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HomeMy WebLinkAboutBuilding Permit #263-14 - 701 SALEM STREET 9/19/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 1 J I Date Received Date Issued: I PORTANT: Applicant must complete all items on this page LOCATION -- Print PROPERTY OWNER .-- Print 100 Year Old Structure yes -no MAP NO: =PARCEL: ZONING DISTRICT: Historic District ye no Machine Shop Village yes no__ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: XCommercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ ❑ Septic, ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District 0 Water/Sewer _ DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Ar-Ae,2 XF� Phone: 9?E- C9 2-� 3/78 Address: C CONTRACTOR Name:nn !s MgQ r4 Phone-;- Address: hone Address: 7 1"J - p Supervisor's Construction License: Q9 �/�- ._Exp. pate:_ Home Improvement License: 16n 614 Exp. Date: �t_ _ r 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. Total Project Cost: $ FEE: $ Check No.:C4 (' Receipt No.: _ NOTE: Pe sons contracting with unregistered contractors do not have accak to the aranty fund, ignature of Agent/'Owner g' '44 i nature®of contractor Plans Submitted ❑ Plans WaivedEl Certified Plot Plan ❑ Stamped Plans ❑ Building Department The foli`owing is-a N t of the retluired.forms to be filled out for the appropriate.permit to be obtained. Roofivq, Siding, Interior Rehabilitation Permits La Building Permit Application ecu Workers Comp Affidavit Li Photo Copy Of H.I.C. And/Or'C.S.L. Licenses u Copy of Contract Li Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Li Building Permit Application Li Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses a Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) u Mass check Energy Compliance Report (If Applicable) Li 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) Li Building Permit Application o Certified Proposed Plot Plan u Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract Li Mass check Energy Compliance Report Li 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.Buhding Permit Revised 2012 Plans Submitted❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OR-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 DATEAPPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS .CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS T Zonis ig 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 DPW Towo Engineer: Signature: Located 384 Osgood Street FIRE-D'EPART'MENT Temp Dumpster on site yes no Located-at 124 Mair Street Fire Departrneriflsignature/date 4 r= 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 El Notified for pickup - Date Doe.Building Permit Revised 2010 Location No. Date s - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ 'I'mo rr« � i^ Other Permit Fee $ kv TOTAL $ ren Check# ,U © Building Inspector i NORTH Town of E 1> Andover O �»� ,, 1 to No. 40 0 - h , ver, Mass, 3 Da�O lA�(E .i• 'Z1CNEWICft V �d pTED /'Pa,`'�5 S V BOARD OF HEALTH Food/Kitchen PERM T T LD Septic System • THIS CERTIFIES THAT ...... .,i�.. ...................y�GIIL�... .. .: ................................................. BUILDING INSPECTOR has permission to erect ............buildings on .701. A �................ Foundation .............. ........ .... ...... I "C ...... Rough tobe occupied as .......... ......... ..........5.......................... .....O °`....................... Chimney provided that the person accepting t is 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 33 • PERMIT EXPIRES IN 6ONTH ELECTRICAL INSPECTOR a UNLESS CONSTRUCT T S 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 NORT#1 Town of 2 : Andover No. V3 — I iL o ��K. h , ver, Mass, A3 COC NICKl MACK y1. �qS RATED OkPa,�gS U BOARD OF HEALTH Food/Kitchen PERM T T LD Septic System • THIS CERTIFIES THAT ......YbV . .......... VOC-0646..A ........ ..I:C................................................. BUILDING INSPECTOR has permission to erect .......................... buildings on ......... Am'.11V.....W.T.M.00................ Foundation ........... Rough to be occupied as A........... .........Cis ............ ....... . ................. Chimney provided that the person accepting 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 D361 . PERMIT EXPIRES IN 6 ONTH ELECTRICAL INSPECTOR UNLESS CONSTRUCT T S 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 A The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations w I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual) �( (� iz, f:Aa w L-C cs Address:2'1 l,QC A4PV %t 1 l LO City/State/Zip:V,0o_ e-iQ(cL Wk OtO^6Q Phone#:-1col-?2(,S 3G O Q Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with L4 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. F-1 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' y p �'• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. E] We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other 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. $Contractors 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 the policy and job site information. Insurance Company Name:`Tt-C,UCAI� Policy#or Self-ins. Lic. #: (01-�0165C L4 CJ'b 13 Expiration Date: L412-61 I Job Site Address: ` Q� �� , eP City/State/Zip: / -r � )���+�( 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage rification. I do hereby certify un the p ins a lt' of perjury that the information provided above is true and correct. Si ature: Date: 9 Phone#:`14D i`ZLkS—345100 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Acc� CERTIFICATE OF LIABILITY INSURANCE 'm` 'y" s � THS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMMK ONLY AND CONFERS NO RIOT S UPON 714E CERFIFICNE KMM11t.T S CERTIFICATE DOES NOT AFFUNATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERnFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUT'HORI?�D REPRESENTATIVE OR PRODUCER.AND THE CERnRCATE HOLDER t holder anADDITIONAL es mast be WWO%sd. 4S Try #WtemnwwdcmcBgonsaf#wPOWAaedalnONdOSM10YC"dM8UGMMM*W&AddWnmtoaUd&Poa doss aot coeHfes la 9is cerdfica%holder In Neer of auch ender PRODUCER Caaaen Cocca Cocca I32garance Associates Inc 8 47a1; 246-3926 dba Nater Street Insurance Age 4as .� 27 Water Street BISUFE AFFORDO0 IZYa:AOE NAICOF Wakefield, MA 01880 INBURPRA:zesex * imunBt a•Travelers Betterbuilt Enterprises LLC mac:T3sranstaLL 27 hater St - Ste 116 T$eURERD: Wakefield, MA 01880 INUMF: COVERAGES CERATE NUAMHER: REVIS M WJ MWR: THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED SELOAN HAVE BEEN ISED TO THE MURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWRi13TANDWG ANY fmoummmr,TERM OR CONDITION OF ANY CONTRACT OR OTHM DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAN.THE INSURANCE AFFCNVEID BY THE POLICES DESCRIBED HSI IS SUB.IECT TO ALL RIE IERW E)CLUSIONS AND CONDITUM OF SUCH POLICIES.LAM SROM MAY HAVE BE'B+!RSD BY PAD CLAVAS TV TYPBOFMOUR/MNHLpoommawm I EIlrra A GENE LIABLfrY 31M104 s/u113 1/21/14 EWHOCCUfaMCE $ 1, 00,000 CereMERaALOEIERMLLVAUTY s CIAS64AAM ®OCCUR MED one i 5,000 PER3ONaL&ADVMJURT $ 1,000,000 cas�ERa AooRSGATE s 2.000,000 SEWL11 ►7ELa0TAFPUESPHDi PRODUCM-WwwPASiB s 2,000,000 POLICY M Loc s AH/7@HLAeOrrY ea AKYAUM BODLYNJURYOerS SCHEDULED AUTOS Ntr eDDO YBiARtY eedde�Q i HretE1AUrOS AvpDS � f S C u" OCCUR ZONJ451413 1/11/13 1/11/14 FACHOCCURRENCE $ 1.000.000 8 Wlemu a CLASWPWAE s 1,000.000 8 vloR rom C0MpmAffNw AND EMPLOYERS'UABILlTY 68085894898-A-13 4/23/13 4/23/14PROPRETORNVIRTNEREXECUTROE 1MCs7A7Hi Y N J:L O0Ff MFAF MM E=LUDEDz NIA EL acs 5001000 imm"w In NNI 500,0 re sesame undw SQQ QO DESCM=OFOP=M=ILOd KMSnF01 =(Awa!►ACM11".Aadl RsaeeMsBda�aMr,Rmaaspastssa�wij n CERTIFICATE HOLDER CANCELLATION SHO1"ANYOF7HEABOVEDE8CMR1EDPOUCE8 BE CANCELLED B» THE EMNATION DALE THEREOF, NOTICE WILL BE DELIVERED 00 ACCORDANCErM M 7HE POL CY HRROVMNS. 1NrrHIDR®R ' Carmen Cocoa 0 19884010 RD CORPORATION. All dghls roserrerl. ACORD 25(201 01011) The ACORD name and kgo aro re ed mafka of ACORD Pilate: Fax: &143t Massachusetts-department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-094612 DENIMS J DRITIS- r✓�� 26 BRISTOL;ROAD, I PEABODY.#A 01960 t r•. °�-'�"•�'''"'�r`15��`� � I Gonnttissianer Expiration _ Vlte�a�manure��I��C�/��sacrcfu�clla Mee of Consumer Affairs&Business Regulation oqk 0 ME IMPROVEMENT CONTRACTOR y egistration: '180616 , Type Expiratior► 802014 .4 Supplement BETTER BUILT ENTERPRISES LLC DENNIS DROGGITIS i 27 WATER STREET 4 WAKEFIELD,MA 01880 Undersecretary i, Contractor License#CS 094612 HIC#160616 Mathew Xenakis May 15,2013 701 Salem St North Andover,Ma 01845 Phone:978-697-3178 Fax:978-697-0049 Dear Mathew, The following estimate is for the roof installation for the building located at the above address. The following paragraphs describe the work that will be performed. Roof Installation Procedure: aik Strip existing roof on the building 4V Inspect decking for any rotten or damaged areas 4 Replace any rotted or broken roofing boards at a cost of$4.00/LF for ledger board or$70.00/sheet for 1/2"plywood 4- Install 6 feet of ice&water on all leading edges,valleys&/or transitions 4. Install 15 pound felt paper to cover the rest of the roof 46 Install an 8-inch drip edge on all eave and rake edges.Color:WHITE jb Install new vent pipe flanges 46 Install new 30 year Architectural shingles,fastened by nails 46 Install a ridge vent system on all peaks of the building 4 Owner to choose color of shingles Color Landmark,Moore Black Additional Specifications: 4� Dumpster to be placed in the back of the building 4 All work will be done in a professional manner,and timely basis 4; Please cover all items in attic to protect from falling dust and debris 4 We are not responsible for any of the cracks that may arise in any walls or ceilings 4- We will remove all of the job related debris 46 Thorough daily job site cleaning and upon job completion 4 Cost includes Building Permit Please Initial the Option you are Choosing: Cost for Labor&Material to Replace Roof on the Entire Building: $19,400.00 Additional carpentry will be billed at an hourly rate of$45/hr plus any necessary material Payment Terms: 30%deposit,30%work in progress and 40% upon completion i Warranty: BetterBuilt Enterprises LLC guarantees all work performed for a period of two years. If any problems occur we will cover the cost of all labor to correct the problem and meet the customer's satisfaction. MA License # 160616 Better Business Bureaus#09862. ; D is Droggitis''r I `lNlathew fnak's BetterBuilt Construction Owner a-- wCL-�, C-7- w6i mA .