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HomeMy WebLinkAboutBuilding Permit #606 - 102 PENNI LANE 3/16/2007 14ORTII BUILDING PERMIT °`ts-E° #6,q"o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: lv0 eI Date Received -3,66-o9Areo SSACHU`�� Date Issued: �' f0 D IMPORTANT: Applicant must complete all items on this page f� pn� � s E c'3 +�s - - «�ll 1T n42 MAPNQ"' H1ST{QR 4�ESTRI es rtci 4 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial tg Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �13tiG �l 1�t11 Fes/ �; odpl � tacr WtShCI DISI rfr F 1. x ,p' j{ ✓@4' ys'¢�. 1� >� J'e�„' '..�"x'A' 93.8 � ��;a' �kF yob �44ty AN4 / / A°'. i, DESCRIPTION OF WORK TO BE PREFORMED: 1, _ u C1� � y Q J2 fes' ;v� Identific ion Ple s or Print Clearly) OWNER: Name: r yp ��Phone: ) Address: of E" ;6 •� .& � � r r-i spa n�i�r e�,�+� v gas t.��.xis y� / � -�"' - t a mom' - Ti�b•'� r �* a GONTGTUlme � fr Phcrti4f= �-x .�� K�➢i,R � °res :,' a_ ,� a e� .�x`°`��" � �,r '. ��3 � € Kms' ��� r Z A- Z pe &e - �� z9 Aft, y, esr7r `tt�`t��}t�� �t 2 7k*01!";"--"11i,/ x « / o �01 lEI1 !©Y r�PanEu -e L it c iia ., i 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: $ 1 7, U�O FEE: $ J Check No.: S q �— Receipt No.:2,00 51-0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty�fund ;I Signature of Agent/Owner Signature of contractor"". Building Department The following 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 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) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products 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 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED .SATE API,PflVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ i j COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street Flt E D PART N mp Durnpste on t .Yes ' � no � x xRr Locatedat 124 ain Stret F�re -¢ea3lnrit sitaurelcate � � � a p Cjjor OMM 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 i II ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 Location 1q2- ( P174 /41- — No. �/ Date NORT1y TOWN OF NORTH ANDOVER i Certificate of Occupancy $ "••s° Eck' Building/Frame Permit Fee $ �' S s4c Hus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r i Check # Building Inspector �auo�ssluawo� ' 6L8E0 HN '3111ANVC) 21a 0d G l r �ldW3l W'NMbHS 3 f00 •pa;�lr;sON 01Q6 :OU'jl 80Q�%Ll/80 aa�ldx3;� OL6l/LG/80 3ap4 M OLZ690 S3':jagwn. z; r N w � I 80SInLI3df1S N0110f1NISN00 :asuapjII SNOI1tilt1J38:JNlalffl8 d0 aad08 is J67Xeo Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement:C ntractor Registration Registration: 153349 Type: DBA Expiration: 11/21/2008 Tr# 253395 BCS & SONS CONSTRUCTION ; ~ t SHAWN LEMAY _ 11 TEMPO DR. DANVILLE, NH 03819 Fo ' Update Address and return card.Mark reason for change. DPS-CA1 io 50M-05/06-PC8490 [j Address Renewal Employment n Lost Card l i i FORTH Town of t` 4 Andover No. dover, Mass., 0 LA COC MIC MEWICK y�t' ADRA7E D p`P -`C3 `S BOARD OF HEALTH PERMIT T D Food/Kitchen ' 1 Septic System / L I BUILDING INSPECTOR THIS CERTIFIES THAT..............rr,I......4.if . ............y..7..'.. . ..I..�............................ ................................................ Foundation has permission to erect........................................ buildings on.....(.2 .....YO n...1.<.......................................... Rough to be.Occupied as...... 4. .... :o .-......................land!/ .....4040..— �a. 0.. cU.!J........f NII. Chimney provided that the person accepting 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO Rough .............. .. . Service ..................... . ..... . .. .. .... .. ... ................ BUILDING INSPECT Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.tnass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): w'nl Address:--I/ City/State/Zip: �vy,//eite� C?'F� Phone.#: 4 o-g_3 y ��4�" Are you an employer?Check the appropriate box: L❑ I am a employer with 4. ❑ I am a general contractor and I Type of project(required):. employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. ] I am a sole proprietor or partner- listed on the attached sheet. 7. Remodelin ❑ g ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' (No workers'comp.insurance comp.insurance.: 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11. Plumbing r myself ❑ g epairs or additions y [No workers'comp. right of exemption per MGL i insurance required]t c. 152,§1(4),and we have no 12.❑Roof repairs employees.(No workers' 13.❑Other comp.insurance required] Any applicant that checks box#1 must also fill out the section below showing their workerscompensation policy information. t Homeowners who submit this affidavit indicating they aro 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-contracton have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and�ob site information. (� Insurance Company Name: Policy#or Self-ins.Lic.#: /, c 6�S %r:;)9, r Expiration Date: Job Site Address: �4'� /����— `�✓ City/State/Zip: dU 107 /, 7 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 insuran a coverage verification. I do hereby certify xnder the pains and penalties of pedury that the information provided above is true and correct Si tune• ---� �� !��'l j Date- 2-1-1 `"C) 7 Phone#: 0,Y � � C3t? Official use only. Do not write in this area,to be completed y city or town offlclaL 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#: Information and Instructions Massachusetts General Laws chapter 152 requires employers to providebervwic of another under any cQ tractokers'compensation for their f hire,s. Pursuant to this statute,an employee is defined as ...every person ui express or implied,oral or written." An employer is defined as"an individual,Partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartnents and who resides therein,or the occupant of the ys persons to do maintenance,construction or repair work on such dwelling house dwelling house of another who emplo shall not because of such employment be deemed to be an employer." or on the grounds or building appurtenant thereto MGL chapter 152,§25C(6)also states that"every state or local shall the commonwealth Ith for anyhold the issuance construct buildings in renewal of a license or permit to operate a business or to g applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be,advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the a ro riate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Offti ce of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext.406 or 1-877-MASSAFE _. Fair#617,727-7749­ Revised Revised 11-22-06 www.mass.gov/dia OP ID DATE(MM/DDIYYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE Bcs&s-1 03/15/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Santo Insurance - Londonderry HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 50 Nashua Road, Suite 208 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Londonderry NH 03053 Phone: 603-890-6439 Fax:603-890-0315 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Penn-America Insurance Company INSURER B: BCS & Sons Construction Shawn M Lemay DBA INSURER C: 11 Tempo Drive INSURER D: Danville NH 03819 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER POLI Y EFFECTIVE P LI Y EXPIRATI N LIMITS LTR NSR TYPE OF INSURANCE DATE MM/DD/YY DATE MM/DD/YY GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY PAC6592968 06/07/06 06/07/07 PREMISES(Ea occurence) $50000 CLAIMS MADE rX]OCCUR MED EXP(Any one person) $ 5000 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 1000000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR El CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ � OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 102 PENNEY LANE, NO ANDOVER MA CERTIFICATE HOLDER CANCELLATION TOWNOFN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL TOWN OF NO ANDOVER IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. NO ANDOVER MA AUTHORIZED REPRESENT John Conroy ACORD 25(2001/08) AMROtORPORATION 1988 I I � I � I I i LO I —4 1 i I 4 I I I � I i I I I i jNot e:This drawing is an artistic 2f, Designed: 12i1g,20061I inter station of the general appearance v Printed: 1;1712007 Pr' g' PPe' of the design.It is not meant to be an exact rendition. I II i bse const. n andovenk-it bsc.const. n andovenkit Drawing;�: I j I I I , I i I I I I I j I I i I I I I I i i I ` I i i i I I I I 111 ff � I � � I I I 1 i I i 4 I I i I I Note:ThiFdrawing s an artistic. ?j'� Designed: 12/18/2006 interpretageneral appearance ,,,,,,,,_,,, ,; Printed: 1/17/2007of the desot meant to be anexact rend I �bse const. n andover_1at bsc const. n andover.ldt Dra«ing#: 1 A' i Ii 1 I i I I ' i i i I i I I I i I S/ a I f \ i i i i i I i I i I i (Note:This drawing is an artistic. �}(1 Designed: 12/18/2006 1 interpretation of the general appearance Printed: 1117/2007 of the design.It is not meant to be an exact rendition. !I bsc const. n andover.kit bsc const. n andover.kit I Drawing#: 1 INSTALL NEW AVONITE COUNTER TOP COLOR ADOBE BROWN, SATIN NEW TOP CABINETS TO BE 36" INSTEAD OF 30 " COST DIFFERENCE IS $560.00 THIS PRICE IS BASED ON NEW DRAWINGS DATE 1/16/07 NEW TOTAL 17,880.00 PAYMENTS AREAS FOLLOWS SONE HALF BEFOR START$9,220.00 FOR SE� jTA`�NT ,33OBWI N EW14W&IME THIRD PAYMENT OF 2,500.00 IS DUE WHEN RED REMAINDING 1,830.00 DUE ON COMPLEATION BATS ARE INSTALLED THANK YOU FROM BCS&SONS CONSTRUCTION All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon accidents or delays beyond our control. Owner to carry fire and other necessary insurance. ACCEPTANCE OF PROPOSAL-The above to prices,�thee work asspand conditions are satisfactory and are hereby accepted. You are authorized pacified. Contractors signature Customer signature IN THE EVENT OF NON-PAYMENT,THE CUSTOMER WILL BE RESPONSIBLE FOR A 25% MONTHLY SERVICE CHARGE . CUSTOMER WILL ALSO BE RESPONSIBLE FOR ANY LAWYER OR FEDERAL FEES DUE TO COURTS OR ANY OTHER LEGAL PARTIES -INSTALL NEW PLUMBING FOR HALF BATH IN LANDRYBATHROOM -CUSTOMER SUPPLIES NEW PLUMBING FIXTURES -INSTALL NEW EXHAUST FAN KITCHEN REMODEL -REMOVAL OF CABINETS -REMOVAL OF KITCHEN FLOOR -REMOVAL OF SLIDING DOOR -INSTALL NEW THREE PANEL FRENCH DOOR WITH DOORS ON EACH SIDE OF FIXED UNIT -INSTALL NEW HEADER SYSTEM 91/4 LVLS -USE OLD KITCHEN FLOOR TO FILL IN OPEN FLOOR -INSTALL NEW BRUCE CABINETS COLOR AND STYLE ARE SALERNO BIRCH BUTTERCREAM -GLASS DOORS TO BE INSTALL IN NEW CABINETS ON BOTH ENDS OF SINK AREA -REMOVE WINDOW IN OLD BATHROOM AND BOARD THE REMAINING OPEN AREA UP -INSTALL NEW VENT SYSTEM TO OUT SIDE FOR HOOD -FILL IN SIDING AROUND OLD WINDOW -INSTALL ISLAND ROUGH 4'6" IN LENTH TWO 27" CABINETS WITH BACKING -REFRIG AREA TO HAVE A FULL CABINET WITH A OPENING FOR A MICROWAVE -THERE WILL BE A THREE FOOT CABINET ABOVE REFRIG -REFRIG TO BE MOVED BACK FOUR INCHES BUY REMOVING THE WALL -NEW PANTRY WILL HAVE FLOOR TO CEILING CABINETS THREE EACH 18' ' OR 21" TOP OF CABINETS WILL HAVE TO BE CUT OUT FOR GLASS .tiJs P ry.yia�, A L o ,0, qo A ti� 11 TEMPO DR `► DANVILLE NH 03819 Milind Heble 102 PENNI 9RD N ANDOVER BATH REMODEL -REMOVAL OF WALL IN OLD BATHROOM TO INLARGE KITCHEN AREA -REMOVAL OF PLUMBING FIXTURES FROM OLD BATHROOM -REMOVE SECTION OF HEAT IN KITCHEN AREA FROM OLD WALL -RE INSTALL HEAT IN ANY AERA THAT WE CAN FIND -REMOVE HEAT FROM OLD BATHROOM AND RE INSTALL IN NEW BATHROOM -REMOVE CLOSET AREA IN WASHER ROOM -MOVE WATER AND DRAIN LINES FOR NEW LOCATION FOR WASHER AND DRYER -INSTALL NEW DRYER VENT -INSTALL BIFOLD DOORS FOR NEW LANDRY ROOM -REMOVE DOOR IN LANDRY ROOM AND CLOSE IN - INSTALL A COUPLE OF OLD KITCHEN CABINETS IN NEW LANDRY ROOM