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HomeMy WebLinkAboutBuilding Permit #785-12 - 60 MOODY STREET 5/1/2012BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 7W` Date Received Date Issued: I IMPORTANT: Applicant must complete all items on this Daize I LOCATION ca O Z%a4E0 Z S f Print PROPERTY OWNERiQ4t//_-' Print MAP NO: P1 PARCEL: ZONING DISTRICT: Historic District yes Machine Shoo Villaae ves io TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial epair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Please Type or Print Clearly) OWNER: Name: Address: KD CONTRACTOR Name: z /. /(i Phone; Address:fri.i+t l tlo. �,ry�r.�S�Z, Aa'�S Supervisor's Construction License: 2:R17 S Exp. Date: 6 a� l Home Im 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. ` Total Project Cost: $ % 90o FEE: $ y '` Check No.: /15'39 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to thoguarantyjund ignature ofAgent/Owner Signature of contractor __ G 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 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 4PNV Town Engineer: Signature: FIRE DEPARTMENT - Ternp Dumpster on site Located at 124 Main Street Fire Department signaturefdate COMMENTS Located 384 Osgood Street yes no Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A -F and G min.$100-$1000 fine NU I t5 and UA I A - (for department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 No 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: Building Permit Application Revised 2.2008 O !%boy Location No. Date Check # /5-2 L/ 25250 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ f Id' 9lnspector it" 1� z M W,4 A ° w° a U) U z w w° 4 U w o w o a' c w o w a U a w i o. u: cn G w x p � a°' _ m u. z P w w v 90 z , � H CO Q o cn a 1 CD O E co L O O v Z CD CL O H � C O cm i O OLa— E m m co 0 CD CL~ ♦_-+ co CL) CD CD o O O a CL CMQ c c 0.-0 c ev cc CD ca co �..i CO) d 0 0 U) ul Y/ W W 19 W N o g� c o O N V V d'O CLC m R C :t O O � N �a �o = v ""' _ o cas. N . o c cm 4' O C CD E • �m 150 C=M C V �' •gip -0 N m 16- CD ac.3 m ' Q1 c_ a •O. C t 32 O m N O" '\t "'999111 Z O ea .o .._ cm m N _.O C .0 ~ co CO) ,C2 -0t L c •N O F. FE .m CZ C O "r m •N z O LU v m c M U C2 COD CL _ ` N '� O a m:10 a 1 CD O E co L O O v Z CD CL O H � C O cm i O OLa— E m m co 0 CD CL~ ♦_-+ co CL) CD CD o O O a CL CMQ c c 0.-0 c ev cc CD ca co �..i CO) d 0 0 U) ul Y/ W W 19 W N '31 4., ACowAutaw'm Siding Proposal Dave Gove 60 Moody Street North Andover, MA 01845 (C)978-973-7103 (H) 978-794-0705 davidgove@comcast.net April 22, 2012 Work completed includes: Aquire building permit. Remove all existing siding and trim from house and garage. Replace all trim with new PVC Trim boards. All windows to be trimmed with 908 PVC trim. House to be Sided with James Hardie Siding with ColorPlus Factory Paint. Replace door on front of garage with octagon window. Any minor rot found will be removed and replaced. (Any extensive rot found will be discussed with the homeowner) Replace front door, Cellar door and install one storm door. New outside lights supplied by customer to be installed. Dumpster on site during entire job. TOTAL LABOR AND MATERIALS Note: Price does not in new gutters. $ 37,000.00 Terms: $ 12,300.00 upon signing of contract ( not to exceed 1/3 of total contract price) $ 12,300.00 when half complete Work to begin on , j 7 /A $ 12,400.00 when job complete Job to be completed on p2 Submitted by: Chris Rivet MA Lic #CS072173 HIC #139962 207 Winter Street (C) 508-265-3115 (H) 978-704-1165 North Andover, MA 01845 All Home Improvement Contractors shall be registered. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor. Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. DO NOT SIGN THIS CONT T ILTHE A ANY BLANK SPACES! �/ Date l Z 9 /2 Homeowner s Signature Date Contractors Signature AcoREF CERTIFICATE OF LIABILITY INSURANCE OP ID NEMA DATE (MM/DDlYYYYI 02/07/12 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(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 Macdonald & Pangione Insurance P.O. BOX 428 POLICY NUMBERF PHONE AX (A1C, No, Ext): (A1C, No): ADDRESS: 104 Main Street North Andover MA 01845 Phone:978-688-6921 Fax:978-688-5350 cusTOMERID s: CHRIS -5 INSURER(S)AFFORDING COVERAGE I NAIC# INSURED Christopher Rivet 207 Winter St. North Andover MA 01845 INSURERA: Preferred Mutual Ins Co 15024 INSURER B: INSURER C: EACH OCCURRENCE 1$1,000,000 INSURER D: INSURER E: INSURER F: COVERAG ES 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. ILTR TYPE OF INSURANCE INSR ) WVDi POLICY NUMBERF i(MM/DD/YYYY) I(MMlDDlYYYY) I LIMITS GENE RAL LIABILITY A X COMMERCIAL GENERAL i EACH OCCURRENCE 1$1,000,000 PREMISES(Ea occurrence) S100r000 LIABILITY CLAIMS OCCUR CPP 0180 57 01 05 09/26/11 09/26/12 MED EXP (Any ane person) s5,000 �� -MADE .. i I - I � PERSONAL &ADV INJURY IS1,000,000 GENERAL AGGREGATE S 2 UOQ OOO I! { 1 � GEN'LAGGRE�GAATE LIMIT APPLIES PER: — X I POLICYF-1 C LOC PRODUCTS - COMPIOPAGG 1$2,000,000— 1 S JE I I AUTOMOBILE LIABILITY j COMBINED SINGLE LIMIT 15 ( ANY AUTO (Ea accident) ; i ALL OWNED AUTOS ( BODILY INJURY (Per person) S BODILY INJURY (Per accident)I S SCHEDULED AUTOS I PROPERTY DAMAGE $ I (Per accident) HIRED AUTOS I i I� NON -OWNED AUTOS f ! I S i► I 5 �l UMBRELLA LIAB I OCCUR ( ( EACH OCCURRENCE $ EXCESS LIAB i ( CLAIMS -MADE I AGGREGATE S DEDUCTIBLE 5 RETENTION 5 ( I 15 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y f N 1 I ! I WC ST TU- I TH- _ TORY LIMITS 1 ER ANY PROPRIETORIPARTNER/EXECUTIV� i E.L. EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? N / A 1 ? (Mandatory in If yes, describe under ( ; 1 � E.L. DISEASE - EA EMPLOYEE] $ I DESCRIPTION OF OPERATIONS below ' � ( ( E.L. DISEASE -POLICY LIMIT I $ DESCRIPTION OF OPERATIONS 1 LOCATIONS t VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder as listed below CF=PTICICATO U^1 nvo - CANCELLATION Town of North Andover Osgood St No Andover MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ITHORIZED REPRESENTATIVE ©1988-2009 ACORD ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD TION. All rights The Commonwealth of Massachusetts Department of rndustrial Accidents Ofjzce ofLnvestigaiions 600 Washinpon Street Boston, 1tL4 02111 www-mizss Workers' Compensation Insurance davit: Builds s/Contra aDLcant Inf'ormaiion ctors/Eiectricians/plumbers r.- Name (Business/O p,,ization/individusl): �/ U ■..nac t L til[ LCa1DlV Address: €� C✓ iti �s.� City/State/Zip: XI,-o-�pOy Phone: �Jr Are You an employer? Cheek the appropriate box: 1. ❑ I am a employer with__ 4. ❑ I am a general contractor and I Type of project (required): . employees (full and/or part-time).* have hired the sub -contractors 2. 6• [:]New construction C1 1 am a sole proprietor or partner_ listed on the attached sheet t ship and have no employees 7• 2Remodeiing These sub -contractors have working for me in any capacity. workers co insurance. 8. ❑ Demolition [No workers' comp. insurance �. MR ❑ We are a corporation 9. Building addition and its 3. ❑required.] officers have exercised their I am a homeowner doing 10•❑ Electrical r epos or additions all work right of myself [No workers' co motion Per MGL mP• a 15_, § I (4), and we have no .11. [3 Plumbing repairs orations insurance requir„d ] t em loyee P s_ [No workers 12.[] Roof repairs_ Pomp. '] insurance regale -„d. y.-r^�f' w^It zat •':::f a box Y.: most &IS(,tr-secs== V"=aa• 13.[] Other Flatneo s4�9R^. :a �. wIIerS wn0 6nOm7L fh1S a�d8 5 -.. R•Or;�a„r- COD.'y....S�C^. i .C'..—....�+�,-ion. vit i h idauna they a._ �t h , cr1 and =h® bite otuside conaz tor; rftiust submit a new affidavit indicating such. 'Contractors that the :this box must attached an additional sheet showing the Game of the sub -contra. -tors and I am an employer that is providing workers' their workers' imp, policy information. coinP ensauon information. II nnssurance for my employees Below is the policy and job site Insurance Company Name:��Q Policy tr or Self -ins. Lir. :_�'� 0/ 70 C Y� f n J Expiration Date: /-- Job Site Address: ero %�~ J Attach a copy -of the workers' compensation policy declaration page (she CQZY/State/Zip: �f p �jt jOav/SyZi Failure to secure coverage as required und.�r Section ?SA of MGL C. i �? wins the policy number and expiration date). line up to $1500.00 and/or one-year imprisonment, as well as civil penalties in theform imposition oaSTOP WORK crimORpenalties of a DS and a nne Of up to $250.00 a day against the violator. Be advised that a co Investigations of the DIA for insurance cove, -age verificanon.py of this stat.Pment may be forwarded to the Office of L ao hereby Certify ofperjury fat the information provided above js true ayrl correct. Official use only. Do not write in this area, to be completedbJ , citJ, or town of�icwl City or Town: Permitucense r Issuing 4uthority (circle one): 1. Board of Health Z. Building, Department 3. Citv/Town Clerk 6. Other Contact person: 4. Electrical Inspector 3. PIumbin,, Inspector Phone r - ��:t�43�'13iiKii� - ).'I):;f'if131•ni itl �ul)13c ti iTs, �Oil3•tl iJl 133iti3t3 x t'��Ui:ii[tif3e :3i)tl E<t, {� ads x,06-31*iLCiiOI- L3 per` isc.r Licans- License: CS 72173 F'ceSY'1CYed to: 0013 CHRISTOPHER F RIVET 207 WINTER ST N ANDOVER, MA 01845 J Expiration: 6/2/2012 - ,.w;ni•.i,,,u r Tr=: 27092 -- - - -- Elie U�arno�zo�iu�eatl� a �✓�L�crat�� '- Office of Consumer Affairs & Bsiness Regulaticis HOME=. irROVEMENT CONTRACTOR =.r Registration: 139962 Type: Expiration: -918/2013 Individual IiRTSTOPHER r RIVET CHRISTOPHER RIVET- 2C-7 IVET2C' WINTER ST. N. ANDOVER, MA 01845 Undersecretary