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Home My WebLink AboutBuilding Permit #150 - 360 ANDOVER STREET 8/27/2008 BUILDING PERMIT of NORTH q tstt�o , do TOWN OF NORTH ANDOVER ": '`- ` Z. APPLICATION FOR PLAN EXAMINATION # Permit NO: Date Received "4`"` 3q °q,T5 .o SSACHUS Date Issued: Wa IMPORTANT:Applicant must complete all items on this page LOCATION J60 Aly'b6W( S'rW l Print PROPERTY OWNERlea gq e Print . MAP NO: PARCEL: DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residenti Non- Residential New BuildingOne fa Addition Two or more family Industrial Alteration No. of units: Commercial Repair, eplacemen Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: fN3fA 1) a kgLACetAeN WlrudDLA.LS Identification Please Type or Print Clearly) Identification eoR 9� ria 6�aa OWNER: Name: G -� Phone: �' Address: ?6o A/ 6oveiq\ sr'Ree7- /1 ma x 41V6bV�& CONTRACTOR Name: AlFReb b 1 PR j177,& Phone: Address: o &71_Mtn1 D01..� AVECS'4/rm) A)A/ r Supervisor's Construction License:C 5"S'078' Exp. Date: �L?Oholb Home Improvement License: H0776 Exp. Date: i�/r"7/a,0Q 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: $ '�'A�r9, U U FEE: $ Check No.: 4_3 Receipt No.: l NOTE: Persons contracting wit re 's re contractors do not have access to the guaranty fund I signature of Agent/ caner Signature of contractor Location -f b 0 4AA ball, No. .1�6 Date NORTH TOWN OF NORTH ANDOVER + s + i Certificate of Occupancy $ Eta Building/Frame Permit Fee $ MUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 457 building Inspector i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public SewerSwimmin Pools Tanning/MassageBody Art Swimming 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS �A 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 Located at 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) i ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 ❑ 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) ❑ 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 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 NORTH own o An T f d over No. LAKE o dover, Mass.,_P/ COCHICHEWICK ORATED '9S E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System I BUILDING INSPECTOR j THIS CERTIFIES THAT.............( �"'c�/. ... .............. . ' .�.... ....... f - ' ..... .... c-1.e ..sl 'c��^F Foundation has permission to erect.........................:.......`...... buildings on ..,,. .... f!t'G!1.c L/f'............ ...........:.....:.... Rough Alk. /� 4?f. .............. Chimney to be occupied as......................... .G..`.... .....1/k. .,��. _ himne provided that the person accep iTng this permit shall in every respbct conform 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T TS Rough ............ ......................... Service UILDING CTOR Final Occupancy Permit Required to Ocmpy 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. The Commonwealth of Massachusetts Department of Industrial Accidents L Office of Investigations r 600 Washington Street Boston, MA 02111 ' www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): ��e U'K� di!/)� Address: o)P1ECIn111100 A 1/f City/State/Zip: 14/e)1,0 All Phone #:_661Y cF7,0 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.'R I am a sole proprietor or partner- listed on the attached sheet. 1 ?• Z Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL ILEI Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit.this aiidavii iiidicaiing they are doitig atl work and lien 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 their workers'comp.policy information. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: HEL, d&35P F Expiration Date: 9 d Job Site Address: City/State/Zip: 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Investigations of the DIA for' y Office of g insurance coverage verification. 1 do hereby certunder t ains and penalties of perjury that the information provided above is true and correct Si ature: Z Date: Phone#: G 6i_> Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: FROM : B BOSIES AGENCY FAX NO. : 603—e9e-5475 Aug. 25 2008 09:35AM P1 CERTIFICATE OF INSURANCE This certifies that STATE FARM FIRE AND CASUALTY COMPANY. Bloomington, Illinois ❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois insures the following policyholder for the coverages indicated below: Name of policyholder Stone Post Home Services LLC Address of policyholder 29 Elmwood Ave Salem New Hampshire 03079 Location of operations Description of operations The policies listed below have been issued to the policyholder for the policy periods shown, The insurance described in these policies is subject to all the terms exclusions,and conditions of those liciesPOLICY PERIOD,The limits of liabili shown ma have LIMITS reducedbeen LIABILITY aid claims. POLICY NUMBER TYPE OF INSURANCE Effective Date Expiration Data at beginniN of policy p2riod) Comprehensive BODILY INJURY AND 94BL0335$F Business Liability [ 04/01/08104/01/09 PROPERTY DAMAGE This insurance includes: ®Products-Completed Operations ❑Contractual Liability El Hazard Coverage Each Occurrence $ 500000 ❑ Personal Injury ❑Advertising Injury General Aggregate $ 1000000 ❑Explosion Hazard Coverage Products-Completed ❑Collapse Hazard Coverage Operations Aggregate $ 1000000 ❑ General Aggregate Limit applies to each project POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Date Expiration Date (Combined Single Limit) ❑Umbrella Each Occurrence $ Other Aggregate $ Part 1 STATUTORY Part 2 BODILY INJURY Workers'Compensation and Employers Liability Each Accident $ Disease Each Employee $ Disease-Policy Limit $ POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date Expiration gate at beginning of policy period If any of the described policies are canceled before its expiration date,State Farm will try to mail a written notice to the certificate holder 30 days before cancellation. If. however,we fail.to mail such notice, no obligation or liability will be imposed on State Farm or its agents or representatives. Name and Address of Certificate Holder e•'• s�'< y; , ,;-. Eleanor George Sig ure of Auth7— k�epmneseentt�afdve 360 Andover St. North Andover, MA 01845 Trtle 558-N4 a 2-90 Panted in U.SA, Date i FROM : B BOSIES AGENCY FAX NO. : 603-898-5475 Aug. 25 2008 09:35RM P2 ACORDCERTIFICATE OE LIABILITY INSURANCE °A�►ao"IYq"� PRODUCER f3ushn 21gurrvy THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION State Farm Insurance Companies ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 220 Main Street PO Box 6 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Salem, New Hampshire 03079 _ INSURERS AFFORDING COVERAGENAIC u - r- ZNfT�`naurance �....... n+suREo' Jtone post ome ervlCt? INSURERA; _ 7 ....... 29 L•lmwood Ave INSURER B; _.. _-.. _.. Salem, JVH 03079 INSURERC: INSURER D INSURER E' COVERAGES 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,AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSAA00'L DL POLICYNLLIBER VOUCYEFFECTIVE POUCYEXPIRATIOfMM=fyylN�� LIMITS LTR INSRQ TYPE PF INSUFIARCF GENERAL LIABILITY DAMAGE TORRENCE is RL COMMEACIAL GENERAL LIABILITY I I PREM'1 $ Ea eccurencel _ S CLAIMS MADE ;;I OCCUR j MED EXP(Any one Aaron) S I PERSONAL 8 ADV INJURY i b �— —� OENLAGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: j PRODUCTS•COMP/OPAGG E — POLICY: I PR_IpLOC AUTOMOBILELuABIUTY ( COMBINED SINGLE LIMIT I$ — i ;(EsecGGenu I ANYAUTO - - I ALLOWNEDAUTOS I BODILY INJURY b 7-7 SCrIEDULEDAU7pS I (Per pardon)- -- -•" HIREOAUTOS BODILY INJURY I S NON•OWNEDAUTOS (PerxcCenU — y PROPERTY DAMAGE I$ -- - (Per accident) GARAGE LIABILITY TO ONLY•EA ACCIDENT, S — _ I ANY AUTO i OTHER THAN EA ACC S-- AUTO ONLY: AGG S i ElCFSSNMfiAELLA LIABILITY I EACH OCCURRENCE b �-j f OCCUR �_ CLAIMS MADE I I AGGREGATE b DEDUCTIBLE --" --' RETENTION S WORKERS COMPENSATION AND 6S$9UB-3107554-3-0$ Eli1/08 511 WCSTATU OTM• _TQRY LIMITS, '• EMPLOYERS'LIASIUTY I I I EACCIDENT L.EACH •E ANY PROPRIETORMAATNENEXECUTIVE EMPLOYEE b 30�V0 V V0V0 E.L.DISEASE OFFICE"EMBER EXCLUDED? -~ S If Vol,"Wrioe under I E.L.OLSEASE•POLICY LIMIT S 100000 SPECIAL PROVISIONS pelprov OTHER i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL � DAYS WRITTEN Eleanor George NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 360 Andover St_ IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR North Andover, MA 01845 REPRESENTATIVES. S '�, r. °>,;•. AUTHORIZEDREPRESENTATIVE ACORO 25{2001108) Am b RPORATION 1988 Hc3rrre .Serc�s, L1.0 Proposal osa l Monday,August 18,2008 Client; Eleanor George 360 Andover Street North Andover,Ma- 978-682-6820 Scotoe Of Work Install and insulate 2 Harvey Industries Ma}esty 'Wood double-hung windows, with brass locks, 1/2 screens, primed interior,and almond exterior. Paint interior of windows with paint supplied by customers Touch up existing exterior window frame with paint supplied by customer. We Propose hereby to furnish materials and labor-complete in accordance with above specifications,for the sum of : $1,649.00 Payments made as foIlows: a. $649.00 ,Deposit is regerired to begin w� b. $SQ0.00 ,Once materials have been delivered and work has started c. $500.00 ,Once all work has been completed -- Checks are to bemade out to Stonepost Home Services,T I.C. Mating Address,29 Ekawood Ave,Salem,NH,03079 All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become and extra charge over and above the estimate.All agreements contingent upon strike%aunt%or delays beyond our control. Owner to carry fire, tornado and other necessary insurance Our workers are fatly cavezed by Wo man's Con Insumum Authorized SiturelAiz Nate This proposal maybe with drown by us if not accepted within days Acceptance of Proposal-The above prices,specifications and conditions are satisfactory and are herevy accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Date of Acceptance Signature-if ials�atcfttt €i`- pct!Ertmet of PutzEle Sa#'ct" is 42��,uiattions allt(l $oat'd (IV 1311 ( itl LO�S.ti4CtiQrl St1i.erv's License 55078 License'. CS a . Restricted to_ 00 s. . ALFRED A DtpRIMA III 29 ELMWOOD AVE SALEM, NH 03079 X�iratiore: 613012010 26803 ( „siuni:,i„ner e�navn� `j lations-and Standards Board of Bnilding Rego HOME IMPROVEMENT CONTRACTOR Registration:. 140996 Tr# 261835 Ezpiratiio.►j:__.8211712009 tiff' Ty¢e:-7ndhgdual ALFRED DiPRIMA IW- ALFRED DiPRIMA. � 29 ELMWOOD AVE: Administrator SALEM,NH 03079