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HomeMy WebLinkAboutBuilding Permit #030-2017 - 31 MAPLE AVENUE 7/7/2016 NORTH BUILDING PE JIT ' o� z�ED TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ H Permit No#:��-�G-f� Date Received Q�R�reo�eay,(y �SSACHUSE� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 1112)ef L tJ 0,'"C,\ V}rJ � 01J .Print PROPERTY OWNER ✓ wI:L ,V Print 100 Year Structure yes n MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes Q19 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition 9-Two or more family ❑ Industrial +Alteration No. of units: a ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain ❑Wetlands 0 Watershed District El Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identifrcation- Please Type or Print Clearly OWNER: Name: '�7\r A ti1LG` n. Z I 0 z Phone: `7 K- (a y 7- y 0 3 Address: Y`1 P9 pl y 2 ry Gv—�� �N����K vim - O ( ,�i 4 Contractor Name: H-c\v /v c yA-Q-r— Phone: C�­i Y `� _3 S LA 9 Email: Address: ►^�e 14 aL"c V-1 .C-I L Supervisor's Construction License: C — O a 04 Exp. Date: Home Improvement License: �7 0-1 Exp. Date: 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_ . Total Project Cost: I FEE: Check No.: �` Receipt No.: � � NOTE: Persons contracting with dnregistered contractors do not have access to the guaranty falrA I Plans Submitted ❑ Plans Waived'J Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Swiumning Pools El Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on z Signature COMMENTS HEALTH Reviewe on Signature COMMENTS i Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Snature Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREtDEPAI2�TIVIENT TempDumpster ori+site Locate_diat;12;4i biniStieet Fire;D'' partment>signature/date COMMENTS. 1 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 Doe.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 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 OTE: 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/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Application Permit A lication 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 $ 153000.00 m $ - $ 180.00 Plumbing Fee $ 22.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 22.50 Total fees collected $ 325.00 33 Maple Avenue 030-2017 on 7/7/2016 attic conversion to family room NORTH BUILDING PERMIT - 6•6 6 TOWN OF NORTH ANDOVER 3r y ``` .,.•.. 0 0 4 APPLICATION FOR PLAN EXAMINATION h ` Permit No#: Date Received p " 7�p�H.t7e° gSSACH;1`��� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION y'11912)C jj,y C_ tJyJ-ch 1+j J 0-i-fc V"IA- C)1614 S� .Print PROPERTYOWNER Print 100 Year Structure. yes n MAP V PARCEL: _ZONING DISTRICT: Historic District yes Machine Shop Village yes (ID TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition 9-Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ,,' Se,ptir :e '�I:ood_ a� ��1Ne,l,: ds :at e �isf•-c - DESCRIPTION OF WORK TO BE PERFORMED: C IC Identification- Please Type or Print Clearly OWNER: Name: N:7Y z Phone: K- G 47- y o3 Address: 0 pl-e P4,J 2 V s4 0 y S Contractor Name: H-e.\y Phone: 6�-1 -3 LA 9 Email v S Address: 1^+e Supervisor's Construction License: C 4 Exp. Date: C' - y I Home Improvement License: 0-1 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S- . Total Project Cost: $ FEE: $ "^' Z 16 Check No.: 10192 Receipt No.: >®(6®0 NOTE: Persons contracting with dnregistered contractors do not have access to the guaranty 7��,F"` ms,' .'�" - a ��'§s T$ro'3 e- :v� o;T- ry §_ N ,.� i €:ie,':',mss" �+ a 'elm.i' Wa^z�' ..Sia t a ie ofAa � - � Sianature of c�ntracfor a _ NORT1l Town of 0 . . No. d3b...2671Vfwd ,� o h , ver, Mass,LAKG COCKICH(WKK 1 7� RATED MP ,�'�y S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT 1��/. .�I.�....�♦�..rA. ' BUILDING INSPECTOR ..... ... .... ..... . .......................... rf�� &Q. Foundation has permission to erect.......................... buildings on .. .� ;121 � � Rough to be occupied ash!!IO.��,....�or .... I��!!!1�►� .�..�5..: Chimney provided that the person accepting this permit shall in every respect c form to the terms of 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. * �p�►� ��j PLUMBING INSPECTOR F�►•i�TiEt A VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS-CONST. 4BU61LD�i TION FinalRough Service SPE OR 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. GENERAL SERVICE AGREEMENT THIS GENERAL SERVICE AGREEMENT(the"Agreement")dated this 5th day of July,2016 BETWEEN: �P tjnJk1An v b of 33 Maple St. N.Andover,Ma (the "Client") AND Melvin Gomez of 20 Montgomery St Lawrence, Ma, and Jose Minaya of 643 C. Broadway Lawrence,Ma (individually and collectively the "Contractor"). BACKGROUND: A. The Client is of the opinion that the Contractor has the necessary qualifications, experience and abilities to provide services to the Client. B. The Contractor is agreeable to providing such services to the Client on the terms and conditions set out in this Agreement. IN CONSIDERATION OF the matters described above and of the mutual benefits and obligations set forth in this Agreement, the receipt and sufficiency of which consideration is hereby acknowledged, the Client and the Contractor individual) the Part and collective) the Parties to this Agreement) (individually Y Y g ) agree as follows: Services Provided 1. The Client hereby agrees to engage the Contractor to provide the Client with services (the "Services") consisting of: - General contractor. 2. The Services will also include any other tasks which the Parties may agree on. The Contractor hereby agrees to provide such Services to the Client. Page 1 of 6 Service Agreement(Construction) Page 2 of 6 Term of Agreement 3. The term of this Agreement(the "Term")will begin on the date of this Agreement and will remain in full force and effect until the completion of the Services, subject to earlier termination as provided in this Agreement. The Term of this Agreement may be extended by mutual written agreement of the Parties. 4. In the event that either Party wishes to terminate this Agreement prior to completion of the Services,that Party will be required to provide at least one days notice to the other Party. Performance 5. The Parties agree to do everything necessary to ensure that the terms of this Agreement take effect. Currency 6. Except as otherwise provided in this Agreement,all monetary amounts referred to in this Agreement are in US Dollars. Compensation 7. For the services rendered by the Contractor as required by this Agreement,the Client will provide compensation(the "Compensation") to the Contractor for the flat fee of$3,000.00. - An initial rate with an understanding if any changes were to occur we would reconfigure a new rate. 8. The Compensation as stated in this Agreement does not include sales tax, or other applicable duties as may be required by law. Any sales tax and duties required by law will be charged to the Client in addition to the Compensation. Reimbursement of Expenses . 9. The Contractor will be reimbursed from time to time for all reasonable and necessary expenses incurred by the Contractor in connection with providing the Services hereunder. 10. The Contractor will furnish vouchers to the Client for all such expenses. i Service Agreement (Construction) Page 3 of 6 Additional Resources 11. The Client agrees to provide, for the use of the Contractor in providing the Services, the following resources: - Client will purchase all materials and fees. Return of Property 12. Upon the expiry or termination of this Agreement, the Contractor will return to the Client any property, documentation,records, or Confidential Information which is the property of the Client. Capacity/Independent Contractor 13. In providing the Services under this Agreement it is expressly agreed that the Contractor is acting as an independent contractor and not as an employee. The Contractor and the Client acknowledge that this Agreement does not create a partnership or joint venture between them, and is exclusively a contract for service. Notice 14. All notices, requests, demands or other communications required or permitted by the terms of this Agreement will be given in writing and delivered to the Parties of this Agreement as follows: a. F13 q t14'.Ll ail T)i a4--Z- 33 Maple St. N.Andover, Ma b. Melvin Gomez 20 Montgomery St Lawrence,Ma C. Jose Minaya 643 C. Broadway Lawrence, Ma or to such other address as any Party may from time to time notify the other. Service Agreement(Construction) Page 4 of 6 Indemnification 15. Except to the extent paid in settlement from any applicable insurance policies, and to the extent permitted by applicable law, each Party agrees to indemnify and hold harmless the other Party, and its respective affiliates, officers, agents, employees, and permitted successors and assigns against any and all claims, losses, damages, liabilities,penalties,punitive damages, expenses, reasonable legal fees and costs of any kind or amount whatsoever, which result from or arise out of any act or omission of the indemnifying party, its respective affiliates, officers, agents, employees, and permitted successors and assigns that occurs in connection with this Agreement. This indemnification will survive the termination of this Agreement. Insurance 16. The Contractor will be required to maintain general liability insurance including coverage for bodily injury and property damage at a level that would be considered reasonable in the industry of the Contractor based on the risk associated with the characteristics of this Agreement and only to the extent permitted by law. All insurance policies will remain materially unchanged for the duration of this Agreement. Additional Clause 17. Any additional personnel or contractor hired by the client not in this agreement is responsible for their work. Legal Expenses 18. In the event that legal action is brought to enforce or interpret any term of this Agreement, the prevailing Party will be entitled to recover, in addition to any other damages or award, all reasonable legal costs and fees associated with the action. Modification of Agreement 19. Any amendment or modification of this Agreement or additional obligation assumed by either Party in connection with this Agreement will only be binding if evidenced in writing signed by each Party or an authorized representative of each Party. Time of the Essence 20. Time is of the essence in this Agreement.No extension or variation of this Agreement will operate as a waiver of this provision. Service Agreement (Construction) Page 5 of 6 Assignment 21. The Contractor will not voluntarily, or by operation of law, assign or otherwise transfer its obligations under this Agreement without the prior written consent of the Client. Entire Agreement 22. It is agreed that there is no representation, warranty, collateral agreement or condition affecting this Agreement except as expressly provided in this Agreement. Enurement 23. This Agreement will enure to the benefit of and be binding on the Parties and their respective heirs, executors, administrators, successors and permitted assigns. Titles/Headings 24. Headings are inserted for the convenience of the Parties only and are not to be considered when interpreting this Agreement. Gender 25. Words in the singular mean and include the plural and vice versa. Words in the masculine mean and include the feminine and vice versa. Governing Law 26. It is the intention of the Parties to this Agreement that this Agreement and the performance under this Agreement, and all suits and special proceedings under this Agreement,be construed in accordance with and governed, to the exclusion of the law of any other forum, by the laws of the Commonwealth of Massachusetts,without regard to the jurisdiction in which any action or special proceeding may be instituted. Severability 27. In the event that any of the provisions of this Agreement are held to be invalid or unenforceable in whole or in part, all other provisions will nevertheless continue to be valid and enforceable with the invalid or unenforceable parts severed from the remainder of this Agreement. Waiver 28. The waiver by either Party of a breach, default, delay or omission of any of the provisions of this Agreement by the other Party will not be construed as a waiver of any subsequent breach of the same or other provisions. Service Agreement (Construction) Page 6 of 6 IN WITNESS WHEREOF the Parties have duly affixed their signatures under hand and seal on this 5th day of July, 2016. kLl A; Z (Client) Melvin Gomez (Contractor) Jose Minaya(Contractor) Copyright 2002-2016,LegalContract.com W � 4� n II N A O' 0 - 29'-8" 7-10" W T-T C4 T Ol A W -^- C' o C 00 Cl) 0. TI c Sn- C y 0 ! c I I N 5 7" 2_6" ro w o (n I U) m T-q" 3',9" _ a 0 40 z 91-3" 13'-9"00, 00o m CL � o m 3•,4•' Q " 10 y O IIF� a A _ f%.J 0 O 0 61'-2" A Abel Tejada Attic Plan Floor Plan 33 Maple Av.N.Andover Date 01/31/2012 MA,01845 Drawn by Jose Melo Al 01 Project number_- Project Number I Checked by PEREZ ENG.C0.1 Scale 3/16"= 11— Act CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) `--�" 05/09/2016 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). PRODUCER CONTACT NAME; Elizabeth Chavez DEGNAN INSURANCE AGENCY, INC. P"C"N xit; (978)688-4474 AIC No; ADDRESS: echavez@degnaninsurance.com 85 SALEM ST. I INSURER(S)AFFORDING COVERAGE _ NAIC# LAWRENCE MA 01843 -INSURER A: TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED INSURER B: _ A M ENTERPRISES CORP INSURERC: INSURER D; 643A BROADWAY INSURER E: LAWRENCE MA 01841 INSURER F: COVERAGES CERTIFICATE NUMBER: 51350 REVISION NUMBER: THIS IS TOCERTIFY 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 SUER POLICY EFF POLICY EXP LTR _Ina WVDPOLICY NUMBER MM/DD MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 17 OCCUR AMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person). $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY C-]PRO- JECT F7 LOC -- PRODUCTS-COMP/OPAGG $ OTHER: i AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ r Ea,accident/ I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLALIABOCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ 1 $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N — ANYICER/M MBER EXCLUDED? 6HUBOG25369615 08/21/2015 08/21/2016 E.L.EACHAccIDENT $ 100,000 A OFFICER/MEMBEREXCLUDED? NIA N/A NIA _ _ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under I _ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION :D- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE MA 01810 Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Bu1:fding,Reg uIations a,hd.Standaeds License: CS-092604 Construction Supervisor MELVIN GOMEZ 20 MONGO.MERY STREET LAWRENCE MA 01841 . I Expiration: Commissioner 11/0512019 Office of Consumer Affairs and Business Regulation 5170 10 Park Plaza - Suite;rte S Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 183707 Type: Corporation Expiration: 11/4/2017 Tr# 272027 AM ENTERPRISES CORP. JOSE MINAYA -- 643 C. BROADWAY — LAWRENCE, MA 01841 ---- — Update Address and return card.Mark reason for change. sen i t: 20M-05111 Address L] Renewal ❑ Employment L-1LostCard `c:��f• !I'%oJi1117077/IRCCJ/�L�n/��7AJryf,�/LaL�yl Office of Consumer Affairs&Business Regulation License or registration valid for individul use only - -( HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 183707 Type: Office of Consumer Affairs and Business Regulation Expiration: 11/4/2017 Corporation 10 Park Plaza-Suite 51.70 Boston,MA 02116 AM ENTERPRISES CORP. JOSE MINAYA 643 C. BROADWAY _ LAWRENCE, MA 01841 Undersecretary Not valid without signature Location /s1A,R'L-15 No. 030 - Date ✓�0,;�f� • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ IRV- Foundation Permit Fee $ Other Permit Fee TOTAL $ Check# 2 'C `; r ! v f1 '` Building Inspector ,{j