Loading...
HomeMy WebLinkAboutBuilding Permit # 4/15/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION + Permit NO. Date Received �pSSqCHUS Date Issued: 4- IMPORTANT: Applicant must coLnElete all items on this pa LOCATION Print PROPERTY OWNER Oxy-, Q1, �,S-K Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES 0 TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building 11 One family 11 Addition 11 Two or more family 0 Industrial 11 Alteration No. of units: Repair,replacement 11 Assessory Bldg 0 Commercial 11 Demolition 0 Moving(relocation) 11 Other 0 Others: 1 11 Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: C Phone:TI, Address: %Cc CONTRACTOR Name: Phone:U Address: Pb e k Supervisor's Construction License: C. ---0 will Exp. Date: Home Improvement License: Exp. Date: c j t � ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.-$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST PASED ON$125.00 PER S.F. Total Project Cost :$ 'Li /J tl —x12.00=FEE:$ Vl( Check No.: 0'� c a Receipt No.:, Page 1,,pf 4 t%®RT•H rim ito, wn of Andover :leo. - _ ver, Mass, COCNICA.M. S BOARD OF HEALTH Food/Kitchen - ER T LD Septic System THIS CERTIFIES THAT ............... ......... .. . .... ............................ .. ...................................................... BUILDING INSPECTOR Foundation :has permission to erect.......................... buildings on ... ..�.(.........�/1�n ••.•. •• •••••••••••••• ® Rough to be occupied as .... ....... .../to ..... .. ... .�. .............. Chimney provided that the person accepting this permit shall in every respe conforhe terms the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and ��Construcfiion'of Buildings in the Town of North Andover. PLUMBING INSPECT®R Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final ITE I I T ELECTRICAL INSPECTOR UN LESS I T 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 Fina' No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Burner Until Inspected and Approvedthe Building Inspector. Street No. s Smoke Det. TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ F1Tanning/MassageBody Art ❑ Public Sewer Well 11Tobacco Sales ❑ Food Packaging/Sales 11 Permanent Dumpster on Site ❑ Private(septic tank,etc. F] Permanent Meter location to project NOTE: Persons contracting wiji unregMeked contractors do not have access to the guarantyfund i -,,I G // Signature of Agent/Owner `z' N',' Signature of contractorG � ; 1�, Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Siznature&Date Driveway Permit Temp Dumpster on site yes_no_ Fire Department signature/date Perry Brothers Construction Contract www.perrybrothersconstruction.com Fully License and Insured ;��, �� ��, Date er r'wIxotflLIG.#022831 HIC.# 108292 � 04/10/15 uKr tructICjri, - Estimate No. 17 P.O. BOX 646 Name/Address Newburyport MA 01951 Adam Clark T: 781-233-7511 864 Winter St F: 978-465-0929 North Andover 01845 E:perrybrothersconstruction@gmail.com T: 978-685-0350 E: aclark@aceticket.com Description Total * Described work: Bedroom 13'x13' 4,080.00 * Gut exterior wall down to studs * Gut ceiling down to studs * Remove existing insulation * Spray walls and ceiling with shockwave mold disinfectant * Change electrical outlets damaged by water * Re-insulate walls and ceiling * Blue board and skim coat with plaster * Install new window and base trim All permits and inspections performed by contractor -Certificate of insurance to be issued to owner -One year gaurantee on workmanship -Warranties on products to be provided by contractor - Remove all debris TOTAL STOCK AND LABOR -$2,300.00 ELECTRIC -$600.00 CARPENTRY-$500.00 10%OVERHEAD-$340.00 10% PROFIT-$340.00 TOTAL-$4080.00 We propose hereby to furnish materials and labor-complete in accordance with above specifications, for the sum of: Four Thousand Eighty 0/100 Dollars Payment to be made as follows: $2,220.00 $1,860.00 } <. - f. , - k -- -- -- !`��r�r-ttrtitrturrr///r�<'(� �yrt�iri-rl�� 'N Office of Consumer,Affairs&Business Regr�u.i'-A MEtMPROVEMENTCONTRACTOR gistration: 108,292 Type: XPIM00n: 8/14/2016 Private Corporat!0 PERRY BROTHERS CONSTRUCTION,INC. William Perry 20 SEAVIEW LANE NEWBURY,MA 01951 Unndd -y ersecretary Massachuse'rts -Departme� ,;of ptiblic Safety Beard o:Building Regulations and Standards - .•r}f�L$311 tirrrs`�i3}rri_l�ucir -. L sense:CS-022831 WILLMM J PERRY = 20 SEAVIT?W LN x. NewburyportMA 01956 0810912015' I i Rightfax N3-1 4/9/2015 7:31:51 AM PAGE 2/002 Fax Server DATE(MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE T. RTIFICATE IS ISSUED ASA 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 BYTHE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE ORPRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pollcyges)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the Certificate holder In Ileu of such endorsemen s. PRODUCER CONTACT NAME: PRESS BATEMAN&TURNER I PHONE PAX 460 TOTTEN POND RD STE 630 (AIC,No,Ext); (AlC,No): E-MAIL WALTHAM,MA 02451 ADDRESS: 22W3L INSURERS)APFORDING COVERAGE NAIC# INSURED INSURER A: 'IRAVELBRSPROPER'PYCASUALTYCOMPANYCFAMMCA PERRY BROTHERS CONSTRUCTION INC INSURER B: INSURER C: INSURER D: PO BOY 646 INSURER E; NEWBURYPORT,MA 01950 INSURER F.- COVERAGES :COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CEATIFYTHAT THE POUCIE9 DF WSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TER14 OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT YdnH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LQ,RrS SHOWN MAY HAVEBEEN REDUCED BY PAD CLAIMS. IHSH ADD SUB POLICYEFFDATE POLICYEXPDATE '..'.. LTR TYPE OF INSURANCE L R POLIGYNUMBER (MMIDDIYYYY) (IMMD1YYYY) LUAR3 '.. GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY CLAIMS MADE F__1 OCCUR. DAMAGE TO RENTED S PREMISES(Ea occurrence) ED EXP(Anyone person) $ GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ GENERAL AGGREGATE S POLICY PROJECT❑LOG PRODUCTS-COMP/OPAGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY I$ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per accident) PROPERTYDAMAGE g (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE ($ DEDUCTIBLE $ RETENTION$ I$ A WORKER'S COMPENSATION AND Y WOsra7UTORY OTHER EMPLOYER'S LIABILITY YM UB•o240M5e5-14 00!142014 09/1412015 1 UMITs ANY PROPERRORIPARTNERIEXECUTIVE OFFICEPJ44EMSER EXCLUDED? WA E.L.EACH ACCIDENT $ 5500,000 0&noatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,desedbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB S 500,000 '.. DESCRIPTION OF OPERATIONS/LOCA'nONSNEHICLES/RESTR1C71ONSISPECIAI.ITEMS THIS REPLACE$ANYPRIOR C&RTIFICATE L3SUm TO THE CERTMCATE HOLDER AFFECMG WORKERS COMP COVHRAGE. '.. CERTIFICATE HOLDER CANCELLATION TOWN OF IPSWICH SHOULD ANY OFTHEABOVE DESCRIBED POLICIES BE CANCELLED 25 GREEN STREET BEFORETHE EXPIRATION DATE THEREOF,NOTICEWILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZEDREPRESEn7yft �? € IPSWICH MA 01938 Ya�r ::'=:: w t ' c ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988-2010fACOR CORPORA7)ON.All rights reserved, ACORD CERTIFICATE OF LIABILITY INSURANCE MDATEWDDIYYYY) 04/0 THIS CERTIFICATE iS ISSUED AS AMATTER OF INFORMATION ONLYAND CONFERS NO RiGHTS UPON THE CERTIFICATE HOLDER;TH�S015 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 poiicy(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 Press, Bateman & Turner NAMEt PHONE 781�gg0-0050 460 Totten Pond Rd, suite 630 �D'NO Ext t ( A/c,No i (781)890--1198 Waltham, NA 02451-1965 ADDRESSt INSURER(S)AFFORDING COVERAGE NAIC# INSURED Perry Brothers Co. Ino. INSURERA: Western World P 0 Box 646 INSURERS: Safety Newburyport, NA 01950 INSURERC: INSURER D: INSURER E: COVERAGES INSURER F: CERTIFICATE NUMBER:Town of Ipswich 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 CONTRACTOR 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. LTR TYPE NSURANCE INSR WVD POLICY NUMBER GENERALLtAeILfiY (MhVDD MM/DD LIMBS _ X EACH OCCURRENCE $ "'000,000 ,000,000 COMMERCIAL GENERAL LIABILITY FR CLAIMS-MADE a PREMISES(Eaocwnence) $ ---- occUR NPP 8201246 09110/2014 09/10/2015 MED EXP(Any.one person) $ 5,000 A PERSONAL&ADViNJURY $ 1,000,000 S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY 'RD- LOC PRODUCTS-COMPIOPAGG $ 1,000,000 AUTOMOBILE LIABILITY $ 3003590 0$112/2014 06/12/2015 Eaacciden!) $ 1,000,000 ALL OWN BODILY INJURY(Per person) S B ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ X HIREDAUTOS X NON-OWNED ( ) ',. AUTOS Peraccident S UMBRELLA UAB $ OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIGI -MADE AGGREGATE g DED RETENTION WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY C ATU- ANYPROPRIETOR/PARTNERIEXEC YIN TORYLIMRS ER OFFICER/MEMBER EXCLUDED? UTNI� NIA E.L.EACH ACCIDENT $ (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE S DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICYLIMIT I S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If mora apace is required) '.. 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. Town of Ipswich AUTHORIZED REffRES NTATIVE 25 Green Street Ip Wich, NA 01938 ACORD 252010/05 ©`1 88-2 0 ZAC&Ke_�,;URPORATION. All rights reserved. ( ) The ACORD name and logo are registered marks of ACORD