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HomeMy WebLinkAboutBuilding Permit # 5/9/2016 oRT#w BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINA ���. I Permit NO: � � � Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION JO&ISad Tint PROPERTY OWNER 'Print MAP NO: 1,014A PARCEL: ZONING DISTRICT: Historic District yes (no 1 � Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential -I New Building I One family I Addition -I Two or more family i Industrial Alteration No. of units: i i Commercial Repair, replacement i, Assessory Bldg i Others: i Demolition C Other �.1 Septic c, Well 11 Floodplain a Wetlands [..I Watershed District [I Water/Sewer 1< , SAP" V JC LuA S �4oDECX11 _ Identification Please Type or Print Clearly) OWNER: Name: HAT-C kV&'rA R, Phone: /#&rr: Address: r4 s6 1" old ►s r�: 4 ��1 q� CONTRACTOR Name: Phone: Address. K% 6 D 1-0 201 , Supervisor's' Construction License: Exp. Date: Home Irnprovementtioensw , Exp., Date. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$'1000.00 OF THE TOTAL ESTIMATED COST BASED ON$129.00 PER S.F. Total Project Cost: $ FEE $ Check No.: �' �'� Receipt No.: ����2���� �5 • u i NOTE: Persons contracting with unregistered contractors do not have access to e guans Signature of Agent/Owner Signature of contractor Flans Submitted ❑ Plans Waived ❑ Certified Plot Flan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL -- Public Sewer ❑ Tanning/Massage%Body Art ❑ Swimming Pools Elwell El Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic taDk,etc. Permanent Duznpster on.Site ❑ THE FOLLOWING SECTIONS FOR OFFICE: USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT ENT Peviewed an ��. � Signatures COMMENTSA�M - N(N' CONSERVATION Reviewed on 15" / Si nature COMMENTS l T HEALTH Reviewed on' Signature n CONIII/ENTS .. ",. 4 .. ✓ f r c pr ° , w Zoning Board of Appeals: Variance, Petition No: Zonin Dec' ' g Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer ConnectionisDriveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street rn FIRE EP i:r, r J ,..:. ,�rGr/r �, ,,iru/�F ,. rr/���.�,.;�r✓r�l�/�,rl./l I r�!,,,< / /ire nr r" 7•r :.�' �/ p, . Y,,.,; ..,n � .ti1(. ,��.�_r�JGirri�ilr%�/.��y�./��>��G„�/ri 'a,( LOG atedt r� � urs /�.�/%i//>f // r /r/, .'f r, r /./r r r // o r/, / ! , � ,r� �:, G%ri/ ,/!/ri:. /i/a,r////,,,o/i r„/ /// r/ „r,//,r. i,. rr�rrf ,!� r� r �� ///..,,, Ui a a� /,� /.,�///.. /„%!!/ ..,/ //ii/ r/rr i�r /(. rt/f/r � 1 lr//�/ � 1! , /Fire1�®� - �� � � �l%//� r/ oi, / /r fG i� r„�r! , / � //r� �r�/ ri - �r (1/ Pl1 fl'��1 Nl /// // //y %� //r �,r,, if� / l � r / �� Y'@��t��L' �// ,�i r✓, / /ilii// // � 1 ./ � r , n t� ✓ r��l � „�1 r ✓i s„ z, �� , COMMENTS/ Vt® Th Town ofAndover 0 ®� ® Z� , h ver, Mass, COC LAKQ NIGHT WICK RATEU PPaR�y BOARD OF HEALTH IN Food/Kitchen P &� RMIT �T %lillf LD Septic System THIS CERTIFIES THAT . ... �t BUILDING INSPECTOR ........ .. ................... ..... .......®.y�..... ... ............................................. 1111� Foundation has permission to erect.......................... buildings on .... .. ........................................ ........... ........:a:. Rough oug to be occupied as ... ... ... . .. .... .a . . .. ... .. .,. .... . .. .. ........ Chimney ey provided that the person accepting this permit shall every respect co #orm 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 EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS T Rough Service ........ ..... . .^ ::�.............................. BUILDING INSPECTOR Final GAS INSPECTOR ccupancy 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. t t y a X9 Frye �. ��....... G �� � cYw),�'� �. �i ���" i,t'+�0� .. ._...wt ESTIMATE 34 Eldonvond 33yve, ftam&ton,'Maassaacabim,4ts N'kM 2016-001 R (78I)CiO-03233 E: Deck Renovation March 31, 2016 CUSTOMER.NAME/ADDRESS Matt Bohenek/Krista Keeler 981 Johnson Street North Andover, MA 01.845 PROJECT DESCRIPTION QTY. UNIT COST AMOUNT Deck Renovation Mase Costs General Conditions: Permits ($12/thousand dollars of work) $ 156.00 Equipment Rental - Concrete Mixer 2 Days 70.00 $ 140.00 Auger 1 Day 80.00 $ 80.00 Travel 8 Days 20.00 $ 160.00 Architectural Drawings - as required for permit $ - Demolition: Removal of all necessary components $ 800.00 Debris Removal - dumpster 1 Ea 550.00 $ 550.00 New Construction: Concrete Piers - replace existing 8"with 10" 18 Ea 90.00 $ 1,620.00 Posts - replace existing 23 Ea 82.00 $ 1,886.00 Stairs (front and rear) - replace framing 15 Treads 31.70 $ 475.50 Trim- replace existing 1x6 w/PVC (white) $ 400.00 TOTAL $ 6,267.50 Decking Option 1 -Pressure Treated New Construction: Decking and Stairs - 5/4" x 6" 1000 LF 3.35 $ 3,350.00 TOTAL $ 3,350.00 Railing Option 1 - Pressure Treated New Construction: Deck Railing 82 LF 18.00 $ 1,476.00 Gates -2 single (4'wide) 2 Ea 200.00 $ 400.00 Stair Railing 32 LF 18.00 $ 576.00 TOTAL $ 2,452.00 GRAND TOTAL $ 12,069.50 Material Specifications: All wood framing materials to be pressure treated. All other materials are as noted. Utility costs (use of electrical,water, etc.) Any unforeseen conditions Repair of any existing rot at deck connection to house Replacement of existing floor joists Staining or painting of any kind Estimate is valid for fifteen (15) days from date above. Any change in work, including unforeseen conditions,will result in the issuance of a change order. All furniture and personal items must be removed from areas of work by OWNER,prior to start of project. PAYMENTS: 30%deposit due prior to start of project, 30%due at midpoint, 35%due upon project completion. e X Cu tomer Signature �1 i l�t� Con r ctor Signature ate f C 1f1 Customer Printed Name Contractor Printed Name (By signing,you are in full agreement with the pricing,terms, and conditions of the proposal) NFA IJ r YARD lJ 7 77-7 1 �,X� �pM.�,. �' �pA ' W f°4�`:� �^"„��'._.----- �4�/ py I�q' ,wE� ', �,� -- --'----.._...._ °,� •� w 1 off, „dYy� -AoI ;, yy yQ 01 ,77= 77 Dlj t } r E 4 t F r y _ , r , F b' 1 4` , y �a 1 , C� a — _ fY tl � � d Iw a Y G pE r P i a — g s e ✓ PR�OTECT2410 -o f,q c -v,t4, to ,c�� . �., s North Andover MIMAP April 11, 2016 � U 11- i r i 1�1�tlri Ji 5i ,l r i r �� ifii ��tu ilirfi ��a I�� i111F,17�A 013�i i, ��iii�aGt i C$MVPC Be Interstates Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, I Meters Data Sources:The data for this map was produced by Merrimack --SR V&QRTh Valley Planning Commission(MVPC)using data provided by the Town of Roads 00 4,r�[n r®'9,k North Andover.Additional data provided by the Executive Office of • d Environmental Affairs/MassGIS.The information de ete($on this ma is k Easements pd a (} t p y Parcels for planning purposes only.It may not be adequate for legal boundary $ ---- a definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING V - - q. THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION 'q U`+� V 93 ft North Andover MIMAP April 11, 2016 927JOHNSON ST 960JOHNSON'ST 953 JOHNSON m" 107.0-0042 107RA-0171 102.A-009181 970 JOHNSON ST967 3OHNS,ON STr " 107.A-0221 ' c� �t 107.A-0030 990 JOHNSON ST 981 JOHNSON ST rrbw, 107F.A-0222 1000 TURNPIKE "f' 107.0-0009+ 1000 JOHNSON 1 I izX°r s, 102.A-0130 sf 991 3C7HNSON S l�f :k^ e O 107..-013 s ,r fo 107.A-0150 107.C-01081 100� � t �93 �r ° 102.A-0200 107.A-0154 MVPC Be Zoning Overlay Zoning �i Municipal Boundary 0 Adult Entertainment Distric Busina a 1 District L,f Machine Shop Village Ova Busina s 2 District Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, -�Rail Line ra Watershed Protection Dist At Busina s 3 District Meters Data Sources:The data for[his map was produced by Merrimack Interstates Historic Mill Area M Busina s 4 District lw� T�'C' Valley Planning Commission(MVPC)using data provided by the Town of ID Medical Marijuana 0 Genem Business District Q t4a u, *Q�„ North Andover.Additional data provided by the Executive Office of 't Downtown Overlay District M,Planne Commercial Dev &p'r .�,�a d� Environmental Affalrs/MassGIS.The information depicted on this map is 13 Historic District Corrido Development Dist , �. for planning purposes only.It may not be adequate for legal boundary Roads Osgood SmartGrowth(40 Con-do Development Dist 0 --- "" L definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER h»u Easementst,Hydrographic Pastures IN Corrido Development Dist 11" % MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING Industri 11 District - THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY Parcels Streams Industri 12 District ,�y OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Wetlands Industri 13 District .r�, ea4 sk 1F ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF EII'I.Industri I S District THIS INFORMATION Exempt Lands Reside ce 1 District �°'�.wrem Reside ce 2 District ' '�SGF{4b�'' Reside ce3 District de ce 4 District I"=93 ft Ede Lidential s District de6 District mage District The Commonwealth of Massachusetts Qi Department oflndustrialAccidents X Congress Street,Suite 100 Boston,MA 0.2114.2017 wwwanass.gov/dia Wovkers'Compensation Insurance Affidavit:Builders/Contractors/ElE lectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY,Applicant Information Please Print Legibly Name (Business/Organizationffndividual): Address: 34 UIX— j, b Df—,w City/State/Zip: S Phone#: qY1 �0_ &- G 2- Areyou an employer?Clrecictfie appropriate box: 'Type of Project()Vequired): 1.❑lam aemployerwith , employees(full and/or part-time).* 7• E]New construction 2$41 am a sole proprietor or partnership and have no employees working for me in $,/,o Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3,F1 1 am a homeowner doing all work myself.[No workers'comp.-insurance required.]t 10 ❑Building addition 4.F1 1 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions propiietors with no employees. 12.0 Plumbing repairs or additions 5.❑1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.F1 Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.Q We are a corporation and ifs officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),andwe have no,employees.[No workers'comp.insurance required.] U;. . *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 si bmit a new affidavit indicating such. tContractors 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. lfthe.sub-contractors have employees,they must provide their workers'comp.policy numb er. I ain an employer that is providing work 6-s'compensation insurance for my employees.'Eeloty is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: / Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation 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 Eno up to$1.,500.00 and/or one-year imprisonment,as well as civil penalties in the form 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 of the DIA.for insurance coverage verificatio X do hereby cer�tif nder lie pai ndpenaltles ofperjury that the information provided above is true and correct. signatur r Date: Phone#: ��� ;z Official use only. Do not Ivrite in this area,to be completed by city or town official.. City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ®® From:TVJINBROOK INSURANCE 781 848 6100 05/09/2016 10:53 #792 P-001 /001 ( CERTIFICATEOF �I I�I�� INSURANCE-- --�DATE(MMID ® ®4��/®R® 4/12/12/ 16. 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 It REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGA11ON 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 CONTACT NAME: Paula_ Neves— Twinbrook Insurance Brokerage FAx - - (781) 843-7000 I A1C No: 400A Franklin Street E-MAIL ADDRESS: Pneves@twinbrook. com Braintree, MA 02184 -- INSURER(SLAFFORDINGCOVERAGEI -_NAIC N _••__ INSURER A:Acadla Insurance INSURED INSURER 8:ABIC Jensen Building & Remodeling INSURER C: i 22 Leonard Rd. , #2 ---------._.._—..— ---------- ----=---------- INSURER D: {----------- North Weymouth, MA 02191 INSURER E_ _— I NSU RER F: f 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 j INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS J) 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. i INSRI IADDLISUBRi POUCYEFF { POGCYEXP ' LT, I - TYPEOFINSURANCE {INSRWVD1, POLICY NUMBER ) MM/DD/YY I MM/DD/YYYY LIMITS A J GENERAL LIABILITY I BOA5163241 I 7/5/15 7/5/161 EACH OCCURRENCE j$ 1 ,000,000 - ___ _ I_—_._--_----..-.__--_-._.-_ -- i ( f DAMAGE TO RENTED X' COM�ERC(ALGENERALLIABILITY r._.- , i PREMIGES_I�.a_ n.�fe�G,eL._._� _.-._...-50_'_000 s i CLAIMS-MADE { }{ I OCCUR ! �' I `1 � ` MED EXP(Anyone person) j 5 __-5,O00 i PERSONAL&ADV INJURY f ENERALAGGREGATE j $ 2,OOO_,OOO _ - --— ----- I -- -- — ' GEN'LAGGREGATELIMIT APPLIES PER `I ) ! PRODUCTS-COMPIOPAGG i s_.2-,000_,OOO { POLICY P O LOC { i �"S AUTOMOBILE LIABILITY ' COMBINED SINGLELIMIT I j a accident I s �_ ---L _.______._----_.�.-- ANY AUTO j i { BODILY INJURY(Per person) is ANYAUTOD SCHEDULED I BODILY Y.._INJURY(Per-acid -c—cid AUTOS AUTOS _-ent $- .---_--.--_---.—_--_----- — —I NON-OWNED I I I � i PROPERTY DAMAGE i s HIRED AUTOS AUTOS I I L(Peraccidon( ' { UMBRELLA LIAB ` ! OCCUR 1 EACH OCCURRENCE_ I S : EXCESS LIAB 1 — --(-------------_.-----I CLAIMS-MADE I ( f AGGREGATE I $ DED RETENTION B ! WORKERS COMPENSATION I I WCC-500-5015482-201 1/25/161 ER 1/25/171 WC STATU- 1 IOTH-I AND EMPLOYERS'LIABILITY Y 1 N L <ZOAYLIMLT� ANY PROPRIETOR/PARTNER/EXECUTIVE ( ! E L EACH ACCIDENT_ !s_ 500,000 OFFICERIMEMBER EXCLLDED? {N I A! I ! I (Mandatory in NH) j { ` F L_DISEASE-EA EMPLOYEE)s__,--• 50.0_ ,OOO 1 It es,describe under T i DESCRIPTION OF OPERATIONS below 1 E.L.DISEASE-POLICY LIMIT $ S00,000 '.. { i I { f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Project: 981 Johnson Street, North Andover MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street Building 20 AUTHORIZED REPRESENTATIVE Suite 2035 IN. Andover-MA- 01845 Joseph P. �f�6 © 198 - 010 ACORD CORP C7 A 1`I. AIF rights reserved. ACORD 25(2010/05) The AC ORD name and logo are registered marks of ACORD Phone: Fax: (978) 688-9542 E-Mail: Office of Consumer Affairs&Business Regulation License or registration valid for individul use only IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ration: 178614 Type: Office of Consumer Affairs and Business Regulation Ixpiration: 5/5/2016 DBA 10 Park Plaza-Suite 5170 _ Boston,MA 02116 JENSEN BUILDING&REMODELING i SETH JENSEN f 34 ELDERWOOD DR. qsigaW, STOUGHTON,MA 02072 Undersecretary �✓ Not validwithout Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-102888 Construction Supervisor SETH M JENSEN , 34 ELDERWOOD DR STOUGHTON MA 02072 Al �..n� CA— Expiration: Commissioner 07/09/2017