HomeMy WebLinkAboutBuilding Permit #276-2012 - 57 STAGE COACH ROAD 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0:.276 Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER Unit#
Print
MAP NO: PARCEL: 2, ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
100 year-old structure 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
pair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
[-i1JfflepTF-# w.e1HT-- (®Floodplain' ® Wetlands (®,W.aR sale Dis t
DESCRIPTION OF WORK TO BE PERFORMED:
S-T T\-`14-�1 �
(, Identifi�catio lease'�,y,�e oar`t,-Jnt Clearly)
OWNER: Name:�o ��� ' �► l �/' Phone:
Address:
a5A� CCk-Ch `'S42(
CONTRACTOR Name:/(�6-,CW C— S12A U`C9--,) Phone: '$
Address: UJ A.-)k,\,W v1^ /V),4
��,' NNS ► � � �r � �
Supervisor's Construction License: ,a ft--k Exp. Date:
Home Improvement License: Exp. Date:
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.
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Total Project Cost: $ 10 4 FEE:
Check No.: 2 Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access t th u my f nd
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Cnnatarc of�ncnt/(hninar - ".>::,. ,.fl-_Cnnati rA-nf.riitn �
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 Siqnature
"COMMENTS
Zoning Board of Appeals: Variance,ance, Petition No: Zoning Decision/receipt submitted yes
4 Planning Board Decision: Comments
.r
i Conservation Decision: Comments
` Water &c 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 Main Street
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
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NOTES and DATA- For department use
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FLU Notified for pickup - Date
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Doc:.Building Permit Revised 2011 June/mi
Building Department
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The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
1
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 Perm%
Addition or Decks
❑ Building Permit Application
-u 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
i must be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
Location
No. - O/Z- Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Gr
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # V�
//Oui ding Inspector
I_`:
NORTH
0VM Of over
0
a Tr I
C' LAKr o , dover, Mass.,
COCHICMEWICK ��
sFATED PPpC3
1 BOARD OF HEALTH
PERMIT Tu D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT....... r "...:
. . ....................................................... Foundation
d �6G ��/�
has permission to erect...........:::.......................... buildings on ...... .... .. .. ....................:!�...........�'................... Rough
to be occupied as ���?/�Q.. ... ./'4P� .............. ..............:... Chimney
provided that the person accepting 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, Alteralion and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
a PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION T TS Rough
.......... .........:....................... Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — ft 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.
lid
203 WASHINGTON ST.#1256
. PRESERVE SALEM,MA 01970
RVA ES carpentry painting roofing t gutters PHONE:978.745.874S
�r Fax:978.745.3476
SALES@PRESE RVESE RVICES.COM
Chris McMann
Date Bid:8/24/2011
57 Stage Coach Rd Estimator:Sean O'Connor
North Andover MA,01845 Email:sean@preserveservices.com
(978)886-4502 Mobile:(978)39S-7737
Ckmcmann@comcast.net
ROOFING ESTIMATE
COMMENTS Replace the roof on the main house and shed. Install a ridge vent on the main house on
all 3 sections and shed.
PRIOR PREPARATION
PERMITTING: All permits will be obtained in accordance with the law as required.
DISPOSAL: A dumpster will be placed in an area designated by the homeowner.
ROOFING PREPARATION
COVERING: Tarp the exterior of the house so as not to damage the siding.
SHINGLE REMOVAL: Remove all layer(s)of old shingles.
NAILING: Re-nail roof decking as necessary.
OTHER: Remove the existing gutters and dispose of them.
CARPENTRY*
Fill in the roof decking as necessary to cover exposed hole below the vented drip edge.
Intall white aluminum on top of the ice&watershield that is on the front facia.
UNDERLAYMENT
FELT: Install 15 lb felt on all areas not covered by ice and water shield.
ICE AND WATER SHIELD: Install 3 feet of ice and water shield on eves and valleys.Install as
necessary on other areas.
G�
OTHER: Install 6'on the front of the house and 9'on the rear terminated the ice&watershield
aproximately 3"down the facia.
FLASHING
DRIP EDGE: Install drip edge on all perimeters.
WALL JUNCTION: Install or rework flashing where the roof meets the wall.
VENT PIPES: Install new boot or flange around vent pipes.
OTHER: Chimney: Reflash as necessary on the left hand chimney and completely on the right
chimney.
VENTILATION
RIDGE VENT: Install ridge vents.
ROOFING MATERIALS
ASPHALT SHINGLES: Install architectural shingles either Certainteed Landmark or GAF Timberline
HD
PRICING
Basic $ 11360
Sales Tax $0
Total Price $ 11360 including Labor&Material
Payment Term .20%deposit(day of start);30%progress; 50%end of job McNisa/Amex
Se 'Connor Customer Signature
ADDITIONAL TO ABOVE ESTIMATE:
BID 1: Install aproximately 132 2"round soffit vents 16"on center on the house.
Price$650 Including Labor and Material
Installation Note:
If you have an older home that has dimensional lumber for roof decking you will need to cover your
attic because shingle debris may fall into the attic and create a mess.
*Above additional prices includes all discounts and coupons discussed prior to estimate. The
above quote is valid for 60 days.
*Warranty: Craftsmanship:ftsmanship:Kyron Inc.DBA Preserve Services warrantees all work performed
for a period of 2 years. If any problems occur we will cover the cost of labor and materials. For the
warranty to be valid the invoice that was presented at the time of completion must have been paid in full.
Materials:The duration of the manufacture's warranty is specified in the materials section above.
Licenses:
Home Improvement Contractor(RIC): 123553
Protection: It is required by law that roofing contractors have a home improvement contractor
license. If a contractor is properly registered,you are entitled to limited protection by the
Residential Contractor Guaranty Fund up to$10,000. (The above is a only a summary of
Massachusetts General Law 142A)To check our license or our competitors go to:
http://db.state.ma.us/homeimprovement/licenseelist.asp and license 123553.
Constructor Supervisor(CS): 93403
The construction Supervisors license is under an individual's name,not a company name. To
check Sean O'Connor,owner of the Kyron Inc.DBA Preserve,license go to:
http://db.state.ma.us/dps/licenseelist.asp select Construction Supervisor and license 93403.
Insurance:
Worker's Compensation:
Our policy is under Kyron Inc.DBA Preserve Services
Protection: Covers the injury of a worker employed by the contractor doing work at your home.
To check our policy or our completions go to http://mass.gov/dia/ on this page go to`'check
worker's compensation proof of coverage"our license is under Kyron Inc.
Liability Insurance
Our policy is under Kyron Inc..DBA Preserve Services and has limit of$1,000,000.
Protection: Covers your property in the event of accidental damage up to a dollar limit specified
on the policy. To check our policy we will have to contact our insurance company.
DATEIN�D►vYYY)
CERTIFICATE OF LIABILITY INSURANCE 5rZ LDFJL
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON T'HE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYAMEND, 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 POlicylies)must beendorsed. B SUBROGATION IS WANED,Subject to
IMPORTANT: if the certificate holder is an ADDMdii L INSURED,
the the Semis and conditions of the PORCy,certain Policies may require an endorsement A Statement on thtS certificate does not confer rights to the
certificate holder in lieu of such endorseme s• Boynton Insurance
PRODUCER ME:
Boynton Insurance Agency PHONE (781)449-6786 FAX (781)449:- 269
72 River Park Street PRODucER 0004109
Needham MA 02494 I S AFFORDING COVERAGE NASO
INSURED IRER A MOX S Ci a1.
NSU
Kyron Inc. I(suRERs:Hartford Insurance
DBA Preserve Services INSURERC:
203 Washington street,#2S6 INSURER O:
Salem,MA 01970 INSURERE:
INSURER F:
f COVERAGES CERTIFICATE NUMBER:14-18 Vnion St. Condo 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 VIMICH 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 SHOVM MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILS POLICY EFF PO EXP
TYPE OF RMRANCE POLICY NV98ER (M arc" M LIMITS
GENERALLIABLLITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES a oowtralf S 50,000
A CLANS4&DE ❑x OCCUR 013100002122 !23/2011 /23!2012 MED EXP(A,one p=w $ _ 5,000
PERSONAL B AOV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMB APPLIES PER PRODUCTS-COMPfOP AGG $ 2,0000000
E POLKW PRO LOC $
AUTOMOBILE LIABLLTTY COMBINED SINGLE LIMB $
(Ea aseidam)
ANY AUTO BODILY INJURY(Par pmon) $
ALL OWNED AUTOS
BODILY INJURY(Per eCCldellt) $
SCHEDULED AUTOS PROPERTY DAMAGE $
HIRED AUTOS (Per eceldam)
NON-0NMED AUTOS $
S
UMOMLAUAS OCCUR EACH OCCURRENCE S
EXCESS Me CLAIMS-MADE AGGREGATE _ $
DEDUCTIBLE $
RETENTION S $ ��
$
WORKERS COMPENSATION WCSTATU- OTH-
AND EMPLOYERS'LIABILITY Y/N X L�[[I,S
ANY PROPRIETORlPARTNERIEXECUTIVE
OFFlCER111EMBEREXCLU10 NIA EL EACH ACCIDENT $ ZOO OOO
(hand NK) S60DB0523H00910 /20/2011 /20/2012
yes EL DISEASE•EAEMPLOYE $ 100 000 "
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 500,00C
i
DESCRIPTION OF OPERA710NS I LOCATIONS I VEHICLES(ARach ACORD 1(H,Ad=Iwai Renar(a Schedule 8 nmro epow raqufred)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELPMJM IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AU714DRMED REPRESENTATIVE
i213.am Rohr/WRIT
ACORD 25(2009109) D 1988.2009 ACORD CORPORATION. Ali rim reserve
INS025(2009w) The ACORD name and logo are registered marks Of ACORD
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Afft cl��tr'ttncnt()f Public.Safety
Bn.3rtl of
Building kct;uhltinns�tncl Stancl<tr
Cnslructi� .Supervisor License As
License: GS 93403
Res ricted t.q 00
SEAN OCONNOR
26 CHESTNUT ST` I
SALEM, MA 01970'
C'r,mmi.sir,ner Xp#ration: 12/31/2011
Tr#: 10208
� c/�LC Lr'b'JT17ltO?Ettr 6�'t,� � .
Board of l3rs rnb itCgulati@hs and Sari;.
yt3r='ifi IMPROVEMENT CONTRACTOR 5.
Regrstrafr Dik
Expiration �'� �*
w K 31612011 . Tri 282379
Type DBA
Et serve Panting }
" Sean G,Connot
1Fi'N�TON 5T #256
SALEM,;MA 0197A
_ Admmistrator