HomeMy WebLinkAboutBuilding Permit #423-15 - 18 Fernwood Drive 11/3/2015 BUILDING PERMIT NORTHED
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TOWN OF NORTH ANDOVER 0� 6.6
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APPLICATION FOR PLAN EXAMINATION
Permit No#: J Date Received
ArED
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��SSACHUS����
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER (uJ ,AJ
Print 100 Year Structure yes n
MAP PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain 11 Wetlands ❑ Watershed District
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
is
Iden ' ication- Pleas ype or Print Clearly
OWNER: Name: 2a,1- Phone:
Address:
Contractor Name:LXAJ, A ,iea ( Phone:i J S t —649.3
Address: 1 .�JdA a_. &-ape � e t 5? Al
Supervisor's Construction License: _ 065L� Exp. Date:, 1/8////
Home Improvement License: f �Q Exp. Date:_, .l l
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ /��r�}�'}, �� FEE: $
Check No.: Receipt No.: 2- 1
NOTE: Persons contArcting with unregistered contractors do not have access to the guaran fund
...r�.._-_..-.® -...®,..T..®..-_...,y.
Signature of Agent/Owner Si nature of contractor
_ g_ _ � __ _ _ __.
-- 4-44 .
Location J
No. Date
. - TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $ I-, —
Foundation
I-Foundation Permit Fee $
Other Permit Fee $
TOTAL $
t Checdhk
Building Inspector
i
"1
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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
r
"COMMENTS
1
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& 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
COMMENTS
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)
❑ Notified for pickup Call Email
Date Time Contact Name
Doc.Building 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
❑ 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
❑ 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
o 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)
o 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
o Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
o 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:Building Permit Revised 2014
I
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
$ 10,520.00 m
$ - $ 126.24
Plumbing Fee $ 15.78
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 15.78
Total fees collected $ 257.80
18 Fernwood
423-15 on 11/3/2015
Correct Finished Basement
11/03/2014 8 : 54 : 47 AM FRED C CHURCH INC - 978-454-1865 PAGE 2 OF 2
FDAT.eco CERTIFICATE OF LIABILITY INSURANCE 11/03/20 4MMIDDIYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED j
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Elaine Dozois,AAI
Fred C.Church,Inc.
41 Wellman Street PHONE 978 3227243 FAX (978)454-1865
Lowell,MA 01851 AIC No Exth CAIC,
No):
E-MAIL edozois@fredcchurch.com
(800)225-1865 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIL#
INSURER A: Peeress Indemnity Insurance Company 18333
INSURED INSURER B
Dan Gobeil Home Improvement LLC
16 Cadida Road INSURER C:
Groveland,MA 01834 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 31946 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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ICY EXP
LTR TYPE OF INSURANCE I SR WVD POLICY NUMBER MMIDDIYYYY CY EFF MMIDDIYYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY PREM SES Ila occurrence $ 100,000
CLAIMS-MADE M OCCUR MED EXP(Any one person) $ 15,000
A CBP2034714 11/24/2014 11/24/2015 PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2.000,000
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000,000
POLICY PEO X LOC $
AUTOMOBILE LIABILITY COMBINED SI GL LIMIT
Ea accident
ANYAUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) $
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS
AUTOS Per accident $
UMBRELLALIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE
AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS'LIABILITY Y/N ORY IM SI hR
ANY PRO PRI ETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
CERTIFICATE HOLDER CANCELLATION
Town of North Andover
1600 Osgood Street
North Andover,MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
P
Client# �u 100 Mst# Cert Holder# 17386 @ 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
r7 NORTy
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COCHICKIWICK 1•
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BOARD OF HEALTH
Food/Kitchen
PERP1T T D Septic System
THIS-CERTIFIES THAT ft.�r!!! ............ .. q' t BUILDING INSPECTOR
has permission to erect ......................... buildings on ....... �,, 0 ,�............ Foundation
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to be occupied as ......CP✓.r .... ...`.. .. ..... .... ......... .. ... Chimney
provided that the person accepting this permits all 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 KiLrrmr
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTI Rough
Service
............... ..................
Final
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.
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HOME IMku PROVEMENT CONTRACTOR �
Registrationt -
Expiration: ,1;; DBA
1!30/2014 Type:
-
OBEIL CONTRACIN +
DANIEL GOBEIL
16 CARLIDA RD
-All,
GROVEC�CND MA Ot83�f
Undersecretary
Dan Gobeil Home Improvement LLC
16 Carlida Road Groveland, Ma 0183
508-451-0493
C.S. 063220 CONTRACT REG. 132182
Homeowner Information Contractor Information
Name Company Name
_Mnihmm V6,5
Street Address(do not use a Post OffLa Box address) / Contractor/Salesperson/Owner Name
City/Town State Zi Code
P Business Address(must inclua stree address)
�IV -00 V
Daytime Phone Evening PhoneCity/Town State
� B I ,; f D PV Zi /
o`,"5 11
p Code
Oje�
Mailing Address(It different from above) Business Phone
Federal Employer ID or S.S.Number
Low requires that most home Home Improvement Contractor Reg.Number Expiration date
improvement contractors have
a valid registration number
The Contractor agrees to do the following work for the Homeowner:
(Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets ifnecessary.)
Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will
and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise
(Owners who secure their own permits will be
excluded from the Guaranty Fund provisions of O Date when contractor will begin contracted work.
MGL chapter 142A.)
�Datewhen contracted work will be substantially completed.
Total Contract Price and Payment Schedule
The Contractor agrees to perform the work,filrnish the material and labor specified above for the total sum of:
Payments will be made according to the following schedule:
$ / upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater)
$-.,309T by / or upon completion of /
$ by / or upon completion of
$ upon completion of the contract. (Law forbids demanding full payment until cont• ct is completed to both party's satisfaction
The following material/equipment must be special $ to be paid for
ordered before the contracted work begins in order
to meet the completion schedule.(**) $ to be paid for
NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may
not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
Tx ress Warran -Is an ex rens warrftabiLbtetijlflrovided by the conrYes
❑ all terms of the warranty mast be attached to the contract
Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third
party/subcontractor utilized by the contractor. The contractor fruther agrees to be solely responsible for all payments to all subcontractors for
materials and labor under this apreement
Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the
contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices
carefully before signing this contract.
• Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear.
• Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and
subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor
registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757.
• Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to
see a copy of a"proof of insurance"document.
• Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer
Guide to the Home Improvement Contractor Law.
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the
contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the
third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!!
Two identical copies of the contract must be completed and signed. One copy should go to the homeowner. The other copy s udbe kept b the contractor,
4Hoe4owner"'s Signature Aonactor's Signature
I vDate
Date
Contractor Arbitration
The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an
alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a
contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless
both parties agree to the optional clause provided below. This clause would give the contractor the same right to
arbitration as is afforded to the homeowner by the Home Improvement Contractor Law.
The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute
concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by
the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required
to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A.
Homeowner's Signature Contractor's Signature
NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute
resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this
section is not separately signed by the parties.
Homeowner's Rights
A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer
protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners
may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law.
Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of
the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a
timely and workmanlilce manner. Homeowners may be entitled to other specific legal rights if the contractor
guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties
provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for
a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be
added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have
questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below).
Execution of Contract
The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced
documents have been attached. Parties are also advised not to sign the document until all blank sections have been
filled in or marked as void,deleted, or not applicable. One original signed copy of the contract with attachments is to
be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing
and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of
the contract,and the three day rescission period has expired.
Accelerated Payments
A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the
homeowner deems him/herself to be financially insecure. However, in instances where a contractor deems him/herself
to be financially insecure,the contractor may require that the balance of fields not yet due be placed in a joint escrow
account as a prerequisite to continuing the contracted work. Withdrawal of finds from said account would require the
signatures of both parties.
Additional Information
If you have general questions or need additional information about the Home Improvement Contractor Law or other
consumer rights, or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement"
contact:
Consumer Information Hotline
Office of Consilmer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787, 888-283-3757 or visit the OCABR website at http://www.mass.gov/ocabr/
If you want to verify the registration of a contractor or If you have questions or need additional information specifically
about the contractor registration component of the Home Improvement Contractor Law,contact:
Director of Home Improvement Contractor Registration
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787, 888-283-3757 or visit the HIC website at http://www.inass.gov/ocabr/
Go online to view the status of a Home Improvement Contractor's Registration:
1_ptt ://db.state.ma.us/homeimprovement/licenseelist asp
For assistance with informal mediation of disputes or to register formal complaints against a business,call:
Consumer Complaint Section
Office of the Attorney General
617-727-8400
AND/OR
Better Business Bureau
508-652-4800,508-755-2548 or 413-734-3114
Version 2.1-11/22/2010
Dan Gobeil Nome Improvement LLC
16 Carlida Road
Groveland, Ma 01834
508 451-0493
C.S. 063220 CONTRACT REG. 132182
CUSTOMER : Ramon f Vargas DATE : October 29 12014
18 Fernwood-Driv "34-'•
North Andover,Ma 01845
PLAN: Correct Basement finish from non-permitted job.
THE JOB WILL INCLUDE THE FOLLOWING: PRICE
• Remove toilet, vanity, section of wall behind both and behind laundry.
• Remove a large portion of existing ceiling tiles.
• Vent ceiling fan properly.
• Lower handrail to code height.
• Taper headroom above bottom stair to get proper height.
• PLUMBING: Vent toilet and sink to existing line if one is present. If not present one will
need to be installed for an approximate additional fee of$1,500.00. Includes removal of
walls on first floor.
• ELECTRICAL: Rewire entire basement with new plugs and switches to code and all
proper lighting connections. Direct runs for any circuits that require them.
• Repair all walls that were exposed.
• Replace all ceiling tiles.
• DGHI MATERIAL: $700.00
• DGHI: $3,770.00
• ELECTRICAL: $4,750.00
• PLUMBING: $1,000.00
• DISPOSAL FEES: $120.00
• PERMIT FEES ALLOWANCE $175.00
• Anything above and beyond said work will be done on a time and material basis @ a
rate of$50.00 an hour
• Clean and remove all related debris.
• PAYMENTS will be 1/3 at contract signing and others at different phases of job.
TOTAL MATERIAL AND LABOR $10,520.00
ACCEPTED & AGREED TO BY:
&W9,--�1
Dawn Vargas V Daniel Gobeil
DATE: roj DATE:_46h/4!�:
The Commonwealth of Massachusetts -
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly,
Name(Business/Organization/Individual):
Address:
City/State/Zip: 6,C6 U�, ®GSA Phone
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. [❑New construction
employees(fall and/or part-time).* have hired the sub-contractors
2.�] I am a sole proprietor or partner- listed on the attached sheet.-1 Remodeling
ship and'have no employees These sub-contractors have 8. []Demolition
working for me in any capacity. workers'comp.insurance. g ❑Building addition
[No workers' comp.insurance 5. El We are a corporation and its
required.] officers have exercised their 10.El Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152,§1(4),and we have no 12.[]Roofrepairs
insurance required.]i employees.[No workers' 13.[i Other
comp.insurance required.]
'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
I-Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
-Tam 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.Lie.#: �4 a-` l �o �?tn 9? Expiration Date: ILI 41 l ZI
Job Site Address: J4W_A1&-99ed PI&O-le City/State/Zip: 4�A"
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 civilpenalties 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 ceritfyunderthepaus and penalties of perjury Mat the information provided above is true and correct.
id
Simafore: ,{-- / !t Date: /(5
Phone#: C 60`
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.PIumbing Inspector
6.Other - - -
Contact Person: Phone#:
TOWN OF NORTH ANDOVER f NORTh 1
Office of the Building Department 3?*!-f- o�`'•"°�
Community Development and Services p
1600 Osgood Street
North Andover Massachusetts 01845 * °�
SSwCHU
Telephone(978)688-9545
FAX(978)688-9542
July 1, 2014
Kenneth Cox
18 Fernwood Street
North Andover MA 01845
RE: 18 Fernwood Street
BASEMENT ISSUE:
Last year you called the North Andover Building Department inquiring about your
contractor who remodeled your basement without obtaining proper permits and worked without a
Massachusetts Contractors License.
Besides not obtaining a building permit your contractor did not apply or receive an electrical
permit or plumbing permit. Furthermore,your contractor forged a building permit(#265-30)
based on a permit pulled at 329 Middlesex Street (#264-14). To date,you have not performed
any work legally or made any attempts to correct the multiple code violations observed. The
building Department is requesting you contact us immediately with any updates.
Note: Remodeling your basement without permits is a violation of 780 CMR of the
Massachusetts Building Code. Section R105.1
It is imperative you have a licensed contractor oversee all the work performed and have the
basement inspected.
Brian Leathe
Local Building Inspector.
i
Town of
• .�.. `Y.T r Andover
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No. 30
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BOARD OF HEALTH
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Food/Kitchen
1 septic system
^ THIS CERTIFIES THAT � COXBUILDING INSPECTOR
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a has permission to er-pt bulidinas on__
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Ln t0 t)8 occupied 8S � �-- �.�-�..��A:L.L Chimney
N provided thaUthe person accepting this permit shall in every respect conform to the terms of the a p'pli•cation s
on me in iris amce,and ro ine provisio�s or ine modes an4 Ily-i-aws reiating Eo me inspection,A itfanQn ana
Construction of'Buildings in the Town�f North Andover. PLUMBING INSPECTOR
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VIOLATION of.the Zoning or Building 14gulations Voids this Permit. Rough
Fina!
�. PERMIT EXPIRES IN 6 MONTHS ELECMIM INSPECTOR
Z UNLESS CONSTRUCTIf ST Rough
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- Display In a Conspicuous Place on the Premises - Do Not Remove Final
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Until Inspected and Approved by the Building Inspector. eumer
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j Septic System
A`000L BUILDING INSPECTOR
THIS CERTIFIES THAT •••••
�i�lQ Foundation
has permission to erect . ... buildings on 1631 •�•.. ... 4�. •••.
.................... ......K .... ......... Rough
to be occupied as ...... .....amot...... Amw.......forwwooL . 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 MONTHS ELECTRICAL INSPECTOR
® UNLESS CONSTRUCT] ST Rough
Service
............... ....... ................................................. Final
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.
SEE REVERSE SIDE
i
Andover
ti Town of _,.
ICL
30
0 'h e'er, Nass,
j softBOARD OF H15ALTH
i
Food/Kitchen
` Septic System
ATHIS CERTIFIES THAT^ Cox
A BUILDING INSPECTOR
Foundationahaspermission to Pr��f s an
butidina
9 Az' ,w Rough
� to be occupied as _ , 1 — 'r -+-�r�-- A 9 V} 9 Chimney
�-
N provided tE�at tfie person accepting tfils
permit shall in every respect conform to the ber g of the plIcatton
on me in finis omce,and w ine proviisiops of tneLodes ane by-i_awS reiating Eo the inspecilon,Alteration ana
Construction of suddings in the Town pf North Andover. PLUMBING INSPECTOR
V1141-ADON ofPermit Zoning or Building 6gutations Voids this PermiRosch
1 Final
r i
PERMIT EXPIRES IN 6 MONTHS ELEGraelCAILiNSPEcrAR
5
°UNLE s.S CONSTRUCTI ST
Service
.............. ...... ............. Final
a 13UILDING MPECTOR
w e y GAS INSPECTOR
YrF� fR .. I ..__ .._..._.7 a Rough
o � rtF � E
- - Display In s Oo. spicuous Placa on the Premises-- Dai Not Remove - Final
-No Lathing ®r Dry-Wall To Be Done FIRE DEPARTMENT
Until Inspected a d Approved by the Building inspector. aumer
N Street No.
Smoke Det.
0
.,? SEE REVERSE SIDE
c�
Cit
- I
r 1NORTH - -
ve. ...
0 .
No. -� -
264- 14 Z : _
:, , ver, Mass, 3
o COCIC I
MWeCK y�
7,e .3
pDA?ArED
s u
• BOARD OF HEALTH
PER Food/Kitchen
Septic System
THIS CERTIFIES THAT ,.,. Q1!�: ,,,r,IT T LD
BUILDING INSPECTOR
......... .`............. .. .... .. . ..R...................... ....
4.-,00%
��]Q Foundation
has permission to erect .......................... buildings on i;,,A•�•............... ....... ........... ...�
Rough
to be occupied as ......��I.s.1,.�ii.*�.i'� ..•. •.••. � ......•. •• •• 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 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCT] ST Rough
Service
............... ....... ................................................. Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Reguired 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.
SEE REVERSE SIDE
Towil of
�. �. Andover
r_L
m -30
1LVer, Mass,
i � �� [or aer[nCwina ti i
4Y BOARD OF HEALTH
L U
Food/Kitchen
Septic System
~ THIS CERTIFIES THAT coy. � BUILDING INSPECTOR �
Foundation
a has permission to pratf buildinas on Rough
tito be occupied as _ ___-- t.. _ __ — �; �„ Chimney _
N provided that-.the person accepting tbis,permit shall in every respect conform to the terms of the 9411cation
on tie in inis omce,and w the prov>isio, or the Lodes and 6y-Laws reiating co the inspeciton,witianon ano
Construction of Buildings in the Town#f North Andover. r PLUMBING INSPECTOR
r i
WOLATION of.the Zoning or Building Permit. Rough
Voids this PerRough
E Final
PERMIT EXPIRES IN 6 MONTHS �\
ELECTRICAL INSPECTOR
CA 'w . :UNLESS CONSTRUCTI ST s Rough
q Service
CAC
_ _ � .............. ...... .. . . ....
BUILDING INSPECTOR
Fia�i
W E GAS INSPECTOR
o J!� Err ierr�c-�� 1'rrt rif �?e�uire F� Q��c•rr rFa F ��e�ifi'r ; Roughf
-
Display In > Picuous PIace on the Premises � Do Ot Remove - Final
No, Lathing Or Dry-Wall TO Be Done rlREasRaRTIUlcrsr
_
Until Inspected aid Approved by the Building Inspector. Burner
Street No.
C
Smoke Diet.
SJE -REVERSE ERSE SODS
car -_- •
r -i NORTH - -
c . . ve
No
2(rili.- 14 s : -
0 — h , ver, Mass, 3
O CoC IC FWL^xvICK y1.
�d A�R�TED C>
S V
BOARD OF HEALTH
Food/Kitchen
PER. IT T LD Septic System
THIS CERTIFIES THAT ,,, ,0.,1!�;�,,Ka���
BUILDING INSPECTOR
......... .`............. .. .... ....... ...
QFoundation
has permission to erect .......................... buildings on3 •�•........ ........... ...,
r ••....••.6
Rough
to be occupied as ...... .Gi !:!.3�,C......a4i..... �l� 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 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTI ST Rough
Service
............... ....... ................................................. Final
4 BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required t®-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.
SEE REVERSE SIDE
P
Andover
Town of
co
C, ver, Mass,
co
11- BOARD Of HEALTH
0%
P soft RM
L
s � Food/Kitchen` Septic system
THIS CERTIFIES THAT COAG t BUILDING INSPECTOR
.t Foundation
-%t has permission to Prort bulldinas on_-
3f A f ! a Rough
� to be occupied as _ ----- _+aFs" •'v _ — — �"t � Chimn$y
Nprovided that.the person accepting th! permit shall in every respect conform to the terms of the 411cation
on me in lints omce,ano w the proviisiojis oTine Lodes anct isy-i-aws reiming to the inspecilon,Alteration ana
Construction of Buildings in the Town 4f North Andover. PLUMBING INSPECTOR
1fiQLATION of.the Zoning or Building l�bgulatlons Voids title Permit. Rough
F Fina!
"' a
PERMIT EXPIRES IN 6 MONTHS 4 ELECTrli1CALINSPECTOR
:UNLESS CONSTRUCTI ST Kflugh
\ .„ ._ Service .
...... ............................. ............... Final
BUILDING INSPECTOR
W GAS INSPECTOR
o f�� Err Errrc�• Isc� writ Required to of-elip r�>r't���e�arr,� Rough
_ Display In-a Conspicuous Place on the Premises — Do Not Remove r4nai
o Lathing or Di _>I' all To Be Done NNE DEPARTMENT
Until Inspected and Approved by the Building inspector. sumer
N Street No.
Smoke Det.
C� SEE EMERSE SIDE . __
i
r- , NORTH -
ve .
No. - . -
2G4- 14 Z
klh , ver, Mass, 3
A-O COCHICHRWICK
'7,es RATED r`YP,t�C5
V BOARD OF HEALTH
Food/Kitchen
Septic System
PER IT T LD
THIS CERTIFIES THAT ... 11! ...r BUILDING INSPECTOR
�'�]Q Foundation
has permission to erect .......................... buildings on 4✓�'�•�•............... .......
Rough
to be occupied as ...... R.4e.�..... ......444 .......fo4wk,�.. 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 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIST � Rough
Service
............... ....... .........4........................................ Final
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.
SEE REVERSE SIDE
i+�•y�`dez
Location
No. `� Date 2—
Tn ORTH ANDOVER
C tific to of ccup Cy $
. r
B in Fra )ermit Fee $
- Fo ndat on P Emit $
ther P i e $
(T
Check#
._ s Building Inspector
r , NORTH
wn .c . : ve" '*
4
yf40h ver, Mass,
T O "AM6 1,
COCHICHIWKK
AERATED PPP��S
S V
BOARD OF HEALTH
Food/Kitchen
PER IT D Septic System
THIS CERTIFIES THAT
vjor4l 74 .' BUILDING INSPECTOR
......................... ......................... .... ... .. ..................... ........................
11 �, Foundation
has permission to erect .......................... buildings on ..l..�..... ... .... .;�....... � ... . ...................
Rough
to be occupied as . . •.. y
provided that the person accepting this permi . every re ect confor o e terms of the appli n Final
on file in this office, and to the provi ons of th, Code . and By-L ws Wanting the Inspection,Al , tion and 10
Construction of Buildings in the To of North ndove . PLUMBING INSPECTOR
Rough
VIOLATION of the Zoning or Buildin Regulatio s Voids t is Per
Final
P RMIT E IR IN 6 MONTH ELECTRICAL INSPECTOR
NL SS CON RUCTION ST . TS Rough
Service
.................. .......................�UILDING.INSPEC.. Final
GAS INSPECTOR
Occu anc tl' ermit Re uir to Occu uildin Rough
Display in a Conspicuous-Place on the Pre es Do No ''emove 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
GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec,etc.
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip-Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate.
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girts-solid brick or steel plate bearing at foundations
'/"air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min. 22x30 w/3' headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
Firecode S/R wood frame of"0"clearance fireplaces&stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8%of floor area.
of required glazing shall be openable.
Bedrooms required min.20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing-Smoke Chamber-Finish
Smooth parging, clean joints, 8"solid @ combust.
DECKS: Lag to house, provide flashing.
Rails min. 36" high, Baluster max space 4"on center.
Over 8'above grade, use 6x6 posts w/lateral bracing.
Lag all posts and rails.
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee- $30.00(Be Ready).
Certificate of occupancy required prior to occupying structure.