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Home My WebLink AboutBuilding Permit #724 - 38 MONTEIRO WAY 6/24/2009TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer �20 r�c��QE CRIPTION OFWORK TO BE P�FORMED: ® �d a # Q� '- T\ --e n d Please Type or,Pr*nt Clearly) OWNER: Name: Address: CONTRACTOR Name:P Address: `t f � )Z� 1� � 04 7s '?Id, V 0167) Supervisor's Construction License: � (� Q Exp. Date: ,to�<J, Home Improvement License: (I G I Exp. Dater '7 j G Y( ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.0`0 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $.�,��, FEE: $ Check No.: 10 2) Receipt No.: '2 - NOTE: NOTE: Persons contracting with unregistered contractors do not have access to the guar ty fund Signature of Agent/Owner Signature of contractor I 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 Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: Comments Conservation Decision: Comments ng Decision/receipt submitted yes 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 MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 M 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 o 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 o Workers Comp Affidavit o 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) o 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 2.2008 Location 3g wUh 4-e,,�0 No. );L Date a o NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ swCHus Building/Frame Permit Fees $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # A; 22tc.0 Building Inspector p x w A O W v u LE L0 co u � co U � GO z z a b wR to C2 C Ex U w � U W z a a .0 z a4 G u. O U W W w o a, C/) w a O V GO z ri Z w A w W c W Z „ C/)cn v Q v ° CL Q Gj " o m ti `N r o 0 7f ... * " cm &j. INO Cc U CA ` c �'Z H t C/) a s ; 3 �. O H PIC � CLC -3 CD N CD VJ m cm =Sa go W^� Oy •O m t m Fri Z c � a o m c o x o m o , N F- m �- o NW O r...�L v.. .vyi at 2 7 yr W •E ci 'Oy • • Q AD V O 0 0 C g �jO h a O >CL go 0- C:03 O 0 z O U Cf) r a co O co O z °' CL O y � C O CM i O h O �O m m 0 co � E— .0 CL CD -ca -v CO � � o 0 a- C Q ca C CcC co c Z CD V y O C C — c H 0 LLI vI 0 W W W , W,ww Y/ �co � o w s O v C N C O Q C a'fl C E 0 C o � s R oco CL Q Gj " o m ti `N r o 0 7f ... * " cm &j. INO Cc U CA ` c �'Z H t C/) a s ; 3 �. O H PIC � CLC -3 CD N CD VJ m cm =Sa go W^� Oy •O m t m Fri Z c � a o m c o x o m o , N F- m �- o NW O r...�L v.. .vyi at 2 7 yr W •E ci 'Oy • • Q AD V O 0 0 C g �jO h a O >CL go 0- C:03 O 0 z O U Cf) r a co O co O z °' CL O y � C O CM i O h O �O m m 0 co � E— .0 CL CD -ca -v CO � � o 0 a- C Q ca C CcC co c Z CD V y O C C — c H 0 LLI vI 0 W W W , W,ww Y/ W o 0 o tr ° .r m � � nm► 3 g A m Rm W d O. G. A ' oo ='�� C6 '� m _moo —CAC O,O W (r1 v py ° o nm► � C W d O. G. A ' �-s ��O..�- _ c " m o �, fA 0 cn 0 CD ^ l 1 0 0 m � �m< &;O oz M q OZzm X -n< C) 0) m Nv 0 q CD 8181 � Ul N� A .. -+ V on 0 0 m o N V A CA m x0 ° o W p CD r -L O O ��O..�- cn :I CD ^ l 1 CD O '� C) �. O O 5 7q. 00 w O O - \ 0 www.naass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): V -'P cft 60 )� UI C9 71VC Address: "01 .305Vt/ P06T >4ji . E — 54�- 1 City/State/Zip: 1YA V WK0 r M9- G17fa�, Phone #: 'fig `lg/ 0/!3-0 Are you an employer? Check the appropriate box: The Commonwealth of Massachusetts 4, A 1 am a general contractor and I Department of Industrial Accidents have hired the sub -contractors Office of Investigations it tli.1, ' 4/1 ` 600 Washington Street Boston, MA 02111 www.naass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): V -'P cft 60 )� UI C9 71VC Address: "01 .305Vt/ P06T >4ji . E — 54�- 1 City/State/Zip: 1YA V WK0 r M9- G17fa�, Phone #: 'fig `lg/ 0/!3-0 Are you an employer? Check the appropriate box: L ❑ 1 am a employer with 4, A 1 am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. i 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.] officers have exercised their 3. ❑ 1 am a homeowner doing all work 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. D New construction 7. ❑ Remodeling 8. ❑ Demolition. 9. ❑ Building addition 10.❑ Electrical repairs or additions 1 l .❑ Plumbing repairs or additions 12.❑ Roof repairs 13.0 Other "Any applicant that checks boz # l 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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: cc om Ale, w t o),, -.7 A)_5 (/12+y c e- // Policy # or Self -ins. Lic. #: ticQ'g�g��g-t7/'t7/ Expiration Date: la//>51061 Job Site Address: 38.6 Ail.( l &6& +g , City/State/Zip: IV )ftwl/E K h -f4 01815 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 andpenalties ofperjury that the information provided above is true and correct. Signature: Date: 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 #: 06/15/2009 10:18 5084600803 HT INSURANCE PAGE 01/03 ACORDCERTIFICATE OF LMIUTY INSURANCE OSI MAI io9 PRODUCER HUTCHINS AND THREATT INSURANCE 488 Boston Post Road E THIS CIE nFN:ATE IS ISM AS A MATTeR OF IATK7N ONLY AND CONFERS NO MWS UPON THE COMCATE HOLOE3i. THIS CeRFWICATE DOES NOT AM ENq E7CfEND OR ALTER THE COVIEPAGE AFS E7Y THE POLK:IPS 8Ei0W. Marlboro, 14A 01752-360 TIOM POLICY NUMBS DATE EMMI Lam INSU MAFFORGSR9COVERAGE NUCS NSUREO INSURERA. SOOTTSDALE INSURANCE INSURER 8: SAFETY Franca Service, InC. INSURER C: CONTINENTAL 17gSURANCE 449 Boston Post Rd Ste 1 INSURER IX Marlborough I NA 01752 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TIRE POVCY 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. DATE TMEREDF, THE ISSRMKR INSURER WILL ENDEAVOR TO mm 30 DAYS wltlTlEN 38 Monteiro Way TIOM POLICY NUMBS DATE EMMI Lam NPOW NO OWJ=ION OR UAIIUIY OF MY KIND UPON THE INSURER. ITS AGENTS OR GENERAL LAWTr AUTHORIZED REPRESENTATIVE AFPRKRBRATTtlEi EACHOCCURRENCE 1,000,900 T11 2-50,000 A 1783116 COMMERCwLGENERALUABILITY :L31453569 CLAW MADE ® OCCUR MED EXP ITIRR R 2 5-00 PERSONALSADVNJIAY S1 000 OOO GEEIIALAGG RQ.RE S 2-00"0 OOO UErLAK,�GILTF,LMRAPPLIESPER PR0DUOTS-COMP4PAM It 2. 000 000 I X POLcYF7PRO LOG B AUTOMOBILE LIABILITY ANYAUTO CO BINEDSNMELMtf -.w o) i 1,000,000 BDOLYPIJURY S (��) i ALLOAMIEDAV" SCHEDUREDAUTOS BDOLYNAXTY i (Rsammtt) = HIREDAUTOS NONOWNFDAUTOS 6200893 9/22/081 9/22/09 NtQOtTYOAMAGE (ReflCG®IM) S I GAMEUIBR.ITY AU1OOKY-EAA00084T I i OTIERTHAN �� i AUIDON Y: AGO S 1_-, MY AUTO EXRESSNMBRELLALMaLITr BlGROOCURRENCE f AG(Ti SPATE S X OCCUR CIANSMADE iI S i DEDUCTIBLE i RETENTION S WORKERS COMPENSATION MID G E TA OFTICERIMEMBER EXCLUDED? 46-808498-01-01 12/16/08 22/16/09,ELM"ACam4f I ,T A X GIN - 500 000RE EL DISEASE-EAEMPLO/EE i 500,000 ELDIMASE-POLICYLW i5QO Q00 OTHER 1 I DESCRIPTION OF OPERARIONSI LOCATIONS I VE"QU I EXCLySIONS ADDED BY ENDORSEMENT/SPEGAL PROV610NS I e+GOMnf-ATZLVU M@ PAW_FR I ATIM " ACORD 25 (2001106) (PACUM COfPORATON 1988 CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE OESCRWO POLICIES89 CANCEI.LEO BEFORE TME EXPIRATION Paul Abourjaily DATE TMEREDF, THE ISSRMKR INSURER WILL ENDEAVOR TO mm 30 DAYS wltlTlEN 38 Monteiro Way NOM TO DI! CR9RTRFICATE VOIDER NAMED TO THE LEFT, BUT FARWRE TO DD SO SHALI North Andover, NA 01845 NPOW NO OWJ=ION OR UAIIUIY OF MY KIND UPON THE INSURER. ITS AGENTS OR REPRESEWATNEs AUTHORIZED REPRESENTATIVE AFPRKRBRATTtlEi Janet HOO"r ACORD 25 (2001106) (PACUM COfPORATON 1988 CERTIFICATE HOLDER CANCELLATION ACORD 25 CNCUM - 0 ACORD CORPORATION 1966 ONOyLD ANY OF THE ABOVE DOMMM POLICIES BE CANCELLED BEFORE THE EXPIRATION PAUL ASOUILTAILY 38 11DNTYIRO WAY DATETIEtWF,TMEIMiVPGINSURERMALENDEAVORTOMWL m GAYSWRITTEINOTICE 1ROILTH Alm, TSA 01845 TO THE CERTIFICATE HOLDER MAMW TO THE LEFT, OUT FALUM TO 00 SO SHALL SOW NO 08UDATIOP OR tJAMNUTV OF ANY KIND UPON TIME INSURER ITS AGENTS OR AFPRKRBRATTtlEi AUTIIOR@OREPRE1dTA 1783116 ACORD 25 CNCUM - 0 ACORD CORPORATION 1966 FRANCA SERVICES INC. Proposal 449 Boston Post Rd. East — Suite 1 PO Box 234 Marlborough, MA 01752 Phone: 508 4810150 Fax: 508 251 2326 HIC 150467 www.franeaservices.com CUSTOMER INFORMATION NAME: Mr. Paul Aboulaily ADDRESS: 38 Monteiro Way North Andover MA 01845 TELEPHONE: 978 258 3367 E-MAIL: abouriaily0-verizon.net DATE: 06/09/2009 Full Worker's Compensation Coverage $1,000,000.00 Liability Insurance Coverage PROJECT INFORMATION JOB LOCATION: same PRODUCT: Fiber Cement Siding / Exterior Painting DESCRIPTION: Fiber Cement Siding: Scope of work: • Remove masonry siding from front, left, right and back elevation; • Remove old home wrap on all four elevations; • Apply new 6 % James Hardie Color Plus (color by customer); • New Tyvek home wrap on all four elevations; • Outside comer and inside comer to be built -out with PT and wrapped with Grace Ice Water; • Remove existing outside comers, fascia board, rake board and replace for new composite material; existing soffit to remain; • Shutters and heathers will be removed and put back after section is done; • Existing ceiling and dental molding on front elevation to remain; • Existing windows trim in all windows and doors to remain; • Existing flat column on front elevation to remain; • New PVC molding for 1 (one) octagonal window on gable front elevation; • New PVC blocking for lights; • Flashing and caulking as needed it; Exterior Painting Scope of work: • 36 windows; • 2 doors; • 2 garage doors; • Soffit on front, right, left and back elevation; 2 flat columns; Ceiling on front porch; Total Price: $ 32,016.00 * The nails to be used on the siding it will be stainless steel, no puttying is necessary. If customer decides to putty (color gray) and than also uniform the color, it will be necessary to paint and this is not included on price. Due .to the..naure ofleahngw�th:ei control toseetl e`actual an ountoft estimate the damage>and the. cost h expected we will ..:review the:- damai Acknowledge: Mr. Paul Abouryaily r the age of the home or wateripet damage it. is `beyond our iagejhat_has occurred :until the work bas begun. We can onty �&on what:we'can see iUthe damage is larger'thaf:what we with= the homeowner and the additiorialcosts that wall° be .paid in full at the time of discovery via:a change order. if this settle basedi on work .performed :to date., FRANCA. SERVICES Rronal=costs _ on CONTRACTOR NOTIFICATIONS All materials is guarantee to be as specified as possible, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a _._ substantial workmanlike manner for the sum above. for a period of '1;2 months from the date of completion FRANCA SERVICES ;INC wmr.rants against any defect resulting from work .ship done. A product -Installed his Its own maiafacttt>e's-,warranty: Approx Start Date: June 15"' 2009 Approx. Completion Date: 3-4 weeks (Weather, material permitting) (Weather, material permitting) Payments to be made as follows: $ 7,500.00 deposit for materials (required 1 week prior to start) $ 4,235.15 after completion Any alteration or deviation from above specifications involving costs will be executed only upon written order, and will become an extra charge over and above the estimatAll agreements contingent upon strikes, accidents, or delays beyond our control. AUTHORIZED SIGNATURE: Note: This proposal may beAvithdrawn by us if not accepted within 30 days. 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 outlines above. Customer's Signajure