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Home My WebLink AboutBuilding Permit #321-16 - 40 WOODBRIDGE ROAD 9/14/2015 S�AM✓v�� //23//S NORTH BUILDING PERMIT �# c�o6s ``o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: r Date Received °, •�s,�: " q�RSTeO � Date Issued: 9SSACHUS�t IMPORTANT: Applicant must complete all items on this page LOCATIONU Print PROPERTY OWNER S fi eU� �_ �d✓tom Print MAF NO: PARCELP ZONING DISTRICT: Historic District yesno Machine Shop Village yes no . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial IN/Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other - ❑ Septic ❑Well ❑ Floodplain DWetlands 0 Watershed District ❑Water/Sewer rLiDvj CIaSS J— Ce«u1o,S,-_ _l.y��izc t� � I Vt 2✓tt�t�X f O��r 3� 1�11z� S � I� (�a Xr��' �,�.�( o+� t Identification Please Type or Print Clearly) OWNER: Name: 5-reye- NOO✓t-p- Phone: 9-7 b-s t Address: CONTRACTOR Name- -7yI-91q-g0_L Phone:ce,(� `774-a� Address: •> Supervisor's Construction License-' Exp. Date: Home Improvement License: Exp. Date: ov L(15 ARCHITECT/ENGINEER Vu" � Phone: �( Address: Reg. No. FEE SCHEDULE:BULDING�PIERMIT.$12A0 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F. Total Project Cost: $ I 0o FEE: $ 1 Check No.:_ j� 7—, Receipt No.: NOTE: Persons-'contracting with unregistered contractors do not have access to Un fund j Signature of Agent/Ownergnature of contractor —� l Plans Submitted❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ e TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dutupster on Site ❑ k THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I CONSERVATION Reviewed on Signature . COMMENTS I HEALTH Reviewed on Signature COMMENTS 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - TempkDumpster onsite eyes ._- ..�_ ._ . nog Located at-124,Main,Street Fire,Department signature/date q COMMEN, S 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.$10041000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 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 L3 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 Li Building Permit Application ❑ Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/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 o 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:Building Permit Revised 2014 Location vv �l � No. Date . - 1 TOWN OF NORTH ANDOVER Certificate of Occupancy $� Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee $_y TOTAL $ ChecY ti r'� �, Building Inspector � NORTH N Town o ndover O µ to -�v Vh ver, Mass O LAKI COC NK neWIC« A. S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT ..........Z14.11&...14.0BUILDING INSPECTOR .. .............................................. has permission to erect ..... buildings on ... ....... Aft V% Foundation Rough Poo=to be occupied as 4 ...... ............ ....W. ..�................ 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 MMOTH ELECTRICAL INSPECTOR UNLESS CONSTRUCTI Rough Service ..........I.... .. ........ ............. Final ILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final YY No Lathing or Dry all To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. i ROBERT F. CALNAN Cell 774-222-2848 CALNAN'S ENERGY SYSTEMS, INC. 105 Harvard St., #5, Waltham, MA 02453 Office(781)894-9626 rfcalnan@gmail.com Steve Noone September 11, 2015 40 Woodbridge Road North Andover, MA 01845 978-808-5176 sjnoone@yahoo.com RE: Contract for Wall + basement perimeter Insulation Insulate shingle covered first and second floor exterior walls as described below; Seal basement as needed to help contain insulation materials. Drill holes as needed for access on interior side of exterior walls to be insulated. Insert tube into wall cavity. Fill exterior wall cavities to capacity with Class 1 Blown-in Cellulose (Dense Pack). Seal all holes weather tight. Any areas that are sufficiently insulated will be deducted from cost of job. Install 2" Thermax over open gable wall accessible through garage ceiling access. Total Cost = $5786.00 Insulate overhangs between first and second floors as described below; Same description as walls. Total Cost = $816.00 Insulate basement perimeter as described below; Seal accessible bypasses, install 2" Thermax Polyiso on all band joists and sill boxes. Total Cost = $1332.00 Grand total = $7934.00 + Cost of permit We are not a Mass Save Contractor Payment Terms:$100.00 upon acceptance, balance t in full upon Completion of job (Same Day) We accept: Cash and Checks as forms of payment We provide a One-Year Warranty on Labor&Materials. 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 the above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control.Registration#108453-Home Improvement.Owner to carry fire,tornado&other necessary insurance. Our Employees are fully covered by Workers Compensation Insurance. Authorized Signature: Ro-&rt't F. cati1a4V Acceptance of Proposal: The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined. Customer Signature— pate� /�/ I The Commonwealth of Massachusetts Department of Industrial Accidents 4 Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Calnan's Energy Systmes Inc. Address:105 Harvard St. Unit 5 City/State/Zip:Waltham, MA 02453 Phone#:781-894-9626 Are you an employer? Check the appropriate box: Type of project(required): 1.Q I am a employer with 4 4. ❑ 1 am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling These sub-contractors have ship and have no employees 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself m se ' right of exemption per MGL Y LT`1o workerscomp. 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.01 Otherinsulation 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, lContractors 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 is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Liberty Mutual Policy#or Self-ins. Lic.#:WC2-31 s-384495-015 Expiration Date:2-4-16 Job Site Address: L40 Lk)W r'&J.0 Ac"J City/State/Zip:.Afwl`k 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 insu an cove ge rification. I do hereby certify under the pai nd p n ' s of perjury that the information provided above is true and correct Signature: Date: CY —(-I 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): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 3/13/2015 7:42:05 AM PST (GMT-8) FROM: 100005-TO: 19785214669 _ Page: 2 of 2 AC ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD"M 3/13/2015 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: H the certificate holder is an ADDITIONAL INSURED,the Policy(ieS)must be endorsed. H SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certHicate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER COWAN INSURANCE AGENCY INC A T 359 MAIN STREET - NaMe HAVERHILL, MA 01830 PRONE FAX NIAAIL DRESS: INSURE 8 AFFORDING COVERAGE MAIC U INSURED NSURERA: Liberty Mutual Fire Insurance 33600 CALNANS ENERGY SYSTEMS INC INSURERS: 105 HARVARD STREET UNIT 5 NSURERC: WALTHAM MA 02453 NSURIERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 3805888 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. LTR TYPE OF INSURANCE DL BR POLICYEFF POLJCY EXP POLICY NUMBER MMN MMIpOryYYY lL1ITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 1-1OCCUR PREMISE =r'ran.l S MED EXP(Any one person) $ PERSONAL BAOV INJURY $ GEN'L ACGREGATE LIMIT APPLIES PER: POLICY❑PRO- ❑LOC GENERAL AGGREGATE $ PRODUCTS-COMPJOP AGG $ OTHER: AUTOMOBILE LIABLRY ANY AUTO emident I $ ALL OWNED SCHEDULED BODILY INJURY(Per parson) $ AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUAUTOS TOS NED AUTOS PPRrPETYpgMAGE $ ARELLA LIAB OCCURSS I)AB CLAIMSADE EACH OCCURRENCE $ ' RETENTION S AGGREGATE $ A WORKERS COMPENSATION WC2-31 S 3&t495-015 $ AND AEMPLOYERS'LIABILITY Y/N 2/4/2015 2/4/2016 STATUTE OR ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBEREXCLUDED? N/A E.L.EACH ACCIDENT $ 500000 (Mandatory in NH) if Dyes,describe under E.L.DISEASE-EA EMPLOYE $ 500000 DESCRIPTION OF CPERATIONS below E.L.DISEASE•POLICY LIMIT $ 500000 DESCRWTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addibmal Remarks Schedule,may be eeachod N more epece Ie required) Workers compensation insurance Coverage applies only to the workers compensation laws of the state MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 36 BARTLETT STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ANDOVER MA 01810 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ��Liberty Mutual Fire Insurance 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 23805898 CLIENT CODE: 1582096 Anne Chandler 3/13/2015 10:39:07 an (EDL) Page 1 of 1 �t Board of Building Regulations and Standards License: CS-058232 Construction Supervisor ROBERT F CALNAN (�f 105 HARVARD ST.#Sr e5 WALTHAM MA 02453' t � r Expiration: Commissioner 08/0712017 V�zc pa rzm-arxr+e �l a� 1/3 A, office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR registration 108453 Type: = kpiratibn: 8/18/2016.. Private Corpo�ratio CALNAN'S ENERGY'SYSTEMS•1NC: .fl Robed Calnan l 105 HARVARD ST UNITS WALTHAM,MA 02453 Undersecretary, i I i I �