Loading...
HomeMy WebLinkAboutBuilding Permit #226 - 64 CHURCH STREET 9/21/2007 r1ORTH BUILDING PERMIT o�,t�E° bq"o TOWN OF NORTH ANDOVER Op APPLICATION FOR PLAN EXAMINATION r e Permit NO: Date Received �SsgcHus���� Date Issued: `a IMPORTANT: Applicant must complete all items on this page LOCAT1tJN Print PRC,�:RERTY OWNER �.SWWk't' Print MAP NO: _ PARCEL; ZONING DISTRiOT Historic District yes no „ ... _ . . Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 19One family ❑ Addition ❑ Two or more family ❑ Industrial )$Alteration No. of units: 11 Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Sufic ❑ 1Nelf1. - ❑ Fl .odplain wetlands 0 Watershed District U1ta#er/Sewer 9 ¢. DESCRIPTION OF WORK TO BE PREFORMED' Go 0C/s71N6 S/D/A.0 /nes T9tC ? g /A/� L,60714)ik- &M70 4nAD nIC&y sl Di n r Identification Please Type or Print Clearly) OWNER: Name: _51-legr'G P�ND62sK Ph one: -6TC=7DUq Address: G y C/ y si;e CONTRACTOR Names 1t C-jfC Phone: zb Address: "/S GCC Supervisor's Construction Licensee.rv. �' �5 Exp. Date. !,3 ` Horne lrrtprovemer�tLicense: Exp. Date 971-7 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: $ 5q q 5'� FEE: $ G�� Check No.: jg /V Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owher mature of contractor Location No. � Date MORT/y TOWN OF NORTH ANDOVER 0 s • ; ; Certificate of Occupancy $ ..�__. : �7s'••a°•'t'�' Building/Frame(Frame Permit Fee $ U "us Foundation 9 Foundation Permit Fee $. Other Permit Fee $ TOTAL $ Check # 9 � r_ r. Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinuning 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 DATE REJECTED DATE APPROVED CONSERVATION ❑ . ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster;nn 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 NOTES and DATA— (For department use F-- LI Notified for pickup - Date ............................................._.........................................................._.............................................._......._..................................... Doe-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 ❑ 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 2.2007 N0RTH own oAndover 0 No. o dover, Mass., ALI 40 / J_ Q LAKE Ap COC MICHEWICK ADRATED '9S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT......... BUILDING INSPECTOR 6�...�.................... ...�.!!!�.� ...... ....................................................... Foundation has permission to erect........:............................... buildings on ..&. ............G.�iV101...GI.........�.r Rough Chimney to be occupied as.......... .. . ,I • .... .... ... .. . . . . . .. . . . . . .................................................................... provided that the person acceptin�th permit shall in.ry 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, 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 bo am PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TRU T S Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: s/s C/0614-1 City/State/Zip: i AC 90,0Y /V4 D/%) Phone #: 635 V.? Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with /'' 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.F1 am a sole proprietor or partner- listed on the attached sheet. + �• E] Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their ME] Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.;4 Other comp. insurance required.] *Any applicant that checks box#I 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. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: If-44A)TIC 1A J_ft,1it'l9A1 (fC)/ 4A9A,"7' Policy #or Self-ins. Lic. #:�j(��� SyO Expiration Date: 2C�fJ Job Site Address: G 7 ZeC1 �12 City/State/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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t/a pains a enalties of perjury that the information provided abov is truand correct. Si nature: Date: 2 Phone#: _041q_7 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# 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#: CERTIFICATE OF LIABI ATLNSURANC.E DATE(MM/DD/YYYY) T�.. ,ROOUCER' Plpllg'(817)857_5110 Far. (817)8575112 02/09/2007 KNIGHT INTERNATIONAL INSURANCE GROUP THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 500 VICTORY ROAD ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MARINA BAY HOLDER. THIS CERTIFICATE.DOES NOT AMEND, EXTEND OR QUINCY MA 02171. ALTER THE COVERAGE AFFORDED BY .THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED ALPINE PROPERTY SERVICES CO.,INC. INSURER A: Clarendon America Insurance Company_ INSURER g: Merchants Mutual Insurance Company 11 WILSON STREET SALEM MA 01970 INSURER C: Hanover Insurance INSURER D: Atlantic Charter insurance Company INSURER E: - - COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONAMED NTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED POLICIES.S. AGGREGATE.LIMITS SHOWN MAY HAVE BEHEREIN IS SUBJECT 70 ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH EN REDUCED BY PAID CLAIMS. INSR ADo TYPE OF INSURANCE ., . LTR INSR POUCY NUMBER POLICY EFFECTNE POLICY EXPIRATION GENERAL LIABILITY DATE MMrp DATE MwDD LIMITS H4`10000161-0 01/04/07 01/04/08 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS MADE� OCCUR PREMISES(Ea0c nca) $ 50,000 A MED.EXP(Any cnc Person) $ 1,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ _ 2,ODO,000 POLICY PRUCS-COMP/OP AG . $JECO T PRODTG LOC _. _ 1,0.00,000 AUTOMOBILE LIABILITY ANY AUTO AFN 857155-00 01/09/07 01/09/08 COMBINED SINGLE LIMIT (Ea-owen() $ 1,000,000 ALL OWNED AUTOS C Per SCHEDULED AUTOS (BODILY reNjURY S X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY (Per Occ�rfo $ PROPERTYOAMAGE S GARAGE LIABILITY. IPer scadrnt) ANY AUTO AUTO ONLY-EAACCIDENT S OTHERTHAN EA ACC $ _ AUTO ONLY: EXCESS I UMBRELLA LIABILITY /08 UR AGG $ X OCCUR 0 CLAIMS MADE TBA 01/01/07 01101EACH OCCRENCE s 5,000.000 _ g AGGREGATE $ 5,000,000 DEDUCTIBLE $ ` X RETENTION S 10,000 _ a WORKERS COMPENSATION AND $ EMPLOYERS LIABILITY WCV0075490D 01/05/07 01/05/08TC tATtl ptHER ORS LIMITS _D. ANT PROPRIETOR/oART1ER/ERECUnVE OFRCEPJMEMBER EXCWgEO7 E.L.EACH ACCIDENT S 100,000 GIAL eyes, RO„r,oer EL DISEASE-EA EMPLOYEE S 100,000 BDEPROVISIONS Below OTHER: E.L.DISEASE-POLICY LIMB $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CERTIFICATE HOLDER -.CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILLENDEAVOR:TO nsAlL10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT;BUT FAILURE TO DO.ENT.S O L IMPOSE NT OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS`AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attention: ACORD Z5(200110s) Harold night: 1 Certificate Q ACORD CORPORATION 198E wMy '' ax ,.. .. HIC#154326 Y F'*1958 EIN#56-2618812 Roofing • siding • Painting Sheryl Pendexter 64 Church St. North Andover,MA 01845 (978)686-7009(home) (978)973-6832(cell) August 16,2007 Dear Sheryl, I have prepared the following estimate for the installation of the vinyl siding at the above location. This will be a full coverage job with no maintenance required and lifetime warranty. All work will be performed to the manufacturer's specifications to ensure a lifetime warranty. Below is a brief description of the work that will be performed. Vinyl Siding: • Go over existing siding with new vinyl siding • Install 3/8"insulation board over all areas prior to vinyl installation • Install CertainTeed MainStreet vinyl siding • All overhang and eaves will be dressed with soffit panel •. All trims will be wrapped with aluminum coil stock • We will install new vinyl corner,j-channels and casements throughout • The soffit and face boards will be done to match the windows • You may choose to have the vinyl match the color of the soffit • You may choose to have us install vinyl shutters(this is an option and is not included in estimate) • Foundation will not be covered • Job will be started and completed without any interruption • COLOR: S Initial options you are choosinz below: ✓ Cost for Labor&Material to Go-Over Vinyl Siding: $5,195.00 Cost for Labor&Material to Install Gutters on Front of House: $ 300.00 Payment Terms: 1/3 deposit$ 1531_� 1/3 work in progress$JB31., and 1/3 upon completion$ Please make payments to Alpine Property Services Company Inc. Total Amount Agreed To Be Paid: $ Warranty: Olympic Painting and Roofing guarantees all work performed for a period of one year. If any problems occur we will cover the cost of all labor and material to correct the problem and meet the customer's satisfaction. Do not sign this contract if there are any blank spaces. ( itt al provisions follow and are incorporated herein by this reference) Mic Connors,Project Manager Sheryl Pendexte I Property Services Company Inc., Homeowner d/b/a Olympic by(Name) Tel: (800) 535-4312 • Fax: (978) 535-2008 • 515 Lowell Street • Peabody,MA 01960 1-888-5 OLYMPIC • www.OlympicContractors.com 15 Tanguay Avenue 117 South Killingly Road Nashua, NH 03063 Foster, RI 02825 Board of Building Regulations and Standards Construction Supervisor License yr License: CS 84795 Birthdate: 5113/1967 Expiration: 5113/2009 Tr# 13916 Restriction: 00' EVANGELOS LIAR1S '`�� 3 LEDGEWOOD WAY#22_ PEABODY,MA 01960 Commissioner __ ,per _ ✓� � �, �.�� Board of Building Regulations and Standards ' HOME IMPROVEMENT CONTRACTOR Registration: 154326 19 Expiration: 2!27/2009 Type: Supplement Card NEP1NE PROPERTY SERVICES C ?VXK'GELOS LIAPIS 11 WILSON STREET _ SALEM, MA 01970 Administrator'"