Loading...
HomeMy WebLinkAboutBuilding Permit #254 - 201 AMBERVILLE ROAD 5/1/2018 I BUILDING PERMIT of"�oT 6qa TOWN OF NORTH ANDOVER o - APPLICATION FOR PLAN EXAMINATION 7D Permit NO: (( Date Received _ �'qs q,T.o SACHu`� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION I. .: ;. P.,t nj .PROPERTY OWNER �/Z�vS _ s " Print.. .. l MAP`N,O PARCEL: . ZONING DISTRICT Historic District yes .n _o Machine Shop Village, yes no . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family AdditiTwo or more family industrial Alteration No. of units: Commercial e air, replacement Assessory Bldg Others: Demolition Other Se "Well Floodplain Wetlands `- Watershed District ater/Sevin DESCRIPTION OF WORK TO BE PREFORMED: SC=rvte'.� '�i.,.j�3 I Identification Please Type or Print Clearly) OWNER: Name: RC113cA--;F- 62�-r,'A p Phone: ( 7F Address: 2,o ( AA&8&w, tf�c- (Zck GO.NTRAGTOR dame.- 7R. Phone: -7151 Address: ���' � � "�i - Sca► l�` Siapenrlsor's Construction.License: C �S'G�,- Exp. Date: (:.t . i Homme Ini vemenf License. G} EE: Date. rtL4 ARCHITECT/ENGINEER Phone: Address: Reg. No. s FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ `'VIO FEE: $ � - Check No.: Receipt No.: [b I NOTE: Persons contracting with unregistered contractors do not have access to th g anty fund Signature of Agent%Owner' Signature of contractor " r 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 i 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 Located at 384 Osgood Street FIRE DEPARTMENT -Temp Dumpstel on site yes nn Located at l24-main Street , FireDepartment signature/date COMMENTS L 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 - Date Doc.Building Permit Revised 2007 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 i ❑ 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 ❑ 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 a 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 o 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 R must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 i Plans Submltted Typ' publicE Ve' plan,W S"µer �Ggaived DISppS9i. well Certitted p°Yate r Plat plan �sePtic tank etc I Tob CO Sale, g odyAil Stamped plans �Sates pe"'taDent D SW t��R Pools �I �Pster on Sit, Pood p 1 rHE POL acgaging Sates PANNI tNrERD PqR M-8E TtDNS F Rp COMMENTG bEvf�OPMEIyr DATE RE,GC DFF U O E oNL r 1 S �ECTEO � I OA7 APpRO I VEO ' CONSERVATipN ICOMMENTS OATS I REJECTEp OATE I O APpRV ED HEACry I COMMENTS DATE REQ IECT ED I f OATEAPpROVED 1 I � 2onl19 B°ard oPgpPeatsr Var' 1 piannrn ard� ance,petitron At,: 9 80 e°fSion: COnsen'ation�ecislo `Zoning Decisio I I water$ n: °mmenrs n/r�eipt Located at SeWerC SUbmided Ftk 3gq 0S9ood St e'Ctiph/Si COments Yeses / �O°a a EpARTtyE t nature&pate Pile �epai�e'n S�e �OMMNTS nt S19nalur��aate mpster on rile des Drivel permit Not' no d for pi,, UP DOp'$uildingPermitRe vlsed2007 XV- ce°C get Tb o$apeV evvO �a<ooave of ebJJ� � NP V°�gegi4e,tea '. G�SaFep3i to �e t�JgtVeg l�se� O°` app �tiy N f ! � ,• 4 w i W QOARD OF Bt1►(pl G R aae� M.� License: CONST � LA- r RLICTIOW SUPERVISdR Number S 089566 Birthdate = I'M xy 6'41.1 �t 4 7 Tr.,tio: 89566 THE B �I c ' HUM P GRAS 1029 - HREI� �' SWAMPSCO i Commissioner • ��' lib:tt�n.. nr tng��1iCtof." ;t:in � Y .t`it t a t l S `•�.�� HOME IMPROVEMENT CONTRACTOR I tcc� I#ef RegistrAPtonc 140838 [soar Exptratton` 11/28/2007 One # ' TYp+ Pnte Corporation Bost ADVANCED BA&E NT FINISHIN fHMORE GRAB 1029 HUMPHREY SWAropsOTT' MA 01: ElT f - �` Administrator Ted Grab Advanced Basement Finishing 1029 Humphrey Street Swampscott, Massachusetts 01907 781-842-0296 advancedbasement(a yahoo.com Federal Tax ID #200140136 MA Home Improvement Contractors Registration # 140838 Proposal To Renovate Basement September 26,2007 HOME OWNER: Karen &Bob Fergus 201 Amberville Rd North Andover,Massachusetts PROJECT DESCRIPTION. 1. Areas to be created in unfinished basement CONTRACTOR SHALL supply all new materials needed to erect, according to State and Local Building Codes, build all walls along walls to create and finish areas as designated on scale drawing. The areas are as follows. ➢ Family Room/Home Entertainment Room ➢ Full Bathroom ➢ Utility/Furnace Room ➢ Office ➢ 2 Closets 2. Ceiling and Soffit Preparation ❑ 1" x 3" spruce strapping shall be installed (as needed) on ceiling joist 16" on center to support weight of new "blue board"ceiling. 3. Wall Structure ➢ Contractor shall make wall alterations as indicated (approximately, as j neded) on scale drawing. All wall structure shall be built according to state& local building requirements. S. Insulation ➢ All exterior walls shall be insulated so that all living areas and spaces are insulated according to code(as needed). The insulation value is R-13. 6. Electrical Work Y A Massachusetts Licensed Master Electrician shall perform all electrical work. This project shall include the following. ❑ Up to 20-6 inch recessed lights in living areas. ❑ Up to 3 dimmer switches to control all recessed lights. ❑ Light fixtures for all unfinished areas separately switched. ❑ Up to 2 cable/broadband wall connections. ❑ Up to 2 telephone wall connections. ❑ Up to 2 computer network connections ❑ Electrical outlets through living area per code. These outlets are controlled by a GFI (ground fault) breaker. ❑ Install exhaust fan in bathroom. � I, ❑ A separate and additional charge will be assessed in the event an additional sub panel is required to accomplish this electrical work properly. 7. Finished Walls, Ceilin,-s & Soffits ➢ All walls, ceiling and soffit of finished areas shall be enclosed with % inch "blueboard". ➢ All blueboard shall be finished to a smooth finish by way of veneer plastering. 8. Doors ➢ All hinged doors shall be "6 PANEL" ➢ All Bi-Fold Doors shall be 116 PANEL" ➢ All doors shall include standard hardware and doorknobs. ➢ All doors to be installed with casing similar to existing casing on the first floor. 9. Plumbing ➢ Contractor shall install supplied macerator toilet and creating new pumping and draining system. ➢ Contractor shall create new water supply line for toilet. ➢ Contractor shall supply drainage for supplied shower. ➢ Contractor shall create new hot and cold water supply for new tub. ➢ Contractor shall create proper drainage for new sink. ➢ Contractor shall create new hot and cold water supply line for sink. IO.Materials Supplied by Contractor ➢ Contractor will supply and install all materials and fixtures. However the j fixture listed below shall be supplied by home owner and installed by j contractor. ❑ Bathroom Sink/Vanity/Fixtures and Faucet Mixer ❑ Bathroom Tub/Shower/Fixture and Faucet Mixers ❑ Bathroom Ceramic Floor Tile,Grout and Marble Threshold i 11.Flooring ➢ This proposal allows for no flooring. ➢ Contractor shall install ceramic tiles supplied by homeowner. 12.Paintin� ➢ This proposal allows for no painting. 13.Permits ➢ All permit fees shall be reimbursed to the contractor by the home-owner. 14.Scale Drawing ➢ Scale drawing attach. shall be construed as an integral part of the proposal and agreement. Project Investment $26931 .00 ➢ Payment Due with Agreement $ 1000.00 ➢ Payment Due when Project begins $ 8996.00 (33%) ➢ Payment Due when rough Electrical Work is completed $8996.00 (33%) ➢ Balance upon completion Commencement Date Project shall begin on or about O 7 and shall be completed on or about ll . These dates are approximate. Accepted by: Date: 6 7 Bob Fergus (/ Accepted by: Date: K iren Fergus Accepted by: Date 48'3 16'5 19'10 12' 4'9 I 11'2�3'11�6'1�5'11 Unfi ished Utilty/Storage F W S zo --——————————----------------------�!!. i 314 ath oom with exhaust fan L ,.1 16'5 1'. / �. ''ini hed Storage Area Family Room i Rec Room uP < -L&W ed Storage Area � co 4'11 1'1 6'11/ / 8'2 10'11 -� 32' LIVING AREA Closet 1297 sq ft Homeowner Contractor Fergus Ted Grab 201 Amberville Rd 1029 Humphrey St N.Andover Swampscott,MA 781-454-5609 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information n� Please Print Legibly Name (Business/Organization/Individual): 2G1�1�1sY�; d` fil Address:�t� City/State/Zip: w ,Ny,Fca .V4- Phone #: Z�f ' ��'�`' S Are you an employer? Check the appropriate box: Type of project(required): 1.ElI am a employer with 4. F1I 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. 1 7. ❑ Remodeling 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 officers have exercised their 10.E] Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4),and we have no 12.0 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. 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereh rtif nd the/airs and penalties of perjury that the information provided above is true and correct. Si nature: yr/""" Date: Phone#: Z gol; S-4 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#: NORTIy own of over No. 0 o �` dover, Mass., a 0 LAK �L COCKICKEWICK 7,9 AERATED AP7 S E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....etfiltw..�......' ........... ............................................. Foundation has permission to er t........................................ buildings on-01.10....... .. .. ... .... .t1r .......� Rough to be occupied as. Chimney �. �> � .. W ........ .�.. .�e �I tom....... C e provided that the person accepting this permit shall in every respect confor o 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 310Y• PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTS Rough Service BUILD TOR 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.