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Building Permit #621 - 1504 SALEM STREET 4/14/2010
BUILDING PERMIT o� NORTHqa ,fit,lO �.rc 46:.�,_ ,,..a..�6 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION s ,� �O •w .,,� Permit NO: Date Received a, ATlo �SSACHUS�� Date Issued: I PO ANT: Applicant must complete all items on this page LOCATION 1504 djjd6vw 04 Print _ PROPERTY OWNER .tr Print 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 L"' 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 PREFORMED: Identification Please Type or Print Clearly) j OWNER: Name: &!xr hara- S tc ae.[ Phone: !2 '78 a58 Pt$o Address: 15641 Su.LVQ 5'Ff�cc'tr NG. 171-A—.O V-ef" /f% r 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 t krBuilding Permit Application Ur'Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses- v`Copy of Contract b'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/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) r ❑ 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 r . 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 2.2008 I Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL j Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic.tank,etc.V Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH . t . Reviewed on Signature . COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes i I Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Si nature&Date D.riveway Permit DPW Town Engineer: Signature: a Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ti 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 4 r 4 h I i i ❑ Notified for pickup - Date .............--..........._....................__...................................................................---............_......_.—...__...--....- ....._._._-._...................................................................._..........._......_..........................-..-----.-----.............---.........---.---.-------------------------.......................... Doc.Building Permit Revised 2008 I Location No. G,2/ Date lL Q NORTH - TOWN OF NORTH ANDOVER 0 9 i a �a Certificate of Occupancy $ ;ass, HUs<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 7� 16 4 Building Inspector V10RT#q Town of 4Andover . No, - - A rt dover, Mass., A- C0CH1CKEWJCK y^' ORATED P' IL �C S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...........avl- w�....... 7..................................... Foundation has permission to erect........................................ buildings on ../r�,� .j`.. .� ..... 1 ...........................:...... Rough g to be occupied as..............................�� � �......:7.......�.. s:F!�....................................... Chimney 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 STARTS Rough s' =................................................... Service BUILDING INSPECTOR 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. , E-el►r o Ac C� s 1 ��7o) a)-,s-4 s Cb/ (S.4b) 1-7 ZA cam+ g a �@ os RDr -------------- J.L. WARD CONSTRUCTIOW DESIGN&REMODELING SOLUTIONS U k ****PROPOSAL**** 1 YEAR WARRANTY ON ALL WORKMANSHIP PROPOSAL SUBMITTED TO: PROPOSAL.03.26.10 Barbara Siegel Date: March 31, 2010 1504 Salem Street North Andover, Ma 01845 (978) 258- 8182 Page: 1 of 3 Dear Barbara We respectfully submit our proposal (# 03.26.10) for the interior renovations to your master bathroom and closet at 1504 Salem Street, as per the proposal submitted by JLWC. The permit fees for the project have not been included. Demolition: We will remove and properly dispose of the construction related debris as follows: We will remove the interior fixtures, trim, flooring, ceiling and wall finishes down to the framing in the existing master bath and closet to allow for the expansion of the space. We will remove and replace sections of the subfloor to allow for the rerouting of the plumbing supply and waste lines. We will remove the wall section in the bedroom to allow for the installation of a door to the new closet area. We will save the existing closet, system in the master closet, we will save and reuse the existing doors. Waste Removal Allowance (JLW): $415. Framing: We will provide the labor and materials for the framing of the renovated spaces in the existing master bath/ closet area; to allow for a new shower, the shower will be 3 ft. 3 inches deep and 5 ft. 6 inches long. We will provide blocking for cabinets if applicable. We will frame for a linen closet and a door to the bath. We will frame an opening from the master to the new closet area and we will reuse the existing door from the closet space at the stair. We will reuse the master closet door for the bathroom entrance. Plumbing and Heating: We will provide the labor and materials for the installation of the plumbing fixtures as follows: Remove and reset toilet, Install a new vanity with double sinks and faucets, a new copper shower pan, shower valve and shower head fixture and a glass door for the shower. We will supply and install water lines, vent and waste lines tying into the existing. We will use the existing HVAC locations. The bathroom fixtures are to be provided by the owner and installed by JLWC. Plumbing Allowance: $ 2,750.00. Bathroom Fixture's to be provided by owner. Copper Pan Allowance: $450.00. 1�1 � Page 2 Electrical: We have provided an allowance for the electrical portion of the project as per the industry standard (schematic not available) the allowance includes a flush mounted ceiling fixture, vanity lights, recessed shower light, an exhaust fan/light and toggle type switches. All ceiling fans, chandeliers, pendants, sconces or otherwise flush mounted lighting fixtures to be supplied by the Owner and installed by us. Electrical Allowance: $ 1,100.00. Walls and Ceiling: We will provide and install '/2" blue board and skim coat plaster with a smooth finish to the walls and ceiling for a smooth finish. We will patch the new closet door entrance as needed. Interior Doors &Trim: We will provide and install 8710 colonial casing to the doors and bathroom window, apply new 8385A colonial base molding in the bathroom. We will supply and install a new door for the master bathroom linen closet. We will install the existing closet system in the new closet area and any additional closet system items, to be purchased by the owner. We will supply and install shelving in the closet area above the stair in the new closet. Interior Door Allowance: $127.50. Flooring and Shower Tile: We will supply and install tile to the floor area of the master bath, we will provide a "mud job" to the shower pan in the shower area (approximately 3' 3" x 5' 6") we will supply and install backer board to the walls and supply and install tile to the floor, walls and ceiling in the shower area. The the material portion of the the allowance is: $ 6.00 per square foot and there is approximately two hundred eleven square feet (211) of tile. Tile Allowance: $3,740.00. Painting: We will apply one coat of latex primer to the walls and ceiling, apply one coat of latex ceiling paint to the ceiling, and apply two coats of latex eggshell wall paint and two coats of latex semi-gloss to the interior trim (colors by owners). Clean up: We will provide daily clean up and we will remove and properly dispose of all construction related waste leaving the home broom clean at the completion of the project. Page 3 Pre-Completion Checklist: Homeowner and Contractor will review all work performed to insure that the project has been completed as specified. Any remaining details will be part of this checklist. On completion of these checklist items, the contract will be complete and final payment will be due. Any issue that arises that is not listed in the pre-completion checklist will be treated as warranty work and will not impact the final payment. TOTAL COSTS FOR ALL ITEMS LISTED ABOVE $ 24,132.00. PAYMENT SCHEDULE: WITH ACCEPTANCE OF CONSTRUCTION AGREEMENT $ 4,826.00 PRIOR TO COMMENCEMENT OF DEMOLITION $4,826.00 PRIOR TO COMMENCEMENT OF ROUGH PLUMBING $4,826.00 PRIOR TO COMMENCEMENT OF PLASTERING $4,826.00 PRIOR TO COMMENCEMENT OF TILE $ 3,619.00 DUE AT CHECKLIST WALK THROUGHT $ 605.00 AT COMPLETION OF CHECK-LIST $ 604.00 ACCEPTANCE OF PROPOSAL: the enclosed prices, specifications and conditions are satisfactory and hereby accepted. Signed and Sealed: Date: v s e t/Agent Signed and Sealed: Date: ^t a 1 a } Massachusetts- Department of Public Safct% Boa�iti6f lt1>'iig'Itt�/St��ibafs ri��d i�� Boars! of Builtlinl Regulations and Standards _ - HOME IMPROVEMENT CONTRACTOR Construction Supervisor License r Registration: 139222 License: CS 63821 :-- Expiration: 6/24/2011 Tr# 284953 Restricted to: 00 , Type: Private Corporation JEFFREY L WARD 'V J.L.WARD CONSTRUCTION,INC. 50 GLIDDEN STREET JEFFREY WARD BEVERLY, MA 01915 50 GILDDEN ST. _C; �• i BEVERLY,MA 01915 Administrator Expiration: 9/16/2010 ( nuwi.�ione•r Tr#: 2308 Restricted to: 00 License or registration valid for individul use only 00- Unrestricted before the expiration date. If found return to: 1G-1 2 Family Homes Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 Failure to possess a current edition of the I Massachusetts State Building Code is cause for revocation of this license. valid without signature Refer to: WWW.Mass.Gov/DPS ACORD CERTIFICATE OF LIABILITY INSURANCE OP IDxl DATE(Mmmoff" JLWAR-1 1 07/10/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Thomas Gregory Associates Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 601 Edgewater Drive 5235 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wakefield MA 01880 Phone: 781-914-1000 Fax: 781-246-2601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A,- National Grange Mutual INSURER R: Technology Insurance Co. J. L. Ward Construction, Inc. INSURER C: 50 Glidden Street INSURER Beverly MA 01915 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOWHAVE SEEN ISSUEOTO THE INSURED NAMED ABOVE FOR THE POLICY PERIODWDICATEO.NOTWITHSTANDING ANY REQUIREMENT.TERMOR 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 SUB.IECTTO ALLTHE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LINKS SHOWN MAY HAVE BEEN REDUCED BY PAO CLAIMS. WSR ADMPOLICY EFFECTIVE POLICY EXPIRATION LTR NSRD TPEOFINSURANCE POLICY NUMBER DATE DATE(MM(DDA-Y) LIMNS GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 DAMAGE TO RENTED A R CONMERCALGENERALLIABILTTY MPP8989B 06/18/09 06/18/10 PREMISES(EAam ) s 500,000 CLAUSMAGE Fx-1 OCCUR MEDEXP(A y—Pe-0 a 10,000 PERSONAL&ADV INJURY s 2,000,000 GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATELIMITAPPUES PER: PRODUCTS-COMPATPAGG s 2,000,000 PR6 POLICY JECT LOC AUTOMOBILE UABRJTY COMBINED SINGLE UNIT S 1,000,000 A AMY AUTO M8P8989B 06/18/09 06/18/10 (Es'�`") ALLOWNEDAUTOS BODILY INJURY X SCHEDULED AUTOS (P Pewa1 S X HIREDAUTOS BODILY INJURY NON-0WNEDAUTOS ) $ PROPERTY DAMAGE (P acdded) S GARAGE LIABILITY AUTOO.YLY-EAA.CCIDENT S MYAUTD OTHER THAN EA ACC $ AUTOONLY: AGG $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE S OLCUR ❑CLAMS MAGE AGGREGATE S s DEDUCTIBLE S RETENTION S S WORIIERSCOMPENSATTOMAND x WC STAN- OTH- TORY UNITS ER EMPIAYERS'LIABILfTY B �MYYPROPRIETORIPARTNERIEXECUIIVE TWC3207880 07/28/09 07/28/10 EL EACHACCOENT s500,000 OFRCERIMEMBER EXCLUDED] El DISEASE-EA EMPLOYEE S 500,000 Hyeq Ctlalbe unEct SPECIAL PRONSroNS baa. E DISEASE-POUCYUMTT S 500,000 OTHER IPTTOx OFOPERATIONS I LOCATIONS IVENWC IEXCLU"SADDEDBYENDOR&EMFMIBPECULLPROVISIONS EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION JL'ARDC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EIPIRATmN DATE THEREOF.THE ISSUING INSURER WILLENDEAVOR TO MNL 10 DAYSWRIREN NOTICE TO THE CER71RCATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL JL Ward Construction IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR 50 Glidden Street 1ePRE "'ATM� Beverly MA 01915 "UDi0R�D1aP ATIVE ACORD 25(2001108) ©ACORD CORPORATION 1988 .�.� II'IiUG '�4�UQ��OZiW�r2'�llflL'll s:✓ `'��'�SSrAlcCl{dQ�S'et�4 ` Depadmeeat X XoarBaessBc°¢�rQ�Z v^rte��(lS Office.0 ICQvesdea tions ' r� 600 Waseaing-f-eStreeQ Boston MA 02111 s rpt c. 6NE41EG►.dass.g®v1aia Workers' Compensation Insurance Affidavit: Builders/Contglctorrs/Eiectricians/Plumbers Alplclicant Information Please Print Legibly Name(Busines--/Organization/Individual): Address: City/State/Zip: /S Phone C/,t 1- :975A Are you an employer?Check t e appropriate box: Type of project(required): 4. I am general eneral contractor and I 1,�am a employer with�_* ❑ have hired the sub-contractors 6. El New construction . employees(full and/or part-time). 7. Remodeling 2,❑ 1 am a sole proprietor or partner- listed on the attached sheet. ❑ g ship and have no employees These sub-contractors have g. EI'Demolition employees and have workers' working for me in any capacity. 9. ❑Building addition comp.insurance.1 �°workers'Comp'insurance' 5. E] We are a corporation and its 10.❑Electrical repairs or additions required.] 5. have exercised their. ... 11.❑Plumbing repairs or additions 3,❑ 1a a homeowner doing alt work right of exemption per MGL myself.[No workers comp. 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required_] *Auy applicant that chocks box X11 must also fill out the section below showing their workers'compensation policy information. t Hnmeowlhers who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such- tCorhmot rs 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:6ontractors have employees,they must provide thew workers'comp.policy number. Jam an employer that bs providing workers'compensation ursuranee for my emrployees. Below is the policy and job site irtrfornwtion Insurance Company Name: 1 — Policy#or Self-ins.Lic.#: C.22072 a$d Expiration Date: '712 a I b Job Site Address: City/State/Zip: O/85rS Attach*.Copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Faihtre 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. X do herebyce fy der the pains and penalties of perjury that the information provided above is true and correct S' afore: Date: / 2D Phone# 17 L15 -4 1 - xf-I official use only. Do not write in this area,to be completed by city or town oeiaL 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#: