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Home My WebLink AboutBuilding Permit #282-14 - 45 SECOND STREET 9/27/2013 a �„ OF NORTH .q BUILDING PERMIT 3? 4•`�``o °.6 -- TOWN OF NORTH ANDOVER ° o APPLICATION FOR PLAN EXAMINATION * - b Permit NO: Date Received `� « 4 Date Issued: CHUS �9SSArap IMPORTANT: Applicant must complete all items on this page LOCATION 45 2nd Street Print PROPERTY OWNER Charles Woods Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yesno Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building R One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 6d Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer Full re-roof Identification Please Type or Print Clearly) OWNER: Name: Charles woods Phone: 978-360-7709 Address: 45 2nd Street CONTRACTOR Name: Romain Strecker Phone: 781-462-8702 Address: 10 Churchill Place,Lynn MA 01902 Supervisor's Construction License: 096385 Exp. Date: 10/8/2014 Home Improvement License: 169698 Exp. Date: 7/27/2015 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 C4 500.00 FEE: $ 4 st, Check No.: Receipt No.: , NOTE: Persoils dentrficting with unregistered contractors do not have access to th'e—Ajaranty fund Signature of Ageot/Owner Signature of contractor S - Plans Submitted-0 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ .TYPE,OF-SEWERAGEDISPOSAL' 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:APPR-OVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS II .CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 DPW To`o Engineer: Signature: Located 384 Osgood Street FIRE-DEPARTMENT Temp Dumpster on site yes no Located-at 124 Mair Street Fire Departinerit-signatifee/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 Yep No DANGER ZONE LITERATURE: Yes No MGL Chapter-166 Section 21A-F and G min.$10041000 fine NOTES and DATA— (For department use f ® Notified for pickup - Date Doc.Building Permit Revised 2010 -- r Building Department The fol owing 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 o Photo Copy Of H.I.C. And/Or C.S.L: Licenses o 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 ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li 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) o Building Permit Application ❑ Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit a 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 I In all cascs if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apo,-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.rted with the building application ' Doc: Doc.Bui?ding permit Revised 2012 Locatio D., l No. —1 Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee �$ TOTAL $ Check# (_ Building Inspector NORTH own of E �, ndover o � Z o h , ver, Mass, COCNIC"*w CN S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT �I�.r.��._.........` 104D s. BUILDING INSPECTOR .............. ...... ................................................... .............................. Foundation .. . has permission to erect .......................... buildings on ......... r......ala...... Rough to be occupied as /� p� ....................... .`.�...... .. .Q ....�.............................................................. Chimney provided that the person accepting this permit shall in eve espect 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO A Rough Service ................... ........................... ............. Final BUILDING INSPECTOR 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 T H E h BOSTON SOLAR C O M P A N Y SO 11�Project Address: 45 2nd Street North Andover, MA1845 Date: 9125113 Customer Name: Charles Wood Phone Number: Email: MATERIALS AMOUNT SUBTOTAL O Architectural North Andover Dual Gra Roof Material warranty-30 year warranty from IKO. Roof I abor warranty-Q,larao- 'from leaks norl ntber installment cla ec s tor 5 years after installation clate. MATERIALS TOTAL LABOR HOURS/DAY SUBTOTAL Remove old shingles&felt paper-dispose. Re-install all new felt paper&Ice/Water Shield at bottom dges of roof surfaces(2 layers)and sides of roof(1 layer) New drip edge along all edges of roof. Install shingles according to manufacturer's specifications. Does not include-repairs that may be needed to roof sheathing. IL Contract Total: $ 4,500.00 Customer Acceptance of Boston Mar Signature Contract Initiated Copyright 0 2012 The Boston Solar Company,LLC. All Rights Reserved. Designated trademarks and brands are the property of their respective owners. 03/27/2013 04:46 17815955820 AMBROEE INSURANCE PAGE 63/03 Aco CERTIFICATE OF LIABILITY INSURANCE 13/27/2013 THIS C1;RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS HO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIMCATE; DOES NOT AFFIRMATIVELY OR NEGATIVELY AIiiEHD, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. T141S CERTIFICATE Or INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE 1SSUtNG INSURER(a} AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; If 4119 earlIf icate holder is an ADDT'IONAL INSURED,tho palWRes}must be endorsed. if SUBROGATION IS VV{MVED,au*ot to the term:and cwldlOons of the policy, gamin pollens&may require an endorsement. A statement an 4hls aer0ftne does not confer rlylits to the cal0lla&0 holder In lieu at such endoraom9ntrs, PRODUCER Ambrose Insurance Agency, Inc. NAM I 56 Central Ave. L -592-8200 a�oNa781-59b-5828 Lynn, MA 01901 -ADDRESS: MUR111130 AFFMINO COUMME NMCP INSURERA;CO10r1 j IN3JRE6 Boston Solar CO. , Ina. INSVRFR B;3afaty IwSURERC;Nat octal Mon Fire of Pitt9b�ILgft 1 10 Churchill Pl. IVOURERD:LS.b®rty Mutual Lynn, MA 01902 1"URER E.. 14SURER F COVERAGES CERTIFICATE (NUMBER: REVISION NUMOEP,: THM 3 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE �OUCY PERIOD IND'GATED. NO-WITHS-ANDING ANY REQUIREMENT,TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TG IA74 DH THIS CERTI=KATE MAY BE ISSUED OR WAY PERTAIN, THE 114SURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS 811.19J=CT TO ALL THE TERUS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ,IBR LTR TYPE OF INSURANCE r POLICY NJMHER lNMIDapynLIEW. LIMITS (GENERAL LIABILITY EgCH OOCuRwE F S 1,000,000 S COMAIERMAL GENERA.LIABILITY ' �RBMIS6S ESe oocurrerrce S 100,000 OLAIK AIADE 0 OCCUR •ME7 W(Ary we mrsT) L $ 080 A -- — GL4046208 .2114/132/14/14 PEF2r,- ,L6ADVINJUR" f 1,000 r0O0 7 1 GENERAL ACOREGATE 42,000 ,000 tewl-AOGREGATic LIMIT APPLIES P_I%: PRODUCTS.C011PIOP AGO 1 2,000,000 POLICY X: LOC I i AUTOMOBILE LIABILrTY rEaaofden 1 000 000 ANYAUTO I BODILY INJURY(Par poman) :r ALL OWNED SCNEDULEq umvvse 8 AUTtir3 ,x IOi7L'INED Y 8216592 1/2 /23114 rirLYlnuuRY(Pr�..uc>dm0. a KUPERTY HIRED AUTOS 'x aU-O5 Par dcddan � 9 I 9 UMPOLLA LIAb IX OCCUR EACH OCCURRENCE t 5 r 0 OO 00 0 C R EXCE130 LrAB CLAIMSdMDE EBU-867910167 2/13/1 2/13/1 AC�GREOATf s 5.000 OOD DED !RETENT16k 3 s 1'10RQW COMPENSATION LY y�P.TLF CT- I ANDERPLOYEIRS'LIADILITY rrN Dur PPo 1-wz-o PA:rrwMZ0 rrt [,L,EA" S 1,000,000 D QPRCEFIK9re6i OMLLCEDr NrR (MerrorIW le Nrll •WC2-31S-3134393-013 1/14/131/14/141E,L,DISEASE-EA Eh1PLOYECs 1 000 000 r dtxbounler DES:RIPT'SON O-(1PfanATICN$be'ow E.L.DISEASE-POLICY LIMIT n 1 0 00 000 A Installation Floater GL40462DR 2/14/132/14/1I $2 1 5 000 13UGRIPT ON OF Or ERATI4HS(LOCATIONS JVEJHrCLES{ lOn ACOFeD 101,Addlumal Ranarke Sel'aduio,If rrxe wa09is recuired) Solar Panel Installation CERTIFICATE HOLDER CANCELLATION I Z'Q9:n Of North Andovi�r SHOULD ANY OF THE ABOVE DE$CRIi3ED 50LICIEs BE CANCELLED BEFORE THE EXF11PAT-on DATE THEREBF, NOTICE WALL BE DELIVERES IN Attn. : Building Dept• ACCORDANCE WITH THE POLICY PROVISIONS. Tonin Hall North ,Andover, MK 01645 AUTuoRI;F0 REPWt=NTATIVE 1 3 1 ACOIZD CORPORArON, All rights mammad, ACO RD25(201 ME) The ACORD name and logo are mglstar@d marks 0f 0 d �' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): The Boston Solar Company Address: 10 Churchill Place City/State/Zip: Lynn MA 01902 Phone #: 617 858 1645 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 2 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. t 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 required.] officers have exercised their 10.[:1 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑ 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.® Other solar installation comp. insurance required.] *Any applicant that checks box#I 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: Liberty Mutual Insurance Policy#or Self-ins.Lic.#: WC2-31 S-384393-013 Expiration Date: 1/14/14 Job Site Address: 45 2nd Street City/State/Zip: North Andover,MA 01845 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 and penalties of perjury that the information provided above is true and correct. Signature: �P� Date: 9/26/2013 Phone#: 617 858 1645 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#: C�/�e�^o»znznrrrr�ur't�a�C��?�cr.:;;ac�ute(t Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 169698 Type: Office of Consumer Affairs and Business Regulation xiration: 7/27/2015 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 THE BOSTON SOLAR COMPANY INC. ROMAIN STRECKER 10 CHURCHILL PLACE LYNN,MA 01902 Undersecretary Not valid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers isur License: CS-096365 t I " r. ROMAIN D STREtKE '�' 10 CHURCHILL RLA* '1 LYNN MA 0190E - f W Expiration Commissioner 10/08/2014