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HomeMy WebLinkAboutBuilding Permit #779-11 - 104 MARTIN AVENUE 5/19/2011 BUILDING PERMIT c* "°RT A TOWN OF NORTH ANDOVER ° o APPLICATION FOR PLAN EXAMINATION 70 Permit N0: 7 7�— _r Date Received 3 "0R,TeD Date Issued: e` �SSgcHus�� ORTANT: Applicant must complete all items on this page sS is 3 g 3 x Fx w 3: w OVA 831 N1t O CI -77777 71 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 Fptrc1111 �zprt� �elarads w � erez7rastr�ct �+ ✓ »�e1J:R7�ier?�', .x ..`� 'N ..; ..s-� r"x .sa ;�u,a.� `` ? "" '�-" } DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: ,4111 Phone: o,�"Z f Address:_ /o// &44�—)il xuy- 44 -24 kr . e a -77 Sip AS 4, ���� ��" � � w + 7 r ,.�.. � _ � _. � w�:w. �,�.._�.�• .mom ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ ,Z 7 s� FEE: $_ Check No.: Receipt No.: y� 6 NOTE: Persons contracting with unregistered contractors do not have access tot aran -- 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 RehabilitationPermits ❑ 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) l ❑ 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 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 2.2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/MassageBody.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 Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street ' az g+w,. � s� �t"`�' *v.�. •-c �,:� -t�c� F' '.i+ i�c.. f3 �10 , i'ITrter �s7te �es _ ou ; y��j¢ +� �.e asYx„c,. r".wY+ 7 +i- . cw y"j'c^�,.r.�es',j �%�- ✓ op L'e ��J�V a-s�' a zle �1� ree �dte '2" �' � , ..�,� � �`�*,to 'a_.s �x .r �a r : �• r �'3 �ro.� `°�h�.'P}: a �+c r'�� s'Sr M:"� �..�'� -;�` �} '-A„ ,_ -fir. .�. mss:: ..._..�.._.,.+� .,..s�+w .r;� ��:,,�.,...z��; -"� �.:✓sY..rt;.-. :.<g-�wr ,..;:�'�"�,,,s...°T;..v�a`°:��;y�.F.i 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 I ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Location �U �� / G� 7,� No. Z' z Date NGQTot TOWN OF NORTH ANDOVER f?.° • ow Certificate of Occupancy $ Building/Frame Permit Fee $ s+CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 24E65 � Bonding Inspector ORTH o 6 over TONM � _ _ .J. _ A K O , dover, Mass., y /`' 1� COCMICKEWICK 7A ADRATED 1 S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR Au 114 '7'�,,,- THISCERTIFIES THAT........ ..................................................................................................................................................... Foundation has permission to erect........................................ buildings on .�� � ''9 �� ........ Rough to be occupied as............................. 1...t�:.l .c ... l. r U<�1 ....................................................... ........ ...... 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC7 0 TARTS 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 .t Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SLIDE Smoke Det. The Commonwealth of Massachusetts ^� Department of Industrial Accidents ;ra-.;� ; Office of Investigations 600 Washington Street Boston, MA 02111 .' www mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual);_ Address: a?D 7 /0 City/State/Zip:AA 4WOVe Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction mployees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet.t 7• ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for mein any capacity. workers' comp.insurance. g. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10. Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c. 152, §1(4),and we have no 12,❑ Roof repairs insurance required.]t .employees. [No workers' 13.❑Other comp. insurance required.] ;Any applicant that checks boz#l must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are 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 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: Policy#or Self-ins. Lic.#: �zzo/1/� �/O Expiration Date: Job Site Address: / i i� /� ,�(�� City/State/Zip: ,o. 14jeolj5 Y/ 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 u to$250.00 a da against the violator.p y g la or. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify de he pains nd Wallies of perjury that the information provided above is true and correct Signature: Date: � 1 ; I 1 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#• R EP CERTIFICATE OF LIABILITY INSURANCE OP ID NEMA 705/18/11 (MM/DD/YVYY) 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,S-utiject 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 endomement(s). PRODUCER Macdonald & Pangione Insurance PHOON P.O. Box 428 (aC,No,Ext): (AIC,No): 104 Main Street ADDRESS: North Andover MA 01845 PRODUCER CUSTOMER IDI;: CHRIS-S Phone:978-688-6921 Fax:978-688-5350 INSURER(S)AFFORDING COVERAGE NAIL# INSURED Christopher Rivet INSURERA: Preferred Mutual Ins Co 15024 207 Wier St. INSURER B: North Andover MA 01845 INSURERC: INSURER 0: 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 MAYBE 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 U. A X COMMERCIAL GENERAL LIABILITY CPP 0170 57 01 05 09/26/10 09/26/11 PREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE ®OCCUR -MED EXP(Any one person) s5,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s2,000,000 X POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) $ — 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 $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION TATU- - AND EMPLOYERS LIABILITY YIN TORY LIMITS ETR ANY PROPRIETOR/PARTNERIEXEC OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory in NH) UTWO E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder as listed below CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover AUTHORIZED REPRESENTATIVE Osgood St No Andover MA 01845 1 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Massachusetts-bepartment of Pu,�ilic Sjttf N • � Bcia.rtl�f Bu�tlin�J.Rc�►ui.iti�.S:tial�S�ani'`sr_ti5.s' FOristruction Su0rvjso`r License.• y License: CS 72173 Restricted to: 00 CHRISTOPHER F RIVET 207 WINTER ST N ANDOVER, MA 01845 ° r Expiration: 612/2012. Colluuissi„ner Tr#: 27092 ..e 1 ~� ✓jie`"C�ant�r�taiuue� o��ddac�itc0et�d•j I i'=' s •� .. ? a Oftce bfLou�titoer�tf�tls f Bd'�tn h�,al txt3r°'f i HOME:MPROVEMENT CONTRACTOR Registration... 1.39952 Expua`icn 9%812091. Tri,70:0 7ta Type Individual CHPiS�JI?'iERF :PtVET: ;i CHR;SxOPHER`RWE, i' ..*7 ANTER ST:f 11. 1 iY- x < u e. W l f ba ir,t ✓ 'Ik Note: This drawing is an artistic Designed: 3/8/2011 interpretation of the general Printed: 3/8/201.1 appearance of the design. It is not meant to be an exact rendition. 30808B6D.KIT All Drawing#: 1 CJZ"WA Cawlu"�an PROPOSAL REVISED#1 Paul Hunter 104 Martin Ave. North Andover,MA 01845 (H) 978-688-0678 paul—hunter@dell.com Kitchen Remodel May 18, 2011 Work to be completed includes: • Building Permit $ 625.00 • Dumpster(additional dumpsters will be extra) $ 475.00 • Electrical—Install six recessed cans in family room. Two,four inch recessed lights above sink. Run four new circuits. Install new switches and receptacles. Install under cabinet lighting. Wire for two pendants over island. Install outlet in island. Four cans in kitchen. $ 3,500.00 • Hang new blueboard and plaster $ 2,400.00 • Install new Andersen Slider. Factory painted white interior. No grilles. $ 2,900.00 Install base and wall cabinets. Install crown moulding around cabinets. $2,400.00 • All necessary plumbing. $ 2,500.00 est. • Install new 2 1/4 Red oak flooring. Sand and finish. $4,000.00 • Move door opening to dining room.New opening to be arched. $ 1,250.00 • Install new baseboard where needed. Trim out doors and windows. $ 1,100.00 • Remove existing closet in family room and re-frame for ext. door to garage. Install door. $ 1,225.00 TOTAL LABOR AND MATERIAL $ 22,375.00 Terms: $ 7,450.00 to start Cabinet cost- $ 15,000.00 est. $ 7,450.00 after plastering Granite cost- $ 5000.00 est. $ 7,475.00 when complete Total project cost $42,375.00 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. Submitted By: Chris Rivet MA Lic#CS072173 HIC #139962 207 Winter Street (C) 508-265-3115 (H)978-794-1165 North Andover, MA 01845 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 bg Wde as !tjtliqo above. Date S /f // Signature Date Signature