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HomeMy WebLinkAboutBuilding Permit #034-2017 - 128 DALE STREET 7/12/2016 w rf -. of - oTh A -� 1 BUILDING PERMIT 3? b°`:+_ X741 � TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION Permit NO: " —Z✓"17 Date:Received Date Issued: �9SSacHus IMPORTANT:Applicant must complete all items on this page LOCATION 12--ff �� �Pcc l Print PROPERTY OWNER Mq-5 tie ( �� Print MAP NO: PARCELZONING DISTRICT: Historic District yes o Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial IWAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer �P int o uv�I e �• I G f�a.,( �- ��.I.�c� � t�cc� C'c..�<hl,c.l S Ce .�V.,T� a f�. S3�.c,C<S�f�(,�- - wo%1 hoe up(L�(-- -r-b "'r'7(4A- r ` Identification Please Type or Print Clearly) OWNER: Name: Sieve �-(. so�..� Phone: 1?T9-6a ( - 7`'&3 Address: 1-a4f ",b A`e- ���e e� ►' ��e� TIS A-IN, El CONTRACTOR Nameq-7r�Phone: -3 6.o -ter ao a av e, �e,1,��n Address: ,i+ (41711' Supervisor's Construction License: Exp. Date: 2,33 -1-01Y12-o/7- Home Improvement License: Exp. Date: / 2 of 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: $ 3�� O FEE: $ '3 Check No.: $'7—5/ Receipt No.: NOTE: Persons contracting ' unregistered contractors do not have ace s to a iy a Signature of Agent/Owner� ASignature of contractor No - T. srs'•^�. -rte__ r' - .- ; _ E 1s r Location No. �3 1�t —�C3,� Date A • - TOWN OF NORTH ANDOVER • i, , Certificate of Occupancy $ Building/Frame Permit Fee $3 Foundation Permit Fee $ Other Permit fee $ TOTAL $ Check# ?� 30605 Building Inspector 1 J Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ I l THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes i Planning Board Decision: Comments Conservation Decision: Comments Wafter& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street ,,FIREDEPAR�TMEMT TenipDumpster, o_ nsite , es�_ rt - �tLo`cate""diat',1�24 IVlai f Y �n0. 1 nlSt"[eet J! EFire{D;epartrrientsgnature/date; C®MMENTS_ _ '__ Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, wast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes leo MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department cruse) ® Notified for pickup Call Email Date Time Contact Name = Doc.Building Permit Revised 2014 1 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 4- Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) 4, Mass check Energy Compliance Report (If Applicable) 4. Engineering Affidavits for Engineered products OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit Iia 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 m ust be submitted with the building application Doe:Building Permit Revised 2014 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 319380.00 m $ - $ 376.56 Plumbing Fee $ 47.07 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 47.07 Total fees collected $ 570.70 128 Dale Street 034-2017 on 7/12/2016 Kitchen Remodel NORTh BUILDING PERMITO�' TOWN OF NORTH ANDOVER a 6 APPLICATION FOR PLAN EXAMINATION '` - Permit NO: Date ReceivedAre- OO �` �9SSACNU5�� Date Issued: IMPORTANT: App licant must complete all items on this page LOCATION f?JrR l� �,PGG l Print PROPERTY OWNER �L CLW sa�.l Print MAP NO: 037 PARCEL ZONING DISTRICT: Historic District yes o Machine Shop Village yes o 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 ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑ Water/Sewer I! `� :QvxioL-;•�Ie' P\ !ttc`� 71:-1Z1P � � iC� eca. I 6 �o J .�'e.� T. Y�c,�v:sPlc45�t' Identification Please Type or Print Clearly) OWNER: Name: ��"e.�e �-( SO,..t Phone: q'lV-6 l' ?K6 3 Address: 1—ail, 'J A e. CONTRACTOR Name. 7i�' Phone: 3(,-.D -4ao Address: ®tL�Si- iLf Supervisor's Construction License: Exp. Date: 233 Home Improvement License: _ Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED DOON$125.00 PER S.F. Total Project Cost: $ 3t 3 FEE: $ C✓- Check No.: ;'�- / Receipt No:: NOTE: Persons contracting unregistered contractors do not have a c c s to t e Signature of Agent/Ownere Signature of contractor r � - NORT#i _ w. .. . . c . . ve" '*. o DN- 2ad7Za oh , ver, Mass, �a .2 .Q coc MICt41WICK 1• �•9 poOATeo S U BOARD OF HEALTH Food/Kitchen PERMIT L D Septic System eol THIS CERTIFIES THAT ......... Y` .. BUILDING INSPECTOR .. ... ......... ..... ......... .... 1� C� .... ......' Foundation has permission to erect . ........................ buildings on ......... .... ....�. .. �..�....... .. s Rough tobe occupied as ........... .�... .. F ....1t...1W JA......................................................... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR TION Rough Service "' Final ZBUILDI SPEC OR 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. y . . . 56 Pleasant Street Methuen, MA 01844 Phone/Fax: 978-688-3944 Company Email Dave@DavidReitanoRemodel.Com Proposal Date: 07/3/2016 Revised 7/6/2016 Submitted To: Mr. and Mrs. Mason 128 Street � at C. N. Andover Ma. Home: Work: Mobile 978-621-7863 E-mail - smason-5@yahoo.com Job Description: Kitchen renovation i We hearby submit specifications and estimates for : Removal of existing kitchen cabinets, counters , flooring, soffit above cabinets and partial sheetrock removal from walls cabinets are being replaced ,exact amount will be determined during demo. Wall separating dining room and new kitchen space will be removed , Half wall will be constructed to accommodate new pensilula New kitchen lay-out plan as approved by owner thru American Cabinet. Electric will be updated to meet Ma. Code requirements including new devices and switches , proper wiring for appliances , 5 recessed lights , 2 pendant lights(pendant fixtures supplied by owner. Appliances supplied by owner. Plumbing includes re-routing sink drain , install new water supply, drain and shut off for Dishwasher , new shut offs for sink area , water supply for fridge , proper disposal connection to meet code. New fiberglass insulation will be installed where disturbed. All walls disturbed during construction will be repaired and blended into original surface including half wall , ceiling in kitchen area will be prepared to receive a skim coat of plaster with a swirl finish , pattern match between dining room and new kitchen space will differ in appearance. Prior to cabinet installation original flooring will be secured with screws in preparation for new % " bamboo material , allowance outlined below . Cabinets will be installed as shown on plan including mouldings and counter tops. Counter top installed by independent company , coordinated by contractor , counter top and cabinet materials supplied by owner. New window trim will be installed to compliment original including baseboard where disturbed during construction. Tile backsplash will be installed as discussed , material allowance outlined below. All walls ,ceiling and some trim in new kitchen will painted and primed were needed including paint materials. All debris will be removed from job-site. Following material allowances are included in overall price Bamboo flooring - $1100.00 Faucet $240.00 tile backsplash -$220.00 Above total price including materials $16.005.00 Above price does not include cabinets, counter tops , and appliances . Phase 2 - remove front living room window complete , install a new Harvey vinyl class 30 degree bay window including double hung flankers with picture window center sash . Exterior includes constructing a roof system properly flashed into existing siding , lower section will be insulation with a flat bottom and knee brackets if required. Interior head and seat board will be birch veneer including trim to compliment main house. All window paint, urethane etc. supplied by owner . Above window total $5375.00 i i *Contractor is responsible for allowances mentioned,anything that exceeds these allowances - Homeowner is responsible for. *Please review this proposal carefully for any items which may be missing. Contractor is not responsible for items not mentioned here. *Please do not hesitate to contact us if you have any questions. I Thank you for considering us for this project - David Reitano David Reitano Workmanship Completely Guaranteed i Granite WC Insurance - policy - DAWC666760 expires 08/06/2016 Paychex Insurance Liability- policy - DABP613505 12/01/2016 Construction supervisor license CS23365 expires 12/04/2017 Home Improvement contractor license 108782 expires 08/25/2016 (Please sign and return one copy) Signature: _ _ rpt_____ Date: Signature: ------------------------ Date: ------------ Customer: Perimeter Cabinets: Island Cabinets. Counters: Steve&Debbie Mason Kraftmaid Vantage(APC) Eclipse Cambria-Berwyn 128 Date Street Grandview Maple Square Full Overlay Square Flat Panel Select Poplar 3/8 Radius Edge North Andover,MA 01845 Finish: Canvas Slab Drawer Front No Backsplash 978-621-7863 #100 Edge Parts: All Plywood Construction Sink: Deliver to: I -V54SH(valance over sink) 314 Hdwd Dovetail DniviBlumotion FE IUM Guide Blanco ff-440176 Above address 2-DREPI 1/2.84(cut depth back to cover fridge box,based on fridge specs) Finish: Healherstone Finish: Biscuit 2-BF3 Installer: 2-INF3.30 Parts: Customer's installer 5-V96C(top molding step 1) 1 1/4"FPL I -LCVMI I ONG(top molding step 2,on sink wall) 1 TUK Ceiling Height, 89" 3-LCVM8.NG(top molding step 2,over remainder of wall cabinets) 1 -3,140SC-S' 2-1/w,r9<8 1 TK 1 -sh/la 1 -WSK2484 48" 5141, so 146 12430BUTT W2730WF3.30 0 DISHW24 B61182484RADXROT L= M 8836BUTT.W Cl) > Important r,iot,-tc)installer. Please reserve LCVfV110 for this run of top molding. 21 DO ,J7 01 .......... W_ 7 3 0 6 < LO to t!i C)71 —1/4"FPL — co NP C0 N SIT CCi 00 113 All dimensions-size designations This is an original design and must Designed: 5/17/2016 given are subject to verification on not be released or copied unless Printed: 5/23/2016 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. Mason 12813ale N.Andover—Ver4 No Scale. The Commonwealth of Massachusetts --- - Department of.Industrial Accidents j � Office of Investigations 600 Washington Street Boston AL4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �IAye_ a ( tQ cn() e eta�fi� -!��✓oy� Address: 15 �_ City/State/Zip: m,7,-z4,,,,, pq 4- d-tky J( Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.[5�4 am a employer with 4. ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.F] 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 box#1 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 thepolicy and job site information. Insurance Company Name: C_ o Policy#or Self-ins.Lic.#: O Expiration Date: b�! Job Site Address: )Z W 1 e .S i d"•v ZCity/State/Zip: �'l�, �., o� 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 insurance coverage verification. Ido hereby tWfy u er the pties of perjury that the information provided above is true and correct. Signature: Date: Phone#: f 7 f'3c o 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#: 1 DAVEREI-01 MINEDI CERTIFICATE OF LIABILITY INSURANCE °"8r5rzo020'rYY"' 15 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(les)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 CONTACT NAME: Granite Professional Insurance Brokerage,Inc. PHONE Fax 6600 Koll Center Parkway#100 Arc .(925)462-8400 No:(925)462-8888 Pleasanton,CA 94566 ADDRESS:lnfo@graniteins.com INSURERS AFFORDING COVERAGE NAIL d INSURER A-.NorGuard Insurance Company INSURED INSURERB: Dave Reltano DBA Dave Reitan INSURER c: Remodeling&Building 56 Pleasant Street INSURER D: Methuen,MA 01844 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 CONTRACTOR 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 AWL BR POLICY EFF POLYEXP LTR TYPE OF INSURANCE SDD POLICYNUMBER MIDD MWD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE FIOCCUR PREMISESEaowar�nce $ MED EXP(Any ane parson) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D JECT n LOC PRODUCTS-COMPIOP AGG $ OTHER $ AUTOMOBILE LIABILITY COMB*RSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY AUTOS AUTOS (Per aogdsnl) $ NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Perartidard $ UMBRELLA LIAR HOrCUR EACH OCCURRENCE $ EXCESS LIAB CLAI S44ADE AGGREGATE $ DED RETENTION$ 1 1 $ WORKERS COMPENSATION PER 07}F AND EMPLOYERS'LIABILITY YIN X ST TUTS ER A ANY PROPRIETORIFARTNERIEXECUINE ❑NIA AWC666760 08/06/2015 0810612016 ELEACHACCIDENT $ 5001000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) EL DISEASE-EA EMPLOYEd 500,00 Ryes desenTmunder DESCRIPTION OF OPERATIONS below F I DISEASE-POLICY LIMIT $ 50010 d, k 4 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION \ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 'j� ® l !• �� !� J THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN � ACCORDANCE WITH THE POLICY PROVISIONS. ✓J AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD s Massachusetts Department of Public Safety ro� Board of Building Regulations and Standards License: CS-023365 Construction Supervisor DAVID REITANO 56 PLEASANT STREET METHUEN MA 01844 I Expiration: Commissioner 12/04/2017 u zccza,/f/ �\ iflltcQ Canso. Type: tion: 8/25116 r Private Cr _ DAVIL REITANO' ;ENrtiiu'L BUcC David Reitano 56 Pleasant St Methuen, MA 01844 Undersecreta,y � I