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HomeMy WebLinkAboutBuilding Permit # 3/5/2015 i BUILDING PERMIT TOWN OF NORTH ANDOVER` APPLICATION FOR PLAN EXAMINATION Permit No#:J0 1 Date Received. �q �Rnreo PPa �,,�� Date Issued l�°t IMPORTANT: Applicant must complete all items on this page ,' r t" ,� fi ,;�, r: x f,.mr r l ✓ ! �` r s rr rr '1 ;/ rsr r ✓ f: j r t',r";•"; u r rr,�-�. ,Ar f r . -x �' T' rr r� r ,,.w'�rry :r J r � ; �f E .,y 'sr x f l { j r` r F r "'f 7,r✓fir r ✓s r. Irr r�'l,l�.,may`r' i r'� ':/ x r•. � ��� J e t�j�f�`��rf �r y ✓. r f _x,.r r' �j f m J �i � � ✓ xr�* <r -:r' :r h a ~• �- a ,: s �,`✓t.�;"r-`�� ri;„mac.�-;, -c jr,� :�r�y �7 r ,r fi tr.:des' nr fir'•.` �,r r,:. � ..r.�t r �f>t:.� rrr �`:.d �,r ,rr/ r r r: f w.+,k�. r a r -rr. A` Y r;. k a r`a'f„/rr�Fl�'�Y'.�.::r r srj. '�-sr r s�'...,✓ �r I� Ir.,,t� 1 f� r � f I r�ylr "N1 r'` ✓- t f ,G" ',r; r ,.,f';d" .:+I } .;.-'r j,=1'" ,I ";.€'54.."f�,J r,Sr' 0%�':f; ^C i r r`'" G f ✓ tri kIv' fi^,h`. >ti yi,.r r ,�y�r., . ✓'f a��r-�'�,'9 z� s'.� :sof `r ir�Y✓� rx�'Y-"x .��, �"rnFr ..k' ::t r r r. / `;. Lr x�W;,� .: �'v -r ,f r;5' -�, r: ',: f r''i,;�d�Y x fi f �� � rf �.F,,r✓�'t'`r�P� � � ✓ `�`f:l rr �, rir,. � �„:�.,,.rf Y � ,� r�!` �,,t�,ru �i :w't � '� r 11�IAP �� � �' � �'PARCEL'�;�F ' �''� ZONING DISTRICT x � �' �Histonc;�Distnct,r �' yes no Lx� r /�� rr � ✓ f, ,� �`� rrr � � r rr hme Shop Village yes rr rrrx 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: R 15emolition ❑ Other ❑.Septic ❑UVell t . ❑ Floodplain ❑Wetlands ❑ Watershed Distract Y r- � ✓ r DESCRIPTION OF WO �K TO BE PERFO IVIED: �� Identification- Please Type or Print Clearly OWNER: Name: LCC, D64- 59-ruo-P-Loc t(/ Phone: 278 gg® ? 7 Address: `1CC�� �C�ontrafcfor Narne �/' / l Phone ��� ��3"�f '�3 Z / .r fr r r r � ✓ x t rr � � t x � r1�vl€� � ✓ r ✓ r x �r .„rl x i r 4p/ xr7 Ud5 v '' 1 r r �'-. �,$f'' r�''� ' �f t/� `�.. i d r r r✓ 1 s �Y `tx r,r f= r r :l /fil Y Jr / ✓rt ft S r. �+���� 1 r � � � � ���� � rz .+ 5 � f !✓r r Sup,�er�u�sorsr,.Constr�ucto�nLicense �U �� C�; r f ,� 1�� r Expo ��Date � � �r��rlrl��x r ✓ ,/ f - t �:rr.n sry .. rf C :_r} l,✓ i 'r >`Y,.-; x x _,r ,* ,�r fJl?I f S� ✓ r I' �1 kJ ,/ ! t f / l r'%!`rL x ".r rfl ' f 5�'�,�.1� ��,r r Yrx �f tes'? � ,� x f � /n� a€. ✓�.�'� '" r r 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: $ Check No.: Receipt,No.: NOTE: Persons contracting wit/i unregistered contractors do not-rave.access to t e g r ind Signature of Agent/Ovi/ner~ Signature,of;contractoc:, .. .. d � NORTfy own of ndover J_ _n ® C, h ver, Mass, ° COC NICHE W1CK Q ` BOARD OF HEALTH Food/Kitchen PERMIT L U Septic System 4 Affik THIS CERTIFIES THAT ... . BUILDING INSPECTOR .... ....... .. .........ATV ...... ..... . . ............... ............. tit Foundation has permission to erect .......................... buildings on ........... ,. ... ...... .................. .............. Rough tobe occupied as .................V- %*................ . .... ....... .... ............................................................ chimney provided that the person accepting this permit shall in every ect 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 16 M THS ELECTRICAL INSPECTOR UNLESS CONSTRU ARTS Rough matService ........ .. .... ...................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry !Nall To Be Done FIRE DEPARTMENT. Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SERVPRO of Lowell Fir.BV&W 0-, SERVPRO of Lowell 9 W. Adams St. unit 3 Lowell,Ma.01851 (978)454-7577 tax.id#27-3673699 Client: Ethan Allen(2) Home: (978)685-3546 Property: 419 Andover St. N. Andover,MA 01845 Operator: VGRANDE Estimator: Vinny Grande Business: (978)454-7577 Company: Servpro of Lowell E-mail: vgrande@servprooflowell. Business: 9 W Adams St#3 com Lowell,MA 01851 Type of Estimate: Weight of Ice&Snow Date Entered: 3/5/2015 Date Assigned: Price List: MAEM8X MAR15 Labor Efficiency: Restoration/Service/Remodel Estimate: 2015-02-03-1506-3-2 SERVPRO of Lowell R.8 Y&N,•Q—,&YeSrorMion" SERVPRO of Lowell 9 W. Adams St.unit 3 Lowell,Ma.01851 (978)454-7577 tax.id#27-3673699 2015-02-03-1506-3-2 Main Level Room 1 Height: 8' DESCRIPTION QTY 45. Tear out wet non-salvageable carpet,cut&bag for disp. 350.69 SF 46. Tear out wet carpet pad and bag for disposal 350.69 SF 47. Tear out wet drywall,cleanup,bag for disposal 306.67 SF reflects 2 layers of wall 48. Tear out wet drywall,cleanup,bag for disposal 87.67 SF 49. Tear out and bag wet insulation 241.01 SF Room 2 Height: 8' DESCRIPTION QTY 56. Tear out wet non-salvageable carpet,cut&bag for disp. 251.39 SF 57. Tear out wet carpet pad and bag for disposal 251.39 SF 58. Tear out wet drywall,cleanup,bag for disposal 254.00 SF reflects 2 layers of wall 60. Tear out and bag wet insulation 127.00 SF Room 3 Height: 8' DESCRIPTION QTY 66. Tear out wet non-salvageable carpet, cut&bag for disp. 172.20 SF 67. Tear out wet carpet pad and bag for disposal 172.20 SF 68. Tear out wet drywall,cleanup,bag for disposal 212.00 SF reflects 2 layers of wall 70. Tear out and bag wet insulation 106.00 SF Room 4 Height: 8' DESCRIPTION QTY 78. Tear out wet drywall,cleanup,bag for disposal 217.33 SF reflects 2 layers of wall 80. Tear out and bag wet insulation 108.67 SF 2015-02-03-1506-3-2 3/5/2015 Page: 2 SERVPRO of Lowell Fm,eV/.W.0a ,sr,«m SERVPRO of Lowell 9 W.Adams St. unit 3 Lowell,Ma.01851 (978)454-7577 tax.id#27-3673699 Room 5 Height: 8' DESCRIPTION QTY 86. Tear out wet non-salvageable carpet,cut&bag for disp. 367.03 SF 87. Tear out wet carpet pad and bag for disposal 367.03 SF 88. Tear out wet drywall,cleanup,bag for disposal 315.33 SF reflects 2 layers of wall 90. Tear out and bag wet insulation 157.67 SF Room 6 Height: 8' DESCRIPTION QTY 96. Tear out wet non-salvageable carpet,cut&bag for disp. 222.48 SF 97. Tear out wet carpet pad and bag for disposal 222.48 SF 98. Tear out wet drywall,cleanup,bag for disposal 238.67 SF reflects 2 layers of wall 99. Tear out wet drywall,cleanup,bag for disposal 55.62 SF 100. Tear out and bag wet insulation 174.95 SF Room 7 Height: 8' DESCRIPTION QTY 106. Tear out wet non-salvageable carpet,cut&bag for disp. 467.50 SF 107. Tear out wet carpet pad and bag for disposal 467.50 SF 108. Tear out wet drywall,cleanup,bag for disposal 364.67 SF reflects 2 layers of wall 109. Tear out wet drywall,cleanup,bag for disposal 116.88 SF 110. Tear out and bag wet insulation 299.21 SF Grand Total 4,185.01 Vinny Grande 2015-02-03-1506-3-2 3/5/2015 Page: 3 -igglift—b-hp. SERVPRO of Lowell Fra&W.,.Cl—p 8 kasiornQan" SERVPRO of Lowell 9 W. Adams St.unit 3 Lowell,Ma.01851 (978)454-7577 tax.id#27-3673699 Grand Total Areas: 3,817.33 SF Walls 2,013.54 SF Ceiling 5,830.88 SF Walls and Ceiling 2,013.54 SF Floor 223.73 SY Flooring 477.17 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 477.17 LF Ceil.Perimeter 2,013.54 Floor Area 2,144.21 Total Area 3,817.33 Interior Wall Area 2,725.50 Exterior Wall Area 302.83 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length 2015-02-03-1506-3-2 3/5/2015 Page:4 Main Level 135'2" 23'Y 16'8" 12'1" -24'4" 14'9" 30' Room I Room 2 Room 3 Room 4 Room 5 Room 6 Room 7 104'6" 30'8" Main Level 2015-02-03-1506-3-2 3/5/2015 Page:5 %611 The Commonwealth of Massachusetts Business Certificate Date neiaess CartiHoato� In coo ortnity with the provision of ChaPter one hundred and ten Section five of the General Laws, as amended, the undersigned hereby declares) that a business under th_e_ titlD of OF LOWELL eme o e� is Conducted at 9 WEST ADAMS ST Lowell,MA 01851 978- 454-7577 . , Sao by the following namedperson(s)'or Corp,full name, Name/Corp. GRABRO LLC Signatur .. ---- Residence(Street,City,Zip) 9 WETS ADAMS. DWELL, MASS. 01851 Name/Corp. Signature Residence(Street,City,Zip) Name/Corp, Signature Residence(Street,City,Zip) Name/Corp. Signature ° Residence(Street,City,Zitp) Purpose of filing this Business Certificate: xxxxx ❑ New Business ❑ Renewal of an expiring p Change in a business business certificate address 0 Partial,withdrawal 0 Discontinuance of a of an owner business .r A cer0cate issued in accordance with this Section shall be in force and effect for 4 years from the date of issue and shall be renewed each 4 years thereafter so long as such business shall be conductea; and shall lapse and be void unless so renewed Middlesex S.S The Commonwealth of Massachusetts 23RD DECEMBER 13 On flus day of20 public or City Clerk's designee,personally �30AM through satisfactory evidenc of idea a on,which were proved to me the jpers s whose name/s I. a 4ign on document, and Wh swore or affirmed too m�at the n of the document e ' and accurate to the best of his&er/their knowledge and SHANNON GOUV61A Ct9tyPGCOmmiSSIOn �' Notary l bt1S My Cwarnicsion Expires 3 N)Ia pmcember16, x016The B ess Cerfificate expires on i° rial or City Seal bLOfO NN Ntnys 90,u mssoxa imia ct i �a�mra r,cNa�xtn inum-so ,9aoa9491����9aa„S:E3A�A6ge 1 1 ludadLicense or registration valid for lndividul use only \ 0mce of Consumer Affairs&li ainess Regutatioa before the expiration date. if found return to: HOME IMPROVEMENT CONTRACTOR ape. Office of Consumer Affairs and Business Regulation Registration: 173795 10 park Plaza.Suite 5170 Expiration: 1111312016 LLC 1.101f lik, A 02116 O BRO LLC. V A SERVPRO OF LOWELL +l VINCENT GRANDE G ZLrt�. 9 W.ADAMS ST#3 1v i-Not v out signature LOWELL,MA 01851 Underseeretary / GPABLLC-01 CONNIEI .4c CERTIFICATE OF LIABILITY INSURANCE DAT1102 DIYYYY) 1/s/2o1 s 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(les)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 NAMEACT Connie Parent Elliot Whittier Insurance Services,LLC PHONE -FAX 75 Sylvan Street Suite 8202 MAIL Ext :(978)977.4884 ac No):(978)977.0850 E- Danvers,MA 01923 ADDRESS:cparent@elliotwhiftler.com INSURER($)AFFORDING COVERAGE NAIC# INSURER A:Everest National Insurance INSURED INSURER B:Pilgrim Insurance Company 0024 GraBro LLC INSURER C:Hanover Insurance Group 22292 DBA ServPro of Lowell 9 West Adams St Unit 3 INSURER D: Lowell,MA 01851 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 ADDLSUBRPOLICY EFF PO LTR TYPE OF INSURANCEPOLICY NUMBER DDNYYY MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,00 TO RENTED CLAIMS-MADE 0 OCCUR 51GLOO6481-141 11107/2014 11/07/2015 PREMISES Eaoccurrence) . $ 60,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY JC ❑LOC PRODUCTS-COMP/OP AGG $ 1,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT G Ea accident) $ 1,000,00 ANY AUTO PGC00001018601 11/17/2014 11/17/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Perecddent $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERSCOMPENSATION AND EMPLOYERS'LIABILITY ER YIN N X STATUTE A ANY PROPRIETOR/PARTNER/EXECUTIVEN� .L5300007408.141 09/30/2014 109/3012015 E .EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) + E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000 00 D C Bus.Pers.Property RHN980328503 12/20/2014112/2012016 $1000 clad. 29,716 C Contractor Equipment RHN980326503 12120/2014 12120/2015 w/RC$1000 ded. 145,61 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) ServPro Franchise CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Evidence of Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD