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HomeMy WebLinkAboutBuilding Permit #058-15 - 84 BRUIN HILL ROAD 9/17/2014 BUILDING PERMITo� NORTH qw- �,I.ED 16 "IO TOWN OF NORTH ANDOVER2 "'.'° °? APPLICATION FOR PLAN EXAMINATION 1 +[ Permit No#: 0 t) Date Received ��SSac HLis���y Date Issued: I PORTANT:Applicant must complete all items on this page 13 IA- it PROPERTY- OWeNER; _ :` _ C n- , _ 11 A1N X100 par, Structure 777 $MAP � `_PARCELZO,NIN'G ®ISTRICT Historic4D st ctxyes3 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No, of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other )��Sept_ 1❑41Ne11 i_ �❑;Flo0dp%lain :Wetlands ' ❑ 1Nat shed District w 3 1 ❑ Water/Sewer r � ��� f ESCRI TION OF WORK TO BE PERFORMED: Idecation- PI ase Type or Print Clearly 60g, OWNER: Name: `Sr/�� Phone: Address: / e!� y r=Contractors 0. e. t,A.dCIfeSS 1 O P f�c �(Y . "� .•�yy� / � �F `�� s�.,� a« j � s a 65 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: $ c.D 0 Check No.: _4�DReceipt No.:_.(9 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owne� `...; ,;Signature'of contra k' ib14 S Location No. �- Date . • TOWN OF NORTH ANDOVER .}, * Certificate of Occupancy $ Building/Frame Permit Fee 3} a Foundation Permit Fee $ l , Other Permit Fee $ TOTAL $ I' e Check# 7 O `� 'i-Building Inspector i i; Plans Submitted ❑ Plans Waived El Certified Plot Plan ❑ Stamped Plans ❑ :.OES.EWERAGE-DISRO.S.A.)v— Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ,❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature r 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 DPW Town Engineer: Signature: Located 384 Osgood Street K°*p ..�^.. �r 'tom ^'t a :A FIRE�DEPARTMEIVT 'Temp D.um ster,msite�'A es u* � n'o . f _ orated a#-f1241MJrli§tre''et t sW Fire Department�si.gnature/date t _ � '^'AT wCr OMME.€-Nt*sT,,.+- . mo �Y,'Sw , 4 Di.mens_ion 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) ❑ 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 ❑ 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/Cross Section/Elevation Plan Of Proposed sed Wor k With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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 Revised 2014 � NORTH Town of n O y Y No. .T % h ver, Mass, COC NIC MEWIc Yt S V BOARD OF HEALTH Food/Kitchen PERM LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ............ ............ ....J.1. ... ................. ............. .V' has permission to erect . buildings on9�++ . QQhrYl i� r Foundation Rough to be occupied as ......................5.. ..... ..........!�!�..., 0.' ^.............Y................ chimney provided that the person accepting this per t shall in every respect conform J 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 100 ,0 PERMIT EXPIRES A6 MONTHSELECTRICAL INSPECTOR UNLESS CONST N S TS 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. =dRD CERTIFICATE OF LIABILITY INSURANCE 6/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRNIA-iVELY 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 NAME: Geay McDonald McSweeney&Ricci Insurance me°NN 781-848-8 Fax No:781-843-8807 420 Washington Street no IIL ri ow iri P.O. Box 850984 Braintree MA 02185 INSURERM AFFORDING COVERAGE NAICe INSURERA;Acadia Insurance Company 31325 INSURED WOOST_1 INSURERS'Star Insurance Charles J Wooster dba Wooster INSURERC: Roofing PO Box 8051 IN3tIi:ERE: Lowell MA 01853 INSURER F: COVERAGES CERTIFICATE NUMBER:1047726M 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. ,1�TR TYPE OF INSURANCE AD SBR POLICY NUMBER MMIIDD EFF MMIDDY EXP LIMITS A GENERAL LIABILITY CPA0083583 0/17/2013 0/17/2014 EACH OCCURRENCE $1 000,000 X DAMAGE TRENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $250,000 CLAIMS-MADE X1 OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $ 000,000 GEN'L AGGREGATE UMIT APPUES PER PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ A AUTOMOBILE LIABILITY MAA0379734 1011712013 0/17/2014_ Ea acadent 1 ODO 000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED AUTOS X• AUTOS BODILY INJURY(Per accident) $ X +TIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Par $ A X UMBRELLA LIAR I X CUA0383967 0/17/2013 0/17/2014 OCCUR EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE- $1,000,000 DED I X I RETENTION$0 $ B WORKERS COMPENSATION VVC0720669 0/17/2013 0/17/2014 XWC STATU OTH- AND EMPLOYERS LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A EL EACH ACCIDENT $2,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E-L DISEASE-EA EMPLOYE19$2,000,000 If Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POCICY,LIMIT $2.000,000 A Property PA0083583 0/17/2013 0/17/2014 Cont Equipment DESCRIPTION OF OPERATIONS I LOCATIONS I 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 Town of Lexington ACCORDANCE WITH THE POLICY PROVISIONS. 1625 Mass Ave Lexington MA. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 4 Office of Consumer Affairs nd Business Regulation K < �. 1 . 10 Park Plaza - Suite 51.70 ... t .A. Boston, Massachusetts 0211.6 r. Home Im rovem of Contractor Reg.istration ! p R , 1 rk . . k. Registration: 100712 Type: Supplement Card CHARLES,Jt �WOO�,8rt f ROOFING`4¢ ;�� ,��N 4; expiration: 6123/2o1s;'1 3 STEF HEN Wo '.8 R ' rig, t� y r}�•�, TEWKS8LiRY, MA 01876 t Al .w 4,� . Update Address and return card.Mark reason for change. 2 SCA i co 20M-05/11Address E] Renewal 0 Employment Lost.Card " , - Office of Consumer Affairs andB.usiness Regulatio'n', " ` ate 517,0 r 10-Park Plaza S� J .. `+:a3?,..tei tg;"•+.ui....''+z �'tR t�twi.:'e t:>✓"fa. mioxi 'ytr' af,'.d3�td�'k''4W,'1'�tj`tI' .r��:ssa�7,����.+ Y .'� �� kL" iK-'�i r<t.� �*N d�•t�,�f 'r:WS 4.� PI tae mnrovement Cdnlctor Registration, t a. Registration: 100712 �s + rpt s a TY TYpDBAI Tr# 539Expiration:�' 6/23/2016 6 ` CHARLES J.'VVOO f:ER ROOFING Charles Wooster, p,O: FOC 8081 r � tr�t / � ,L WELL, MA 0188 Update Address'and return card 1Vlark reason for change pk "D Address .[� Renewal ( Empioyment :� Lost Card Y e 1 x�?�� SCA 1 �itffV�U�119 g, r k i iw '�.f a� Jr- 4,T## r y� "C-4-- a]- i ,,J fir. '9: : e a€ t,-t7." x.ab�la 1�Ck.., 4 a•�;' ,£ s : .q`4,f a $ t.; * ? f� p ""•T?"'�. t• y f;. 1 p. �R� t�,w�.^ F� s�.t, r:+'' ': + a 4 i l� N s '� � , � E �, rr ,4z¢I ;6 .rs•`rr`"dFL' ,t )a ' r Wr a .r P a ;•-, x a� 4 t,.,t '.,.e"°'^ > Q' ,.a�5. `s1a ifk GT a 4 Lw.::. 1 10.?.ety yl zt Massachusetts tfjo ptnlent of Pibiic Saf Board�sf 13tiil i n' #t'eq.` ilat t iis+8nd`$tanclards: 0 y y [o �� B g zEti161k'IJct)+� ��� Ikits{ f K x •t',�r x� �.t#t, k i cr+;w x .a,. harles= WbosterV .'tat• _ t r 1 -s r:� t i .,rOBOX#8051 ,.e'..t t"'Cq.,.,,, :., tT 4"`4. ta""$Mcn..w A°. "`f. C. x..^' p.. "'.. ..- 4 {'• .*.arF" r. 47 :. weill''1�� 105 � 'n I. Y r::'i � 'C�G `ty k G• x ti >~ '• � a. � •. .` ..5 '��. 3./' �q .; �� tri' 9 T.. �f`$S`da 4`) �,' r r'` t v',Y 4•+ �. ¢ f k y J�, '�'F t o f�� r Y". : Y�` •4 . iC 'Expi;ration'. �' �a' x,t'a&" a Comriissiar3er ' 0511112016`.y 1 F�4 �a �lE -� �� a -.t v �''�C=,R' v'v�F�.ii.�� tom,,§a�� �� f ; Sara k{e'y tk�,� e�'f ,�5 •:i ��.. � ;�� ��.:pis +�4. , ..�"t��,,;-•. E 1 'r r f k7 a+ yy r '4 f �, . 'B,„.c>„4 .N' -TY°t a4 + -s'sY+,i l'kb`:. M [; +w ) fir, s` u 3 rr4 m": 3' ? .F{ y: € s, 1 •r{�rx �rr xn li., a w d y 3tt k I � G a r •:�s§ a: tf •'ix'sa +6k` 'i k`.,.� ,:ia: �,,-'.��s+. -S �' ..�, )�4c 5°4i�;A��'�°�.�y ri,�l, �t`,h' Ott e�'`,i R'�..o{.w A sr„�5, - ( '• A R ','� ;.. +5 "�°4t�'t „ -%,d'' r:;. �y x YpyFsr �.;�•i}+c .rr• �tk,. �y ,,,4-,s "t}r a. ,� :' #;. S 510 '.:�ra'l rpt " ' ,, '" %�,,� if '• �,dyit`c i - '�` '..5ar.�}$.- : 5�-,,�' e $ r .r:..�+Y�.�} `a'.c r� st•4' ”' n '" „p,Lbs'' a t'��'.'.'-'” aX ,4.. 1 �`vr::;, { t:��' g3 "'a ��.��t. ��f�y�, ,..�`��t tti,�?k �} ' '� 'k-i vh�,k71�4 ti:,.a •,,;_ �'�5������a ��W 2'e"f y.;' k -,•t..� Jd'�. :'��br^lt � L "• 1"��- S. + .,,,��` �"" �.,� t. :crl tj �`s+ in h',' + �'},-< ) r �,{,Ott_�r� �4� '�, f�rix,,,k�F.. ;b ...- i 1.r� �t 9 "s A ..Cr �-ss A/ xi..a d.' r 3 )*2 E;. �' kl y�}< , +� �*; } �� cc bt�m-�; r ., k ssi»�' � .AAs rr, � 3 � . ,c, k' fess- •�t�� ' ,� a �.Y 7��.1,?"..,� i'"yy t $ 'taa k ,. y t .i ,a 3., ;rr *t. ^r z �<[ x� WOOSTER ROOFING PROPOSAL ��� ALL TYPES OF ROOFS DATE: 7/6/14 ODS &ROOF TED SERVICES Always Hand Nailed License Numbers: Charlie and Steve Wooster Construction Supervisors 54268 One nail at a time- 1-888 ROOFIN-1 (766-3461) Home Improvement Contractor Main:978 251-7181 Registration 1007.12 Serving MA&NH since 1984 Fax: 978 251-0159 Call For Our References Proposal Submitted To Work To Be Performed At Name Leff Buck Name Company Name Company Name Street 84 Bruin Hill.Rd. Street City No.Andover State MA Zip Code 01845 City State Zip Code Home# Mobile# Work#978 360-0526 Fax# We hereby propose to furnish the materials and perform the labor necessary for the completion of the following job. Strip the entire roof to the roof deck. 1. Renail any loose decking and replace any rotted at$2.00 per foot. 2. Install 8"white aluminum dripedge. 3. Install 6' of Grace ice and water barrier on all eaves. 4. Paper remainder of roof with Grace Tri-Flex roofing paper. 5. Install Certainteed Landmark Lifetime shingles,hand nailed. 6. Install Shinglevent H ridge vent. 7. Flash vent pipe,chimney and hood vents to roof. 8. Clean and dispose of all debris. OPTION To reroof the roof over the existing layer would be$5,450.00. Workmanship guaranteed for 10 years.We are fully insured with workers'compensation as well as liability insurance. Please return copy of proposal: All material is guaranteed to be as specified, and the above work to be performed in accordance with the specifications submitted.All work will be completed in a substantial workmanlike manner for the sum of Dollars($8;325:00), with payments to be made as follows:Job paid upoji completion. Respectfully submitted Note-This proposal may be withdrawn y us if not aceted within 30 days. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. �j Payment will be made as outlined above. Date Signature_ Mailing Address: P'0. Box 8051 -Lowell, MA 01853 Location: 525 Woburn Street-Tewksbury, MA 01876 E-Mail: Info Wooster-Roofin .com Website: www.Wooster-Roofinq.com