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HomeMy WebLinkAboutBuilding Permit #615 - 31 MOODY STREET 5/13/2009L - Permit NO: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received *I (01 ISD O T TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ New Building L?6ne family ❑ Addition ❑ Two or more family El Industrial ❑ A ration No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg El Others: ❑ Demolition ❑ Other ;�+ `J7Ftoipl�rt C` 1Nate 777,77, y Wet►afds:� 1rl`ed�©tract �S ' e . DESCRIPTION OF WORK TO BE PREFORMED: 00, Identification Please Type or Print Clearly) �Phone: �� OWNER: Name: ARCHITECT/ENGINEER Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED 025.00 PER S.F. Total Project Cost: $ � ` FEE: $_ �� ! Check No.: -1 ��r Receipt No.: ry C U 1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund J Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSA 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 El DATE COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS U 1-1 HEALTH F1DATE REJECTED DATE APPROVED ❑ ,- COMMENTS r b Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature date Located at 384 Osgood Street Driveway Permit 0"0RTM-%- 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 \I..��w - - - - Doc.Building Permit Revised 2007 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 ❑ 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 /ertified Surveyed Plot Plan /wc�orkers Comp Affidavit Choto Copy of H.I.C. And C.S.L. Licenses opy Oj Contract ❑ FI rossection/Elevation Plan Of Proposed Work With Sprinkler Plan And raulic Calculations (If Applicable) ❑ M s check Energy Compliance Report (if Applicable) ngineering 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 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 2.2007 Location,31 ObOJ44- I = No. V/ Date j0*TN TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ACHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1/7) ;3L 212 U :o �Buildmg lnspe�cto, The Commonwealth of Mauachuseft Department of Industrial Accidents O,fjIce ofInvesh'gadons 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): Address: City/State/Zip:,/� -�„ , el*/ hone #: i � 4�7�11 Ays6 an employer? Check the appropriate box; ;1. I am a employer with / 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp, insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required] t employees. [No workers' comp. insurance required.] Type of project (required): 6. 0 New construction 7. [] Remodeling 8. ❑ Demolition 9. [] Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.[] Roof repairs 13.❑ Other _. R. MM .a. bac UW scenon odow snowing thdr 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 subcontractors and their workers' camp• Policy information I ane an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Policy # or Self -ins. Lic. #:y Expiration Date: Job Site Address �� / �rtk� 01 City/State/Zip:%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 penalties of perjury that the information provided above is true and correct. y Offleial use only. Do not write in this area, to be completed by city or town o ficiaL 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 M CA m m m YI m m v C � CO) Cl) CD CZ CA CL o �, r c � c C2. = CO) CD o v CDCL O Q CD CD o CSD w w B. C CD CO) CD CLO CO) CD F v CO) O � Z CD � CD CD 0 C CD I E ,� VJ cn n O cn r v C/) rD O C_ O C O d G �= O OGn -�N Q H d O m y ro '�7 O pCq x IS nCD m C! �7 O �- r 0 H CCD CCD m TJ G Z r d 0 cn O �• y 'r9 O a r O o ? a =r CD O y G y O 2 p 0CD �p O a A O N C� m: OD C, -&o =r CA = O, eo 06 O m m N ;� A m ami: m col N EL U o �= a H m ` O :t m / 0cp q co m co ON CD'O m a� o i CD CD 3 O zCD V/r ^ A � tit m N i CD dd: �M. 41 C r v C/) rD O C/) o m G ti O d G �= O OGn G ro '�7 O pCq x Cil r" ?1 .7 �7 O �- r 0 '� J w n TJ G ►n G w o r d 0 cn O �• y 'r9 O a r O o p I Q Proposal Twomey and Legare Contracting Inc. Building & remodeling Office 978-685-7447 P.O. Box 366 Fax 978-685-7446 978-556-1547 No. Andover Ma. 01845 J1 ✓� sl✓ May 12, 2009 To: Kenny &.Cx15 Crouch 31 `Moody Street. North Andover Ma. 978-683-3256 Ref: New Deck Thank you for the opportunity to quote the following project. The TWOMEYAND LEGARE CONTRACTING price is based on our discussion on May 11, 2009 concerning your project at the above address. The following is a description of work as discussed. 1. Remove existing stairs and deck to back slider and dispose of. 2. New deck to be P.T. 11-9x11-9 `with steps to grade. 3. Construction to consist of 2x10 p.t. floor joists, timbertec rails and decking , 4. Contractor to provide 12" cement form tubes to support deck with triple beam. 5. Stair risers and deck frame to be wrapped in PVC trim boards. 6. Contractor to dispose of job related debris. 7. Contractor responsible for all permits and inspections. 8. Area under deck to clear of owners items. 9. At completion of deck work area will be raked clean. Si gQnOJJUS._ fit..- k Job total & payment schedule Thank you for considering TWOMEYAND LEGARE CONTRACTING for your project. Please feel free to call with any questions or concerns at 978-685-7447. Respectfully, Shaun Twomey Si q' Balance 1 St On signing 2 $ ,500.00 7 $ ,180.00 2nd The day work starts $4,000.00 $3,180.00 3rd Completion of deck frame $2,000.00 $1,180.00 4th Completion of project $1,180.00 Thank you for considering TWOMEYAND LEGARE CONTRACTING for your project. Please feel free to call with any questions or concerns at 978-685-7447. Respectfully, Shaun Twomey Si r^"Cn A r_cc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ACORD,. CERTIFICATE OF LIABILITY INSURANCE D5f2008110:29 Y) 06252008 10:29 PRODUCER (800) 225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fred C. Church. Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 40 Kenoza Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I layerhill, MA 01830 1 800-225-1865 I INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA Arbella Protection Insurance Company I -- INSURER B: — Twomey & Leeare Contracting Inc P O. Box 366 North Andover. MA 01845 INSURERC: _. INSURER D: CLAIMS MADE L OCCUR INSURER E: I r^"Cn A r_cc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONVOF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- INSR'ADD-L LR INSR6 TYPE OF INSURANCE 7 POLICY NUMBER POLICYEFFECTIVE POLICY EXPIRATION UNITS GENERAL LIABILITY AUTHORIZEDRNTATIVE /1 EACH OCCURRENCE S 1.000.000.00 DAMAGE TO RENTED PRE�lEaooarDI 1 S 10000.00 -- - X 1 COMMERCIAL GENERAL LIABILITY I MED EXP (Ary am pemm) 1 S 5.000.00 -- CLAIMS MADE L OCCUR PERSONAL a ADV INJURY f S I-000.000.OD A ; 8500012700 6222008 i 6/222009 GENERALAGGREGATE 1$ 2,000.000.00 I i PRODUCTS - COMPIOP AGG S 2.OW.OW.00 GE -L AGGREGATE LIMIT APPLIES PER: -_ I i POLICY PRO- I LOC JrCT i AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT S • I ANY AUTO r (Ea arddarp) — BODILY INJURY I � ALL OWNED AUTOS SCHEDULED AUTOS - (Per P«s'ar1) 5 t MIRED AUTOS BODILY INJURY S ' NON -OWNED AUTOS (Per accident) DAMAGE S ----------------------- i t— I iPROPERTY GARAGE LIABILITY AUTO ONLY - EA ACCIDENT j S EA ACC ! S ANY AUTO OTHER TWW AUTO ONLY: AGG S EXCESSJIMBRELLA LIABILITY EACHOCCURRENCE Is _ OCCUR I CLAIMS MADE 1 AGGREGATE S r e --- ;s 1 , S DEDUCTIBLE i is i RETENTION S I WORKERS COMPENSATION AND � We STATUY OTH- EMPLOYERS' LIABILITY = ANY PROPRtETORIPARTNERIEXECUTIVE I [E.L.EACH ACCIDENT 1 S DISEASE - EA EMPLOYEE S OFFICEMMEMBER EXCLUDED It Yes. Oescnbe uncW SPECIAL PROVISIONS below I �------ E -L. 05EASE - POI ICY UMI 1 S OTHER I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENOORSEMENTI SPECIAL PROVISIONS GI. Con CERTIFICATE HOLDER CANCELLATION I ox%it UI'North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 27 Charles Street DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TD MAIL 30 DAYS WRITTEN North Andover- MA 01845 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE UxT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE WSURER. ITS AGENTS OR NATIVES AUTHORIZEDRNTATIVE /1 ACORD 25 (2001/08) Client # 5458 Mst # 08/09 Cen # ©ACORD CORPORATION 1988 RightFax NZ -2 12/16/2008 6:09:35 AM PAGE 3/003 Fax Server A " h ACORD. CERTIFICATE OF INSURANCE DATE(MMIDD\YY) 12-16-08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DOHERTY INS AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 21 ELM STREET" ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOY 1985 COMPANIES AFFORDING COVERAGE ANDOVER, VIA 01810 22YVIX INSURED TWOMEY & I EGAtE C'ON'1'RAC')'1NG INC PO BOX 366 NORTH ANDOVER. MA 01845 COMPANY A TRAVELERS INDEI.VL'NffV CONIPANY COMPANY B COMPANY C COMPANY D COVERAGE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEOTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUNIEMENr, 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. LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP AGGREGATE LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDrYY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-CAMP/OP AGO. $ CLAIMS MADE OCCUR. PERSONAL && ADV. INJURY S OWNERS && CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE (Any one fire} $ MED. EXPENSE ;Any one person) $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULE AUTOS W RE D AUTOS NON -OW NED AUTOS GARAGE LABILITY ANY AUTOS COMBINED SINGLE LIMIT $ BODILY INUURY (Per Person) $ BODILY INJURY (P9r Accident) $ PROPERTY DAMAGE $ AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ON �Y: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB -029010954-08 MA8-08 09.16-09 STATUTORY LIMITS X THEPROPRIFTOR! EACH ACCIDENT $ 500,000 PARTNERS/EXECUTIVE INCL DISEASE - POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE - EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESrRESTRICMONSBPECIAL ITEMS THIS REPLACES ANY PRIOR CER'I1FIC.A rE ISSUEL) TO THE CEIC'IFICAT'E HOLDER ANI'ECCLVO WORKERS CUNPCOVERAOC CERTIFICATE HOLDER TOWN OF NORTH ANDOVER 1600 OSGOOD STREET NORTH ANDOVER, MA 01845 ACORD 25.5 (3193) CANCELLATION SHOULD ANI' OF THE ABOVE DESCRIBED POLICIES BE CANCELLED EEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DA'YSWRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO VA.ILSUCH PIOT CE SHALL IMPOSE NOOSUG.ATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITB AGENTS OR R3RESENTATIVES. AUTHORIZED REPRESENTATIVE Charles J Clark V . r t dJStan o�R�IaA n Boardgicense uction Su>eaisoL Constr l —,tee: CS 67560 Birthdate 1012511966 Tr# 6.403 E 1rado #til -512009 '`Etestdi�+bn 00�.' SHAUN M TWOMEY 61 pATROIT ST 01845 Commissier N ANDOVER. MA JXi �iom.,io.a ue�zl!!a ,o ✓l culuvekB Bmrd of Building Revulati ns and Stmadards H01ilIE I)VIFROVEMENT CONTRACTOR Rego ration: 136779 - Expiration: 8,/26/2010 Tm� 272334 Tye: Paq%erahip jyvc)MEy + LEGARE-CO C INC: SFhAViM TiWOMEY _ 61 PATRIOT ST. N. ANDOVER, h1A 1645. Administrator . Massachusetts - Department of Public Safet} Board of Building; Re.-ulations and Standards Construction Supervisor License License: CS 55108 Restricted to: 00 -f DOUGLAS J LEGARE.i 79 GARY AVE HAVERHILL, MA 01830" c ---e-1 �y� Expiration: 9/2/2010 Commissioner Tr#: 3242 1 sc -..'T VT �6� Sir fff � a +� �„..... �...