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HomeMy WebLinkAboutBuilding Permit #748 - 312 BOXFORD STREET 4/24/2014OF N� oT 6 Ati BUILDING PERMIT 3? b;F. '_'�_'•'6 °oma TOWN OF NORTH ANDOVER t APPLICATION FOR PLAN EXAMINATION Permit NO: " Date Received '� 04 <�,� :• �> 1 L' 1 �9SSgCNUS��� Date Issued: C MPORTANT: Applicant must complete all items on this page LOCATION 3lZ Y\dx�isZ41< PROPERTY OWNERPrint , k<Am� ��y Print MAP NO: �1 PARCEL M 1 ZONING DISTRICT: Historic District yes rn !Machine Shap Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building I/One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial Vi rRepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0 Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: Address: CONTRACTOR Name: .?a4 VA- E "li\ V ` Phone: 4.\n•9ho 15b_, 1 Address: -�, _V►1 �s� Toru "��;� "� v�c�owo - '1A ��hq Supervisors Construction License: Exp. Date: 'LS•ci� 5,�\, �o\ Home Improvement License: Exp. Date: VVY 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.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce# to the guaranty fund IL, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: - IMPORTANT: Applicant must complete all items on this page LOCATION �PROPERTYfOWNER _ - iP_nnt : 100Year Old structure yes AnbvY MAF N©#°PARCEL ZONING#DISTRIGT tHistonc,Distnct; eyes no '" ,; ", �MachineShop;Village yes no TYPE OF IMPROVEMENT ❑ New Building ❑ Addition ❑ Alteration ❑ Repair, replacement ❑ Demolition PROPOSED USE Residential ❑ One family ❑ Two or more family No. of units: ❑ Assessory Bldg ❑ Other Non- Residential ❑ Industrial ❑ Commercial ❑ Others: �� =� -; ��o�rlooctpiain� �-U�vv�eua►iva� .�� 3 DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: 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.F. Total Project Cost: $ FEE: $ _--- Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund -a 'Slafure,of:contractor. .: `i - ;Signature of Agent/Owner Plans Submitted F5 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location 2-- X 4V S No. Date U. . TOWN OF NORTH ANDOVER •_ 'rte- t Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Che�9 2:-L V/ Plans -Submitted ❑ Plans -Waived ❑. a _Certified Plot Plan ❑ Stamped Plans ❑ "TSP); OFSEWER�GEDIS�OSAL- Public Sewer ❑ Tanning/Massage/BodyArt ❑ .. .Swimming Pools ❑ Well ❑. Tobacco.Sales 0 'Food Packaging/Sales ❑ -Private•(septic tank, etc:_ . ❑.. - , _PermandfAD mpster on:Site ❑ THE..:FOLLOIlVIIVG SECTI.ONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM -.-DATE REJECTED- DATE:. APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS .,CONSERVATION COMMENTS HEALTH CQMMENTS. Reviewed on Signature Reviewed on Siqnature 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_'To,vv Engineer: Signature: t_ocatea 6u4 Us ooa z>treet TRE DEPARTil E`NT.--'Temp'Dumps:ter on site yes no Located -at .124. Mair, Street - Fire"Departme►it signature/date COMMENTS - - imension Number of Stories: Total square feet of floor area, based on Exterior dimensions. :Total land -area; sq. ft.: ELECTRICAL: Movernent:o.ff.Meter. location, r *ast-or service drop requires approval of Electrical Inspector Yes No DANGER. ®NE LITERATURE: Yes No MGL -Chapter 166. Section 21A -F and. G min.$100=$1000..fin.e NOTES and DATA — (For department use ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department :_--Tire following hi-a=list of:the required:forms to be filled ouf for.:the appropriate -permit to 'be obtained. R.00fivg, Siding, Interior Rehabilitation Permits L) Building Permit Application ❑ Workers Comp Affidavit LiPhoto 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) 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 ❑ 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 submAted with the building application Doc: Doc.Building Permit Revised 2012 From: Christopher ShanahalFax: (888) 465-7642 To: +19786889542 Fax: +19786889542 Page 2 of 4 04/2412014 1:36 AcoRoP CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIY 4/24/20144 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(les) 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 Tonry Northwest Insurance Agency, Inc. 238 Bedford Street Lexington MA 02420 CONTACT NAME: Colleen Mathews PHONE ('781) 861-1800 AIC No), (781)861-1804 AIL ADDRESS:cmathews@tonrynw.com INSURERS AFFORDING COVERAGE NAIC # INSURERAEndurance American Specialty 41718 INSURED Merrimack Construction Group, Inc. 15 Maplewood Avenue Tyngsborogh MA 01879 INSURER B: Commerce Insurance 34754 INSURER C: INSURER D: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1432708229 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYWY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR CBC10001460000 /4/2019 /9/2015 DAMAGE TO RENTED PREMISES Ea occ�mence $ 100 , 000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE -IMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY D PRO LOCI $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ 100,000 B ANY AUTO ALL OWNED X SCHEDULED AUTOS ALTOS LJ2069 4/23/2014 4/23/2015 ( ' BODILY INJURY (Per accident; $ 300 000 X HIRED AUTOS X NUN-OVINLU ALTOS PROPERTY DAMAGE $ Peraccdent 250,000 Medical Da mems $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETDR/PARTNER/EAECUTIVE OFFICER/MEMB--R EXCLUDED? u N / A TQRY LIMITS ER E.L. EACH ACCIUEN I L.L. UIS=ASE - LAEMPLOYLE $ (Mandatory In NH) If ye=_, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, ifmore space is required) Job Location: 312 Boxford St., N. Andover, MA 01645 Certificate Holder is an Additional Insured, when required by written contract, but only to the extent provided in the Additional Insured endorsement(s) attached to the policy, a copy of which is available upon request. (978)688-9542 Andover Town Hall 36 Bartlet St. Andover, MA 01810 rr WF[LJ ca tcv rwW1 INSn75 oninnsl ni 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 cTonry Jr. /CMATTH `-��- Cl ti.,.,. US 1988-2070 ACORD CORPORATION. All rights reserved. The Ar r)12r1 nmm. -41 1- arc r mic+n A morUo of arnon v vi• C Cl) n 10 O 0 0-0 Zcn CD CL 03 r-liko ca• '2 o 23 vCD 0- c S _ CD CD o CDCDW "vCDim CO \V ' � v O m z n o CD B O CD O O • z O h CD N c° O c 03 z� rnrn U) D o) M C z I ;o 2. < � M C Cl) --q z CD z�g O z Q E cn M m n 00-0 � O � 2 o T :tl U) = < O -<D C -.0 N n c Q' C m rt rt C 3 -tea O V! „O,r C—D - y o. TI O O rt Q. O O m N WFfn O -� SD lD � CD 2 O O Q -z n rt O (Q O N rt O O C7 ;�O O rt CD M n S Z7 O T O N (D o�( � O GQ s O N 7A ZA -0 Z - o h rt a- aC� CL _ C-)_ 0 CL < CO N CD y O O O CD CD O �-r ((D CD CL :5� CD � C N rt O n O o (D t O O =F C 3 N CD n (D rt �C CD N 7 S O_ i n D <D O Z CD - 0 F' (D c� o 0)N CL r v 3- V)7 W T :tl T N A T 3 O O ((D O j ;�O O T j n S Z7 O T O N (D T O � O GQ N °—' °—' _ 'a O �-r ((D :5� � 7 Q (D =F n (D S S 7 S O_ n \ O Z (D 0)N (D * p v s � W rD c c 3 ' n W ® (A '° ° m z z ° y �' O f7 tA NLA T m -O 0 m m A 0 0 0 x --6a 0 c 4/!1C �a97L7%C071CU(,'C7�Ifl c•!G>>!/(,lYJ1CGCI �cJelr3 Office of Consumer Affairs.& Business Regulation OME IMPROVEMENT CONTRACTOR i registration 172286 Type: expiration 61712014 _, Private Corporatio MERRIMACK CONSTRUCTION GROUP, INC. CHRISTOPHER SHANAHAN`_ , 54 CHURCH ST LOWELL, MA 01852 - " Undersecretary Page 1 of 1 .. GCS -089764 DANIEL TEMPLE t 1 MAIN ST GROTON MA 014550 .•"' -"'� 051 1112014 https:Hgm l .ggpht.com/hIgBnYDGjZBHret3rgZTfP2_Uacl-fRk5xsFbopgg7b-grVgrJpzwdf... 3/16/2014 L M, MAT Licensed and Insured Chris Shanahan 54 Church Street Lowell, MA 01852 978-512-9211 Attn: Paul Kroon Address: 312 Boxford North Andover, MA 01845 Date: 4/22/14 Proposal Per attached roof plan • Clear the area of any breakable items that would obstruct the job site • Completely remove any existing layers of asphalt shingles and dispose of in container provided by Merrimack Construction Group, Inc., up to 2 layers included in price. • Completely de -nail roof and re -nail roofing boards as needed, completing a full inspection of the substrate. (Up to 50 lineal feet included in price - $10.00 per foot thereafter) (Up to one (1) 4'x8' sheet of plywood included in price - $60.00 per sheet thereafter.) • Apply GAF/Elk deck armor. • Apply GAF We/atherwatch ce,/Water Shield 6' tip from bottom perimeter of roof and around skirt. 4.6knsi 1L,%b(- •o6It'.vef o-% 6444C. aJ accse- • Install new 8" drip edge around perimeter of house. C-6ro • Install new Cobra ridge vent and cap with Timbertex Cap. • Apply new 30 year architectural shingle roof system — HD Barkwood • Grind and point chimney Qe'. u.:� L"i uacevc►�/� Total Cost Labor and Materials: $7,200.00 *Note: Lifetime manufacturer and workmanship warranties Provisions: '/2 due at signing of contract '/2 due upon completion of job Any changes or add-ons in contract will be drawn up, priced if need be and signed by both parties before work is performed Acceptance of Contract The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to the work as specified. Payment will be made as outlined above errimack Construction Group, Inc. HomeovwnerqaA thorized Si atur rZZ Date Date Thank you for choosing Merrimack Construction Group, Inc.