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HomeMy WebLinkAboutBuilding Permit #759 - Permits #759 - 75 THISTLE ROAD 5/19/2007 ■ BUILDINGPERMIT O ttoRrH a TOWN OF NORTH ANDOVER 0 a2� APPLICATION FOR PLAN EXAMINATION � Permit NO:: �' Date deceived �,. p "AT90 n?P`�� �SAc Wu � Date Issued: w IMPORTANT: Applicant rnUst complete all. items on this page Print PROPE,R `" ' WIN R - MAP NO; P EEL: ONIN� C I TRICT: FII TO ICb'ISTRICT 'y s� , o TYPE OF IMPROVEMENT PROPOSED USE. Residential Non- Residential 1 New Building I I One family 1-1 Addition f 1 Two or more family i I Industrial ,,&Alteration No, of units: F Commercial L II Repair, replacement I Assessory Bldg C:1 Others: [1 Demolition C I Other � eptl 14 %-; 11 Flood lain. El'Wetlands ,�' �; n Watershed,District `. I I Water/Sewer DESCRIPTION F WORK TO BE PREFORMED: Adentificatio base Type r Print Clearly) OWNER: Name: ,f.. w �µm Phone: Address: CONTRACTOR Name �' - 'Phone: � � Address; .° m. � . uper is rr"s C rnstructi n Licen e:; ' Exp. Cale; Home Improvernerit Llden e, � E p, ate: ARCHITECT/ENGINEER Phone: Address: Reg. No. F THE TOTAL ESTIMATED COST EASED ON$125,00 PER S.F. Total Project ro ect Costs rnl�PE rT,�Y$�a.aa r�Elz �aao°aa o� �"a FEE: " t Check Na.: ....._ Receipt o.: P . NOTE: Persons contracting with unregistered contractors do not have access to tJ Aguranty f ignature of Agent/Owner Agent/Owner Signature of contractor � PETERS CONSTRUCTION GENERAL CONTRACTOR 112 VALE STREET TEWKSBURY, MA 01876 PHONE: 978-640-9361 • CEL PHONE: 978-479-7845 JOB DESCRIPTION Repair deck posts add two windows Contractor to install single window Anderson tw28521owE with grills inside tilt wash on second floor of house to match existing windows as close as possible. Contractor to remove plastered wail inside in order to install app. Header and repair plaster. Contractor to install trim to match existing house homeowner resp. for painting of all disturbed are /n Contractor to install Anderson Casement window Three windows left opens middle stationary right opens low E with grilles inside. Contractor to install window in back of garage centered Contractor to install window to match existing house interior and extgrior. Contractor to repair plaster in garage to the best possible cannot repair perfect. ] Homeowner resp. for all painting. Contractor to remove existing 4x6 posts from deck and replace with 6x6 $4475.00 ! post with base plates to go on existing sona tubes. Contractor to install 45 degree angles on each post to try to stop swaying of deck. Contractor will not warranty 6x6 posts from warping. Contractor will not warranty deck from swa in with new posts. ®A no -(-- 24,4%r- Contractor to install white aluminum at bottom o rakes in front of house 125.00 two rakes total to try to stop animals from getting in. Contractor to repair pine around front door on left T and M for material $40 and and labor. Contractor to match routing as close as possible hour Building permit $125.00 Need money as soon as possible to order windows aprox. 2 to 3 weeks Thank you Scott Peters 1 Contractor not responsible for any utilities in way of this project. Extra IV le Per- JT $4725.00 � ey 2 ( HP) i PETERS CONSTRUCTION GENERAL CONTRACTOR 112 VALE STREET TEWKSBURY, MA 01876 PHONE: 978-640-9361 • CEL PHONE: 978-479-7845 SUPERVISOR'S LICENSE #CS 061185 HOME IMPROVEMENT# 130867 PROPOSAL - .�. -: , .. CLIENT INFORMATION: Date: 5/11/07 Name: Mario Abdenour Address: 75 Thistle rd. City, State: N Andover Ma. Zip: 01845 Contact: 978-688-6465 Title: PROJECT INFORMATION: PRIOR TO START OF JOB: $1,700.00 DUE UPON COMPLETION:Moneys as needed TOTAL: $4,725.00 ' v c' Contractor carries Workman's Compensation Liability Insurance. Contractor not responsible for excavation of any Ledge, Boulders or Obstructions greater than 3'x3'. Prices subject to change 30 days after date of written proposal. All construction subject to building permit, if applicable. ACCEPTANCE: Client Acceptance: //}J - J TC' 7 �J"1 } F Signature: R�G Contractor Acceptance Signature: ...........VIP own of Andover 0 No. LA over, Mass., CHIC ()/?-4TEt) PQa` CO BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System 51 Ct , BUILDING INSPECTOR THIS CERTIFIES THAT............. .......Ykp.......... ........................................... Foundation has permission to erect.....................................— buildiggs on......1� ...... ...............4-A......... Rough to be occ upied .......... ........ .................... Chimney -iQ Final provided that the person accepting this permit shall in every act conform to the terms of the application 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 fk ,-- PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS Rough ...................... . ..... ........................ ........................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough 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 Smoke Det. The Commonw ealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Affidavit: tWorkers' Compensation Insurance Builders/Contractors/Electricians/Plumbers cians/PlumbersA licant Information Please Print Le ibl Name(BusinesslOrganization/Individual); �-� ,..� ,�, Address: [ � L City/State/Zip: phone#: i — ;,F`�)�Iyj_ Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4.'0 I am a general contractor and I [8D project(required): 2.❑ employees(full and/or part-time).* have hired the sub-contractorsew construction I am a sole proprietor or partner- listed on the attached sheet.tmodeling ship and have no employees These sub-contractors have working for me in any capacity. workers'camp. insurance. emolition [No workers'comp. insurance 5. ❑ We are a corporation and its ilding addition required.] officers have exercised their ectrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL mbing repairs or additions thyself.[No workers'camp. c. 152, §I(4),and we have noinsurance required.]t employees. [�Vo workers' of repairs comp.insurance required.] er Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. #Homeowners who submit this affidavit indicating they air 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 subcontractors and their workers'comp,policy information. I am an employer that is providing workers'compensation in information. surance for my employees. Below is the policy and job site .� Insurance Company Name: 1 _ / Policy#or Self-ins. Lie.#: 'J Expiration Date: Job Site Address: _. , r. s Attach a copy of the workers'compensation policy declaration page City/State/Zip; ng the licy Failure to secure coverage as required under Section 25A of MGL . 52(can led to he imposition bof criminal er and pt penalties datea 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 p lttes of a Investigations of the DIA for insurance coverage verification. a Office of I do hereby certify u r th pains and p ltie o f perjury that the informatiart provided abov 1s IN and correct Si nature: Phone#: Date: -�� Official use only. Do not write in this area,to he completed by city or town offfciaL City or Town: Issuing Authority(circle one): Permit/License# I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical inspector 5. Plumbing Inspector b.Other Contact Person: Phone#• ACORD CERTIFICATE OF LIABILITY INSURANCE oTiMMIDD i) PRODUCER (800)333-7234 FAX THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Natick, MA 01760 Jr, Joseph Carroll INSURERS AFFORDING COVERAGE NAIC# INSURED James Scott Peters INSURERA: Safety Insurance Group DBA: Peters Construction INSURERB: Travelers Prop & Casualty Amer 112 Vale Street INSURERC: Tewksbury, MA 01876-1538 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN 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 DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS )ATE(MMIDDfYYI GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE 0 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO- F-] LOC JECT AUTOMOBILE LIABILITY 2433745COM01 01/19/2007 01/19/2008 COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ A X SCHEDULED AUTOS (Per person) 100,000 HIRED AUTOS - BODILY INJURY $ NON-OWNED AUTOS (Per accident) 300,000 PROPERTY DAMAGE $ (Per accident) 100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO EA ACC $ OTHER THAN AUTO ONLY: AGO S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR FI CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 7JUB679X361A06 10/12/2006 10/12/2007 WC STATU- O R EMPLOYERS'LIABILITY B ANY PROPRIETOPJPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE•EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS be€ow E.L,DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT 1 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 FAILURE TO MAIL.SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Town of North Andover OF ANY.KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIV North Andover, MA 01845 AUTHO IZE REPRESENT IV,, 1 ,r I ACORD 25(2001/08) ©ACOR ORPORATION 1988 .+ol¢.ysluruI[IV'Ofld')(i 91810 V" 'Aangs�mq_L )S alell Z 6 t saalad sower ssa$ad •S sawel IenplAlpul :adA_L R00Z/G19 :uor4e.rrdx3 L980E6 8010VHiNO3.LN3WaAO11dWl3WOH ' a.l � sp.�epuelS pur.suol�r;ln9ag uoll�irnll to(ti.ieo4l ` ..Y1iP f-o�uaru;-rarrcrzll� of;.jt�z:i;tcu,�zu6e� Board of Building Regulations and Standards Construction Supervisor License I License: CS 61185 Birthdate: 12/17/1962 ®47 Expiration: 12/17/2008 Tr# 6923 ' Restriction: 00 JAMES S PETERS 112 VALE ST Gj TEWKSBURY, MA 01876 Commissioner