The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #1034-15 - 216 REA STREET 6/10/2015 ��}y� ^��''✓ NORTH BUILDING PERMIT ..::• ._ . ; o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: J Date Received Date Issued: ��SS�cMus t� IMPORRTANT:Applicant must complete all items on this page LOCATION SC4' Print PROPERTY OWNER Print MAP NO: PARCEL 1 32-ZONING DISTRICT: Historic District yesno Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building T IY Tnie family ❑Addition ❑ Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer ✓"� a.(- 4,01 f r t e /hC(ctd�s lr2s �Iy� �-1b/te`d -Ree- 5b"ee- Identification Please Type or Print Clearly) i OWNER: Name: �✓ t�7/f�iro� Phone: x/7-3/ 9,_d S q3 Address: a16 i2 S7-. vaD4 ht- 0vr-tz - 0 CONTRACTOR Name: / /'1923 546-Phone: 47 Address: ,3zs- sc-4&i1 V. R,4 D2¢72r Supervisor's Construction License: e,FA -067 Je Exp. Date: Home Improvement License: �Z3 6��, Exp. Date: /8 7 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.512.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. x Total Project Cost: $ �h,�O�- b FEE: $ Check No.: Receipt No.: o NOTE: Persons contracting with unregistered contractors do not have access to th guara fun e Signature of Vent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑w' Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Sody 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 COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Q Wafter& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT Tern ®um stet on site esu _ no T t _ 4 14 --s61G t c3 ,., p kp �. 1y ► Locatedjat%,124.MainStreet � � ;�r°� r °- _ '� � '` `'°'3� �` � - �''n��,��'� ..."'."4 '<.,t r. •t' �?r � sr=:•'3�}-p.f s .7, e .; - i�,-b._ "�"°.��`"e"-!a't's. !4^�.g.s.l'h 4 Fire`�D°epart,mentssignature/date _ _ _ � � � � - ;�� }} t Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: i ELECTRICAL; Movement of Meter location, roast or service drop requires approval of Electrical Inspector Yes No i DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) I ® C Notified for pickup all Email Date Time Contact Name _ Doc.Building Permit Revised 2014 r 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 1 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4, Building Permit Application 4 Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses j 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) s Engineering Affidavits for Engineered products OTE: 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 + 2012 I ECC Energy code 4. Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 Location :2A No. 6 '� / Date lU l . - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ Itc-.Ot Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 2 G J Burling Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 189000.00 m $ - $ 216.00 Plumbing Fee $ 27.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 27.00 Total fees collected $ 370.00 216 Rea Street Bathroom remodel 1034-15 on 6/10/2015 r 1NORTH - ve" '*A- ;Mauwa*A�- zti lm 2.0115 No- 1634- 15 it o vh ver, Mass, ( I G coc Nlc Nt WICK 11Ot• S V BOARD OF HEALTH Food/Kitchen PER ...MIT T LD Septic System t �� s BUILDING INSPECTOR THIS CERTIFIES THAT .......... ...... ... .............................................................. .............................. Foundation has permission to erect .......................... buildings on ... v.....Rfm.... .. ..... .. ........... Rough kP_to be occupied as ��`�. ...........d0k*-- � ....� 6wo. ......K � !�...... .. .. �',.4.�r. ! OPERATION INDEPENDENCE Accessibility Renovations Operation Independence, LLC Tel./Fax 617-923-4545 325 School Street - Watertown, MA 02472 operation independence.net May 6, 2015 Daniel & Lori Hooley 216 Rea Street North Andover, MA Operation Independence is pleased to submit the following proposal for Accessible modifications to your home. Renovation of art existing 2nd floor bathroom for wheelchair accessibility. The proposal for work inludes: SHOWER Install the ClearPath threshold-free shower pan system in the shower area, Blocking in walls for grab bar and fold down bench installation (bench optional)Approximate size of wet area is estimated to be 32° deep by 59"wide. • Supply and install a new Symmons 96-500... series shower valve with mounted/adjustable handheld sprayer and a traditional fixed shower head. • Walls will be built with sufficient blocking so to accommodate grab bar installations and mounted fold-down bench. • Includes installation of white/biscuit porcelain comer shelves • 2 grab bars in shower • Shower Light (6" Recessed can) TOILET- Install new Kohler Cimarron Toilet . Recommended round bowl to maximize open sapce in bathroom DOORS Reuse the existing 27" entry door converting it to a pocket door. WALLS Shower walls will be finished with the (allowance $4.50 per square foot with approximaely 85 sf area) from floor to an approximate height of 84", walls above tile and outside shower are will be blue board and piaster finish above to ceiling. FLOORING The existing floor will be removed and new cement board substrate, and tile will be installed in both the shower area and throughout the bathroom. (The floor tile allowance is 4.50 per SF)The estimated plus contingency the area is 48 sf. • TILE ALLOWANCE This proposal was calculated based on the installation cost of uniform 4"x4" or 6"x6" wall tiles and 2"x2n floor tiles (inside shower) and tile size TBD outside shower. American Olean or comparable type 1 or 2. Alternate sizes and brands may require additional charge. JIOPE�RATION INDEPENDENCE Accessibility Renovations Operation Independence, LLC Tel./Fax 617-923-4545 CEILING - will be a smooth plaster finish (tile ceiling option is at an additional charge) Install 1 recessed 6" shower light Install 1 NuTone Qu 7 CFM Exhaust fanlight install—new duct work required to vent exhaust outside, The heat option for the exhaust fan is included in this proposal. Install 1 GFCI Outlet near existing sink Configure switching for room per the homeowner's needs. GRAB BARS Includes up to three standard (stainless steel or gloss white finish) grab bars 18", 24" and 36" Locations: 1, near toilet, based on user's needs and 2 in shower (located based on the user's needs) FINISH DETAILS Patch, Blue board and plaster all affected areas as needed realeted to work before painting. Prime & Paint (2 coats) bathroom walls, ceiling, trim, and door. Colo►finish TBD • Paint may include primer This bid includes municpal building permit fees, inspections , and a thorough, broom-cleaing of areas affected by our work. Operation Independence is fully licensed and insured. Total Cost of Bathroom Project as described $ 18,000 Terms Deposit to begin project $ 6000 Milestone 1: Rough Plumbing Inspection $ 6000 Milestone 2: Final Municpal Inspection $ 6000 Scheduling This job is expected to take three consecutive weeks from start to finish but is dependent on timely municipal inspections for electrical, plumbing and building. (a total of 6 inspections) AcceptaTce of Terms ZZ 6 - 1 0 -Is— � /o /S� Homeowner o esig to Date Operation Independence, C a 1st Floor o - � o Y � y N O O �o Z 1 3 F 0 3 � � N W C7 • � U O J EL W v -Db F3 l.E P0 GV-GT '(>OD ¢ na v -�- 32 36"�- c v J O LL N m CP 01 20 3, =o 1:22 Hooley 62 sq ft Bill Macmillan bilI@operationindependence.net INDEPENDENCE 617.9234545 ACCESSIBILITY 2015-04-02 16:23 PAGE NO:1 The Commonwealth of Massachusetts F Department of IndustrialAeddents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia G',M Sv�v Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plum ers. TO BE FILED WITH THE PERAUTTING AUTHORITY. Please Print Legib A ` licant Information Name(Business/Organization/Individual):�i��//1+� �'�ddD 64Olt Address: 32S .5r two 1 55 . City/State/Zip: YYA 4C 07'V M# Phone#: Are you an employer?Check the appropriate box: Type of project(required); to ees(full and/orpart-time).* 7. El New'construction 1.u 1 am a employer with�—em P Y ( 2.❑I am a sole proprietor or partnership and have no employees working for me in 8• Zemodeling any capacity.[No workers'comp.insurance required.] 9• ❑Demolition 3.Q I am a homeowner doing all work myself:[No workers'comp.insurance required.]t 10❑Building addition 4.F1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.❑Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12-b Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 110 Roof repairs These sub-contractors have employees and have workers'comp.insurance 14.[]Other 6.❑We are a corporation and its,officers have exercised their right of exemption per MGL c. 152,§1(4),andwe have no employees.[No workers'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 $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities,have s'comp.policy number. employees. If the sub-contractors have employees,they must provide their worker I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 6u�. .y Expiration Date: ! /¢ �S Policy#or Self-ins.Lic.#: 0Pwe_ ( $ /At Job Site Address: , / tit, 4.0t, City/State/Zip:/ h✓•Lr 4447 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a foie 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 ent may be forwarded to the Office of Investigations of the DIA for insurance day against the violator.A copy of this statem coverage verification. I do hereby certify and r tlz pains and penalties of perjury that the information provided above is true and correct. Date• Si nature: Phone#: 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): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.PIumbing Inspector 6.Other Phone#: Contact Person: I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defnied as"an individual;partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver`or trustee of an individual,partnership,association or other legal entity,employing emplbyees.—However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub=contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia HIRE HATHAWAY workers' Compensation and Em lover's Liability Polic BE KSNorGUARD insurance Company - A Stock Compan +� ADCOMPANIESINSURANCE Policy Number oPWC51661 Renewal of OPWC41371. NCCI No.{251344 Policy Information Page [1]Named Insured and Mailing Address Agency Operations Independence LLC AFFILIATED AGENCY OPS CO. 325 School St. Post Office Box A-N Watertown, MA 02472 Wilkes-Barre, PA 18703 Agency Code: PAAAOCIO Federal Employer's ID 04-3555811 Insured is Limited Liabflity Coro !LLC; Risk ID Number 0278976 [2] Policy Period From July 14, 2014 to July 14, 2015, 12:01 AM, standard time at the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensaty l Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work �n each of the states listed in item (3]A. The limits of our liability under Part Two are: Bodily Injury by Accident - each accident $100,000 Bodily Injury by Disease - each employee $100,000 Bodily Injury by Disease - policy limit $500,000 C. Other States Insurance -Part Three of this policy applies to ail states, except any stat listed In item (3]A. and the states of North Dakota, Ohio, Washington, and Wyoming. D, This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms i (q] Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Cia$sifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) 10 2015 11:57 OPERATION INDEPENDENCE 6179234545 page 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers icor 1 do 2 Family License: CSFA-067965 RICHARD J CASM 325 SCHOOL ST i WATERTOWN 113A Expiration Commissioner 06/26/2016 • � !�%gip�a�iars:onrurr,��Jl r.�'(-3��r:y�rrc�r�irlli k Office of Consumer Affairs&Business Regulation ,i ME IMPROVEMENT CONTRACTOR t agistration: 123619 Type: xpiration: 3/111!1517 DBA OPERATION INDEPENDENCE.: :'. r Richard Casting 325 SCHOOL ST. WATERTOWN,MA 02472 I Undersecretary Massachusetts - Department of Public Safety Massach ni4^+; an c+�;;uarus Board of Building RegUICAL cJ,s a„u (,olistruetioll SuPer",ut License: CSFA-067965 =� RICHARD J CASINO ; 1 / 325 SCHOOL ST WAT ,RTOWN MA 02472 ' ' Expiration J, 06/2612016 Commissioner s roff�ous�eea� �r�ffa � n. 4 l t3 f _ ..f , ME IMPROVEMENT*CONTRACTOR egtstxa# a�: '123619- ,k r)Type! r , T)QN iNDEP&ADENCIw Richard Cas%160 325 SCHOOL.ST. WATER`f('�WN y�f`TF ;:giln �r dersecretary oma. IbfM,q_... .,- .,. _