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HomeMy WebLinkAboutBuilding Permit #298-14 - 100 JOHNNY CAKE STREET 10/10/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: , Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION f r2 J �'�/�//►/�/�,�1 /7 Print /- PROPERTY OWNER /CC 0�i4kn/Q Print 100 Year Old Structure yes 0 MAP NO: d� PARCEL:��� ZONING DISTRICT: Historic District yes D Machine Shop Village yes t0 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well 0 Floodplain ❑Wetlands ❑ Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: /� Identification Please Type or Print Clearly) OWNER: Name:yoS/ e 0 Phone: Address: © � c��iU/1/�✓1��� /� CONTRACTOR Name: C4�-� X1416'7— Phone Address: L- .�2-0 �,//r'✓7'i��Z )� �l!✓ooJi�2 �� Supervisor's Construction License: �vS/ Exp. Date: 01 07 Home Improvement License: /� Ql � Exp. Date: 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 r _� Total Project Cost: $ IS*' �� g FEE: Check No.: j Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to auaranty nd ;Signature of Agent/Owner Signature of contract Plant .qo ihmittP-H I—{ Plan-, WaivPci I—I Certified Plot Plan Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ..TYPE OF-SEWERAGEDISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ , Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS :CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes �. Planning Board Decision: Comments Conservation Decision: Comments Wates' & Sewer Connection/Signature& Date Driveway Permit DPW'Todd. Engineer: Signature: _ Located 384 Osgood Street FIRE-DEPARTMENT - Temp Dumpster on site yes no . Located at 124 Mair Street . Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A=F and G min.$100-$1000 fine NOTES and DATA— (For department use D Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fohowing is a-list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cas<s if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apn-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Bui?,ding Permit Revised 2012 Location No. Date /3 . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee • Foundation Permit Fee Other Permit Fee $ + TOTAL $ Check# Building Inspector Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost 15po.00 m $ - $ 180.00 Plumbing Fee $ 22.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 22.50 Total fees collected $ 325.00 100 Johnny Cake Street 298-14 on 10/1/2013 Bath Remodel F_ 7 NORTH - w: .. . At. . .. .c . . ver Rc o 0�9 — 1q * 1 h ver, Mass COC MIc Nl Wlc" ,v'1' �.9 AD�'STED I'PP'��� S U BOARD OF HEALTH Food/Kitchen PERM T L D Septic System THIS CERTIFIES THAT ................... . .�., ......o . ........................................................ BUILDING INSPECTOR has permission to erect .......................... buildings on ....(.Q0...zyc) �Q M.� 0&. ... .............. Foundation Rough to be occupied as .( �..... .�i? ...... ..�.�... lv ........................................... Chimney provided that the person accepting 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 EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR I UNLESS CONSTRUCTION RT Rough Service ...................... ........................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. SEE REVERSE SIDE "1 OP ID: SHHE ,a►c�o,Ro CERTIFICATE OF LIABILITY INSURANCE 709/30113 Y) 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 Phone:978-688-6921 CONTACT NAME: Macdonald&Pangione Insurance Fax:978-688-5350 PHONE FAX P.O.Box 428 A/C No Ext): A/C No): 104 Main Street E-MAIL North Andover, MA 01845 ADDRESS: PRODUCER CHRIS-5 Michael Pangione CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE I NAIC# INSURED Christopher Rivet INSURER A:Preferred Mutual Ins Co 115024 207 Winter St. INSURER B: North Andover, MA 01845 INSURER C INSURER D: INSURER E: INSURER 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 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. OLICY EFF POLICY EXP LTR TYPE OF INSURANCE JhMll_MD ADDL SUB POLICY NUMBER MM/DD/YYYY MM/DD YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A . X COMMERCIAL GENERAL LIABILITY CPP 0180 57 0105 09126/13 09/26/14 PREMISES Ea occurrence $ 100900 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO JECT n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE _ S _ DEDUCTIBLE S RETENTION S $ WORKERS COMPENSATIONWC STATU- I 0TH-I AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) 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 ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St No Andover, MA 01845 AUTHORIZED REPRESENTA IV Michael Pangion I ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ekyb jqiud tuictian Bill &Marie O'Mara 100 Johnnycake Street North Andover, MA 01845 (H) 978-289-2403 marieomara@comcast.net August 17, 2013 Bathroom Remodel Work to be included includes: • Acquire Building Permit. • Pick up all items purchased at Peabody Supply for installation. • Pick up of tile selected from outside vendor for floor/shower. • Advise and work with granite vendor for install of granite counter top for sinks. • Demo and removal of existing floor and ceiling. • Demo and removal of existing tub,tiles, shower install, glass shower door,vanity,towel racks, mirror, lighting—all items and contents of entire bathroom except toilet. • Coordination and completion all required plumbing. • Complete all electrical (lighting, install new Panisonic vent unit, ceiling light fixture, new switches and plugs). • Install vanity and tub. • Install new ceiling,plaster ceiling and tub walls. • Install tile on tub walls and ceiling. • Install DenseShield tile board on floor. • Install new tile floor. • Install new baseboard heat cover and baseboard. • Install new toilet paper holder,towel bars, faucets and shower plumbing. • Install linen towel tower on top of vanity. • Hang wall mirror and over the mirror light fixture. • Removal of all debris. Note: Estimated start date is mid to end of September. TOTAL LABOR AND MATERIAL $ 7,700.00 Note: This quote does not include any plumbing fixtures,vanity,tiles,grout, granite, or paint. If current vent is not properly vented,we will need to address. Terms: $2,500.00 upon signing of contract(not to exceed 113 of contract price) $5,200.00 when job complete Submitted By: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C)508-265-3115 (1)978-794-1165 North Andover,MA 01845 Uomeownerfs rights A homeo-winer's rights under the Home Improvement Contractor Lew(iVtGL chapter 14.2A)and other consumer p•otection laws(Le.MGL chapter 93A)may not be waived in any way,even by agreeme�rt. However,h maybe excluded from certain rights if the contractor they choose is not ro ext re omeowme-s $omeowzsers who secure their own building permits are automatically xcl ded�xom 0 Guarauiy Band pred ovisions of the$ome improvement Contractor-Law The contractor is responsible£or completxu the soils as timely incl orlonanlike+na,,,,er. Homeowners maybe entitled to other ecifc legal described,in a guarantees or provides an express w �rights if the contractor provided by the contractor,a1 ��'for v+'orltmanship or materials, In addition to guarantees or warranties goods sold-in,Massachusetts cany an implied warranty of merchantability and fitness for a Pal icular purpose. An enumeration of other matters on which the homeowner and contractor Iawfiill agree added to'die leans Of the contract as long as they do not restrict a homeowner's basic consumer zip y be questions about your cons,mer/homeowuer rights,contact the Consumer Information Hotline its. If yott have (listed below). �xect,don of Coutraa The contract muse be executed in du li doctunents have been attached, cate and should not be signed until a copy of all exhibits and referenced PM-des are also advised not to sign the document until all blank sections have been Med in or marked ow as void,deleted,or not applicable. One briginal signed copy of the contract vrYdt a�aehments is to be given to the owner and the o'dier Rept by the cantractm. Any modification to the.or= �; ,,,.,,� ac=ust o „ and agreed to by both parties.Contracted wont may not begin until both parties have rec�eNed a fiery executed copy the contract,and•the three day rescission period has e)q)ired. py of A'ccelerated Bayme• . f3 A contractor may not demand payments in advance of the dates specified on'rhe a homeowner deems him/herseli to be financially insecure. However,in' p yment schedule in cases where the to be fiumcially insecure,the contractor ma require instances where a contractor deems him/herself account as a prerequisite to continuing the retracted work, Withdrawal of ort twc m ds not yet se be placed in a j oint escrow signatures of both parties. said accotmt would require'`ae Additional 1dorz..Y+.a•-i or. If you have general questions or need additional in£orrmation about the Rome Tin ovement Contractor` - consumer rights,or if you wish to obtain a free co of nA, Law or other contact: PY l�Iassachusetts Consumer Guide to Home improvement" Consumer I&ormationHotline Office of Consumer Affairs and Business Regulation. 10 Pails Plaza,Room 5170,Boston,MA.02116 6.7-973-8787,888-283-37:57 or visit the OCABRwebsite all : ,,�ymass.aovIotab1/ about the contractor registration comor If you want to verify the registration of a contractox if you have questions or need additional infoxma•. n ponent of the Home Improvement Contractor Law, contact; on sped dcally Director ofHome Improvement Contractor Registration Office of Consumer Affairs and-Business Regulation 10 0,Bost 617-973-8787, 888 283- 757 orvis ttheSa[C website MA 02116 e at fin://wtvty rn, Go online to view the status of a Hone Improvement Contractor's Registration. �s aov/oc�br/ htt7):/IdU,sfafe.ma.us/tiomeim rovelvent/licenseelist as For assistance with informal mediation of disputes or to register fo rural.complaints against a business,call- Consuinner Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Btueau 508_6S2_4800'508':755-2S48 08-652_4800'508-7552548 or 443-734-3114 V=ioa2.1-II/22120I0 iJ All Home Improvement Contractors shall be registered.Inquiries about a contractor relating to a registration should be directed to; Registration Division,Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor.Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payments will be made as outlined above. Date � 4 ,3 Homeowner Signatur Date A�� - Ia Contractor Signature 5e, Contractor Arbiirahion The Home Improvement Contractor I aw provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right isnot automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner .in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeown,by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that inthe event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration:firm which has been approved by the Secretary of the Executive Office of Consumer Aff ivrs and Business Re on and the 003_per shall be regn lied to submi such arbitration as. ovided InlYlassachusetts General haws,chi 42A.. 1303nowner's Signa-Lue tractor`s Si Zre NOTICE'The signatures ofthe parties above apply onlyto the agreement of theracto parties to alternative dispute resolution initiated to the contractor: The homeowner may initiate alterative dispute resolution even where this section is not separately signed by the parties. CS-072173 CMUS i ORHIER FRIW T � 207 WMIT'EER ST N MM?OV—ER Mk-- 01345 954, - ---- 06102120114 �rtrza:rur�a�� Office o?Consumer Al'zs&BYsincss Rcvin ii=:; HOIME: 3PROVENAIENT CONTRACTOR Registration: 139962 Type: Expiration: 9181201Individual ;FTi1TS T 0?HER F.RIVET CHRISTOPHER, RIVET 2t.;"WINTER ST. N. ';NDOVER,MA 01845 Llndcrsccr etary The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): i'/� Address: 62 0 City/State/Zip:/(.lc,. _�i�la �� �C� '/FAY „fit V/ Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction ployees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet.t ? �emodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. workers' comp.insurance. 9 y p ty ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 1311 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: zz'�/1 .t'�SG' �G71� N 5'. a Policy#or Self-ins.Lic.#:—If 6�c/go S-7 0%a s— Expiration Date: Job Site Address: /OeQ t�)QzmLN� .S">lf'feir 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. l do hereby certify it der he pains and p allies of perjury that the information provided above is true and correct Sijznature: Date: �� Y Phone#: t7 Official ztse 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#: