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HomeMy WebLinkAboutBuilding Permit #75 - 137 BAY STATE ROAD 7/31/2007 BUILDING PERMIT TOWN OF NORTH ANDOVER o A A APPLICATION FOR PLAN EXAMINATION X04 ,� • Permit NO: Date Received SS R, SAGHU`� Date Issued: -7 //0:7 P RTANT Applicant must complete all items on this page a3x A hl tt w15 '*�"� . a c^, TYPE OF IMPROVEMENT PROPOSED USE esidential Non- Residential ❑ New Building One family [I Addition Ll Two or more family Li Industrial Y1 Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg Others: ❑ Demolition ❑ Other y ;� s p mit tTM' "� � �,.. tl�.S y '€ �+� u - i.a' �a ;9` frYY +# ���,' a. �' '�" a a"zM� l 4 .._ �.,:, ... DESCRIPTION OF WORK TO BE PREFORMED: Identification Please.Type or Print Clearly) OWNER: Name: Q 44-1f(n P Phone: 7 Wm T`m ,�• -Ab }�ddFss .i i�'�.Y� S; � •v� z# `'~ d10,Sil ±a''',_ 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: $ / G . FEE: $ Check No.: /D / () Receipt No.: 02 SQL/ NOTE: Persons contracting with unregistered contractors do not have access to the aranty� d' Signature df Aget3t/Ov�ner �` �f 9�>�, � y� Slgnat�r�,of Contract 3� � =�=M .. . Location /1 t No. Date O NORTH TOWN OF NORTH ANDOVER f D Certificate of Occupancy $ b'••'° '<� Building/Frame Permit Fee $ 7sJuMUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r w 4 204 �t4 `wilding Inspector 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Si nature&Date Located at 384 Osgood Street Driveway Permit 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 a a ` ❑ Notified for pickup-- Dat-e ------ . Date Doc-Building Permit Revised 2007 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 ❑ 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 o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) V ❑ 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) o Building Permit Application o 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 TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal,demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: 2/rJ ��✓Uv1� Est. Cost 7,? Address of Work / 1254 te- Owner Name: Date of Permit Application:_ '7" I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. Job under$1,000 Date Building not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: 7-3 G 7 -5r�S6 Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name Jul •27. 2007-11 :58AM No-3268 P. 4 ACORD CERTIFICATE OF LIABILITY INSURANCE N„,c(MWDDNYYY) 07/27/2007 P oaucE (781)438-5000 FAX (781)438-$OZ8 THIS CERTIFICATE IS ISSUEDM A MATTER OF INFORMATION New England Heritage Insurance Agency Croup, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 335 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Stoneham, MA 02180 INSURERS AFFORDING COVERAGE NAIC# INSURED A & 3 Services Building Contractors INSURERA: National Grange Mutual 14788 �- lason Sabatino DBA INSURER B: P 0 BOX 931 INSURER C: Byfield, MA 01922 INSURER D: ........ ........ .. – INSURER E: COVERAGES 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 CCIATIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 10 ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 40 LTR NSR TYPE OF INSURANCE POU CY NUMBER POLICY 51W ECTIVE �_4P it IRAT LIMITS GENERALLIADILITY MP099983 02/03/2007 022r/r031/22008Y cACI'OCCURRENC,F L� 2 404,00COMMERCIAL GENERAL LIADILITY DAMAGE TU RE PREMISES Ea otcurer ce 500 40CLAIMS MADE �OCCUR MED EXP(Any one person) 10,00A PEkS6"L&ADV INJURY 000,00GENERAL AGGRFGATE 440,44 GEN'L AGGREGATL•LIMIT APPLIES PER: PRODUCTS-COMPIOP AOG S 2.000,000 POLICY J( %R LOC: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AIITO (Ea rfp;itlttnl) $ ALL OWNED AUTOS RODILY INJURY - SCHEDULED AUTOS (PIY Person) S mmw AUTOS BODILY INJURY $ NON-OWNED AW OS (Her ecoldent) . ._� PROPERTY DAMAGE S `.•. (Pcr avArinf) GARAGE LIABILITY AUTO ONLY-EA ACCIOFNT S ANY AUTO CA ACC S OTMCR THAN AUTO ONLY: AGG S EXCEWJUMBRELLA LIABILITY W14 OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE DEDUCTIBLE $ RETENTION S $ WORKERS COMPENSATION AND _ TORY LIMITS ER EMPLOYERS UABILRY ANY PROPRIFTOWPARTNFRrFXFCVrUE E.L.EACH ACCIDENT $ autCCRlMEMBER EXCLUDED? E.L.DISEASE•EA EMPLOYE. S If yIs.dewl)e under SPECIAL PROVISIONS Ucbw E.L.UISEASE-POLICY LIMIT S OTHER I� O N O I7N I A F9C l SEC arpentry Contractor - Subject to the Terms, Conditions, Endorsements and Exclusions of the policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of North Andover EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Attn• Building Dept -ft—DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 1600 Osgood Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Bldg 20, Suite 2-36 OF ANY KIND UPON THE INSURER.ITS AGENTS OR REPRESENTATIVES. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE T�f�Y William Kelly/RTW ACORD 25(2001/08) ©ACORD CORPORATION 1988 JUL 27,2007 11:59A page 4 Liberty Mutual Group Liberty P.O.Box 7202 Mutual® Portsmouth,NH 03802-7202 Telephone(800)653-7893 Fax(603)-431-5693 July 24,2007 TOWN OF NORTH ANDOVER 120 MAIN ST NORTH ANDOVER, MA 01845- ------ �- RE: Certificate of Workers Compensation Insurance Insured:=ALAN F SABATINO DBA A&J-SERVICES PO BOX 464 BYFIELD, MA 01922 Police Number: WC2-31S-219747-047 Effective: 7 /2/2007 Expiration: 7./2/2008 Coverage afforded under Workers Compensation Law of the following state(s): MA Eml2lo;ers Liabilitl,LLimits� Sole Proprietor/Partner Coverage Election: Bodily Injury By Accident: 5 100,000 Each Accident The workers'compensation policy does not provide Bodily Injury by Disease: 8 100,000 Each Person coverage for. Bodily 1njuty by Disease: $ 500,000 Policy Limits ALAN J SABATINO As of this date,the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Co under the policy listed above, The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions,and is not altered by any requirement,term or condition of any or other documents with respect to which this certificate may be issued. This certificate is issued as a matter of information only and confers no right upon you,the certificate holder. This certificate is not an insurance policy and does not amend, extend,or alter the coverage afforded by the policy listed above. If this-policy is cancelled before the stated::expiration date,Liberty Mutual will endeavor to notify you of such cancellation. � AUTHORIZED REPRESENT ATWE LIBERTY MUTUAL INSURANCE GROUP This Ceiiificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those companies. cc: Insured: Producer of Record: AT,AN F SABATINO DBA A&T SERVICES W GOCHTS INSURANCE AGENCY PO BOX 464 113 CAMBRIDGE STREET BYFIELD, NIA 01922 BURLLNGTON, MA 01803 7/24/2007 A &J Services Proposal Building Contractors PO Bt)x 931 gate Byfield,MA 01922 7,t312t1!)7 tele:978 465-1493 fax:978 463-0819 Customer Name and Address Joe Morino 4K.no 137 Baystate rd Noah Andover 01845 Terms:This contract is good for 30 days Description Total Remodel Lit floor bathroom as discussed bathroom wit(be gutted to studs.New electrical and plumbing 9,885.58 will he as needed for lighting,receptacle,andplumbing fixtures.New green board and drywall will be installed and prep for paint.Bottom half of walls will have mdf bead board installed and also two doors made out of bead board.All finish fixtures to supplied by customer and onsite for the start of the job.All labor in this price complete the bathroom. Install two basement windows 0.00 Move thermostat 0.00 Xi 2 Contractor signature Payments are to be made as follows: 1. First third of payment after signing of the contract 2. A third halfway through the project 3. Final payment due upon completion of the project. Acceptance of the contract:The above price; specification,and conditions are satisfactory and are hereby accepted. Customer signature _ � Looking forward to working with you on this project. Total $9,885.58 NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the,I�rovisioij of MGL c 40 S 54, a condition of Building Permit at: 3 � �T 6' -that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL C 11, S 150 A. Also, note Permits are required under Fire Prevention laws.-Chapter 148 Section I 0A. The debris will be disposed of in: e�JU1114 ' 6511 �e cis (Location of Faci ity) Signature of"Permit Applicant Fire Department Si off P � Dumpster Permit Date Bou a lon a c anar`"`�'s 11 HOME IMPROVEMENT CONTRACTOR Registratio rr:�,136095 Expiration 6!7/2008 T e fndEiuidual JASON A.SABATII`I&� JASON SABATINC ;r 23 FATHERLAND DRIVF BYFIELD,MA 01922 Deputy Administrator �`�� De fie�omwna�uaea / w-' " . BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR � Numbe -,CS 078729 r I ` Bi05127/1976 Tr.no: 23315 I � '1=xptrQsr 0512712©0 Restr�cteds. 00 r JASON A SABATINO . PO BOX 931 ,e.. I BYFIELD, MA 01922" Commissioner tAORTH Town of over 0 No. 0 dover, Mass., 7AZ -7 LAKE 7 COCHICHEWICK R-A T E D BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........4�70.f .............................................................................. ........ ............. ...... Foundation has permission to erect...... . . ................... Rough ............. bu.11dings on ou Chimney to be occupied as................ .c.. /1 ....................................................................................... 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ARTS Rough ............... Service BUILDING INSPI�� 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.