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HomeMy WebLinkAboutBuilding Permit #559-11 - 178 STONECLEAVE ROAD 2/10/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NODate Received ._5"_ _ I' Date Issued: r MORTANT:Applicant must complete all items on this page LOCATION ' PROPERTY OWNER Print MAP NO.- dV40 PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Reside • Non- Residential [I New Building ne family ❑Ad on ❑Two or more family ❑ Industrial P,AIteration No. of units: ❑Commercial ❑Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ her " �EFl odplainW�eflands t,© WatershedlDistnc t ;K, O S�eptrc ®W , : $ a r .JJ,, , yy t} �. � 2 • t� ����Vater/Sewer � C1 DESCRIP ON OF WORK TO BE PERFORMS : Aa Tdenfific f on Please Typ or Print Clearly) OWNER: Name: R�i �t Cf'GI' �'°' 3 Phone: Address: CONTRACTOR Name: OGS v Phone: 7E' Z Z Address: Supervisor's Construction License:. ` Exp. Date: I Home Improvement License: /d y � Exp. Date: q Ze /'Z i ARCHITECT/ENGINEER Phone: Address: Reg. N°• FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000,00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 'Z 006 . bG FEE: $ Check No.: D Receipt No.: ,?3 do not have access to the uaran and NOTE: Pefsons c ntrachng with unre altered contractorsg ty f :Jct____—_—_ — F.__ Si nature'ofcontracto =A`eri I Sigriafire: f__g_= - =- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Pians ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Svdn2ming 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature CUA MMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer ConnectioniSignature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date `."' . '*.=, �,►" . .� ., COA4MENTS 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 El Notified for pickup - Date Doc:.Building Permit Revised 2008 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 ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work k ❑ 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 1 ❑ 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 M ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals tat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording - lust be submitted with the building application Doc: Doc.Building permit Revised 2008mi Location No. Date NORTM TOWN OF NORTH ANDOVER f �,y f � R 9 }�a Certificate of Occupancy $ �MUs Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #� (p 2380 ' Building Inspector C NORTH '9 0 Of �B _: over No. ~ _ o y '� dover, Mass., COCMICMEWICK yet• RATED BOARD OF HEALTH Food/Kitchen . .PERM, IT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT °I,. . ✓ �lt� ...........Q..... ........ .................................................................................................. Foundation • has permission to erect.............. buildings on V ..� ,` � g ... �... Rou h .... .. � 0.41-9. Chimney • to vided that the arson, ....... ....................................... .-............................................................................... P� p p 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 ofithe Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 ONTHS UNLESS CONSTRUC O START ELECTRICAL INSPEC'T'OR 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. / /\yVVV1 Novi V/\INfl^I BWl• Date: 1 he, Boa rd Client Name: - Space Planning System Contact Name: T_ Drawing# Tel,#: /q15, v.,el.,�W• Furniture Series: I Fax#: Area: Dealer Name: User Name/Rm. # Project Reg. #: Estimated Delivery: COLOR SCHEITE RO-B Laminate: Palnt: Fabdc: Trim: 6rM.I.lpn hkamie.VC.lw7 SCALE:1/4" T . 1 2 3 4 7 9 10 11 ip 13 14 15 r �tl per. N r fr7 a' I,-VML�ILL�11-�.!il- �Itl1111WAN111'll;I { Q 111111 1 IN 24 i Az r _ a, w (pllt))(I t) 1.1 1 11 I v 1 il ''��� i t fir N M r! 1 l IIIIlyl�ilf llll.lhlll - �" Harmonious Interiors "Feeling Good Starts At Home." P.O. Box 3124 . Beverly, MA 01915 . Telephone 978-578- 3087 . Fax 978-927-1078 Dr's Tricia and Randy Burba 178 Stone Cleave Rd. N. Andover, MA November 24, 2010 Dear Tricia and Randy, Per our conversation; The following process will be done for your kitchen facelift. I will provide design services and make all necessary purchases such as cabinetry, lighting and sink. I will also assure all necessary permits will be applied for as well as a dumpster or trash removal as well as assist in scheduling Any trade necessary for the project. Carpentry will be provided by Tony Sydorko of Beverly at an amount previously agreed on and paid directly to him. The plan is to have existing cabinetry removed and replaced by new all of the existing base cabinetry from the right side of the stove through the peninsular. As well as remove and replace the upper cabinet to the right of the window over the sink and the soffett and molding. Since working with existing materials is unpredictable, the best effort will be used to remove the long piece that run the length of the sink wall. A new set of base cabinets to the right of the stove , as previously selected and upper to the right of the sink will be installed inclusive of the trims and moldings, the island as previously selected, pantry cabinet and small cabinet over the refrigerator. A"patch"as best possible will be made to the floor where the peninsular has been removed and the existing hardwood floor. When poly is applied it will require you to remove yourselves from the home for two days. It is unhealthy to be in the home while the poly dries. The electrical for the additional lighting and plumbing to reconnect the dishwasher and faucet will be coordinated as well coordinating the installation of the new granite countertop . We have also discussed a new Chandelier and or 2 pot or pendent lights over the island. Light fixtures other then the two pot lights will be at an additional charge which will be approved once you have made that decision. You have requested a porcelain sink and I am unsure if you are replacing the faucet. Pricing does not include these items as they vary a great deal in price. Lastly we have discussed retro fitting some functionality inserts to the area with the glass doors. We never did settle what and how many.,If you do want them again it can done at additional charge for the fixtures and his time. Total cost for Cabinets and labor for installation as listed, granite, electrical and plumbing is estimated at$24;610.62. Unfortunately, it is unknown what the shape of existing plumbing and electrical wiring. Please be advised, all above pricing is with the understanding that there are no hidden or"unknown" issues. To my recollection and knowledge,this consists of our entire conversation of requirements, if I have inadvertently missed something or left something out, please bring it to my attention. A deposit of$7200.00 will be required upon signing this contract. This will be Used as a deposit for my design services as well as a deposit for the cabinets. Please call with any questions. ACCEPTING THE ESTIMATE/PLEASE SIGN AND FAX IT BACK TO OUR OFFICE AT (978)- 927-1078 AND PROVIDE OR MAIL ORIGINAL COPY TO P.O. Box 3124, Beverly, MA 01915. The above specifications, terms-and conditions are satisfactory, and(I) (We)hereby authorize the scheduling of this work. Date: ,I-- Signature Harmonious Interiors, P.O. Box 3124, Beverly, MA 01915 - Telephone 978-578-3087 -Fax 978-927-1078 ` 2'he Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA. 02111 UV www.mass.govklia 'workers' Compensation Insurance Affidavit: Btiidde:rs/Contractors/JEleclriciansfPiumbers Applicant Information Please Print L,eObly Name(Business/organization/Individual): ro V k�:) Address: �' C�'OS � -- City/State/Zip: ev ev/ qlf r Phone#: Are you an employer?Check the appropriate box: Type of project(required): L�EIIZ aem to er with 4. ❑ I am a general contractor and IP Y 6. ❑New construction oyees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet.z 7. ❑Remodeling . ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. y, (]Building addition [No workers'comp,insurance 5. ❑ We are a corporation and its ' required.] officers have exercised their 10.❑Electrical repairs or additions 3.El am a homeowner doing all work right of exemption per MGL I1.❑Plumbing repairs or additions myself. [No workers'comp. c.152,§1(4),and we have no 12.E]Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box 41 must also fll 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. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido Hereby certify der'thepains ndper les fpe#ury that the informationprovidedabove is true and correct. Si ature: Date: Phone#: Official use orzly. Do not write in this area,to be completed by city or town official City or Town: P.ermit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ', ,nt huSct\ uPecv`5ov JEe g�wCOrstT' 0 e ore`\5e . Op Restr��ted to SYOORKO ONS PNS ROSS 51 01 -A5 �y2p12 B�vEEt�-`l,MP fie �'arinzaiuuea ✓�aaaaclzuaG `� Office of Consumer Affairs&Bness Regulation HOME IMPROVEMENT CONTRACTOR. Registration: X108488 . , Type: , Expiration: _&V2P12 DBA S RICO CARPET# , E Anthony Sydorko .38 CROSS ST: Beverly,MA 01915 "......' Undersperetary i a