HomeMy WebLinkAboutBuilding Permit #443-2017 - 15 WALNUT AVENUE 10/25/2016 BUILDING PERMITNORTF�
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TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION ~
�-7 AAn e
"Permit No#:
Z' Date Received 74A�RA7E0.PP`�5*
� gSSACHU`���
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION ,50.1V���' �1IQ
Print
PROPERTY OWNER �CW
Print 100 Year Structure yesn0
MAP _PARCEL: ZONING DISTRICT: Historic District yes nc
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 ❑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: Aary k�naPhone:
Address:
Contractor Name: 1F/4 / AePhone: 97f ?`f'r SSS-1
Email' /L G
Address: ry Q ,��Ce ,� �drt/A-c/ �(1v,�7' �ti/��,/ 4d4= e/ttr S` -'
Supervisor's Construction License: (!S7j 9° '7 Exp. Date: 69/,/29/ _ Grp
Home Improvement License: % op Exp. Date: IQZZSV2017
3
ARCHITECT/ENGINEER Phone: '
�a
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: $ 71 k mpi FEE: $ 9�z
Check No.: Z43e Receipt No.:-7 /
NOTE: Persons'contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contracto ,
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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
t
I
I
CONSERVATION Reviewed on Signature
0
COMMENTS
i
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
i Planning Board Decision Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
ated 384 Osgood Street
FIRE DEPARTMENT -Temp. DumpSter on site. yes.__ no
_ n
Located at 12.4:Main Street; -
Fire Department signature/date
COMMENTS
I
Dimension
f
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 Call Email
Date Time Contact Name
Doe.Building Permit Revised 2014
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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 9
❑ 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 i
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
o 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_ f z lyd t o'y 1 1
No. 17 3 '-Zel' z— f- + ` Date
• - TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee
Foundation Permit Fee $
' Other Permit Fee $
TOTAL $
Check#
�` Building Inspector l/
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
71 X000.00 m
$ - $ 852.00
Plumbing Fee $ 106.50
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 106.50
Total fees collected $ 1,165.00
15 Walnut Avenue
443-2017 on 10/25/2016
Second floor remodel wo bedrooms
tAORTH
Town Of s n dover
0
No.
% **h ver, Mass, /92 ZS "Ag
COCHICMIWKK y1.
A°RArEc) ►Pa,��(y
S U
BOARD OF HEALTH
Food/Kitchen
PERMIT _T LD Septic System
THIS CERTIFIES THAT ........a." 14114G i0 BUILDING INSPECTOR
......... .......... ...... .................:................................
��,,.. ..r.....0. Foundation
has permission to erect .......................... buildings on ...... �ll�r ........
Rough
to be occupied as s,�C.O�!! ..,�F ...illl!�I�a�..,.4-� T7r7; AM �� Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the a lication Final
on file in this office, and to the provisions of the Codes and By-Laws re-ting to the Inspection, Alteration and
Construction of Buildings in the Town of North Andover. /Ir Ir • PLUMBING INSPECTOR
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR.
UNLESS CONSTR TIONS S Rough
Service
. .. ...... . .. . .. ...........
Final
BUILDING INSPECTO
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.
Frame 2 Finish Construction Services
49 Parker st.
North Andover, MA 01845
Jamaalframe2finish@me.com
ESTIMATE
ADDRESS ESTIMATE# 1022
Mary Kenny DATE 10/17/2016
15 walnut ave j
North Andover, Ma 01845
ACTIVITY QTY RATE AMOUNT
bathroom remodel 1 0.00 0.00
Complete gut re-design, and re-construct all material and labor
included, with the exception of tile, fixtures,and granite.
Miscellaneous Framing 1 0.00 0.00
additional rough framing outside of plan detail.
Blue board and plaster 1 0.00 0.00
Insulation 1 0.00 0.00
Install all applicable insulation to meet and satisfy required areas.
Finish work 1 0.00 0.00
Installation of finish trim moldings
Electrical 1 0.00 0.00
All electrical services needed
Window replacement 1 71,000.00 71,000.00
Replace windows that were Broken due to fire
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------
TOTAL $71 p000.00
Ac ed By Accepted Date
t, '0L� `� I'.ilSlCrJI:�{�)llSt111ICnt Company, �i1C. ---�!'
649 North Main St.
P.O.Box 446
Brockton,MA 0230,
(50804-2343
Inss C�casterE�ad jiti naon(.cunt
Recap by Category with Depreciation
O&P Items RCV Deprec. ACV
APPLIANCES - -229.2.6 45.85 -- 183.41
CARI T,TRY 3,350.32 676.05 2,704.27
C'LEAN'ING J,013.39 1,013.89
GENERAL DEMOLITION 11,401.6.1. 11,401.61
DOORS 2,750.00 550.02 2,199.98
DRYWALL 2,172.92 434.59 1,738.33
ELECTRICAL 3,313.44 551.09 2.762.35
FLOOR COVL:RING -(.;AIZPC'I' 202.00 40.40 161.60
FLOOR COVERING -CERAMIC TILE 2,272.41 2,272.41
FLOOR COVI.RIN(;-VINW, 1,090.1.8 65.06 1,025.12
FLOOR COVERING - 1VOOD 5,21.3.05 616.03 4,597.02
PERMITS AND F.EEE 1.00 1.00
FINISH CARPENTRY/TRBIWORK 2,047.09 399.12 1,647.97
FRAIMM; & ROUGH CARPENTRY 1,083.$2 1.1183.112
IIEAT. VENT&AIR CONDITIONI)\G 612.84 122.58 490.26
1 MS tJ,LA TJ ON 2,377.85 319.21 2,058.64
LIGHT F IXTU R P;.S 126.71 126.71
INTERIOR LATH & PLASTF,R 71567.76 542.20 7,025.56
YI,I)14I3IN(', 3,849.26 746.63 3,102.63
PANEI.,ING & 1VOOD 1VALI,FINISHES 2,583.5=1 383.97 2,199.57
PAINTIM; 9,097.55 1,108.29 8,859.26
SIMNC 450.00 450.00
TENNIPORARI' RI"PAIRS 350.08 380.08
WIND0kV'.I'R F;ATM ENT 94$.93 1.70.311 775.63
WfNDOWS- VINYL, 1,253.76 250.76 1,003.00
O&J' Items Subtotal 66,319.27 7,022.15 --- 59,297.12
Overhead 6,632.05 702.34 5,929.7).
Profit 6,632.05 702.34 5,929.71
Material Sales Tar 1,346.37 170.23 1,176.14
Total 80,929.74 8,597.06 72,332.68
RICIIARD_TVIOUNTAIN 6./20/2016 PaRe: 29
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Hallway
Right Bedroom
Master Bedroom
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R1CCI-IARD_NIOUNT'AIN 6120%2016 Page: 33
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RICIIARD—MOUNITAIN 6/20/2016 P: e: 3 3
' The Commonwealth of Massachusetts
usetts
Uig"
Department of Fire Services
Office of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775
�
610! PER�VIIT Date:/,.e
Permit No
(City of Town) (If Applicable} Dig Safe Number
In accordance with the provisions of MG.L. Chapter 10 as provided in section 5 2 7 OR 34
This Permit is granted to: �/��� ) X'X C- Start Date
Full name of person,Firm or Corporation
Permissionto locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 25 ' from structure or covered with tarp or plywood
Restrictions: at end of// workday
atdT S✓�E f
(Give location by street and no.,or describe in such manner as to provied adequate identification of location)
Fee Paid
_ ture(of offcal ganng pemut) COfica3anting permit
(Title)This Permit will expire Signa
��' TNLC taf=RMIT hill LCTRF ["_C)IV�PI('_I i[ll!CI if Pl'1CT�l� l Ipt'1Rt TNF PR!~Mf_Ci=C '��
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
h
Boston, Massachusetts 02116
Home Improvement Contractor Registration
=— Registration: 183487
Type: Individual
Expiration: 10/20/2017 Tr# 271487
MATTHEW RAE
MATTHEW RAE
39 RICHARDSON AVE.
NORTH ANDOVER, MA 01845
{ Update Address and return card.Mark reason for change.
Address [] Renewal F-� Employment Lost Card
SCA 1 0 20M-05/11
C'/�� L6Ilt)![QIltCCC[lt1[ p�C'/t�C[JJr!('�[[Jelf License or registration valid for indi�vidul use only
Office of Consumer Affairs&Business Regulation g y
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
3 Registration. 183487 Type: Office of Consumer Affairs and Business Regulation
Expiration. ..11 124/2017 Individual 10 Park Plaza-Suite 5170
= Boston,MA 02116
MATTHEW RAE
MATTHEW RAE
39 RICHARDSON AVE: _.._t: ,_,.,•;: .;_
NORTH ANDOVER,MA 01845 Undersecretary Not valid without signature
I
L
ACORDT. CERTIFICATE OF LIABILITY INSURANCE 10/1/2o 6
PRODUCER (978) 745-6464 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Rose Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
66 Loring Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 958
Salem MA 01970- INSURERS AFFORDING COVERAGE NAIL#
INSURED INSURERA:COMMERCE INSURANCE. COMPAN
Rae, Matthew INSURER B:Guard
39 Richardson Avenue INSURER C:
INSURER D:
North Andover MA 01845- 1 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 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.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION
tNSR ADIYL LIMITS
LTR MSRD .TYPE OF IN SURANCE POLICY NUMBER DATE(MMIDD/YY QATE(MMlDD1YY)
A GENERAL LIABILITY BGWXTK 05/21/2016 05/21/2017 EACH OCCURRENCE $ 1000000
COMMERCIAL GENERAL LIABILTTY DAMAGE TO RENTED $0000
PREMISES ra occurrence S
CLAIMS MADE ❑OCCUR / / J / MED EXP(Any One Person) $ 5000
PERSONAL&ADV INJURY S 500000
GENERAL AGGREGATE 6 2000000
GEtdL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 5 1000000
POLICY F-12-MOTLI LOC / I / I >ialvaTD
AUTOMOBILE LIABILITY / I / I COMBINED SINGLE LIMIT
(Ea acciderri) S
ANY AUTO
ALL OWNED AUTOS I / / I BODILY INJURY S
(Per Person)
SCHEDULED AUTOS
HIRED AUTOS I / BODILY INJURY S
(Per accdent)
NON-OWNED AUTOS
PROPERTY DAMAGE S
(Per aocdern)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
ANY AUTO I / / / OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCESMMBRELLA LIABILITY I / I / EACH OCCURRENCE S
OCCUR FICLAIMSMADE AGGREGATE S _
S
DEDUCTIBLE
S
RETENTION S H-
B WORKERS COMPENSATION AND R2iiC740161
05/21/2016 05/21/2017 X TOR LIMITS ER
EMPLOYERS LIABILITYE.L.EACH ACCIDENT $ 100000
i
ANY PROPRIETORIPARTNER/EXECUTIVE 100000
OFFICERIMEMBER EXCLUDED? / / I I E.L.DISEASE-EA EMPLOYE 5
It yes,desatbe under EL DISEASE-POLICY LIMIT $ 500000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPF32ATIONSILOCATIOHSMiIJICLESIEXCLUSIONS AODED BY ENDORSEMENTISPECtAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
\ EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT
14ary Kenney FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
15 Waknut Avenue MSURER,ITS AGENTS OR REPRESENTATNES.
North Andovek, MA AUTHOI�r`r-J EPRESENTATR+E
�-lM
AGORA o ACORD CORPORATION 1988
26
Page 1 of 2
INS026(olm)m
�.unsu ua.uvn�u Ncr vrsur
Restricted to:
Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of enclosed
space.
Failure to possess a current edition of the Massachusetts.
State Building Code is cause for revocation of this license.
DPS Licensing information visit: WWW.MASS.GOV/DPS
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massacnusetis Liepartment or i'uolfc Satety
Board of Building Regulations and Standards
License: CS-108937 .
Construction Supervisor
MATTHEW RAE, '
39 RICHARDSON AVEWUE 4
1 NORTH ANDOVER MA 01846
E,xpiration: .
Commissioner 0112912019"
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