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HomeMy WebLinkAboutBuilding Permit #303-15 - 13 WALKER ROAD 9/25/2014 BUILDING PERMITopORTH qw. qt LED 16 'Y TOWN OF NORTH ANDOVER o� h� ' ` a, APPLICATION FOR PLAN EXAMINATION �O Q�q�reo V��I"J , , ,. 4( Permit No#: Date Received SSACHUS� Date Issued: 9�261111 IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER29&zrL Print 100 Year Structure yes �no� MAP Q� PARCEL:T ZONING DISTRICT: Historic District yes Machine Shop Village yes �Ro ), TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building )-(One family 11 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_ DESCRIPTION OF WORK TO BE PERFORMED: e`YtOc� �d�:�DaZrrr�tle�'t Identification- Please Type or Print Clearly OWNER: Name: f Phone: Vz?- �'71-�714 Address: Contractor Name:gjjg-&/?�'%khone: Address: /� - y QX' �/(/ �v" ✓� .�° r D.���'� Supervisor's Construction License: — � 1 � Exp. Date:��!-'�`` ' � Home Improvement License: /�-�-�- Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BAS D ON$125.00 PER S.F. Total Project Cost: $_71.2, O" FEE: $_4 dw- Check No.: /�� Receipt No.: NOTE: Persons contracting wit Zistercontractors do not have access to the g arantyfund Sinature of Agent/Owner - _ignature of contractor 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 Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNINGD & DEVELOPMENT ELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature 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 FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department Signature/date I COMMENTS 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 ❑ Notified for pickup Call Email I Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The followingis a list of the required forms to be filled out for theappropriate ermit to be obtained. q p 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/Cross Section/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 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 Doe:Building Permit Revised 2014 Location WcCk '—` 2 M T Ck, No. �u-� Date 112- • • TOWN OF NORTH ANDOVER Certificate of Occupancy $� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check,# Building Inspector NORTFi Town of A- I _n No. g h ver, Mass, O i .c! 1. COC NIG M!WICK S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT � i BUILDING INSPECTOR has permission to erect .......................... buildings on .... ... Ak .... .....�a T Foundation Rough AA to be occupied as ...rC.VAV g�"&#.......................................................................... 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 MON HS ELECTRICAL INSPECTOR UNLESS CONSTRU - I RTS Rough Service .......... ... .......................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. NOI TH SET RE BUILDING SERVICES LLC 1 'Westward Circle i North leading, MA 01864 1-500-564-4016 Deter Barbagal10 Licensed:CS-060141,TiIC-1555380,RRP Lead Certified PROPOSAL i September 21,2014 Mike Moore 13 Walker road 92 North Andover,MA 018045 We hereby submit specifications and estimate for: Moore Residence Remodeling SCOPE OF WORK: ea Demo—Lai7aged sbePtroci areas,bathroom r, oor and cast icon tub.Rei-trove Metal door frames and cased opening in hallway. * Electrical—Move plugs,switches and fixt•-tres per customers locations.Check all wiring- detectors plugs,p s and switches. Install new fight g g fixtures/ fans.All electrical to Massachusetts code.All fixtures to be supplied by owner. f9l 1'0 CP Pit-,:r-,-.biiig—ITiti%all iie"w fibergiass tuu-, slio� er varve,vapit3,, sink, lav faucet, toilet,exhaust fan/light, and recessed mirror.All plumbing to b -Massachusetts code. Contractor to supply fiberglass tub, all other fixtures to be supplied by owner. e Insulation—Exterior walls and ceilings per Massachusetts code. Blue board and.Plaster—Blue board and Blaster ceilings and.walls in.damaged areas.Moisture resistant blue board in bathroom. S Install J = Interior EioCirS trirz,v�G baseboard49 k boa .[— �ns�all eiraiseu�panel lzoliow core doorstrimed.with 2-1/2"colonial casing.All trim to be 2-.1/2"colonial casing. vy All baseboard to be 5-1/2"speed base.Install new front door to be as exists. Install: ='i she G-/v7-J- SP L!6-#r -t- 3,) Foo D/'"M Alr- �L,0 �7 o c"O- 1 ,14 11411yl-z-2 Painting—Apply two finish coats on ceilings,wails,trine,baseboard and doors. Bath room II'led shower—lfnStal l wall ti le in shower and vanity back splash. $3.00 per s.r. allowance for file material. -ro S-Op,O v -7-146-- Flooring 7-/L6--Flooring—install preiinished engineered flooring click lock system ux living room, kitchen,and hallway.$4.50.00 per s.l:allowance for flooring materials. Install tile in hath room, $ 3.00 per s.f allowance for the materials, ,'.nstall carpet in two other rooms, $25.00 per yard allowance for carnet,pad and installation. We propose hereby to fiirnish allmateriads lx except as noted below)and labor— complete in accordance with the above specifications, for the,stiiii or $ 18,900.00 Eienteen`Phousand bine Hundred Dollars *Customer to supply all piunibing and electrical fixtures,batliroorn vanity and top, bathroom mirror, and hath room accessories. A cna year limited warranty.All other warrantees are through the nianufact=..firer. 11 warrantees will be hull and void iflob is not paid in full.Thank you for lettrg Us serve YOU. Payment to be as follows: cii acceptance p proposal. 1. 1./1/3 �p � of 2. U33 Ripon completion of fming. 3. 1/3 uponcb J completion. Acceptance of proposal—T.,be above prices,specifications,and conditions are Satisfactory and hereby accepted.You are autho6zed to do the work as specified. Payment will be made as outlined above. �f �� 0 l�at� .._acceptance:_ 3 f iistOiiiei'v igflat'cii'e f oilfract Signatur A CERTIFICATE OF LIABILITY INSURANCE 9/25 2014 ) 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 CONTACT NAME: A & K Fowler Insurance PHONE . (978)664-0366 FAXAIC No (978)664-2209 200 Park St E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# North Reading MA 01864 INSURER AWestern World Insurance INSURED INSURER B Peter Barbagallo DBA INSURERC: North Shore Building Services INSURER D: P.O. BOX 663 INSURER E: North Reading MA 01864 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1463006076 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MWDD/YYYY) (MM/DDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE Fx_1 OCCUR NPP1375802 6/26/2014 6/26/2015 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X I POLICY PRO LOC1 1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STAT U- OTH- AND EMPLOYERS'LIABILITY Y/NTORY ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ D? OFFICER/MEMBER EXCLUDE ❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ' Insurance Verification CERTIFICATE HOLDER CANCELLATION mdeems@ townofnorthandover. 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. 120 Main St. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Nicole Orlanzo/NMO ACORD 25(2010105) ©1988-2010 ACORD CORP ORATION. All rights reserved. INS025 t9ninnm m Thu Ar f)Pr)name nnrl Innn mru runicfururl mnr4c of A&( r)Pr) The Commonwealth of Alassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 0211.1 www.mass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/I;lectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 11� City/State/Zip:A/ r /1n 41! /r�y Phone Are you an employer?Check the appropriate box: Type of project(required): I.❑ I am a employer with 4.,K I 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. $ �•,�Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp. insurance. g, ❑ 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 11.0 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' 13,0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ' 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. 1 ant an employer that is providing workers compensation instirdnee for my employees. Relow-is the policymrd-jVb-site'-- information. Insurance Company Name:, Policy# or Self-ins. Lic. ` L Expiration Date: Job Site Address: Z? Jl�� i" City/State/Zip: �7s 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. n ormation provided above is true and correct. hereby cerci under the pains and enalties o erjury that the r f p Ido Iter y jy P P lP Signature: Date: 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)- ]. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone#: Massachusetts -Department of Public Safety' �J Board of Building Regulations and Standards Construction Supervisor yr License: CS-0601493 PETER J BARBA(}► 25 CEDAR STAl N READING MA%0186 "''}` Expiration Commissioner 10/31/2014 Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Cdntrra. ctor Registration ,,.. Registration: 165538 Wt n Type: Corporation s Expiration: 311/2016 Tr# 248873 C.J. & B CONSTRUCTION CORP PETER BARBAGALLO ` 1 WESTWARD CIRCLE — NO.READING, MA 01864 r 5 j,,%•..,,•rf Jr;,t` Update Address and return card.Mark reason for change. Address (] Renewal ❑ Employment ❑ L+t ncatd SCA 1 Co 20M-05111 License or registration valid for individul use only office of Consumer Affairs&Business Reguiation before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR office of Consumer Affairs and Business Regulation gistration 165s38 Type: , - 10 Park Plaza-Suite 5170 xpiration 3f1f��Y18 Corporation Boston,MA 02116 C.J.&B CONSTRUCiDN COj�P PETER BARBAGALLO 1 WESTWARD CIRCLtr" NO.READING,MA 91864 Undersecretary Not valid without signature Unit 2 -301 S" --------9' 8 61---- 2' It Bedroom 2 Bathroom 00 Bedroom I F4 /rclos- 16' Hallway 131 5" ....................................-81 2f ... 19'411 Closet Fq 1-21 4"n Living Room Fn 20' Unit ',! MEADOW—VIEW—CONDOMIN 8/22/2014 Page:22