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HomeMy WebLinkAboutBuilding Permit # 9/21/2015 BUILDING PERMIT %4Q D 6" TO OF NORTH ANDOVER m h�, 4g o APPLICATION FOR PLAN EXAMINATION Af- Permit No#: � �� Date Received Date Issued: 9IM11/0 iivirukrANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER rt Print 100 Year Structure yes no MAPC1/ N 0 PARCEL5)WV ZONING DISTRICT: PV Historic District ye no to/O/0 -(zW,-(AxV,0 Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑ Two or more family ❑ Industrial teration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain CJ Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: /21er,C C- 111J° C , t Clj / Identifac OWNER: Name: 7 {21 Address: ,cs Location No. 2 / �',��( t Date / a� Contractor Name: lyl °l.. Emaila6 j Address:/'? aa. co ® ® TOWN OF NORTH ANDOVER Supervisor's Construction Licen �f��"�1 Certificate of Occupancy $ Home Improvement License: Building/Frame Permit Fee $ Foundation Permit Fee $ ARCHITECT/ENGINEER Other Permit Fee $ i Address: TOTAL $ FEE SCHEDULE:BU DING PERMIT.$ Total Project Cost:t_ # ,. Check No.: Building Inspector NOTE: Persons contracting 4i Si nature of A ent/Owner ature of contractor i 9 9 _ _ '� _ ttORT H flowl"i of nuover O No. 261 IL = - o LAKE h ver, Mass, C?_1 Z01115 COCHICHEWICK V BOARD OF HEALTH Food/Kitchen PER...MIT D Septic System 1010' a e THIS CERTIFIES THAT ... .... . ......... . �► �• ,,,,, R41L........................ BUILDING INSPECTOR ...... ......... .......................... ..... . . Foundation has permission to erect .......................... buildings on 4& • s .`n � Rough to be occupied as ........... ... ..... ....` .. . .... ..�r1C.l. .... ...................................... Chimney provided that the person accepting this permit shall in everyect conform tone 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 EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTI S S Rough Service ............... ...... ..... ............................................... BUILDING INSPECTOR Final GAS INSPECTOR Occupancy Permit Required t® 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. es no d Co struc ion, Inc. Date:09/13/2015 Proposal Stephen Noone 40 Woodbridge Road North Andover, MA 01845 PROPOSAL— Installation of New Vinyl Siding Remove existing wood siding. Al debris to be removed off site via dumpster. Crescio Trucking to haul off. Install Tyvek house wrap and ice and water shield as needed. Install main house body with gray siding, 7" reveal. Install white corner boards, electric box pads, exterior light blocks, electric meter wrap. All to be the same color of siding. Install P.V.0 trim,to receive J-channel as needed. Install attic soffit venting. Total $ 14,350.00 All material is guaranteed to be as specified, and above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of$ 14,350.00. 50% upon signing $ 7,175.00 50% upon completion of project $ 7,175.00 An interest charge of 1.5 % per month will be applied to any balance due 30 days after completion of this project. Any alteration or deviation from above specifications involving extra cost will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Desmond Construction, Inc.,P.O. Box 41,North Andover,MA 01845 Phone:978-682-2279/FAX:978-682-2279 bm-desmond@comcast.net 11 Page "es,. -mon- d- Construction, Inc® Owner to carry fire,tornado and other necessary insurance upon above work. Workmen's Compensation and Public Liability Insurance on the above work to be taken out by Desmond Construction, Inc. Respectfully submitted per Matthew Desmond NOTE:This proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specification and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payment will be made as outlined above. -s n [�� t Signature: �� Date: l t Signature: Date: i f Desmond Construction,Inc.,P.O. Box 41,North Andover,MA 01845 Phone:978-682-2279/FAX:978-682-2279 bm-desmond@comcast.net 2 1 P o g e the Commonwealth of Alassarhusefis • Department of'1"ndustriral Acczdents 1 Congress Street,Same 100 Boston,MA 02114-2017 www-mass;,go-v/dza Wo kers'Compensation InsuxauceAffidavit:Builders/CoutractoxslEXectricians/PXur�tbexs. TO BE MED WZ'Z'H'X'HE PER MITTn1rG AUTHOZ2I'Z`X. Applicant Information Please Print Legibly Name(1usiness/OrganizatioaalXndividual): torr City/State/Zip: l,,,�r Szgdlez,', � � " Phony Areyou an employer?Checktlie appropriate box: Type of project(Vgquired): 1.[]1 am a employer withj:_ . employees(full and/or part-time).* 7. ❑Now construction 2. 1 ama sole proprietor or partnership and have no employees Working fox me in 8. Rerilo delirig any capacity.[No workers,comp.insurance required] Demolition 3.. I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9 10 Q Deming addition 4.[]1 am a homeowner and-will be hiring contractors fo conduct all Work on my property. Twill U 11.❑Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprictors with no employees. 12, plumbing repairs or additions 5.❑I am a general contractor and T have hired the sub-contractors listed on the attached sheet. 13.0 Roofrepairs These sub-contractors have employees and have workers'comp.insUrance.T 14. Other 6.Q We are a corporation and its officers have exercised their right of exemption perMGL c. [� 152,§1(4),and we have na,employees.[No workers'comp.insurance required.] Any applicant that checks box#1 must also til out the section below their workers'compensation policy information. Homeowners who submitthis affidavit indicating they are doing all work andthen hire outside contractors must siibmit anew affidavit indicating such. rConiraotozs that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have , omployees. ifthe sub-coniraciors fiave employees, iey must provide their workeis'comp.policy number.' f am an employer thatispiovzdzngworJrc rs'compensation insuraracefor my empl6yees.'Below is thepoliey andyob site information. Insurance Company Name: Policy#or Self ins.Lie.#: �' �°�t t ExpirationDate; Job Site Address: City/State/Zip: Attaffi a copy of the workers'coxnpensati(M'p olicy declaration page(sho),Ving the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fin.e up to$1,50 0.00 and/or one-,year imprisonment,as well as civil penalties inthe foira of a STOP WORD 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 ofthe DIA for insurance coverage verification. X do hereby certify uncle t7a pains andpenalties of peryury that the information provided alcove is floe and correct. sign ture: Date- z /`` / Phone 4: Official use only. Do notwrite 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.BuildingDepartmment 3.City/'Porn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: ACO-R& CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/YYY1) 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 pollcy(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). PRODUCER ONAME:TAOMOT.Victoria Lowes, CISR gtO No MTM Insurance Associates PHONE (978)681-5700 )681-5777 1320 Osgood StreetADpRl :vickiel@mtminsure.com INSURERS AFFORDING COVERAGE NAIO d North Andover MA 01845 INSURER A:Travelers Casualty Ins Co of 19046 INSURED INSURER B:Travelers IndemnitV CompanV of 35682 Desmond construction Inc INSURER O: 19 Upland et INSURER D: INSURER E: North Andover HA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 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.ADDL - rALR TYPE OF INSURANCE POLICY NUMBER PAOVLDICDY EFF PIG.L�IOY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occun ce $ 300,000 " 0803AB233671542 7/7/2015 7/7/2016 MED EXP(Any one person) $ 5,000 PERSONAL 6 ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JEST 0 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Bikt Addl Ins Contractors $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) E HIRED TSAUTOS OWNED PerOaE dent DAMAGE $, $ UM13RELLALIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION 77 $ WORKERS COMPENSATION Beatrice and Ratthery X _ AND EMPLOYERS'LIABILITY SEAE ER Y/N ANY PROPRIETORIPARTNER/EXECUTIVE Deearond are excluded E.L.EACH ACCIDENT E 1 000 000 OFFICER/MEMBER EXCLUDED? Y❑N/A B (Mandatory In NH) IEOB3AB3186515 8/23/2015 '8/23/2016 E.L.DISEASE-EA EMPLOYE $ 1,000,000 UU yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT 1$ 1,000,000 I DESCRIPTION 000 000 DESCRIPTION OF OPERATIONS/LOOATIONS/VEHICLES(AOORD 101,Additional Remarks Schedule,maybe attached If more space Is required) This certificate of insurance represents coverage currently in effect and may or may not be in compliance with any written contract. 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 1600 Osgood Bt. ACCORDANCE WITH THE POLICY PROVISIONS. N Andover, MA 01845 AUTHORIZED REPRESENTATIVE L Mancinelli, CIC/SAM ///✓2^v�Y.l�'" ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 nnimtl 9to Mmo .tauaissiruw0� 5t7SI0 I.raeopud qijoN aaaalS PIIgldn 61 aruol� �Q 3 A 3 MyVW .to�i.t.rac[ei, uuy�n.alst!°,� spjvpuvs pue suoile►n6a� 6u► taruS awlaeda p►!n8 jo pAt=08 i►gnd !lua a - s;,,asnuat?ss�Lti� t, Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 yVe . Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 143109 Type: Private Corporation Expiration: 6/18/2016 Tr# 254059 DESMOND CONST. INC. MATTHEW DESMOND 19 UPLAND ST N. ANDOVER, MA 01845 Update Address and return card.Mark reason for change. Address [11 Renewal ❑ Employment r] Lost Card SCA 1 0 2OM-05/11 ` c /rs`mer Affairs&Bu c/ssbagslation�ll� License or registration valid for individul use only Office of Consumer Affairs&BusiEress Regulation g Y — ► OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 143109 Type: Office of Consumer Affairs and Business Regulation 4, 10 Park Plaza-Suite 5170 xpIration: 6/18/2016 Private Corporation Boston,MA 02116 DESMOND CONST.INC. MATTHEW DESMOND' 19 UPLAND ST N.ANDOVER,MA 01845 Undersecretary Not vaY without signature