HomeMy WebLinkAboutBuilding Permit #838 - 1149 OSGOOD STREET 6/19/2007 BUILDING PERMIT of NORTH
TOWN OF NORTH ANDOVER 3?
APPLICATION FOR PLAN EXAMINATION 6 -1 _
Permit N0431k Date Received �.'•o;"`"""�'`
CHUS��.
Date Issued: • d
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
❑ Addition ❑Two or more family ❑ Industrial
.Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PREFORMED:
92JOUATIlU
�_ ,lam I�rI�SM
Identification Please 7QType or Print Clearly)
OWNER: Name: if Li� Tom, Phone:
Address: 11qqQ -5-r-
01g
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 32,129 , 7� FEE: $
Check No.: Receipt No.: 2 O
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ FoodT,$ftg4nqtest�* ❑
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
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
,u
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
z
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
❑ Notified for pickup - Date -
Doc.Building Permit Revised 2007
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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
o Copy of Contract
o 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
o Certified Surveyed Plot Plan
o Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ 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)
❑ 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)
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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
t
4.
Location 116
} No. Date_
f NORTH
TOWN OF NORTH ANDOVER
10. y
S
` Certificate of Occupancy $
♦ s ? i
sMUs Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # —�
t
2H�sa 7 --^--
�,Y Building Inspector
-ORTH
Town ofA-.�_ -� ..,����.��� � ndover
0
No. 838
0 over, Mass., (a �1
0 tL- LAK
COCHICHEWICICK
7,9 ORATED
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT............. ..... or....�..U'00.0.............................................................................
Foundation
has permission to erect........................................ buildings on ...........1-NA......0.11
,�.. O-Ojd .................. Rough
to be occupied as...............&A.C.Q.0 ... qt* -60y% Chimney
provided that the person accepting this perm'f shaffl-iozie.4.4,.........RAP'to . ..... .... . ..............................................
very respect conform to the terms of the application an 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 CONS O� T TS Rough
.................................................BU
BUILDING INSPECTOR
................................................... Service
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 SIDEJ Smoke Det.
a'
r FT
INSTALL NEW FRENCH DOORS
A5 SHOWN
I
INSTALL NEW 6A5 FIREPLACE I I I I V4AL< I
REMOVE EXI5TIN6 PARTITION
AND INSTALL (4)2X12 61RDER
TO CARRY ATTIC FLOOR
P05T EITHER END TO FOUNDATION - I I dJ REMOVE EXI5TIN6 WINDOW
INSTALL NEW 5-1/2" STEEL LALLY ( LAND J AND INSTALL NEW 2'8/6'8
COL. IN BASEMENT ON 24"X24"XI2" r — — I %Q EXTERIOR DOOR
GONG. FOOTIN6, IF NONE EXISTS I INSTALL
NEN
OOR
AS SHOWN
I I
dJ I I
REPLACE E 15TIN6 EXI5TIN6 HOUSE
DOOR
I
00
NEW b' VANITY
FIRST FLOOR PLAN EXI5TIN6 TUB TO REMAIN '71-411
MUD ROOM
DRAWN BY:
MARTHA MAGINNIS TYLER RESIDENCE
55 REOENT AVE.
BRADFORD, MA. 0Ib35 114`1 OSOOOD STREET
(q'78)5-74-a-7Iq NORTH ANDOVER, MA
The Commonwealth of Massachusetts
U1Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
`Workers' Compensation Insurance Affidavit: Bu des/Contracto
rs/Electricians/Plumbers Applicant Information
Please Print Legibly
Name(Business/organization/Individual):
Address: L
S�
City/State/Zip: phone#:
x'71_ 3 ;r& o
Arer1am
an employer?Check the appropriate box:
1 LiJ a employer with 4. ❑ I am a general con Type of project(required):
employees(full and/or part-time).* have hired the sub-ontractor7.
sl
6• ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet.t
7.ship and have no employees ❑Remodeling
These sub-contractors have 8. ❑Demolition
working for me in any capacity, workers'comp,insurance.
[No workers'comp, insurance 5. ❑ We are a corporation and its 9-Building addition
required']
3. I officers have exercised their 10.0 Electrical repairs or additions
myself.[No workers'comp.❑ a homeowner doing pwork right of exemption per MGL "'0 Plumbing repairs or additions
.d. t c. 152,�1(4) and we ha
insurance required.] 12. Roof repairs
q employees. ,oyees. [No ve 12.[]workers'
comp.insurance required.] 13.0 Other
*Any applicant that checks box#t must also Tilt 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.
1Contraetors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'cora policy
I am an employer that is providing workers'compensation in
information. surance for my employees Below is thepoicy and job site
Insurance Company Name: ARP ccn
S.
Policy#or Self-ins. Lic.#: ?16 6
Expiration Date.--f//L
Job Site Address:_ I �Gj h 56 60 2) S
Attach a copy of the workers'compensation policy declaration Page(showingl�hetaolictpnumber dEN�W,�alluz
Failure to secure coverage as required under Section 25A of MGL . 152canlead to the imposition of criminal ration datea
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties of a
of up to$250.00 a day against the violator. Be advised that a copy off this staff mentimay be forwarded t TOP �ORDER nd a fine
Investigations of the DIA for insurance coverage verification
hereby1 do
cerrrJyu er the ares »dPena/hes OfPerjury that the rnformahon provided above is true and correct.
SiLynatt>_re-
Date: g
Phone#:
Offlcial 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):
I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person'
Phone#:
08:58 5;EG15'EVE HAL P96E 19V02
AaQRD CERTIFICATE OF LIABILITY INSURANCE CSR CIE 0AIt(MMDrfYYY1
TORRI-I 1 05 19/7
PROnUCm THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CER71FICATE
Segrave & Hall Insur.Assoc.1ric HOLDER.THIS CERTIFICATE DOES NO`f AMEND,EXTrND OR
305 Morth Main St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Andover MA 01810
Phoxxo:978-975-1300 INSURERS AFFORDING COVERAGE MAIC
INSURM I MUKR A: A__4,*j3x vmrtjm
TorrisRi Construction Imc- INSURE-RC:
110 Haverhill Road STE 364 �Lfll___
Amezbury MA 01913
COVERAGES
T—Hr POLICIM OF INSURAMCCA ISTEM BELOW HAVE BEEN MUM TOTHE#4St3:M0 NALISO A90VE FOR THE POLICY{`'MOO WDICATM 10MINSTANDING,
&RV REQUIREURNI,TEPRra OR CONDMON OFAMY CONTRACT OROTHER OCZUW_ATVVITH RE','%MCT TOffWCJi TKSCE9TF3CAWNKYEF_jS3I f:DOA
MAY PMA44,TlINSURAWE APTURDED BY THE FOL CIES DEW"M HERON IS SUBJECT TO ALL THE TER 4S. _-,UrH
POUCIES.ACPIAEC.ATE LV TTS SHOWN MAV HAVE BEEN R-tLx_CED BY PAID CLAIUS.
LTR NSRft TYPE OF INSURANCE POLICY t, MB V�—_—'p�"E b�ppnlZ7 LPATS
CENeM UAWUTY
I EACH OCCURPENCI! i 10 0 0 0 0 0
Amrw
rom �w
XP COIAMERCIALCzENERALLIAMMiTY 8500034294 06108/07 06108/03 , I
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i I CLA"MAM if
X I Of'XAM.if r mFD Ev, 00ny @m cry I 1-S5000
PERSONAL&A;)Vtr4."JRY S 1000000
GURAL AGGREGATE &2000000
Gm L AG%GC,k TE LffJiT APPLIFS PST,
PwmtT-9 commop A--r. $2000000
rOuCC), %?T
AUTOMOBILE LMLtTY
COMOINM SIKGLm-LIFATT
*IYAUTO S 100000
tc-.owdmfl
ALL OWNED- AUTOS
BODY
A SC4N JLED AUTOS 9891.7400003. 09/03/01; IL
09/03/07 "'IJURv s3OOOOO
HMO AUTOS iBODILYIN
JURY
5 7LOOO(I3.00000
NOIJ-0MED AUTOS
P.RQPER-Y DAMAGE
H�RAGE L&APALITY AUTO 014LY-FAACCIDENT S
_
MYAMO
9AACC S
OTHER THAN
AUTO OAA
Am jS
EXCESS tABRE"LtAMWTY EACH OCCUIVVZNCZ S
G MOE
DEDUCTIRLp-
$
WORnr,S COMP01%ATON AND
�TORY U11-5 CR
5000C
j EN-LOYEW UASnITY i
I AWiPROPR13:-:TDR-PARTNEPJFXECUTfVE AGCI;�NT
A 910189 IDS/02/07 05/02/08
OMCZ4ENaM EKCLUDED?
F.L.IDIS-.A.SE.EA r�KfrtOYFq S 500000
if de.- u
is =Vim.Ste;&.
S500000
OTHER
DESCfIVMONOT!OPERATMSILOCATMStVFMCLESI ID(CLUMONSADUM 8Y MMRT I SPECIAL j�r—gMSMz
RE: Tyler Residence 1149 Osgood Street North Andover
glectrician --Steve cote
CERTIFICATE HOLDER CANCELLAInON
bTOR-MAN $HOULO ANY 6E THE ABOVE 0MCMIMM POLICIES nV CANCFLLED GUMIRE THE EXPIRATION
DATE TREWOF_THE ISSUING IMUREP WILL ENDEAVOR TO rAAIL LAYS VMTTEN
Town of NorthAndover NOTICE TO THE CERTIFICATE RDLDFR HAMM TOIHE LEFT.BUT FAILURE TO DO SO SIJALL
Building Inspector
Main Street IMPOSE NO OMMATIUM OR LukmLrrr'OF ANY Kt THE SHS ITS Aoe�rTs OR
Worth Andover MA 01845 REPRF-3ENTATTWEE.
AUTHORIZE0 REPRESENTATIVE
Lawrence J. Hall
ACORD 25(2001188) JDA40RD/cORPORATIONi-PaS
JLYN 19,2.0{07 10:07 9789757596 Page 2
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TORRISSI CONSTRUCTION INC.
110 HAVERHILL RD#364
AMESBURY, MA 01913
978-388-6180
March 29,2007 C/S 066961
HIC 127852
Tyler
1149 Osgood St
North Andover MA
978-682-9502
Proposal for Interior Renovations to Match Plans Provided by Homeowner
#41
Scope of Work
Demo
• Contractor will remove all interior Partitions as needed for build out
• Contractor will remove framing needed to install Stairs to Attic
• Contractor will remove framing to needed to install Exterior Doors
• Contractor will remove tile on walls and Floor of Bathroom
• Contractor will remove Plumbing fixtures and Supplies where necessary
• Contractor will remove Electrical needed for build out
Framing
• Contractor will Supply and Install 2"x4"Framing for all new Partition Walls
• Contractor will Supply and Install Headers to meet Code for new Exterior Doors
• Contractor will Supply and InstallBeam to Carry the Ceiling Joist in the
Bedroom T-""
• Note one of the windows in the Bedroom will be Blocked off from the inside but
will look the sarpe on the outside
• Contractor will Supply and Install Stairway to Attic from Dining Room
Doors
• Contractor will Supply and Install one Therma-Tru Smooth Star Fiberglass
Hinged Patio Door(Please see Sample from Contractor)this door will be Installed
in the Master bedroom
• Contractor will Supply and Install one Therma-Tru Smooth Start Fiberglass 9
Light Passage Door(Please see Sample from Contractor)this door will be
Installed in the Back Porch to Patio
• Contractor will Blend in Siding and around new doors
Heating
• Contractor will Relocate Heating where necessary for Renovation
1
Plumbing
• Existing Tube upit will Remain and be-used in new Bathroom
• Contractor will Install Homeowner Supplied Shower Valve (Note if Homeowner
Picks a Shower Valve that Requires a hire Volume of water Pressure there may be
a Extra Cost to Homeowner to Change Supply line Pipe Size)
• Contractor will Install Homeowner Supplied Toilet(Note it will be the one that
was Removed during Demo)
• Contractor will Install Homeowner Supplied Bathroom Sinks and Faucets
r
Electrical/Lighting
• Contractor will Install Receptacles-to-meet Code in Bedroom and Bathroom
• Contractor will Install Homeowner Supplied Light in Closet
• Contractor will install Homeowner Supplied Ceiling Fan Combo's in Bedroom
• Contractor will Re-Install Homeowner Supplied Bathroom Light
• Contractor will Supply and Install Exhaust fan in Bathroom(Note Fan will be
Vented to the Exterior of the-House)
Insulation
• Contractor will Supply and Install Fiberglass Insulation to meet Code in Ceiling
and Walls
Sheetrock
• Contractor will Install %2"Sheetrock-on-Ceiling and Wails
• Contractor will Finish Sheetrock to a Smooth Paint Ready Surface
Finish Trim/Doors
• Contractor will Supply and Install Trim around Doors and Windows to Match
Existing in House
• Contractor will Supply and Install Baseboard to Match Existing in House
• Contractor will Supply and Install Interior Doors(Please See Contractors
Samples)
Painting
• Contractor Prime all Ceilings, Walls and Trim in Effected Areas
• Contractor will Paint Ceilings with two Coats of White Ceiling Paint
• Contractor will Paint Walls with two Coats of Eggshell wall Paint
• Contractor will Paint Trim and Doors with two Coats of Semi Gloss Trim Paint
• Note all Colors will be Picked-by Homeowner and will be Ben Moor Paint
Flooring
• Contractor will Patch Hardwood Flooring in the Bedroom where the walls where
Removed
• Contractor will Re-Finish Hardwood Flooring in Bedroom(note the Colors of the
Hardwood flooring may not Match Exactly)
2
( Tile
l a Contractor Nv711 Install Homeowner Supplied Tile and Grout on the Floor of the
Bathroom
a Contractor will Install Homeowner Supplied Tile and Grout the Walls of the
Bathroom in the Shower Stall area and four foot up from the Floor in the Rest of
the Bathroom
Cabinet
s Contractor-*will Install Homeowner Supplied Vanity in the Bathroom
Debris
® Contractor Avill Remove all Debris from Site
Permit
e Contractor will be Responsible for all Permits
Total Cast of Renovation$32,129.76
With Payments as Follows
1'`Payment of$5,000.00 at Signing
2"d Payment of$5,000.00 at Start of Demo
3`a Payment of 5,000.00 at Start of Framing
4`h Payment of$3,500.00 at Start of Plumbing
5'h Payment of 53,500.00 at Start of Electrical
6'h Payment of$2.000.00 at Start of Sheetrock
7`h Payment of 52,000.00 at Start of Flooring
8`h Payment of$2,000.00 at Start of Tile
9`h Payment of$2,000.00 at Start of Painting ,
10`h Payment of$2,129.76 at Completion of Renovation
ontractorsSignature Date
!L
Homeowners Signature _ Date /
C��, �-dr,- Rry /l� f>
Homeowners Signature ate
6