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HomeMy WebLinkAboutBuilding Permit #325 - 31 BRIDGES LANE 10/14/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:. � Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER ,5WtZ Unit# Print MAP NO:I PARCEL: AV ZONING DISTRICT: Historic District yes no Machine Shop Village y no 100 year-old structure y no TYPE OF IMPROVEMENT PROPOSED USE �� Residential Non- Residential ❑ New Building �One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement p Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well F - 0 F a la�ii l ds loo _ =fi rs D tlan Is _ 'We .�� D urate ed strict DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print rant Clearly) OWNER: Name: hone: Address: '311 1_2,,a.j2 CONTRACTOR Name: Z,1�17 phone, Address: 5 Supervisor's Construction License: DSS' Exp. Date: via Home Improvement License: Exp. Date: _9V1 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: $ %6. 75� OdFEE: Check No.: 3 'Z—,, Receipt No.: NOTE: Persons contracting with nregistered contractors do not have access4thearanty fund Signature of A ent/Ovvner, .•;. Signafu'"'-f contractor __ _9 - --- Location � j Date ` J No. ,,oRT� TOWN OF NORTH ANDOVER i Of� ..o ,..�o c � a a k` Certificate of Occupancy $ -- �+•' Building/Frame Permit Fee $ �Stt JI, Foundation Permit Fee $ ----- Other Permit Fee $ ----- TOTAL $ Check # Building Inspector 24769 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools 0� . Tanning/MassageBody Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales 0 Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY t' INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS . i 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 DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 •(/©ice�l-/' �S l Gi/�''! ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi 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 o Workers Comp Affidavit o Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract a Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products (VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permi Addition or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Flo or/Crossection/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 o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 Doc: Doc.Building Permit Revised 2008mi NORTFp TO" of And No. F. ,.. lot �. o , dover, Mass., • 1 O -- IAKE COC MICKEWICK RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..............Mo. L..........(Z. a............................................................. Foundation has permission to erect........................................ buildings on ..... ............ �� .. ........ .. Rough oil 01 to be occupied as........'���. .. ...... /h lail-in."­every . .�.+. .... .. ............................... ................. ...... Chimney provid9d that the person acceptingthis perm respect conf m 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 1 PERMIT EXPIRES IN6 ONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC O ST TS 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. HammerTime- Invoice 382 Primrose Hill Rd. Dracut, MA 01826 Date Invoice # (978) 957-9078 8/15/2011 447 Bill To Mark Roberts 31 Bridges lln. 1 N.Andover Ma 01845 P.O. No. Terms Project Rate Quantity Description Amount 10875.00 We propose the following remodeling project at above address. 10,875.00 Strip all existing masonite siding off of house and dispose of in dumpster provided by contractor. Install vapor barrier provided-by customer Wrap window frame and trim with custom bent white aluminum(not' front windows). Wrap door trim with custom bent white aluminum. Install premium white double four inch vinyl siding on entire dwelling exterior walls(not front of house) Install vinyl vented soffet to all soffet areas. Install custom bent white aluminum to all fascia. All construction debris to be cleaned up daily. All labor,permits and materials for the sum of ten thousand eight hundred seventy five dolldis ($10,875.00)with payments as follows. One third upon acceptance and approval of contract three thousand six hundred twenty five dollars ($3,625.00). Second deposit due upon delivery of materials and start of work three thousand six hundred twenty five dollars($3,625.00). With balance due upon completion and permit sign off three thousand six hundred twenty five dollars ($3,625.00). 0.00 New cellular no maintenance PVC trim around both garage doors 0.00 additional seven hundred fifty dollars($750.00) This proposal may be withdrawn by us,if not accepted within._days. Total Phone# 978-957-9078 Pagel „�A f � .� `.l �� i i I r HammerTime Invoice 382 Primrose Hill Rd. Dracut,MA 01826 Date Invoice # (978) 957-9078 8/15/2011 447 Bill To Mark Roberts 31 Bridges lln. N.Andover Ma 01845 P.O. No. Terms Project Rate Quantity Description Amount 0.00 Any rotted sheathing or other weather damaged areas to be addressed 0.00 with customer and billed as time and materials �l This proposal may be withdra y u ' not accepted withi days. Tota) $10,875.00 Phone# 978-957-9078 Page 2 '�_ I I � i ._ M1 � , II I Ntassachusetts- Departnnent of Polk Safety Z.lyd of Building Re!,til:itions and Standards - Constructions Supervisor License License: CS 92065 a; i JAMES H GODFROY 382 PRIMROSE HILL RD DRACUT, NIA 01826 Expiration: 5128/2013. ('unnnissi�rnrr Tr#: 12133 uLicense or registration valid for mdividul use only Office of consumer-Affdim&B mess Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ;-139503 Type: Office of Consumer Affairs and Business Regulation. F4ERTIMEC0NS-TTR_­_i Expiration: 7!27!2013 DBA 10,ParkPlaza-Suite 5170 Boston,MA 02116 UCTON_&REMODELING JAMES GODFROY = - 382 PRIMROSE DRACUT,MA Undersecretary Not valid without signatur6 i i XFINITY Connect Page 1 of 1 XFINITY Connect vicsdad@comcast.nei +Font Size- Mark Roberts From:Bonnie Welch <Bonnie@fepins.com> Fri,Oct 07,201101:13 PM Subject:Mark Roberts #1 attachment To:vicsdad@comcast.net Attached is the general liability certificate for Mark Roberts. I have requested the workers'comp from the company and should receive it within 2 business days. As soon as 1 get it,I will forward it to you. Thank you. Bonnie Welch Bonnie@fepins.com Francis E.Provencher Insurance Agency,Inc. 53o Rogers Street Lowell,MA o1852 p(978)459-8681 .f(978)454-9343 Hammertime Const..pdf ►a 57 KB http://sz0160.wc.mail.comcast.net/zimbra/h/printinessage?id=205620&xim=1 l b/7/2011 RightFax C1-2 10/10/2011 4 : 15: 02 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE 101101,2011 THIS CERTIRCATE 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:H the certificate holder is an ADDITIONAL INSURED,the policy(es)must be endorsed. H SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate folder in lieu of such andorsemenf(s). PRODUCER CONTACT NAME: PHONE FAX FRANCIS E PROVENCEER INS (A/C,No,E)d): FAX 530 ROCERS ST E-MAIL (AIC,No): ADDRESS: PRODUCER i.OWELL,MA 01852 CUSTOMER ID S: 26F9G INSURER(S)AFFORDING COVERAGE NAIC$ INSURED INSURER A: HARTFORD GROUP INSURER B: GODFROY JAMES DBA HAMMERTIME CONSTRUCTION INSURER C: INSURER D: 382 PRIMROSE HILL ROAD INSURER E: DRACUr,MA 01826 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 REQUI REMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER QOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOLSUBR POUCY EFF DATE POLICY EXP DATE TYPE OF INSURANCE POLICY NUMBER (WADDSYYYY) (MtADD1WYY) UMITS LTRINBR WVD GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrenre) MED EXP(Any one person) PERSONAL&&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident)ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY S (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAS OCCUR EACHOCCURRENCE $ EXCESS LU1B CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKER'S COMPENSATION AND WC STATUTORY LIMITS OTHER EMPLOYER'S LIABILITY YIN US-4305PG06.11 07/2712011 07/22/2012 E.L.EACH ACCIDENT S 100.000 ANY PROPERITOR/PARTNER/EXECUTIVE Y OFFtCEPJMEMBER EXCLUDED? E.L.DISEASE EA EMPLOYEE $ 100,000 (Mandatory In It yes,describe—der— E.L.DISEASE POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS!LOCATIONSIVENICLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER.AFFECMG WORKET.S COhfP COVERAUE; THE WORKERS'COMPENSAnON POLICY DOES NOT PROVIDE COVERAGE FOR GODPROY JAMES. CERTIFICATE HOLDER CANCELLATION MARK ROBERTS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 31 BRIDGES LN WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE N ANDOVER,MA 01845 Ramani Ayer ACORD 25(2009/09) 1988-2009 ACORD CORPORATION. All rights reserved. G0DFJA1 OP ID: BW CERTIFICATE OF LIABILITY INSURANCE DATE10107D/YYYYj 10/07/11 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(ies) 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). CONTACT PRODUCER 978-459-8681 NAME: Francis Provencher Insurance 978-454-9343 PHONE FAX Agency,Inc. Alc No): 530 Rogers Street E-MAIL Lowell, MA 01852 ESS- Mike Provencher INSURERS AFFORDING COVERAGE NAIC# INSURER A:Preferred Mutual Insurance Co. 15024 INSURED James Godfroy INSURER B: dba Ham mertime Construction 382 Primrose Hill Road INSURER C: Dracut,MA 01826 INSURER D: INSURER E: 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 SUB POLICY EFF POLICY EXP POLICYINIUMBER tMMIDDNYYYI IMMIDDNYY1r1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500,0001 A X COMMERCIAL GENERAL LIABILITY CPP0140592482 09/13/11 09/13/12 PREMISES IE,occurrence $ 50,00 CLAIMS-MADE Fx]OCCUR MED EXP(Anyone person) $ 5,00 PERSONAL&ADV INJURY $ 500,00 GENERAL AGGREGATE $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,00 POLICY PRO- LOC $ 2O BIN D S GLE I IT AUTOMOBILE LIABILITY accident _ $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOSH I AUTOS er accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS I ER ANY PROPRIErOR/PARTNER/D(ECUTIVEE.L.EACH ACCIDENT $ OFFICEWMEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ "CERTIFICATOPERATIONS FOR WOLOCATIONS KERS COMP COVERACORD GE WILLABE ISSUED DIRECTLY FROW Trequired) COMPANY WITHIN 2 BUSINESS DAYS" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mark Roberts ACCORDANCE WITH THE POLICY PROVISIONS. 32 Bridges Ln. N.Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD