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Home My WebLink AboutBuilding Permit #550-2016 - 32 ESSEX STREET 11/3/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: "J "��So Date Received Date Issued: � I S IMPORTANT:Applicant must complete all items on this page LOCATION s-k Print PROPERTY OWNER hG y— Unit#_ L Print MAP NO: PARCEL.-W43 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building Rldne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial epair, replacement ❑Assess Bldg ❑ Others: ❑ Demolition 9<51—her p � �. ,_ } Flbodp ai'n� I9 We lands: �®Welly - �f �.. ®Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: ry C, (I ntifiea ' n Ptae se Type or Print Clearly) OWNER: Name: P7 Phone: ,1- $ 0.3.35.0 Address: f%Sse -S-k _ CONTRACTOR Name: )kb"J)kb" L &rbgr Phone: i/-Y)bq5-4-,)333 Address: /&O C 1)41 I cl ��-- Supervisor's Construction License: O�f'f�` Exp. Date: Home Improvement License: l6Yl, Exp. Date: / �l ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 5yos FEE: $ a Check No.: s`��'� Receipt No.: Z.,- I NOV: ,Perso contracting with unregistered contractors d ve access to the guaranty fund _ 3 tgriature.of;coritracto�E. Location '^ &ss e/ No. -Gam,�o Date , �J TOWN OF NORTH ANDOVER' ED Certificate of Occupancy $ Building/Frame Permit Fee $ _~ � ' Foundation Permit Fee Other Permit Fee �a TOTAL $ Check# �� 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 Siqnature 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 l 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 0 Notified for pickup - Date Doc:.Building Permit Revised 20117une/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 ❑ Building Permit Application o Workers Comp Affidavit o 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 o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ 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) ❑ 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) o Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o 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: Doc.Building Permit Revised 2008mi NORTH own of t E ndover h ti ver, Mass, COCHICKIwICK y�• ADRATED 1p**00 �S S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT � ! CIAZ� BUILDING INSPECTOR ............. .......... .................. .... ........................................................................... c has permission to erect buildings on �SSe x Foundation .......................... ......... .................. . .......... ................................. /, ............................................................. Rough to be occupied as ............��1P.........�....r.�ra��......:. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION RTS Rough Service �.-.-- .................. .... .. ........ .. .................................... Fina BUILDING INSPECTOR 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. EXPRESS R00MG - ESTABLISHED 1985 PROPOSK DATE OF PROPOSAL 911712015 www.expressroofer.com mike exwessroofer.com HOME IMPROVEMENT CONTRACTORS LICENSE#108126 PO Box 542.Chelmsford,MA01824 CONSTRUCTION SUPERVISOR LICENCE#99497 Phone 978.256-2333/Fax.978.251.2907 ••• PROPOSAL SUBMITTED TO: • • WORK TO BE PERFORMED AT: "A'"E STEPHEN PINCHER DORESS 32 ESSEX STREET AWREss 32 ESSEX STREET INORTH ANDOVER MA 01845 NORTH ANDOVER MA 01845 PHONE' 617-840-3350 We hereby repose to furnish materials and perform the labor necessaw for the completion of. STRIP ALL ASPHALT SHINGLES OFF HOUSE-PORCH-GARAGE CLEAN UP AND HAUL AWAY TARP OFF HOUSE TO HELP PREVENT DAMAGE TO HOUSE AND LAWN AREA COMPLETELY DE-NAIL OLD ROOFING NAILS AND RE-NAIL ROOFING BOARDS AS NEEDED WITH 8D RING SHANK NAILS ALL WALL FLASHING WILL BE INSPECTED AND REPLACED AS NEEDED Install:IKO Storm Shield 97up from the bottom eaves IKO Storm Shield under chimney lead and Y down on roof RHINOROOF SYNTHETIC ROOFING UNDERLAYMENT over roof boards IKO Storm Shield 3'on roof where roof buts into walls IKO Leadina Ed a Plus Starter strip on all roof decking ed es IKO Cambridge Architectural shingles We install 6 nails per shingle for a 130 mph IKO wind warranty) Cut in 1 1/2"opening onpeak of roof and install Roof Saver ridge vent along all ridge surfaces All ridge vent is Hand Nailed IKO ridge cap shingles 8"Drip edge on all outside roof edges white New pipe flanges over vent pip2s 2"-4" All shin les will be fastened using 1 '/."-1 '/"roofing nails BLOW OFF ENTIRE ROOF AND CLEAN GUTTERS AND DOWNSPOUTS ROLL 3 FOOT MAGNETS OUT TO PICK NAILS OFF LAWN AREA FOR FINAL CLEANUP INCLUDES:ALL LABOR AND MATERIALS FOR THE ABOVE AND ROOFING PERMIT ALL ROOFING MATERIALS STRIPPED OFF YOUR ROOF WILL BE RECYCLED AT ROOF TOP RECYCLING 15 YEAR WORKMANSHIP LIMITED AND A LIMITED LIFE TIME IKO SHINGLE WARRANTY CLEAN UP AND HAUL AWAY ALL SHINGLES Note No warranty on problems and/or damaged caused by ice backups No warranty on Did skylights All material is guaranteed to be as specified,and the work to be performed in accordance with the drawings and specHications -.g submitted for above work and completed in a substantial workmanlike manner for the sum of. ;= 5.9 J PAYMENT IN FULL AT COMPLETION OF JOB WITH CASH OR BANK CHECK MADE OUT IN THE NAME OF Michael L.Cortner f Call Toll Free Respectfully submitted Bim.. 1-888-210-ROOF ••• Note-This pmposal may be withdrawn by us It not accepted by: 9/2412015 All workers fully insured ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above.Any additional work than the above will be an extre charge. UPGRADE TO OWENS CORNING DURATION ARCHITECURAL SHINGLES WITH"SURE NAIL PATENTED TECHNOLOGY" INCLUDES A LIMITED 50 YEAR NON-PRORATED COVERAGE ON MATERIALS AND LABOR OWENS CORNING SYSTEM ADVANTAGE WARRANTY IS FULLY TRANSFERABLE Signature iM Date SHINGLE COLOR IKO CIIii1RCOA CSE Homeowner is resbonsible for protecting and cleaning content of attic from possible dust and debris during your roofing project. Not responsible for any issuos caused by avid Any 112 in.Plywood installation will be an additional charge of$60.00 per sheet Labor and materials ANY BOARD REPLACEMENT WILL BE AN EXTRA CHARGE OF$4.00 PER BOARD FOOT We recommend new chimney lead with all new roofs for an extra charge of$595.00 per chimney The Commonwealth of Massachusetts Department of Industrial Accidents a 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information ^ Please Print Le ibl Name(Business/Organizati n/Individual): M t G v( Address: S f2 �1 G 7 City/State/Zip: K Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.[]I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. F1 Demolition 3.F1 I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure tall contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions pro retors with no employees. 12.❑Plu ' . ng repairs or additions am 5. a general contractor and I have hired the sub-contractors listed on the attached sheet. 13repairs These sub-contractors have employees and have workers'comp.insurance.: p 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their 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 sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: C AR {�� J Policy#or Self-ins.Lic.#: d2-;I �' 103 y S3 Expiration Date: l �� Job Site Address: 3 >e Sp— City/State/Zip: /V. fl/ILla� f.� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 pai nalties of perjury that the information provided above is a a7 d cor�ct. Signature: Date: / a/ Phone#: 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#: ACORDM CERTIFICATE OF LIABILITY INSURANCE 04103/201S THIS LIERTIFICATE 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 NCONTACT AME: ANDRE SILVA Repo & ]epsen Financial and Insurance Services P,X"No : 508-875-S600 Ax N/:SO8-87S-S885 1103 Commonwealth Ave ADDRESS: Boston, MA 0221S INSURER(S)AFFORDING COVERAGE NM r INSURERA: Essex Insurance Company INSURED ECUAUSA CONSTRUCTION INC INSURER B: AMGUARD INSURANCE CO 1 S 3 ARLINGTON ST APT 2 INSURER C FRAMINGHAM, MA 01702 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: EXPRESS ROOFER 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. LTRWSRI TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY M LIMITS GENERAL LIABILITY TBA 03/12/2015 03112/2016 EACH OCCURRENCE $ 1,000,0001 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,00ol CLAIMS-MADE FX] OCCUR MED EXP(Any one parson) $ 5,0001 A PERSONAL 6 ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- JECT LOC $ AUTOMOBILE LIABILITY (1E,,%=)" $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED 7 SCHEDULED AUTOSPROPERTY AMAUh BODILY INJURY(Per accident) $ NON-OWNAUTOS HIRED AUTOS AUTOSED Per accident)S I S UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ wbRKERSCOMPENSATIONR2WC623453;01/16/2015 01/16/2016 X AND EMPLOYERS'LIABILITY Y/N TORY LIMBS ER ANY B OFFICER/MEMBER EXCLUDED?ECSIVEFN/A E.L.EACH ACCIDENT $ 11000,000 (Mandatory In NH) E.I.DISEASE-EA EMPLOYEE $ 1,000,000 If yyreres describe under DESGtRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,"mon space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CELLED BEF THE EXPIRATION DATE THEREOF,NOTICE WILL BE DE RED IN ACCORDANCE WITH THE POLICY PROVISIONS. EXPRESS ROOFER mi ke@expressroofer,com AUTHORIZED REPRESENTATNE 16 JONAS RD WE TFORD, MA 01886 ®1988.2010 AIMJDR ORPO TION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 i Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supenisor Specialty License: CSSL-099497 wo _, I �. AUCHAEL L C04TNFX 16 Jonas Road Westford MA 01986 'I l''\, Expiration Commissioner 04/24/2016 Office of Consumer Affairs&Busidess Regulation �OME IMPROVEMENT CONTRACTOR Registration: 108126 Type: ' expiration: 8/13/2016 DBA MICHAEL L.CORTNER-EXPRESS ROOFING Michael Cortner 16 JONAS RD WESTFORD, MA 01886 Undersecretary