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HomeMy WebLinkAboutBuilding Permit #345 - 18 BUCKINGHAM ROAD 11/17/2008 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION of "�DTH t 1, y < •, 00 o � ` s Permit NO: `7 Date Received + ► Date Issued: / 7 �( SSACHUSS INIPORTANT: Applicant must complete all items on this page LOCATION 18 13 u(-k IN& k Print PROPERTY OWNER Y)C-6 ie- 120 m ow c Print MAP NO.: PARCEL: f i ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building JK One family ❑ Addition ❑Two or more family ❑ Industrial X Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑Commercial Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED aw /'/%;'F / / l &uf KI 1otiG►, w �) Reynodr,6 - RC^DuiNU N -kat � 13cr•K�^+4 wA/I bdwCCW / At '%l'F ROOM fe �°tn+d ne ikl�tw S�cx . &Y"ovi^�►y CA. w��vd �+1,e (qn„/el l2ov�►+��•�in+cJ (�,+- w„ £h,�u-/e,i,�,rr►e,Jt^. cktj r. New C"I"Je. d - Identification Please Type or Print Clearly) OWNER: Name: DoN De.bb;e. /R&m&,o ,o Phone: 918- 988-33L9 Address: /8 llo-r1 CONTRACTOR Name: )9kQ-,-kdo S o dalc r- ,lw e. Phone: 63-896 066 Address: �r�rov� �•�.1 .5�.l.C.rr� /tl� 030 / Supervisor's Construction License: 09� �!3 Exp. Date: 8 7—,8La9 Home Improvement License: 106 8 ,%l Exp. Date: ARCHITECT/ENGINEER �''!� Name: Phone: Address: �lA Reg. No. FEE SCHEDULE:BULDING P V1IT.•$12.00 PER 51000.00 OF THE TOTAL EST1'ti1ATED COST BASED ON$125.00 PER S.F. Total Project Cost l l I/� Zv x12.00=FEE:$ Check No.: Receipt No.: G Page IoC4 L Location Ue No. ( I Date O�.NOR7�y 3� .yo OWN OF NORTH AND �: , •� a ER 1 Certificate of Occupancy $ J4CNUSEt Building/Frame P Fee $ �— mit t t Foundation Per d Fee $ Other P ermit Fee TOTAL Check # Building inspectori _., ... TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales 0 Well ❑ 11Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty Sec C&jA; c-�, k Signature of Agent/Owner Signature of con 4)z1-- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan n��Stamofd Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other 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/Sienature& Date Drivewav Permit Temp Dumpster on site yes no Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Re uired Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA--(For department use) - - . Page 3 of'4 IN)c:INSPECTIONALSERVIC'ES MPARTIVIENTANTORb105 Created 1IIC.hn.:006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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 DEPAR'rMEN'r:BPF0RhIU5 P;we 4 nrJ . ` "ORTH '9 TO" ® Andover No. _= o � '� dower, 1Vlass., O COC MICME WICK ^ 7�A�RATED P'Pa` �� �S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ,{') BUILDING INSPECTOR O elm r-'q® THIS CERTIFIES THAT....:.... .................................................................................................../.-.�...... .........,.......... Foundation has permission to erect........................................ buildings on ..f..4`/&, ``('6 A'*Y' � .... .. . . Rough l to be occupied as....................:. .... ./.. G / t%./L(/... 4?��41.................................................................... Chimney ' e 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 I1 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTION STARTS Rough Service BUILDIN INSPECTOR Final Occtoancy Permit Required t® Ocaipy 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. r � $ f - ±b ' 5 + ti tbQ i1�e# Itlu!use only egafM t I pp�.y� ro too t� I i � j \ The Coninionwealth ofMassacl:usetts - -' Department of Iiidustrial Accidents ~: �S Office oflnvestigations 600 Washington Street Boston,M4 02111 www.mass:gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information n Please Print Legibly NaMe(Business/Organi2ation/Individual): �O 1301' d 7;4e_ _ Address:- CitY/Sta&Zi :SaL, N 14 630` Phone#: 03-8576- 0668 FIAre . you an employer? Check the appropriate box: Type of project(required): E I am a employer with 7y 4• ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 5. Q New construction 2.Q I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g. Q Demolition working for me in any capacity. employees and have workers' insurance_i g [3 Building addition comp.[No workers' comp.insurance P• required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions 3.Q I atm a homeowner doingall work officers have exercised their 1 I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑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. tContractors that check this box must munched an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. Irthe sub-contractors have employees,they must provide their workers'camp.policy number. I am an employer that is providing wor/rers'compensation insurance for my employees. Below is the policy and job site information. /� Insurance Company Name: /r/ �`h t4�v l`.S -4yS wGW c e- 6 i o?4 Policy#or Self-ins.Lie.#: WC-14 90 9 / ExpirationDate: 0 9 Job Site Address: Citylstate/Zip: h)cx h p"U-44-- Attach a copy of the workers' co&Jensation 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 ce 17ar ,yfo enaf perjury that the information provided above is true and correct Date: Q 8 Phone#: 63'g a86 Official use only. Do not write in this area,to be completed by city or town of iciaL City or Town: Permit/License# Issuing Authority (circle one): I.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#• ACORDCERTIFICATE OF LIABILITY INSURANCE DATE07/31/2008 731/ 20 8Y ) TM. PRODUCER Phone: (978)562-5652 Fax: 978-562-7120 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION WELSH&PARKER INSURANCE AGENCY,INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 131 COOLIDGE STREET,SUITE 100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR HUDSON MA 01749 C RDED BY THEP INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Merchants Insurance Group BLACKDOG BUILDERS,INC. INSURER B: BLACKDOG BUILDERS INVESTMENT HOLDINGS LLC INSURER C: 7 RED ROOF LANE#1 SALEM NH 03079 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 ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOtj INSR LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MM/DDfM DATE MMIDD LIMITS GENERAL LIABILITY CMP9149773 07/01/08 07/01109 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 PREMISES(Ea occurence) CLAIMS MADE FX� OCCUR MED.EXP(Any one person) $ 10,000 A PERSONAL 8 ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 2,000,000 POLICY PROECT LOC J AUTOMOBILE LIABILITY CAPS265878 07/01108 07/01/09 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY A SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON•OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY CUP9139768 07/01/08 07/01/09 EACH OCCURRENCE $ _ 1,000,000 OCCUR ❑CLAIMS MADE AGGREGATE $ 1,000,000 A $ DEDUCTIBLE $ RETENTION $ WC $ i WORKERS COMPENSATION AND WCA9095570 07/01/08 07/01/09 RYTATU- LMTS OTHER EMPLOYERS'LIABILITY A ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100,000 N yes,describe under SPECIAL PRONASIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION BLACKDOG BUILDERS,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE BLACKDOG BUILDERS INVESTMENT HOLDINGS LLC EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 7 RED ROOF LANE#1 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS SALEM NH 03079 AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE *c&&[ Y??C4 Attention: Nicole M. McMeekin ACORD 25(2001108) Certificate# 28658 ©ACORD CORPORATION 1988 6 .�_ aX'�sn. S.{,�:�`r1:,.Ct. J:�..v,�.�'s, a � �Fe"�.`i�����L"icy''.`�`iso:�e��P.CKt.�,'��"�r41i`�Z�"Sl����a'�F;'x:5��lr `�3 .i�i .�. �t•. VP - � i f Existing Front Hnll and Stairs I{ i � � _ Existing Fatuity Room � E - CH= 100 3/4" Z � � I -- 224r'" 1 i t E i `��;>����?.�',��'w�ra�.f��"{�?'•� ( —t r �,�±�� — _1F n Chimney„ I / Fridge. i f ------IFF---��� 1434 L34-j" O Toilet �If �• I - Existing Dinning Room Existing Kitchen CH= t00 3/4" CH= 100 3/4" _ i I f1 i k 1 i Dishwashe C I O I i I Mudroam Entry ` ;,i.r: �[��,-r`:.'es�.'4 a.Fl;4r�ft:3hlda�� _ II 2824• The Romano Residence Kitchen Plan-As Built CH: 100 3/4" I i i All dimensions -size designations given are f This is an original design and must not be Designed: 3/31/2008 {subject to verification on job site andrel eased or copied unless applicable fee has Printed: 6/27/2008 adjustment to fit job conditions. E ,been paid or job order placed. f ' I i 'As Built4 AsBuilt _Struct. Changes !Drawing #: 1 ! Scale : 0 1/4" = U F 224-P ' I III(f I .�)tFfr.'1h"r�s`�r."e'�•it'at�lir�,- +,tiq,QY.,�� ��54�-Y�N:. �[ '� j �':�T »..'i�l�:' I UP Remove window and I I I ' j frame in to close off. Front Hall t I f Family Room - and Stairs --- I CH=100 3/4•• �- y. j 1i f C Remove wall paper in f¢mily room. I i I Remove.carpet 1{ 5 I � r 8 -�,,,�;ti,,:�'4,+i>,+.ri.. l'v�tt -n ,-_i�MDl A.Da S; } aS T•T��` ;',���`„�r5y,`3�"'rs'`Si � k t.T,,�P'-,� I I I tai ...... ���«.�.5.�.:v.F1..��i:9A,.:_iY;<1.:.� ..�. .✓in�.`. b�I.it."N'.'c�.�.'� f Basement .� kN ' t i I Chimney $Li uili14 {a I i l II N > Dining area: s1 ' J Remove plaster ceiling. j Do not remove trim and plaster on walls I l In dining area. Remove wallpaper in dining area. SalX.nge wood ffaor. Remove w¢II :� rya...,•�. -'r. :.°iRi :• _� Y Replace p, toilet f I 0 I Frames new t/2 wall for \\ Corian wall cap I I Kitchen I I CH=100 3/4" j I Remove plaster on walls and ceilings. I M Salvage wood floor. ' Mudroom Entry 0 j •d 4d _ � •O _re Windj ow rennins � I �f t��.J..� V�� ,k P, "�',.u.Y- ....y a.a,��.TS.�nM.1i>.�.i�tei+l,'c h:! i -� I' _ L�+.f�.tti<:�1:7c Yy.o�R'w-;.;����f�.X.el��1•.5:�'t�.z'f�i�3l i.k`lU,i. ���W:Rd;::�`,.i!i 1 I L43 -- 1394' _53- 336+" I The Romano Residence Kitchen Plan-Structural Changes CH a too 3/4" j 'All dimensions _.size designations given are - ; . This is an original design and must not be ' Designed: 5/23/2008 i subject to verification on job site and � j , released or copied unless applicable fee has ; Printed: 6/27/2008 i adjustment to fit job conditions. been paid or job order placed. • t REMC)DEL f ��- Presentation final I AsBuilt _Struct. Changes ; Drawing #: 1 Scale : 0 1/4" = 1' l Fr...�:".4"5 "a" fi - front hall orastairs i -'- -- - Entertainment center II ,4 Family Room CH= I00 3/4•' Install new carpet .... . _ - � r t I ) f 9 8 Basement. S, dn,'r:). k+ S4-c f ",�q.'' >,:�•:<,.� :a,rr�cr�r' 2'.><.ati..rK+��y:sc+r. .�'', �"� f tirs'.�o.' 1 i s I Chimne Keep base board heat C a j Fridge. Access doors Y f Additional access •=\ door on side ti Gorian all cap } cab.! Tall Cab ^��. `— . ...........: drawers Kitchen Replace CH=100 3/4•' " - -------- I - i Refinish wood floor I j 1 �, II I Corian top ? a IW 3 drnwers kick space heater 3 drawers Mud Roorn FRs Trash Ow v) f�`7 iwood � U 1 { ;d esk top f LO I Q I 4 x 1 .;�.^uc .o-f '__`` :',,•..3 *+�;rF45,x t.:)ya.4:s Y`i •�< Y v_..,Y.ar --Fi.::'i. i'. a1 r M::�•..1)f .N.:,.S�'41 c:.5..�: 414' ..1 ":,ryi ,.�ll•t. Keep existing window s`Y t" Keep existing window Romano Residence Layout#2-Presentation Plan i CH=100 3/4" I ;All dimensions .size designations given are This is an original design and must not be Designed: 5/28/2008 subject to verification on job site and released or copied unless applicable fee has k Printed: 6/27/2008 r 'adjustment to fit job conditions. C been paid or job order placed. I I C REMODEL i f �'� FINAL Presentation Plan i Drawing #_ 1 ! Scale : 0 1/4" = 1 'I t v •� _p F -se- .,.,,,.�,.<- --- '`:c:S,..r.:° i••'},�z;,j.;,3:y<.-@,12 iiz `i �%'{ 5 ev:=?el _ ,,.�,< t^� ,i,;-.,er KITCHEN CANDLELIGH T CA BINETS 30 1 Maple wood 4 BurMshed Stain 'I'� FAMILY ROOM P Classic square full overlay doors/drawes [; CANDLELIGHT CABINETRY woni I I [ r Maple od Y�y i v 4 I W3620.24 Natural finish l i Classic squore full overlay door style �-+ 2 W3336 FER ---- Matching wood top 3 W3336 I \ 4 X53"L 1 BFH1324.16 FEL \ 111 II 3 �'� Reduce Depth to 16" �\ f I 4 W 1536E FER WITH FURN r. a ..-- 3"ANGLE IS FLAT 2 BFHB30.20 FEL 3" -/clipped 5 `N1536 R FEL lr pped corners n W/O�FLUTE Reduce Depth to 20" �: 6 W3036 n` I Oi / 3 BFH 830.20 FER 3" ./clipped corners C ( 4 7 833 FEL 2 h I Reduce Depth to 20" I -----. 4 BFH624.16 FER I� B 8027.03 I Reduce Depth to 16" (" v X53"L S R N _ 9 SS33 FEL ! v• ' 5. Matching wood top - f u 1 manufactured by Candlelight to fit ,-T l0 BWD2L I 3/4"overhang past finished sides 1 i I � , . nd 3/4" thick doors _ I 11 0830.03 } 12 at2L PER I 33" ... 33 384" .�-22r' �-39.r" j 30-l" -T- 734" 304" 33 x5 ' i I { 13 D815.04 FEB All i.. S'rc....3rv'»'�'� _ s�.<sv. i i� _sa 1'c'.: ..:`. C-F'. -P' :r..c.•i�'..�.. I I.x;;&a S.: ,�" i j I I 29r„ 2 V I. I SHELF KIT i I I ,.y r ,•+c..;9 [ I 15 UB2790.12 7 I .iv \ \ BEAD BOARD ON WALL F SHELF KIT .. ___..__.___._... I� X53"L ��- ;i C Y AND KNEE WALL SUPORT 16 TEP753090 UNDER TABLE B \16 6 1,7 -jr 17 TEP753090 t4 118 BEAD BOARD I t5 w. ADD DOORS I " •� 19 550612 ON SLOE OF 1 20 CM-OB N f rj I\ CABIET13 -4 t �^ 2t MTK OB ly l'"r 1 1 I .•I l 4Ls" 4 50 e i TRASH DISHWASHER I I _ I� to LL a [0)='Ij 0 `Et y 6 5 4 3 r I I x ,`, r 28. 30 —�-21 .( 33" 2a 27" 30"---fi-.L5"-1 .�15 �_—_33•� A_--_-87 -1• ,F _�_--__--139=. --_ - -__�,r--- [OOv.. I G Romano Residence Layout 2-Final Layout CH- 100 3/4" 'All dimensions _size designations given are , v This is an original design and must not be i Designed: 5/28/2008 subject to verification onjob site and I released or copied unless applicable fee has Printed: 6/27/2008 adjustment to fit job conditions. been paid or job order placed. I - Li IREM- ► • — �� 'FINAL I Final Layout__ ; Drawing #: 1 ; Scale . 0 1/4" — I'