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HomeMy WebLinkAboutBuilding Permit #419-2017 - 238 REA STREET 10/19/2016 �i NORT}{ BUILDING PERMITp�t�,yeD.;6.1 6 10 TOWN OF NORTH ANDOVER o - - APPLICATION FOR PLAN EXAMINATION Z y n � Permit No#: 4 -- a-o(� Date Received 1 O (ci �qss AreaCHUS Date Issued: DRORTA.NT:Applicant must complete all items on this page 77-7,F--7 - Print I?R®PERTYp OWNERS s ` nn -: 10,D YearxSfrueture es 1: nog i f *_n IVl%�P` FARCEL_ ZON1NGiDISTRICdT Histonc9Distr t� yesa j not `iMachine�ShoPa91_Y so) TYPE OF IMPROVEMENT PROPOSED USE Resi ntial Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑ eration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other tO,Septic, �Wel1L <.;:yKi #, :� ❑Floodplain - 1>Wetland j� ���, WatershedlDistrict� .° L _ �D�Vllater/.S erg- ��_-�•�� �` Y _ T ;---•-�. ESFIPTION OF W RK TO BE PERFORMED: AJ 1� 1 wrju U) g" - CDC,,.4V Identification- lease Type or Print Clearly /4-7? ��a OWNER: Name: / .�-���I Phone' — Q Address: `7�'r ` ._�Y. r _; '_ 771" ' �' •- - �� ,�_y F. ,+7 y CortractorName1.:,�� e7 �.= Email: . : • �- � _ �- ;.�, c—" �, t __�_ � �-•r�.:` Address `Superviso�r's,Const efi n License `-4,� W0 2 2 _ .•..r � "-'��.. .?' ''�j � '.3.r �,;r .moi '� _ r •�Iu �,{}T){ ��" mow.. f+.+ -yy ti t ,--•J LHrne Imp.r ement,License' 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: $ �o 6o � FEE: $ Check No.: « g Receipt No.: 31066 , NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund .... ... ... .. Signature'of AgentlOwner Signature ofscontraeto Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL, Public Sewer ❑ Tanning/MassageBody Art ❑ Sw'm'rmg 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE.DEPAR>fMENT - Tem0 p,Dum ster on site p-. Liecated at 124,MaintStreet -- Fire Department signature/date _ COMMENTS i 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 I I Building Department 1 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 o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o 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 a Certified Surveyed Plot Plan u Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses D Copy Of Contract u Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o 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) u Copy of Contract o Mass check Energy Compliance Report o 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 Doe:Building Permit Do .B ng P Revised 2014 Location ` 2 ` No. ��!f' " ��� _ J Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ( Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector NORTH '9 Town of 6 ndover No. 4 - �oh ver, Mass, C`� • �• 0/ �i COCNIC �•9 A°RATED S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR . � t Foundation has permission to erect .......................... buildings on ........ .... .......... . .. .................... Rough to be occupied as .......................... .... ..............`.... .......... .......... t Chimney provided that the person accepting this permit shall in every respect 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI AR70ILMM-0 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. TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ 1-1 Tanning/Massage/Body Art ❑ g Public Sewer Well F1Tobacco Sales 11Food Packaging/Sales ❑ ElPermanent Dempster on Site Private(septic tank,etc. F1 Permanent Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner � Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING&DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other 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/Snatare&Date Driveway Permit Temp Dumpster on site yes no_ Fire Department signature/date B M CONSTRUCTION LLC 161 School St Woburn,Ma 01801 781/820-5316 PROPOSAL/CONTRACT DATE: 9/29/2016 PROPOSAL SUBITTED TO: Wilson Chan ADDRESS: 238 Rea St N. Andover PHONE: 978/685-1478 JOB NAME: Roofing and Window JOB LOCATION: We propose to furnish labor and materials for the following work at 238 Rea St N. Andover I. Strip and re-roofing Include shed $7,000.00 II. Replace 1 casement window and 19 Double Hung Windows $6,000.00 Diamond Windows 3100 Series D/H Tilt Low E Glass with ARGOW GAS Full screen 6 over 6 Grid All materials are guaranteed to be specified. Any alteration or deviation from above specifications involving extra cost will be executed only upon written orders, and will become extra charge over the above estimate This proposal may be withdrawn by us if not accepted within (15) days Homeowner's Signature Date Contra or' Signature g Date 4i i I BMCONST-01 CGOULET CERTIFICATE',OF LIABILITY INSURANCE DAT19/2D/YYY1) 9//19/2016 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(les)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 CONTACT NAME: Vivelros Insurance Agency Inc. PHONE F Commercial Insurance Center A/C o :(0"898-9151 A/c No): 508 324-4533 375 Airport Road ADDRESS: AIL Fall River,MA 02720 INSURERS AFFORDING COVERAGE NAIC* INSURER A:Graphic Arts Mutual Ins Co 25984 INSURED INSURER 8: BM Construction LLC INSURER C: 161 School St INSURER D Woburn,MA 01801 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 INSURANCE ADDL R POLICY EFF POLICY EXP LTR POLICY NUMBER MMID MMA) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 7 OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1-1 PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOSAUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident) $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 4655027 06/12/2016 06/12/2017 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100,000 ff yes,describe under - _T DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main St ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ti tVl'�SSaC?l!f>Eiis -..` TJ«jrHr-ant of ?Lt1711C Safety Board of3- ui<c;! q Rv9ulaticns and Standards Cbnstructiur Super%isco- license: CS-086620 Steve B Mei - 161 School Street Woburn MA 01801 `� �xPiration -x,21 08/13/2017 commissioner �J 11C: rp.%J(7J7lyJl(gL'((�ll!1/��(,C(.iiC(P�/(5C'f7" Office of Consumer Affairs&Business Regulation WFIXNNMOME IMPROVEMENT CONTRACTOR —. iRegistration: f ::142511 Type: o - Expiration: 4[7!20.18 Individual Steve B.Mei Steve Mei 161 SCHOOL ST WOBURN,MA 01801 - Undersecretary