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Home My WebLink AboutBuilding Permit # 3/9/2015 cAORT1-/ BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION. 49 Permit No#: Date Received a Py S .. `�'�A�RA7ffU Aep� ,pry SACHUS Date Issued: 1 ir IMPORTANT: Applicant must complete all items on this page ` � G /i / rl e / / / /✓„f , /' !/ ///,// 17 , ,r//1, to r „h r r/ /, 1/✓�1, � ��,�ll%%i//1 ✓ rW11 r IIY /, %1 f ff Y /i� � , r,. r J , .i ! � ��,. i I.�f("rN �,� ,.JJ , r111N / /,1..,rr% Y>•1 f 9'rrVrrd I%!I / ./ ,r >" .y, 1 ////ii,. / r I r � � � � �,: � ` � �/ >�/ �/� ✓ ,/� rrr,/ ,V, r � / t-, / TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ixr6e family ❑Addition ❑ Two or more family ❑ Industrial ❑AI ration No. of units: ❑ Commercial P?Ikepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other n tlrh',,,.G/ !/r / / / / L i/lf� , r /a /,.c c r. /r/, / // r � c,,,✓,r, !/,u. _rl/ �/i/ r , r ..,, /, ❑ Se �c ,, Wel l// i/ r ,%,❑�r lood Iain ❑ e a r ds r /1/r �, J W / r r� / �„ , i I f / / / / , W t ,, , ri /, r ,❑J tershed,Dist , / , DESCRIPTION OF WORK TO BE"PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: X62, J /�'/1 .. X- Phone: 'Z / Address: 4>v'Q77 'v ��r r, /� t , � l rr r /, / ., ,, i , „ '. ,r ,.hr is/rl r 7111,7,: :,�'JM:M i�f r rr' ✓",r3 ��.:, 1II Y � 11 n ,., r y i,..,.,.r. f !, I r � „r„ , � ,., ✓/i/, r'�r,l�ifiL�dfdilvuf»uiatl�iircn��:�im,fllNs///oio/Iluiriiiluf�armri��immriVr,ru�varyl[uuunlm�uNimi//if��m{I`r ._.`tia rN�r,�i%r��irm„��i rrl�r,na .,, ... Y' '� ,.�m�/��r ARCHITECT/ENGINEER Phone: Address: Reg. No: FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.I= Total Project Cost: $ Ir FEE: $ ` fel Check No.: .Receipt No:: ,w, NOTE: Persons contracting 't1a unre istered contractors do not have access t th guarani Lntl Signature of Agent/Owner '' ignature of;,contractor„w- NORTH Town of2 EAndover O a. „ 1 0 11- 1 T C% IANF h " ver, Mass, • COCNIM-1cK U BOARD OF HEALTH PERM.. I T LD Food/Kitchen Septic System THIS CERTIFIES THAT ........ % I I AA .C.1%,. BUILDING INSPECTOR has permission to erect Foundation .......................... buildings on ....... a'k .�11 .............................................. ... Rough to be occupied as ..A(W........ 0. ♦NW. ..4........... ... ...��. .. ,. ... .�..... Chimney provided that the person accepting this permit shall In every respect form to the ter of the application Final p p p g 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCRTS 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. X31 Page# of pages !I !i lj �) i Atli i Proposal 5ubroNt ed TO, Job!dame I Job#f ill Address Job Location DateDate of Plans lei -Led �1tPhone Fax f I Architec fT i We hereby submit specifications and estimates for. L� OV - - - We propose hereby to furnish material and labor—complete in accordance vrith tne above specifications for the sum of: with payments to be made as folloviu:—T�4�C�006° - &751:�S i d66 ,-- --�— Any alteration or deviation from above specifications involving extra costs will be ;espectfuliy j executed only upon viritten order, anti will become an extra charge over and f SI.Ibmitted i above the estimate.All agreements contingent upon strikes,accidents,or delays iVs Mote—this r000 t rna»be xithdrav ri by us lE not accepted vvithin dams. i beyond our control. P � --days. �i specifications and cond'sfions are satisfactory!and are Th above price-,,sp_ �Igna-wr hereby accepted.You are authorized to do the wotik as specified. —rl i� Payments will be made as outlined above. hate C)i"ftceptance — : ionatur, (� Ci CI GENERAL CONTRACTOR BRUCE FERRIERO BILL MCKENZIE • SIDING 32 LIBERTY ST. • CARPENTRY DANVERS, MA 01923 • REMODELING (978)777-2146 • BATHS BRUCEFERRIERO@GMAIL.COM • KITCHENS Contracting • ADDITIONS Dr. Pierre 6zy 22 Monteiro Way No.Andover, MA 01845 January 10, 2015 i SCOPE OF WORK • Replace all windows with"Harvey Classic"vinyl double hung energy star rated windows with grids between glass • Replace 2 picture windows with same style windows and grid configuration • Strip existing siding and dispose • Replace rotted plywood as needed ($1,000.00 allowance) • "Typar"building wrap and tape all seams on entire house • Apply 3/8"foam insulation over Typar • Trim all window and door casings(inc flashing)with white aluminum • Trim windows in brick front with PVC including decorative area (match existing) • Cover all soffits with vinyl v-groove soffit material (vent as necessary) • Cover all trim (fascias and rakes)with white aluminum • Apply"Certain-teed" double 4" white vinyl siding • Install seamless white aluminum gutters and downspouts • Remove all job debris The Commonwealth of Massachusetts Department of Industrial Accidents t .. .; 1 Congress Street,Suite 100 Boston,MA 02114-2017 1V;v't www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERIVHTTING AUTHORITY. Applicant Information Please Print Leyibly Name(Business/Organization/Individual): ( ' Address: City/state/Zip: Phone#: 7;7;2 " Are you an employer?Check the appropriate box: Type of project(required): a a employer with employees(full and/or part-time).* 7, ❑New Construction 2.®I am a sole proprietor or partnership and have no employees working for me in 8• remodeling any capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9• El Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.F]I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] IL *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i 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. sY Insurance Company Name; Policy#or Self-ins,Lie.#: /expiration Date: _... Job Site Address: � � City/State/Zip: ,�?�� • �°� W`� "'°' Attach a copy of the workers'compensation polipf declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby P if z der the pains a d penalties of per jury that the infor rnution providerl above is true and correct. Si nature: Date: r., ,,• "" ... Phone#' ��_.. � .,s'" ",•;� 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#: M'1SSaCh41sP_tjS, Deparfimeoc ur< iC 1 Beard Of Building Reg Const aiid,;tandarcis Safetyfet Cr�ristructiun supersism L'canse. CS-030038 WILLIAM D MCKENZEE 34AHARRBOR STREETDanv , MA 01913 �,< tr�t 001MISS/Oi"iei 10/16/2015 •r. y!� dWOMMVIII'WVV f-^y/Jy///n — Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 144018 Type: DBA Expiration: 8/27/2016 Tr# 256650 WILLIAM MCKENZIE 34 HARBORBOR STREET - DANVERS, MA 01923 - Update Address and return card.Mark reason for change. Address ❑ Renewal ❑ Employment ❑ Lost Card SCA 1 0 20M-05/11 1 ® DATE(MM/DD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 03/09/2015 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 Jacqueline Marie Melanson,CLCS Phil Richard Insurance, Inc. NAME' 27 Garden Street 'JC, Ext, (978)774-4338 x105 aC No: (978)774-1318 Unit 1 B ADDRESS: jackie@philrichardinsurance.com Danvers,MA 01923 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Arbella Protection 41360 INSURED Bruce Ferriero DBA Weatherseal Contracting INSURER B: A.I.M. Mutual Ins Co AIM 32 Liberty Street Danvers,MA 01923 INSURERC: 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 ADDL SUER POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS LICY EXP LTR A GENERAL LIABILITY 8500060043 08/01/2014 08/01/2015 EACHOCCURRENCE $ 1,000,000 DAAGE TO RENTED 100 000 COMMERCIAL GENERAL LIABILITY _PRMMISES Ea occurrence $ CLAIMS-MADE IV OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY PRO--vLOC $ AUTOMOBILE LIABILITY (CE OMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ '.. ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NO OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ '.. EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ '.. B WORKERS COMPENSATION AWC-400-7029488-2014A 08/02/2014 08/02/2015WCSTATT OT AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/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 Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE d044"O fJj`j, j�^j,� k-C...�1C�,�YVi(tJEr @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD