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HomeMy WebLinkAboutBuilding Permit #878-14 - 95-97 Second Street 5/1/2018 Of NDe oT a q~O r BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: �9SSACHu5� ):K& IMPORTANT:A licant must com lete all items on this a e LOCATION95 Second Street, North Andover, Ma Print PROPERTY OWNER Eugene Piacentini Print MAP NO: ��PARCEL-W ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition XTwo or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial XRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑Water/Sewer Strip existing roof and Replace with New architectural Shingles .� Remove old chimney from Roof up and replace Identification Please Type or Print Clearly) Y) OWNER: Name: Eugene Piacentini Phone: 617-524-2080 Address: 92 & 95 Second Street N. Andover MA CONTRACTOR Name: Frank Candido Phone: 978-804-1521 Address: 4 McGrath Road, Pelham, NH 03076 Supervisor's Construction License: CSSL-099141 Exp. Date: 04/06/2016 Home Improvement License: Exp. Date: 152283 08/15/2014 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: $ 10,000.00 FEE: $ 1 /ca Da Check No.: Receipt No.: -12 NOTE: Persons contractinAwi u red contractors do not have acceXand 4 Signature of Agent/Owner --- i ture of contract r -: Plans Submitted ❑ Plans-Waived ❑ Certified Plot Plan Stamped Plans ❑ TYPE=OF`;SEWERAGEDISP-OSA' Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales -Food Packaging/Sales ❑ Private:,(septic tank,etc__ ❑ -Permanent Dumpster ori"Site ❑ THE_:FOLLOWING SECTIONS FOR-OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM ,I -- :.. DATE REJECTED . DATE.APPROVED PLANNING & DEVELOPMEN7' ❑ COMMENTS CONSERVATION Reviewed on Signature 4 COMMENTS HEALTH Reviewed on Signature COMMENTS t 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 ADPW To`v;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT. - Temp Dumpster on site yes no 'Located-at 124 Mair, Street -Fire Department signature/date— COMMENTS t I Number of Stories: Total square feet of floor area, based on Exterior dimensions._ :Tdtal land area;sq. ft. ELECTRICAL: Movement.of.Meter location, rust or service drrop requires approval of :Electrical Inspector Yes No I DANGER ZONE LITERATURE: Yes No MGL Chapter 166.Section 21A--F and G min.$100-$1000 fine I NOTES and DATA— (For department use i i i i I I _ I i i B Notified for pickup - Date E Doe.Building Permit Revised 2010 - - -- -- r Building Department rhe foftowing 19'a-list of the required.forms to be filled out'for.the.appropriate.permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o B..uilding Permit Application ❑ Workers Comp Affidavit Li Photo Copy Of H.I.C. And/Or-C'.S.L Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products NOTE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application a Certified Surveyed Plot Plan Li Workers Comp Affidavit o 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) o 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) o Building Permit Application Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report Li Engineering Affidavits for Engineered eered roducts NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cascs if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the aprr,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm-tted with the building application Doc: Doc.Building Permit Revised 2012 i Location `1� -� g� _ C �- No. Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ / /•.ca, Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 1 � C. /1$uilding Inspector NO RTF{ Town of t E : Andover O1' ..:•' .'F to t1v iq * �i , over, Mass, 6110 ►-5RAcocN�cNew�c� 01- Olt ArED reD PkI4P��5 U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System .... F BUILDING INSPECTORTHIS CERTIFIES THAT 'U ................................................................................... has permission to erect .......................... buildings on ... .. ...��., ....:S,<<°::`:�.:...f...................... Foundation Rough to be occupied as .............X1P.P.. 17l- 1;,. .........f .......... :....`..?.. .7.............................. ... Chimney provided that the person accepting this permit shall in eve�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 CONSTRUCTI TARTS 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. CANDI-2 OP ID:JD2 CERTIFICATE OF LIABILITY INSURANCE DATE 4 14 THIS CERTIFICATE IS 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). PRODUCER CONTACT North Andover Insurance Agency PHONE FAX M.J.Foster Insurance Services Alc No Ext): A/C No): 163 Main St. E-MAIL North Andover,MA 01845 ADDRESS: Michael Lescord INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:MAIN ST AMERICA ASSURANCE CO 29939 INSURED Candido's Home Improvements INSURER B:NATIONAL GRANGE MUTUAL Francisco Candido DBA 4 McGrath Road INSURER C:LIBERTY MUTUAL INS CO 23043 Pelham, NH 03076 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY MPT4069G 11/08/2013 11/08/2014 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,000 -PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY (Ea DISINGLE LIMIT $ 1,000,000 B ANY AUTO B1T4069G 12/10/2013 12/10/2014 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT X UMBRELLA LIAB I X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE CUT4069G 11/08/2013 11/08/2014 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10000 $ WORKERS COMPENSATION X V C STATU- X OTH- AND EMPLOYERS'LIABILITY TORY LIMIT ER C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N MA WC ASSIGNED RISK 01/17/2014 01/17/2015 E.L.EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) ISSUED BY CARRIER E.L.DISEASE-EA EMPLOYE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) PROJECT: 97 Second Street, North Andover, MA 01845 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St Bldg 20,Suite 2035 AUTHORIZED REPRESENTATIVE North Andover, MA 01845 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD >1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supemisor Specialt, License: CSSL-099141 Frank J Candido 4 Mcgrath Road 0, Pelham PTH 03076 �tJ .t�t5 will � Commissioner Expi ration 04/06/2016 ,s 1 `� fie -t°anv�na�u�ealbi a�,�aa�ac�ivar./aa �\ 0k saf'Consumer Affairs:lic Business Regulation { HOME IMPROVEMENT CONTRACTOR - = Registratiom .,-152283 Type: c - Expiration: 4/15/2014 DBA I D 0 S NOME IMPI20VENIENT.. FRANK. CANDIDO' = r 41'v1CGRATH RD ` PLHAN,NH 03076 f' a Undersecretary The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Frank Candido Address: 4 McGrath Road, Pelham, NH 03076 City/State/Zip: Phone #: 978-804-1521 Are you an employer?Check the appropriate box: Type of project(required): 1.EkI am a employer with 1 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑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 8. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance. 1 � required.] 5. E] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[K Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' 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: Liberty Mutual Fire Insurance Policy#or Self-ins.Lic.#: WC2-31 S-601261-014 Expiration Date: 01/17/2015 Job Site Address: 92&95 Second Street, N. Andover, Ma 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 the pains and penalties of perjury that the information provided above is true and correct Sianature: Date Phone#: 978-804-1521 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#• Restricted To:CSSL-RF-Roofing CSSL-WS-Windows and Siding Failure to possess a current edition of the Massachusetts. State Building Code is cause for revocation of this license. $ For DPS Licensing information visit: www•Mass.Gov/DPS ;,icense or registration valid for individul use ond' i before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MAS 16 _ N alid without signature 1 • 0.l LOnract ALI FREE ESTIIIMMAATTTE}�S-(y�� ?. y 4 McGrath Road, Pelham, NH 03076 Phone 978-804-1521 candidoshomeimprovement@comcast.net DATE: JUNE 3, 2014 TO Eugene Piacentini 92Et95 Second Street North Andover, Ma WARRANTY: 2 Year Labor warranty provided by Contractor. 50 Year roofing materials warranty provided by Manufacture. DESCRIPTION LINE TOTAL Contractor responsible for pulling all permits. Strip Existing Roof Dispose (3 layers) of materials properly. Install: $9,250.00 Re-nail any loose plywood on entire roof. 6 Feet of Ice and water shield on eves and edges of the roof Pipe boots Drip edge New cobra vent (ventilation for the roof) 50 Year Architectural Shingles (choice of customer color as long as stocked color) Remove old chimney and dispose Install: $750.00 New Chimney from rooftop up with new lead flashing Leave job site completely clean at departure. 1/2 of the payment is due at signing of the contract The remainder is due at the completion of the project Total $10,000.00 Deposit $5,000.00 Balance Due $5,000.00 omer Signature ate Co, ctor nature Date THANK YOU FOR YO R BUSINESS!