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HomeMy WebLinkAboutBuilding Permit # 6/9/2015 µORTN ' BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: ��/ Date Received �'Syssw•.NcsE R Date Issued_ - �_ IMPORTANT:Applicant must complete all items on this page LOCATION PROPERTY OWNER Print 100 Year structure yes n MAP7•/+ PARCEL:�� ZONING DISTRICT:__Historic District yes F/ no Machine Shop Village yes. no TYPE OF IMPROVEMENT PROPOSED USE - -- _ Residential _ Non-_Residential ., ❑New Building ❑One family [i Addition - Li Two or more family Ll Industrial ❑Alteration No.of units: C COt"merclal DIRE i,replacement ❑Assessory Bldg Others: Ll Demolition fl Other c art eI �t�" "-�vTt �® oodp ain� U, etla ds '� ,�°�c�s\A,`Iaters eci�[9istnct r;j. DESCRIPTION OF WORK TO BE PERFORMED: __ Identiliication-Please Type or Print Clearly _ OWNER: Name: >c Phone: CN, C Address: Contractor Name: Phone 3�-- Email: Address:� ' Supervisor's Construction License: jt�OIJJ Z 2t Exp. Date: Nome Improvement Licens : G I Exp. Date; ARCHITECT/ENGINEER Phone: Address: Reg.No. FEESCHEDULE:6ULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ f)C FEE:$ Check No.: ,S /� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to th g lyfunrd � E QfA9enfLOwner` '� .>,�ig_naLl[e"©fs:ontracYr?r.v'- t :'rw:: \ _ _ Town of 2 "°RT" Andover No. 58� ��Th ver,Mass, PER s IT ® ILD Sept/!'tte BOARD OF HEALTH Y' �f PE — T/O.Bsq L/ BUILDING INSPECTOR THIS CERTIFIES THAT ................... .... .......... .......... ...................................../. ....... ................. ......... ....... has permission to erect..........................buildings on S..�...... ..�.............�.....S..�c1 GE Fo�r,aeeo� ............................. p pi P Sp 9../ .i. g'� ....ry..................................................... :............ Rough 4o be occupied as................:...l.�.....�r:^G... cnlmeey provided that the person accepting this permit shall in eve respect conform to the terms of theapplication Fir,ai 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 F!,ei PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR ........ µ^—! .............B6i PECTOR Fo�gh UNLESSCONSTRUCTION TARTS Rerg/e GAS INSPECTOR Occupancy Permit Required to Occupy Building R-gh Display in a Conspicuous Place on the Premises—Do Not Remove Flrol No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. °eY Street No. Smoke Det. Fully tcansId am M—b—f tidy Bene r gyp 975a umuer or GAF Con—,20212 au '➢I� .C...�. Hie Reg#eleasel NH r" .wens Com ng Preterted Cont IX %212828 MA CSL#104728 p^'� OSHA se Herr ConstructonSfty manng ,:� EPA Leatl Safe Cenihetl Genera/Contracting,roc 51 S.Broadway#2214 Salem,NH 03079 (603)890.0084 110 Stevens Street#141 Andover,MA 01 B10•(978)475-0095 E _ - r<_ e -d:tc f; " �(�e `J"i- ;nir �oa,rore Comeduelysproteot the home with tarps to catch falling debris.Respect and protect shrubbery and flower beds. Strip off ' layers of roofing material down to the bare roof deck.Inspect the roof deck for structural defects. Determine the condition of the underlying plywood or boards,and repair and replace as necessary*. Inspectroof ridge for proper 116"spacing on either side of ridge for maximum-exhaust ventilation.Cut in H necessary- , Install new heavy gauge tom'^ 't, (color) � drip edge at roof eaves. Install =a' e and water shield to meet manufacturer's spec atone(i...6 feet from roof edge,3 feet centered In volleys,around all swighty,cchmmyyba'ses roof p t tions and at all sd ' transitions) - In t II L dr - breathable roof deck protect on toremrd r of the roof deck - r Install new heavy fl ( Irl dt'^n drip edge at root rakes. fn tall - starter strp at roof ea and Instal `' 4 � � desired color. (color) Install new flashings o et manufacturer'sape ci cations.f.e.sae ells,chimneys skylights and roof penetrations). li Install is (feet) ridge vent at roof ridge to allow maximum ventilation. Hand nail-.o ensure proper fastening. _ - Install (feet)off-„t ., cx distinctive hip and ridge cap.Hand nail to ensure prop "astaning. Thoroughly clean up and dispose of all roofing debris on property.Magnetically sweep property for nails. Notes Edmunds General Contracting will: •Obtain all necessary construction-related permits to complete this project. •Perform work as efficiently as possible without sacrificing quality. •Furnish and install all necessary materials to complete the project. •Provide a thorough clean-up and disposal of all debris generated during project. Edmunds General Contracting LLC agrees to commence work on/or about��= and described work w II be completed-n about i days. ISI Product Upgrade 1: T-� - ProdJCt Upgrade 2 _ Ge mractors employees are fully covered by wod<mens comp anseton and liability It 11 dinner agreed that ih'scontract may be ass gned by the cdntradtr d to ;nsurance. that the ohl'gat ons hereof shall bind antl apply to their tons,successors or across s of the parties. Upon mail on of the above vrdry all unders gned agree to execute and der var to the contractor their tont Imil m accordance with his(the,)above obl gat ons as EQplAllred General Contract re LLC guarantees all laorkmensh'p pertormed for requested by contractor.Upon refusal be do on,contractor may at its option cases _year, . the entire contract pride or se much as than romans unpaid mmedlataly due antl ^ payable it agreed that fparmtted by law contractor shall be pad by the W rill reg t y v'" factory enhanced warranty ()II as bl 's[ tt nay) d psurlier to the p tl'g y f material defect e pae nd. .years of A := amount&a d-unpaidTo shall be tl fes,o the tom,antl conditionsvmlonduchptlf t mough 'Y for of theentradtantl/ any len'n cdnnedbn herewith. no bhame" _the`abdt nal rest of )} - ' LN. ce upm cdf.aria cos. - r In,nmll,rol eco r ..S.fJ J ..Edm,,d,Gel-arzl Contracting,LLC ogroea to fWrri h th material end � }b complete in dooerdamewith the sperificetions,for th,dram f colors D ""�"1 _ •Pym mTerme. 121 Naca a •g ed p kof (nett d1/3 tth t mrsc)s a�01Il­ - eye nrml. due n start of work.The bol n v E.y s due when work Author zed Signature: is completed to the satisfaction of all parties.y, "-"`C•"- Edmunds aenerxl cunuecung Lm �•.A finance charge m 1.5%par month(18 o per year)will be charged on Note:This propesaL[pey be withdrawn by us if not accepted withln - past due accounts over 30 days -..5 days acuptari of Jornapea5at-meabovepro,aspeorfiro venae OO NOT SIGN THIS CON3RAGTIFTHERE,ARE-IWY+RLANK SPACES. contl t ons are ser efic ry antl are hereby accepted.You are author zed to do '4 the wbrk as specred Fayment roll be made as ortl'ned above. Authorized Signature y^= Date df'accept Authorized S'g tura.^ .n =roan oonsn m o•:: unre s m en. ;valLesru sa am re=:: :an.e un m •.,..r. t sa ravmr, =.oe, i roil. 'The Commonwealth of Massachusetts Depm•tment of LadustrialAecidents _ 1 Congress Street,Suite 100 Boston,MA 02114-2017 Z wive mass.gov/dia Workers'Compensation lusurance Atildavit:Builders/Contxaetors/Electricians/Plombors. TOBEFILCDWILIII'BDPLR2OT'1TNOdU1'BOl - Please Print Le ibl Applicartlaforuetinn Nalne wsmess/organizati<m/Inaivldeaty N� - ' I -r l.I Address: � -> , Phone#: —7'z- City/State/Zip: — - Aroyov vamploYerP Checle bra appropriate box: Typa ofpxoj0.(}'aquId nodany capacity.(Noworkm'omp.in ran rcgure 9.❑Demoti10�Buildingodditioall work ov my ycporty.Iwill xepah a enrsthae au aonvactora eidrerhnva workars°compensation imurance or are sole 11.[]Electrical radditio s propdet=,,Rh nn emPIWWI. M[_1 Plumb]ng repairs o n S.Qlamagertcmi contractor pndthavehired Ne snircontractors lisle don l6e Ynaobed ghee[ 13.QRoofrepairs 'these sub-contractors lmvo emptoyees vrdl—workers comp.i- 6 �umn lq.�Other 60 Waero acorpomtlanand iixoKrcersh¢veezeroised thele right of§xomptiev perMGL c. ,§I(4),andwe have no employees. e workers'camp.msmance,rgw,ed 152 [Nj 'Airy appl_,th¢t checks boxXt moat zlso felt out the scctiov below showiugthevworkers'compensation Pelicy intbrmatiw. gent tHom who submit this affidav'tindicativgthey azo doing all work end ihanhira outside connectors moat su6miC arrew afhdavtt indicaziv h. tGonUeotom that checkthis box most attached ll,dditional sheetshowwgthe name of tlm sub-contractors and state whether or no[tlrnse entities bvve employees.Ifihe subcontractors have employees,they mus[pravide Neir workcrs'comp.policy number. Zom an enployerthatisprovidingworhers'compeasation inlione eff•ny employees.Min,is d:epalicy andjob side inforniation. M�h� Insurance Company Name: (—t YUU / Policy'lk or Self-ins.Lic.#: WL��,[S _ '' -197 —ExphationDate:_y�21Z��. Job Site Addass:�7' 4+ City/State/Zip: Ic:�C�1 Attach a copy of the worlrexpolicy declaration page(showLg the potioy number and expiration dateD. Failure to—le as roquhed udder MGL c.152,§25A is a criminal violationpunishable by afine up to$1,500.00 and/or one-year 3mpeisonment,as well as civil penalties in tine form of a STOP WORK ORDER and a fine of up to$250.00 n day against the violator.A copy of this ststen estmay be forwarded to the Office oflnvestigofions of the DIA for iusurance coverage verification. �Phone �h.,,*�,bbylbntthe infarmationpdD t FF o+dy.Do notrvrite in this area,to be completed by city or tmvn offietal n: PermitiLicense# hority(circle one): p� g pecHealth 2.Building Department 3.City/Torm Clark 4.Electrical Infor 5.Phmrbin Ina for Phoneson: i--l' EDMUN-1 OF ID:NB 4I.oR® CERTIFICATE OF LIABILITY INSURANCE e05122120151O0 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 holtler 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). moeucea ighIn-30a le °i.ome°CT James A Santo 224 Man Street nce-SaO xF .603-890-6439 a°c xo:603-890-6521 224 Main Street Suite 3C Salem,NH nt. n�c No ext. ntoin-_-. -.-. James ASanto nooness:Jamie san_toinsurance.com Ixsuasrelsl Avroreolxc covaaAcs __ xAlca Ixsuaas A:St Paul Surplus Lines Ins Co Ixsuaso - Etlmunds General I,,,—,,,,,Liberty Mutual Insurance Co__ Contracting,LLC wsureea c PO Box 2214 ---- -- Salem,NH 03079 wsUreere o 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 CIAIMS. An X c regAL ea IDTvEACH Tsg 1,000,00 IMS MAOEEOc cuR 5236058 11/11/2014 11111/2015 °p MA sus UEOCCURR 5 50,00 u REI ISIS o��,rer,oe -_. _. .ED EXP IA11—per-1 3 5,00 __-. PE NAL s Aov I—EY s 1,000,000 111 Ac IT APP sPER. cE FIE s.. 2,000,00 POLICY❑PRET [ III _ c 8 2,000,000 "T01-01 Ll L11111ITY ool_INOLE U.1T FIT. REHLY LL E RviPe;Pa„o�, RY IRe�a��Ida���s LIBEOAUTE1 NON OWNEo PROPERTY OAMAOE AUToa Pe,a��das SLA .MADE AOOREOATE a oEoRETENTIoxs IxoaXeascon UA.T'lox srATUTe L°d” x,PE B Aly 11"BEroa nv YO N WC5-31S-602821-014 04103/2015 04/0312015 e s s00,000 (mann-'hrvE,Ex LuoEoa 3A:NH I I RIWAW PE EMILEIEEJ5 500,000 500,000 ss(FC011 tot,A11111-1 RD-11.s<neauA. y anacnea,f—L.­— Dave, orpaa,sDave Edmunds is excluded from work comp coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover,MA ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover,MA 01845 AUT"°elzeo are"ease"T" ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ..1—01.-DIP"tment of Publ Safety Board of Building Reg I t s and St ndards C'u"fi ctlbn Snpcniror License.CS-104728 DAVID C EDMU"S P.O.BOX 2214 N. SALEM NF 03039 �waiy Ex t Commissioner 10/03/201 J S� Off iC rAff &B eines R g 1 t o G OMEIMPROVEMENTCONTRACTOR _. eg t bon 166661 TYR - - xp ton' 6/2114016 C Moratmn EDMUNDS GENERAL CONTRACTING,LLC. DAVID EDMUNDS 18 ASHFORD RD HAMPSTEAD,NH 03841 - lu.dcrseeremry