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HomeMy WebLinkAboutBuilding Permit #905-12 - 160 BRIDLE PATH 6/15/2012 t%0RTJJ BUILDING PERMIT ,,%-r.0"6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Z- Date Received 0 Permit NO: CHUS Date Issued: IMPORTANT Applicant must complete all items on this page -4 4—01--. OU L C�GAT 10 N Zi K PRQP,ERTY V.i-it t 77777- Ma.`chme Shop Vill TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building W One family 0 Industrial [I Addition El Two or more family o Commercial [I Alteration No. of units: $-Repair, replacement 0 Assessory Bldg El Others: 0 Demolition ❑0Other -Z f - * 'FlodaihWetl Wetlands C- Wa-.tef- §Nbl ESeptO e DESCRIPTION OF WORK TO BE PREFORMED: Je 14-4, 11 /i9!�/,/ %/017-5 Identification Please Type or Print Clearly) Phone: OWNER: Name: "gel Address: -0 NT -77 2Z 1"0 �RACTQR-"Wrli T'':";A;' --N sA .7 '.9 nf - '-;.1k, Elp i L;Q 6 D81 eij apervisoV�'C5 liol Mdense ttw-Nt-Vi .8 if Q,ns ruc TU% ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.-BULDING PERMIT.-$Izoo PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 2 FEE: 00' Total Project Cost: $ �7- Check No.: le� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund I / l Location f o "�J�� ,�, No. / Date_V1412 TOWN OF NORTH ANDOVER .. Certificate of Occupancy $ Building/Frame Permit Fee $ -7 C/ -� Foundation Permit Fee $ a Other Permit Fee $ TOTAL $ Check#AU7 i / s 25420 ,Buildind inspector i i i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Metter location, avast or service drops requires approval of Electrical Inspector Yes No ®ANGER ZONE ITERATURE: 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 I Doc.Suilding Permit Revised 2014 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 o Building Permit Application o Workers Comp Affidavit a Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products i NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks i ❑ Building Permit Application Certified Surve ❑ C ed Plot Plan y ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses r ❑ 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 ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit to In Sprinkler Plan And ❑ Two Sets.of Building Plans (One To Be Returned) 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. Permitof Apeals I In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the and oard roof of recording that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. one copy a p must be submitted with the building application Doc:Building Permit Revised 2014 i f Estimate 130 Centre St. Danvers, Ma. 01923 978-423-8463 Christina Morgan 3/7/2012 160 Bridle Path Rd. N. Andover, Ma. Project Description Total recess lights and a new light in the shower, an additional GFI receptacle will be installed above the vanity as well as two new vanity lights. A new wire will be brought up from the basement to feed the towel warmer and the electric floor mat. Our plumber will install a new tub with a new drain and tub valve, a new single control shower valve and floor drain with a rubber pan liner. We will install new fiberglass insulation in the ceiling and the exterior walls to bring them up to code. The walls and ceiling will be blueboarded and veneer plastered smooth. We will install an under floor electric radiant floor heating mat under the tiles and install a wall mounted thermostat. The floor will be covered with a layer of Durock tile underlayment followed by tiles and grout. Inside the shower we will cover the walls with Durock underlayment followed by tiles and grout and the floor of the shower will be tiled as well. The walls around the rest of the bathroom will be tiled up to a height of 42" off the floor. We will install new pine window and door casing. The new toilet, towel warmer, vanity, sinks, faucets, mirrors and accessories will all be installed. The glass shower door and glass side panel will be measured, fabricated and installed. Total Signature mfgoodwincompany@gmail.com Page 2 Mass.CSL #081670 Mass. HIC #105029 - I Estimate 130 Centre St. Danvers, Ma. 01923 978-423-8463 t Christina Morgan 3/7/2012 160 Bridle Path Rd. N. Andover, Ma. Project Description 1 p Total The walls and trim will be primed and painted with Sherwin Williams paint. All rubbish will be removed from premises. The work will take approx 4 weeks to complete. All the tile work is based upon a single size tile in each area. Marble, glass or decorative patterns may have an additional labor charge. The homeowners will provide the tub, faucets, cabinets, toilet, surface lighting, tiles and grout. An allowance of$1000.00 is given for the shower glass. References are proudly given upon request. Town permit fees are additional and will be billed separately. The work will start mid may. Total Estimate: $ 18,250.00 Payment terms; A deposit of$ 6200.00 is due upon starting A payment of$ 6200.00 is due upon completion of Blue board and Plaster. Balance of$ 5850.00 is due upon completion Tota i Signature mfgoodwincompany@gmail.com Page 3 Mass.CSL #081670 Mass. MC #105029 Estimate 130 Centre St. Danvers, Ma. 01923 978-423-8463 Christina Morgan 3/7/2012 160 Bridle Path Rd. N. Andover, Ma. Project Description Total Acceptance of contract: Homeowner: ��, z f un Date: Contractor:,.-, >i'-i-- Date: i Total $18,250.00 Signature mfgoodwincompany@gmail.com Page 4 Mass.CSL #081670 Mass. HIC #105029 06/15/2012 08:22 9786833147 PAGE 01/01 C4ORi °P CERTIFICATE OF LIABILITY INSURANCE °"'E`�"'°""""' s/15/12 THIS CER'nFIcAT-- IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 001:S NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CI=RTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSU REPRESENTA RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polley(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and con dltlons of the policy,certain policies may require an endorsement A statement on this certificate d certificate holder in lieu of such endorsemen Des not confer rights to The DROdJC� CONTACT M.P. Roberts Insurance Agency NAMNE 1060 Osgood Street (978 693- p73 FAX ,); 1978) 683-3147 North A>zdove:r, MA 01845 A ss kAULA@NMOBERTSINSURANCE.COM INSUI�R(SIAFFOROING COVERAGE NAIC9 - INSUR.ExA,Norfolk & Dedham INSURED MICHAEL GOODWIN yggERa:AIM Mutual, INSURER C ME GOODWz2�T - 7 HOLT ROAD INSURER D: EPPING, NH 03042 INSURER E: IN URER F. COVERAGES CERTIFICATE NUMBER. REVISION NUMBER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE B I EO TO INS ED NAM A 0R THE POLICY INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY t C NTR Ad T ORO H ! P8210D WiTH �F'ECT TO WHICH THIS CEFMFICATE MAY 15E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY T P IIS ( D EREN 65 SUB T CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEACV O EN LTR TYPE OF INSURANCE UDR POUCI NUMBER E � _ Li9ATb A GENERALLIABIUTY R0714141 � G I� ENE � X COMMERCIAIGENERALLIABILITY 6A-MAGE TOI�E� 1,000.000 ISS P} . CLAMS-MADE NO OCCUR NED EXP Wnyone ptrsm) $ __5'_Q00 PERSONAL&ADV INJURY E 1 OU 000 OF.NERALAGGREGATF, S 2,000 000 DEN'LAGGREGATELMITAPPLIESPER PPRODUCES-COMP/OPAGO POLICY R O OOO AUTOMOBILELIABIUrY S CONBI INGLELIMIT ALYAUTO a occldglq LOW1WD BODILY INJURY(Per Pomon) $ nuTOS SCHEDULED AUTOS , ];DOILY INJURY(Por wcldenl) S HIREDgU70s AUTOSWNED PPtOodTY PERDAMAGE L ereY UMBRELLA LW9 OCCUR EXCESS LIAB CLAIMS-MADS EACH OCCURRENCE g D RErUU1 N MXWCMUA .g 13 VYORKEASCOMPENSATION S AND EMPLOYERS,uoBiuTY YIN VWC6015175012012 2/15/12 2/15/13TU- OTH- ANY PROPRIETORIPAF:TNER/EXECUTNF, QS� OFFICERMENBERpqLlipED7 NIA gOEM 5 5OO 000 (Mandatory In NH) — Ilyae deseribo under E.L.DI F.A6E-EA EMPLOYE_ 9 500,Q00 DESCRIPTION OF OPEiRATIONS below F.L.DIS EASE.POLICYLIMEE $ .500 OOO AESCRIPTION OP OPERATIONS/LOCATIONS I VDICLES (Attach ACORD 101.Additional Rermrks Schadule,if more spce is iegtlrod) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEDREPORE TOWN OF NORTH ANDOVER THE EXPIRATION DATE THEREOF, NOTICE WILL BE OEUVERED IN BUILDING INSPECTOR ACCORDANCE WITH THE POLICY PROVISIONS, 1600 OSGOOD ST. BLDG 20, AUTHOREEDREPRESENTATIVE SUITE 2-36 O ANDOVER MA 0184 G i ACORD 25 2010105 0 1988-2010 ACORD CORPORATION. All right9 reserved. The ACORD name and logo are registered marks of ACORD Phone: Fax: (781) 942-9071 E-Mail; I NORTH own of 2 T E ., ndover 0 ,`1. ..., No. 06 *� $q, r. hver, Mass, coc..Ic.uw1c. 1• �i9 �R'�TED 11-V S u BOARD OF HEALTH Food/Kitchen Septic System THIS CERTIFIES THAT PERMIT ' ' „ ,,,,, 4d+ 4 ............. BUILDING INSPECTOR ..... ...........��r...... � .... ...... .. Foundation has permission to erect .... - ...................... buildings on ... .... ............................................. Rough tobe occupied as .............1`�.`r.�...c�6�6(......�.�"�.-.....7........................................................................... 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 CONSTRUCTIO ARTS Rough Service .......... ..... �,�,•lfirrr�.__/___'....:'.�`:�...................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. SEE REVERSE SIDE The Commonwealth ofMassachusetts , - DepaYtment ofludustriglAccidents Office oflnvestigadons 600 Washington,Street Boston,MA 02111 www.massgovIdia Workers'Compensation Insurance Affidavit:Builders/ContractorsfEIech icians/Plumbers AP plicant Information Please Print Le�iltly Name(Busimssl0rganization/individual): Address:_ City/State/Zip:_ ��,���< �>l� a30,� � Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.© lam a employer with �Z- 4. 01' am a general contractor and I 6. ❑New construction employees(full and/orpart-time).* have hired the sub-contractors 2.01 am a sole proprietor orpartner- listed on the attached sheet.x 7• aRemodeling ship and'1ave no employees These sub-contractors have S. El Demolition working forme in any capacity. workers'comp.insurance, g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.[]Electrical repairs or additions required.] officers have exercised their 3.❑1 am a homeowner doing all work right of exemption per MGL 11.n Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and wehave no 12.QRoofrepairs insurance required.]t employees.[No workers' .13.❑Other comp.insurance required.] 'Amy applicanttirat checks box#1 mustolso fill outthe section below sho*gtheirworkere compensationpolioy information. i Homeowners who submitthis affidavit indicating they Ale doing all workaud then hire outside contractors must submit anew affidavit indicating such. t0ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. .1 am an employer that£s providing workers'compensation insurance for my employees Below is ihepolley amljob site information. Insurance Company Name% Policy#or'Self--ins.Lic.#:_ 6e 511701 oZ Bxpiration Date: Job Site Address.-.X� . X �Il d/ Allo i, City/State(Zip: 400lIle Attach a copy of the workers'compensation-policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A o£MGL o.152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one-year imprisonment as wellas 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 maybe forwarded to the Office of Investigations of the DIA.for insurance coverage verification Xdo hereby cert&under Aepains andpenalties ofperjury that the injbi rmationpTov1dedaboYe is true and cor=4 Signature:,i _��! Date: 1_7 � Phone#: FOther only. Do not write in this area,to be completed by city or town official n: PermitlLicense# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.PIumbing Inspector - - - son: Phone#: l; -- illassachusetts- Department of Public Safetc Board of Buildinf; Relaul<ttions and Standards Construction Supervisor License License: CS 81670 MICHAEL F GOODWIN 7 HOLT RD EPPING, NH 03042 c— J"�" Expiration: 8/8/2013 Commissioner Tr#: 2951 ��e�a��za>rarccue«�fl a�(�/['C<cJlac�crJer Office of Consumer Affairs&Busihess Regulation OME IMPROVEMENT CONTRACTOR =i egistration: 105029 Type: xpiration: 7/16/2014 Individual MICHAEL F.GOODWIN JR. Michael Goodwin Jr. 7 HOLT RD. g �� EPPING, NH 03042 Undersecretary I i • i f i i. i t r /