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HomeMy WebLinkAboutBuilding Permit # 9/17/2015 � � BUILDING PERMIT �oraro-� o " ,(ED 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#e Date Received " �yRAo n .AK a. Rg7ED PP �G3 G 6iU5E� Date Issued: Y IMPO TANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes MAP ) 59 PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family. ,, ❑ Industrial ❑Alteration ❑ Repair, replacement .. ❑ Demolition Location ❑ Septic ❑Well ... °� Date i 11Water/Sewer No "�� DESCRI 5. in',0 0- V, � ® TOWN OF NORTH ANDOVER Certificate of Occupancy $ Identificat Building/Frame Permit Fee $ OWNER: Name: Foundation Permit Fee $ Address: ` ; VJ Other Permit Fee $ TOTAL $ Contractor Name: - Email Address: , check# a ro� Supervisor's Construction Licens Building inspector .d/ ,w Home improvement � . , ,��� � " . ti E�p. t�a�:+✓: , �,. u. �� ._,..��:, ,� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ _ FEE: $ q Check No.: } Receipt No.: DOTE: Persons contracting with unregistered contractors `o not have access t ,a gcycrcrc Signature of Agent/Owner ignature of contractor - ' i 'own ot txORTH 11 .1,, Andover ® : No. C® LAKE � lie ��l' ass, COCNICNEWICK y1" �®AORATEO P��`�.(� 7S U BOARD OF HEALTH Food/Kitchen PER- MI T LD Septic System THIS CERTIFIES THAT ............................ ........................... ,, �.... ............................................... BUILDING INSPECTOR ....... has permission to erect .......................... buildings on Foundation � � Rough ,u) to be occupied as . ........ .... ... ... .. .. ........................................................................... Chimney provided that the person acce ting this permit shall in every respect 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 EI IN 6 MONTHSELECTRICAL INSPECTOR LESSCTI R Rough Service ...................... ......................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy PuildinRough 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. rule Licensed and Insured-Member of MA Belief Business B��reau^� yrA r:lsmbar or NH Beller Business Bureau ` GAF Cert ME#26212 � HfC Reg t.'166661 Owens Corning Preferred Contractor N212B28 MA CSL#104728 OSHA 30 Hour Construction Safety Training Aim" EPA Lead Sate Certified El_ ' . Denera/ Contracting, LLC a i 51 S.Broadway#2214 Salem, NH 03079 (803)890.0084 10 Stevens Street#141 • Andover MA 01810 • (978)475.0095 rmc- Trn; ds-''t ' 0 ts CITYnTF;, e 1 `� I` Completely protect the home with tarps to catch falling debris.Respect and protect shrubbery and flower beds. Strip off I�J 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'. Inspect roof ridge for proper 11,12"spacing on either side of ridge for maximum exhaust ventilation.Cut in if necessary. Install new hemvy geuwi,_, t.?�d_r _ (color) AA:vgIj C1,0 drip edge at roof eaves. Instal IQ,s 6d4V ,�L h_ice and water shield to meet manufacturer's specifications 0,e.6 feet from roof edge,3 feet centered in valleys.around all skylights,chimney bases,roof penetrations and at all sidewall transitions) Install\'C'-iIli rX f1 AO breathable roof deck protection to remainder of the roof deck. Install new heavy gauge t kAll i (color) A1W1A iNV n drip edge at roof rakcs. Install (� - si1 starter strip at roof eaves and rakes. h,slHll"._.Cj �_ J�'t f ,;k _f� - 1„'1 .___desired color. 7PSb (color) C_ " Install new flashings to meet rnanufacturer's specifications,(i,e.sidewalls,chimneys,skylights and roof penetrations). Install 410 (feet)of_L,1—wxs 5" CJ {?�n S�k ridge vent at roof ridge to allow maximum ventilation. Hand nail to ensure proper fastenint{. Install i No (feet)of y) e di$tinraivo hip and ridge cap.Hand nail to ensure proper fastening, Thoroughly clean up and dispose of all roofing debris on property.Magnetically sweep property for nails. Notes: .1 tit.i�Cl,+ /tl(.i.t_) lec L �1L'.l4 S.,,fl.`��1�t ''-4�-,?_ra�L—�x_r._._LY1 '<x�l''"1 t".�__�r� itT" t'•("J`47-��"I�['t6 �' a-F rr _C3t- ' s.t5�.!4'v�__�,jl.S`J.l-/—�/J r �1.3_, vL, It�1,.1�`[(( ri CO 3 S;(-fr� C P 7k P0 C., 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 materiais 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 /S and described work will be completed in about h—) days Product Upgrade 1, y Product Upgrade 2: Contractor's employees are fully covered by workmen's compensation and liability It Is further agreed that this contract may be assigned by the contractor,and also Insurance. that the obligations hereof shall hind and apply to their heirs,successors or estates of the parties. Upon completion of the above work,all undersigned agree to execute and deliver to the contractor,their joint note In accordance with his(their)above obligations as �Iminds General Contracting LLC guarantees all workmanship performed for requested by contractor.Upon refusal to de so,contractor may at its option declare L h years. the entire contract price or so much as then remains unpaid,Immediately due and payable.It Is agreed that,if permitted by favi,contractor shalt be paid by the We will rclil_Sej,` 3 factory enhanced warranty owner(s)all reasonable costs,attorney fees,and expenses,in addition to the pro44mg-- years of matadaI AIsSl�pt r use and�years a amount due and unpaid,that shall be incurred in enforcing the terms and conditions workmanship date t coverage through, ? Y._ _ -.—_.__._1br Of the contract andfor any lien In connection hereviith. no charge _the additional cost of 'Edmunds General Contacting LLC viii prmnle the materials,lahW ool tlis osale a reptaca up to- all 1t.o roo16?ckand 2a 11 or Pasch at no addittonal coal eop Anyaddhioual n'dledals incnding labor and disposal skill bsreplaced at`�Ltv _persh,ator +�3 lineartool, (rfrnunds General Contracting,LLC agrees to furnish the material and M rall��u +,a:, i a, az vxtza,sr aJrl`ivlM dtWol,r.e rt,,,, _0".iWqerL,eY..s roA ra rra.+,tm Y.Jl;a, labor toniplete In evilb the al spe-nlicallotlsr for.the su(n o&",,aj u t h aA L*r„t4 w l 11,t,t ar 1174ria ,res d rt dca G t,al 1 W n,0flo dxde ) 11!6_01 La 30W of CIJAooC 1 tit� �t?>t>� _doll.f5 1$1( x)_fi.1C>Ir rr; q l, z r t,><.e.a s s� c d L*6,1w. t "xt r r 0 ua le a e a.m"�1 j Ore.' A T`� CV � fs ,ams}; ,& t sf(-,Vs ,N hr`Sti t t v &�+S'10 At r :rd�T+sr if mir /"71�r�1 r t°4 C''4.lAJ ��Ci xt owrU is n r i K* to ki os'I '.tau t"'My,A wv Rr, pe,e+- PaymentTerrins: > q r ca or ++_tu �t >r� am a. Rxrrrev� x .celI,J 0 d"Mtk,A d!.' ..ear il'Yn�4;lsc is d+ a4zfrd LR[rrti • A deposit of (not to exceed 1/3 of the total contract)is //J2 a due upon start of work.The balance of ._ji Is due when work Authorized Signature f�r �.— is completed to the satisfaction of all parties. rev;J;General C,cmt—ung LLC • A finance charge of 151%per month(18%per year)will be charged on Note: This fOroppsal mAy bo withdrawn by us if not accepted within past due accounts over 30 days days.. RL[eptatice Of Vro]ool The above prices,specifications,and DO NOT SIGN THIS CONTRACT IF THERE ARE ANY DLAJK SPACES, conditions are satisfactory and are hereby accepted.You are authorized to do { C.----�-� the work as specl(led.Payment vdll be made as qulnnad 36o�t. Authorized Signature: t ,_ Date of acceptance: r� l� ? _. _ Authorized Signature: N;,a-¢anp;Cr[m::calr•ttcas ile"Ce r.,l:l:na F I-¢.N=?bau;a mn:rz;l r a.u_cs.I;tW'rtlttrJi la a Rv+in.aa_...7 tt Q'rL::d lo:e✓:o'G.,mt:r Alhns zM E�... Ii.,,,d:a 10 Pa,%P>:3,$u+l¢5170 Fmi;e,A,A P21!6 trt­617-973-De71 e,r^ar•eh,scee-e},cr v:,n rMsln s�>:n--;�.t e:n��o:de?I'u.'lr u5r:j51:red saJaUoiS s^z94,uect'JP,na>si ro lr=Gutxn'.cE Fu'd Pow)':—,NN.Gle142A Ra:sln?:u'.1 ra::r.a2s�^;`;.9 ail,,r Itis wct tt?'u?;,�.t rHl cunrn-.E lbeexrr:AlS�.�rf')er:Y:su•2,Iorncsl lM1"s cwtba:ta'd l^:utr)C7n:'i;Camzp::.:frc3lri:d9:ehec'_A IOEG:u.i,unsetl Nn'n::i:)LlCat1'.ea6mc nv e1c3 "fie Commonwealth of Massachasetts . ..`. Department of IndlustrialAccidents a I Congress Street,Suite 100 1 - ;d µ Boston,MA 02114-2017 ��. www.amss.go v/dia Sy4 ovkers'Compensation InsuranceAfradavit:Builders/Contractors/EXectrici � anslPZuznbexs. TO BE FLED WITH THE PERIVRTTING AUTHORITY. Apl ilicant Information Please Print Le 'bl NaMo(Sttsiness/OrganizaRoii dividual): C Wa w e Address: :a 7 I V City/,Mate/Zip:� ,� c;'1 Phone (�Q" Are you,an employer?Cheekthe appropriate box; Type of project(required): 1.[4I am a employer with iT. employees(Roll and/or part fime).x 7. E]New construction 2.E]I am a sole proprietor or partnership and have no employees working for me in 3. ❑Remo deliAg any capacity.[No workers'comp.insurance required.] 9 Demolition 3..❑I am a homeowner doing all work myself,[No workers'comp.insurance required.]t ]0 F1 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 11.❑Electrical repairs or additions proprietors with no employees. ftE]Plumbing repairs or additions 5.❑I am a general contractor and I have hiredthe sub-contractors listed on the attached sheet. 13.Fl Roof repairs These sub-contractors have employees and have Workers'comp.iusuraace. 14.El Other 6.❑We are a corporation awnd its officers have exercisedtheir right of exemptionperMO c. 152,§1(4),and we have no employees.[No orkers'comp.insurance required.] *Any applicant that checks tiox#1 must also fill.out the section below showing their workers'compensation p olicy information. T Homeowners who submit#his Adavit indicating they are doing all work andthen hire outside contractozs must submit a new affidavit indicating such. ?Contractors tbat check this box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. Jffhe sub contractors have employees,they omit provide their workers'comp.policy number.` ,d am an employer that ispr•oviding worlrers'compensation insurance for my employees.'Below is the volley andiab site information. a Insurance Company Name; �f 6-4,V-" Policy#or S elf ins.Lic.#: WC °o) Expiration Date; MA Job Site Address: r1J"1 City/State%Zip: Attachh,a copy of the workers'60=1?ensatiowvollcy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MOL 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 viol for A copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage ve " zcatio =.,� I do hereb eer err tliepains andpenatties ofperjarry that the information provided above is true and correct. Date: , Phone# .. G 3 Official use only. a not-Ivrite in this area,to he completed by city or town official. City or Town: Permit/License# Issuing Authority(circle(Me)a ; 1.Board of health 2.BuildingDepartment 3.CityJTown Clerk. 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact?person; Phone#: A CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 9/18/2015 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 PLANRIGHT INSURANCE& FINANCIAL LLC NAME:CONTACT 224 MAIN STREET STE 3C PHONE FAX SALEM, NH 03079 E-MAIL Ext AIC No: ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: LM Insurance Corporation 33600 INSURED INSURER B: EDMUNDS GENERAL CONTRACTING LLC P O BOX 2214 INSURER C: SALEM NH 03079 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 26473324 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 ICY EXP N DL SUER POLICY NUMBER MMIDD�YY MMIDDIIYYYY LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ D AGE TO RNTED CLAIMS-MADE 17 OCCUR PREM SES(EaEocc."..C.) r ence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PRO ❑LOC PRODUCTS-COMP/OP AGG $ JECT $ OTHER: AUTOMOBILE LIABILITY EO..dentSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB Id CLAIMS-MADE AGGREGATE $ DED I I RETENTION$__ $ A WORKERS COMPENSATION WC5-31S-369752-025 1/26/2015 1/26/2016 STATUTE ER H AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 500000 OFFICER/MEMBER EXCLUDED? ❑Y (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF NORTH ANDOVER, MA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE \n(\�jj 1(J A�j (n/� ^ •./'n/� ��• O�/T SCJ �CW"�v"�� LM Insurance Corporation U ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 26473324 1 1-369752 115-16 WC I Ashish Borgaonkar 1 9/18/2015 10:41:30 AM (EDT) I Page 1 of 1 N 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction SuperVisor License: CS-104728 , DAVID C EDMUNDS , P.O.BOX 2214 r SALEM NH 03079 92, �i 1"+ Expiration Commissioner 10/03/2015 + Ulze W11.2011eaea4a P/l�ecava�ueeGf j I \ Office of Consumer Affairs&Business Regulation qjOME IMPROVEMENT CONTRACTOR egistration: 106661 Type: xpiration. 6/2112016 Corporation j EDMUNDS GENERAL CONTRACTING,LLC. DAVID EDMUNDS 18 ASHFORD RD g HAMPSTEAD, NH 03841 Undersecretary it. License or registration valid for individul use only I before the expiration date. If found return to: Offiee of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 j Boston,MA 02116 . I I i 1 . Not Etitsignature