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HomeMy WebLinkAboutBuilding Permit #585-2016 - 25 CAMDEN STREET 11/10/2015 S-7WA1411-P 11-/a/s' s. TOWN OF NORTH ANDOVER f° _ APPLICATION FOR PLAN EXAMINATIO Permit NO: ° Date Received 0 / � Oy cx.nia:rt. '4 — CHUs Date Issued: EWORTANT:Applicant must com Tete all items on this page LOCATION__2.S' &' 120 Q tu 414 Print. PROPERTY 0WNE1 N Print . T MAP N0: PARCELW3ZONING DISTRICT:, Historic Districtyes,. . o desMachine Shop Village TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building Xbne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: Demolition ❑ Other l we tic Well [ Flood .Iain 0 Wetlands ❑ Watershedbistrict p p Water/Sewer w . `� Sivd/ Sew � ! &a A f— Identification Please Type or Print Clearly) OWNER: Name: eAJ -w'^ � eylll Phone: Address: CONT RACTO R Name (7()" Address:' �.ii a: Address: supervisors Constru p ctlon Licens Home Imrovemen# p License - Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. 'w FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ r S FEE: $ �?�� ,�j� Check No.: Receipt No.: NOTE: Persons contracdn th un r gistere4 contractors do not have access to the guaranty fund !dbature of Agent/Owni r �- urs"of contrac#or Location 114 ' j No. /i Date i I i - TOWN OF NORTH ANDOVER LED'y6�` . .` f•= Certificate of Occupancy $ ,3' max_ z Building/Frame Permit Fee Foundation Permit Fee $ 4r" Other Permit Fee 4r"p. TOTAL $ MCheck !� #—��Z�Z� 1 2966 Building Inspector Plans Submitted ❑ Plans Waived.El Certified Plot Plan ❑ Stamped Plans ❑ TYPF OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming 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 FIR DEPRT,ME Teri p D mpsfer on site y.es �no i(Locatetl�a2#Main Street: - ,� �me�;nt V�or, MEN w __ . 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 Pennit 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 o 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 E3 Certified Surveyed Plot Plan ❑ 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 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) o Copy of Contract - ❑ 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 Doc:Building Permit Revised 2014 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 40,000.00 m $ - $ 480.00 Plumbing Fee $ 60.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 60.00 Total fees collected $ 700.00 25 Camden Street 687-2016 on 12/4/2015 Kitchen and 2 bath remodel I NORTH Town o . t EAndover 0 . - :,. No. o�h , ver, Mass, _ COCMIC„ewICK *�• AERATED S U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System • �. .4.... BUILDING INSPECTOR THIS CERTIFIES THAT .................;3. .�.. .•Wr. ................ ... ... ......... ................. Foundation has permission to erect .......................... buildings on x.... .. . .. .......... ........ Rough to be occupied as ......�...its &/r ... ........ .�............. ./. ............................ Chimney provided that the person accepting th' permi shall in every respect conform tot rms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the nspection, 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 ONTH ELECTRICAL INSPECTOR Uf4NLESS CONSTRUCTI T S 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. 1 _j Ryan Contracting and Property Maintenance 75B Lockwood Lane Boxford,MA 01921 978.882.3329 mobile November 8, 2015 Demolition Prepared for: Jennifer Manning 404-910-9669 DESCRIPTION: The following proposal is for a Complete full gut to studs for a single family House @ 25 Camden Street,N Andover SCOPE OF WORK: 1.Demolish first and Second floors to studs 2.Demo chimney from roof line to basement floor 3.Frame hole in roof and apply new plywood ,tar paper and weather shield then patch in shingles to complete roof 4.Leave all hardwood floors 5.Remove all thresholds and door jams in all rooms However save all solid doors and store in shed. 6.Dumpsters will be put in driveway for all debris to be removed from site 7.Remove nails from studs to prep for new re model 8.Dumpsters that will be used on site provided by DUMPSTERS R US out of andover ma 9.Time for demo 4 days 10.All work will be done at 25 Camden street N Andover mass 11.Before work is to start we Ryan Contracting will supply Ms Manning with a CERT of Workers Comp and GL from our insurance carrier ARCHER insurance out of Beverly mass via email or fax 12.If we agree to take on project and had notice we could start project on Tuesday and be completed by end of this week 13.Dumpster price is$625.00 per each with a 5 ton 10,000 lbs max We will only bill for the cans used during demo and will supply a invoice from Dumpsters R US for your records The property will be dry vaccumed & broom swept at completion We will be using a 6/7 man crew for the project We ask for nothing up front till we complete our contract and at completion full payment is due. Our cost for the project is$8025.00 plus Dumpster cost Thank You for letting us bid your project we look forward to working with you, Tim Ryan/Ryan Contracting Date Jennifer Manning Customer Date �� Office of Consumer Affairs & Business Regulation- Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation Home Consumer Rights and Resources Home Improvement Contracting HIC Registration Complaints 'lu+ Registration# 176848 Home Improvement Contractor Registrant RYAN CONTRACTING & PROPERTY MAINTENANCE Registration Home Page Name TIMOTHY RYAN Address 69 LYNN ST City, State Zip PEABODY, MA 01960 Expiration Date 10/02/2015 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search ©2012 Commonwealth of Massachusetts. Mass.Gov®is a registered service mark of the Commonwealth of Massachusetts. https://services.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=78765 11/10/2015 "n 1 If noA 1 C VP LIADILI I T IIM0UMAIVtrC 11/9/2015 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(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 C NAME: Neal Hutchins krrcher Insurance PHONE (978)922-4600 o:(978)922-9276 N 271 CABOT ST E-MAIL ADD SS: INSURERS AFFORDING COVERAGE NAIC If 3EVERLY MA 01915 INSURERA:CONEXCO INSURANCE AGENCY, INC. NSURED INSURER B:MASS. WORKERS COMP. Ryan Contracting A Property Maintenance INSURER C: 75B Lockwood Ln INSURER D: INSURER E: 3oxford MA 01921 INSURER F: OVERAGES CERTIFICATE NUMBER:CL1511900668 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. dSR AODLSUBR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NU BER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS MADE X�OCCUR PREMISESDAMiaET(E�occurrence) $ 100,000 NPP8237783 3/7/2015 3/7/2016 MED EXP Any one person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JJEOT- 1-1 LOC PRODUCTS•COMP/OP AGG $ 11000,000 OTHER: Employee Benefits $ AUTOMOBILE LIABILITY CEOMBddEent GL I T $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO I I RETENTION s $ WORKERS COMPENSATION R STATUTE ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA A E.L.EACH ACCIDENT $ 100,000 B OFFICER/MEMBER EXCLUDED? 7PJU8-5872173-5-14 11/29/2014 11/29/2015 (Mandatory In NN) E.L DISEASE-FA EMPLOYEEI$ 100,000 If Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more apace Is required) Job Site: Jennifer Manning 25 Camden St North Andover, NA 01845 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 01845 AUTHORIZED REPRESENTATIVE Neal Hutchins/ALBXA 0 1 988-201 4 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD e od�( The Commonwealth of Massachusetts Department of IndustrialAccidents X Congress Street,Suite 100 _ d Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legib Name (Business/Organization/Individual): Address: �S v5 gin/ v City/State/Zip: G 1cj A Phone Are you an employer?Check the appropriate box: Type of project(required): am a employer with employees(full and/or part-time).* '7. ❑New construction 2. am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. rQDemolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El 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-contractors have employees,they 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.#: O b G C 6 Expiration Date: Job Site Address: S ( �04 V f City/State/Zip: 1 V � � 1 a �� 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-yJar 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�thepainaltiesof at the i ormation provided above 's true and correct. Signa Date: l d Phone#: 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,b checking the boxes that apply to your situation and,if necessary,supply sub=contractors)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 an questions regarding the law or if you are re aired to obtain a workers any g g Y q compensation policy,please call the Department at the number listed below. Self-insured 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 bum 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-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia Office of Consumer Affairs and Business Regulation q 10 Park Plaza - Suite 5170 Boston, Massachusetts Registration 02116 Improvement Contrac Home Im t P �. . Registration: 176848 Type: DBA Expiration: 10/2/2017 Tr# 272129 RYAN CONTRACTING & PROPERTY MAIN TIMOTHY RYANi 69 LYNN ST PEABODY, MA 01960 ``JAM eUpdate Address and return card.Mark reason for change. Address Renewal [:] Employment Lost Card SCA 1 0. 20M-05/11 ,m... .. License or registration valid for individul use only &Business Regulation before the expiration date. If found return to: Office of Consumer Affairs OME IMPROVEMENT CONTRACTOR 1 Office of Consumer Affairs and Business Regulation 4.1 Type: Registration:--176848 10 Park Plaza-Suite 5170 Expirationa-1012/2b17 DBA a Boston,MA 02116 RYAN CONTRACTINaG_&_PROPERTY MAINTENANCE TIMOTHY RYAN 69 LYNN ST k _ y .:c= - =f• — Not valid without signature — PEABODY,MA 01960 Undersecretary f< l ' r i /I i i i Office of Consumer Affairs and Business Regulation -�, 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 I., - Home Improvement Contractor Registration Registration: 176848 {?" Type: DBA IT Expiration: Tr# 245305 RYAN CONTRACTING & PROPERTY MAIN r TIMOTHY RYAN 69 LYNN ST PEABODY, MA 01960 Update Address and return card.Mark reason for change. SCA1 0 20M-05/11 �i s•Address •E]*Renewal- Employment Lost Card /ze rpan�r2aruu o�C�/j/lcraoac�uiaeL�.o . Office of Consumer Affairs&Business Regulation License or registration valid_for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: tion: ;1768 Type: Office of Consumer Affairs and Business Regulation xpiration: DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 RYAN CONTRACTING&PROPERTY MAINTENANCE TIMOTHY RYAN 69 LYNN ST PEABODY,MA 01960 Undersecretary Not valid without signature i I. 1 e V Massachusetts Department of Public Safety 1 Board of Building Regulations and Standards License: CS-015760 Construction Supervisor , I ��` • qui. V A JAMES T S ULLIA , 215 POLAND AVE` r% n77 TEWKSBURY Mb 018 Y. Expiration: Commissioner 1010912017 I � s J