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Home My WebLink AboutBuilding Permit #826-14 - 148 MAIN STREET 5/21/2014 Cf NOFI a oT a qti BUILDING PERMIT 3? ,.,; _. o` TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION - Permit N0: � -� Date Received � °�.,q Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION i l n S7, arAn 20/-y- � 0 cM� S '` Print — PROPER OWNER S d z�0 tit. t°1 r-'07-e r Print MAP NO:0 PARCEL: ZONING DISTRICT:—Historic District yes n Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition /Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial "epair, replacement ❑Assessory Bldg ❑ Others: I ❑ Demolition ❑ Other ❑ Septic ❑Well ❑Floodplain D Wetlands ❑ Watershed District ►'Water/Sewer r��`pIr,GC. 71�G 111 S l�'�L✓�� V"ke., I/Ci e., � , ISa 0" V Il l J -file, de. l/�ar orh J �J� WtI 111 Identification Please Type or Print Clearly) OWNER: Name: ,�t/Z�1/�/Jie krg/�.e,,- Phone: Address: X07 CONTRACTOR Name: Phone: Address: Supervisor's Construction Licen + Exp. Date: 51,5' Home Improvement License: Exp Date: ARCH C TECT/ENGINEER Phone: _ Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00PER$1000.00 OF THE TOTAL ESTIMATEiD COST BASED ON$125.00 PER S.F. Total Project Cost: $ �y 6 FEE: $ 4 6Z W Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund i nature of Agent/Owner Signature of contracto xr TOWN OF NORTH ANDOVER .. APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION. Print. PROPERTY OWNER Print 100 Year Old Structure yes no MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 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 0 Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: 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 ON$125.00 PER S.F. v � Total Project Cost: $ FEE: $ ._.. Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature Of 6gent/Owner Siglature of contractor Plans Submitted LJ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El Plans Submitted' ❑ `Plans Waived.❑_ Certified Plot Plan `.' Otamped Plans ❑ - .-TWE--,OF-.SEWERAGE-DISPOSAL-"-Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ ..Tobacco Sales ❑ Food Packaging/Sales ❑ Private-,(septic tank,etc._ v ❑ Permariei�t Dumpster ori Site -THE..FOL"'LOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE. REJECTED . DATE,APPROVER _ `PLANNING & DEVELOPMENT` ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & S.ewer Connection/Signature&.Date Driveway Permit DPW To`v;, Engineer: Signature: - Located 384 Osgood Street FIRE-DEPAPTME'AT: Temp Dumpster onsite yes '. no Ucate&at.124,Mair, Street Fire De16 tine►"it signature/date f COMMENTS ". - -:-Dim-ension i Number of Stories: Total square feet of floor area, based on Exterior dimensions._ .-Total land area, sq..ft. ELECTRICAL:-Movement of Meter locat on,'m`a' st-or service drop requires approval of Electrical Inspector Yes No DANGER.. ®NE LITERATURE: Yes No MGL-.Chapter 166.Section 21A.--F and G min.$100=$1000.fine i NOTE and DATA— For department use EI Notified for pickup - Date I i Doc.Building Permit Revised 2010 i Building Department The fol�wing is a list of the required forms to be filled ouffor:the appropriate permit to.be obtained. Roofivg, Siding, Interior Rehabilitation Permits U Btailding Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/O'r G.S.-L: Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks La Building Permit Application ❑ Certified Surveyed Plot Plan ❑ 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) ❑ 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 cans.if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apu,�al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Bui!ding Permit Revised 2012 Location No. O Date Z l • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $. �a ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 8,5'500.00 m $ - $ 102.00 Plumbing Fee $ 12.75 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 12.75 Total fees collected $ 227.50 148 Main Street Unit 207 Osgood Bldg. 826-14 on 5/21/2014 Bathroom Remodel F NR OTH a Town of E : 1., Andover No. al h ?, h ver, Mass, (A � o C0CN1Cnt W1C. *_ A�RATEO PPP��S S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT !!!.�.,..... r BUILDING INSPECTOR ........... haspermission to erect ... � G�N,Sr C '....... 1 Foundation p ....................... buildings on ................ .... .. ...... ............ 01 .` �,/� 0 Rough to be occupied as ........ . .......�.4I.!...!.........�.�ll.�l►.�..............................:................ 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION VARTS Rough Service .................. .. ...`: ^,,............................... Final BUILDING INSPECTOR 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. r. ACQ LJ2 � 05 CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY) �....-''= 05/115/20512014 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 01722-001 CONTACT Mike Roberts M P Roberts Insurance Agency FSC.No.Ext): (978)683-8073 Fk.No.: (978)683-3147 1060 Osgood Street EMAIL North Andover,MA 01845 ADDRESS: Paula@mprobertsinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: A.I.M.Mutual Insurance Company 26158 INSURED Michael Goodwin INSURER B: INSURER C: 7 Holt Road — - Epping,NH 03042 INSURER D, _ 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 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. ILTR TYPE OF INSURANCE AOR VA/D POLICY NUMBER MR'(j�j 99/o�Y/Y�n LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS-MADE OCCUR MED EXP(Any one person) $. - PERSONAL&ADV INJURY S - GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Y T OLICY ECT OC AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ yyp DrrEDgHENRY CCp RETpEN`TIION $ �yc S TU $ AND EMPSO ER t AtI oTY X TORY LIMITS OERH ANNy P ppPRR��EETppR/P R7NER/ExECUTIVE Y/N E.L.EACH ACCIDENT $ 500000,00 A 0WFICEWMEMBER IXCI.UDED? 7 N/A VWC-100-6015175-2014A 2/15/2014 2/15/2015 �({ManddIN I ION VnF Vattory In rN1H))fl� E.L.DISEASE-EA EMPLOYEE $ 500,000.00 DsCRPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space is required) CERTIFICATE HOLDER CANCELLATION Town Of North Andover 1600 Osgood Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE North Andover,MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE _ @ 1988-2050 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i. Massachusetts -Depar1menr of Public Safe,* Board or Building Regulations and Standards Construction Supervisor License: CS-081670 MICHAEL F GOO�DWIN 7 HOLT RD Epping PIH 03042 ' oinmissioner 08/08/2016 rJ/c��nur irrncrr/fl,c/.cell i.;:;ac/rc;c/(.i ,! -- --- --- --- -:.—_–_- . `,.N Office of Consumer Affairs&Busifiess Regulation License or registration valid for individul use only - .--=NOME IMPROVEMENT CO before the expiration date .�,_.__. . CONTRACTOR If found ,. return_ � p n to: INN istration 9 105029 Type: Office of Consumer Affairs and Business Regulation expiration: 7/162014 Individual 20 Park Plaza-Suite 5170 Boston,MA 02116 MICHAEL F.GOODWIN JR. Michael Goodwin Jr. 7 HOLT.RD. EPPING,NH 03042 Undersecretary Not valid without signature The Commonwealth o Massachusetts Print Form Department o f Industrial Accidents . t EE Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):MF Goodwin Co. Address:? Holt Rd. City/State/Zip:Epping MH 03042 Phone #:978-423-8463 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 3 4. ❑ I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' insurance.t 9. ❑ Building addition comp.[Na workers' comp. insurance P• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]if c. 152,§1(4),and we have no LN employees. o 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:AIM Mutual Ins Policy#or Self-ins.Lic.#:VWC 601517501 Expiration Date:2-15-14 Job Site Address: 5/ 07 �/ � City/State/Zip:R/yr�6�,d-c., 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. I do hereby cert under the pains and enalties are" 'u that theInformation provided above is true and correct Si ature: Date J a o y Phone#:978-423-8463 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 p Contact Person: Phone#• Proposal 130 Centre St. Pro p Box C-1 Danvers, Ma. 01923 978-423-8463 Suzanne Kramer 5/16/2014 148 Main St., Osgood Bldg, # 207 North Andover, Ma. Project Description Total This Proposal is for the following work. 8,500.00 Bathroom remodel Scope of work; We will apply for the proper town permits. The existing tub and tub walls will be removed. Our plumber will relocate and install a new shower valve to the right hand end of the tub. A new 5' tub and tub drain will be installed. A wall will be built on the left end of the tub, sheetrocked and open shelves installed. The walls above the tub area will be covered with Durock tile underlayment to prep for tiles. We will install tiles above the tub to a height of 5' above the tub rim. The bathroom floor will be tiled and grouted. A new vanity, sink, faucet, mirror, vanity light and toilet will be installed. The walls will be ready for paint. The hole in the closet will patched and ready for paint. Our electrician will run a new line from the panel to the whirlpool tub. A new vanity light and exhaust fan will be installed. Total Signature mfgoodwincompany@gmail.com Page 1 Mass.CSL #081670 Mass. HIC #105029 _ i Y Proposal 130 Centre St. Pro p Box C-1 Danvers, Ma. 01923 978-423-8463 Suzanne Kramer 5/16/2014 148 Main St., Osgood Bldg, # 207 North Andover, Ma. Project Description Total All rubbish will be removed from the premise. Town permit fees are additional and will be billed separately. The homeowners will provide the tub, shower valve, tub drain, toilet, vanity, sink, countertop, mirror,vanity light, tiles and grout. No painting is included. All tile work is based upon a single size tile for each area. Marble, mosaic, glass or decorative patterns may have an additional labor charge. An allowance of$1000.00 is given for the electrical work. All work will be completed in a workmanlike manner according to standard business practices. Any deviation from the above specifications involving additional work and/or materials will be an additional cost and will be executed upon written authorization. Total estimate: $ 8500.00 Total Signature mfgoodwincompany@gmail.com Page 2 Mass.CSL #081670 Mass. HIC #105029 Proposal osal 130 Centre St. I� Box C-1 Danvers, Ma. 01923 978-423-8463 Suzanne Kramer 5/16/2014 148 Main St., Osgood Bldg, # 207 North Andover, Ma. Project Description Total Payment schedule: A deposit of$2,850. 00 is due upon starting. A payment of.$ 2,850.00 is due upon starting the tile work. The balance of$,2,800.00 is due upon completion Acceptance of proposal: Contractor: / Date: Homeowner: Date: < This proposal may withdrawn by either party within 3 day of signing by either party. Total Signature mfgoodwincompany@gmail.com Page 3 Mass.CSL #081670 Mass. HIC #105029 Proposal 130 Centre St. Pro I� Box C-1 • � , Danvers, Ma. 01923 978-423-8463 Suzanne Kramer 5/16/2014 148 Main St., Osgood Bldg, # 207 North Andover, Ma. Project Description Total Total $8,500.00 Signature mfgoodwincompany@gmail.com Page 4 Mass.CSL #081670 Mass. HIC #105029