Loading...
HomeMy WebLinkAboutBuilding Permit #699-15 - 105 FOXHILL ROAD 3/4/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: " Date Received Date Issued: - MPORTANT: Applicant must complete all items on this page LOCATiION _ F?nnt x" 'PROPERTY OWNER;_ Print 100Year Old'Structure yes no MAP,NQ _ � PARCEL: �._ ZONING DISMTRICT Historrc Distract es no, - . w $ M erase, yes. no acliin hop Villag TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition 0 Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ ❑Flood Iain �.,-I Wetlands 1Natershed District, �Septic ❑1Nell� p = El ater/Sewer� _ e DESCRIPTION OF WORK TO BE PERFORMED: r�---5 c M,�n/r R F h, d /D if ,L �j e �/ fi rryii e Identification Please Type or Print Clearly) OWNER: Name: C.4-P�--o STa ^r Phone: ' 41 Address: /�� Y-14 !> CONTRACTOR'�Name r!D „* c��5?�,�� - PPhorie / �' g Address: rY Supervisor,'s�Constructlon.,License - - .4 a Home Improvement Lleense ., n /.U �� _ - O i ,Exp •Date: �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. f l Total Project Cost: $ �� ��� ' 4� FEE: $ Check No.: o� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund �Signature�,of�Agent/Qwnerr�. ~_ _ _ -.. _ Slg� atureontractoru Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan 0 Stamped Plans ❑ Location No. ® Date • - TOWN OF NORTH ANDOVER T Certificate of Occupancy $ 4 Building/Frame Permit Fee $ 7 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ .Check# ,[ ! 28541 Building Inspector Plans Submitted ❑ PlansWaived-❑ Certified Plot Plan ❑ Stamped Plans ❑ -TYPE_OF-SEWERAGEDiSPOSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑ 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 e i 4 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 f DPW Tow Engineer: Signature: Located 384 Osgood Street FIRE-DEPARTMENT - Temp Dumpster on site yes no Fire Departmer-jt sidngturelddte `r : • _ : ,, 4^. ,-x: f, ,.i "a ;4 N r _OMM TS 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 4 I 4 I. B Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fol',2*wing is'a list of the required forms to be filled out for the appropriate.permit to be obtained. I 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 cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Building permit Revised 2012 . i Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 26,240.00 m $ - $ 314.88 Plumbing Fee $ 39.36 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 39.36 Total fees collected $ 493.60 105 Foxhill Road 699-15 on 3/4/15 Basement Remodel r -itoAk #I w: "a. :. .c . ver 0 No. soh ver, Mass, cocHictowicw y1' S V BOARD OF HEALTH Food/Kitchen PER L D Septic System THIS CERTIFIES THAT ............. .. .. ... . .�. BUILDING INSPECTOR 10 it Foundation has permission to erect .......................... buildings on ..I. ... . ................. .............. Rough tobe occupied as ....... ,i !!1/ ........ ...... ........ .................................................................... 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 MONT ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T S Rough Service ................ .. ............ .................... Final BUILDING INSPECTOR 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. November 13, 2014 Proposal submitted to Heidi Gladstone to repair damage sheetrock,change basement windows,remove and replace carpet, strip bathroom wallpaper,paint all in the basement and update electric at the address 105 Fox Hill Rd.,-North Andover,MA. Details of project are outlined as follows: 1. Debris Removal—All debris generated by construction to be removed by Contractor. Remove 5 windows, glue down carpet and damaged sheetrock. 2. Repair of Sheetrock-Remove damage sheetrock around columns,beams and misc. wall repairs. 3. Interior Trim—Blend in basement around repaired columns. 4. Windows -Remove existing 5 windows and install Harvey basement vinyl PL/ windows. 1 5. Fan Vent for Boiler Room - o Install new Fields CAS-4 combustion make up air fan for gas boiler&hot water heater o Install water heater inter lock kit CK-20FV/FG o Install 4"make up air duct from outdoor termination kit to indoor fan ® Associated materials and labor o System startup 6. Electrical-per enclosed listing. 7. Plumbing—No plumbing work figured into this proposal. 8. Flooring-Main space and stairs to be carpet over concrete with an allowance of $30./yd. to include removing existing carpet and install of new. Allowance $4,920.00. 9. Paint-All woodwork to be painted with two coats of finish paint. All walls to be primed and two coats of finish paint,remove existing bathroom wallpaper. Smooth ceilings to be primed and two coats of finish paint.All colors to be chosen by homeowner.Natural woodwork such as banister,handrail and thresholds to be natural urethane finish. Total cost to complete-$26,240.00 Thank you for the opportunity to quote your project. Should you have any questions or would like to take your project to the next step,please contact us. Sincerely, William T.Foster Cote and Foster The G'omntonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' I Congress S'tree4 Suite 100 Boston,MA 02114-2017 w was.mass gov/dia Workers' Compensation Insurance. davit: Buflders/Contractors/Electricians/Plumbers Ag2licant Information Please Print Legibly Name(Business/Organiaation/indMdual): Address: /V �- City/State/Zip:2�E 7-Wut/VI ,u 4 o /?yV Phone#: Are you an employer?Check the appropriate boa: Type of project(required): 1.❑ I am a employer with 4. )[I am a general contractor and 1 6. F1 New construction employees(full and/or part-time).* / have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees illese sub-contractors have 8. 0 Demolition , working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.irmirance$ required.] 5. We are a corporation and its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all-work officers hive exercised their 11.[(Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.[]Roof repairs insurance required]t c. 152,§1(4),and we have no employees.[No workers' 13.❑ Other comp.insurance required_] =Any applicant that checks box 01 must also'M 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. lam an employer that is providing workers'compensation insurance,for sny enployees. Below is the poky and job site iiia,fo tion- Insurance Company Name: 2 C —7 Ar y Policy A or Self-ins.Lie.#:_ZL,� e DO y fe -> 9,3 ,7 Expiration Date: Job Site Address: U,ff " RI CitylState/Zip: /Yf A--`7-V /i Ar>>o r�, `4 Attach a copy of the workers'compensation policy declaration page(showin the policy number and expiration date).G 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. I do hereby c__ under the tains and genafties o nary that the!%formation provided above is true and correct- Signature: orrect:Si ature: Phone#: 419,?- I a 3 - ro Woo Official use only. leo not write in this area,to be completed by city or town ofcial City or Town: Permit/License# Issuing Authority(circle one): 1.hoard of Health 2.Building Department 3.Cityffown Clerk 4.Electrical bspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: l I Rice of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR 'egistration 107fi02 Type: " Expiration g!5l2016 ' I= Supplement C� COTE&FOSTER CANT WILLIAM FOSTER 20 Aegean Dr Unit 15 � .�_ a _ �• Methuen, NIA_ 01844 � Undersecretary ;h ---------------- Massachusetts - Department of Public Safety q Consti-`u:,i ACoORV CERTIFICATE OF LIABILITY INSURANCE DATE(MM'DD"r") 12/11/2013 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 CONTANAME:CT Victoria Lowes, CISR MTM Insurance Associates PHONE . (978)681-5700 FAX A/C. /C No): (978)661-5777 1320 Osgood Street E-MAI ADLDRESS:vickiel@mtminsure.com INSURERS AFFORDING COVERAGE NAIC# North Andover MA 01845 INSURERA:State Auto Insurance INSURED INSURER B:Commerce & Industry Insurance Cote & Foster Contracting, Inc INSURERC: 20 Aegean Drive INSURER D: Unit 15 INSURER E Methuen MA 01844 1 INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 Master List 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. INSR ADDL S BR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYYI (MMIDD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGET RENTED 300,000 PREMISES Ea occurrence $ A CLAIMS-MADE OCCUR OP2722545 2/31/201312/31/2014 MEDEXP(Anyoneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO-JE LOC $ AUTOMOBILE LIABILITY Ee accident) SINGLE LIMIT 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS X AUTOSSCHEDBODILY 2370166 12/31/2013 2/31/2014 BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ $ WORKERS COMPENSATIONX WC STATU- I 0TH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N❑ N/A (Mandatory in NH) 0004962937 6/20/2014 6/20/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 A Property Coverage BOP2722545 12/31/2013 12/31/2014 Business Personal Property $39,367 A Scheduled Equipment BOP2722545 12/31/2013 12/31/2014 Contractors Equipment $169,928 DESCRIPTION OF OPERATIONS/LOCATIONS/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 Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. North Andover Town Hall Main St. AUTHORIZED REPRESENTATIVE N Andover, MA 01845 /] P MacDonald CPCU, CIC I ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD