The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #802-14 - 5 WEST WOODBRIDGE ROAD 5/1/2018 ac....i BUILDING PERMIT 3a ,•,,•, <..�,,, 00 TOWN OF NORTH ANDOVER w 2. APPLICATION FOR PLAN EXAMINATI, _a Permit NO: Date Receii ».as.�- Date Issued: RSs�CHU IMPORTANT:Ap2licant must complete all items on this page LOCATION 5^ � '� �uvoa�. �� e✓f Print PROPERTY OWNER �- � "vq Print MAP NO PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes o - TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial K Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer RDOT 4-- SJ i ka R P 6 n 63 GV-A-7 er 15 ('d Identification Please Type or Print Clearly) OWNER: Name: 06✓l hG Phone: Address: CONTRACTOR Name: 7 r Phone: Address: Supervisor's Construction License:. Exp. Date: Home Improvement License: �� 7 Exp. Date: _aaI .��_ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. a Total Project Cost: $ GO D0 FEE: $ 1 �� Check No.: 2-k O Receipt No.: 2 z. NOTE: Persons contracting with unregistered contractors do not have access t0t ar ty fund igna#ure of Agent/Owner Signature of contractor TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page 7 LOCATIO:N1r 1PROPE,'TY &W-N.ER` �_ _ �Pr nt" FMG,Yea�Old St�ucture�- yes, �n'o �. MAPNO _� PARCEL ZON�ING��DISTRICT' Hlstoric�-istrict. yes nog _ r - - — y t. s f �Machine�Shop Village ye 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 T7Septic ❑Well' ` . . N Flood Iain ¢ �4V1/etlands � F D Watershed®istnctk �a - DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: ijll COIVTRACj'.®R Name r 6�Phone '¢ $ Address 4F O-C- visor's Constrtactlon{Licen e _ 3 Exp Date. . 4 Norrie lrnprovemqp ent`�Llcerise rE, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$100.0.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. o Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund n ofTA `ent/Ownerr _ t; , _071671.5tiareVof°:contractor_bA Plans Submitted Li Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ -_ Plans Submitted ❑ Plans Waived ❑. -.Certified Plot Plan ❑ Stamped Plans ❑ YPE-OF:SEWERAGE.131SP_OSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑. . ..Swimming Pools ❑ Well ❑ Tobacco.Sales -� Food Packaging/Sales ❑ Private::(septic tank,etc- Permanent.Mmpster 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 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 TowEngineer: Signature: Located 384 Osgood Street TRE 1DEPARTI!!It N' Temp Dempster on site , yes no Fire`Dep _ _ ' ►�tsignature/date �" �# >•� I COMMENTS : ® mension-- 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 Z®NE LITERATURE: =Yes No MGL-.Chapter 166.Section 21A=F and G min.$100-$1000.fine NOTES and DATA— For department use i D Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department Tire following i"s°'a list of the required.forms to be filled ouf#or:the.appropriate.permit to b-e obtained. Roofirg, Siding, Interior Rehabilitation Permits Building Permit Application Li Workers Comp Affidavit u Photo Copy Of H.I.C. And/O'(C.S.LL. Licenses u Copy of Contract o Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products NOTE: All dumpster..permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks a Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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) u Building Permit Application Li Certified Proposed Plot Plan u Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) u Copy of Contract o Mass check Energy Compliance Report o 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 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 submAted with the building application Doc: Doc.Building Permit Revised 2012 Location v " S� �` - '' No. Date ry. s - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ r - Foundation Permit Fee $ �f Other Permit Fee $ TOTAL $ Check# 27552 Building Inspector NORTH Town of i v le r 0 �. No. — - T7 - kh ver, Mass O LAK A-� COC NIC Ht WICK y1. 7�ADR.{TED P'V' �5 S ll BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System 1 R tY1 I BUILDING INSPECTOR THIS CERTIFIES THAT ... .��....... ..... .. . . ..��I. .1.1�.�......... ................................. has permission to erect ..................... buildings on . 0 9g� Foundation Rough to be occupied as .. .... .. ., 'e ......... .. ..... 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 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO STARTS Rough r, �... .. ......... 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. From:Arthur S Page Insurance 978 462 0890 05/08/2014 08:44 #760 P.001 /002 CATAL-1 OP ID: CC CORv® CERTIFICATE OF LIABILITY INSURANCE DA CERTIFICATE 05/08/2014 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: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT None Arthur S Page Insurance Agency PHONE FAX 57 State St Arc No 1211 1:978-465-5301 A/c Nol: 978-462-0890 Newburyport,MA D7850 E-MAIL None ADDRESS: INSURERS AFFORDING COVERAGE NAIC q INSURERA:Norfolk&Dedham Mutual 23965 INSURED . Stephen Catalano INSURER 6, 85 Turkey Hill Rd Newburyport, MA 01950 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I=Wyn POLICY NUMBER MMID MM/DD I LIMITS A COMMERCIAL GENERAL uABIUTY EACH OCCURRENCE $ 300,000. DAWGL TO RENT"' CLAIMS-MADE FIOCCUR R0511836A 08/12/2013 08/72/2014 PREMISES Eaoccurrencw $ 100,00 X Business Owners MED EXP(Any one person) S 5,00 PERSONAL&ADV INJURY $ 300,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 600,00 POLICY ]JEST F—] LOCPRODUCTS-COMP/OP AGG $ 600,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Me accident ANY AUTO BODILY INJURY(Per person) S ALL AUTOS J� AUTOSULED BODILY INJURY(Per accident) S NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTO$ Par accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STAT TE ER ANY PROPRIETORIPARTNERIEXECUTiVE OFFICERIMEMBER EXCLUDED? EIN/A E L EACH ACCIDENT $ (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE $ If yea,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ PROPERTY 10,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) CARPENTER CERTIFICATE HOLDER CANCELLATION TOWNN-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 1600 Osgood St AUTNOR¢ED REPRESENTATIVE North Andover,MA 01845 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD Catalano Remodeling Estimate Licensed and insured Contractor Phone 85 Turkey Hill.Rd. Nfewburyport,Ma 978-499-7689 License#CS 98634 HIC#490= 01950 /73?1 E-mail boatalano85@comcast.net Prepared for: Donna and Kevin Sullivan Work to be performed at: 5 Westwood Bridge Rd., North Andover 978-685-1569 Prepared by: Stephen Catalano, Contractor May 7, 2014 Description of work to be done ----- Removal and Disposal of 6 square of shin- gles on back of house. Install 6 square of 25 year 3 tab shingle to match existing on house Install 5 square of vinyl siding on 3/4 dormer. Install aluminum flashing on trim. Includes material, labor, disposal and permits. Total $6,000.00 Terms: If you agree to the estimate please sign and date at the bottom and return via. fax, e-mail or regular mail.A check in the amount of 1/3 of the total estimate cost will be required at the start of any work. The remaining balance due will be as follows.: 1/3 due about half way through project and final third due upon completion of project. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature&Date Sly 'ti v 61 Contractor Signature&Date �Q/ { � �ze Tpanvr'rw�rzurecz�z a�C-/[/laao�zuteGta 1 Office of Consumer Affairs&Business Regulation i ME IMPROVEMENT CONTRACTOR egistration: 1;73897 Type: xpi ration: 11/23614 Individual STEPHEN CATALANO STEPHEN CATALANQ� t to 85 TURKEY HILL RD. NEWBURYPORT,MA 01950 Undersecretary ' i Massachusetts -Department of Public Safety ^Board of Building Regulations and Standards Construction Supervisor License; CS-098634 " t STEPHEN C CAT",.,O-- Viz% 85 TURKEY HQ.E ROAD' NEWBURYPOR MA til 0 / Expiration Commissioner --0 I I I I i Y The Commonwealth of Massachusetts Print Form7' Department of Industrial Accidents Office of Investigations 1 Congress Street; Suite 100 Boston,MA 02114-2017 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anylicant Information Please Print Lmibly Name(Business/Organization/Individual): �� Irl �G TT Address: 7v_/` !' City/State/Zi : 2W fr^ 019% Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. [3 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in an capacity. employees and have workers' � y p tY� comp,insurance.: 9. �Building addition [No workers comp.insurance p' 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 [No workers' comp. right of exemption per MGL 12.M Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box k 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 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 certi er the ins and penalties of perjury 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#: