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HomeMy WebLinkAboutBuilding Permit #018-14 - 255 MASSACHUSETTS AVENUE 7/3/2013 -ORTH q BUILDING PERMIT ?°e`s``� "• TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION - m Permit NO: f Date Received ,fo9w` « 7 �Awreo Date Issued: `OLl SSACHUS�� IMPORTANT Applicant must complete all items on this page w u r a 't•� aar -..' E c' "�•�-"'�.si� .x„.e` a �, ma INK 2-i 2N v .. tj �RflPERT1' C}UUNER % '8 . 0 � '- �^s+��N' •,:tea"mac[-, >,'s•^` CSL: TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building )(One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial KRepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other - t L Well x�sz >`r a < se ate..h s 1 as x •Rt, y �tictflo�ptf .WBl �ds � �atersed Itstrtct ���:` �•.V4/aterlSew.e. �� ase Sys �.. ..�, r .£�� .�'� €r. S�i2i d• a 3 s,. Aad. Re Rote a 3 s . d1Roe.) cln . S.F. s! a Identificaiion Please Type or Print Clearly) OWNER: Name: G/lAv►LU(( 102v U C Phone: 412 IF3s�3A Address: I SPO MCiA Ov, 11 0- UrL►- k f Z CC `I�t�2ACTOR-Nast y � Pia y z c ar a Lzk�� �� � � ��.,� ��.,�' a id`s �- '..,^e �. � "�•} �.,�. � s.� 1�*�j ��� � � t iC �� s �SUerUlSbr S Gt�n��t�' = tipn��IerISE' # Mme ImprovemeLJ-6-65 IN 3 W� fl �'k`; u ARCHITECT/ENGINEER Phone: 4 Address: Reg. No. _ FEE SCHEDULE:BOLDING.PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON V 00 PER S.F. Total Project Cost: $ "'Cl ,�bC�, O FEE: $ Check No.: Receipt No.: NOTE: Persons co trac ng with unr iste d contractors do not have acce s to the guaranty fund Signature of Agent/j wne � gnatu�eoo�iactr ;; x TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION'. PROPERTY OWNER not 100 Year0ld St[ucture:° yes. rio;. MAP NO: _ PARCEL: ZONING DISTR-ICT: - Historic,District yes no� Machine Shop Village yes., no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family 11 Addition 11 Two or more family 11 Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ -Septic ❑Weli? 0 Floodplain, 0 Wetlands ❑ Watershed [District) . p Waterl$ew.er DESCRIPTION OF WORK TO BE PERFORMED: I Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: i CONTRACTOR' Name: - Phone: Address: _ Supervisor's.Construction License: ,Exp: Date.: � ' Home,Improvement License;: _ Exp. Pate.- ARCH ITECT/ENGI NEER ate.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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sig`nature�of Agent/Ovyner Signafure of.contraetor 4 Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ Building Department The fol;owing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofivg, 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 ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ 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 ❑ 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 ❑ 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 apu,,al 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: Doc.Bui?ding Permit Revised 2012 f, s Plan s Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF.SEWERAGE.DISP.OSAL 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS i I a Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes . I Planning Board Decision: Comments Conservation Decision: Comments d Water &Sewer Connection/Signature& Date Driveway Permit ,,I,f)PW Tow;! Engineer: Signature: Located 384 Osgood Street FIRE`DEPARTM��1�1` - Temp Dumpster on site yes no Located at'124 Mair,'Street Fire ®eparfime ' signature/date f COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of fleeter 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.$10041000 fine NOTES and DATA — (For department use i ® Notified for pickup - Date I Doc.Building Permit Revised 2010 i Locationr�� No. �� � Date7 —/ P • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ f � Foundation Permit Fee $ Other Permit Fee $ I A7 D`tt TOTAL $ Check#- 26588 Buil in d g Inspector r NORT#1 Town of 0%- 1 No. - ,� oh , ver, Mass, 3 COC N1C"I WICK A04'4TEU S U BOARD OF HEALTH Food/KitchenPERMIT T LD . Septic System THIS CERTIFIES THAT BUILDING INSPECTOR 4fi /ys V. Foundation has permission to erect .......................... buildings on .��. .. ..... ......... �...r.............. Q� Rough to be occupied as .......� ....:!k..... .0 ... ...................................................... Chimney provided that the person accepting this permit shall in every resp t 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. PLUM BING.INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO - ARTRough - J Service ................ ..... ............. ........................... ........... BUILDING INSPECTOR Fina GAS INSPECTOR Occupancy Permit Reguired to Occupy Buildinz 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. SEE REVERSE SIDE AC R®. CERTIFICATE. W) OF LIABILITY. INSURANCE DATE(NIM/DD!YY TF6S CERTIFICATE 1$ ISSUED AS A MATTER OF INFORMATION 10/23/12 .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. CER'f1FICATE OF INSURANCE DOES NOT CONSTfi ft 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 ofthe policy,certain policies may require an endorsement A statement on this certificate does not confer rights tothe certificate.holder in lieu of such endorsment(s). PRODUCER CONTACT Metro Boston Insurance Agency, P MEI: 9-6 Central Ave (617). 884-5480 FAX N : (617) 884-6487 E-MAIL Chelsea, MA 02150 ADDRESS: INSURE S AFFORDING COVERAGE NAIC# ' INSLIRERA:Atlaritic' CasualtV Insurance Co INSURED Raul Baez INSURER B:The .Hartford dba Dante's .Construction INSURER C 8 Wheatland St NSURER D: Salem, MA 01970 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 RUED 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. LTR _--TYPEOFINSURANCE AM -SUB - - - POLICY EFF P011CYEJCP — — — IN POLICY NUMBER MIDD MMIDDlYYYY LIMITS A GENERAL LIABILITY APP67417102 9/19/12 9/i9/13 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY. DAMAGE TO RENTED $ lOO 000 CLAIMS-MADE OCCUR MED EXP(Anyone person) S 5,000 PERSONAL&ADV INJURY S 1,000,000 4�4 GENERAL AGGREGATE $ 2,000,000 i GEN.LAGGREGATELIMITAPPLIESPER PRODUCTS-COMPIOPAGG S 2,000,000 POLICY PRO IECT, 171 LOC $ AUTOMOBILE LIABILITY GONE INED SINGLELIMIT a accident) $ - ANYAUTO BODILY INJURY(Per person) $ ALL 0S SCHEDULED BODILY INJURY Per accident $ AUTOS .AUTOS ( ) NON-OWNED HIRED AUTOS AUTOS PRerOPERTY DAMAGE $ acddent $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS MADE AGGREGATE S DED RETENTION S $ B AND EMP COMPENSATION 6S 60UB5B60144812 9/18/12 9/18/13 NIC STATU- OTH- AND EMPLOYERS'LIABILITY Y,N OFFICE RIMEMBER EXCLUANY DED?D? NIA EL.EACHACCIDENT S 1,000,000 r 000,000 (Mandatory in and E.L.DISEASE-EA EMP LOYE S 11000,000 If yes describe under DESCRIPTIONOFOPERATIONS below EL DISEASE-POUCYLNArr Is 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEMCLES (AU6 ACORD 101,Additional Remaft Schedule;if more spars isregiired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dante's Construction ACCORDANCE WITH THE POLICY PROVISIONS. Salem, MA 01970 AUTHORIZED REPRESENTATIVE Daniel De La Rocha ©1988-2010 ACORD_CORPORATION. All rights reserved. ACORD 25(2010105) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: FANTASTIC PAINTING 19 SIDNEY ST LYNN MASS 01902 PHONE- 781-426-1889 PROPOSAL 7-3-2013 Dear Sir or Madame, Based on my visit to your house located at the above address and our discussion,I have prepared the following proposal. Please review the following outline of the general specifications and the work required in order to complete the hoofing lob to your property. The following project/work will be completed in accordance with the building codes set forth By the Commonwealth of Massachusetts 780 CMR: Description of the Job 1. Contractor to obtain required building permit(s)from the city/town North Andover Mass. 2.Remove off the existing 1 layer old roof shingle.(If 2 layer addifional charge) 3.Install a new architect roof shingle lifetime warranty. 4.Install 3 tap shingles top the house.(Caps) 5.Install#15 asphalt felt paper. 6.Install Ice&Water Shield 3 feet from the bottom edge of the house,all around the house. 7.Install drip edge 8"D white. 8.Install cobra Y ra ridge vent System.If needed. � 9.Any rotten weod'that we found will be extra. 10.Flashing around the chimney.If needed 11. Contractor responsible for the debris does to the construction work... Total cost of labor and materials:6300.00 Work could begin within(i)to weeks of acceptance and take approximately(I)to(1/2)days to complete,depending on the weather. Once started,all work would be performed in a timely and professional manner. Please note that any changes to the above listed specifications would have to be discussed and re-evaluated as expected. CONTRACT ACCEPTANCE:Signing this proposal means you have accepted the terms and specifications as stated in the proposal and In addition,the signing of this proposal by both parties'converts this authorize FANTASTIC PAINTING to begin work at your property. proposal to a binding contract between the two parties. I thank you for your business and look forward to helping you add value of your property. Sincerely, Fantastic Painting 19 Sidney st Lynn,Mass 01902 Date accepted: 7-1- 13 Signature of property owner: 4 �e �am andel���''` /?j. Signature of contractor: T Date accepted: 7` 3 ft Estevan Fantastic Painting III Page 1 of 1 I rx �e e�anvnzayuue�a��r�ar�utet�i . _ . Office of Consumer Affairs.&Business Regula'Iion ME,lMPROVEMENT CONTRACTOR a gastration 1,732 14 Type: x{�imtion 911712 4 Individual RAWL BAEZ b RAUL BAEZ. 81NHEATLAND-ST .{`'d �• _ SALEM,'MA01970 - Ubdersecrefa . rY «l Massachusetts -Department'Af Public Sa#ety. Board of Building.Regutations and Standards Construction Supers icor E License: CS406464 ^ RAUL BAEZ. ` 8 WMATLAIV'D ST'R s Salem NU 019707 Expiration Commissioner 09/0412016 i i