HomeMy WebLinkAboutBuilding Permit #218-11 - 11 ANVIL CIRCLE 9/14/2010 BUILDING-PERMiT F µoRrry
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TOWN OF NORTH ANDOVER or
APPLICATION FOR PLAN EXAMINATION
Permit Date Received
�AD,.Sr.D
Date Issued. SSS C"LisE�.
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
_AdAition ' Two or more family industrial
anon No. of units: Commercial
_Rqxtir, ' p acement- Assessory Bldg Others:
Demolition Other
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SCRiP ION OF WORK TO BE PREFORMED:K
Iden_tification Iease Type or Print Clearly)
OWNER: Name: (1/t D l Ca-T-A Phone: `� 7� v 66`0 6
Address:
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ARCHITECT/ENGINEER Phone:
I
Address: Reg. No.
FEE SCHEDULE:BULDIN G PERMIT:$12,00 PER$9000,00 OF THE TOTAL ESTIMATED COST BASED ON$12$00 PER S.F.
Total Project Cost: $_ A, �� FEE: $___ )�f
i
Check No.: Receipt No I S�� 3
: �
NOTE: Persons contr--acting with unrebgiister�ed contractors do not have* cess to the guaranty fun
.,,. .__.�s. - . 1 I�caU1EOCO '`" 3 �; -11 'x *
n qac=r== :, :- '. _ ._
Location Aal Vt
No. 2 Date v
MORT„ TOWN OF NORTH ANDOVER
• s
• i ; , Certificate of Occupancy $
Building/Frame Permit Fee $
s�CHus
Foundation Permit Fee $ �I _
Other Permit Fee $
TOTAL $
Check #
234 ,D
Building Inspector
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/MassageBodyArt 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 Sigriature
CVIVIIVIFENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals.`Variance, Petition No: Zoning Decision/receipt submiffed yes
ry •
Plannirig, Board Decision: Comments
Conservation Decision: Comments
Wafer & Sewer Connection/Signature&Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
.J^ �� :Frjsriia ..ya'7f•�.: .4lnL•3r
15 AW l. 7Aa��� - _,Y:`4.:t. - -sem
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at�`'- -
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- 'h^_mac^__ _ �::•:r^:.-.�•:a::�-�•t�+ _
Dimension j
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
❑ Notified for pickup- Date
Doc.Building Permit Revised 2010
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
i
❑ Building Permit Application
Li 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
o 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
P P
Hydraulic Calculations (If Applicable)
❑ iviass 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
I-Irl ' Pr if l�`-� 1�%_i '!an
Ure❑ 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:Building Permit Revised 2008
NpRT1y And ,
Town of _
over
0 . V, 11%
a dover, Mass., '
Q LAKE
COCHICHEWICK V
ORATED P �C'l
�l U BOARD OF HEALTH
Food/Kitchen
P-ERMIT� T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT 1c� 4.L....a..... . ..—o-..........................................
.............................C.................................... Foundation
has permission to erect buildings on ...... ..............A^vi.. .... ....... Rough
to be occupied as........ Chimney
p 3, .,�. .... ret.. ........ ...........................................................
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
10LI PERMIT EXPIRESOINMONTHSELECTRICAL INSPECTOR
UNLESS CONSTRARTS Rough
.... .... ....................
Service
BUILDING IN PECTOR
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.
The CommonweQlth of Massachusetts
Department o f Industrial Accidents
Office of£n vest gations
600 Washing-ton Street
Boston, M4 02111
asse ov/din
Workers' Compensation Insurance Aff �
da
Av licant Informaiion �' BuilderslCon�ractors/Electricians/Plumbers
�_, Please Print Legibly
Name (Business/Organization/Individual):
Address: U �
City/State/Zip: rc 1 Phone#: -7F1
Are you an employer?Check the appropriate boa:
1•❑ I am a employer with 4. ❑ I am a general7�:
Type of project(required):
employees(full and/orpart-time).* have hired the 6• ❑New construction
2.7"I am a sole proprietor or partner- listed on the at7. ❑Remodeling
ship and have no employees These sub-contractors have
working for me in any capacity, workers com , g ❑Demolition
(No workers' c P insurance.
omp. insurance �. ❑ We area corporation and its 9 ❑Building addition
3.❑ required.] officers have exercised their 10•❑Electrical r
I am a homeowner doing all work right of ex ��or additions
myself �Ptr�Per MGL 1 i.❑Plumbing repairs or additions
Y [No workers'comp, c. 152,§I(4) and we have no
insurance required.] t employees. [N kers 12,E]Roof repairs
o wor
'omp.ins ance required] 13•❑ Other
`=.nS'a^.plicaa:that ch:,,k.;boxt!! Must a?sc fce s
F3oneown us tYu oet gees beioa Wov W�
era who submit this affidavit indicatmg .-,, gal work and workers cow L....=f
th�� a-=dCtII r--....?^CC Y,.....� ...:...'`'rra.
'Contractor-'that cherk this box must attached an additionai sheet showing the thea hire outside confft.,AAs.atrbmit a new affidavit indicating such.
name of the sub-couttactm and their workers'comp.poiicy information.
jr am an employer that is providing workerscompensation insurance for my e
mfoJI'Ma on. mployees, Below is the policy and job site
Insurance Company Name:
Policy#or Self-ins.Lic.#:
Expiration Date:
Job Site Address:
City/State/Zip:
Attach a copy of the workers' compensation policy declaration pane (she
Failure to secure coverage as required under Section 25A of MGL C. 152 can lead to thr impositthe Policy ion number
criminal matron date).
fine up to$1,500.00 and/or one-year imprisonmentr. ,as well as civil Penalties of a
Of up to$250.00 a da against penalties in the form of a STOP WORK ORDER and a fine
Investigations of the DIA for insurance coverage erificised ation t a copy of this statement may be forwarded to the Office of
I do hereby c u er the s and penalties o er
fP fury thw the in
f
Si ature.
ormation provided above is true and correct
Qn
di+'l G I< ed", �a
Date:_.._ 7 . l
Phone#:
Official use only. De not write in this area, to be completed by city or town official
City or Tovvtt:
Permitucense#
Issuing Authority(circle one): -
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.plumb
6. Other b Inspector
Contact Person:
Information an- d .Instructions
Massachusetts General Laws chapter 152 requires all employs to provide workers'compensation for their employees.
Pursuant to this statute;an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other leeal entity, or any two or more
of the foregoing engaged in a joint enterprise,and including t]ne Iegal representatives of a deceased emplover, or the
receiver or trustee of an individual,parmexship, association oY other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartii-x_eats and who resides therein,or the occupant of the
dwelling house of another who employs persons to do mainte:301111ee,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not be:cause of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing-agency shall withhold the issuance or
renewal of a license or permit to operate a business or to c--onsh-uct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of co3mpliance 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 un-V-1 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-contractors) name(s), address(es) and phone numbers)along with their certificate(s)of
insurance. Liunited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'comp ration 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 stere to sign and date the affidavit. The affidavit should
be ivtuau'vd to i-iLe vaty or towTi tlia—,i11B aL'u11CSic4n ft3r il2e p0ll3n1t or license LS being requesxd,not the Of
Industrial Accidents. Should you have any questions regardinge law or ii you are:.-1 1.-ed to obtain a workers'
compensation policy,please call the Department at the numbeT listed below. Self-insured companies should enter their
self-insurance license number on the appropriate 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 p=nitllice;nse member 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 peizaits or licenses. A new affidavit must be filled out each .
year.Where a home owner or citizen is obtaining a license or pert 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 oflnvestigations would like to than you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call-
The
allThe Department's address,telephone.and.,fax-number- ..
The Commonwealth of Massachusetts
Departm=t of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. 617-72.7-4900 est 406 or 1-9 7 7-M ASSAFE
Revised S-2F-Qj
Fax#6.17-727-7749
vrvr,A7.mass..aov/dia
Massachusetts-
Department of Public Satet�
Board of Buildin�j
Construction Rc�ulations and Standard~•;i
License: CS Supervisor License
Restricted to: 00 89566
i
THEODORE B
GRAB t
1029 HUMPHREY'ST `{
SWAMPSCOTT, MA 01907
t rnmrissiunr� Expiration: 11/24/2011
Tr#: 10221
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
Registratioh.. X1.40838
Expiration _=::1.172.8/2011 Tr# 290650 I
Type'1 =Priva_tCIP-rporation
ADVANCED BA$ENIENT-FI-NISHING, INC.
THEODORE
1029 HUMPHREY,ST.._F.__..
SWAMPSCOTT —,
MA'0 T90;7–
Undersecretary
i
1
Ted Grab—Interior Renovations
Advanced Basement Finishing
1029 Humphrey Street
Swampscott, Massachusetts 01907
781-430-0415
(cell) 781-454-5609
MA Home Improvement Contractors Registration#140838—Exp 11/27/11
Construction Supervisor License#89566—Exp 11/24/11
Proposal To Renovate Basement
August 30,2010
HOME OWNER: Amy and Marco Pallota
11 Anvil Circle
North Andover, Massachusetts 01845
PROJECT DESCRIPTION
1. Areas to be created in unfinished basement
CONTRACTOR SHALL supply all new materials needed to erect,
according to State and Local Building Codes, build all walls along walls
to create and finish areas as designated on scale drawing. The areas are
as follows.
➢ Family Room/Home Entertainment Area
➢ Full Bathroom
➢ Utility/Furnace/Storage Room (unfinished interior)
➢ Storage Closet/Sprinkler Room Closet(unfinished interior)
7 i6c ,�
2. Ceiling and Soffit Preparation
❑ 1" x 3" spruce strapping shall be installed (as needed) on ceding Joist 16" on
center to support weight of new drywall ceiling.
3. Wall Structure
➢ Contractor shall make wall alterations as indicated (approximately, as
needed) on scale drawing. All wall structure shall be built according to state
& local building requirements.
S. Insulation
➢ All exterior walls shall be insulated so that all living areas and spaces are
insulated according to code(as needed). The insulation value is R-13.
6. 50s
➢ The left hand wall of staircase (as you are walking up the steps) shall be
opened and a half wall angled wall shall be fabricated to create an open
affect.
7. Electrical Work
➢ A Massachusetts Licensed Master Electrician shall perform all electrical
work.This project shall include the following.
❑ Up to 14-6 inch recessed lights in living areas.
❑ Up to 7 switches to control all recessed lights.
❑ Up to 2 cable/broadband wall connections.
❑ Up to 1 telephone wall connections.
❑ Electrical outlets through living area per code. These outlets are
controlled by a GFI(ground fault)/Arc Fault breakers.
❑ Install exhaust fan/light in bathroom.
❑ A separate and additional charge will be assessed in the event an
additional sub panel is required to accomplish this electrical work
properly.
❑ The cost of electrical breakers cannot be determined until the
electrician is on site. This cost will be allocated and billed when
electrician has completed his work. Contractor has agreed to "cap"
this cost at$250.00.
8. Finished Walls. Ceilings & Soffits
All walls, ceiling and soffit of finished areas shall be enclosed with % inch
"blue board".
All blue board shall be veneer plastered to a smooth finish on walls and
ceiling.
9. Doors
➢ All door are hinged doors and shall shall be"6 PANEL"
➢ All doors shall include standard hardware and doorknobs.
➢ All doors to be installed with casing similar to existing casing on the first
floor.
IO.Baseboard, Door/Window Casing
➢ Contractor will supply and install new baseboard, door/window casing for
all finished areas.
II.Plumbing
➢ Contractor shall install and supply a toilet and create new pumping and
draining system.
➢ Contractor shall create new water supply line for toilet.
➢ Contractor shall supply drainage for supplied shower.
➢ Contractor shall create new hot and cold water supply for new shower.
➢ Contractor shall create proper drainage for new sink.
➢ Contractor shall create new hot and cold water supply line for bathroom
sink.
➢ Contractor shall create new hot and cold water supply line for kitchenette
sink.
➢ Plumber shall move shut-off valve to outdoor spigot into ceiling.
➢ Plumber shall connect laundry overflow drain into drain pipe.
a. Contractor shall have option whether or not to utilize an up-
pump toilet system or a traditional toilet. If contractor
chooses up-pump toilet, the contractor shall supply this toilet
system. If contractor chooses to use tradition toilet, the home
owner shall supply toilet.
12.Heating/HVAC/New Duct work/Thermostat, etc-
➢ This agreement allows for no heating, additional duct work, combustion air
1p' g�
intake or thermostat installation. Homeowner has contracted with separate
heating professional. Said heating contractor will adjust all air supply
hardware to be consistent with new ceiling height and shall install all finish
HVAC registers
13.Materials Supplied by Contractor
➢ Contractor will supply and install all materials and fixtures. However the
fixture listed below shall be supplied by homeowner and installed by
contractor. Macerator toilet to be supplied by contractor(if required).
❑ Bathroom Sink/Faucet
❑ Bathroom Shower/Faucet Mixer
❑ Bathroom Toilet/(as needed,see paragraph 11 a.
❑ Toilet seat
❑ Bathroom Ceramic Floor Tile,Grout and Marble Threshold
14.Flooring
➢ This proposal allows for no flooring.
)0, Contractor shall install ceramic tiles supplied by homeowner for bathroom
floor.
1 S.Painting
➢ This proposal allows for no painting.
16.Permits
➢ All permit fees shall be reimbursed to the contractor by the homeowner.
Homeowners acknowledge that 3 permits are required: Building, Plumbing
and Electrical. Contractor has agreed to include cost of include the cost of
plumbing permit and "cap" the total cost of electrical and building permit at
$250.00.
17.Fire Sprinklers
➢ Contractor will engage a licensed Fire Sprinkler Contractor to provide the
necessary fire protection tasks. These tasked will include changing all
sprinkler heads in finished area, and installing new heads as needed. The
contractor shall provide an estimate to the homeowner and this sub -
contractor shall be paid directly by the homeowner. The homeowner shall be
allowed to seek alternate sprinkler contractor.
18.Scale Drawing
➢ Scale drawing attach shall be construed as an integral part of the proposal
and agreement. All measurements are approximate and homeowners
acknowledge that changes may be required due to building codes and
obstacles in the unfinished basement.
19.Novisions
➢ Homeowner acknowledges the following and hereby agrees to abide by these
provisions:
1) Reasonable access must be made to the premises during working hours.
2) Working hours are from 6:30 AM through 5 PM on weekdays (except
Friday). Contractor may request the option of working on Friday and/or
Saturday with homeowner's approval. Said approval shall not be
unreasonably withheld.
3) The basement area is a construction site, therefore, children and pets should
not be allowed in this area.
4) All personal property must be removed from construction site and
contractor shall not be held responsible for this property.
5) Quite often,communications concerning the project and questions regarding
the project will be done via "E-Mail". Homeowner agrees to reply
immediately and acknowledges that these communications shall become a
part or a change to this agreement.
6) Homeowner authorizes the reasonable use of bathroom facilities.
7) All parties agreed that this agreement represents the entire agreement
between the parties and that any changes must be done in writing and/or
email and acknowledged by all parties.
Project Investment
➢ Payment Due with Agreement $ 1000.00
i
➢ Payment Due when Project begins $
➢ Payment Due when rough Electrical
Work is completed $
➢ Balance upon completion
Commencement Date
Project shall begin on or about and shall be completed
on or about .These dates are approximate.
Accepted by:
Date: ?AJ u lC)
Marco Pallota
Accepted
U --Y — �J
Awk 2%-�
Date:
AMY Pa 1 to
Accepted by:
Date �d
Ted Grab—Interior Renovations
Advanced Basement Finishing
42'8
10'10 18'3 CABLE 137
CONNECTION RECESSED LIGHTS
THROUGHOUT
0 6
qABL E/PHONE
/ ON NECTION
--------------- ---- ----- --
0 0
STORAGE N_ co
N
--------------
FURNACE HOT WATER OIL ANK
HEATER
LALLY
COLUMN
UNFINISHED NFINISHED UNFINISHED
INTERIOR UP INTERIOR INTERIOR
0
3' —5'11
Go
0�
MACERATING
UP-FLUSH
FIVE FOOT -V TOILET
BI-FOLD DOOR
SPRINKLER
SYSTEM'
NIAIN WASTE 23'5 19'3
IPE
42'8 J
LIVING AREA
EXHAUST FAN 992 sq ft
42'8
10'10 18'3 CABLE 137
CONNECTION RECESSED LIGHTS
THROUGHOUT
6 0
r
4ABL E/PHONE
ON ECTION
------
0 0
STORAGE OD
NN
N
FURNACE HOT WATER OIL ANK
HEATER
LALLY
COLUMN
UNFINISHED o NFINISHED UNFINISHED
INTERIOR. INTERIOR INTERIOR
0
3'
co
O�
MACERATING
FIVE FOOT UP-FLUSH
—FOILS
BI-FOLD DOOR
SPRINKLER
SYSTEM
AIN WASTE 23'5 19'3
IPE \I
42'8
LIVING AREA
EXHAUST FAN 992 sq ft