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HomeMy WebLinkAboutBuilding Permit #127 - 41 Milton Street 8/14/2012 BUILDING PERMIT c� pORTH q ,TL�D 6 ti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� �a . . Permit NO•. Date Received '1/pA°RATE°�'P"0�4`� �SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page LC?CAt .ION �� lm j Novi St -- Brin- PROPERTY`OWNER, /-I-( La- Print • J - - "MAP NO` PARCEL: _ ZONING DISTRICT:. Historic.District yes- no, Machine Shop Village yes; no TYPE 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 W611 - floodplain Wetlands Watershed',District' Water/Sewer, DESCRIPTION OF WORK TO BE PREFORMED: A164,on �rr��calafi`drrt ins, /ate "//s _ Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR_ Name- _��'�-�(iL1SL-)IJh®s2 Phone: ?25-/ ��'� �� T� -Address Supervisor's,Construction License,— loer --.5xjzrt Exp. .Date Home Improvement License::. Exp. .Date_ . ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ k3,0(D0_-0C:, FEE: $ Check No� Receipt No.: NOTE: Persons contracting with unregistered contractors do not h access to the guaranty fund ct Signature of Agent/Owner Signature:of contra 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 Signature COMMENTS a s 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 -Temp Dumpster on-site yes no. Located-at 124 MainStreet 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) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 VOTE: 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 No.R Date /a)-- • • TOWN OF NORTH ANDOVER n- Certificate of Occupancy Building/Frame Permit Fee f� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#� 25613 Building Inspector NORTH .own of � ndover O .,ti. 0 : No. % h ver, Mass, 1. COCNK Nl WKK V - S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .............�.��...W................... .... .............................................. BUILDING INSPECTOR 1 Foundation has permission to erect ..........r............... ildings on ... .C........ .. ........4e.......�............................ .................... Rough to be occupied as !. ..�.— ,-,,.� —�-' Chimney provided that the pelSsn 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 3(aw UNLESS CONSTRU N S TS Rough Service ............ ... ............... Final BUILDING I PECTOR 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. SEE REVERSE SIDE NORTH --own of t EAndover 0 :. - � No. �wow % h ver, Mass, C OC NIC"t WIC S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System s BUILDING INSPECTOR THIS CERTIFIES THAT .............(r.�.. ..... ...W.................... ................................................... has permission to erect (g,6.. ... ildings on .�........ .. .....I... v.4 .......,,,,,, Foundation ........... .............. Rough to be occupied as /''.WSJ. ..�. .......................... Chimney provided that the pe;ln 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 34* UNLESS CONSTRU N S TS Rough Service, ............ ... ............................... ............... Final BUILDING I PECTOR 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. SEE REVERSE SIDE 362 Eastern Avenue Lynn, Massachusetts 01902 781-598-7043 • • ' Memo To:Building Department CC: Date: 08/1412012 Re: permission for Neil Moore to pull permits To Whom It May Concern: I, Albert Souza give Neil Moore permission to submit paperwork on my behalf in order to obtain building permits for Danetti Insulation Company. Thank you Albert Souza 1 _ Job Number.. W7 8131201 Client Elena Walley . address 41 Mllton.St 1-Floor.- . . :. city l town. North An over: :.. contractor 1.WEATHERSTRIPPING/CAULKING QUANTITY" TOTAL •AUDrrOR NOTES-" " Door Kits Q-Lon or Equiv. Door Sweeps(Regular) 0 . 0.00 Door Sweeps{Automatic) - 3. fi9.00 Reglaze IMndows.An.inch 0 0.00, Window.WeathstrSdtlegal.perside 0 0.00 Tenmat Recessed Can Cover 0" : " 000 AtticfBasementbypass sealing manthr:.. Attic sealing with 2-part foam inarilhr : A :.0.00 SUBTOTALS :' 415.60 2A.INl=1LTRATION 1 INSULATION - AUDITOR NOTES - - Domestic pipe Hot-Water Tank 1st 6' 1 15.78 - Sill Insulation R-19 CF 0 0.00 SfILTwo Farf Foam w/Fiberglass.Batt 0 0.00 e Drape Perimeter R-5 Arich.Sq.ft: 0 0.00 . Perimeter 2".T-max or equlvaleM foam board sq:ft. 0 0.00 Drape-DOOR R=5 or T-4nax or equivalent on door.- 0 ,. 0.00:. Tape Joints jAluma Grip only)per hr. 0 0.00 -Ductlnsulation.&Tape"sq.ft:R-5 0` - 0.00 Rigid Foam Board Anch.="1'per board 0. 0.00 tiydron'ic pipe insulation to"1°"R-5 .-.-.--o --0.00 HydnMic pipe in5.1 25"-1.5°R=5 0 0.00 Steampipe Ihs.to1.25"-iron pipe R-5 - _ 0 : 000" Sieampipa ins.1:5"=2"iron pipe R-5 0 . 000 Steampipe Ins:-3".trQn'pipe R-5,.. 0 0.00 Air ConditionerMesting,Rai 0 0.00 Air Conditioner Cover 0- 0.00 , Air Conditioner Cover Special Order .0 0.00. SUBTOTALS,: 15.78 - 2t3.INSULATION: - AUDITOR NO'T`ES. . - Open Unrestricted R 49 :. 0 -.0.00 Open Unrestricted:R 38. 0-: 0.00' : -"--Opbri UnrestdcteidR 30. _.. . .0" :"0.00 = Open Unrestricted.R 20 :... 0 0.00 .Open Unrestricted"R 10 0 0.00 Reshlct FUSlol*-R 30 0'' 0.0.0 Restricted,FUSloped R 20'__ .0 0.00 Restrict FUSloped:R 10 0 0.00 R-19 FGB open raf rslwalislkneewails 0 0.00 - 1141 FGB:open refteis/walls/krieswalis-: :. `0 :. 0.00:. Attic,Stairs(stairwell.&cemrnori wall) .0 .0.00 Cover Pull Down Stairs Thermadome- �0" 0.00 Site;burlt.obli down stairs-2"foam box - 1 -180.00 - 2-Hoor M11 INSULATE ATTIC.AND WALLS USING.BLOWN CELLULOSE :. . :. gy Boom M Cst-aft-Miltz - _ - Type� Nadi AMIMAM _mar_ Cbwk Lm : _ 4� L2-0 1 [�g -- - t II boo 1143 - - - - - _ Value - " per- mift! ow DO L&O3 AdAwVWMfg seen era mom ffoaiwft IPPIR - _ - WPM 7 I-- S f2-smaawg2womemeat & mm43m& �. °°� ACORD�, CERTIFICATE OF LIABILITY INSURANCE OATS(MM/OD/YYYy) [th CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 07/05/2012 TIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED RESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. RTANT: If the certificate holder is an ADDITIONAL INSURED,the clic es)must be endorsed. ff SUBROGATION IS WANED,subject to rms and conditions of the policy,certain policies rrla p yU icate holder in lieu of such endorsement(s). y require an endorsement A statement on this certificate does not confer rights to the ER Insurance Agency, Inc. NAME: roadwa atiroEr<t: (781)593-1200y WC,No:Square ADDRESS:MA 01904-2602 INSURER(S)AFFORDINGCOVERAGE INSURERA: Arbella PrOtectiOn InsurCo NAICDanetti Insulation C/o Edward Chamny INSURER B: Safety Insurance CO any 362 Eastern Avenoueue INSURER C: Commerce & Industry Insurance Co Lynn, MA 01902-1626 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER:006 INSURER F: THIS IS TO CERTIFY THAT THE POU IES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A180 NFOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITENT WITH RESPECT TO WHICH THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIION OF ANY CONTRACTOR OTHER DOCUM CERTIFICATE MAY ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE-TERMS, MITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER GENERAL UABIUTY MMID MMIDDIYYYY LIMITS 850004041 06122/2012 06/22/2013 EACH OCCURRENCE s 1,000,00 X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE Fy I OCCUR PREMISES Ea occurrence) $ S0,000 A MED EXP(Any one person) $ S'00 PERSOI&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1 000 00 X POLICY JEtT LOC PRODUCTS-COMPlOP AGG $ 2,000.000 AUTOMOBILE LIABILITY $ S02214C 07/08/2011 07/0812012ANY AUTO Es aociderrtLIMIT s 1,000,000 B ALL OWNED— AUTOS X SCHEDULED BODILY INJURY(Per person) $ NON-OWNED BODILY INJURY(Per accident) $ X HIRED AAUTOS UTOS X gUTOS Per aocideM $ UMBRELLA UAB $ OCCUR EXCESS UAB EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION$ ANDD EMMP oYs UABIILIITY WC001605728 01/04/2012 01/0412013 s ANY PROPRIETORIPARTNERIEXECYIN TORY LIMITS X ER C OFFICERlMEMBER EXCLUDED? N/A EL EACH ACCIDENT $ 500,000 (Mandatory in NH) UTIOTM If yes,describe under EL DISEASE-EA EMPLOYEE s S00,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 fSCRIPTiON OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) oRID Corporate Services LLC d/b/a National Grid d/b/a Boston Gas Co, d/b/a. Colonial Gass Co, d/b/a :sex Gas CO, and Action Inc and Greatern Lawrence Community Action, and the certificate holder are Iditional insured ERTIFICATE HOLDER CANCELLATION AX: 978.654.7919 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE (?;EXPIRATION DATE THEREOF,NOTICE WI E DELIVERED IN ACC ROANCE WITH THE POLICY PROVISIO Community Teamwork, Inc A III ATTN: Lawrence Bevere A DREPR ENTATIVE 45 Kirk Street Lo ell, MA 018S2 ©1988-2010 AtORO MR O Ii rights reserved CORD 25(201") The ACORD name and logo are mgmL marks of ACORD 2=�'' ��l*r�saclruaeti+-l3c�rar turcat"Public>afel► &card ref$uildiMZ Regul,tion.and-Standard,. risorSpecialtyL:L_ s License: CS SL 102707 # t Restricted to: IC .ALBERT SOUZA -4 RANTOUL ST UNIT 1 BEVERLY.MA 01915 intm.i,.i..urr Expiration_ 525,2M3( - - --- --- Trg.- 102707 �� Wommomma" 0/� Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement-Contractor Registration _ Re_glstration: 135956 Type: DBA Expiration: 5/28/2014 Tr# 223334 DANETTI.INSULATION CO. EDWARD'CHAMPIGNY _ 362 EASTERN AVE. - - LYNN, MA 01902 Update Address and return card.Mark reason for change. E] Address .[] Renewal EmPloyment Lost Card SCA 1E zones, C�1e zzznzanrar�zlfii o C�/f�ivarlucsetl3 License or registration valid for individul use only Office of Coummer Affairs&BuAdm Regulation E IMPROVEMENT CONTRACTOR before the expiration date. If found return to. _- - Type: t16ice of Consumer Affairs and Business Regulation eg'lstratiom 135956 10 Park Plaza-Sake 5170 iraffon: 5128120_]4_ DBA Boston,MA 02116 DANEM INSULATION`CO EDWARD CHAMP16NY=° 362 EASTERN AVE Qa�� LYNN,MA 01902 Undersecretary Not valid without signato