HomeMy WebLinkAboutBuilding Permit #844 - 58 GLENWOOD STREET 6/21/2007 (2)Permit NO:
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
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
[I Other
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DESCRIPTION OF WORK TO BE PREFORMED:
I1 S 1 0 US -1— ' 1/2- �GG ` ,
Identification Please Type or Print Clearly)
OWNER: Name: CUA Phone o £� 9�l � • a of R
ARCHITECT/ENGINEER c�. i Lc.�r Phone: ti �2 3- (i S
�i�����?� 7 4
Address: 2i Y —,/, 4-4� Q� �.,\o Reg. No.
FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ tk-i S I� FEE: $ 0
Check No.: �u�� L- Zoe, Receipt No.: 0 303
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
1% J
Permit NO:
Date Issued:
Amb
IWOP
TOWN OF NORTH ANDOVER
NORTH
APPLICATION FOR PLAN EXAMINATION a? os , +• ° *. �tio L
,
Date Received 10 It 6 L +
I IMPORTANT: ADDlicant must complete all items on this Daae
LOCATION 5S I C,W TAl ST N - A nJc✓t✓
PROPERTY OWN
MAP NO.:
PARCEL:
TYPE AND USE OF BUILDING
5 e,
Print I
ZONING DISTRICT:
HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non—Residential
New Building
❑ Addition
Alteration
❑ One family
❑ Two or more family
No. of units:
❑ Industrial
Repair, replacement
Demolition
❑ Assessory Bldg
❑ Commercial
Moving (relocation)
❑ Other
❑ Others:
Foundation only
UESC UFTION OF WOKK TO BE PREFOKMED
c.X I ; ��� wt bui (1,�
Iden(kkation Please Type or PH& Clearly) USd .
OWNER: Name: A M ✓' Phone:
�y�• �o19
Address: Lei TyJ S`T /U • A�)�✓�
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License:
Exp. Date:
ARCHITECT/ ENGINEER Name: Phone:
.lddress: Reg. No.
FEE SCHEDULE. BOLDING PERMIT.- S12.00 PER %1000.00 OF THE TOT.aL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost S FEES
Check No.: Receipt No.:
Page lol'4
I
Location,"
No.
Date 15;� �/-90 -Ir
of 09"Th�
+ TOWN OF NORTH ANDOVER
0
certificate of Occupancy $
CHUS Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
20�4j
Building Inspector
0
Plans Submitted P� 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
PLANNING & DEVELOPMENT ❑
COMMENTS
DATE REJECTED
DATE APPROVED
1
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
HEALTH
i
COMMENTS
❑N
DATE REJECTED DATE APPROVED
0
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
Located at 384 Osgood Street
Dimension
Number of Stories: 123 Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.: 1 s , O�
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
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
ation
❑ Cert' ' lot Plan
Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
° tion 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 2.2007
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P,600, (Naofd Street :i
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December 27.200-1
Ghamary Hussein
58 Glenwood Street
North Andover MA 01845
Mr. Hussein..
YctP 5.i2
The property at 58 Glenwood Street has a Zoning. board of appeals Decision 2,007-015 for a height relief.
Regular inspections are being performed according to Massachusetts's building code 780 -CMR. All
engineering documents have. been provided for lifting and flood proofing.
Gera Brown
00-01
Inspector of Buildings
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06/17/2007 20:17 FAX 6033628204 granite state
CONTRACT
ONS GraNN Std NMI OMM LW
21 Westside Dr.
001/001
Atkinson, NH 03811
Phone 603-362-9580 lune 17, 2007
Toll free 877-240-0040
Fax 603-362-9204
Cell 603-231-7469
Web site: Granitestatebuildingmovers.com
Email: hsemover@storband.net
Hussein Ghamary
58 Glenwood Street
Andover, MA 01845
Tel: 508-942-2019
Fax: 979-699-7240
Work to consist of.
A) Structurally support house, raise approximately 5 feet and hold while others add to foundation
height.
B) Once foundation is complete mover will set house back on top of foundation wall. Pockets must
be left in foundation for mover's steel to be removed Lally columns to be supplied and installed
by others.
C) In the process of raising a building cracks may appear in sheetrock seams, plaster or masonry.
Should any cracks develop it is understood by all parties that the mover is not liable for any
repair or cost of any repair.
D) Mover carries Workman's Compensation, One Million Liability with Two Million Umbrella,
and Cargo Insurance. Certificates will be requested and made available upon signing this
contract
E) All carpentry, masonry, electrical, plumbing, concrete, excavation work etc. to be done by others
at no cost to the mover.
F) Proposed time frame Summer 2007. First come first served for getting on the schedule.
G) Total cost to lift house. is Fifteen Thousand Dollars.
Terms of Payment
1) Due with signing and returning this contract a deposit of S2,000.00.
2) Due the day the house is raised 00.00.
3) Due the day the house is to 1, .00.
I
Start's -Granite State Building overs, LLC Hussein Gham
* Owner has 40 days to complete work or a rental charge will go in to affect of $300.00 per week,
payable monthly.
*Contract must be signed and returned with deposit within ten days or contract will be null and
void. All checks issued to mover to.be certified bank checks.
�rom: Deb MoNal AL MIeyLlii a Agenwy FaXIP: TO: Movers, LLC
Data: 0=12007 03,39 PM Page: 2 of
A,. CORD. CERTIFICATE OF LIABILITY INSURANCE OP ID DATE tai
O -1 06/20/07
PRODUCER THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION
Maguire Agency
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Agency MOLDER. TMIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1935 !vest County Road 3-2,#241 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Roseville bN 55113
Phone 651-638-9100 Fax :651-638-9762 INSURERS AFFORDING COVERAGE NAIC Y
mauREO IWt Lkn 8t. Pati! Fire 5 Maxine
INSURER D:
scan, s Granite state Building ,N iUHkH
21 11�eawide Drive INyj)+.LHU
Atkinson, NH 03811
INF.I IRF17 F .......
COVERAGES
THP 110I ICIFS OP INTI Om;C.P I IATFA F!n tl)w HAVE RFFN IPAI )Fri TO THF IrIFA AF0 )wvAPn AROVF FOR THF FOI ICY PFRiOn INDICATED NOTWITHSTANDING
ANY REQUIREMENT. TERM OF, CrNh�N O
JDITF ANY CCWMACT i0 c,rW-r? CRXIJMENr WITH r)FFrFrT Ti � C.
WHICH THIF. FrMFlCArF MAY RF IF M IFn lip
MAY PL'I{IAIN• TI IL INCAMANL•L All OULILLJ UY l I IL I-'OLICIL.i UL::CRIGL'U I CJiMN I: 14N.0:1TO ALL Ti C TCR1.>ti • CxC:LU„ 10NC: AND CONDIT*NP, OF alcH
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DATE
LTR NS TYPE OF INSURANCi POLICY NUMBER (MMIDDJW) DATE (MMWD LIMRB
OENERAL UABILRY
EACH OCCURRENCE
$1,000,000
A
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660-98160526
04/02/07
04/02/08
i 100,000
ARPMIr.FS(Fifl
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MELT EW (Any ono Perron)
4 $1000
$1,000,000
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DESCRIPTION
OF OPERATIONS I LOCATIONS I VEHICLES
I EXCLUSIONS ADDED BY ENDORSE
NT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
HOSSEIN SHOULD ANY OF THE ABOVE OESCMNhU PULX:la RE CANCELLED OEFORC THE EXPRATICIN
OATS THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAY8 WRITMN
NOTICE TO Tl•IE CERTIrICATE HOLDER NAMED TO THE LEFT, 6UT FAe.LIRE TO OO 60 $HALL
589 Glenwood 5�Jha IMPO86 NO OBLIGAT1ON OR LMa1LRY OF ANY KIND UPON TWE INSURER ITS ITS AGENTS OR
lentstreet r
Andover, m 01845'5 REPRESENTATWES.
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T00 E 821929 02TU13Jg V0Z6Z9CC09 YVA CT:OZ LOOZ/OZ190
BOARD OF BUILDING!, REGULATIONS i
License: CONSTRUCTION SUPERVISOR !
Number: CS 084047
Birthdate: 08/15/1960
Expires: 08/1512008 Tr. no: 29149
Pik, Restricted: 00
s
SIMEON O OLAPADE
36 PITMAN OR
READING. MA 01867 Commissioner�
V lle i%'6YIlI/f07EU%6Rlill. 0� '�LQ:iJQCIt[G:EGC'.
b` Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 137468
Expiration: 11/15/2008 Tr# 125027
Type: Private Corporation
AGAPE PROPERTY MAINTENANCE CO INC
SIMEON OLAPADE
36 PITMAN DRIVE.t„aGl.Z..1
READING. MA 01867 .Administrator
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From: Ericka Linares To: Joanne Paris-Wildes
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OUCER Salial # A18684
ON RISK SERVICES, INC. OF FLORIDA
001 BRICKELL BAY DRIVE, SUITE *1100
IIAMI, FL 33131-4937
HONE: 800-743-8180 FAX: 800-522-7814
jRFD
ADP TOTALSOURCE, INC.
10200 SUNSET DRIVE
MIAMI, FL 33173
-ALTERNATE EMPLOYER:
GRANITE STATE CONSTRUCTION SVC
Date: 820/2007 Time; 2:38:58 PM Page 3 of 3
DATE (MMODIY
06/2012007
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
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INDICATED, NOTWITHSTANnING ANY REOUiREMENT• TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MT14 RESPECT TO W141CH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED e Y 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.
TYPE OF INSURANCE POLICY NUMBER DAITE (MMloon� bAA1E (MMMIIDOPM N UMR3
GENERAL LIAEIILITY CFPEPN. AOW HAII' s —
VFRCIAL GENERAL LIAEAIITY
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UMBRELLA FORM
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EMPLOYEES WORKING FOR THE ADOVE NAMED CLIENT COMPANY, PAID UNDER ADP TOTALSOURCE, INC.'S PAYROLL, WILL BE COVERED LINDER THE ABOVE
TED POLICY. 'THE ABOVF NAMED CLIENT IS AN ALTERNATE EMPLOYER UNDER THS POLICY.
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9MOULO ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
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58 GLENWOOD STREET 30 DAYS WRITTEN NOnceTo THEcswrimcmHOLDER NAMED TO THE LaFT,
ANDOVER, MA 01845 BUT FAILURE TO MAIL SUCH NOTICE $HALL W'OSE NO OBLIGATION OR UABILRY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AON RISK SERVICES, INC. OF FLORIDA
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