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HomeMy WebLinkAboutBuilding Permit #098-13 - 53 CONCORD STREET 8/3/2012 NORTH BUILDING PERMIT O� (g LED ,6q•�•0 TOWN OF NORTH ANDOVER fo APPLICATION FOR PLAN EXAMINATION y _ ©7 �j� Date Received '1sRA'a�reo Permit NO: �SSACHU`-+��� Date Issued: 3 Z O/R�TANT:Applicant must complete all items on this page LOCATION Printf , MAP NO _ � ;:PARCEL ( � ZONING DISTRICT:. Historic District yes. no Machine:Shop,Village ,:yes: n _ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential w ing On n Two or more family Industrial era ion Commercial Repair, replacement Assessory Bldg Others: Demolition Other _ " isfri Flood Iain etlands Watershed.Dct . Se ti -�Ahell R Water/Sewer- SDE CRIP�TIONhOF lfil®RK(O �E PAF®RMED: Y.17L'CK D F1cC a dentification Please Type or Print Clearly) OWNER: Name: AV TvsA Phone: J'78 'a?75-71 Address: �� ©� S r GONTRP►CI QR Name: Phone: �}9� ,.. _ A-ddres s " a1fim . Supervisor stCoiistruction L+icense` Exp, rQate - Home Improvement License:: _ , Exp: Date: e ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ l*4 ©a FEE: $ lyo 1 0 Check No.: , l Receipt No.: _Q NOTE: Persons contracting with unregistered contractors do not have access to the guaranty and Signature of^Agerit/Owner Signature of contractor Location No. (-� — Date ? 2 ® ' r TOWN OF NORTH ANDOVER e ® Certificate of Occupancy $ Building/Frame Permit Fee $ � a ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 1 � 7 25580 Bu'ding Inspector 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 l Sign COMMENTS O ► SSt,-J a c_ HEALTH Reviewed on Siqnature 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 Os ood Street FIRE DEPARTMENT =Temp' Dtampster on site yes FireDepa0" '1- t'.jgnatbi-e/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 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 2.2008 Marc A. Gibbs Construction General Contractor 25 Smith St. Phone/Fax 978 455-1192 Chelmsford,Ma 01824 Lic#034037 Reg. 108198 Paul Tusa 978-683-4173 Home 53 Concord St. 978-273-7186 Cell N.Andover,Ma. July 25,2012 Contract Exterior Deck; Add 15'-0"x 4'-0" to existing deck match elevation new decking Composite Balance of existing deck to be Composite Repair stairs with composite decking and support to ground Replace all existing handrails,post and balisters with white composite parts Contractor no responsible for preexisting conditions Remove all debris. Materials and Labors $ 11,600.00 Payment to be made upon completion of deck Upon signing,I agree with terms of this contract and that all materials and labor are included " date 1710LK.L. date �i ,,.;,;hu+rtt D r ►rimvitt. ,t Pi.'. Ii ;t•. :1 Hoard oil*8uil.lin, Re-ulatuon. and �lan,i +,, Construction Supervisor License Licerse: CS .34037 N �e MARC A GIBBS 25 SMITH ST CHELMSFORD, MA 01824 Expiration: 6/30/2013 Tr#: .16231 92C sumLnza7erueal� n�it fz •�-- - Office of Consumer Affairs&B smeT Regulati�o License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR Registration: 108198 before the expiration date. If found return to: Type: y ;;- Expiration: 8/13/2014 Office of Consumer Affairs and Business Regulation DBA 10 Park Plaza-Suite 5170 MARC A.GIBES CONSTRUCTION Boston,MA 02116 Marc Gibbs 25 SMITH ST CHELMSFORD,MA 01824 Undersecretary ------- of valid without signature '� OP ID:JR CERTIFICATE OF LIABILITY INSURANCE DATE08/0 DIYYYY) 08/02/12 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 policy(les)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). CONTACT PRODUCER 978-256-3367 NAME: Talbot Insurance Agency,Inc. PHONE FAX 221 Chelmsford Street 978-256-8215 AIC No Exit: A/C No): Chelmsford,MA 01824 E-MAIL Edward J.Talbot,Jr. ADDRESS: PRODUCER GIBBS-2 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED MARC A.GIBBS D/B/A INSURER A:Seneca Insurance Company GIBBS CONSTRUCTION 25 SMITH ST INSURER B:Safety Ins.Co. CHELMSFORD,MA 01824 INSURER C: INSURER O: 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 TYPE OF INSURANCE DOL UI3R POLICY NUMBER MMIIDDDY EFF MM/DD/YYYY LIMITS LICY EXP LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY BAK 1004994 04/21/12 04/21/13 PREMISESTORMTEDEa occurrence $ 100,00 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY JECT PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 100,00 ALL OWNED AUTOS BODILY INJURY(Per accident) $ 300,00 B X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS 1601639 12/09/11 12/09/12 (Per accident) $ 100,00 X NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N _1TORY LIMIT R ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ F—]OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XDESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re:Evidence of Insurance for work performed by Marc Gibbs Construction, LLC CERTIFICATE HOLDER CANCELLATION TOWNNAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 120 Main Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009/09) The ACORD name and logo are registered marks of ACORD 1 p �crete, Sols c�S W7rig'� l 3�Y ecs AM bo�f3 2x8115 Al f)OOse 2 � R►°m �L- e- 2-2 8d�m TO) &-itto cof)cr* NORTH -T - n of E : ., n over No. sT ver, Mass, z. h , �•p coc.ac ewuw v1' A�RATIE S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System // BUILDING INSPECTOR THISCERTIFIES THAT . Ul.... ��..: ..��.............................................................................................. �� Foundation has permission to erect , 'buildings on ." � !� G`''jcf .....................� Rough s,- to be occupied as . �`` �.� ;..... . t. .: ..../;:. -:::?.. ....:......:5:....... 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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough Service .................. ....... .. .. .:�::......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises — Do Not Remove 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