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Home My WebLink AboutBuilding Permit #400 - 240 DALE STREET 11/15/2006 TOWN OF NORTH ANDOVER NORTH l S`!D /6 APPLICATION FOR PLAN EXAMINATION Q�S 3� , oL O X70 1- �v Date Received Permit NO: 7 DRA7ED/'PP�.��J _ 9SSACHUS� Date Issued: `— '0 IMPORTANT: Applicant must complete all items on this age nPROPERTY y Q A �- Print NER �- printPARCEL: (�1 ZONING DISTRICT: 10 TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Non-Residential Residential ❑New Building ❑One family ❑Industrial ❑Addition ❑Two or more family ❑ eration No. of units: epair,replacement ❑Assessory Bldg ❑Commercial ❑Demolition ❑ Others: ❑Moving(relocation) ❑ Other ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED Ide tification Please Type or Print Clearly) Phone: 1' 99'"�a�1 OWNER: Name: Address: a� 0 �T Phone: si" CONTRACTOR Name: C �� '�` p i Address: 1 L h� r��h)4N��ds�� Supervisor's Construction License: Exp. Date: S a3 �� Home Improvement License: ly i as 3-- Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PFS, 1T:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 4�l1C) FEE:$ 7 Receipt No.: Check No.: ! l Page 1 of 4 Location No. v0 Date �� D M0RTM TOWN OF NORTH ANDOVER - f D i Certificate of Occupancy $ SJACMUSEt� Building/Frame Permit Fee $ 5a Foundation Permit Fee $ Other Permit Fee $ �. TOTAL $ s Check # /-7/3 ! 9306 Building Inspector TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contracto Plans Submitted ElPlans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH F1 ❑ I COMMENTS FIRE DEPARTMENT - Temp Dumpster on si 0 Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision receipt submitted yes � Planning Board Decision: Comments Conservation Decision: Comments � Water& Sewer Connection/Si nature&Date g Drivewav Permit T Buildin Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created.IMC..Ian.2006 f 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 Addition Or Decks ❑ Building Permit Application o 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) 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 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 I Page 4 of 4 1 R&M Carpentry LLC 165 Marblehead St North Andover, Mass 01845 (978)794-2446 Mike Bubar 240 Dale St. No.Andover,Ma. 01845 Roofing and Siding The following contract from R& M Carpentry LLC. Consist of Roof and Siding Repairs at the address of 240 Dale St.No.Andover,,Ma. 01845 .R& M Carpentry Is responsible for building permit,Disposal of all construction Debris from the site. Ordering all construction material,Sub-contracting,Scheduling of work to be performed.All work perform will meet local and state building codes. Job Description Roof --- Remove all existing asphalt roof shin les .Install metal drip edge and roof edge. Install ice and water shield for ice barrier for roof and valley areas. Install felt paper to cover roof area and asphalt architectural roof shingles. Flash around chimney boxes and along side walls. Siding---- Remove existing masonite siding and corner boards .Install tyvek House wrap barrier.Install Mastic vinyl siding(carvedwood series) and j-channel Install vinyl vented soffit.Install color metal wrap for window and door trim. Install metal wrap on fascia and rake boards .Install vinyl smooth corner boards On each outside corner. ti f Job items 30 SQ of asphalt roof shingles 5 ice.and.wator shield 50 metal drip edge .8 felt paper 3 cobra ridge vent 31 SQ vinyl siding and removal 20 soffit vent 4-relb-metal coil- 2 box j-chaunei 3 tyvek house wrap 2 30yd containers for.:disposal 1 permit ; Total cost of construction and material $43,400.00 Schedule job oi-work schedule $ 1,500.00 Start roof work and material $ 16,300.00 Roof completion and-start-siding $ 11;600.-00 Payment half the siding install $8,600.00 Balance on completion of job $5,400.00 "Finocihiaro Home owner R&M Carpentry L 165 Marblehead St. No.Andover,Ma.01845 ,.10 R TH Town of _ Andover No. �O - LA E dower, Mass., COCKICKEWICK 7,9 ADRATED PP�,��y S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... .. ......... .. .. .................................................................................. Foundation has permission to erect........................................ buildings on,. ......A0.0.44......4I1100W................................ Rough to be occupied as... .... ... �� ! ! i........................................ Chimney ...... ....... .................. .... ............ .... ... provided that the persona pti g this permit sl i ke-v conform to th rms 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 CONSTRUC- N Rough ....... ..... ... . seMce . . .... ........... ...... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy 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 Smoke Det. ACORD CERTIFICATE OF LIABILITY INSURANCE OIDDIYY) �, 05//10/210/2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MacDonald & Pan lone Insurance Agency, InC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 428 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 104 Main Street INSURERS AFFORDING COVERAGE North Andover, MA 01845 INSURED R&M Carpentry I INSURER A: Preferred Mutual Fire Insurance Company Ron Finocchiaro INSURERS: Safety Insurance 165 Marblehead St INSURER C: No Andover,MA 01845 'INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS.SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I TR TYPE OF INSURANCE i POLICY NUM BER DATE MMIDD N TIVE PDATE MMIDD CY TION i LIMITS A (GENERAL LIABILITY I {EACH OCCURRENCE I$ 1,000,000 I�COMMERCIAL GENERAL LIABILITY CPP 0130 56 5146 112/06/2005 12/06/2006 1 FIRE DAMAGE(Any one fire) $ 100,000- CLAIMS MADE OCCUR (MED EXP(Any one person) Is 5,000; i PERSONAL&ADV INJURY $ 1,000,000 fi I i GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ! PRODUCTS-COMPIOP AGG $ 2,000,000. 1 POLICY J RCT 1 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO 2980424 , 03/31/2005 03/31/2006 (Ea accident) $ 1,000,000 I � I ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS 1 (Per person) HIRED AUTOS 1 BODILY INJURY $ f j f (Per accident) NON-OWNED AUTOS {{E I I (PROPERTY DAMAGE I$ (Per accident) i GARAGE LIABILITY i 'AUTO ONLY-EA ACCIDENT $ { OTHER THAN EA ACC $ANY AUTO i i AUTO ONLY: AGG 1$ f < EXCESS LIABILITY ; i I EACH OCCURRENCE $ j {OCCUR !CLAIMS MADE i ll AGGREGATE $ $ DEDUCTIBLE I$ j RETENTION $ j' $ TH- WORKERS COMPENSATION AND 1 WC STATU- I kk ER `TORY LIMITS! t ER I EMPLOYERS'LIABILITY G E.L.EACH ACCIDENT $ 111 E.L.DISEASE-EA EMPLOYEEI$ I t- E.L.DISEASE-POLICY LIMIT I$ OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Certificate holder as listed below for job site: 49 Summer St.,Andover, MA 01810 CERTIFICATE HOLDER f ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL-10 DAYS WRITTEN Town of Andover NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Attn: Building inspector IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 36 Bartlett St. REPRESENTATIVES. Andover, MA 01810 AUTHORIZED REPRESENTATIVE ACORD 25-S(7/97) 0 ACORD CORPORATION 1988 ............... ..- �ie.�o�nea� °�,/�.aaaacjivarlfs Board of Building Regulations and Standards lug HOME IMPROVEMENT CONTRACTOR Registration:;_141202 .,Expiration: 1/2112008 Type;'Ltd'Ciability Corporation R+M CARPENTRY GLC RONALD FINOCCHIARO 165 MARBLEHEAD ST.. N.ANDOVER,MA 01845 Deputy Administrator ✓/ze'C�omnszonaured.�a��/1��+'�acc��tuQe� BOAttD-OF BUILDING REGULATIONS t License; CONSTRUCTION SUPERVISOR '4 Number CS 077344 :Birthdate; 072311.987 Expires:67/23/2008 Tr.no: 29099 Resected; DO RONALD E FINOGCFitARO JR 165 MARBLEHEAD ST C MA 01845 N ANDOVER, Commissioner i s The Commonwealth of Alasstiehuselts Department of Industrial,tecidents Office of Investigations 600 Washington Street Jy� Boston, AM 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers kpplicant Information Please Print Legibly Name lt3usincss;t)rganiialit,nilntli�itlu,tl): �� N�2 �� Aciclress: - City.StateiZip: �Qz ��- ��V�ti Phone' Are you an employer?Check the appropriate box: Type of project(required): 4. ❑ I am a general contractor and I,Ella t a employer with 6. E] New construction e ployees(full and'or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees "These sub-contractors have 3. ❑ Demolition working for me in any capacity. workers' comp. insurance. y. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I ern a homeowner doing all work right of exemption per MGL I I.[] Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.]t employees [ N workers' 13. Other comp. insurance required.] °Any applicant that checks box J l nmst also IiII out the section below showing their workers'compensation policy information. y Ilomeowners 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 slowing the name of the sub-contractors and their workers'co nip.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 4 or Self-ins. Lie. .'-?:__—_-- —_ Expiration Job Site Address: CityState/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 35A of%lGL c. 153 can lead to the imposition of criminal penalties of a Fine up to$1,5 0.00 and;or one-vear Yc ri nment,as well as civil penalties in the form of a STOP Nk ORK ORDER and a tine Of up to 0.00 ay against the vio . e adv iced that a copy of this statement may be forwarded to the Office of Invcsti rations of th o insur e c verage verification. 1 do liereby erti ' ui l r tl a pai s and p talties of perjury that the information provided above is true and correct 1�i1,;tttI — Date: 1) 1 d G r)/ficiuJ trs'e only. L►u,:ut�rr•ile in this nrca, n,he .nnrplctcd h).•ciO�rcr natvn,�l�iciul. City or T,)wn: Permit/License 4 Issuing Authority(circle one): I. Board of Health 2. Building Department I City/Town Clerk T. IE'ectrical Inspector S. f'lurinhing inspector 6.Other Contact Pcr;atn: _ Phone