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HomeMy WebLinkAboutBuilding Permit #1215-2016 - 58 SAUNDERS STREET 5/19/2016 a��lP l r- �aonra� AAJJ - q BUILDING PERMIT ® �=L�° 8 0 TOWN OF NORTH ANDOVER 10� APPLICATION FOR PLAN EXAM INA-R—ONU - Permit No#: / j Date Received, U, ) CHUS�( Date Issued: I ORTANT: Applicant must complete all item§`dn this,page LOCATION 5-3 3,4u/I rvg Sf I , P int 12 PROPERTY OWNER r!� f J� Print 100 Year'Str"aeture yesOno MAP _PARCEL:�ZONING DISTRICT: Historic District ye Machine Shop Village ye TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family [I Addition El Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Others - n. atershed stnctt v Se ,we ❑UVelh ❑ Floodplain, Weflan ❑`Water/Sewer - DESGRIPTION OF WORK TO BE PERFORMED:, i2�v (r H Sr�i� f ��— i'1GajoLy/ �t�t '� Identification- Please Type or Print Clearly OWNER: Name: �H N NQA n!Ad di4C Phone: q -��Z-�`!�0 Address: 4C-A s r�CS /66 Contractor Name: d�N /Vd/ M�� ' Phone: Email:' A� ��1�Dov Lr� Giwi Address: . Supervisor's Construction License: �� Exp:. Date: / p a Home Improvement License: M `1 13 Exp.-,,Datff ARCHITECT/ENGINEER Phone: Address: Reg.:No FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED OoST ffl—C7SEfQ�.$125.00 PER S.F. Total Project Cost: $ Z �� CU FEE: $ l Check No.: Receipt N6-_-_;--- MOTE: Persons contracting with unregistered contractors do not haveaaccess o.4he guaranty fund MOM— t �� — r _. .. -.� —• � e — g. 1 Plans Submitted ❑ Plans Waived ❑ Certified Plot Flan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tann.._g/MassageBody Art ❑ ✓limning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Pennauent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF o U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS C, Zoning Board of Appeals:Variance, Petition No. Zoning Decision/receiptsubmitted yes ,,Planning Board Decision: Comments d Conservation Decision: Comments Water& Sewer Connection Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREx - s y - : ®EPAR¢TMENY Temp Dumpsferonsite esu " no _" . Located at 1x24 Main Street ,� O * � 4477,77,77 , Fine Department signature/date �i a• rt i �r.� ? ted "° - mac' ^fie+= Ivi y .moi Dimension = Number of Stories: Total square feet of floor area, base&, derior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop- q W* res approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes N® MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA-- (For department ease) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 i6 Engineering Affidavits for Engineered products OTE: 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) 4. Engineering Affidavits for Engineered products OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit from the Board of peals In all cases if a variance or special permit was required the��s recorded wn Clerks at the Registry of Deedsfice must stamp the clOne copy and proof of recording that the appeal period is over. The applicant must then get must be submitted with the building application Doc:Building Permit Revised 2014 1 ■ ,r k. At Location [ •t-' �-� �� No.� " 2.©� Date _ 1�1 • - TOWN OF NORTH ANDOVER Certificate of Occupancytic $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ _' TOTAL $ ` Check# (t Building-Inspector �1 r 1 t%ORTFt - _ _E . .- .c . " ve. 0 �r No. _ o Lx"s h ver, Mass COCNICHEWICK IV 'ls.9s°'4^rEo �Pa��S U BOARD OF HEALTH Food/Kitchen PERMIT T_' Septic System THIS CERTIFIES THAT C 4 v �� BUILDING INSPECTOR ................................................ .. .....'.'�..... ... ............ ................ has permission to erect ........... buildings on .. 041.*1. Foundation ............... .... .... ....+fit �................ Rough � AW to be occupied as 0 ...... 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 CONSTRUCTIONS ARTS Rough .�� . UIL• Service ................-.. .,,/ �': .......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. 42C f _._ �. Apex Roofing & Restoration LLC ; 3 Easy St.,Westford,MA 01886 7 Phone:978-692-8900 Fax:978.692.8828 H.I.C.#181413 CSL#061982 a, x-4i•. .�.._� Info @axpe roofer.com Na Patricia&Jerry 6ettftelemceIw 978-314-1277 H a Add-58 Saunders AT S{- email: hon rd�03@verizon.net city North Andover sem!MA JOAddrsaa: Same We hambysubma specirtatiom and estimates for: All sections of entire roof except bay window&front porch.Also includes new EPDM system on top of roof. • we will supply a clean roll off container and place lumber under the container wheels to prevent damage to the driveway, •We hang tarps to protect your property and strip all layers of roof related debris. • Replace all existing bathroom louvers and soil pipe flanges. • Re-nail your existing sheathing with 8d ring nails.This extra step will ensure that your sheathing does not -p`in the future. • Install CertainTeed€,{:.: f.<,a lc°granular ice&water shield or equivalent on all side walls,valleys,skylights,and chimney flashing.Massachusetts building code calls for 3 ft.of ice&water shield on horizontal eaves... We double it to 6 ft l • Install Synthetic Underlayment(25x stronger than felt paper)in all areas not covered by ice&water shield. • Install 8"aluminum Drip-edge/Rake-edge along entire perimeter(choice of white,brown or mill finish). • Install CertalnTeed.S41?P,t`,tiiii7^starter shingles in order to ensure proper edge adherence. • Install C nsumerReports recommended CertainTeed i.a}=ldlww;k architectural shingles(6 nails per shingle for 130 mph wind warranty). •Cut 2"opening at all ridges and hand nail CertainTeed ;,=?{?P+ Vim t ridge vent(a typical upgrade for other roofing companies). • Install CertainTeed 6 cap shingles on all ridge and hip locations, - Clean up&perform a magnetic sweep of property.Remove debris from gutters&downspouts(if existing). •The roll off container will be picked up in a timely manner upon completion of the project and hauled to a recycling facility. s.. ,f ...-�... .., r:✓�..,:!.'nit:r _IY .:... ._...:,4i,.�..... i '7.1 .r',f'l, a..... Ply, S.. i:r... :' ... ! . .•:!': fs. ., ,i'.I)f.�i. r x.k, .:' lei:)...;. .i t. .•..\ :....._.. ..' :�.. ., i l!',... : .i li Y If on Unlike our competitors we do not offer high pressure time related coupons.Please call or e-mail us with any questions. Payment Is due in full upon completion of job.We accept cash or check I,rrr. rtA0N!EY r)0^W fpt Apex Roofing&Restoration LLC agrees to all labor,material and building permit specified above for the sum of: $ 7,285.00 Notes:Any rotted plywood will be replaced for an additional charge of$1.80 psf for 112"plywood: Any rotted roof boards will be replaced for an.additionai charge of$4 plf(1x8"): Cut and install new lead flashing on brick chimneys for an additional charge of $595.00 per chimney: f LM RIM �e atltt.x 3� r ,t : 3 s`46Ir �.•� i,,,a�,yE '� a 4L. -.71 6�1 luw a r4�ir !e iaxaa .yA 6 A&...s.ii.u. nir .xa . .:�r�,,,.,.��c;�r l,k'm uh7l�.�..:�K- en* ro iii rv+» i ? ? Contract Acceptance:Upon signing,this document oeoomes a binding contract under law.You may cancel this agreement provided you notify Apes Roofing& Restoration in writing at their main office by ordinary mail posted not later than midnight of the third business day following the signing of this agreement FImparty Owners signature Date ShinglelCo1w Selection i r 517/16 Property owners Signature Date Authorized Signature:John w Normandie III/owner Date Submitted Note:This agreement may be withdrawn by us if not accepted within 30 days. a6ed OLEOLb8L6 >Wd'dG 8tf1 FDI Wd90'.t0 960Z El, AeW The Commonwealth of Massachusetts Department of IndustrialAccidents > I Congress Street,Suite 100 Boston,MA 02114-2017 www,massgov/dia N orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeLyflil Name(Business/Organization/Individual): �j�!1ti�/ QQ' �� Address: G S 54- �'i G- City/State/Zip: WOI� O MA 20& Phone#: 97g GqZ poo Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).' 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.[]I am a homeowner doingall work myself t 9. ❑Demolition y [No workers'comp.insurance required.] 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property.ro I will 10[]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees.. 5I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.[]Plumbing repairs or additions These sub-contractors have employees and have workers'comp.insurance.I D iRoof repaai'rsA I 6.E]We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#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. tContractors 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 thepoliey and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: i, Expiration Date: Job Site Address: S�v�bQ�� S� " -010 A 41M 90& t,/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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage.verification. I do hereby certify t e az d e s of perjury that the information provided abo a ig true ylnd 59"ect Signature: ate: f l Phone#: AIL vgqpw-- Official use only. Do not write in this area,to be completed by city or town offkiaL City or Town: PermitlLicense# 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#: From Rapo ]epsen Insurance 1.508.875.5885 Tue Mar 15 10:06:05 2016 MDT Page 1 of 1 AC"R V CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDM Y1() 1✓' 03/08/2016 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(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 NAAmE: ANDRE SILVA RAPO&JEPSEN INSURANCE SERVICES INC 'WC Ext: _ AIC No: 5-5885 191 CONCORD ST E-MAIL ADDRESS: FRAMINGHAM MA 01702 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A:ESSEX INSURANCE CO INSURED JDQ CONSTRUCTION INC INSURER B:AIM MUTUAL INSURANCE CO PO BOX 351 INSURER C; FRAMINGHAM MA 01704 ENSURER 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 TYPE OF INSURANCEADDL POLICY EFF C7 EXP UNITS LTR 1 POLICY NUMBER MM GENERAL UA131UTY EACH OCCURRENCE $1 GOO 000 RENTEU- COMMERCIAL GENERAL LIABILITY IES( a X PREMISES Ea orxunence $50,000 CLAIMS-MADE a OCCUR F MED EXP(Any one person) $1,000 A 3EE2219 03/02/2016 03/02/2017 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN L AGGREGATE LIMIT APPLIES PER, PRODUCTS-COMPIOP AGG $2,000 000 X POLICY PE a LOC $ . AUTOMOBILE LIABILnY _ r Ea BBIINdBD SINGLE M T $ ----- ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acddem) $ AUTOS AUTOS NON-OWNEDROERTYtDAMAGE $ HIRED AUTOS AUTOS accide UMBRELLA UAB OCCUR r EACH OCCURRENCE $ EXCESS LiAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'•LIABIUTY YIN TORY U S B ANY PROPMETORIPARTNERIEXECUTIVE AWC40070314042015A 09/05/2015 09/05/2016 E.L EACH ACCIDENT $1,,00,0,0 OFMCEIMEMBER EXCLUDED? Y N!A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $1 000 000 If yx,d6orbe under i- ELDISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS!VEHICLES(Attach ACORD 101 Additional Remaflls Schedule,if more sspp�ee Is required) APEX ROOFING AND RESTORATION•LLG IS LISTED AS ADDITIONAL INSURED ON THE TOM GENLIABILITY POLICY, CERTIFICATE HOLDER o CANCELLATION APEX ROOFING AND RESTORATION LLC SHOULD ANY OF THE ABOVE DESCRI P ES BE D BEFORE THE EXPIRATION DATE THEREOF, TI WILL EUVERED IN 3 EASY ST ACCORDANCE WITH THE P L ICY PROVI51 WESTFORD MA 01886 AUTHORIZED REPRESENTATIVE ©1488-2010 ACdRV 9APORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs&Business Regulation r* OME IMPROVEMENT CONTRACTOR IStration: 181413 Expiration: 4/1/2017 LLC TYPe APEX ROOFING$RESTORATION LLC. JOHN NORMANDIE 3 EASY ST WESTFORD, MA 01886 Undersecretary ,y 3 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-061982 Construction Supervisor JOHN W NORMAND`IE 111. 3 EASY STREET: ' WESTFORD fo11.90ft Commissioner Expiration: 09/08/2017