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HomeMy WebLinkAboutBuilding Permit #362A-11 - 233 MAIN STREET 10/29/2010 NORTH BUILDING PERMIT TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION '- �7 Permit NO: L� Date Received �f 'C� Sys R-A,-Eo f0v SACHUS Date Issued: LWORTANT:Applicant must complete all items on this page LOCATION o� 33 Mo S� �or.t ti 1`1(I�OJi�' M Print T Y OWN ER.: e1..Oa ro l �ER - 2� Print MAR.210 i..0 PARCEL. e;. 20NwG DISTRICT:_ Histone District. yes. no . Machine Shop.Village yes no TYPE OF IMPROVEMENT PROPO USE -R-esi nti Non- Residential ❑ New Building ❑ O e family [I Addition Wwo or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other d Septic Well. D Floodplain` 1Netlands ❑ Watershed District. ❑Water/Sewer. DESCRIPTION OF WORK TO BE PERFORMED: 0.A R�\oca 14u r oom u : srb e e NP(A POLLS (Z3. �001„Lnee l4r<s ;�• base rent Identification Please Type or Print Clearly) OWNER: Name: �bog--\1 Cwra1 NcLryp Phone: Address: .: -�reectu ConS�ro�� o� Cure - CONTRACTOR Name: Phone: 6$.5 Supervisor's.Construction License: a»41 Exp.'Date:..: .S 14116. Home..lmprovement License: 1�g'�B Exp. Date q C�� a o a ARCHITECT/ENGINEER Phone: Ili - 36 a - 650 Address: Reg. No. FDR SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ 3a 35 0o FEE: $ 2 Check No.: 2 Receipt No.: g3&; &; NOTE: Pers sno contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner QG_J Q. ."Al Signature of contractor 91�-t��a_ 4 �€ i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tning[Massage/Body Art ❑ Swimming Pools ❑ ell ❑ 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 TS CONSERVATION Reviewed on Signature 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 D-PW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT' - Temp Dumpster on site yes no' Located at 124 Main*' Street .Fire Departmeht 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 dieter location, mast or service drop requires approval of Electrical Inspector Yes No DANCER ZONE I ITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ® Notified for pickup - Date Dor—Building Permit Revised 2010/October 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 ❑ Flo or/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ En9 ineering Affidavits for E NOTE All dumpster permits require sign Engineered products n off from q 9 Fire Department prior to issuance of Bld Permit P g p 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 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 ®TE: All dumpster 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 Doc:Building Permit Revised 2008 Location� Molln is Na Date • NQRTIy ,�,,�„ ,•,ti TOWN OF NORTH ANDOVER Certificate of Occupancy $ �ssncNust< Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 23623 �- Building Inspector ORT#q Town of Andover No. 3G0 A0 K 0 dover, Mass.,— ///,Z/ COCHICHEWICK 0RATED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... ......................................................................... ... ................................................................... Foundation /�"--td- eA"'I 3. ,1/W has permission to erect../................... ....... buildings on ..... .......................... .....�� e07- . ....................... e 4 61'A"e ...... Roug h tobe occupied as......................................................................................................................................................................** Chimney provided that the person accepting this permit shall in every respect conform to the terms 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, Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough ................................I.................... Service ...................................... BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy 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_jl Smoke Det. ORTH And 0 o _ over 0 W. No. o dover, Mass.,LAK COCMICHEwICK V 7�ADRATED P5 `S tJ BOARD OF HEALTH Food/Kitchen Septic System PERM IT T D BUILDING INSPECTOR THIS CERTIFIES THAT ��'It'a 6.1& �?Ax� ............................................................••••p••••••............................................................. Foundation -Al has permission to ere�cjt..O.j. 4'eWl ............ buildings on .....a3 .................Qi...... ...... . .°..�................. Rough CR�9%�Ci �� "LvG9T°L 1..4Ntid.�.�/QOaA'�, Chimney tobe occupied as ............................................................ ..................................................................... ............... provided that the person accepting this permit shall in every respect conform to the terms 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION 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 Fina, —nr Dry Wall To Be Done FIRE DEPARTMENT _i•�ing Inspector. Burner. Street No. Smoke Det. s tiORTy Town of .North Andover 3 4 Machiiie Shop Village Neighborhood Conservalioti District Commission �s•„o ��� 1600 Osgood Street. North Andover, MA 01845 SwCHU .CA-Upplicat on For EXCLUSION From Certificate to Ater Certain alterations are excluded from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicants,for exempt projects must fill out the form below and submit to the Building Department. Date: 10 J 3 0 Z 2 010 Contact Name &Address: Carol Markey 233 Main Street North over, MA 01845 Project Address: Same Project Description (attach additional pages,if needed): Install window at back of house (not visible from street or sidewalks, or even sides of the house) Exclusion From Review Requested.For: D 1. Interior Alterations existing conditions including materials, design and dimensions. D 2. Storm windows and doors, screen. windows and doors. D 9. Replacement of existing substitute doors, substitute siding or substitute C] 3. Removal,replacement or installation of windows with new materials that are gutters and downspouts. substantially similar to the existing condition. D 4. Removal,replacement or installation of window and door shutters. C] 10. Replacement of original fabric windows or doors with substitute D 5. Accessory buildings of less than 100 windows or doors that maintain the square feet of floor area. architectural integrity with respect to form, fit and function of the original D G. Removal of substitute siding. windows or doors. ® 7.Alterations not visible from a public D 11. Reconstruction,substantially similar in way. exterior design, of a building,damaged or destroyed by fire,storm or other disaster, ❑ S. Ordinary maintenance and repair of provided such reconstruction is begun architectural features that match the within one year thereafter. MSV NCDC Pagel i RT1y % a=�= fla �y�© Town of North Andover Machine Shop Village Neighborhood Conservation District Commission 1600 Osgood od Street. Nord ndover, MA 0184 5 sgCHU . hcation For EXCLUSION From Certificate to Alter For Items 9,10 or 11, provide the following documentation; Photos/drawings of existing doors, windows or siding, as applicable Description/Catalog Cuts of proposed materials to be used for doors, windows or siding Plan and elevation of reconstruction for Item I 1 Determination.- This etermination:This project is determined to be exempt 0 not exempt from review by the Machine Shop Village Neighborhood Conservation,District Commission. Projects that are not exempt must complete the Application for Certificate to Alter, available from the Building Department and be reviewed by the Commission. Determ' tion made by: Signature V Y � Title, Building Department(Items I through 8)or Neighborhood Conservation District Commission(Hems 9 through I I) �jo -y 2—A^2 10 Date MSV NCDC Page 2 f�sosrH� ��O`�<L£o'6'akpOy7 Town of North Andover i Machine Sinop Village Neighborhood Conservation District Commission 1600 Osgood.Street. Nord]Andover, .MAO 1845 T- 4Ss�acwus�� Application For EXCLUSION From Certificate to Alter Certainalterations are excluded from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicants far exempt projects must fill out the form below and submit to the Building Department. Date: 10130/2010 Contact Name&Address: Carol Markey 233 Main Street North over, MA 01845 Project Address: _Same Project Description(attach additional pages,if needed): Install window at back of house (not visible from street or sidewalks, or even sides of the house) Exclusion From Review Requested For: ❑ 1.Interior Alterations existing conditions including materials, design and dimensions. 0 2.Storm:Nvindows and doors,screen windows and doors. 0 9.Replacement of existing substitute doors,substitute siding or substitute ❑ 3.Removal,replacement or installation of windows with new materials that are gutters and downspouts. substantially similar to the existing condition. 0 4.Removal,replacement or installation of window and door shutters. ❑ 10.Replacement of original fabric windows or doors with substitute ❑ 5.Accessory buildings of less than 100 windows or doors that maintain the square feet of floor area. architectural integrity with respect to form,fit and function of the original. ❑ 6.Removal of substitute siding. windows or doors. ® 7.alterations not visible from a public ❑ 11.Reconstruction,substantially similar in Way. exterior design,of a building,damaged or destroyed by fire,storm or other disaster, ❑ 8. Ordinary maintenance and repair of provided such reconstruction is begun architectural features that match the within one year thereafter. MSV NDC - -� Page 1 tIORT" 20e 4.,�ta,sAati00 Town of North Andover Machuie Shop Village Neighborhood Conservation District Commission 1600 Osgood Street North Andover, MA 0184.5 Rssacwuse Apphcation For EXCLUSION From Certificate to Alter For Items 9,10 or 11,provide the following documentation: Photos/drawings of existing doors, windows or siding,as applicable Description/Catalog Cuts of proposed materials to be used for doors, windows or siding Plan and elevation of reconstruction.for Item 11 Determination: This project is determined to be exempt " C]not exempt from review by the Machine Shop Village Neighborhood Conservation.District Commission. Projects that are not exec must complete the Application for Certificate to Alter, available from the Building Department and be reviewed by the Commission.. Deternz' tion made by: Signature a I�- Title,Building Department(Items i through 8)or Neighborhood Conservation District Commission.(Items 9 through 11) Date MSV NCDC Page 2 - —ray M —3,; r .3.. -3, 4---24 _;—. _._. _ }Q^_ .. .24-.'" 7 L�" -29i" —j — 39 -. -, --39` Ast ir B24ROTSR �I =; VERIFY EXACT LOCATION f OF RADIATOR f " t ^�r THIS DESIGN IS NOT FINAL if this design is used for .�$ .,t !.__1 m irotellation of cabinetry,Moynihan Lumber accepts NO r ,444 responsibility for measurements.Precioe installation ngfeis I : # still need to be added to make the design fined. z [.1 YJAWSGt;7T.3tT34 }} 7 r } r _02724 W301724 T 4 2LQ" 704" --26" f,2,, -30"—. _j,-251'- i ARBE LLA INSURANCE GROUP u'_oers' Compensation Policy Notice i Date: 3/26/2010 Insured: Roger Marceau Construction Corp. P.O. Box 66 Methuen, MA 01844 Policy: 9104530310 Term: 3/19/10-3/19/11 Dear Insured: Thank you for placing your Workers' Compensation policy with Arbella Protection Insurance Company. Enclosed please find: ® A Workers' Compensation Notice to Employees ❑ A Workers' Compensation Claims Kit ® An application relating to the Massachusetts Construction Premium Adjustment Program. The estimated premium for this policy is $13,452.11, which will be billed on our direct bill payment plan. Please note that the Deposit Premium of$3,395.65 is due at the time of binding coverage. According to our records,the deposit premium of$3,395.65 has not been received. Please post the Notice to Employees on a bulletin board in a suitable public area on your premises. If there is a claims kit enclosed, please review the information in the claims kit and acquaint yourself with our claims reporting procedures. If you are a contractor, it is suggested that you complete the enclosed application relating to the Massachusetts Construction Classification Premium Adjustment Program as you may be eligible for a credit. If you have any questions concerning this payment plan, please contact our Workers' Compensation Unit at(800)999-0274. If you have any questions relating to your Workers' Compensation coverage please contact your agent. I ' Sincerely, a tO Donna Steinberg CL Operations Specialist cc: Agent uoo Crown Colony Drive P.O.Box 699103 Quincy,MA 02269-9103 telephone(617)328.280 wwwarbella.com ARBELLA PROTECTION INSURANCE COMPANY WORKERS' COMPENSATION AND EMPLOYER' S LIABILITY POLICY Extension of INFORMATION PAGE MASSACHUSETTS Premium Basis Rate Per Estimate Total Estimated $100 of Annual Code No. Classifications Annual Remuneration Remuneration Premiun 5437 CARPENTRY-INSTALLATION 124, 206. 00 5 . 93 5606 CONTRACTOR-EXEC.SUPERVISO 334, 785. 00 7, 365 . 9 8742 SALESPERSONS 1 ' 75 5, 858 • % 8810 CLERICAL/DRAFTING 52, 000. 00 0.20 104 . 0 9812 INCR. EMPL. LIAB. LIMITS 132, 540. 00 0. 12 159. 0 2 . 00 269. , Total Manual Premium: Experience Modification Factor13, 756. ` 0.89 (1, 513 .2 Standard Premium: 243 . 6 Premium Discount. 0053 12,(204 . 1 Expense Constant: 0900 12, 039.5 338. 0 Total Estimated Annual Premium: 12, 377 . 5 DIA Assessment: 7.20 881 . 5 Terrorism: 9740 0. 03 193 . 0 Annual Deposit Premium: MA $ 13, 452 . 1 If installments elected: Deposit premium: $3, 395.65 Installment Payment Schedule: 04/19/10 $1, 257. 06 05/19/10 $1, 257. 06 06/19/10 $1, 257 . 6 07/19/10 $1, 257.06 _ 08/19/10 $1,257.06 / 1 10/19/10 $1, 257.06 13/19/10 $1, 257. 04 0919 1 / 0 $ , 257 . Q This schedule forms a part of the policy to which it is attached. WC 00 00 01 A ii The Commonwealth of Massachusetts 1 Department of Industrial Accidents s Office of Investigations 600 Washington Street Boston, MA 02111 t t www.naass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual); �11r�rCPd�l l 'on��ruc� on corT Address: as &Aoo�1, S1cee City/State/Zip: Me-o o`ter_ MA a%`yj A Phone #: . g rii-6$g- �J q o L Are you an employer?Check the appropriate box: Type of project(required): 1.® 1 am a employer with 13 4. ❑ 1 am a general contractor and 1 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.1 7. ©Remodeling ship and have no employees These sub-contractors have $. [] Demol ition. workingfor me in an capacity. workers' comp. insurance. Y9. Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 1 I.❑ 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' comp. insurance required.] 13.0 Other *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 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: QcbeA\(, f sonnte, GrOL) Policy#or Self-ins. Lic.#: c1I a 45 30 3 f o Expiration Date: 3I ld l► Job Site Address: a3--S �cla n �' 1 City/State/Zip: No, A4d0J Lrr A_o t Si 4 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 certify under thepains andpenalties ofperjury that the information provided above is true and correct Signature: e.4 a. ' 1�i. a.y Date 1 o r a I,►o Phone#: S_14-6t5- y ob 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#: From:Joanne Hogan FaxID: Page 2 of 2 Date:10/29/2010 09:12 AM Page:2 of 2 OP ID:JL ACORO" DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10129/10 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 PRODUCERACT 781-455-0700 NAD E: Roblin Insurance Agency, Inc. 781-449-8976 PHONE Fax 144 Gould Street E-MAILo Ext. IAK No: Needham,MA 02494 ADDRESS: PRODUCER MARCE-2 Roblin Insurance Agency, Inc CUSTOMER ID*. INSURER(S)AFFORDING COVERAGE NAIC• INSURED Marceau Construction Corp. INSURER A:Peerless Insurance Company 24171 R.B.Desjardins LLC INSURER B: Mr.Roger A.Desjardins INSURER C: 28 Osgood Street Methuen,MA 01844 INSURER D INSURER E 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEADOL POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/YYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP 3699023 08/06/10 081f08111 PR MISES Ea occurrence $ 50,000 CLAIMS-MADE F—XI OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 X PER LOC AGGREGATE GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICYPR0 Loc Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO BA 3699018 08!08110 08108111 (Ea accident) $ 1,000,00 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJJRY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE X HIR ED AUTOS (Per accident) $ X NON-OWNED AUTOS $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,00 A CU 8792631 08108/10 08108111 DEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Equip Floater CBP 3699023 08/08/10 08!08111 Leased! 100,00 Rented DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is requlred) Carol Markey 8r The Town of North Andover are additional Insured. CERTIFICATE HOLDER CANCELLATION CAROLMA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Carol Markey ACCORDANCE WITH THE POLICY PROVISIONS. 233 Main Street North Andover,MA AUTHORIZED RE PRESENTATIVE > AVa ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Office of orYum°"'e f yrs i es egu'a'`fi°on License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: . 109481 Type: Office of Consumer Affairs and Business Regulation Expiration: 9/18/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 AU CONSTRUCTION CORP ROGER DESJARDINS :a 28 OSGOOD ST gn METHUEN, MA 01844. f- Uudersecretar yNot va wit on ig ure Massachusetts- Department of Public Safet, Board of Building RegTulations and Standards Construction Supervisor License License: CS 21191 Restricted to: 00 ROGER A DESJARDINS 4 COTTAGE RD ANDOVER, MA 01810 Expiration: 5/2/2012 ('onunisiuncr Tr#: 24282 t I I NOTES_ 1.ALL DIMENSIONS INSTALL NEW 2x6 INTERNAL. HEADER Wi EXISTING SIMPSON HANGERS STAIRWAY 2.(4)EXISTING 6"WOOD COLUMNS NEED EXISTING wooD REPLACEMENT WITH 3-1/2" COLUMN TO LALLY COLUMNS W/DOUBLE REMAIN SIZE TOP PLATES. _ I 3.COLUMNS TO BE 6'8"TALL. EXISTING BRICK '+ PIER TO BE INSTALL NEW(2) DEMOLISHED �- LALLY COLUMNS 4.RE-NAIL EXISTING N BRIDGING. @ EXISTING JOISTS 5.TEMPORARILY SUPPORT EXISTING STRUCTURE DURING COLUMN REMOVAL. ) m � 6.ALL TOP&BOTTOM N_ 20c PLATES TO BE 6"X 8". ANCHOR PLATES ABOVE AND BELOW. I 7.REPLACE BEAM#1 W/NEW T 7 (3)11-7/8"LVL. a.FOliow MANUFACTURERS GUIDELINES FOR FASTENING OF MULTI-LAYER LVL. -r-. REPLACE WITH 9.ALL CONDITIONS TO BE (2)3-1/2 LALLY INSPECTED BY ENGINEER COLUMNS PRIOR TO INSTALLATION OF ° RUBBLE STONE NEW COLUMNS. FOUNDATION I i BEAM#1 N I ro in ADD(14)JOIST HANGERS TO EXISTING JOISTS WHERE PULLED-AWAY 7'-0"-- 6'-1" GREATER THAN 1/4" f REMOVE EXISTING SMALL BRICK PIER. BRICK CHIMNEY FLUE TO REMAIN. I � I NEW 3-1/2" -REMOVE EXISTING LALLY COLUMN STONE.INSTALL NEW 16"X16"X12"DEEP CONCRETE FOOTING W/94 REBAR @ 6" O.C.EACH WAY. 20'-1" N tl BASEMENT COLUMN & BEAM LAYOUT SCALE:3/8"=1'-0" I I i I 233 MAIN STREET DESIGN: -,_.SPF _ REVISION DAYS NORTHANDOVER,MA DRAWN, __pJ �,ElikAlmorcs g r� PnoFEsso"u CHECKED: SPF r� 3 mwu nxArrenEO w ` RYEY - CML - STRUCTURAL SCALE: _$8t1'd'_ —"- ~nom m­.m,,, (9]8)352-6509 PROPOSED COLUMN&BEAM REPLACEMENT 5 3 Z, �� � 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 (Z�D in, /,/'1'7 C;�) av ❑ Notified for pickup - Date Doc.Building Permit Revised 2007