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Home My WebLink AboutBuilding Permit #264 - 30 EAST WATER STREET 10/14/2008 BUILDING PERMIT NORTH q �tt�eo.a°• �O TOWN OF NORTH ANDOVER ~� APPLICATION FOR PLAN EXAMINATION Permit NO: LP / Date ReceivedArev ACHus Date Issued: IMPORTANT:Applicant must complete all items on this page LOCAT3�i grant -PR0PERT`'0WNER ?e, A/ _ . . lAR'l O.:aii_V%45t✓E-L; :Z0-NIN I�l)TiRIC :1 istorac rstr c#, des no I ladt�ine OP vi la a des., TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial e air replacemen Assessory Bldg Others: Demolition Other Septic Fox c plain , % lands ersta d bike of DESCRIPTION OF WORK TO BE PREFORMED: ` . Fe,'d O Identification Please Type or Pint Clearly) OWNER: Name:__�Z,g�t� ; j/ Phone: Address: -ONTM TFOR, N3Taae: oT1eW '" 7 T v.! b, St�psT�soT.�-,Constru,ubon L�der�se� � �� Ftp Df -& � 1.orae Irnproer��eT �Liceras : 'c �aea flJ /d ¢' ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.0 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $� 5 Cd' FEE: $ Check No.: c>U I c Receipt No.: NOTE: Persons contracting ith u registered contractors do not have access to the guarantyfund ofi AetlQrr jgnatoreo corgi#racto i Location 30 No. z�` Date "� 0 r NORT1y TOWN OF NORTH ANDOVER F A Certificate of Occupancy $ Building/Frame Permit Fee $ ' Foundation Permit Fee $ Other Permit Fee $ y TOTAL $ Check # 2 , 5 : / "Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 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 Lx�catedt.�241lain:`�Str�e#; r � ae sii .na vexa +e: C0� 1F. "T� imension t umber of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: LECTRICAL: Movement of Meter location, mast or service drop requires approval of lectrical Inspector Yes No ANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use I F i 1 i ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 i 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 - - a/ Workers Comp Affidavit rK Photo Copy Of H.I.C. And/Or C.S.L. Licenses a' Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products N TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building PP Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit I New Construction (Single and Two Family) i ❑ Building Permit Application ❑ Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses E3 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 Li 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 NORTH c Town of No. LAKE oy dover, Mass., T Q - COCMICMEWICK S RATED 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... . ....... ....... .. ......................... ...................................... ........................... Foundation has permission to erect........................................ buildings on .2 .... � ...................... Rough to be occupied as...... ... .f6apting 4.i -7...... .Q..t�..... ... .,dc.4�.............................................................................. Chimney provided that the person this permit shall in e�y 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 "I q • PERMIT EXPIRES IN. 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU O 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 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. Circle Insurance Fax:978-777-4898 Oct 14 2008 12:09pm P001/001 ACDRDee CERTIFICATE OF LIABILITY INSURANCE I DAU`MMf ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Circle Huainess Insurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 247 Newbury St. ALTER THE COVERAOE AFFORDED BY THE POLICIES BELOW. Danvers, MA 01923 979-777-7030 INSURERS AFFORDING COVERAGE NAIL* INSURED Build Tech Inc. INSURER A Safety Insurance CgMM INSURER B: Granite Stato Insurance CO. 5 Granite St INSURER C: Methuen, MA 01844 INSURER D: 97 — - INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVC 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 CONDITIDNS OF SUCH i POLICIES.AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. mm LTR pip POLICY NUMBER D T T MI LIMITS GENERAL LIABILITY EACH OCCURRENCE f 0 000 X COWAERCIALGENERALLIABILRY PREMISES Eeooc~ f 0 000 CLAWSMADE Q OCCUR MED EXP one person) f 51000 A BPO0006930 05/27/08 05/27/09 PERSONAL&ADVINJURY s 500,00 GENERAL AGGREGATE f 00O 000 GERI.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 000 POLICY PRO- LOC - AUTOMOBILELIOILRY COMBWCD SINGLE LIAR � ANYAUTO (E+Iaaddem) . ALL OWNED AUTOS BODILY INJURY SCHCDULED AUT08 ( (Per Deleon) S HIRED AUTOS BODILY INJURY s NON-0VMMAUTOS (Pw�eaeeM) PROPERTY DAMAGE (Pwaade^q GARAGE LIABILITY AUTO ONLY•EAACC90ENT S ANYAUTO OTNERTNAN EAACC f AUTOONLY: AGG 9 EXCESSIUMBRELLA LOSIUTY EACH OCCURRENCE f OCCUR CLAIMSMADE AGGREGATE 9 s DEDUCTIBLE s RETENTION S s WORKERSCOMPENSATIONAND T S ATU- ITY ANTPALWLOEIASLIABRTNE WC8449040 03/25/08 03/25/09 ANT 6ROOHIETOA�ARTNERlE�OIlIIVC E.L.E.L.EACHACCIOENT Z_ 5001000 B oFFICeAMgmalk EIAOU mal El.DISEASE-EA EMPLOYEI S 500,000 PE-6=0I ON9 aiow E.L.DISEASE-POLICY LI)AIT s 500,000 OTHfiR DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEWNT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBGD POLICIES SE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS YIIRmEN Building Dept -Att>n' Brian NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO$O SHALL 1600 Osgood Street WHOSE NO OBLIGATION OR L OF ANY KIND UPON TWE INSURER ITS AGENTS OR North Andover, MA 01845 REPRESENTATIVES. AUT'NORIZED REPRESENTA Fax: 978-688-9542 ACORD25(2001M*) OACORD CORPORATION 1988 Buildtech, Inc . 5 Granite ST,Methuen,MA 01844 � � � 978-375-3967,f:978-682-3453 buildtechl@verizon.net www.Buildtech l nc.Biz Page No. 1 of 1 Pages PROPOSAL SUBMITTED TO Dean Thornhill PHONE DATE STREET 30 East Water ST JOB NAMEFR-THO-091308 CITY.STATE AND ZIP CODE JOB LOCATION North Andover, MA 01845 same Writ. DATE OF PLANS JOB PHONE We Wei Price to floor repair east Water ST right side Scope . Re-n-l-vu-Iffaudrng-and di- Remove and replace damage framing lumber by-d[y rot Install new 3/4 advantech subfloor t-g glued to new framing members. Remove beam at right side and replace with new engeneer lumber. Include : labor and materials debris removal. Exclude; plum Ing, a ec rlca , building permit. I C 1:11rOjIOOe hereby to furnish material and labor-complete in accordance with above specifications, for the sum of: Payment to be made as dollars($ $245.88 follows: M meleMl b ylmreM b Ce--P.UW,An x to Oe eerrlPlaleO In a worhmeMlke rmmer aocwdhp M ftndwd aBWt A.v u—I nm aermumfm ab m.P.uT�c,l wig ~r�°r� e .sroWob mA Yves M Nadeau Nate:TM,PrePe..l rr,,,.ee 15 wtlllCrevnl M In B nd exegee vABW dp. ZiLLCptance of VroPoj al SIGNATURE DATE OF ACCEPTANCE: ' / SIGNA Bo'��t oafiaewr�€ �ti� �r�( tri � HOME IMPROVEMENT CONTRACTOR Registration: 127137 Expiration: 9/10/2010 Tr# 274612 Type: Individual YVES M. NADEAU YVES NADEAU 5 GRANITE ST METHUEN,MA 01844 Administrator o�if�G�vd�A�au ;oard of Building Regulation and Std'hdwrds * ; 'onstruction Supervisor License License: CS 64691 a¢il Birthdate: 3/.3/1965 Expiration: 3/3/2009 Tr# 9444 Restriction: 00 YVES M NADEAU GRANITE S'f ,G METHUEN,MA 01844 Commissioner .... 'gyp:. _. . . ._,.... .,.........d..:�.,.c... � .;«aarnsal. i I The Commonwealth of Massachusetts ^; 1 Department of Industrial Accidents Office of Investigations ' 600 Washington Street a; - Boston, MA 02111 i� www.mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anplicant Information Please Print Legibly Name (Business/Organization/individual): 601'/cj- e L' Address: .. .... .s City/State/Zip: Ak, CJatjr,/y - Phone#: 33qc -7 Are you an employer?Check the appropriate box: Type of project(required): 1.E l aam a employer with 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.x 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp. insurance. Y P h'• 9. ❑ 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 1.❑ 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' 13.0Other F /r comp. insurance required.] 'Any applicant that checks boz#l must also fill out the section below showing their workers'compensation policy information. I 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. r Insurance Company Name:- e_ 5. .0 Policy#or Self-ins. Lic.#: �'V �Q �� Expiration Date: 6 3—c;Z Job Site Address: c �� $f rte•. / City/State/Zip:—�� '"��1 ' l 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 the pains and /geeqal 'es of perjury that the information provided above is true and correct Signature: ✓— Date: Q Phone#: 1 ?r— ' J 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#: