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Home My WebLink AboutBuilding Permit #240 - 100 MARBLERIDGE ROAD 5/1/2018 TOWN OF NORTH ANDOVER �Lqo APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER A,,1,,.,-_A. Unit# / Print MAP NO: ,,yyam� RCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes 100 year-old structure yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building R*Dne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other --_ x.._ __ Septp c (®W�elllI®Floodp ain (] Wefland"s f®,Water'shedlDistnctF -- _- _ s-edl .. DESCRIPTION OF WORK TO BE PERFORMED: (Identificationlease Type or Print Clearly) OWNER: Name: /tea /��/ !�/ Phone: ��2—✓!?fd' Address: l'do CONTRACTOR Name: �G9� ✓ ti�� Phone: J7�> �i,�• 2q Address: ,or/,8 , �7 Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. I� FEE SCHEDULE.BULD/NG PERMIT.,$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 11— 0® CJ FEE: Check No.: Receipt No.: NOTE: Persons contracting. ith unregistered contractors do E04mve access to theuaran and g �f 4 <,..Jlier 'se7^:g.•'= � .- , ' ' 4.F 1 ...a. 4.+1' �-'it-r':`;.: Y }.'f''dY -�,.. Cinnati iro•nf:OrtAnt/Cl�nincr ,. .,... .. , .. Cir'inafi ira nf.cir►frartnr`�'t - _ ;'a.:;.;*��-,�_., ,. :, Building Department The following is a list of the required forms to q be filled out for theappropriate ermit to be obtained. p t Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit ❑ Photo Copy of H.I.C.And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o 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 -u Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses I ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits g g for Engineered rode g products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Y) o Building Permit Application o 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) o Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008mi T _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEkc-1E DISPOSAL 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 Consewation Decision: Comments Water &c Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior di � mensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service droprequires a Electrical Inspector yes q approval of No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine i NOTES and DATA— For department use I ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi _ r i Locatio d r4 No. Date �aRTM TOWN OF NORTH ANDOVER 3 9 } ° Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s,+cNust 9 F Foundation Permit Fee $ Other Permit Fee $ v TOTAL $ Check # 24623 Building Inspector NORTH TO" of 0 No. v 0 , lover, Mass.,-� je D - LAKE COC MIC HE "CK 7�S RATED P' CC BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... ...............�..........................~'................... �!!...... . Foundation has permission to erect............::...... .................. U!IdingS on ...... .. ...... ...... ....... .......... Rough to be occupied as........ �.. .. . . Chimney . . . . ........... ........ .... .. .. ... .......................................................................... provided that the pegs ccepting this permit shall in every respect conform to the terms of the application on file in Final 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 M S ELECTRICAL INSPECTOR UNLESS CONSTRUCTI0 S Rough ........................ _...................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. FRED L. WEBSTER CO., INC. Plumbing & Heating Contractor 306 Walker Street LOWELL, MASSACHUSETTS 01851-1848 (978) 453.2891 Fax (978) 453.0941 PHONE DATE TO: JOB NAME/LOCATION 978.682.5718 06121111 Kim Melchin 100 Marbleridge Rd North Andover, MA 0))�fb JOB NUMBER JOB PHONE We hereby siRg�fknu Ions ana estimates for: Kohler white plumbing fixtures, 1.32"x 60 inward Whirlpool tub filler,trip waste,electrical work and tile apron.K-1112—GF. 96($1750 allowance) 1.85"x 22"Granite lavatory top with Kohler brushed nickel 8 inch faucet with pop ups. 2•Undermount K-2210 bowls. 1-Nutone combination fan and light. I-Devonshire comfort height elongated closet combination with seat. 4 414' Plate er vanity. f-S- 1•Kohler anti scald shower valve. 1•New section of baseboard heat. PLUMBING TO INCLUDE: Remove existing plumbing fixtures and floor in complete bathroom. Repair sub flooring. Install new drain pipes for lavatory and tub with new hot and cold water lines with separate shut- offs through walls for lavatory. New closet flange and bolts for toilet. Install all new fixtures complete. CARPENTRY TO INCLUDE: Build necessary partitions for tub.Lower ceiling over tub area and build partition for tub apron, Install waterproof backing in complete tub area with new waterproof sheetrock walls installed where necessary.Apply joint compound and taping to all new sheetrock walls,sanded and finished. Wooden baseboard around room area. CERAMIC TILE TO BE INSTALLED: In complete tub area up to and including ceiling and on face of partitions of valance and whirlpool.Ceramic tile floor with marble threshold. Install two corner shelves. Install tile 3'112" high in complete room area with rope and chair rail.If tile is not installed 3112" high deduct$1,250.00 from estimate. NOT INCLUDED: Paint' ,papering shower do and towel bar set. Install ers supplied ceilin fixture. 2ND FLOOR CHI NS BATHROOM: 1-Granite nter top with und�hecablnet bowl and Kohler 8" shed nickel faucet op up. 1—In owners supplied me and light f' re. IT isc- Plumbin We PropResp } ; fiTgt%ibaRffordance wiS he above specific ons,for the sum of: dollars(5 Payment to be made as follows: MATERIAL&LABOR INCLUDING$500.00 COUPON: TEN THOUSAND DOLLARS DOWN PAYMENT BALANCE UPON COMPLETION. All materials guaranteed to be as specified. All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders, and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted within days. Acceptance of Proposal—The above prices,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as t n� ny specified.Payment will be made as outlined above. Signature Signature Date of Acceptance: HVWrAL.. vN..MIL a 81 aWN-1 ■ Mr• va 0as—%vi6r1 I 08/10/2010 PRODUCER 978.887.4900 FAX 978.887.2404 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Edward F. Sennott Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND EXTEND OR 16 South (Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, P. O. Box 457 Topsfield, MA 01983 INSURERS AFFORDING COVERAGE NAIC N INSURED Fred L. Webster Co. , Inc. INSURERn Safety Insurance Company 39454 306 Walker Street INSURER a. Travelers Indemnity Co of Amer Lowell, MA 018S1 INSURER C: INSURER O INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EXPIRATION LTR 9SMRILTYPE OF DURANCE POLICY NUMBER DATE DATE LIMITS GENERAL LIABILITY BP00014268 08/01/2010 08/01/2011 EACHOCCURRENCE $ 1,000,000 X CONMERCIALGENERAL LIABLRY PREMISES(E ) $ 5O,0Q CL AMS MADE I OCCUR MED EXP(Arty one person) f 5,00( A PERSONAL&ADV 94JLRY f 1,000,00 GENERAL AGGREGATE S 2,000,00( GENT AGGREGATE LMR APPLES PER PRODUCTS COMP/10P AGG $ 2,000,00( POLICY PLOC AUTOMOBILE LIABILITY 6210797 08/01/2010 08/01/2011 COMBINED SINGLE LMR ANY AUTO (Ea accident) f 1,000,000 ALL OWNED AUTOS BODILYINJURY S A X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILYNJURY f X NON-OWNED AUTOS (Par accident) PROPERTY DAMAGE f (Per accident) GARAGE LIABILFTY AUTO ONLY-EA ACCIDENT f ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG f EXCESS 1 UMBRELLA LIABLITY EACH OCCURRENCE f OCCUR CLAMS MADE AGGREGATE $ f DEDUCTIBLE f RETENTION f f WOREMPLOYER .L,,,ON XHUB-4712Y67-6-10 0810112010 08/01/2011 X AND EMPLOYERS'LIABLITY YIN TORYLMRS ER ANY PROPRET0RIPARTWRF-XECUTIVE El EACH ACCIDENT f 500 B OFFICERMIEMBER EXCLUDED'? ❑ r 00 pd�cl°�be NIH) E.L.DISEASE-EA EMPLOYEE S 500,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMT S 500,00 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR To MAL 10 DAYS WRITTEN City Hall NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Plumbing & Gas Inspector IMPOSE NO OBLIGATION OR LIABLITY OF ANY KIND UPON THE INSURER,rrS AGENTS OR 375 Merrimack St REPRESENTATIVES. Lowell, MA 018S2 AUTIgRI>ED REPRESENTATNE Peter Sennott LA ACORD 25(2009101) FAX: 978.446.7103 Oa 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD narne and logo are registered marks of ACORD Fold,Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS7-1 BOARD IIIN f-LIJIVItS• a Allmy• GATFIII llcf%a.� IMPORTANT NOTICE PL LICENSED AS A MASTER PLUMBER :> PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED ISSUES THIS LICENSE TO r FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. TYPE STEPHEN WEBSTER -M 6 VISTA DRIVE . PELHAM NH 03076-30:3 756565 10615 05/01/12 7,56565, �'.. LICENSE NO. DATE SERIAL NO. Fold,Then Detach Along All Perforations Fold,Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS DIVISION PROFESSIONAL LICENSURE IMPORTANT NOTICE POARD LICENSED AS A JOURNEYMAN PLUMBEF PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED ISSUES THIS LICENSE TO FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. TYPE STEPHEN 'WEBSTER -J 6, VISTA DRIVE iN; PELHA.M NH 03076-3033, 756564 20066 05/01/12 756564. ` LICENSE • . EXPIRATION DATE SERIAL NO. Fold,Then Detach Along All Perforations Fold,Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS ' • • ''• • IMPORTANT NOTICE BOARD PL REGISTERED AS A PLUMBING CORP, PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED ISSUES THIS LICENSE TO FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. TYPE STEPHEN WEBSTER FRED: 1 WEBSTER CO, _ INC -C 306. WALKER STREET LOWELL MA 01851-1848. 754083 1885 05/01/12 ..754083. LICENSE NO. EXPIRATION DATE SERIAL NO. Fold,Then Detach Along All Perforations