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HomeMy WebLinkAboutBuilding Permit #623 - 222 BRIDGES LANE 4/15/2010BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: _//_� Date Issued: 7 " IMPORTANT:—A Date Received must complete all items on this LOCATION - r� O w L.CLYI u Print PROPERTY OWNER Good rtau ., Print MAP 210 % 0 PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Villaae ves v-�t�eo �6i�ryC 9Ic e 1• �4 q�R'1TED nPP�,��7 no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building Qtfe family Addition Two or more family Industrial Iteration No. of units: Commercial Others: Repair, replacement Assessory Bldg Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer 11111111 1U Ur wUKK TO BE PREFORMED: ANC/ POOr- Identification Please Type or Print Clearly) OWNER: Name: Rosimoru Good ria U Phone: 99F�- &i V6*--c2q/ i Address: oa-a �rlGi LaYt,f 1�,7 h CONTRACTOR Name: _B t UL.n S Kb -O n I bd' Phone: � 7 R ��i L y 33 3_' VfY4-11 N41 D 19 Z3 Supervisor's Construction License: -132) 75 Exp. Date: Q131)'D Home Improvement License: ) 0 3 ip l I Exp. Date: 7 h 1% 0 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 3DB 000 • — FEE- $ Check No.: I C( 06 4 Receipt No.:?.2_q 367 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund _ 5griature of Agent/Ovvner Signature of contractor �2! f Location faKx.-. - No. 0� Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ $ �� 0 Its. Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# ( Y004 22936 Building Inspector 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 COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature 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 signatureidate 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 - Date Doc.Building Permit Revised 2010 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 ❑ 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 ❑ 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 2008 O z s? x A O fA � O w ; cn V) o � z z "�+� g c w to a: E U w 0 � w w 0 � w u U W w cqi x w � C7 bo w w H w � w a W w ° � U) o E a N 0 N C O cmCD cc O) c m 0 CD C C N O L 0 Z O CD F. pa IWO I z O U w a e U O O v 0) O O �+ O v :.s Z °D 0. O y C C O CDMAa E m m CD 0 CD CI.—L " CD O� 3.0 Cm O O OL c 0a a CMa �� o c Cc CO C Z ts co C.3 CO) O C CL C H 0 cl LU C4 19 W W W N 'Eo m c - o o � C N O r C O v_ C2 •d'O a C ev ev ,= O . r r cc O L- N= Ea CF as '� 2m L _ v a. N 0= C r 0�O 0 r c .� m . N CL*� 'bmo co �' 3 m O� CO Ncc N m aI,L: y O ; :coa C Z 0 0� v Z .: O .� CL o O C O 00 aOF- W r CO N y,,, CDs M.�.� •N C W .E O.t c 0 r v' v 'O cm LD COO CL o O� O� mC.g0 Z =�a�m E a N 0 N C O cmCD cc O) c m 0 CD C C N O L 0 Z O CD F. pa IWO I z O U w a e U O O v 0) O O �+ O v :.s Z °D 0. O y C C O CDMAa E m m CD 0 CD CI.—L " CD O� 3.0 Cm O O OL c 0a a CMa �� o c Cc CO C Z ts co C.3 CO) O C CL C H 0 cl LU C4 19 W W W N b16�c T' BR p W N'S KITCHEN & BATH CENTER 15 Elm Street * Danvers, MA 01923-2058 Mailing address: 72 Holten Street, Danvers, MA 01923 Telephone (978) 774-3333 * Fax (978) 774-8709 Home Improvement License 9103611 * Mass. Builders License # 073375 CONTRACT This contract, dated below, for materials and/or labor to be supplied by Browns Kitchen & Bath Center (Hereinafter, referred to as the contractor), at the sole request and order of. NAME: Rosemary Goudreau PHONE: 1-978-686-2419 DATE: March 3, 2010 ADDRESS: 222 Bridges Lane N. Andover, MA (Hereinafter referred to as the owner or buyer) to be supplied/performed at premises set forth above, subject to all of the terms and conditions set forth on both sides of the Agreement, as follows: Brown's Kitchen and Bath Center is happy to furnish you with a quote on your Bathroom project. MASTER BATH Ca en : We will remove walls to the studs where necessary. We will remove wallpaper in entire room. We will remove softs containing lights. The walls will have new blueboard and plaster where needed The shower walls will have waterproof backer -board and Owner supplied, Brown's installed tile. There will also be new trim around doors and windows, and around the base of the room. We will supply and'install a vanity size: 75" x 18" color knobs are included with vanity. The vanity will have a Eorian counter top with integral bowls. (This could also be Granite) — There will be a wall cabinet between 2(two) mirrors Flooring: The floor will be prepared for owner supplied and Brown's installed tile. Plumbing: We will disconnect all fixtures. We will supply and install a 34"x 60" Swanstone shower base -- COr4lowe-`' We will supply and install a Kohler Forte shower valve We will supply and install a Kohler 8" Forte lave faucet. II� We will supply and install a Highline Comfort height toilet w/elongated seat. — p iscu—IT All work to be connected to existing plumbing. If any upgrades are needed a quote will be provided Shower Door. We will supply and install a shower door. Price for this is not included in quote, once choice of door is made we will quote you a price. (Please note that installation of shower doors take 2-4 weeks after template) Heating. We will replace section of baseboard Ventilation: Fan light vented to outside. Electrical: We will supply and install a GFI outlet. We will install a fanlight. We will install owner supplied light above mirror. All electric will be connected to the existing electrical service, if any upgrades are needed a quote will be provided. (Allowance for electrical is $2000.00 but this will be quoted). *The cost of a Runtel heating unit is $600.00 this is not included in the quoted price. **We will save all existing fixtures and cabinets *** To supply and install a Teak seat would be $400.00, this is not included in the quoted price. ****Tile quote is based on a straight installation. Intricate patterns are higher in price for install. Marble like tile is a higher price for install. "AI lime of job all knobs, handles, TP holders, towel bars etc. must be on sire for installation. /f not on site duringjob installation a servicefee will be charged to return to job and install these items. Nothing other than stated above is included in this quote. No paint or paper. All sales tax is included All work is fu11v insured Anv debris created by Browns will be disposed of by Browns. L2LL1 Hermit fees not included. This quote is good for (30) Thirty Days from date above. The owner represents and warrants that he is owner of aforesaid premises and that he/she has read this agreement, set forth on both sides. IT IS EXPRESSLY AGREED THAT NO STATEMENT, ARRANGEMENT OR UNDERSTANDING, ORAL OR WRITTEN, EXRESSED OR IMPLIED NOT CONTAINED HEREIN WILL BE RECOGNIZED AND THIS CONTRACT CONSTITUTES THE ENTIRE AGREEMENT. It is further agreed that this contract is not subject to cancellation except by written consent of both parties.' SALESPERSON: ACCEPTED BY: TO ALL CONDITIONS ON THE REVERSE •� �(� TE`CHHNNOtOGIEES This is an original design and must not be released or copied unless applicable fee has been paid or job Designed: 1/21/2010 Printed: 1/21/2010 conditions. order placed. All Drawing #: 1 Designl i IE CP --� o u' a CP 6 CN m o _ MCO � w T— ch en 5 eat o N ��� N I I j j= 15n 1 i- 5 1s — - -- --- , rr-- - 45,6 - --- - I 19"- -- � 4t �, --------sinr r ------ ----- - - - -- - All dimensions size designations given are subject to verification on job site and adjustment to fit job •� �(� TE`CHHNNOtOGIEES This is an original design and must not be released or copied unless applicable fee has been paid or job Designed: 1/21/2010 Printed: 1/21/2010 conditions. order placed. All Drawing #: 1 Designl S KITCHEN & BATH CENTER BROWN 15 Elm Street * Danvers, MA 01923-2058 Mailing address: 72 Holten Street, Danvers, AM 01809 Telephone (978) 774-3333 * Fax ( ) Home Improvement License 4103611 * Mass. Builders License # 073375 CONTRACT d by lBrowns This contract, da ed b , lowfor mat t alas nd/or labor to at thesole equue t and order of- Bath Center (H DATE: March 3, 2010 NAME: Rosemary Goudreau PHONE: 1-978-686-2419 ADDRESS: 222 Bridges Lane N. Andover, MA 01845 (Hereinafter referred to as the owner or buyer) to be supplied/performed at premises set forth above, subject to all of the terms an conditions set forth on both sides of the Agreement, as follows: Brown's Kitchen and Bath Center is happy to furnish you with a quote on your Bathroom project. MAIN BATH e walls to the studs where necessary. We will remove wallpaper from entire room. Ca eat : We will remov We will remove soffits containing lig The walls will have new blueboard and plaster where needed The tub wall will have watnrPround doors and windowoof backer -board and s aner king Acrylic walls nobs around nd the base of the room. There will also be new tri Xa ! color___ knobs are included with vanity. We will supply and install a vanity size: I 61w The vanity will have a Corian counter top with integral cinchest. owl (This could also be Granite) h l Above the vanity will be either a mirror or meds Floorin : The floor will be prepared for owner supplied and Brown's installed tile. Plumbin : We will disconnect all fixtures. We will supply and install an Kohler Sterling Acrylic tub. We will supply and install a Kohler Forte Shower valve We will supply and install a Kohler 8" Forte lave faucet. We will supply and install a Highline Comfort height toilet /elare needed a quote will be provided. d seat. All work to be connected to existing plumbing. If any upgrades Shower: None (Please note that shower doors take 2-4 weeks after template) Rating., We will replace section of baseboard Ventilation: Fan light vented to outside. Electrical: We will supply and install a GFI outlet. We will install a fanlight. We will install owner supplied light move mirrades are needed a quote will be provided. All electric will be connected to the existing electrical service, � any pgr (Allowance for electrical is $2000.00 but this will be quoted). (Light switch on outside of bathroom will remain there) CA- i9 *The cost of a Runtel heating unit is $600.00; this is not included in the quote price. We will save all existing fixtures and cabinets ***Tile quote is based on a straight installation_Intriicte patter ire higher in price for install. Marble like tie is a higher pricefor install. DisOOn6L ® T�� *At time of job all knobs, handles, TP holders, towel bars etc. must be on site far installation. If not on site during jab installation a service fee will be charged to return to job and install these items. cluded. ll other than stated above is included in this quote . No paint or paper. Local sales erntiit esntot include work is Nothing disposed o b ,. r....=.. fully insured Any debris created by Browns will be of'by that he/she has read this agreement, set forth on both sides. y OR UNDERSTANDINGORAL OR WRITTEN, IT IS EXPRESSLY AGREED THAT NO STATEMENT, ARRANGEMENT , EXRESSED OR IMPLIED NOT CONTAINED HEREIN WILL BE RECOGNIZED AND THIS CONTRACT CONSTITUTES THE ENTIRE AGREEMENT. b written consent of both parties. It is further agreed that this contract is not subject to cancellation excepty SALESPERSON: 4AC ED: ACCEPTED BY: ,ovmWi-T TO ALL CONDITIONS ON THE REVERSE SIDE 1611-t--33-1211 311-114-V -a { 01 J O 91 1611611 611 All dimensions -size designations given are subject to verification on job site and adjustment to fit job W20% Tecenoionot This is an original design and must be released or copied unless applicable fee has been paid or job Designed: 1/21/2010 Printed: 1/21/2010 conditions. order placed. Design3 All Drawing #: 1 05/27/2009 A -00M 22:28 7812462601 THOMAS GREGORY ASSOC CERTIFICATE OF LIABILITY INSURANCE 01) ID CRDATE(MMIDDmYY) sRpx os28 09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A: AlbaLLa DseCection Inc. W INSURER B: INSURER C: INSURER D: INSURER I -- PAGE 18/19 Thomas Thomas Gregory Associates Inc. 601 Edgewater Drive S235 Wakefield MA 01880 Phone:781-914-1000 Fax:781-246-2601 INSURED BF Murphy Plwabing & Heating, Inc &Browns Kitchen & Bath Inc 72 Holten Street Danvers M 01923 25 (2001/08) 0 ACORD CORPORA'noN 1986 .cr —Q THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY DATA WNDEFFFD/1ry DATE MMIDO/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X OOMMERCiALGENERALLIAWLflY 8500025389 06/01/09 06/01/10 PREMISES EsoTrED — $ 300000 CLAIMS MADE FX OCCUR MED EXP (Any pnGpwaon) $ 5000 PERSONAL$ ADV INJURY $1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMB APPLIES PER; PRODUCTS - COMP/OP AGO S 2 0 0 0 D OO PRI Loc POLICY SM Ben. 1000000 AUTOMOBILE LIABILITY A ANY AUTO 99770400002 COMBINED SINGLE LIMIT 06/01/09 06/01/10 (EaoWdent) $ 000 1 r ,000 ALL OW NED AUTOS X SCHEDULED AUTOS BODILY on) (Peroeraon) $ X HIREDAUTOS X NON -OWNED AUTOS (Per ee den!) (PEI �C'CidCntf S PROPERTY DAMAGE $ (Pcra�ddenq GARAGEUABILITY AUTO ONLY -EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUr0 ONLY: AGG $ E](CESSNMBRELLAUABILTIY A X d EACH OCCURRENCE $ 1000000 OCCUR CLAIMSMADE 4600025390 06/01/09 06/01/10 AGGREGATE $1000000 $ DEDUCTIBLE X RETENTION $10000 $ S WORKERS COMPENSATION AND EMPLQIIER$'LIABILT/ X TORVLIMiTS ER A ANY PROPRIEIOR/PARTMERIEXECU9095020608 O6TIVE /01/09 06/01/10 E.L. EACH ACCIDENT S 500000 OFMCERIMEMBER EXCLUDED? IFye• do wibeunoer E.L. DISEASE• EA EMPLOYE 5500000 SPECIAL PROVISIONSbebry OTHER E.L.DISEASE •POLICYUMIT $500000 DESCRIPTION OF OPERATIONS I LOCATION5 I VENICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION NORANDO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Town of North Andover NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO ED SHALL 978-688-9545 IMPOSE NO OBLIGATION OR LIABILITY OF ANY IQNO UPON THE INSURER, ITS AGENTS OR Torn Hall RMnENTATwx. North Andover MA ALITHORIIED/lBPRESENTAT 25 (2001/08) 0 ACORD CORPORA'noN 1986 The Commonwealth of Massachusetts Department of Industrial Accidents UOffice of Investigations 600 Washington Street Boston, Mass. 02111 - www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual) : h CDLs�i'1 S i t c h e✓1 a Liu Ch i�t✓(1 In x Address: 12 H,:ok +er, St. City/State/Zip: tan\less , Wk u1q 23 Phone#: c)1k - "114 - -131?) Are you an employer? Check the appropriate box: 1. ❑ I am an employer with 2 4. ❑ I am a general contractor and I employees (full and/or part time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached 'sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. $ required] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4), and we have no employees. [no workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. VRemodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: CU O1 4 fU%ec7Oyi i rC. Policy # or Self -ins. Lic. #: ' IUci-5b2 O LaO�& Expiration Date: Ll < l i b Job Site Address: '1XX 3 ,Ams, Lar -w— City/State/Zip: N • Awlxgr i M Q Cl 24S 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 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 $250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct Print Name: Phone #: 0 Oficial 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 Heath 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact person: Phone #• �1ee �jiom„swxu�ea,�i o./�aaaariivae�a Board of Building Regulatiods and Standards HOME IMPROVEMENT CONTRACTOR e •'h RegistraEi9t.. 103611 E P IrA -P, 7 $/2010 Tr# 271116 4te Corporation BROWN'S KITCHt $c"1N ER BRIAN MURPHY 72 HOLTEN ST.-tr«"Q-° Danvers, MA 01923 Administrator COMM "NWEAL! O N(ASS74C t�E ..:5 DIVISION OF I, I ` . ` ` " . is8ij S Ti4I9>LC`d N§E TO �4.1V 'F *01%* m a DANVERS RA09233 I t, Massachusetts - Department of Public Safety i Board of Building Re-,ulation.r.;tntl Standards Construction Supervisor License I License: CS 73375 Restricted to: 00 t„ BRIAN F MURPHY 11 KENMORE DIS DANVERS, MA 01J-3 i Expiration: 9/3/2010 ('ommisaioner Tr#: 2299 �1ee �jiom„swxu�ea,�i o./�aaaariivae�a Board of Building Regulatiods and Standards HOME IMPROVEMENT CONTRACTOR e •'h RegistraEi9t.. 103611 E P IrA -P, 7 $/2010 Tr# 271116 4te Corporation BROWN'S KITCHt $c"1N ER BRIAN MURPHY 72 HOLTEN ST.-tr«"Q-° Danvers, MA 01923 Administrator