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HomeMy WebLinkAboutBuilding Permit # 10/22/2015 t&ORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received ZED Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Al-14 104 11011 Pril PROPERTY OWNER Oi A PARCEL: r. Print 100 Year Structure yes no MAP VT ZONING DISTRICT: Historic District yes no Machine Shop Village yes no MAP TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 11 New Building 11 One family 11 Addition [I Two or more family El Industrial El Alteration No. of units: El Commercial ,E'Repair, replacement [I Assessory Bldg El Others: El Demolition [I Other � Irrid"WAS NO V)gw 0 g/� g/ 1J,1//IN JUIVN(jua "gi Mini J vi) 10 gri M DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Tye or Print Clearly OWNER: Name: 0((AVI 4.�- 6 Phone: '9 �J Address: Contractor Name: )-a4i Phone: Email: 1,, 77 7 Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: /);�)/2 24� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: J" Receipt No.: 29 NOTE: Persons contracting with ur gistered ontractors do not have access to the guaranty fund Ig-- n P n F tA®RTHTown of -N vPr • 26 1 7� r ��/�s� Y• C. LAKE h vel' 1�1LlSS.� CoCKICNEWICK 04ATED P, ll BOARD OF HEALTH Food/Kitchen PER I T soSeptic System THIS CERTIFIES THAT � 1+ I��w� ............. ............................ BUILDING INSPECTOR ........ ..... ... . ...... ....a.ft ... 7 has permission to erect buildings on Foundation .......................... oft III ® ............................................................. Rough to be occupied as ..............111037160.. ............ ........ ............:. chimney provided that the person accepting thil 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 MONTHS PERMIT EXPIRES 6 MONTHS ELECTRICAL INSPECTOR LESS C CTI® AR ..... Rough Dj Service ................... .... ............................... Fina BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. Ch ftTerf r.0 a 1 l__U11 Types ypes t)12E �i ..1. EEEpert Masonry Work M a S S_l"cal! FC-- � Licensed & Insired ,l 800-W�?I A.-US L,ct Ids r,v Q�r �zr�l �, t 1976 �- ��' License#034200 &c> (924-8487) Cloe 5 cfA"o �==_2ffl 'We Work k Year Y oun,d Proposal To: Diane Bauer Date 3/30/2015 treet: 216 Foster St. 978-682-0242 N. Andover MA Roof proposal diane@bauerconsultingassociates.com IKO Cambridge/Certainteed Landmark 1. Extra caution will be taken to protect house 12. Building permit included. exterior and landscaping as best as possible. 13. Contractor workmanship warranty: 12 years under (tarps etc.)Magnets run at final clean up. normal wind and rain conditions. 2. Remove all shingles from entire house. 3. Total roof cost. Inspect and re-nail any loose or lifted plywood. Any compromised plywood will be replaced at an additional cost of$55.00 per sheet of 1/2" Certainteed X10,900.00 CDX fir. Option: Upgrad 5541/water 4. Install heavy gauge 8" white aluminum drip shield. $350.00 a i Tonal cost. (Best defense edge to all applicable rakes. against ice dam le s 5. Install 6' of IKO Armourguard or Certainteed Install (4) nelux s ylights and flashing kits: Winter guard ice and water shield along all Fixed unit: $650. a dit'onal cost for each eaves. 6. Install IKO roof guard or Certainteed Diamond Venting units: $85 0 dditional cost for each Deck synthetic underlayment to remaining Install (1) Lomenc hermo/humidistat controlled power vent. $450. 0 itional cost_(does not in- sheathing up to ridge. clude electrical hook up 7. Install all new pipe boots. Both IKO and Certaintee direct extended non 8. Install IKO Leading Edge or Certainteed Swift Start shingles to all eaves. pro rated 20 year fully transferable warranties 9. Install IKO Cambridge or Certainteed Landmark included in this proposal. Please refer to pamphlets in estimate package. Offered and Limited Lifetime architectural shingles to entire included in this proposal to our local referrals house. 15 year non pro-rated warranty by mfg. 10 year if Certainteed is chosen. All shingles at no additional cost. y *Note*: Please be advised if applicable, valuables in r will be installed and fastened according to mfg. the attic should be moved or covered due to minor 10. Counter-flash chimney lead, wall connections debris, dust and asphalt particles that will accumulate 1 y during the stripping process. All Under One Roof not and skylights with ice and water shield,tie into responsible for any damage or clean up that may new shingles and seal. 11. Install a new GAF Cobra ridge vent capped with occur in attic. color matched IKO or Certainteed hip and ridge Balance due upon completion, no deposit required shingles. References available upon request IliE,hly rated member of the accredited BBB and Angie's List Thank soul The Commonwealth of Massachusetts Department oflndustrialAccidents " = 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Li lectricians/Plumbers. TO BE FILED WITH THE PERNHTTING AUTHORITY. Applicant Information Please Print Lelzibl Name(Business/Organization/Individual): Gr Address: `�— City/State/Zip: ✓m'l � �'� !� Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t ❑4.F1 am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5. 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors Jhave employees and have workers'comp.insurance.$ 6.Q We are a corporation and its officers have exercised their right ofexemption per MGL c. 14.00ther C 152,§1(4),and we have no,employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check 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-contractors have employees,they must provide their workers'comp.policy number. Iain an employer ifiat ispi'ovidingworkers'compensation insurance for•my employees.'Beloiv is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins,Lie.#: Expiration Date: Job Site Address: b �� / -ell City/State/Zip: AJ^_1�76 J—4 Attach a copy of the workers' comp nsae it on policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under thep 'ns pelties of erjury that the informationprovided above is true andcorrect. Signature: Date: Phone#• q !?2 I-?_ • '7f 3 Official use only. Do not write in this area,to be completed by city or town official.. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: CERTIFICATE OF LIABILITY INSURANCE DATE(mnwDD/YYYY) Va-posinneATE Fa UM ASA 13 A-fflER OF IWORKAXION ONLY AND CONFERS NQf GWIS UPON THECI~fiTIFICATE HOLDER. THIS GOES NOT dtFF(ft►>�+tRV(VE�V QZ 11 ATtVELY ANENT?,MFEtM OR AI,MR THE COVERAGE AFFORDED BY THE POLMISS BELOW. Run RT(FiCA.TIy CF(NaUR=9 DOES NOT CONSTt )T'E A CtImRAcT RzT`>�IEwThi IsSuING It'SURER($),AUTHORIZED REPRESENITATIVE 07—ORTANT:N the co3tiftcate holdw is an ADD!t(ONAL tMURED,the Pcalb*glas)must be endosed. If SUBROGATION IS WAIVED,subject t®the and o6nditla ss a8 the Pratisy,certain pattcies may require and endorsement. A sio ement Ort this aerttfteate doers not canter rights fo the ;��.(ttr-a:�4�otstet in(i'?ct o4 sus�t e��t52nRer3 �_ k-ikCA 3UGER CONTACT raASyE: T-VA 1ID E'P.Ell-ER INS ACst:k praas�E � -171)I-YN N W AY pA1t {Arc to EM} (AJC,too): LYNN,MA 0001 E•;'1A1L ADDRESS: INSURER(.S}A'FFORt31t3[3 COVERAGE N&IC 4 LtR%D itt'SUA1=R A: ACE Aa�f&RtcnA3t3tsvRarrcE coMr4m P,ERRY,FRANK&SERRY.JAWIES DBA FRANK a SONS 1145ilRER 8, i3�JAER G: 45 YVINBROOK DRIVE INWRER D. EPPING,NH 03042 it�URER E: 3Pi:iE3RL-RIF; a� Sd�AACS CER7i3�CAT8 tdUPfREtfi REV3&fON NtlPA6ER: 1 �t� O:t:33T1FV7 dTYt' t9; �'lJFERP4�1i.tu�E�B�E.Qi7tlAYk`i1!�.t213S'a�i C}73ic1<iStJfiI3#rtA!<'-EUfiEt]J1E1�3Ft7i(E9f7LY:.YPEFi3QDl1L1F>rA7ED.tIOTYATHST/1N6Y76 ws #iCQ*?11ftEE'13f f,Tt33 r1 pfl CtIKD7Ti.'tJ OF APIY CUttrAACr OA O1H1 i3 rt17iC[iittEPJT L'[6PlREf iz�{:7TOY7}flCF67Yt5 C�LATR�IGATE MAY BE3firs3iJ;T}OR MAY RFSITAE4. THE WSURAi4CE 1fr'aORR£O i3V T3tE f+til{yt$S 3IEBG3i Efl ti ifsdN Pii Sit8lECf YQ ALLTME iER3i 3 CCLGSfAL3 AKR Cfl 3i>iCt1c�OF 8VCH FOIXIE& LIMITS SHOWN MAY HAVr:BEEN RMC M- By 3Y+"SsalrtArd�. AMD a Ft1t1CiCFFvATe POUCYIEKPOATE tcx. (Lim TYZtOF M.WRANCE L R 6tf2L3GVrwR'F3E3i 1r nDrnvvrr3 (rt737D1YYYV9 Rg GENERAL t_QAMUTY J\CH OCCURRENCE CC�04FIRCFAL GENERA-LtAd9L17Y C MM--S MADS CCCtJP.. AMAGE TO RENTED S REMISES(Ea orcurraye) ,ED EXP(Anyone person) i$ .a,.� ...--.on..�...� ' GEN'L AGGREGATE>..MlIT APPLIES PER: ERSONAL A ADV WURY S AGGREGATE y POLICY -?3tCTJECT �LOC ENEHAL PRODUCTS•W-010P AGCi AUTOMOWLE LJARILrrV ANY AUM COMBINED SINGLE IS LttdCt'(Ea accidmu) ALL OWNEDALn QS bootLV muRY $ SCHEDULI;AUITOS (Per parson) HIRED AUTOS • BODILY INUURY ;S NON-OL"tNED ALiTCJS (Pet acridBrt) PPOPERTYDAMAGE �S �«- - .••W-•- ------....� .__ (hat saddarl) i U,YIBRi~LLA UAB 0,.:.:JR EACHQCCURREtdCE $ EXCESS L1A9 Ca>?.'IMS MADE AGGREGATE $ Utl- UUTIULE RE"TEt�tTtDt4 3 ;S ~trJ43FliiEFi'9CtE 51"ENSfAYtII CSJC} VtCSTATUTORY OTI, EMPLOVER'S UA@3LffY Y44 US MOL434-14 111,95!4^014 11105f2015 LtIMITS ANY PROAEtd!1^!%'PARIiSEWk?tEL'U9;Vc � t 0P;:iC;z 1M;ff#k1ER EXCLUDEC? RJA E.L EACH ACCIDENT 5 1r10,OD0 (P mtlatoryBrrtY) 'El.DISEASE-EA FJJiPLOY£E.$ 100,000 tt1�.tic:.csiir un+:a Q(4C1�IPTiCS:dbrO?l 4lTit?tiS[7E:nw F-L.cISEASr.-POLICYLGttr ;s nn,oan u.��'r'�I�TiUf��t3� A 1L�IIGATtC}AtS.+VE(tYGLE�ti3ESTRIGfiZQi9fS:`S#�t�AL(int-`t!S REF'dAfi�S.atb�'ltiftOR EI:R`t`IT"i;`.ATL iSSUEi9`t'£'i73tiR CIR'tY�ICA'lllFlCtt.DE.R Ab'�C'!'F,'vti 1*fntt2S Cti7�fP t:rJVk'kA(Ji "40 PAt1TNTMS ARE C#3"o'MFD VV 7€S'atHOLDER 6VQ€21.i.GitS'Cam LT�CdS,\tFC3?ti F4I.Is Y. GAiVCELt,ATtt)N ALL Ul`DEI:ojiv ItQOF CH DULD ASSY Or-THE A>GOVE DEGCR gv-o PALiC3ES OE CANCELLED 'tfl TG-44Pi t:TW Seer-o iET"E EXp"r ATI0:4 DATE THEREOF,,NOTICE I-ALL 05LVV-'ED ' t. Massachusetts-Depm'�tment of Public SOWY Board of Building Regulations and Standnrdt License.* CS-OS9.20 h!t 1 IMIPIM DR t� METHMMA int 5184 3rttz;�' Expiration Cmestr�is�aaner t�dJi?�f�fft� a(icafCiff RG 12at1GT11J1 .J Click on the registration number to view complaint history,You can also view arbitration and Guaranty Fund histo(y. The list i current as of Wednesday, October 8, 2014, J�. Search Results REG NT RESPONSIBLE REGiSTRkk`I?`4011 EXP RATION r� iNUNIDUAL NUMBER ADDRESS DATE S��+Tt�� Am-uumn oNg R000 L.ANZAFAME, 137057 166 A MERRIMACK ST 1010212016 Current JOHN METHEUN, MA 0184 ©2012 Commonwealth of Massachuselts. Mass.GOAD is a registered service mark of the CbrYt"r lonwealth of Massachusetts.