are hereby apeWed. You are authorized to do the Signattrrc work as specifled. Payment will be made as outlined above_ Date of Acceptance: Signature _ .r hm hc,,,, e