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HomeMy WebLinkAboutBuilding Permit #585-15 - 151 HILLSIDE ROAD 1/6/2015 14ORTFI C.4 Of fsq BUILDING PERMIT 3r b`-; _"' '•'.6�OOL TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATI N 4 Permit NO: Date Received �gsSAc Wto Date Issued: IMPORTANT: Applicant must complete all items on this pae LOCATION S lam s1 Print PROPERTY OWNER / c S Cal 17- Print MAP NO: 026 PARCEL:64df/ZONING DISTRICT: Historic District yes n Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Resi ntial Non- Residential ❑ New Building Vbne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District L5'*, ater/Sewer I 4/✓J—Ir, 1��sy/y'G, Identification Please Type or Print Clearly) OWNER: Name: J�,W—,s Phone: Address: CONTRACTOR Name: / Phone: Address: 7y1 � Supervisor's Construction License: Exp. Date: y S Home Improvement License: f © � Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $_5-2-, cOVY oo FEE: $ � 2- 4 Check No.: a 2-4 (z Receipt No.: '— NOTE: Persons contracting with unregis red contractors do not have access to the guaranty fund wgnature of Agent/Owner ignature of contracto Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ TypF 6F SEWERAGE DISPOSAL Public Sewer ❑ Tanning/1V4assage/Body Art ❑ Swimming Pools ❑ Well ❑ ❑ Tobacco Sales Food Packaging/Sales ❑ ' Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I CONSERVATION Reviewed on Signature COMMENTS I HEALTH Reviewed on Signature COMMENTS I p I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Fonservation Decision: Comments Water & Sewer Con nection/signature & Date Driveway Permit i DPW Town Engineer: Signature: Located 384 Osgood Street t-El RE 11 DEPARTMENT Temp Dumpster on site , es.. _ rno. _ _ - `Locatedtat t124�MaintSt�eet � ��-�- �� y 4FreDepartment�signature/date.__ ICOMMENTS, i i 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 - _ 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of HJ.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 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 li 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 ! i 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:Building Permit Revised 2014 i Location Na Date • - TOWN OF NORTH ANDOVER S n4 p . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# r Building Inspector 1 .® DATE(MM/DD/YYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 1/20/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE HOLDER. THIS I' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. l IMPORTANT.: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. H SUBROGATION IS WAIVED,subject to the terms and conditions of the Policy,certain policies may require an endorsement A statement on this certfficate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: M P ROBERTS INS AGCY INC :PHONE t: (918)683-8073 A/C No:(978)683-3147 ! 1060 Osgood Street ADDREss: aula@ robertsinsurance.com North Andover, MA 01845 INSURER(S)AFFORDING COVERAGE NNC0 ! i INSURER A:NORFOLK & DEDHAM INSURED MICHAEL GOODWIN 'DBA INSURER B:AIM MUTUAL MF GOODWIN INSURER C: 7 HOLT ROAD INSURER D EPPING, N4 03042 INSURER E: f 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, I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL USR L .LTR TYPE OF INSURANCE INSD vvvD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE -E 1 O00 .000 CLAIMS-MADE ®OCCUR PREMISES, eEoCcurrence $ 50 000 04,/27/14 04/27/15 MED EXP(Any oneperson) $ 5,000 A R0714141 PERSONAL d ADV INJURY $ 1,000,000 i GEHL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE i 2,000,000 1 POLICY EJJECT F]LOC PRODUCTS-COMP/OP AGG $ 2 i 000 r 000 j OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE Ea accident LIMIT = i ANYAUTO BODILY INJURY.(Per person) $ i ALL OWNED SCHEDULED BODILY INJURY(P�r accident) i AUTOS AUTOS -RMMTY DAMAGE HIRED AUTOS AUTOOSWNED Per accident) t l S. UMBRELLA LIAR OCCUR EACH OCCURRENCE 3 EXCESS.LIAB CLAIMS-MADE AGGREGATE $ f DED RETENTION$ S WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERtEXECUnVE E.L.EACH ACCIDENT ; 500,000 . B OFFICEIVMEMBER EXCLUDED? (Mandatory In NH) NIA VWC10O 60151752014 02/15/14 02/15/15 E.L.DISEASE-EA EMPLOYEE$ 50:0.'000 If yes,describe under DESCRIPTION OFOPERATIONS below E•L.DISEASE-POLICY LIMIT $ 500'000 i DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) FAX: 978. 688-9542 .CERTIFICATE HOLDER CANCELLATION NORTH ANDOVER BUILDING DEPT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA _01845 ;AUTHORIZED REPRESENTATIVE f ©1088-2014 ACORD CORPORATION.All.rights reserved. E ACORD25.(2014/01) The ACORD name and logo are registered marks of ACORD I Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost 523,000.00 m $ - $ 624.00 Plumbing Fee $ 78.00 Gas Fee 100 comm. $; 100.00. Electrical Fee $ 78.00 Total fees collected $ 880.00 151 Hillside 585-15 on 1/6/2015 Kitchen Remodel NORTF� Town of .� � . 0% h ver Mass ­ � o IJI�A� COC NICMIWICN y1' A0R�TED S V BOARD OF HEALTH Food/Kitchen PER T L D Septic System THIS CERTIFIES THAT ................. SJBUILDING INSPECTOR Foundation .... has permission to erect .......................... buildings on ..1.5.1..... .�.. .. � .... .....%..... ! Rough to be occupied as ....... It .�.�t..... .................................................... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 M TH ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO A Rough Service .................... .. ............................................ Final i 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. Proposal 130 Centre St. Pro p Box C-1 • , , Danvers, Ma. 01923 978-423-8463 Jim Cirame 1/3/2015 151 Hillside Rd. N. Andover, Ma. Project Description Total This Proposal is for the following work. 29,250.00 Kitchen remodel Scope of work; We will apply for the proper building permits. The existing fixtures and appliance will be disconnected and removed. The kitchen will be gutted down to the studs, subfloor and ceiling joists. The closet in the front hallway will be removed and the doorway to the kitchen widened. The wall between the Diningroom and kitchen will be opened up and a Laminated beam installed. We will replace the window on the driveway side with a shorter window to match the one on the front. We will call Nupro to see if we can get a new construction window. The exterior walls and the ceiling will be insulated with fiberglass batts. The walls and ceiling will be blueboarded and veneer plastered. We will install Durock tile underlayment on the floor followed by tiles and grout. The cabinets and moldings will be installed according to the plans titled 'Cirame 8' by Bravo kitchens. The windows and doors will bet new pine window sills and casings. Total Signature mfgoodwincompany@gmail.com Page 1 Mass.CSL #081670 Mass. HIC #105029 Proposal 130 Centre St. Pro p Box C-1 Danvers, Ma. 01923 978-423-8463 Jim Cirame 1/3/2015 151 Hillside Rd. N. Andover, Ma. Project Description Total The appliances will be installed and the hood vented to the exterior. Electrical; Our electrician will change the electrical panel to a 40 circuit panel to accommodate the needed spaces. The kitchen will be rewired to code. This involves all new GFI protected outlets, Wiring for all the appliances, 9 recess lights, a pendant light over the sink, toe-kick heater, dimmable switches. Plumbing; Our plumber will rework the plumbing to bring it up to code for the existing sink area and the new corner sink, installing proper venting as need for both sinks. New shut-offs willbe installed for both sinks. The existing baseboard heat will be disconnected and a toe-kick heater will be piped under one of the cabinets. The new sinks, faucets, dishwasher, garbage disposal and water line for the refrigerator will be installed. All rubbish will be removed from the premises. References are proudly given upon request. Town permit fees are additional and will be billed separately. Total Signature mfgoodwincompany@gmail.com Page 2 Mass.CSL #081670 Mass. HIC #105029 130 Centre St. Proposal Box C-1 • , , Danvers, Ma. 01923 978-423-8463 Jim Cirame 1/3/2015 151 Hillside Rd. N. Andover, Ma. Project Description Total The work will take approx 5 weeks to complete. An allowance of$6000.00 is given for electrical. An allowance of$400.00 is given for the window. The homeowners will provide the cabinets, countertops, hardware, appliances, plumbing fixtures, pendant light, tiles and grout All work shall be completed in a workmanlike manner according to standard business practices. Any deviation from the above specifications involving additional labor and/or materials shall be executed upon written authorization and may be an additional charge. Total estimate: $ 29,250.00 Payment schedule; A deposit of$ 8775.00 upon starting. A payment of$8775.00 upon completion of plastering. A payment of$8775.00 upon major completion of Cabinet and trim installation. A balance of$ $ 2925.00 upon completion. Total Signature mfgoodwincompany@gmail.com Page 3 Mass.CSL #081670 Mass. HIC #105029 Proposal 130 Centre St. Pro p Box C-1 Danvers, Ma. 01923 978-423-8463 Jim Cirame 1/3/2015 151 Hillside Rd. N. Andover, Ma. Project Description Total Acceptance of Proposal: Contractor: Date: / 2-�S Homeowner: Date: T NOTE: This proposal may be withdrawn by either party within 72 hours of signing. Total Signature mfgoodwincompany@gmail.com Page 4 Mass.CSL #081670 Mass. HIC #105029 Proposal 130 Centre St. Pro p Box C-1 Danvers, Ma. 01923 978-423-8463 Jim Cirame 1/3/2015 151 Hillside Rd. N. Andover, Ma. Project Description Total Total $29,250.00 Signature mfgoodwincompany@gmail.com Page 5 Mass.CSL #081670 Mass. HIC #105029 The Commonwealth ofllassachusetts Department of Industrial Accidents Dice 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 Hanle (Business/Organization/Individual): M.F. Goodwin Co Address:7 Holt Rd City/State/Zip:Epping NH 03042 Phone#:978-423-8463 Are you an employer? Check the appropriate bog: Type of project(required): 1.Q 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. 0 Remodeling ship and have no employees These sub-contractors have g• Demolition working for me in any capacity. employees and have workers' comp. insurance.+ 9. Building addition [No 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 12.0 Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No 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 isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name:AIM Mutual Ins. Policy#or Self-ins. Lic.#:VWC 601517501 Expiration Date: �2j-15-15 Job Site Address: /s` 1�1�dr, sG' City/State/Zip: 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: //:� Date: A Phone#: 978-423-846 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 Contact Person: Phone#: f ( Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-081670 MICHAEL GOOfiWIN. 7 HOLT RD m� Epping NH 0304 Expiration Commissioner 08/08/2015 P��e �ra/x/un/zuseal/�of�,',&1Ctj3cec1ccsef N. Office of Consumer Affairs&Busifiess Regulation License or registration valid for individul use only i OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: =_-_ egistration: 105029 Type: Office of Consumer Affairs and Business Regulation • xpiration: _ 7/1612016. Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 MICHAEL F.GOODWIN.JR. , Michael Goodwin 7 HOLT RD. fEPPING,NH 03042 Undersecretary Not valid without signature ®Boise Cascade Double 1-3/4" x 7-1/4" VERSA-LAM® 2.0 3100 SP Floor Beam1F1301 mg�® Dry 1 span No cantilevers 10/12 slope Tuesday, January 06, 2015 BC CALC®Design Report Build 3272 File Name: GOODWIN HILLSIDE ST Job Name: MIKE GOODWIN Description: Designs\FB01 Address: 151 HIILSIDE STREET Specifier: City, State, Zip: NORTH ANDOVER, MA Designer: Customer: Company: Code reports: ESR-1040 Misc: wV 09-02-00 BO 61 Total Horizontal Product Length=09-02-00 Reaction Summary (Down/ Uplift) (lbs) Bearing Live Dead Snow Wind Roof Live BO, 3-1/2" 1,062/0 565/0 B1, 3-1/2" 1,062/0 565/0 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125% 1 Standard Load Unf. Area (Ib/ft^2) L 00-00-00 09-02-00 20 10 11-07-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 3,364 ft-lbs 40.2% 100% 1 04-07-00 End Shear 1,309 lbs 27.1% 100% 1 00-10-12 Total Load Defl. L/506 (0.207") 47.4% n/a 1 04-07-00 Live Load Defl. L/775 (0.135') 46.5% n/a 2 04-07-00 Max Defl. 0.207" 20.7% n/a 1 04-07-00 Span / Depth 14.4 n/a n/a 0 00-00-00 %Allow %Allow Bearing Supports Dim.(L x W) Value Support Member Material BO Post 3-1/2" x 3-1/2" 1,626 lbs n/a 17.7% Unspecified B1 Post 3-1/2"x 3-1/2" 1,626 lbs n/a 17.7% Unspecified Notes Design meets Code minimum (L/240)Total load deflection criteria. Design meets Code minimum (L/360) Live load deflection criteria. Design meets arbitrary (1") Maximum total load deflection criteria. Calculations assume Member is Fully Braced. Design based on Dry Service Condition. Deflections less than 1/8"were ignored in the results. Page 1 of 2 7 '" 1 55' -12" ' 27" 12 55,,-6 — '9 33 s„ „ „ 6 ,.,, „ �„ 3 3,... 17 8„ 18 a 8 - 33 2 - _35.6 - - 33 6 ... .. _ 29 8 2 6 - ' i 6'//-37 1 3„ 6/712 -2 3� X15"- 2 "- -24' / 3 T' 1 B It-In 1 icry� Cabinet - - _ ull Cabinets out 1233 W1233 . 933 ack Wall ' c� VBMW273621 co 1 - _�_._p,- -- - -- T 5L T B24RII W331524 A o_ 12TDR �'- � �R B1 �I ar TE�2 _�- --r l ! Tray Divider Rollout 2 Drav�er/Slideout Shelf 2 Rollout helves -1 Wall to 0"Deep for T, Sink Front/Floor and Standard Depth Refrigerator 2 Angled Fillers/Tiltout Tray Kemper Cabinetry "' �) Provence, Full Overlay, Door Style Maple Wood With Toasted Almond On Coconut ail�� Soffit MaterialNictorian Crown/Rope Moldings Soft Close On Doors & Drawers die 2 Rollout Shelves v I 2 Bin Trash. ullout �Im 2 Rollout Shelves Mullion Door -�_s� 1 Mulli n Door ; i P oposed Wider Opening BTC92LR B�. 321 B2.ATL 12RL Tall Utility With v mie � j 4 00 1 _ . , Rohi.-Ives � HOOD-3 W2-133-L 3`' LG33RV2133R __... Base 12"Deep Cabinet ;U248724RT `5a" l With Flush Toe�Kick _ _ 1 ---9 VIA if 20" WB48 0 t g r> rV 24;, J ; - 2,,. —21, 30„ / 21„ /i 12yR „ \Half Wall(§'f4 /2( _igh.._48 �� _ -- 24" J Propos d Built-In Closet e' S , ' -00-W3 Existing Fireplace Sill/-__.___ „r, C'-.�.�1 7„ a 2- t6 386 -748"-- / All dimensions_size desi nations202 °� This is an original design and must Designed: 11/14/2014 given are subject to verification on TECHNOLOGI�ESFJ not be released or copied unless Printed: 1/3/2015 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. Cirame 8 CS Kitchen All I Drawing#: 1 No Scale. -206-BL" 3n 1 n -55-411 12" 27" 1211 5516 ,�rr - 33rr 5341111 5416rr 52 4 rr 44116 LEO LO — o ® CW3u U 524 W1233 BMW273621 1233RCD 00 933 � Q 0 N =, I n EP2487WD ;J33F EF-2D ---31, u oAp _JCV �o ACSF42 FB12TDR 24.DISHW 2D930RT B15L SB24 B24RT CO 3 4 rr �� 12" 2 rr 30rr 15" -24` 241► 34-8111 4 4 18 a rr—77 47 9rr 53 4 rr 17 8 rr All dimensions_size designations lil� This is an original design and must Designed: 11/14/20141 ZO .O�r' < not be released or copied unless Printed: 1/3/2015 given are subject to verification on TECHNOLOGIES job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. Cirame 8 CS Kitchen El 2 Drawing#: 1 I No Scale. 8 7n 21"-12" � 2� 30•• 21 12.E HOOD-3 N W2133R EQ123 3R WEC1233L'V2133L COT LO MV N 0) m ® Dai ® ® d. o `-c BTC12 21 RTL 30-RANGE1 BWB21 TQ12LR co 12.. 219E 311 -21111210 .E 2 $ —501" /1 49 All dimensions_size designations C This is an original design and must Designed: 11/14/2014 20 `IE:� not be released or co ied unless Printed: 1/3/2015 given are subject to verification on TECH NOLOG iES `' p - job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. Cirame 8 CS Kitchen El 3 Drawing#: 1 No Scale. - -- -- - 747 it i i SIN LO MV TF387!48724RT 30 B48 ' cY) 24 _„ r 48" if 8 16 16 A11 dimensions_size designations ]ls F 20 !J This is an original design and must Designed: 11/1.4/2014 given are subject to verification on TECHNOLOGIES not be released or copied unless printed: 1/3/2015 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. C frame 8 CS Kitchen El 4 Drawing#: 1 No Scale. 14416 ' 5 67 a,� 18 s.. 48 s 8 c+��v -100 L LO co I[r N o i -100 INB24RT F610 ACSF42 C4 d- M co 7 816" ------ -- -- -- - - 24"----- - --------3 716" _ -— - 16 126" 1816" All dimensions-size designations 20Fi7 This is an original design and must Designed: 11/14/2014 given are subject to verification on TECHNOLOGIES! not be released or copied unless Printed: 1/3/2015 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. Cirame 8 CS Kitchen O 1 Drawing#: 1 No Scale. NORTH TO" Of And - � No. . o -= dover, Mass., COC MICKEWICK y^ 7� TE ADRAD `�5 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............ ...1iy''�..... . amc- �..r........................ Foundation has permission to erect.................: ........ buildings on .'/,<—/ . ��`���� ` .............. ............. ............�/......................................... Rough to be occupied.as 1� .. Ale C9b 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 PENT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS TS Rough ............................... 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. Information an. d-Instructions Massachusetts General Laws chapter 152 requires all.employt--rs to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employdr-is defined as"an individual,partnership,•associ lion,corporation or other legal entity,or bny two ormore of the foregoing engaged in a joint enterprise,and including tate legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association am�other legal entity,employing employees. However the owner of a dwelling house having not more than three apartr,L eht� and who resides therein.,or the occupant of the dwelling house ofanother who employs persons to do maintenance,coiaStruction or repair work on such dwelling house or on the grounds or building appurtcnant thereto shall not because of such.employment be.deemed to be.an employer." MGL chapter 152,§25C(6)also states that"every state or IP-cal Iicensing'agency shall withhold the issuance or renewal of a licenseor permit to operate a business or to�onsiruct buildings in the commonwealth for any applicant who has not produced acceptable evidence of co�pce with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor auy-of its political subdivisions shall' eater into any contract for the.performance of public work ung acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.,, Applicants Please ffll-out the workers'compensation affidavit completehy,by checlang the boxes that apply to your situation and,if- necessary,supply sub-contractor(s)name(s),address(es) and phone number(s)along with their certificate(s) of . - insurance. Limited Liability Companies(LLC) or Limited Liability partnerships(LLP)with no employees other than the membeis or partners,are not required to cavy workers'comp 1=ation inmrance. If an LLC or LLP does have employees,apolicy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. .Also be sture to sign and date the affidavit. The affidavit should `e iuu cur a that o 2: P-_i b t ed to the City or`�C3n ri�Ia�the au�+tecat-ion. tui elle pent or lrcerse, being requested,not!he.Departzr_ent of Industrial Accidents. Should you have any questions regardirt g the law or Lf you are rNa red to obtain a irorl ers' compensationpolic-y,please call me Department at the number=-listed below. Self-insured companies.should enter their self-insurance license number on the appropriate line. = , City or Town Officials Please be suf8.that the affidavit is complete and printed Iegzbly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Inuestigai ons has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be-used as a-reference number. In addition;an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under`Job Site Address"•the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially siampe:d or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future perzmits or licenses. A new affidavit must be filled out each . year.Where a home owner or citizen is obtaining a license or permit not related to any business.or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this a.ff davit. The Office ofInvestigations would film to than y_ou in advance for your cooperation and should you have any questions, please-do not hesitate to give us a call The Department's address,telephone.and.fazc.number.__.._ The Carnmonwe dffiL ofMassachusatts. Department afhdustHal Accidents 0.1race.of Imesttaations 600 W s1•i;tgton Stt'aet Boston,MA 02111 Tel 9 617-7 77-4900 eaft4;06 or 1-9 77IMAS.SAFE Revised 5-26-05 Fay;#6.17-7-27-.7749 um rw.mass._govAha. The Commonwealth of Al assachusetts Department o f•fin.dustri 1_4ccidents Offace'of£nyestit ations 600 Masiz, Street ,$ostOJ7, 3 4 02111 ' 'A'Orkers' Compensation Insurance Affidavit: Builders/C A Iicant Informaia.on - ontractors/Electrieians/Plumbers . PIease Print Legibly Name(Business/Org*7a6on/individual): Address: C�� ��c�-f• '�-1�+ \may v J 1 �;�7 ,��� Clty/S`fatC/zlp: •,_}/1J( Q 1 — • "� ^\ . "�4� Phone#: r)- you an employer?Check the appropriate box: T ant..a employer with' 4. ❑ T am a generalType of project(required):' employees(full and/or partart-time).* have hir ti the sub-coficontrr and l 6• ❑Neur Construction' ' 2•❑ I am a soleproprietor or partner- listed on the attached sheet $ 7• E]Remodeling ship and have no employees These su}�.contractors have working forme in any capacity, workers' COMP. 8 ❑Demolition p insurance. [No workers' camp:insurance 5. ❑ Qije are a corporation and its 9' ❑Bmldmg addition 3.E] retluired] officers have exercised their 10•❑Electrical repairs or additions •I am a homeowner doing all work n t of ex oruption per MGL 11.❑Plumbing repairs or additions myself [No workers'comp, c. 152,§1(q) and we have no In required] t employees_ 12 oofrepairs * Gomp.M&UI aIIce required_] 13.❑Other nY lirsnr that checks box-M must also 0 out the secrio+b?ov.,shov:r.r ;. 'I!ameown=who submit this affidavit indicating they are doing all wo.n and t r wer c^s'cam, as r�-:ci .° far, +Contractors that chwk this box must att=che3 an add-id anal sheet show weri hire outside cont—tor,m=submit a new affidavit indicating such. the same of the s•_b.conuartA,��and their work I that is providing workers'compensadon insurance or my e � comp.policy rn{ormahon am an employer inform¢iwn_ f mployee& Below is the policy rrnd joh site Insurance Company Name: Q Policy#or Self-ins. Az Lic.#:_ V?Vx) 13 o d ao _ Expiration Date Job Site Address: tA\"`1 1 kil Attach a copy of the workers'compensation otic de J _ /Zip- p y clary. gage(showing the policy ummber and expirafiion date). Failure to secure coverage as required under Section 25A ofMCGL c. 152 can lead to the imposition of c fine up to $1,500.00 and/or one-year imprisonment,as well as civil Penalties riminal penalties of a in the form of a Of up to$250.00 a day against the violator. Be advised that a coa STOP WORK ORDER and a fine copy in this statement may of forwarded to the Office Investigations of the DIA.for insurance coverage verification of I do hereby cern•fy under the pai�andfies o - er : fP IBJ tficttthe information provided above is true and correct: Signature: ' --. Date:.-- �1� � Phony#: -1 — �7— �- E-87 only. Do not write in this area, to be completed by;citj,or toinn official n; P.ermit/J=,icense# bority(circle onej;Health 2.Euildiia;Department.3.City/ own Cleric 4.EIectrical.Inspector 5.Plumbing Inspector son: Phone#: {fir 1rdaF$CJl`'a:tg.R�UlA�tfbh `�T'rto�.c1". "OPIC, 41PROV<:ME $And Stand Registragon 1208 CONTRACTOR Piration: 3/6/2011 , Rtcst TYpe: DBA Tr# 282378`§ NC AaiOng, i Sean G ConAor 203'v,1?%K:N SnCE GTO&''ST.#256 '"jmibi ofl�tss.tchtB tts- Dclrirtrncnt Of Public, afety Board uildinIF Rel, Construction Su nl;ttinns and St.Indar(iS pervisor License License: CS 93403 Restricted to:,00 -P SEAN OCONNOR 26 CHESTNUT STP SALEM, MA 01970 C`f°�nrT�«�oner' Expiration: 12!31/2011 Tr#: 10208 M rX 203 WASHINGTON ST.#256' PRESERVE SALEM,MA 01970 carpentry:painting`roofing:gutters PHONE:978.745.8745 SERVICES FAx:978.745.3476 . SALES@PRESERVESERVICES.COM ' Jim Cirame 151 Hillside Rd nate Bid:4/28/2010 Estimator:Sean O'Connor North Andover MA, 01845 (978)974-0290 jimcirame@verizon.net ROOFING ESTIMATE PRIOR PREPARATION PERMITTING: All permits will be obtained in accordance with the law as required. DISPOSAL: A dumpster will be placed in a area designated by the homeowner. ROOFING PREPARATION COVERING: Tarp the exterior of the house so as not to damage the siding. SHINGLE REMOVAL: Remove all layer(s)of old shingles NAILING: Re-nail roof decking as necessary. UNDERLAYMENT FELT: Install 15 lb felt on all areas not covered by ice and water shield. ICE AND WATER SHIELD: Install ice and water shi wdhcmftteJrnnf FLASHING DRIP EDGE: Install drip edge on all perimeters. WALL JUNCTION: Install or rework flashing where the roof meets the wall. VENT PIPES: Install new boot or flange around vent pipes. CHIMNEY(S): Install new flashing around all chimney(s). VENTILATION RIDGE VENT: Install ridge vents. �---, ROOFING MATERIALS ASPHAULT SHINGLES: Install architectural shingle 30 year. PRICING Basic $9315 Sales Tax $ 0 Total Price $9315 including Labor&Material Payment Terms: 20%deposit(day of start); 30%progressa50u-%/o d of job Mc/Visa/A` meX �r Sean O'Connor Customer Signature *Above additional prices includes all discounts and coupons discussed prior to estimate. The above quote is valid for 60 days. *Warranty: Craftsmanship: Kyron Inc.DBA Preserve Services warrantees all work performed for a period of 2 years. If any problems occur we will cover the cost of labor and materials. For the warranty to be valid the invoice that was presented at the time of completion must have been paid in full. Materials: The duration of the manufacture's warranty is specified in the materials section above. ACORN, CERTIFICATE OF LIABILITY INSURANCE OS/Z4 2010 05/24/2010 PRODUCER (781)449-6786 FAX (781)449-4269 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BOYNTON INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 72 RIVER PARK STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NEEDHAM, MA 02494 INSURERS AFFORDING COVERAGE NAIC# INBuRED Kyron Inc INSURER A: Max Specialty DBA Preserve Services INSURER& Hartford Insurance 203 Washington Street,#256 INSURER C: Sal em,MA 01970 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 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. LTR TYPE INSURANCE POLICY NUMBER DATE Y DATE II POLICY EXPIRATION LIMITS GENERALLIABILITY MU01310000309 05/23/2010 OS/23/2011 EACH occumwcE i 1 000, X COMMERCIAL GENERAL LIABILITY PREMISES En 0=9MM) a 50,0001 CLAIM MADE a OCCUR MED EXP(Any am pwon) i 5 A PERSONAL i ADV INJURY a 1,000, OENERALAGGREGATE a 2,000, GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG a 2,000,00 X POLICY PRO- LOc JECT AUTOMOBILE LUMUTY COMBINED SINGLE LIMIT a ANY AUTO (Eaaoc- 1) ALL OWNED AUTOS BODILY INJURY a SCHEDULED AUTOS (P-P—) I HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS m- $ PROPERTY DAMAGE GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC a = AUTOONLY: AGO a EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE a OCCUR CLAIMS MADE AGGREGATE i a DEDUCTIBLE i RETENTION a a AN °WORKERSCOUPENSATION YIN 014IM392 05/20/2010 05/20/2011 X TORYUMRS ER I� B OOFFICEORNAEIMB�ER EXCLUDED? E.L.EACH ACCIDENT I 100'0 J Jkylo�e� InInN) YES Eundw .L.DISEASE-EAEMPL S 100 f sPEI&PROVISIONS bakm E.L.DISEASE-POLICY LIMIT i 500 .000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADOTA BY ENDORWM Wr I SPECIAL PROVISIONS 1,000 Bodily Injury and /or Property Damage Deductible FOR INFORMATIONAL PURPOSES ONLY. IF ADDITIONAL INFORMATION IS NEEDED PLEASE CONTACT THE AGENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS wRrrm NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SKALL III NO OBLIGATION OR LIABILITY OF ANY IND UPON THE INSURER,ITS AGENTS OR REPREBMA AUTHOR2780 REP:!!!] TO WHOM IT MAY CONCERN ACORD 26(2009/01) ®1888-2 AC RD CORPORATION. All rig rved. The ACORD name and logo are registered marks of ACORD