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Home My WebLink AboutBuilding Permit #794 - 16 DUFTON COURT 6/4/2007 ( NORTF/ 3 �� `�' BUILDING PERMIT of TOWN OF NORTH ANDOVER F t APPLICATION FOR PLAN EXAMINATION Permit NO: �� Date Received 9SSU`��t Date Issued: 'a IMPORTANT: Applicant must complete all items on this page ot wkg PIP r .Y TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family El Addition El Two or more family El Industrial VAlteration No. of units: ❑ Commercial Y'Repair, replacement ❑ Assessory Bldg ❑ Others: VDemolition ❑ Other Ut Not .SYf !' €i,Fil <gs W� rte'. fry y' ..y DESCRIPTION OF WORK TO BE PREFORMED: Z �✓iK/,0 ouI S ��la/,FJ� � f� /1/F�t/ S�L iQ� /-✓S�FJ� Identification Please Type or Print Clearly) OWNER: Name: vF L Phone: 7�-_ � Address: ��F dsUS cow ^"4� a, 00� a4,4 A ARCHITECT/ENGINEER ,nyc% 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- 41 Total Project Cost: $ 2�q FEE: $ a-A- Check No.: U (e Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Ag�nt�Owrt�r: ,. S gnatut�;taf xcontract0 Location '5T �rut.�t •�r 1'r No. Date t1O" NORT1y TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ a ,Ss4CMUstt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #1 2 Building 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 Drive Permit FIRE ©E�/�TM�� UoidateO at:1 24 Mali Fitbetrltt � alr®ttlal �` i z4 I COIVI�I � a Dimension p, Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ii 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 2 1 A—F and G min.$100-$1000 fine NOTES and DATA— For department use I 0 Notified for pickup - Date .................................._.........................._..........................................................................................._........_..........................................................................._._.............................._.......__._..._...__................................................................................................_ ..................._.._.................._......._............................... Doc.Building Permit Revised 2007 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 �-'-orkers Comp Affidavit oto Copy Of H.I.C. And/Or C.S.L. Licenses ,,a--06py of Contract roposed Interior Work .o gineel-inrg fFldavits--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) ❑ 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 I Revised 2.2007 I NORTH Town of : tAndover No. gy o dover, Mass., ` • Y �' -'S� Coc..CNEICK y�. 7 TED WP'? �5 '9S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........4.115-0....................1... .!c�............................................................................... Foundation has permission to erect........................................ buildings on..sy......... ..�......... Rough to be occupied as....... .... t. .I...... 4. • 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU NST TS Rough .... ........... Service .. .... . ..... ..................... UIL SPECTOR Final Occupancy Permit Required to Ow.cpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final T No Lathing or Dry Wall 1 o Be Done I FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. �R k, Lee Bluemel ftTo' 54 Bradstreet Rd. TN. Andover, MA BOTTOM 978- 687- 7948 ";• CONSTRUCTION n ' Top to Bottom Construction agrees to provide labor and materials for the following specific work: 1. The two windows at the far end of the sun room will be F.t e�_pt/.�int�and the kitchen sink removed. A new opening will be framed for the installation of a new 6' slider. The slider will have simulated divided glass. The exterior will be finished to match. The interior will be trimmed as needed. No price will be given to remove the heatat this time. I'll bring a plumber out to price it before work starts. 2. Eight windows will be removed on the sunporch. The openings will be framed to install new double hung windows with simulated divided glass. The interior and exterior will be finished to match the existing. 3. The two end walls in the living room will have corner base units with book shelves over installed. A window seat will be installed between them. The window seat will need to be discussed as it also will double as a radiator cover. The material will be 3/4" Birch plywood with select pine trim. The base units will have two raised panel doors installed on each unit. 4. An allowance will be given for the electrician to move wires in the exterior wall where the door is being installed. 5. All debris will be removed from the site. 6. Not included: painting, flooring, plumbing. Price breakdown: Item 1 - Slider - 2,300 �- Item 1 - Interior& exterior trim - Material - 350 I Item 2 - 8 windows - Sim div glass - Material - 5,000 Item 2-Trim - Material - 820 Item 3 - Material 1,520 Item 4- Electrician- Allowance -450 trash removal - Dump fees - 500 Labor - Items 1 - 3 ----- 12,350 Total Material & Labor $23,290 A ballpark price on the basement will be around $ 26,000. Details to be discussed. No bath included. If you would like, I can detail this. Michael V. Poirier Top to Bottom Construction 2/14/07 Payment terms: To be discussed. Michael V.Poirier • 8 Agate Street • Beverly,MA 01915 (w) 978-969-3060 (C) 978-420-5492 carpenterathome@hotmail.com i You as a homeowner have a right to cancel this contract within three days of signing the agreement under M.G.L. c.93 sec. 48: M.G.L. c. 140 sec. 10 or M.G.L. 255D sec. 14. SPACES DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK Permit notice: That it shall be the obligation of the contractor to obtain such permits as the owner's agent. The owner shall be responsible for obtaining any special permits for the work to be performed. Owners that secure their own permits or hire unregistered contractors shall be excluded from access to the Guaranty Fund. All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration, P.O. Box 871, Taunton, MA 02780-0871 phone 508 821-9375 Section 12 Acceleration Clauses Section 12: No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of this contract. Section 14: Arbitration. The contractor and owners hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit such arbitration as provided in M.G.L. C 142A. Signed _ -.,-..-i'/ -- Date o ri l 1 Y{b"1 Owner 4 Signed Dates s Michael V. Poirier Top to Bottom Construction NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. This contract is good for ten (10) days from date of receipt. i i ns and Standards Board of Building Reg CTOR f HOME IMPROVEMENT CONTRA Registrations`155529 Tr# 255082 E)iWatio ei A12312009 lug Tyae: DBA '. TOP TO BOTTOM CQSTRVCI ION p MICHAEL POIRIER � is 8 AGATE ST Administrator . BEVERLY,MA 01915 �omvinanuieiand` dsrds \ Board Building Regn construction uction Supervisor License Ucer so.,CS 58955 8irthd8te:- 1.21711959 ExiAMOori; 121712008 Tr# 9909 Restricilon: IG MICHAEL V POIRIER 8 AGATE ST BEVERLY,MA 01915 Commissioner ATE(MMIDD[YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE D6/01/2007 06/01/2007 PRODUCER (978) 745-6464 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rose Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 NAIC# INSURED INSURER A:PENN-AMERICA INSURANCE Top to Bottom Construction INSURER B:Hartford 8 Agate Street INSURER C: INSURER D: -Beverly MA 01915— 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. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DDNY DATE(MMIDDNY) LIMITS GENERAL LIABILITY / / / / EACH OCCURRENCE $ 500,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 50,000 CLAIMS MADE F—I OCCUR NC643868 02/14/2007 02/14/2008 MED EXP(Any one person) 5,000 PERSONAL&ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY JECT LOC AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS / / / / BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS / / / / BODILY INJURY NON-OWNED AUTOS (Per accident) S PROPERTY DAMAGE Fl (Per accident) S GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO / / / / OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY / / / / EACH OCCURRENCE $ OCCUR El CLAIMS MADE AGGREGATE $ S DEDUCTIBLE RETENTION $ S $ WORKERS COMPENSATION AND TBA 05/31/2007 05/31/2008 X WC STATU- 0TH- EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? / / / / E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS I i I 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 l Town of North Andover FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER I fNTS OR REPRESENTATIVES. AU HO D R SENTAT(VE A ACORD 26(2001/08) ©ACORD CORPORATION 1988 *TK INS026(0108).05 ELECTRONIC LASER FORMS,INC.-(800)327-0545 Page t of 2 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 SV www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): '40 ` (/U 5 �M" i Address: City/State/Zip: /9'lS Phone —?I:/;, p 3616 A,ree ou an employer? Check the appropriate box: Type of project(required): I.U I am a employer with 4. f[am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. LJ C5Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their ME] Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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 their workers'comp.policy information. Iam an employer that isproviding workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: P6 5,6� /,df . /� i Policy#or Self-ins. Lic. #: >fG �i 7�U�� Expiration Date: Q3 o 9 Job Site Address: V RW 5*klr �✓ City/State/Zip: A,41dAla It - d/Q 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. Ido hereby certify unde the pain�enalties of perjury that the information provided above is true and correct. Sianature: Date: �/Y/7 Phone#: 979 --06 9- 3ovl i 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#: