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HomeMy WebLinkAboutBuilding Permit #421-14 - 69 HIGHLAND VIEW AVENUE 11/8/2013 O�ND11 a or a qti R BUILDING PERMIT 3 °<•�• .` "6 °� TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: - Date Received � j �9SSACHUS t� Date Issued: I / IMPORTANT: Applicant must complete all items on this paEe 'LOCATION Print PROPERTY bWNER `CE. � "'�� ..Print, MAP NO: PARCEL. .ZONING DISTRICT. . V Historic District yes no ? Machine Shop Village. ;Yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition X'Two or more family ❑ Industrial ❑ Alteration No. of units: 2 ❑ Commercial -Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p .Well ❑ Floodplain ❑:Wetlands ❑:Watershed Distric - etic ❑ t � d S Water/Sewer 67 1 Identification Please Type or Print Clearly) OWNER: Name: / ei>�/� a,9,e•14A,P Phone: -SO?-- Address: 69 1711GHL4,✓p Y/E1k) i41,e'- A10 CONTRACTOR Name: Phone 9?$:-8 36.7oS3 Address Supervisor's Construction License Exp .Date GSo7o-7 yb 3/o/s Home Improvement License: Exp. Date ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT;$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. titiw Total Project Cost: $ Z O� OoO, a t7 FEE: $ Check No.: Receipt No.: NOTE: PersWnrcoiftracting with register contract rs do not have a cess to the gu ranty fund SSignature of Agent/Own gnature.of contractor L I� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION I I ft j Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page 77 _ 7 — �u'ar � y # a � � ��','^.. � � �,� LOCATiIONfnsw Pring . s'f 4" a (PRO_PERTY"01I. 4E �MAP�NOaPARCEL ZL NINGDIS�TRI:CT HistoncYi©istncth yes„ nog e.6 y w -d-..,�..Y.��a.° ,�.,-,..�,�— ,...a _:.� ' �$.t_�, ° _ � �:: „s.�>:.-*. a Sho.•� .:: TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family if ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0'Se tic gUllell ❑ Flo_o dpl"aint DWetlands � Y❑ �IVat'er.etl Dis rt -i 6t ��,�❑�1.Nater/Sewer` � .._� � � � w� � DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACT # hone g ` i Address y 41 �.b �b•c." '.ri `---N� ''- r x„' + 3...€ r°¢ x a.a:'� q'' a,� ! up (�Sup ,Zdervisorgstru'ctlon Llcense� )-!—IN '' 1. �' 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund r - SI Batu a ofcor►tractor= � �- i . Signature�of'A.9t/Owne ... � �_� . � gr3 _ Plans Submitted LJ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted-0 PlansWaived-[] Certified Plot Plan ❑ Stamp ed Plans ❑, TYPF--'OF°:S)✓tNERACE DISPOSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑. . ..Swimming Pools ❑ Well ❑ Tobacco-Sales ❑ i Food Packaging/Sales ❑ If Private(septic tank,etc.. ❑ - - Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR-OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM - ,DATE REJECTED DATEAPPR.OVED PLANNING & DEVELOPMENT` ❑ ❑ COMMENTS I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: ZoningDecision/ receipt receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Towo Engineer: Signature: Located 384 Osgood Street FIRE DEP 'RTMr NT Tenip Dump�ster on site yes no Located at�124Mair, Fayre Deparfine!�t signature /date 'f .#.'d 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 I I I' i i r I ® Notified for pickup - Date j f Doc.Building Permit Revised 2010 i k Building Department ti =The foll-3wing is-=a list of the',required.forms to be-filled out-for the appropriate.permit to.be obtained. Roofing, Siding, Interior Rehabilitation Permits o Bailding 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 cans.if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Building Permit Revised 2012 Location �� NoAL i! kq Date Z 0 e - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ j Check#27086 Building Inspector � NORTl1 Town of 2 . Andover O 0 No. _ - ZI 12 ��► h ver Mass COC NICMl WICK V� A�R�TEO J0, % �5 S U BOARD OF HEALTH Food/Kitchen .PERMIT T LD Septic System THIS CERTIFIES THAT .... ..... ...Q .... ...................... .......................... .......... BUILDING INSPECTOR `ahi .� Foundation has permission to erect .......................... buildings on .����.. ...... .. .1. ..... .. . r� � Rough .. ... . ....................... .... �� ...LA Chimneto be occupied as ..... . .a'! ' . .. . v provided that the person accepting this permit s all 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 CONSTRUC N ARTS Rough Service ........... ...... .. . ............................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. SEE REVERSE SIDE 0 INFINITE SOLUTIONS. Keith Barnard October 14, 2013 Re: 69 Highland View Ave., North Andover, Ma. Infinite Solutions, Inc. is pleased to present you with the following price proposal for your review and use. Scope of work: 1. Removal of existing Brick chimney above roof line. Cap off below roof line, Repair roof and plywood over existing opening. 2. Rip and replace existing(2) layers of shingles. Replace Plywood where needed. 3. Replace with 30 year architectural shingles. (color to match existing) - Replace all drip edge, ice an water shield 6' from eves and any penetrations. Replace all roof vents. - Includes disposal of all construction debris 4. Installation of gutters along both sides of house. S. General plumbing upgrades and repairs to existing(2) bathroom (showers,sinks,toilets) & (2) kitchens (1 sink per unit) Inspections of existing designs and upgrade/update where needed. 6. Remove and close off/tile over (1) window in existing showers. (2) Total, 1 per unit. 7. HVAC/Boiler rip and replace with new high efficiency propane boilers (2) total.Wall mounted units with side exhaust(chimney to be capped off) General Materials included cost:$10.200.00 - (16) Square architectural shingles, (3-4) sheets of replacement plywood, drip edge,ice and water shield, roof vents, dumpster rental. -Gutter materials,hangers, downspouts. -General plumbing upgrade materials, existing piping to be replaced with plastic (4 Sinks) (2 showers) (2 toilets) -plywood and tile to close close off windows in existing showers. - 2 high efficiency wall mounted Propane boilers. Labor: $9.800.00 Removal of existing Brick chimney above roof line. Cap off below roof line, Repair roof and plywood over existing opening once removed. -Rip and replace existing (2) layers of shingles. Replace Plywood where needed. -Replace with 30 year architectural shingles. -Replace all drip edge,ice an water shield 6'from eves and any penetrations. Replace all roof vents. 214 Andover St. Unit#1 Phone 978-836-7053 Wilmington, MA 01887 Fax 978-658-7153 O INFINITE SOLUTIONS,.. - Labor for General plumbing upgrades and repairs to existing (2) bathroom (showers,sinks,toilets) & (2) kitchens (1 sink per unit) Inspections of existing -Installation of gutters along both sides of house. Window removal and tile work in existing showers (2) Total:$20.000.00 *All plumbing to be completed by MA licensed plumber Mathew Ryan. License # PL32857-J If you have any questions,please feel free to call me at 978-836-7053. Thank You, Chuck Wing Infinite Solutions, Inc. 214 Andover St. Unit#1 Phone 978-836-7053 Wilmington, MA 01887 Fax 978-658-7153 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 209000.00 m $ - $ 240.00 Plumbing Fee $ 30.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 30.00 Total fees collected $ 400.00 69 Highland View Ave 421-T4 on 11/8/2013 Bath Remodel (2) ReRoof, Repair Ceilings i A� CERTIFICATE OF LIABILITY INSURANCE D0/17 ,DD013 10/17/2013 THIS CERTIFICATE 1S 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). PRODUCERONTAC NAME: T Gail Conlin Nicholas A Consoles Insurance Agency Inc PHONE (978)223-4037 FAX (973)223-4033 153 Andover Street Unit 208 E-MAIL gall@consoles nsurance.om INSURERS AFFORDING COVERAGE NAIC# Danvers MA 01923 INSURERA:First Specialty Insurance Co rp INSURED INSURERB:Safety Insurance CoMany 39454 Infinite Solutions, Inc INSURERC:Torus Specialty Insurance Co 214 Andover Street INSURERD:Zurich American Insurance Co Unit 1 INSURER E: Wilmington MA 01887 INSURER F: COVERAGES CERTIFICATE NUMBER:Master Cert 2013 to 2014 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 ADDLSUBRY EXP Y EFF POLIC POLICY LTR TYPE OF INSURANCE POLICY NUMBER MM IC LIC LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TORENTEb- -1 PRE IS S(Eaoccurrnce $ 50,000 A CLAIMS-MADE OCCUR RG200091600 /18/2013 /18/2014 MED EXP(Any one arson) $ EXCLUDED X Per Project - $5 MIL CAP PERSONAL&ADV INJURY $ 11000,000 X $2,500 Deductible GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY X PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a i n 11000,000 B ANY AUTO ALL OWNED XI SCHEDULED 6200922 BODILY INJURY(Per person) $ /29/2013 9/29/2014 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS NED APROPERTY DAMAGE AUTOS Per accident) $ $ X UMBREEXCESS LAS X OCCUR EACH OCCURRENCE $ 5,000,000 CFFOED EXCESS LIAB CLAIMS-MADE X AGGREGATE $ 51000,000 10 00 801 RETENTION$ 41B132ALI 3/18/2013 3/18/2014 D WORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS'LIABILITY YIN X ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N/A E.L.EACH ACCIDENT S 1,000,000 (Mandatory In NH) C4578874-02 /20/2013 /20/2014 E.L.DISEASE-EA EMPLOYE $ 1,000 000 If s,describe under DPSCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1 0 00 0 0 0 DESCRIPTION OF OPERATIONS!LOCATIONS,VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Keith Barnard ACCORDANCE WITH THE POLICY PROVISIONS. 69 Highland View Ave North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Anthony Consoles/GCON ACORD 25(2010!05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201otoos).o1 The ACORD Warne and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street ,. Boston, MA 02111 " www.mass.gov/clia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Le� ibly Business/Organization Na1ne: i� i, � G uti - �vL y Address: City/State/Zip: LILAV^ � .€1 � UISS Phone #; '30. 3 Are you an employer? Check the a ropriate box: Business Type(required): 1. I am a employer with J 7 employees(full and/ 5• ❑ Retail or part-time).* 6. Restaurant/Bar/Eating Establishment 2.[] I am a sole proprietor or partnership and have no employees working for me in any capacity, 7. E] Office and/or Sales (incl. real estate,auto. etc.) [No workers' camp. insurance required] 8. ❑Non-profit 3.a We are a corporation and its officers have exercised 9. ❑:Entertainnient their right of exemption per c. ..152, §1(4), and we have 10,El Mantlfacturirg no employees. [No workers' comp, insurance requ:ired]* 4.El We area non-profit organization, staffed by volunteers. 11.0 Health Cesar With 110 employees. [No workers' comp. insurance'req.] 12.9 Other rrY� *Any applicant that checks box 41 must also dill out the section below showing their%workers'compensation policy information. "If the corporate officers have exempted themselves.but the corporation has other employees,a workers'compensation policy is required and such an organization should check box i 1. I.nm all employer that is providitk ►vorhers'coinperasa on irrsurtrirce for irrlr employees. Below is the policy information. Insurance Company Name: Insurer's Address: . 016 Citi-/State/Zi 109 ilk A4 A Potic r 4 or Self-;ins.Lie. 2--Expiration.Date: 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 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. 11/0 hereby certif}., under th tti is and penalties of perjury that the infortnatiott provided above is true awl correct. Si nature: Date: Phone 4: 7 3�,- 76 -43 Official use only. Do not write in this area,to be completed by city or tolvtt oci J City or.Town: Permit/License# Issuing Authority(circle one): I.. Board of Health 2. Building Department 3. City/Town Clerk 4.Licensing Board S. Selectmen's Office 6. Other Contact Person: Phone#: !Hilt Massachusetts-Depa!tmen!of Public Salety ��pJJ Board of Suilding Regulations and Stand•5rds ClowrtuffiilSjip fi�cn License'CS-070740 CHARLES R N'INC!R 3 PiNF i iEDLF i ANF' CEORCETOWNI%IA 07833 comm YSstw'" 0313012015 I i i