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Home My WebLink AboutBuilding Permit #293 - 445 BOSTON STREET 10/17/2007 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS 4 - Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Conn ection/Sig nature&Date Drivewa Permit Located at 384 Osgood Street .`-FIRE sDEPARTM.EN7 :Temp)Dumpster on site rao Located at 124 MainStreet s AFare Depalrnent`�ignature�aate �COMIVIEN7'S �� ,r t { Location 3 ` No. '� Date ^TM TOWN OF NORTH ANDOVER O e Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 7 2069 Building Inspector i M1 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration 128612 Tri 129477 ikoi-f tion 4/28/2009 s Type D4A THOMPSON'S RQOFI�1Gy THOMAS DOYLEY 8 WESTS T Administrator SALEM,NH 03079 BOARp OP-BUILDING�REGULATIONS -'.'j UPERV ONSTRUCTIQN`SISOR License: C y I j Numbers='CS 060112 gtir� tlate 08/04/1956 Exp�reS 08/04/2008 Jr.not 28784 Rest�� ted THOMAS T DOYLE -v r 8 WEST ST SALEM, NH 03079. "` Commissioner ;- NQRTH 0 0Andover 0 0% JAI` �- o dover, Mass. /d' 1 • O T O a- LAK ' 2COCMICKEWICK ADRATED BOARD OF HEALTH PERMIT T D - Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......To . _4 ........e.*Art...O&A11%.. ......... ........?..... ......... • Foundation has permission to erect.................................... buildings on . ........�.. n............... ... Rough to be occupied as...... !l.:... O..A......... ............ Chimney ' .............................................................. provided that the person acceptfhg this permit shall in.every respect 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 CONSTRU T TS Rough Service BUILDING INSPE Final Occupancy Permit Required to Occupy 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 Office of Investigations 600 Washington Street t Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly -- me Name (Business/Organization/individual): !29/e `sk. s Address:_A at S f' City/State/Zip: IL Phone #: s If f 3.i Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 1 7. ❑ 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 officers have exercised their 10.E] Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12#eJoRoof 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. 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: QisS x-hi SA/ `% Policy#or Self-ins. Lic.#:Aft CA gC :>d L 4Q 1 Expiration Date: 0 Job Site Address: y r S AtA& 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 Office of Investigations of the DIA for insurance coverage verification. I do hereby certiunder the pains pVenalties of perjury that the information provided above is true and correct. Si nature: [ (/ Date: ( V Phone#: — e3 S- 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#: NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws:Chapter 148 Section 1 OA. The debris will be disposed of in: Ld t� R Sca 6 K)s f+ (Location of Facility) Signature o Permit Applicant Fire Department Sign off: Dumpster Permit Date �1 CORD CERTIFICATE OF LIABILITY INSURANCE FDA (MM/DD/YYYY) k 03/2007 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Pelham Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 960 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 122 Bridge Street Pelham NH 03076 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Nautilus Thomas Doyle INSURERB:Associated Industries dba Thompson Construction & INSURER C: 8 West St• INSURER D: Salem NH 03079 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 T1 IE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS-.AND _CONDITIONS OF SUCH POLICIES_ r+Gv+«vi-�+E LIMITS SHOWN MAY HAVE BtEN REDUCED B`Y�AID CLAIMS. -- - - INSR ADO'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD/YY) DATE(MM/OD/YY) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY NC 532152 04/15/2007 04/15/2008 DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ CLAIMS MADE F—I OCCUR MED EXP(Any oneperson) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PE+t PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY JE(T LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY . AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ I FIOCCUR ESS/UMBRELLA LIABILITY EACH OCCURRENCE $ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE I - $ RETENTION $ $ B WORKERS COMPENSATION AND AWC7012214012006 04/21/2007 04/21/2008 X TORY LA ITS OTH- ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? If yes.describe under E.L.DISEASE-EA EMPLOYEE$ 100,000 SPL-CIAI_PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Various Construction L CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Mike Rodden Construction FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. 47 Prescott AUT ORIZED REPRESENTATIVE N. Andover MA 01845 ACORD 25(2001/08) ©ACORD CORPORATION 1988 INS025(01G8).07 AMS VMP Mortgage Solutions,Inc.(800)327-0545 Page 1 of 2 � Page of 'Propogat Free Estimates 105 Haverhill Street Fully Insured Methuen, MA 01844 THOMPSON'S ROOFING (978)691-1355 Shingles - Slate - Rubber Roof Single Ply - Copper Work PHON PROPOSAL SUBMITTED TO E! 7 WE 19-7-07 Tom Connolly /J STREET JOB NAME 445 Boston Street CITY,STATE AND ZIP CODE JOB LOCATION North Andover MA 01845 ARCHITECT DATE OF PIANS J013 PHONE we hereby submit specifications and estimates for: _S.t in- off_-al I cn% Renail all loose plywood Install aluminum drip edge around roof line Apply ice and water shield 6 ft. up all along edges Apply 15 lb. felt paper on rest of roof area Reshingle with a GAF timberline 30 Architect shingle Install flanges aroun soil pipe Install a ridge vent ( Remove all workrelated debris 30 year warranty on material 5 year guarantee on labor construction lic. #060112 improvement #128612 Ue j)r0P!9t hereby to fumish material and labor-complete in accordance with above spedf"dons,for the sum of: Sevn thousand four hundred dollars($ 7 ,400 . 00 Payment to be made as follows: $3 .000 . 00 start of lob balance upon completion A I material is guaranteed to be as specified.As work to be completed in a wolara wa manner w J according to standard practices.Any alterehon or deviation from above g Aud0 2oksAX I �.� antra costs Mall le smWed'ornly upon written orders,and wM beeonre an Oldra charge ova►and above the estimate.All agreenterits aonthvw upon strikes,eoeldents or delays beyond our aybe workmen's control.Owner to carry fire,tomado and other necessary kvianoe.our workers aro fully witfrd<awn by us if not accosteddote:This propose!m"witbe � days covered by Cor ton Insurance. Receptance Of ri>ipOga[—The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the OL work as specified.Payment will be made as outlined above. sis" Date of Acceptance: ` Q Dimension i 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 - 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 i New Construction (Single and Two Family) I ❑ 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