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HomeMy WebLinkAboutBuilding Permit # 6/9/2016 BUILDING PERMIT o&�O°T 6 9�0 TOWN OF NORTH ANDOVER �a E APPLICATION FOR PLAN EXAMINATION " �o Per¢mitNo#• I iy Date Received J SSacrouse Date Issued: �1 _ I PORTANT:Applicant must complete all items on this page LOCATION 71 �2'UL/✓ /7SLC ��. Print PROPERTY OWNER �nr�Nl F �1L-(C.Zs✓Cont Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District ye no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE _ Residential Non-Residential ❑New Building X one family ❑Addition ❑Two or more family ❑Industrial )`Alteration No.of units: ❑_Commercial Repair,replacement ❑Assessory Bldg ❑ Others: ❑Demolition ❑Other ❑.Septic, 0 Well C Floodplain r. ❑Wetlands ❑ Watershed District 0 Water/Sewer ^7 ` DESCRIPTION OF WORK TO BE PERFORMED: _ K�/7G47/ l�XsSTLNGOOp S/yt.i 1.,S,,.- Z�/S74CL �iifS �vC�C4« L�S�iPT Identification- Please Type or Print Cleary OWNER: Name: tJ 0/""Zi X)ruzy.5 dr/ Phone: Address: Contr' actor Name: G /9IIAIv Phone; Email 77'7Edn1T2t[1-Z,16 2e f 92e o1`7 Address: lxrze 5 9 s y Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date_ ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S-F. Total Project Cost:$ Q 9�3 FEE:$ Check No.: Receipt No.:_ `�� NOTE: Persons contracting with unregistered contraetors do not havemccess to t1teoguarano fund --8iynaLuLc of Ags'nt(O�n_rnPr _ Lure of rnntrar•.tor rN14 town of Andover No. 4L 26t ver Mass, h 0 MEMELU BOARD OF HEALTH Food/Kitchen PtRMIT T ILU Septic System THIS CERTIFIES THAT............ e....L3 Sd'.-.................................................I—............ BUILDING INSPECTOR has permission to erect.................. buildings on ..........................................L 4-a[. Foundation Rough to be occupied as.............. ....4q�mk.... . .:� ......................... Chimney provided that the person ac&pting 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 116N 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ST S Rough . . . ..... Service _ Final ..................................... IL61NGINSPECTOR 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 Approved by the Building Inspector. Burner Street No. Smoke Det. Bonnie Wilkinson T.M Contracting 41 Bruin Hill Rd. 94 Van Kleeck Rd No.Andover,MA 01845 Millis,MA 02054 Phone:(774)217-3343 (978)258-4141 Email:kilma6@msn.com/tmcontracting9@gmail.com Estimate# 000101 Date 05/1612016 Total Description Remove and disposal Of existing zero clearance wood fireplace $0.00 T.M Contracting will remove fireplace mantel,open up wall and rear of Chase wall for the purpose of removing an existing zero clearance wood fireplace and all chimney. Mendota Full view Zero Clearance Gas Fireplace $2,200.00 Reframe fireplace opening to accept Mendota full view gas fireplace.Price includes removal and disposal of existing fireplace,and framing and installation of new gas fireplace.Vent will be horizontal at approximately 8'height above existing deck.Exterior Chase will be restored to its original condition.Price includes labor and material for removal and instalation of old/new fireplace,and does not include any interior finish options.Price does not include any electric or plumbing costs that be pahilr ' site. al and ithanne s part ofthe s all price.Old fireplace and chimney will be removed from Optional/Removal Of Existing Chase Top $365.00 At clients request,we can remove existing aluminum Chase top.it will be replaced with solid plywood with Azec,Blthane and Azec trim to create a drip edge.This would be the recommended method to ensure a water tight finish.Price includes material. Optional Wall Prep For Cultured/Quarter Stone $410.00 As part of our install,we will be installing durarock around the new fireplace approximately 8" extended on three sides to meet the manufacturers requirements.However,we do recommend installing durarock over the entire surface that is to be covered with cultured stone,approximately 56 sq.feet,to ensure proper and permanent bonding of the finishing material.While it is not required,it is very highly recommended for a proper and permanent finish.Quoted price includes Durarock and required screws. $0.00 Electric Requirement The Mendotta fireplace does not require a dedicated circuit.For ease of installation and to keep costs reduced for homeowner,we will make the electrical connection within the fireplace and bring a lead through the floor of the chimney chase and into the basement.We do recommend an electrician make the final connection. $0.00 Warrantee T.M Contracting will warantee the workmanship on this project,for a period of three years. Manufactures warranties on the products being used are seperate and their own terms and conditions. Page 1 of 2 Subtotal $2,475.00 Discount $110.00 Total $2,865,60 Notes: Pricing does not include any plumbing or electrical work that may be required.Also does not include finish/stone,woodwork.Siding is pre painted masonite and customer has extra pieces. However if there is not enough to restore the Chase to its existing condition,customer is responsible for the cost of any additional siding,or touch up paint and caulking,billed at 55 dollars per hour.Per Tom Moran,we will look at additional work..."fixing the apron trim on rear deck".This work may be done"No Charge"..providing the material is present and it does not require a return trip.If this work is not able to be preformed while we are working on site,we will provide a reasonable hourly estimate to return and do this work separately. i ! 1-?J T.M Contracting Bonnie Wilkinson Page 2 of 2 Bonnie Wilkinson T.M Contracting 41 Bruin Hill Rd. 94 Van Kleeck Rd No.Andover,MA 01845 Millis,MA 02054 Phone:(774)217-3343 (978)258-4141 Email:kilma6@msn.com/tmcontracting9@gmail.com Estimate# 000102 Date 05/27/2016 Total Description Real Stone-Bluestone 6x24 Panel $678.00 install Real Stone,6 x 24"blue stone panels over prepared durarock surface.Stone is a finish product.Area to be covered is approximately 42 sq ft.if area to be covered is increased,the work will be billed at 20 dollars per sq ft.Finished wood trim,provided by the customer will be installed on the right and left side of the stone only.if customer chooses to add more trim it will be billed at 55 per hour plus materials if not supplied.As with all tile/stone some setteling may occur.If it is necessary to return during the curring period"approximately two weeks"to rework some panels, this would be billed at a reasonable rate for the homeowner and contractor.Area to be covered is floor to ter als.Stonep=cfa to and bome ft. dndin e. r alnentosuh lied is b f the ocust project is labor only, Subtotal $678.00 Total $678.00 Notes: When vlsome ion the stone, happen lals not a time intensive issue is usually assimple as just adding surdditioalmortrtoa joint. Page 1 of 2 By signing this document,the customer agrees to the services and conditions outlined in this document. s Bonnie Wilkinson Page 2 of 2 SPECIFICATIONS ,e*zErcr¢t MODEL FV41 High Fire Adjustable to- Low Fire `� BTUH. (MODEL FV-41) NAT.GAS 40,000 13,000I■ BTUH. (MODEL FV-41) LP GAS 40,000 15,000 C (QCs NOTE:LPG CONVERSION KIT,#New#,MUST BE PURCHASED SEPARATELY TO �'haek CONVERT TO BURN LPG IN THIS FIREPLACE. MAIN ORIFICE[0-2000ft(610 m)]:REAR BURNER:#42 NAT.GAS[#54 L.P.GAS]—FRONT BURNER:#42 NAT.[#54 LP] OVERALL EFFICIENCY:............ AFUE 71%,PA FE 72.66% CO-AXIAL DIRECT VENT FLUE:..........5"INNER,8"OUTER TOTAL WEIGHT:..................__ 225 POUNDS SAFETY:.......................................... AGA/CECERTIFIED IPI AUTO ELECTRONIC IGNITION SYSTEM ACTIVATED WITH THERMOSTATIC REMOTE CONTROL. APPLIANCE CERTIFICATION AND TESTING AGENCY INTERTEK TESTING SERVICES,ICBO#AA6474 Certified under ANSI Z21.88(2005)•CSA 2-33(2005)"Vented Gas Fireplace Heaters"not for use with solid fuel. Approved for bed- room installations and mobile homes. UL307B approved for"mobile homes,after first sale of home,not for recreational vehicles." GAS REQUIREMENTS..........................SUPPLY PRESSURE: GAS INLET:112"N.P.T. NAT.GAS: T'W.C. (5"W,C.MIN.,11"W.C.MAX.) L.P.GAS: 11.0"W.C. (11"W.C.MIN.,13"W.C.MAX.) ELECTRICAL REQUIREMENTS...........120 VAC,LESS THAN 1.5 amps APPROVED VENT SYSTEMS...............DURAVENT,SELKIRK,AMERIVENT,SECURITY MINIMUM CLEARANCES TO COMBUSTIBLE CONSTRUCTION UNIT TO FLOOR Oin.(Omm) GLASS EDGE TO ADJACENT SIDEWALL 18in.(457 mm) UNIT TO ENCLOSURE SIDEWALL 1J2in.(13mm) VENT PIPE TOP TO COMBUSTIBLES 21n.(51mm) UNIT TO ENCLOSURE BACK WALL 1/2in.(13mm) VENT PIPE SIDES TO COMBUSTIBLES lin.(25mm) UNIT BOTTOM TO ENCLOSURE CEILING 50in.(127 cm) VENT PIPE BOTTOM TO COMBUSTIBLES lin.(25mm) UNIT BOTTOM TO ROOM CEILING 72 in.(1829 mm) 8"MANTLE ABOVE DISCHARGE AIR OPENING 18 in.(457 mm) MINIMUM COMBUSTIBLE ROUGH FRAMING DIMENSIONS WIDTH=45'(114cm) HEIGHT=47"(119cm) DEPTH =19-3116"(49cm) THIS FIREPLACE INCLUDES A SEALED COMBUSTION SYSTEM,8-PIECE CERAMIC FIBER LOG SET R COALS,FIREBRICK LINED FIREBOX,NEO-CERAM GLASS,ELECTRONIC IGNITION SYSTEM,DUAL BLOWERS,AGA CERTIFIED SAFETY SYSTEM, ACCENT LIGHT and THERMOSTATIC REMOTE CONTROL. OPTIONS: BLACK,VINTAGE IRON,SWEDISH NICKEL,ANTIQUE GOLD,ANTIQUE COPPER STEEL DOORS,STAINED GLASS FRONT,BOULEVARD DOORS,SERENADE AND PORTRAIT TRIMS and other accessories. CAUTION NOTE:This installation must conform to local codes.In the ab- THESE INSTRUCTIONS ARE TO sence of local codes,you must comply with the National Fuel Gas REMAIN WITH THE HOMEOWNER. Code,ANSI Z223.1-latest edition in the U.S.A.and the Natural Gas and Propane Installation Code,CSA B149 installation Codes in Canada. This appliance may be installed in an aftermarket,permanently located, manufactured home(USA only)or mobile home,where not prohibited WARNING:Do not operate this appliance with the glass removed, by local codes. cracked or broken. A licensed or qualified person should do re- This appliance is only for use with placement of glass. the type(s)of gas indicated on the rating plate. HIGH ALTITUDE INSTALLATION INFORMATION:Prior to installing at altitudes higher than 7500 feet,please contact the Mendota technical service department for specific venting requirements and venting restrictions. 85-03-00890 6 1 P a g e Mendota FullView FV41 & FV46 Direct Vent Gas Fireplace Specifications F .. 4agd' ,v r>a�uuuhfwdn"wk0 isibl"GI SS Frame.; F147 FV46 Specifications JFFV41: 31-1/2'Wide x 28-1/32"High A aTA 15s Brun wa7 Ev4s nw4oaBa �n�o1a61ro1�Poa l-- E FV46: 36-314'Wide x 32-112"High B 46 B.57 112 45500 C 42-1/2" C _48E1Geacy tle D.O.E. Eft enncy Req emen _ls o k.FUE)ffor tvelwuH Iara VtIshd OoeniWmeog E 191/2 E 22712 Gas Supply Nw I LP432-3/8 ex28-1/2"Hi h 42s72 F s4a venSoe s Exhaust, I1ake eco qFV46: 38"Wide x 33-1/4"High _ a/a H 42 V2 H 47 - _Safety System AGA C mbe9 IN Auto El 1 Ignition Finished0 nin 172 tm Co.., syre alsea mrn >atr Pimeno . .- - r� Willow&Homestead Dons: Safetyiestetl irtmeR to cmvn Areslstandards FV41: 34-5/16'Wide x 29-7/16"High Weight FV41 as.225 �I� 1 gi FV46 325 co, n FV46: 39-7/8"Wide x 34-1/4"High S?an9�t0��megt A B H I � one Ceram te ptdqc�sumer&we mea coals,AGA scar burner feack sumer tum-off from m trot)premium k, 'NII II ri I crof with flame&fars in modulao&e Ceett ghUng cwltroety system,P Freight acronic cent gh�A wars remote rys�i �G f`li FV46 has tw to rumors "Mcm. I.a t, c Q94myg i cn 9 Im C 0 - Mansard fronts&tl 'Black P 1 fl fl t 1-measure Bock Natural Agad H,mgbone&Bed "r 1 II l .M tl (/ rymSnicier Cod-Bdok must selcot an me,or Ider Irades Cluesub'nng to operate�e unit. ......... U'u""-,azCc In the n,SA. \,. �w -------- un I Check with youdealer for rAIMa and evp Ia6lIIy, The Commonwealth oflblassrxcheasetts Department ofdndustrialAccidents 1 Congress Street,Saite 100 Boston,MA 02114-2017 wwlurnass.govldia Workers'Compensation Insurance Affidavit:BuilderslCoutractois/L�lectricians/PIumbers. TO BE FILED WITH THE PER-MYTiNG AUTHORITY. Applicant Information .�y� ,y /I Please Print Le`'bI NaMO(Susincps/Organivatiio/ontlridividual): !��,7/W5 !y 0J*,✓ Address: City/Stale/Zip: 1 GL G S eVe s Phone#:: Areyou an employer?Cheekt&appropriate Uox: Type of project()Vequhed): I-❑Zama employer with seployees(full andlerpact tune).' 7, ❑I ow constiuction 2Ta am asolc proprietor orpartnership and have no zmployees Working£or mean $• [_I Remodeling ny sagacity.[No vrorkers'comp-insurance required.] 9. 0 Demolition 3.E]S am a tomeowner doing ell work myself 1rlo workers'comp.insurance required.]t �l.❑I am a homeowner andwitl be hiring eonhactors fa conduct all work onmy property.I will 10❑Budding addition e-mcne,that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs of additions proprietors with no employees. 12.h Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-con±ractore listed on the attached sheot. ❑ 13.❑Roofrepairs These snb-contractors have ernployzes and haveworkers'comp.i srussm; 6.[J We are acorporation and its of5cers havz exorcisedtheir right of-reptionper-MGL c. 14 Other S _ IS$§7(4),and we have nq exnployees.[Yo ivorkers'enmp,ssuranee requi[ed.] ..-. ,�i�Sl.vLL xAny applicantthat checks tiox'-tl must alsd 811 out the sec±ion belowshowingtheirwarkas'compensationpolicy in;ormatioa. 4 Homzowners who sabinitthis af8devitiralkaiing they are doing all work and thenhire outside contractors fdust submit anew affidavit indicating each. - tCon4actorsthatcheckthi§boxmusYapaehed an additional shzet showing the name ofthe sub-contractors and sfate 4vhether ornot.thaseentitias have , employees.If the sub-coriiranlors Piave employees,liiey mrxst provide their wcr',.eis'comp,policymnnb-' Iain an employer tfiat is pidviding worfceis'compensation insurance for nzy employees'Below is thepolicy andjab site information. Insurance Company Name: Policy#or Self-ins,Lem�ic.#: !` Expiration Date,::/ �t,� Job Site Address- 7/ �'U l� /71 LC_ At . Cty/State/Zip:` -14' 1t�r? l!if arg/�{ Attach a copy of the workers'compensation policy declaration page(showingthe policyuumber and expiration date). Failure to secure coverage as required under TMGL 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 fire Office of Investigations ofthe DDI for insurance coverage verification. X do hereby certify Baader finepains andpenaltfes ofpeettoy that the information provided above is true and correct. Sian at I Date: Phone#: 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#:__ Fax Server 6/8/2016 11:25:51 AM PAGE 3/003 Fax Server AC L> CERTIFICATE OF LIABILITY INSURANCE DATE(k MiDD YYV) F 6/8/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS' IN THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE Cr, .CAGE 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(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). CONTACT PRODUCER NAME: ROGER& AND GRAY INS AGCY CLSC NGM Insurance Company PeAALc No._ErO,866 456 4909 _ 1 FAA, No).[e 66)&32-ATT6 55 West Street EADOflESS:-MAtL 3e cecenter@msagroup.c INSURERS)AFFORDING COVERAGE NATO Keene NB 03431 INSURER A Main Street America Assurance 129939 INSURED INSURER 8-: Thomas Moran INSURER C; 94 Van K1eack Rd INSURER C; INSURER E: Millis MA 02054-1267 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 Master Certificate REVISIONNUMBER: 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,I HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL I HE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. wSR DDL SUBR POLICY EFF POLICY EXP LIMRS LTR( TYPEOFINSURANCE wS wvDl POLICY NUMBER tAM:DDIVYYY MM+DDfYVY X COMMERCML GENERAL LI ABILITY ' § 1,000,000 'EACH OCCURRENCE :GANiAGE TO RE TED A CLAIMS-MADE D OCCUR 'PREMISES iEa occvrtenca7, 5_. 500,000 ([sz6H81e 8/21/2015 8/21/2016 MED EXP(Any rs e P—) I§ 10,000 PERSONAL&ADV INDURY 5 1,000,000 GENL AGGREGATE APPLIES PER: 2 000,000 - . PAI AGGREGATE 5 X POLICY LjjRQ O ! IRO UCTSCOMPUP AGO 2,000,000 OTH=R: 5 CIX".BINE)SING AUTOMOBILE LIABILRY �.LE@acckoni 3 ANY AUTO (BODILY INvU EY I—person) § ALL OWN EDHSCHEDULED 80DILY IRU RV(Psr acddenl: § TOS AUTOSNDN-OWNEDPROPERTY DAMAGEHIREDAUTOSAUTOS - ;IPE+acddettl § § UMBRELLA LUIB QCCUR I I ' EACH OCCURRENCE § EXCESS LIAR �CtAiMS A.9AOE (AGGREGATE § __ DED RETFJiiION$ (§ WORKERSCOMPENSATION PER .. �ANDEMPLOYERS�LIABILITY Y/N STATUTE :ANY PRO PRFICHIPARTNER'EXECUTIVE ❑ ,EL EACH ACC 0 FNT NI5 OFFICE zMEMSER EXCITOED1 A - — �(Nkndatory m NH) E.L.DISEASE-EA EMPLOYE 5 jyy descnbeender ESCRIPTION OFOPERATIONS bMA EL.DISEASE-POLICY OMIT 3 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Addilionai Remarks Schedule,may b anached K more space is required) CERTIFICATE HOLDER CANCELLATION (978)688-9542 gabrown@townofnorthandover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street Bldg 20 Suite 2035 AUTHORIZED REPRESENTATIVE No Andover, MA 01845 nQ.,.la e_Ou_=1rOL8 ©1988-2014 ACORD CORPORATION.All rights reserved, ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I NS025 nmvnf 1 Orr, ofConsum Affa "o/U l W ��e9Mtatjo VEMENT CONTRACTOR R V115 piration: 613/2 X696 TYpe: T.M.CONTRACTING DOA THOMAS MORAN 94 VAN KLEECK RD. MILLIS,MA 02054 triry under �: rdassacnusetts Oepanment Ot punlic Safety Board of Building Regulations and Standards License`.CS-093061 Construction Supervisor THOMAS K MORA" 94 VAN KLEECK ROAD MILLIS MA 02054 i Expiration: Commissicner 0811612017 __ __ _. _ _ __ _.. _ __ __ _ _ _ __ . _ ... _ _ _ _ � � �y��b4�" �_._.�..___...._.�. _ _ � _.._._., w.._.. --_. --� __ ._�_ .ff. ,,I _ __ __ _ _ _ _ _ __ _