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HomeMy WebLinkAboutBuilding Permit #243 - 95 GREENE STREET 10/6/2008 BUILDING PERMIT 0 NORTH q tt�e° ,6 4• TOWN OF NORTH ANDOVER o= '. :'" ` ~ '° c APPLICATION FOR PLAN EXAMINATION Permit NO: �� Date Received T.o �SSACHUS�� Date Issued: �� 6 �� IMPORTANT: Applicant must complete all items on this page LOCATION �Czl?(Te ki S-7 / Print PROPERTY OWNER .S't1 c' /Ati3ry ✓I /,�rZ£'.�a C f I Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building 1.e a family Addition Two or more family Industrial �teration No. of units: Commercial impair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE,PREFORMED: 9616 4 0 U J5 i �or2rc,N 4,�iJ /U c C.v /=/ c �� s-o ti = I�C r 6 c , h/ar�1Cs www �a vr2-90 ic... c. 6.lsr%� G (3 - Identification Please Type or Print Cle ly) OWNER: Name: Phone: 27et-) '-7U z7 Address: CONTRACTOR Name: ,, ra A,� c Phone: q7,!P--., ' a -z Address: C t fEter . .5`1 5 ro ? N` Supervisor's Construction License: 6,�— Exp. Date: Home Improvement License: /5 -7 fit; Is' Exp. Date: 10 ZI t2 2 ARCHITECT/ENGINEER all 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: $ a- UCS FEE: $ T�< 00 Check No.: 7a /y Receipt No.: .2/ .0/ NOTE: Persons contracting with unregistered contractors do not have access to th uaranty fund pignature of Agent/Owner ;�gzignature of contracto r 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp'Dumpster on 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 2.2008 .0 Location 7 No. Z qJ Date Aj K MORTp TOWN OF NORTH ANDOVER � 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ G Check # a 2 5 / � J� Building Inspector Date.. . . : .... . RECEIVE M f'ORTH ANDOVER 3? yt a PERMIT FOR GAS INSTALLATION APR 91iEO'QP �5 �'�S"`"UsEt No.Andover Collector This certifies that . . . . . . . . . .,. . .,. . f . . . . . . . . . . . . . has permission for gas ;n�tallation ,f. in the buildings of . . S f . . .,� s.r.. .? _ � . . . . . . . . . . . . . . . . . . at . . . ..�':�,� . . :. :�,._ . . ._ f. . . . . . . ., North Andover, Mass. Feefr. . . . . . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . � GAS INSPECTOR WHITE:Applicant- CANARY: Building Dept. PINK:Treasurer GOLD: File • •-• w"Ir %Jnrvt ArrLK;AiSUN FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER ,MASS. Date____�.�_2 ZZ_Z�g �7 Z4s Building ✓ /rig,�3� Locallon �2����. S� Permit # IJJC(J Owner's Name &N+ ttJAS L 2dSCt4 ) New ❑ Renovation (I Replacement 93"' Plans Submitted:. Yes ❑ No tc h K N tl J XuC M l- C U H lo- NJ y z M fell- < $ Ztl h W O K9 tlQ � 1111I M 9 g N « h 1! V r = X F' A p f i : EIL X s M - i !' 0 J w � � 110931008- r,= odo SUA—BSMT. BASEMENT IAT FLOOR 2ND.FLOOR I sRUFLOOR 41TH FLOOR ATH FLOOR ! STH FLOOR ► c 7TH FLOOR HITt ATH FLOOR ' Check one: Certificate Installing Company Name �.fir` •� Corp. Address 5'j r d Partnership fy) nor-) a rm/Co. Business Telephone 6 6 Z— Z(p(o 9 Name of Licensed Plumber or Gas Fitter_ �� INSURANCE COVERAGE: Check one have a current !!abMRy Insurance pellc v br !le substantial equivalent. Yes tr No ❑ It you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Er""' Other type of k>,demnlly ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the Ilcensee does no( have the Insure Chapter 142 of the Mass. General Laws. and that my signature on this nae coverage required by permit application waives this requirement. Check one: Stgnaluto of Owner or Owner's Agent Owner ❑ Agent ❑ (hereby certify that all of the details and Information 1 have submitted(or entered)in above application are true and accurate to the best of my knowledge and that an plumbing work and Installations performed under the permH Issued for I pertinent provisions of the Massachusetts State Gas Code and Chapter 112 of tM bis lion will be M compliance with all General Lfor t Typal of Lkense: Tlik Milumber na ure o nae of or as Ll stiller �y/T� aster License Number Q . L�Joumeyman Af' noVED(OFFICE USE ONLY) WALL & PAVER CONTRACT (978) 469-0289 ° FAX: (978) 372-4613 SJE, INC. 298 Amesbury Road, Haverhill, MA 01830 R. JV SJ DATE o/ Name lU i Address_, City State Zip Code Home Phone( ) Bus.Phone( ) Cell Phone( ) SJE,Inc.hereinafter called the Contractor,proposes to furnish all material and labor necessary to complete the project according to the job plan for work at: No. - Street City State Zip Code SCOPE OF WORK: ccs L Ly_w_ c. �✓`1lr Any material and labor a sociated with the project unless state above will be additional ie:Machine time,plumbing,electrical,and drainage. THE UNDERSIGNED AGREES TO PAY THE SUM OF $ r 47`0 (30% DOWN, THE SUM OF $ YO (30%) AT DELIVERY OF RAW MATERIALS,THE SUM OF$ / 7 ) (30%)ON 75%COMPLETION OF JOB,THE SUM OF —(TO%)@ COMPLETION OF JOB. TOTAL JOB COST$ THIS AGREEMENT SHALL BECOME A BINDING CONTRACT UPON WRITTEN ACCEPTANCE OF SJE,INC. THIS CONTRACT CONTAINS THE FULL AGREEMENT BETWEEN THE PARTIES AND NO REPRESENTATION BY ANY AGENT SHALL BE BINDING UNLESS SPECIFICALLY INCORPORATED HEREIN. YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN CONSUMMATED BY A PARTY THERETO AT A PLACE OTHER THAN AN ADDRESS OF THE SELLER WHICH MAY BE HIS/HER MAIN OFFICE OR BRANCH THEREOF,BY A WRITTEN NOTICE DIRECTED TO THE SELLER AT THIS MAIN OR BRANCH OFFICE BY ORDINARY MAIL POSTED,BY TELEGRAPH OR BY DELIVERY, NOT LATER THAT MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING THE SIGNING OF THIS AGREEMENT. 1. Owner shall provide reasonable access to the site,and all utilities to complete 6. Contractor shall not be responsible for incorrect property drainage caused by the work to be performed by Contractor.All dirt shall remain on the job site owner/architect landscaper during landscape procedures. unless otherwise specified herein. a) Note:all ground water is to be diverted from walls,patios,walkways and 2. The Contractor shall not be responsible for damage to the premises(including driveway area. but not limited to grass,shrubs,sidewalks,curbs,.driveways,patios and other 7. In the event of default by Owner of any provisions of this contract,Owner improvements)resulting from the reasonable performance of Contractor's work. agrees to pay all collection costs,interest from date of default and reasonable 3. The Contractor is not responsible for excessive movement of soil,generally attorney's fees. caused by water migration. 8. Disclaimer-Due to the natural variance of the raw materials used,all 4. Warranty and/or repair work shall not be performed until contract is paid in full. manufactured blocks and pavers can vary from samples and pictures shown 5. In the event Owner authorizes the use of neighbor's property for Contractor's to client. use during access and construction,Owner agrees to be responsible for any damages incurred.Contractor agrees to exerc' a reasonabl are. �,, Accepted s Date 1 ;� ..� fl G' SJE,Inc. CUSTOMER Date NORTH 0 o sAndover No. Z _ - �` - A K o dover, Mass., /°�`� D 1. COCMIC MEWICK V oRATED IPGt�� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR �i P� CJ!^.;5..%�i................................................................................ THIS CERTIFIES THAT..........�.../............� ........... � """' Foundation has permission to erect................ '..:...... buildings on ....... � ..�� ..:....... Rough ........... �......... ji................../t E� � e:) . a t /%'`5' ��'��`y r Chimney to be occupied as.....................���- ... ..........:................... .... .............. ....... ....................... ........ .............. provided that the person accepting this permit shall in every 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 PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS . ELECTRICAL INSPECTOR kRough >_�'............. ....... ..... Service BUILDING PECTOR 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 j Smoke Det. e i ✓die �arrvniaruuerzCl�e a�✓�dacluc�,� Board of Building Regulations and Standards Construction Supervisor License License: CS 85750 Birthdate: 8/10/1966 Expiration: 811Q/2009 Tr# 4259 Restriction: 00 MANUEL E AFONSO 161 MAPLE ST STOW,MA 01775 Commissioner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 157565 Expiration: 10/16/2009 Tr# 260108 Type: DBA RIVEREDGE RENOVATIONS MANUEL AFONSO 161 MAPLE STS, STOW,MA 01775 Administrator IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001108) INS025(0108).06 AMS Page 2 of 2 ACORD,„ CERTIFICATE OF LIABILITY INSURANCE DATE /D ) 10/0606/20082008 PRODUCER (978) 686-2266 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION N0. ANDOVER INSURANCE AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR M.J. FOSTER INSURANCE SERVICES ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 9 WAVERLY ROAD NORTH ANDOVER MA 01845-2415 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:HANOVER INSURANCE CO Riversedge Renovations - Manuel Afonso INSURER 8: P. 0. BOX 216 INSURER C: INSURER D: Merrimac MA 01860— INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS A GENERAL LIABILITY ZBN8539396 01/05/2008 01/05/2009 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS MADE F OCCUR / / / / MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PROT LOC / / / / FLL 300,000 AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS / / / / BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS / / / / BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO / / / / OTHER THAN EA ACC $E AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY / / / / EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE / / / / $ RETENTION $ $ WORKERS COMPENSATION AND / / / / TORY LIMITS OER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? / / / / E.L.DISEASE-EA EMPLOYEE$ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLES/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 WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT TOWN OF NORTH ANDOVER FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE BUILDING DEPARTMENT INSURER,ITS AGENTS OR REPRESENTATIVES. 1600 OSGOOD STREET AUTHORIZED REPRESENTATIVE NORTH ANDOVER MA 01845- ACORD 25(2001/08) ©ACORD CORPORATION 1988 INS025(0108).06 Page 1 of 2