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Home My WebLink AboutBuilding Permit # 9/8/2015 t%o R Tal BUILDING PERMIT 4 6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o -- x Permit No#: hH�l Date Received o "a q Hus��5 Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �i /��i(Atm l e S,e,( a Print PROPERTY OWNER-, E' C Inl 15 IL- Print Print 100 Year Structure yes Lno MAP PARCEL: ' � ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition P, f'wo or more family ❑ Industrial ❑ Alteration No. of units: `¢ ❑ Commercial repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed Distract C1WaterlSevyeX ' ' ',r DESCRIPTION OF WORK TO BE PERFORMED: �s (Jii ✓G- Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: 62 Address: 5-6- y,z 6� 1� Supervisor's Construction Licensee/6 Exp. Date: Home Improvement License: Exp. Date: �La ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASE ON$925.00 PER .F. Total Project Cost: . " - !2,24--, a& FEE: Check No.: /y? Receipt No.: NOTE: Persons contracting with unregistered contractors do not have qccesto e guaranty fund-11--y04 _ �, -- 'Town Andover 2 1, ® i y 02 9b. //0 r q * h vel', ass' —Al 9_ kir__ O LAKE COCHICKQ W/CK ®QOOATED 1`s ij BOARD OF HEALTH Food/Kitchen T LU040 Septic System ( BUILDING INSPECTOR THIS CERTIFIES THAT .....FER ............ .. .. ... . Foundation 4 has permission to erect .... buildings on ...... �. .. . ... .. . .. ..... p ............. .... .. Rough 1koo am .k. .... ..................................... Chimney to be occupied as ............ ..... .........VI... e provided that the persona epting this perm all In every respect confo 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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final ITE IES 1 OT S ELECTRICAL INSPECTOR ®K VIA LES CTI TS Rough Service . ............. ................................ Final .. . ...... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occum Building Rough Final ® Display i a Conspicuous lace on the Premises — Do Not Remove FIRE DEPARTMENT No Lathing or Dry Wall To Be Done Burner Until Inspected and Approvedthe B uilding Inspector. Street No. Smoke Det. Pa&A of 2 1111..65,0 coinlgrtjrry(Ctriroinl Jffeith vre,1n111 ai) JULY 19, 2015 BOB SECHRIST 146 MIDDLESEX ST 01845 NORTH ANDOVER,MA JOB:VINYL SIDING PLANS DATED: ESTIMATE 1 INSTALL 3/8" FANFOLD INSULATION. RS ONLY.FACIA ITE COIL STOCK ON ALL WI FDT MAWS TE DOES NOT INCLUDE (2) LBOARDS ARE ADDITIONAL.THIS ANY ROT REMOVAL OR REPAIR' y CERTAINTEED DOUBLE 7" 3) INSTALL 13 SQ OF CEDAR IMPRESSIONS B „VINYL SIDING ON ( � ON SHINGLES ON THE FRONT OF THE HOUSE,AN STRAIGHT EDGE PERFECTION FIT.BOTH PANEL COLORS ARE LIGHT TEED WOLVERINE AMERICANOF LEGEND DOUBLE CERTAINUP TO THE S ALL REMAINING WALLS CHANNEL TO MATCH AS WELL. MAPLE AND THE CORNERS/J- SOFFIT BRACKETS AND INSTALL J-CHANNEL AROUND THE DET RAT$CI�FTS AT THE SOFFIT. INSTALL VINYL SIDING UP TO THE (5)INSTALL STALL SHUTTERS ON ALL WINDOWS SK. (6) REMOVAL OF ALL DEBRIS CREATED FROM THE ABOVE TA LABOR AND MATERIAL TOTAL- ,$36,925.00 - $38,925.00 HE THESE PROJECTS SHOULD TAKE APPROXIMATELY 4 - 6 WEEK SIGN AND TIIANGES DATE (YET TO BE DETERMINEDI)NCOURAGE HOME OWNERS TIONUE F START THIS PROCESS. MADE THROUGH OUT CHANGES AT ANY TIME AS THE PROJECT CO ANY SUGGESTION FULLY LICENSED AND INSURED MA.LIC it CS 104466 HIC LIC#167074 Page 2 of 2 ANY CHANGES ARE MADE A CHANGE ORDER SLIP WILL NEED TO BE SIGNED AFTER A PRICE HAS BEEN AGREED UPON. DISPOSSAL OF DEBRIS IS NOT INCLUDED IN THIS ESTIMATE,UNLESS OTHERWISE STATED OR AGREED UPON. UPON EXCEPTANCE OF THIS PROPOSAL PLEASE SIGN THIS COPY AND RETURN: EITHER IN PERSON, OR MAIL TO M.S.O CONSTRUCTION @ 56 NEWPORT ST. METHUEN, MASS 01844. IF YOU HAVE ANY QUESTIONS YOU CAN CALL ME ANY TIME THAT IS CONVIENENT TO YOUR SCHEDULE.THIS ESTIMATE IS VALID FOR 30 DAYS FROM ABOVE DATE,THERE AFTER A NEW MATERIAL QUOTE WILL BE NEEDED. UPON ACCEPTENCE OF THIS PROPOSAL A 1/3 WILL BE DUE AT SIGNING,A THIRD WILL BE DUE 1/2 THROUGH THE PROJECT AND THE REMAINING BALANCE IS DUE UPON COMPLETION.ANY AND ALL EXTRAS WILL BE DUE ONCE A PRICE HAS BEEN AGREED UPON.ANY INVOICE THAT IS NOT PAID WITH IN THIRTY DAYS FROM THE DATE RECIEVED IS SUBJECT TO A 5% LATE FEE PER MONTH OF THE OUTSTANDING BALANCE. THANK YOU FOR CHOOSING M.S.O CONSTRUCTION,AND I HOPE I CAN SERVE ALL OF YOUR REMODELING NEEDS IN THE FUTURE. ani 77�� MICHAEL O'NEIL M.S.O CONSTRUCTION 0, L� CIO P �f- -)IdOld 7 -y FULLY LICENSED AND INSURED MA. LIC#CS 104466 HIC LIC#167074 ■� Sep. 08.2015 01:39 PM Advantage Insurance Agenc 978 794 4833 PAGE. 1 7 Ole on CERTIFICATE OF LIABILITY ItlSURA1S0^E DRTE(MMIDV 109/08/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the rt celflcate o er s an IN URED, the pollcy(Ies must a ondomed, If SUBROGATI Bu ect to the terms and conditlona of the policy, certain pollCles may require an endorsement. A statement on (his Certificate dose not confer rights to the aerlificate holder In lieu of ouch endoreement(S). PNAME; PAUL+ D3VIN PRODUCER .ADVANTAGE INSURANCE AGENCY INC. KONN E.e: 978-681-1055 acj,Nv:978-79-4833 184 PLEASANT VALLEY STREET ADDRESS: -- METHVL}N MA 01844 __IN8URElAFFORDING COVERAGE NAIC N ----- INSURERA.-ARBELLA PROTIMCTIO14 SNS. COMPANY INSURBD --_...._.._. INBURERB: M$O CONSTRUCTION INBURERC: MICHAEL ONEIL DBA INsuRERD: 56 NEWPORT STREET INSURER E. INSURERF: METHfJEN MA 01844 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS Is TO CERTIFY THAT THE POLICIES OF INSURANCE LI TED BELow HAVB SEEN ISSUED TO THE INS Eff NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$ SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Tm""r T pM� POLICY NUMBER (MMIDDfYYW MMIbp/rrYY) LIMITS LTR _ TYPE OF INSURANCE INSR WVb A GENERAL LIABILITY 8500047872 07/21/201$07/21/2018 EACHOCCURRENCt $ 1,000,000_— ^ PREMISE9(EdoCor9torlce) 9 100,000 COMMERCIAL OENERAL LIABILITY ' CLAIMS-MADE ®OCCUR MED EXP(Anyone person) $ 5,000 _ PERSONAL&ADV INJURY $ 1,000,000 pENERAL AOOREGATE 8 2,000,000 PRODUCTS.COMPIOP AGG S 2,000,000 GEN'L AGOREOATE LIMIT APPLIES PER $ POLICY JETRO. LOC AUTOMOBILE LIABILITY EB ecaldeni $ p wn) 8 ANY AUTO BOOILYINJURY(Par _._.-.... ...__.... -'- ALL OWNED SCHEDULED BODILY INJURY(Per ncddanl) b AUTOS AUTOS NON-OWNED -IF-tilaffil - MREDAUTOS AUTOS $ EACHOCCURR@NCE E UMBRELLA LIAR OCCUR AGGREGATE $ EXCESS LIAR CLAIM$-MADE '—'""" DEO RETENTION $ WORKERS COMPENSATION TORYLIMI7S ER AND EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT $ ANY PROPRIETORIPARTNER/EXECUTIVE ❑ N I A OFFI0rRjMFMFFR EXCLUDED? E,L.OIS@AS@.@A EMPLOYEE 8 tMwtdatory In NH) f nya,deac&B under E.L.DISEASE.POLICY LWIT _ $ DCSCRIPTION OF OPERATIONR bolow DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD f D1.Additlonaf Ramarua achodulo.If more epa0e le le(1146d) CERTIFICATE HOLDER CANCELLATION TOWN OH' NORTH ANDOVZ)g SHOULD ANY OF TME ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPT. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE VATH THE POLICY PROVISIONS, 1600 OSGOOD STREET SLD-20 SUITE 2035 NORTH ANDOVER MA 01845 AUTHORIZED REPRES I! 01988.2010 CORD C ORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD The Co s;�monwealtlt ofMassc chusetis 13 Department oflndus, flAccidents 1 Congress Street,Suite 100 ' Boston,MA.02114.2017 wwwanass.go-v/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TPM PERAU TING•AUTHORITY. A licaut Information Please Print Le ibl Name(Bitsiness/Oxganization/Individual): , {' .Address: �f(' JJ utY/statc/ziP:fl7q4o,oJAPhone#: cr y 73 Are you an employer?Clrecktu,appropriate box: Type of project )Vequired): 1.F]I am a employer with employees(full and/or part-time).x 7. ❑Now construction 2.V1 ama sole proprietor or partnership and have no employees working for me in $, [4-R'emo delirig any capacity.[No workers'comp.insurance required.] 9. El Demolition I C]I am a homeowner doing all work myself;.[No workers'comp.insurance required.]t - 10 Building addition 4.E]I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole II.E]Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.FJ We are a corporation and its officers have exercised their right of exemption perMGL c. 14.[]Other 152,§1(4),and we have nq employees.[No workers'comp.insurance required.] f 'Any applicant that checks Box 41 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submif k!*affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. rContractors that cheek 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-coniracfors have employees,they riru t provide their workeis'comp.policy number. I am an employer Mat ispN viding-workers'compensation insurancefor my employees.'Below is thepolicy and job site information. Insurance Company Name: Policy#or Self ins,Lie.#: ExpirationDate: Job Site Address: City/State/Zip: Attach a copy of the workers' cornpensation•policy declaration page(showing the policy number and expiration(late). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a flue 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 DTA.for insurance coverage verification. Ido hereby certify under the pains andpenalties ofpeijury Haat the information provided above ' true and corr'ect. Signature: n Date: e Phone# 4 7 Z )(;6 Official use only. Do not-write in this area,to be completed by city or town official. City or Town: permit/License 0 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##: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 w Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 183128 Type: Individual Expiration: 8/28/2017 Tr# 270040 MICHAEL O'NEIL MICHAEL O'NEIL 56 NEWPORT ST METHUEN, MA 01844 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card SCA 1 C. 20M-05/11 �lZB00?9//72041.l.I1G'CG �d��i� �Of!-C/ZGCUG' License or registration valid for individul use only_ - ofce of Consumer Affairs&Business Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation o Registration: ' 183128 Type: 10 Park Plaza-Suite 5170 ;j Expiration: 8/28/2017 Individual Boston,MA 02116 MICHAEL O'NEIL MICHAEL O'NEIL A4� 56NEWPORTST ,.=, -`=.,, �METHUEN,MA 01844 - Undersecretaryalid without signature iViassacbusetts -Department of Public,Saaety Board of Building Regulations and Stas-�daras Construction Supervisor icense: CS-104466 - 1VIICHAEL S ONE ,\ 56 NEWPORT STREE METHUEN MA 01844 3�-V� pi ration ,• Commissioner 0,91.23120'15 .