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Building Permit #021-2017 - 225 BRIDLE PATH 7/7/2016
/ p t ♦ NORTh BUILDING PERMITg`s1�lD TOWN OF NORTH ANDOVER ° : o APPLICATION FOR PLAN EXAMINATION 4 h r Permit NO: OZI,-W1 Date Received 0 Date Issued: �9SSACHUS���y IMPORTANT: A plicant must complete all i ems on this page �tPLOCATION Tint PROPERTY OWNAndER ..:.� � � � � Forint � N1AP N :, �� ARCEL: ZONI G dISTR,ICT: Historic.District yes no.-:,- no Machine Shop Village es ..; _ Y TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building XOne family 11Addition n Two or more family ❑ Industrial Alteration No. of units: ❑ Com cial ❑ Repair, replacement ❑Assessory Bldg ❑ O ers: [IDemolition F1Other q Septic ❑Well ❑Floodplain > Wetlands ❑ atershed District w, ❑Water/Sewer 0)0 Y) t I v A - ,J Z9 S�b� LAQ rQS�, Identification Pleas Type or Print Clearly) At OWNER: Name: (� o n , Phone: -1 ' Gg�O 0l Address: Z r- L Pc 1 VCT A e rMA a i 84 s— ;,CONTRACTOR Name _. Ph ne: `7 >. t a ; AddTess, Supervisor's Construction License: Exp. Date: »'w. t Home Im rovgment,License /� . p fl �'�� "�°` �'[" �_, Exp. Date: ARCHITECT/ENGINEER NA 'ione: 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: $ '��EE- $ Check No.: Receipt No.: NOTE: Persons contracting w',h nregist red contractors do not have access to the guaranty fund i Signature of ewn Signature of contract A j , Location No. OU "'" Date t—1 `', TOWN OF NORTH ANDOVER C Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# t %� J ` fesBuilding Inspector ` fT L ---- ' — ' I I I - Plans ElIII Plans Submitted ❑ PlansWaived-11 Certified Plot Plan ❑ Stamped _ ...-TYPE OF-;SEWERAGEDISPOSAL- Public Sewer ❑ Tanning/Massage/BodyArt El Swmin imgPools 0 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- DATEAPPROVED PLANNING & DEVELOPMENT El � COMMENTS .CONSERVATION Reviewed on Signature F COMMENTS HEALTH Reviewed on Si nature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision: Comments 'F Conservation Decision: Comments Drivewa Water & Sewer Con nectionisi nature&Date Permit DPW Town. Engineer: Signature: Located 384 Osgood street FIRE OEPARTifNT =Terimp Dumpster on side yes.. . :. no Located"at U4 Mair Street ; Fire ®epartmer�tsignatureldate- GOIMMENTS ORTFI ° BUILDING PERMIT <1�� .6Ati 3? y..,'' a OL TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION '] e^ Permit NO: d V 1 201 T Date Received '� �- -.-�• �' �9SSACfHUSF��y Date Issued: IMPORTANT: Applicant must complete all i ems on this page LO'CATI N ry PRRERTY¢OWNE XG w>EE}�5' F�tCT Hlstonrrs#r�ct yes no � : x� ..... l� me ST10 Image .. yeS n©_ . ach i TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building } One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Com cial ❑ Repair, replacement ❑Assessory Bldg ❑ 0 ers: ❑ Demolition ❑ Other Strc3 t Ve11F Q F[oodplai�� E Wetlands QatershedDrs#etc# 11 � A - S;bN Identification Pleas Type or Print Clearly) OWNER: Name: (� Phone: 01b__7 f�Address: Z r' Ca. ` o Nc)r MA Z)1 ?4 9 - CaITR�ACTflRNltne Address = � N —77 7777 r s ;,q Mu,onstttrctton Lroerti✓ Exp �..'�' �r E 7 rx a Home,tt t�rovern $ [_biose, d ate ARCHITECT/ENGINEER /UA ne: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASE Q ON$125.00 PER S.F. Total Project Cost: $ 1 -FEE: $ Check No.: Receipt No.: 310 NOTE: Persons contracting w'.h nregist red contractors do not have access to the guaranty nd . Srgriatureaof n} _a/vt £yt'r47Sgnature bf contact ' K w NORTH own Of No. p _ h ver, Mass, coc U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ASAAS.�.�il.....4#11111 f BUILDING INSPECTOR . ..................... ....... has permission to erect buildings on Foundation Rough tobe occupied as ..5,liar*ft04........................................................................................................ 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 CONS Rough Service !! .. .. .. . .......... Fina BUILDING INSP OR 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. i t Page 1 of 3 � II CONTRACT TERMS AND REQUIRED NOTICES Notice: All home improvement contractors and subcontractors engaged in �I home improvement Contracting,unless specifically exempt from registration #I by the provisions of Chapter 1 42A of the general laws,must be registered with the Commonwealth of Massachusetts. Inquiries about registration and tGJ�?l ! G7Y1C� a"'tit F' CIS` / 1fP71'f>/ !TSC status should be made to the director,Home Improvement Contractor Registration,One Ashburton Place,Room 1301,Boston,MA 02108. 354 Merrimack Street(Entry C, Suite 500) • Lawrence, MA 01840 888-49BUDGET • Fax(781) 333-5240 • budget-exteriors.com I/We hereby agree and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the specifications,terms and conditions,on the premises below described which I/We represent that we have good record title in our own name. Owners Name: Gregory Andrusin Home Phone 978-686-0157 Work Phone Email Gandrusin@gmail.com Job Site Address 225 Bridal Path North Andover MA Massachusetts Contractor Registration #161932 Work Specifications described attached on pages of. Permits: The contractor agrees to apply for and obtain all construction related permits(building/electrical/plumbing)but shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting,or inspection agencies,authorities or individuals. Notice: The homeowner who secures his own permits will be excluded from the guarantee fund of MGL Chapter 142A. Price:The contractor agrees to do all work described by the contract for the total price of $15,320.0 Notice: No agreement for home improvement contracting work shall require a down payment(advance deposit)of no more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must,in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever is greater. Payment Terms: Advanced Deposit $3,320.00 Payable on signing of contract Interim Payment 1 $6,fl(lf -00 Payable at start. Halfway Payment Halfway through project. Final Balance Payable on completion unless otherwise specified. Work Schedule: The contractor will not begin work or order material before the third day following the signing of this agreement unless specified in writing. The contractor will begin work on or about 7/20/201Barring delays caused by circumstances beyond the contractor's control,the work will be substantially completed on or about a homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoid abl/ i2Wfictor shall not be considered as violations of this agreement. The contractor shall not be liable for any delay or non-performance caused by strikes,accidents,weather or any other contingency beyond its control. Insurance: The contractor agrees to maintain workers compensation and comprehensive general liability insurance during the operation of this job to cover the acts of its employees and or agents. Warranties: The contractor warranties its workmanship for up to a period of 7(seven)years and assigns the rights to any manufacturer's warranties to the homeowner after substantial completion and payment of the contract terms. You may cancel this agreement if it has not been consummated by a party thereto at a place other than an address of the contractor,which may be his main office or a branch thereof,provided you notify contractor in writing at his main office or branch by ordinary mail posted,by telegram sent or delivered,not later than Midnight of the third business day following the signing of this agreement.The instrument and any and all other documents attached hereto and signed by the parties set forth the entire contract between parties and may be modified only by written instrument executed by both parties.Receipt of a copy of this contract and duplicate notice of cancellation and explanation thereof is hereby acknowledged. Notice: Cancellation of this agreement after three business days will result in a restocking fee of up to 33%on custom products and 25%on non- custom order products. HOMEOWNER: Do not sign this contract if there are any blank spaces. IN WITNESS WHEREOF, the parties hereunto signed their names on 6/11/2016 P Budget Exteriors, Inc. Re Homeowner 9 Accepted Budget Exteriors, Inc Homeowner Page 1 of 3 101 : 111 H :v Owners Name: Gregory Andrusin r'rall�'11 ,and p qac c>f y rrr� Aw— IMGs 354 Merrimack Street (Entry C, Suite 500) • Lawrence, MA 01840 Work Summary 888-49BUDGET • Fax (781) 333-5240 • budget-exteriors.com We hereby propose to furnish and perform the labor necessary to: • Remove and properly dispose of all existing wall siding down to wood sheathing • Inspect sheathing and re-nail as necessary (additional $1.50 per foot to replace) • Install Hardy wrap home wrap to all exterior walls • Custom flash bottom of all walls with color coded aluminum to match wall color • Install 4" Hardie fiber cement clapboards to exterior of home. • Hardie Clapboard siding to have smooth finish • Prime, paint, and flash all joints in accordance to Hardie specifications • Install 4 1/2" Hardie corner in choice of color to include drip cap • Install 2" white cellular PVC at bottom of sides of dormers where sides of dormers meet roof and cover with color coated aluminum in wall color • Install 6" white cellular PVC water table to include drip cap, as needed, at the bottom of wall in accordance to Hardie specifications • Install white cellular PVC light blocks to all exterior wall light fixtures for a more attractive appearance • Neatly caulk Hardie boards to all trim using Hardie color coded caulking • Remove all work related debris from job site at job completion • All workmanship guaranteed by Budget Exteriors for 7 years • Budget Exteriors will obtain all permits and shall be reimbursed by customer for cost of permits and/or any city fees Above quote is rear left wall to include upper left main house wall, rear wall to the right of the chimney, right house wall to the left of the chimney, and two dormers on the upper front of home Remove and reinstall gutters above garage door and on rear of home to the right of chimney necessary to install wall siding on main house left wall and replace the fascia board with solid white cellular PVC respectively Replace 4 foot rotted rake board on right side of home with solid white cellular PVC Replace all trim boards, including kick plate, surrounding sliding door with solid white cellular PVC Replace "hidden" fascia board on left house wall with solid white cellular PVC For Low and Steep Roofs Only I. Roof Color Edge Metal Color Page 2 of 3 iTO Owners Name: Gregory Andrusin r r : i it a -A--I L - �j Qm-aMr a"Id o/` is I fur I 354 Merrimack Street(Entry C, Suite 500) • Lawrence, MA 01840 Work Summary 888-49BUDGET• Fax (781) 333-5240 • budget-exteriors.com Replace all trim boards surrounding both windows on right gable wall to the right of the chimney with solid white cellular PVC Replace all wood trim boards surrounding the cluster of Windows on the rear new addition with solid white cellular PVC i i I I . J The Commonwealth of Massachusetts Department of Industrial Accidents �0 1 Congress Street, Suite 100 Boston,MA 02114-2017 M Sye`'es www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/individual): Budget Exteriors/C/O Lou Milano Address: 354 Merrimack Street ( Entry C, Suite 500 ) City/State/Zip: Lawrence, MA 01840 Phone#: Home/Fax:86O-315-5266 Cell:86O-753-0452 Are you an employer?Check the appropriate box: Type of project(required): 10 i 1.0 I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.[:]1 am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.rl I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 4.[]I am a homeowner and will be hiring contractors to conduct all work on my property. I will ]0 ❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12•❑Plumbing repairs or additions 5.❑1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. ]3).❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.* R6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[Z]OtherHctr�ie 152,§1(4),and we have no employees.[No workers'comp.insurance required.] mIF 6 ' ` *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information./Y— + � t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit in icaung succi. *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 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: Atlantic Charter Insurance CO. / 781-593-1200 Policy#or Self-ins. Lic.#: CBC20000017401Expiration Dat : 07/31/2016 Dr Job Site Address:ZZS 0 r �� iPCity/State/Zip Attach a copy of the workers' compensation policy declaration page(showing the policy number and expi at�te). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce•t y lnder the p � s and penaltie of p r'ury tl t the info mation provi ed above is true and correct. Si g natu Date: { 2—0k e ome/ Fax : 860-315-5266 Cell : 86 53-0452 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#: RESET EOF2'M' A� ® DATE(MM/DDNYYY) �- CERTIFICATE OF LIABILITY INSURANCE F 07/25/2015 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) 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 Y' certificate holder in lieu of such endorsement(s). PRODUCER CONTACT d Aon Risk Services Central, Inc. NAME: a Chicago IL Office (acNNo.Ext): (866) 283-7122 FAX No.): (800) 363-0105 y 200 East Randolph E-MAIL c Chicago IL 60601 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: ACE American Insurance Company 22667 Sears HOldincis corporation INSURER B: ACE Fire Underwriters Insurance Co. 20702 dba Sears Home Improvement Products, Inc Attn: Risk Management E3-219A INSURER C: 3333 Beverly Road INSURER D: Hoffman Estates IL 60179 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570058793162 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDNYYY1 (MMIDDfYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG2739 4 8 08/01/2015 08 01 2016 EACH OCCURRENCE $5,000,000 CLAIMS-MADEX❑OCCUR DAMAGE O $5,000,000 PREMISES Ea occurrence MED EXP(Any one person) Excluded PERSONAL&ADV INJURY $5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $S,000,000 rn X POLICY ❑PEST ❑LOC PRODUCTS-COMP/OP AGG $5,000,000 N OTHER: o A AUTOMOBILE LIABILITY ISAH08859000 08/01/2015 08/01/2016 COMBINED SINGLE LIMIT `n $5,000,000 A ISAH08859012 08/01/2015 08/01/2016 Ea accident) A ANY AUTO ISAH08859024 08/01/2015 08/01/2016 BODILY INJURY(Per person) 0 X ALL OWNEDX SCHEDULED BODILY INJURY(Per accident) a) AUTOS AUTOS NON OWNED PROPERTY DAMAGE U X HIRED AUTOS AUTOS Per accident t: Q> UMBRELLA LIABOCCUR EACH OCCURRENCE U EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION A WORKERS COMPENSATION AND wcuc48589662 08/01/2015 08/01/2016 X PER OTH- EMPLOYERS'LIABILITY YIN OH, WA, WV STATUTE ER ANY PROPRIETOR I PARTNER/EXECUTIVE E.L.EACH ACCIDENT $2,000,000 A OFFICER/MEMBER EXCLUDED? NIA WLRC48589650 08/01/2015 08/01/2016 (Mandatory in NH) All Other States E.L.DISEASE-EA EMPLOYEE $2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000- DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sears Home Improvement Products, Inc. AUTHORIZED REPRESENTATIVE '1 1024 Florida Central Parkway Longwood FL 32750 USA i��'L�eLfc e/stv.� �LlaG✓tea ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000034159 LOC#: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services Central, Inc. Sears Holdings corporation POLICY NUMBER See Certificate Number: 570058793162 CARRIER NAIC CODE see Certificate Number: 570058793162 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. INSR POLICY POLICY ADDL SUBR EFFECTIVE EXPIRATION LTR TYPE OF INSURANCE IVSD N'VD POLICY NUNIBER LIMITS UATE DATE MM/UD/YYYY NIM/DD/YYYY WORKERS COMPENSATION B N/A scFc48589674 08/01/2015 08/01/2016 WI ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD i � f f 1 � _`��.�fl+" t!('11171�f111tt�f:�'i�/JI/• e`' '��� tff..�,i�t('/1(t;.i�',�f� Office of Consumer Affairs Ad Business Pegulation. k r V 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Pegisti�ation Registratiom 177704 Type: Supplement Card Expiration 2/1,!2018 BUDGET EXTERIORS LUBOS SVEC 354 MERRIMACK ST ENTRY C LAWRENCE, MA 01840 ...... Update Address and return card. Mark reason for change. Address Renewal i:mployment Lost.Card � fi`J. It.lt(!ft)t T!'_'"tfT l(i%f� (�Y!'•a:f!:'ld�f�✓.�� "t7fGcc of C onsumer Affairs&Busints./s ke9111ru4in License or registration vniid for individual use only yr,� 1'{ ME IMPROVEMENT CONTRACTOR Ucfure the expiration data If found rtturu to: Office of Consumer Affairs and Business Regulation sRegistration: 177704 Type: 10 Park Plaza-Suitt 5170 Expiration: 2/1/2018 Supplemeni Card Boston,MA 112116 BUDGET EV ERIORS LUBOS SVEC 354 MEPIR ST ENTRY C, LA:W'RENCE.MA 01840 `ati i tout signature t ndtrcraxtar} I IMa achusetts- Depirtment of public Safety 11 IV'2So d.of Mu(ding RI-q ulafl-ons and Standarcjs �fiT•#62 i"�CFttgri�E1jDl`;1t4€S f' License: CS-097619 LUBOSSVEC 827 THOMPSON:ROA1} Thompson CT 06277 r f, ,. .. �1 i x: :riot ern 0813112016 I jF B { ^s P. ,9. �, � � ..��e s'>" ,� ,r:_ �+.aa;. > x`1�'t?r/ ✓ s A:+ I ;...n"€ •i:tT`.34:{-. its--`.f ! f ''.5.;IP500� t. MA004� � ..,,�1�E3t�D�.� rz.(?`,i't#.?";�1�3• "�a+r>tz.t3sts>..;;�'erc�rs;,�„ _ Oflicc nfComumer Affairs 'k Business licg,llafirm [license or registration valid for individul use only yOME IMPROVEMENT CONTRACTOR before the expiration elate. If found return to: to r{f �egistrai on: 177704 Type: Office of Consumer Affairs and Business Regulation <�Expiratio�: 211/2018-- DSA 10 Park Plaza-Suite 5170 Boston,AIA 02116 BUDGET EXTERIORS LOUIS MILANO r �f. 354 MERRIMACK ST ENTRY C LAWRENCE,MA 01840 Undersecretary Not valid without signature s I { .::ftse CS-037519 ra LUROS SXrEC 827'FHOKPSON,ROAn. . Thompson C'F 06277 08/31/2016 1-71 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 I DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine I I NOTES and DATA— (For department use i ❑ Notified for pickup - Date i I Doc:.Building Permit Revised 2008 I 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: Doc.Building Permit Revised 2008 Location "�� S / fir VA A� 1-540 Date NORTN TOWN OF NORTH ANDOVER O? • • Ow � 9 s ; ; Certificate of Occupancy $ 9 cwu ''�s'"••°'�I Building/Frame/Frame Permit Fee $ s� st Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check # Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: �� � DATE ISSUED. � SIGNATURE: ✓�� Building Comnlissioner/lEEeLxtor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 225 SRtmi Cov" toy C �y A)o(`w A-JDouc�, MA A Nq Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: r S 30Z ' Zoning Distrid Proposed Use Lot Area(sf) Frontage ft 1.6 BUILDING SETBACKS ft I Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water S ly M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone_ Outside Flood Zone ❑ Mimicipal On Site Disposal System ❑ SECTI N 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.11 Owner of Record 2Z5ot,F— A-TEi e(Print) Address for Service: 78- 69&- 015-7 0 Vgnature Telephone 14 2.2 Owner of Record: Name rint Address for Service: z Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervis O&v p5 ?r V r/6eft-j /�f� o Olga y License Number Address G� f',17 I Z� Expiration Date Signahtrt Telephone 3.2 Regi ptered Home Improvement Contractor Not Applicable ❑ -� �►,�� Dt%Si�,v � �urcD :�ompany Name 2 32 37 Registration Number address J� I✓ 1 [" mom Expirati Date ii nature Telephone SECTION 4-WORKERS COMPENSATION(NLG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ 1 Addition ❑ Accessory.Bldg. ❑ Demolition ❑ Other SpecifV_7 Brief Description of Proposed Work: G/N1,SM AciX15�N6' SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be . OPFICIA)(.USE4}NLY` Completed by permit applicant I. Building (a) Building Permit Fee Multiplier 2 Electrical (b} Estimated Total Cost of 7 � Construction / 3 Plumbing Building Permit fee(e)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR/APPLIES FOR BUILDING PERMIT I Qvn/i+� ��� cl as Owner/Authorized Agent of subject property HeUy authorize ��l �ESlbnf (jU2p I>ZC_ to act on y half,in allSk tive to work authorized by this building permit application. S' tore of Owner Date S TION 7bb OWNER/AUTHORIZED AGENT DECLARATION I, J i PNS✓ l Pu G� ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief 5�; Me. . Print N 512_ ©4- Si ature of Owner/A ent Dae T NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR THVMERS IST 2ND 3 SPAN DINIENSIONS OF SILLS ` DROENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations l Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: J ghqj AWO P L;S,A) Location: ZZS.. &,e)(It3 I ATH Q itV 6P,"+ AWP"L.0 O(8 HS Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity' . I am an employer providing workers'compensation for my employees working on this job. Compartyname: 0 ,-iyt . Address 3� l'��ii"acK S iiz04- �UltA�nlC CRY 003 9Aff- 9V� Insurance Co. Poli: .# W61 0012701 Company name: f""fl 7� Acc!kn4y 6il",FAV/11ej M. P0 SyO-44 ME IJAUMM /77/4- - 17 0 tom* psi-X737. -y� Insurance Co. �'/aY3�t rry T<�J Policy# 0R S °&WJ4 Faiknre to se=ecoverage as required urder Section 25A or VIGL 152 can Jud Wthe iriposition oftriuku t penalties or arrm UP-40$4.!, andtor one years'ornsorimmt-as jcn#4 erna m-mjheSam -&.a xiP fws(S jQD m)-a�. understand that a copy of this statement may tie forwarded to the office of Investigations of the DIA for coverage verification. /do hereby c&W ttie and /tiers of wy that the k0bm)atiar provided above is bye and correct Signature Bate 3 22 Print name Official use only do not write in this area in be completed by city or town official' i eify or Town P Edi [:]Che«r Y mrrettiate response is required .p E.kensirlg ea . p SelectmaWs � Contact person: Phone# Health Depar Other I I I i North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant d Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i 03-18-2004 11:34 From-THE MCCARTHY COMPANIES +1-781-893-6679 T-316 P.001/001 F-570 4GR "ri4M 1 c Vr L1HD1L1 1 T IMJUKANUt OPID Nq "'" PRODUCER HOWEL-1 03;19/04 Brenton Tyler/Ralph Rubin Ina. THIS CERTIFICATE IS 133UED AS A MATTER OF INFORMATION The McUrth Co ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE y meanies 169 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Waltham MA 029 P.O.Sox A 02459-0169 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. — Phone: 781-•893-4808 Fax:781-893-6679 INSURERS AFFORDING COVERAGE NAIC# INSURED _... INSURER Hartford insurance 22357 INSURER 11: 9afet Insurance Co an Howell Design & Build, Inc INSURER c, Atlantic Charter 360 Merrimack St Suite 5 INSURER D; Lawrence MA 01843 INSURER E: � � COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRINSRO TYPE OF INBURANCBPOLICY NUMBER DATE MWDDl�E DATE MMIDDIY OIT LIMBS GENERAL LIABILITY EACH OCCURRENCE i 1 000,000 A X COMMERCIAL GENERAL LIABILITY OBSBACH6835 06/01/03 06/01/04 PREMt�ao�enoe S 300,000 CLAIMS MADE I•• I OCCUR MED EXP(Anyone pomon) b 10 000 X EPL-$S000 _ PI:RSONAL&AOVINJURY $ 1,000,000 OcNERALAGGREGATE 52,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: POLICY PRO' PRODUCTS•COMP/OP AGG S 2,O0O,000 JECT LOC AVTOMDBILP LIABILITY H ANY AUTO Co MI51NED SINGLE LIMIT 1500162 04/17/03 04/17/04 (Eaeccldeeq £ ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY IPerperson) 1250000 X HIRED AUTOS 8()DILY INJURY XNON.OWNEDAUTOS (Peracclderkj $ 500000 • PHOPERTYDAMAGE S 250000 (Pei oocidenq GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO — 01 HER THAN EA ACC 8 ALrrO ONLY: AGG S — EXCE651UMBRELLA LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE A6:GRE0A7E f DEDUCTIBLE — RETENTION £ — ^• S S WORKERS COMPENSATION AND G, EMPLOYERS'LIABILITY X TORY LIMITS ER ANY PROPRIETORIPARTNER/EXECVTIVE WCA00120702 06/01/03 06/01/04 E.I.EACH ACCIDENT s 100000 OFFICERIMEMBER EXCLUDED7 Ifyye��S,describe under E.L.DISEASE•EA EMPLOYE S 100000 MAL PROVISIONS below 961 — OTHER E.L.DISEASE•POLICY LIMIT £SOOOOO DESCRIPTKIN OF OPERATIONS!LOCATIONS contactor /VEHICLES J EXCLUSIONS ADDED BY ENDDRSEMENT 15PECIAL PROVtSI0N5 CERTIFICATE HOLDER CANCELLATION CHRBOX- SHOULD ANY OF'HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE I55VING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITYEN Chris Noren NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAIWRE 7D DO SO SHALL 3 9 Adams Rd IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AOE/JT&OR Boxford MA 05921 REPRESENTATIVES. AUTHM W RESENTATIVE 1 ACORE)25(2001/08) CORD ORPORATION 1 Board of Building Regula ions and Standards k One Ashburton Place - Room 1301. Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 123237 Type: Public Corporation Expiration: 1/10/2005 HOWELL DESIGN & BUILD STEPHEN HOWELL 44 BEECHWOOD DRIVE N. ANDOVER, MA 01845 Update Address and return card.Mark reason for change. Address F-] Renewal ❑ Employment Lost Card Board of Building Regulations and Standards jiOne License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the ex iration date. If found return to: Registration: 123237 Board of Building Regulations and Standards Expiration: 1/10/2005 Ashburton Place Rm 1301 Boston,Ma.02108 Type: Public Corporation HOWELL DESIGN&BUILD STEPHEN HOWELL i 44 BEECHWOOD DRIVE N.ANDOVER,MA 01845 Administrator Not valid without signature Board of Buildin �eglafions One Ashburton Pace 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 02/14/1962 Number: CS 068232 Expires: 02/14/2006 Restricted To: 00 STEPHEN D HOWELL 15 MT VERNON RD BOXFORD, MA 01921 Tr.no: 16114 Keep top for receipt and change of address notification. I • I I /ze Vr o7,a��wowie 11J4,,661.1u. 6I&I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR �,- _ Number: CS 068232 Birthdate: 02/1411962 Expires: 02/1412006 Tr. no: 16114 Restricted: 00 STEPHEN D HOWELL 15 MT VERNON RD ! BOXFORD, MA 01921 Acting Cc mis oner i i PM r-pPl CHANGE ORDER FORM AND ACCOUNTING SUMMARY HOWELL DESIGN&BUILD,INC. Riverwalk: Building 5 360 Merrimack Street Lawrence,MA 01843 (978)989-9440 C.S.L. #068232 H.I.C. #123237 DATE: March 25,2004 OWNER'S NAME: Jeanne and Gregory Andrusin ADDRESS: 225 Bridle Path j North Andover,MA 01845 PROJECT: Andrusin Residence Additions and Renovations CONSTRUCTION CHANGE ORDER#: 8 i L GENERAL SCOPE OF WORK DESCRIPTION Pursuant to the Construction Agreement between Contractor and Owner dated October 14,2003 as requested by the Owner,the Contractor agrees to make the following changes to the work in the original agreement: I General Notes • Items marked Option have not been included in the Contract Sum. See List of Options for amounts carried for each Option. • Items marked Allotment have been included in the Contract Sum. See List of Contract Allotments attached to this change order for amount carried. Owner's Responsibilities • Remove all personal items&furniture from areas to be remodeled. Plans&Permits • The Plans shall be based on the Sketch of the Floor Plans by Stephen D.Howell, which were used for detailed estimating&specification purposes. • Prepare Town of North Andover building permit application,file the application,and post the permit on-site. • Allotment Item: Building Permit Fee. See List of Contract Allotments for amount carried. Site Prep& Demo • Remove existing stair treads,risers, skirts,&handrail. (Framing&Plaster to remain) • Remove& save the existing basement door to the garage. • Site Portajohn for(1)month duration. I Framing Materials: • All wall framing materials to be#2 SPF KD unless otherwise specified. Floor Framing(None) Wall Framing Interior Walls: • 2x4 @ 16"OC with P.T. sill;including the following: o Frame new walls according to the sketch against the foundation o Frame interior wall partitions according to sketch. o Frame new door opening to the Garage in new location. o Option: Frame(2)new half walls in the opening to the TV Room. i Other Framing: • Cut&frame new door opening into the Garage per plan. Frame in old opening. • Option:Remove(1)lally column in the basement. Add structural support to existing main carrying beam in location where lally column to be removed. • Install blocking in walls for bathroom accessories and other finishes • Frame soffits around drop beams over pool table area and opening into the TV Room. • Frame soffitted ceiling over Game Table/Bar Area as shown on plans. Roof Framing • None Roofing&Flashing • None Exterior Doors&Windows • None Plumbing General Notes: • Type L Copper Water pipe. • PVC Drains&Vents. • PVC Plumbing Vents through the roof. • Allotment Item: Plumbing Fixtures. See List of Contract Allotments for amounts carried. • Owner to select fixtures. Plumbing Contractor to supply fixtures. • Note: Underground piping and ejector pump for basement bath was included as part of Contract Change Order #3. Bath: • Install remainder of rough plumbing for new bath fixtures through new framed walls. • Supply and install the following plumbing fixtures: I o (1)Toilet and seat o (1)Pedestal Sink o (1)Pedestal Sink Faucet o (1)Fiberglass corner shower(including glass doors) o (1) Shower valve,trim, and head • Option: Supply and install(1)Utility Sink and Faucet in the unfinished part of the basement. HVAC Supply and install the following heating system: Heat: • Install(1)new zone of heat on existing boiler. • Install heat lines running back to boiler • Install baseboard heat in Basement and Bathroom. Heat Recovery Ventilation System: • Option: Supply& install Heat Recovery Ventilation System(required by MA State Building Code) Electrical General Electrical Notes: • Allotment Item: Decorative Electrical Fixtures. See List of Contract Allotments for amounts carried. • Allotment Item: Electrical Demo. See List of Contract Allotments for amounts carried. • Allotment Item. Electrical Permit Fees. See List of Contract Allotments for amounts carried. • Owner to select decorative fixtures. Contractor to supply decorative fixtures. Decorative Electrical Fixtures included in Contract(as Allotments): • (1)Ceiling Pendant Light over the Pool Table Area 0 (2)Wall Sconces Electrical Fixtures included in Contract(Supplied by Electrician) • (15)6"Juno Recessed Lights with white baffle trims • (1)Panasonic Bathroom Exhaust Fan • (2)Fluorescent Closet Lights • White Plastic switch and outlet cover plates;dimmer switches Electrical Work by Area: Bathroom: • (2)Wall Sconces • (1)GFCI Receptacle • (1)Panasonic Exhaust Fan with a timer • (1) Switch TV Room: • (1)TV Outlet • (5)Receptacles • (4)Recess Lights • (1)Dimmer Switch • (1)Telephone Outlet Game Room: • (9)Receptacles • (1)Closet Light • (2) Switches • (1)Dimmer Switch • (1)Pendant Light • (8)Recess Lights Mud Room: • (3)Recess Lights • (2)Three Way Switches • (1) Switch • (1)Closet Light • (2)Receptacles Insulation Supply and install the following fiberglass batt insulation: • Exterior Walls: 3-1/2"R13 unfaced with 4 mil poly vapor barrier • Fill around door and window rough openings with fiberglass insulation Plaster Supply and install the following plaster: • Walls: '/2"gypsum blue-board screwed to framing with 1-1/4"screws • Ceilings: '/2"gypsum blue-board screwed to framing with 1-1/4"screws • Apply smooth skimcoat plaster finish on all walls and specified ceilings • New coat of plaster(only)on garage wall and stairway walls and ceiling. Acoustical Ceiling Tile Supply&install Acoustical ceiling tile throughout TV Room,Pool Room, and Mudroom Area. • Allotment Item: Tile and grid to be selected by Owner and supplied by Contractor • See List of Contract Allotments for amount carried for ceiling tile and grid. Tile General Tile Specifications• • Allotment Item: Bathroom Tile and grout to be selected by Owner and supplied by Contractor • See List of Contract Allotments for amount carried for tile. • Mudroom Tile to be Supplied by Owner. Salvaged slate from 1'floor renovations. i • Installation labor for the Bathroom floor has been included assuming 6x6 ceramic tile,rectangular layout parallel to walls. Special patterns, setting of accent tiles or patterns that include large amounts of cutting would be extra. Contractor may revise pricing once the actual tile and patterns are selected by Owner. • Install Anti-fracture coating over concrete cracks and new concrete slabs as necessary. • Sealing of grout or use of epoxy grout has not been included. Install ceramic tile in the followingareas: reas: • Bath Floor 60 SF total tiled area. • Mudroom Floor 104 SF total tiled area. Total ceramic tile: 164 SF Interior Doors General Notes: • All interior doors to be pre-hung on solid double rabbetted jambs • Jambs to be clear f primed pine • Jambs widths 4-5/8" • Doors to be ordered without casings. Casings to be installed in field. • Doors to be pre-bored for standard hardware. • Owner to select finish for hinges and hardware prior to ordering doors. Interior Door specifications: • All interior doors to be 6-panel solid core, smooth finished masonite doors;unless otherwise specified. Interior Door List: • (1)2068 Hinged(Sump Pump Room) • (1)2468 Hinged(Bathroom) • (1)2868 Hinged(Unfinished Mechanical Room) • (1)3068 Steel Fire-rated Door(Garage) • (1)6068 bifold doors(Mudroom Closet) • (1)4048 double hinged flush doors(Game Table Area Closet) I Interior Door Hardware: • Supply&install locksets on above doors. • Allotment Item: Owner to select hardware for doors, Contractor to supply and install. • See list of Contract Allotments for amounts carried. Interior Trim& Millwork Supply and install the following clear,paint-grade pine and/or poplar interior wood trim. All interior trim and moldings to be 3/d'thick(nominal l"unless specified otherwise. • Window Casings: 2-1/2"Colonial casing, mitered with stool and apron • Door Casings: 2-1/2"Colonial casing, mitered. • Baseboards: 5-1/2"base plus 1-1/4" cap • Option: Install(1)paint grade decorative wood column in Pool Room Area. • Option: Install(2)paint grade decorative wood half columns in opening into TV Room on top of half was. • Option: Install(1)half wall wood shelf below two-wide double hung windows at the rear of new addition. Mudroom Closet Interior: Supply&install(1) 8' shelf and(1)8'Fir closet pole. Stairs: Supply and install the following stair parts: • Plywood Treads&Risers,prep for carpet(as necessary) • Skirts: 1x10 Poplar(Paint Grade) • Handrail: 2-1/4" Oak handrail stock profile mounted to the wall with brass handrail brackets; Owner to approve style and profile. Cabinets • Install upper cabinets savaged from the kitchen renovation in unfinished Mechanical Room. Option:Built-ins: Supply and install the following: • Bar Area Cabinets—(Paint Grade) • Bench—(Natural Maple—Pre-finished) • Cubbies—(Natural Maple—Pre-finished) • Coat/Hat Rack—(Natural Maple—Pre-finished) • Base Cabinets(Below Stairs)—(Pre-finished, simple full overlay doors). Countertops Supply and Install Laminate Countertop in the following areas: • Option: Bar Area. • Option: Base Cabinets Below Stairs. • Owner to select and approve laminate prior to fabrication. Specialties Install the following list of specialty items(Supplied by owner): • (1)Mirror • (1)TP Dispenser • (1)Towel Holder • (1)Shower Door(Materials Included in Plumbing Fixture Allotment) Carpet • Allotment Item: Supply and install carpet throughout Basement Renovated Area and Basement Stairs. • See List of Contract Allotments for amounts carried. Option: Painting General Painting Specifications • Owner to select colors. • Colors: Ceilings: white;Walls: 1 color per room,dark colors may require additional coats to cover,which would be extra;Trim.Doors. &Windows: 1 color per room different than walls. Dark colors or dramatic contrast to wall color may be extra. • Contractor to supply materials and labor. • All interior paint on trim to be latex with semi-gloss sheen. • All walls to be latex with eggshell sheen. • All ceilings to be latex with flat white sheen. I Interior Painting: • Trim: prep+(1)coat prime+(2)finish coats. • Walls: prep+(1)coat prime+(2)finish coats. • Ceilings: prep+(1)coat prime+(2)finish coats. • Interior Doors: prep+(2)finish coats paint • Windows&Grills: prep+(2)finish coats paint • Stairs: Skirts: prep+(1)coat prime+(2)finish coats paint • Stairs Handrails: prep+(3)coats polyurethane I • Bar Area Cabinetry: prep+(1)coat prime+(2)finish coats. • Base Cabinets Below Stairs: None(Pre-finished) • Bench, Cubbies,&Coat/Hat Rack: finish edges: prep+(3)coats polyurethane. Clean-up • Jobsite to be cleaned up daily. • All construction debris and Contractor's equipment to be removed from site upon completion. • The work area shall be left"broom clean"upon completion. i III. GENERAL CONDITIONS A.PAYMENT The following Schedule of Values for this change order shall be added to the Schedule of Values for the Original Agreement: Demo&Framing $ 6,000 Electrical $ 5,000 Plumbing $ 8,000 Insulation&Plaster $ 6,000 Ceiling $ 3,000 Tile $ 3,000 Interior Doors&Trim $12,123 Carnet It 2 200 Total $45,323 I B.INCORPORATION This Change Order,by agreement of Owner and Contractor,is incorporated by reference into the Construction Agreement between Owner and Contractor. All terms and conditions in the"General Conditions" section of the Construction Agreement between Owner and Contractor apply to this Change Order. C.DATE OF SUBSTANTIAL COMPLETION 1)Original Date of Substantial Completion March 26,2004 2)Net change by all prior Change Orders 37 business days 3)Adjusted Substantial Completion Date prior to this Change Order May 18,2004 4)Net change by this Change Order 15 business days 5)Adjusted Substantial Completion Date including this Change Order June 10,2004 Note: Selection of options may delay Date of Substantial Completion Date of Substantial Completion to be approximately June 10,2004 including the additional work specified in this change order,not including delays and adjustments for delays caused by: inclement weather, accidents,additional time required for performance of Change Order work(as specified in future Change Orders),delays caused by Owner, and other delays unavoidable or beyond the control of the Contractor. I have read and understood the Change Order above,and I agree to all of its terms. Date OWNER'S SIGNATURE Date OWNER'S SIGNATURE Date CONTRACTOR'S SIGNATURE n L vc v, r CONSTRUCTION SERVICES AGREEMENT Owner: Jeanne and Gregory Andrusin Date: October 14,2003 225 Bridle Path North Andover,MA 01845 Contractor: HOWELL DESIGN&BUILD,INC. Riverwalk: Building 5 360 Merrimack Street Lawrence,MA 01843 (978)989-9440 C.S.L. #068232 H.I.C.#123237 Project: Andrusin Residence Additions and Renovations I. PARTIES This contract(hereinafter referred to as"Agreement")is made and entered into on this 14th day of October,2003,by and between Jeanne and Gregory Andrusin, (hereinafter referred to as"Owner");and Howell Design &Build,Inc.,(hereinafter referred to as"Contractor"). In consideration of the mutual promises contained herein, Contractor agrees to perform the following work: IL SCOPE OF WORK DESCRIPTION & CONTRACT SUM The Contractor shall perform the"Work"as described in this Agreement and the following Attachments, which are incorporated into this Agreement by reference below: ATTACHMENTS 1) 11 page Scope of Work Description&Specifications by Howell Design&Build,Inc., dated October 14,2003, 2) 10 sheets of Plans titled"Andrusin Residence"by Howell Design&Build,Inc.,all sheets dated December 20,2002 3) 1 sheet of Plans titled"Permit Site Plan"by Hancock Engineering Associates,dated July 31, 2003 and last revised September 5,2003. 4) 2 page List of Contract Allotments by Howell Design&Build,Inc. dated October 14,2003. 5) 2 page List of Contract Options by Howell Design&Build,Inc. dated October 14,2003. 6) 1 page Schedule of Values by Howell Design&Build,Inc. dated October 14,2003 7) 1 page Substantial Completion Agreement by Howell Design&Build,Inc. 8) 3 page Limited Warranty by Howell Design&Build,Inc. dated October 14, 2003. CONTRACT DOCUMENTS The"Contract Documents"consist of this Agreement,the Attachments listed above,and Modifications issued after execution of the Contract. There are three(3)types of modifications: 1) a written amendment to the Contract signed by both parties, 2) a"Field Change Order"is a written directive from the Owner for the Contractor to proceed with a change in the work prior to the final cost of the change being known,the exact amount of extra time required for performance of the change,and/or prior to a "Contract Change Order"being executed. 3) a"Contract Change Order"is a written agreement between the parties to change the Page: 1 of 8 Initialst' l ` binding upon the parties. N. TRANSFERENCE This Agreement is between Owner and Contractor and is not transferable to other parties without the prior written consent of both Owner and Contractor. 0.OWNER'S 3-DAY RIGHT OF RECISION The Owners may cancel this agreement with no further obligations by notifying the Contractor in writing that they wish to cancel the agreement within 3 business days of the date they signed the agreement. I have read and understood,and I agree to,all the terms and conditions contained in the Agreement above. DAte Thomas L.Heffer " Project Manager Ho 11 Design B i ,Inc. I a e Owner i �a 3 Date Wer i i Page: 8 of 8 Initials: �l �.1ORTH Town of 6Andover Zcolo '� dower, IViass. — T O _ - LAK 1 1 A_ COCKICMEWICK V 7.ADRATED S u BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR �t d N�V �i 6'r�� ,/Q N el v S �J THIS CERTIFIES THAT.................... ........................................... ........ .................................................................................... Foundation f�ws�i�u has permission to erect........................................ buoldings on .................... ... .................................................N!. Rough to be occupied as............. .. .y f;k oal J3a sC *7C-Vf Chimney p .............. ................................. ........................................................................ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. / 09C / 8 y f $*Soo 000 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough Al . .•........................ .C ` . .......... Service BUILDING INSPECTOR 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. pro y CLI it '51vik- C44 al V,<1 lef"goc k V�A 4N, L Ro— Location No. a f Date rORTp TOWN OF NORTH ANDOVER Certificate of Occupancy $ }y�s'•• <�'# Building/Frame Permit Fee $ s�04 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ a911 Check # b Da a /�� ( ( �-- 16 �s � g Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSI'RUCI REPAIR,%OVAAOR DEMOLISH A ONE OR TWO FAMH,Y DWELLING ✓5.., ,gr.r-£",,.."ra ,.r=K rte. _-:. . _ - _;,� - ;., �.. +Y.;.. w- ff BUILDING PERMPT NUMBER: DATE ISSUED: D7l " -� a SIGNATURE: Building Commissioner r of Buildings Date Z SECTION 1-SITE INFORMATION C 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 2z.6- 15AIPI-C Noe Map Number Parcel Number a o«Y� NOoV�.R r ✓� � 1.3 Zoning Information: 1.4 Property Dimensions: r SINGLE rMlel! - 965i`0fi-J71PL 44.614 Sf Zarin Distrix Proposed Use Lot Area Froubi A 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Provide A Provided Required Provided 1.7 weer s ty M Cad-C.4o. s4I 13. Flood zone Idarmadow 1.8 n;spwd system Posse Priwre ❑ 7� outside Flood zone, ❑ Municipal on sae Dispmd Sy.: ` SECTION 2-PROPERTY OWNERSHIP/AUTHORDMI)AGENT rn 2.1 Owner of Record //�� Cj1LW 4 JEANniE AAwAUsIni 22S &Ibt,E PAT-N Name(Print) Address for Service: X� 9 78- 0157 l Signature Telephone Q 1�1 2.2 Owner of Record: Name Print Address for Service: a M Si re Tel hone f SEOTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor. Not Applicable ❑ C II JTEP1tErJ Q 40POLLCS 06S 23 Z � Licensed Construction Supervisor: QLicense Number � 115 PAT Va (0,410 P-0)( v" PU MZl min Address 02 tN�2ooy —n't-4970 - 3 - 7 Expiration Date .rte SignatuA Telephone r 32 Registered Home Improvement Contractor Not Applicable ❑ rvcc �rrs�6,� $ l�►� .1,,uc. 12323 � Com ny Name ,I ltegishation Number r y �EECtIwW� , Rn� bvoov�lt MR 01$yS r Addrlss G Q U 0i 1101Z005 za—dj) i 9'0 - 989- 9 /yo Expiration Date z Cionmilre.. I Tdmhnne SECTION 4-WORKERS COMPENSATION(ALG-L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildinrmit Signed affidavit Attached Yes...... No.... .0 SECTIONS Desch tion of ProposedWork check a e New Construction ❑ Existing Building V Repairs) ❑ Alterations(s) 0 Addition Accessory Bldg. 0 Demolition Other . ❑ Specify Brief Description of Proposed Work: sr 3 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ? ti r � Completed by permit applicant 1. Building 41001000 (a) Building Permit Fee Multiplier 2 Electrical l O DOo (b) Estimated Total Cost of Construction 3 Plumbs 0 Building Permit fee a x 00 � t) (b) 4 Mechanical AC 0 5 Fire Protection 6 Total 1+2+3+4+ 25 Oop Check Number b o o SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, STD Nen1 Q, 40w6.C( as Owner/Authorized'Agent of subject property ' Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief STEP)A J �A. Il�utsl t. Print!7e �,�, � /) J'� l b Si ture of Owner/A ent � Date 1 I I -NO.OF STORIES Z SIZE 350 SF BASEMENT OR SLAB SAS&A&JT. RD SIZE OF FLOOR TIMBERS P1 X ZiO 2 ZX 10 3 SPAN 1Z, M ENSIONS OF SILLS ZX 6 DRM ENSIONS OF POSTS Z X 4 DR ENSIONS OF GIRDERS Z X HEIGHT OF FOUNDATION = THICKNESS J O SIZE OF FOOTING 10" X 7-0" MATERIAL OF CHIMNEY ' IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Mo 1 FORM U - LOT RELEASE FORM �"l6 03 INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. i *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT PHONE 979, LOCATION: Assessor's Map Number 1 C- PARCEL PO SUBDIVISION + LOT(S) STREET ���.ac /ITh/ ST. NUMBER 225 ******************************* **OFFICIAL USE ONLY*********************************** RE MM N TIONS WN AGENTS: rC-ONS VATION AD 19f-RA-TOR DATE APPROVED DATE REJECTED -- COMMENTS RECE TOWN PLANNERDATE APPROVED DA• E REJECTED COMMENTS d /IUB, OC � �- PLANtJt�s UEPAii;rMENT FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED i COMMENTS i PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm 05/07!00 16:33 FAX 9784703700 SUSAN SELLS ►006 ! o Icy '3aI 'bP-At- t t.,1 ' r ASGMC—%I C LOT 17 co N. ry .g 2 STo i;y 40 �° �O Q D �StAMlr �r e V' '" 'taWClL1NC� c 0 •xi 3t �a° 42 CQ L0-r X90 �\ NOTE' C341&d A t S 3 tU 83F To P.ES4�tG?re�S,tOHDt?FQdS Aft Eh'�EME11T9 , II`A�1'!, t►1SoFAIL KS 'tit'- SAME AU lou) APPuuue. FOUR SEASONS ASSOCIATES.INC. 93 NEWBURY STREET, LAWRENCE.MA TELEPHONE 661-0091 _ I North Andover Building Department Tel: 978-688-9545 i DEBRIS DISPOSAL FORM In accordance with the provision of MGL 640 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MOL c 11, S 150 A. h The debris will be disposed of in: (Location of Facility) j Signa ure of Permit Applicant b+10 r ( Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i WThe Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations Q` Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: i City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity i I am an employer providing workers' compensation for my employees working on this job. �l Company name: I,JUk vest o� Address l5 v-euwu,.o oats City: Am AMOUyV2 A Phone#. 9n- 98 / - 91 y0 Insurance.Co. �'iLfWV r_ C4,4,C r n Pnliry It CA CO 1 Z 701 Company name: Address City: Phone#• f Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 and/or one years'imprisonment_as well_as_ciml.penatties in-ffie form rffo_STOP WORK ORDER and..a.fine of.(.$iAOM)a iday against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and p n61 ies of perjury that the information provided above is true and correct)If Signature 41h.1141�L Date 0 3 i1 �r I Print name §Teptketj �. t Njex Pbone# Official use only do not write in this area to be completed by city or town official' City or Town PermiULicensinq ❑ Building Dept ❑Check if immediate response is required 0 licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department ❑ Other i i �� ../!tG�0477/I7241Uf/J2CGLfJL O�J��O�GZiIbC�b j �-•, BOARD OF BUILDING REGULATIONS j License: CONSTRUCTION SUPERVISOR Number: CS 068232 Y' Birthdate: 02/14/1962 Expires: 02/14/2004 Tr.no: 17808 I � I Restricted: 00 t STEPHEN D HOWELL 15 MT VERNON RD BOXFORD, MA 01921 Administrator C ✓fie %�oo�v��zo�uuea�l�i o�i� uaelt .` Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 123237 Expiration: 1/10/2005 Type: Public Corporation HOWELL DESIGN&BUILD STEPHEN HOWELL 44 BEECHWOOD DRIVE N.ANDOVER,MA 01845 Administrator I I ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J Applicant Name: Site Address: Applicant Address: City/Town: Use Group: Date of Application: Applicant Phone: Applicant Signature: Compliance Path(check one): ❑ Prescriptive Package(Limited to 1-or 2-family wood frame buildings heated with fossil fuels only) Package(A through KK from Table J5.2.1b): Heating Degree Days(HDD65)from Table J5.2.1a: (For items d.through i.,fill in all values that apply from Table J5.2.1 b:) a. Gross Wall Area sq.ft f. Wall R-value R- b. Glazing Area sq.ft. g. Floor R-value R- c. Glazing%(100 x b_a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE ❑ Component Performance: "Manual Trade-Off"(Limited to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet, if applicable] ❑ AWcheck Software Attach Compliance Report and Inspection Checklist printouts 4� Home Energy Rating System Evaluation Attach Home Energy Rating Certificate(HERS rating score must be 83 or higher) ❑ Systems Analysis OR ❑ Renewable Energy Sources i Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: j a.Gross Wall+Ceiling Area )D 2 sq.ft. b.;Glazing Areal 1W, sq.ft. c.Glazing%(100 x b_a) L6 I ® ADDITION with Glazing% (c.)up to 40%may use 780 CMR Table J1.1.2.3.1 below: MAXIMM -value -Values Fen ation2 Ceflin aB Floor Basement Wall I Slab eri a er Depth 0.39; -37 R-13 R-719 MR Qj 0 4 ft 1 Glazing Area may be either Rough Opening or Unit dimensions. 2 Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e:not compressed over exterior walls,and including any access openings.) ❑ "SUNROOM"addition(greater than 40% glazing-to-wall and ceiling gross area) Attach"Consumer Information Form"from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved ❑ Denied ❑ Date of Approval/Denial: needed on back side Reason(s)for Denial: (provide additional details as ) JL %.IV VV i1 Vi L i%01Lv i 460i ° No. a 81 * . _ o t- LA o dower, Mass. COCHICH WICK A0'4ATED P9�G,`�5 S 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....�. . ... .... Q a Ar/V /4 + A ................................... ............................................. Foundation f* .. . .. .....�. �. ./ .....I° has permission to erect... ............... .I .. buildin s Rough t0 be occupied as......... '...n..V.I .... f ,�� N�,r A�I t ��«y Chimney ............................................................................ . . . . . .. ...................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Law relating to the , Alteration and Construction of Buildings in the Town of North Andover. 'O� C Ins actionPLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ......................................................................... Service BUILDING INSPECTOR 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 Until Inspected and Approved by the Building Inspector. BurneTFIRE DEPARTMENT Street No. SEE REVERSE SIDE smoke Det. ION FORM U - LOT RELEASE FORM i i INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. j *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT �T€���N r"' ��C PHONE 97F- LOCATION: Assessor's Map Number 103 PARCEL___I_t SUBDIVISION LOT(S) STREET �fi'�oc� /_ �/ ST. NUMBER 225 ************************************OFFICIAL USE ONLY*********************************** ECOMMENDATIONS OF TOWN AGENTS: — CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED l Z—Is I26— `I — Q COMMENTS M A- FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING — 5 s6diftSOT( iCCI7E Two ' M BUILDING PERMIT NUMBER. DATE ISSUED. SIGNATURE: Building Commissioner/1for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 22.5 Y1RiOLE PA7-)I , I /V I0R� /1 wva M^/� �� U` Map Number Parcel Num 1.3 Zoning Information:('I 7 J 1.4 Property Dimensions: Zoning District Proposed Use Lot Area s_ Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re 'red Provided 30 • ©, & 83 a 1.7 Water Simply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Se Disposal Disposal System: Public 12/ Private 0 One Outside Flood Zone 0 Municipal y On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record GRf& t J EAIVN6 AN06U51-11,J 22� ��,l p L6 P,o,,a Name(Print) Address for Service: 97F- Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ �T ►t�v D. Howea— CS Q6$23Z Q Licensed Construction Supervisor: J-5- /'/T SNOW 1 X060 &,KrC R 0(9Z I License Number wn Address r_ OQ C)Z IIq r Z00u L 7� 3� o Expiration Date l -1 Sigda re Telephone r 3.2 R9064L tered Home Improvement Contractor Not Applicable ❑ v 4 6VI LO T.L . Company Name n1 2 32 37 M 7 �j �NUG�D Al✓as /(L�µl7�✓/pUF/� � ���ys Registration Number r Address v Ol110t -3 Z - c-)78 - ��9 - 9yyr Expiration Date �'1 Si nature Telephone YI SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......V No.......❑ SECTION 5 Descri tion of Proposed Work check all applicable) New Construction ❑ Existing Building V Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition Other ❑ Specify Brief Description of Proposed Work: / /40,01-0,"1 OEc -S'l1/b i �Y✓!, G�!ri/✓G/`fl�M. SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building 00 OOv (a) Building Permit Fee Multiplier 2 Electrical �O OO O (b) Estimated Total Cost of Construction 3 Plumbing �, t700 Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 /25-,ob® Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AURITHOjRIZED AGENT DECLARATION I, 5TreA"N fi , iiccc as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Na Si nature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2ND 3RD SPAN M ENSIONS OF SILLS DIMENSIONS OF POSTS DENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHNNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE TOWN OF NORTH ANDOVER DIVISION OF PLANNING FACSIMILE TRANSMITTAL SHEET TO: FROM: Tom Heffernan Kathy McKenna,Town Planner COMPANY: DATE: 12/9/02 FAX NUMBER: TOTAL NO.OF PAGES INCLUDING COVER: 978-989-96441 1 PHONE NUMBER: SENDER'S REFERENCE NUMBER: RE: YOUR REFERENCE NUMBER: 225 Bridle Path ❑URGENT ❑FOR REVIEW ❑ PLEASE COMMENT ❑PLEASE REPLY ❑ PLEASE RECYCLE NOTES/COMMENTS: Allison McKay, Conservation, has discussed your building permit application with me. I would Eke to take this opportunity to go over a few issues from the Planning perspective. The property of the addition is located within the Watershed Protection District. As such any alteration or addition requires a Planning Board Special Permit or a waiver. Before making a determination it is necessary to receive a letter from a surveyor or wetland consultant stating the distance of the limits of work (including drainage) to Lake Cochichewick and any wetlands. Allison has told me that there is a possibility of wetlands nearby. This item would need to be clarified before I recommend any Planning Board action. Further, I would need to know the gross floor area of the existing structure and the proposed addition. Gross floor area is defined as"the floor area within the perimeter of the outside walls of the building without deduction for hallways, stairs, closets, thickness of walls, columns or other features." If the addition is within 325 feet of the Lake or wetlands the expansion can not be 25% or more of the existing structure. If it is,a variance from the Zoning Board is required. To sum up the first step would be to have an engineer and / or hydrologist (wetland scientist) certify the distance of the construction from the lake and from any wetland areas. If you have any questions,please call me at 978-688-9535. North Andover Conservation Dept. 27 Charles Street North Andover,MA 01845 To: Tom Heffernan Fax: 1-978-989-9441 From: Alison McKay,Conservation Date: 12/06/02 Associate i Re: 225 Bridle Path,Building Permit Pages: 2 including cover CC: 0 Urgent o for-Review 0 Please Comment 0 Please-Reply Q Pleace-Recycle . . . . . . . . . . Attached is a list of Consultants that can help in determining the wetlands on site and/or within 100 feet of the proposed work. Once the hired consultant'has been determined, f6el free to notify me and we can discuss the logistics at that point I caught Kathy McKenna,the Town Planner,on her way out of the office and informed her of the site and situation. You may call her at 978-688--95-35 to discuss the planning issues in further detail. I also would like to emphasize that no work may start until the final building permit is issued after both-the Conservation department and Planning department sign off and approve the work. Thank you for your anticipated cooperation. Please feel free to contact me at any time to discuss these matters further. Sincerely, Alison McKay, Conservation Associate I I i . . . . . . . . . . . 05/07/00 16:33 FAX 9784703700 SUSAN SELLS 0006 2 � o 30731zPC I`AS cNt c—%1'r LOT I7 • l . 00dfi ti110, a o 5A `ry ' s 2 5TO Z4 h100v FRAME 44r u t 5°•o'.. N - pa . �p 4V `'w 1 LOT V'90, E.ES4QIGire�lS,tOttDl'1'iod4 h>!D . E�t'�ME11?9 , IF�ldy, +t15oFA�. !�S Ti1'E SAME AQIr Blau) APPucABLE. FOUR SEASONS ASSOCIATES.INC. 93 NEWBURY STREET, LAWRENCE.MA TELEPHONE 681-0091 VET AND SHOULD tE USED FOA YOoTwuan -_---- TION OF FENCES O4 CONSTRUCT' PURPOSES.IF BUILDINGS SHOWN LESS THAN ONE FOOT FROM THE MOM THIS IS NOT SUR HOUNv►a*�.�G=••• SuavET TO VEDIFT THESE MEASUREMENTS, THE SHOWN I FUFITHEA CERI7FT TH&T Tmf au INGS�sES-AND Au.BUILDINGS.EASEMENTS. C NFOMAED TO THE ZONING LAWS ANO AMENDMENTS OF 141).Au oaVfG0.WHEN NGON STRUCTEo.I FUATNER CERTRY THAT THIS vnODERTY IS Ng*fLOCATED IN THE ESTABLISHED FLOOD HAZARD AREA. ''�" OF Uka RBU4ER l TO THE THEAR- M C.,i o to I � L)'ST com*gtiIy 6g c. AND TITLE INSURERS x J""`E BOOK: 13Z�s MORTGAGE INSPECTION PLAN 3 572 y PAGE: LOCATED �a PLAN NO.: � c�sT�R SCALE; I"=40'-00'% '1,�� R 1 L> Q k i i I I LO .-AgD DV E I? , MA DATE: t Ih r 8 TO BE USED FOR MORTGAGE PURPOSES ONLY I II t q � i s r�b f.Gc•�,�-✓ i d LA S Q i2 -:17/v S`T+ c/A % •zJ (3 y ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J Applicant Name: ST1fP*ftJ 0. KW&L Site Address: 225 Applicant Address: $wfec ._Esq $ 611WE10,Zk City/Town: RTN A.voovcy_dMA 0(P5- */3666W&W J 0,ew46 Use Group: /o,ery Date of Application: 12 2 oe- Applicant Phone: 9?8"-999- 90149 Applicant Signature: IV Compliance Path(check one): ❑ Prescriptive Package (Limited to 1- or 2-family wood frame buildings heated with fossil fuels only) Package (A through KK from Table J5.2.1b): Heating Degree Days(HDD65) from Table J5.2.1a: i (For items d. through i., fill in all values that apply from Table J5.2.1b:) a. Gross Wall Area sq.ft f. Wall R-value R- b. Glazing Areal sq.ft. g. Floor R-value R- c. Glazing % (100 x b_a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE ❑ _ ComroneYt Performance: "Manual Trade-Off'" (Limitel to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet, if applicable] ❑ MAScheck Software Attach Compliance Report and Inspection Checklist printouts 0 Home Energy Rating System Evaluation Attach Home Energy Rating Certificate(HERS rating score must be 83 or higher) ❑ Systems Analysis OR El Renewable Energy Sources Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross Wall +Ceiling Area V.57 sq.ft. b. Glazing Areal 172 sq.ft. c. Glazing%(100 x b_a) % ADDITION with Glazing % (c.) up to 40% may use 780 CMR Table J1.1.2.3.1 below: MAXIMUM U-value MINIMUM R-Values Fenestration2 Ceilin 3 Wall FloorBasement Wall Slab Perimeter Depth 0.392 R-37 R-13 R-19 I R-10 R-10 4 ft I Glazing Area may be either Rough Opening or Unit dimensions. 2 Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation maybe used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e.-not compressed over exterior walls, and including any access openings.) ❑ "SUNROOM" addition (greater than 40% glazing-to-wall and ceiling gross area) Attach "Consumer Information Form" from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved ❑ Denied ❑ Date of Approval/Denial: Reason(s)for Denial: (provide additional details as,needed on back side) North Andover Building Department Tel: 978-688-9545 i DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) Signat re of Permit Applicant f� 02 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector W The Commonwealth of Massachusetts M , Department of Industrial Accidents a d Office of Investigations Boston, Mass. 02919 '�,M Spey Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. 0 I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: &CL(. p���^> 1Lp, „!C. Address * &,a4Ai-,0V �e,,e City: (72, Phone#: 9 2,9" Insurance.Co. /'1TL>Avyc- CNS Krf7 t Policv# CHIC A OO1 Z?41 Company name: Address City: Phone [� # Insurance Co. � `TLAv-ri c t1Rre,,� Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment.as welLas_civil,aenaltiesinshefnrmcf-a_STOP.W._ORK ORDER.and..a fine_af�.$1.00M)-ailay.againstme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. } I do her certify u er the nainsand allies of perjury that the information provided above is true and correct. Signature Date 6( Q Z Print name s P n/ t✓6tC Phone# 9 Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing O Building Dept ❑Check if immediate response is required Q Licensing Board p Selectman's Office Contact person: Phone#. ❑ Health Department Other safe- 6/10/02 04:02 PM Sender's Far,!D:9789880038 Page 2 of 2 � II � AC0RD CERTIFICATE OF LIABILITY INSURANCE OP ID CL DATE(MMIDDIYY) PRODUCER HOTIEL-1 06/10/02 Brenton Tyler/Ralph Rubin Ins. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The McCarthy Companies ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE THIS CERTIFICATE CATE DO P.O.Box 540169 HOLDERES NOT AMEND,EXTEND OR Waltham MA 02454-0169 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone: 781-893-4808 Fax: 781-893-6679 INSURERS AFFORDING COVERAGE INSURED INSURER A: Hartford Insurance INSURER BMISC.INS.CO- Howell Design & Build,Inc INSURER Safety Insurance Company 44 Beechwood Dr. North Andover m& 01845. INSURER Atlantic Charter COVERAGES INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I4SR _TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION GENERAL LIABILITY DATE MMIDDIYY R) DATE MMDIYY LIMITS A % COMMERCWLGENERALLIABILITY 0$SBAGH6835 EACH OCCLRRENCE $ 1,000,000 06/01/02 06/01/03 FIRE DAMAGE An $ CIAIMSMAOF F OC'C'UR (Any one fin;) 300,000 MFn FYP(Anynne Person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GLNLRALAGGRLGAIE $2,0001000 GENU AGGREGATE LIMIT APPLIES PER' POLICY PRO- PRODUCTS COMP/OP AGG $2,000,000 ! JECT LOC AUTOMOBILE LIABILITY C ANY AUTO 1500162 COMBINED SINGLE UMIT 04/17/02 04/17/03 (Ea accident) $ ALL OWNED AUTOS i B SCHEDULED AUTOS BODILY INJURY $250000 (n.W..s ) S HIREU hVIUS $ NON OINKED AUTOS BODILY INJURY (Per accident) $500000 PROPERTYDAMAGE $ 250000 (Pcr acciticnl) GARAGE LIABILITY ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN FA ACC $ AUTO ONLY. AGG $ EY.CE6$LIABILITY EACH UCC:LRRENCE S 1,000,000 S OCCUR, CLAIMS MADE QUOT 07/10/01 AGGREGATE 02 07/ /lO $ 1,000.000 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND $ EMPLOYERS'LIABILITY WCSIAIU- UIH- TORY LIA4fTS ER ACA0012701 06/01/02 06/01/03 E L.EACH ACCIDENT $ 100000 I E.L UISLASE-LAEMPLOYLE $ 100000 OTHER E.L.DISEASE-POLICY LIMIT $500000 SCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION EDIDE02 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Evidence Of Coverage NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORRED RE SENTATIVE ORD 25-S(7/97) t ©ACORD CO ORATION 1988 i . BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Vl- Number: CS 068232 Birthdate: 02/14/1962 Expires: 02/14/2004 Tr.no: 17808 Restricted: 00 STEPHEN D HOWELL j 15 MT VERNON RD BOXFORD, MA 01921 Administrator .' � ✓�ie v�oma��aarua� o���a�cu,�u�ae�'� Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 123237 Expiration: 01/10/2003 Type: DBA HOWELL DESIGN&BUILD I STEPHEN HOWELL '44 BEECHWOCD DRIVE N ?,NDOVER,NIA 01845 Administrator TABLE 2 SUMMARY OF DIMENSIONAL REQUIRMENTS, fRes.1 Res. Res Res Village Res. Res. Bus. But. Bus: Bus. RCormnm. General Ind: Ind. Ind Ind1 2 3 4 `Res. 5 6 1 2 3. 4 Bus. 1 2 3 S Lot Area. Min.S.F. 47,120 43,560 25,000; 12,500 43,560 43,560 130,680 25,000.25,000 126,000 80,000 90,000 25,000 80,000 80,000 435,600 50,000 HeightMax(ft) 35 35 35 35 35 35 35 35 35 35 60 40 45 55 55 55 55 Street Frontage — — _ - - -_---- __ - -- _ --- -- Min.(ft) 175 150 125 100 85 150 150 ' 125 125 . 300 200 200 125 150 150 150 150 Front Set-Back Min.(ft) -- 3030 30 a 25 30 25 30 25 100 50 50 25 50 50 100 t0 30 Side Set-Back Min.(ft) 30 20 15 15 25 15 20 25 50 50 25 25 50 50 -i0-0---16- 20 -y Rear Set-Back - Min.(ft) 30 30 30 X30 30 30 30 30 50 50 25 35 '50 200 0 30 Floor Area _ — _--- Ratio Max. N/A N/A N/A N/A N/A 0.75:1 0.25:1 's 0.30:1 0.75:1 0.4,0:1 1.50:1 N/A N/A 0.50:1 0.50:1 0.50:1 0.50:1 Lot Coverage Max. N/A N/A N/A N/A N/A 200/6 20% 30% 35% 30% 25% 25% 35% 35% 359/6 359/6 35% Dwelling Unit Density Max/Acre N/A N/A N/A I N/A 1/acre 12MUlti-Famil 'Z 9/acre 'Z N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Townhouse Open Space 25% ------ ---- ----- •Two Stories not to exceed 40 ft. — Refer to Sections 8.1(13)and 8.4(6) Please refer to the footnotes for add itional`information .2 7 4` J,tlVZ-,e% EL F V14-TIOAI S A T HOUSC-•. . 174. 6s' TAJVK INLET- . . . . . . X74• ¢4 7-4Vk OU74E7-. . - - . . BOX/A/Lc�T- F' BOX OurLF7- • - . - . E�/D of BED . . . . . . 173. 77 F i C jig. 96' SUBSIJ,���1C'E c..SEWA6E D/sP�sAl c_��ST-E;l.�j cScQLE 1'=40' D4 7,E:Dec /2,/97F 6vc. z-OT .33 5.e/OLS P4Th/ F � y5 c"n�s r D,vE��: eo • -�.�. -.�.�;• ,�,� �: ,C10. .4�c./1�Drr�,Q , MASS. X ZDCAT GOT— .�/DLE _ P,4T,4-1 LOT /�' o S:F o r�XSR/9 9p0 an over consultants NO. 742 /s8/7 _ - t Inc. /STER`�� 8 Tilton Street, Methuen , Mass. oAt s� Tel. 687- 3828 A.16)7- '�� 0 ^n�1. Tom'Lr'EZD 4,5' 11 a !�I, :,/L�' . 7 1.��� T. 7-1-1E 5Y,57-e'-H--1V lAI I(-' L 4 /SDo 4GG Opt/ . :5-6P,7-1C TAAIA::� Zo PE2FAT�ZD B.�`'� P/PE �0�2G?U%(/,J1'�S o06 I mop. �: y* �.. `/��n. �,.� .•ter-,� G'�� v •-'' . . �• •tea..♦ ♦.. t..., .. Ex��sr ollEg AGG TDRS°a�G S�IB�SO�L • - ' J`r'rD.G!'� •'` �+ '�� 1�L'/Tf•�/.t/ .,�'S_F7'" .D� L�3E� ,��E�_ , i�PI�I�'E �. W1, C'GE.9.C/. CosQ,PS c fl f!!? off. Ali'E A 4,: eX0&710A1 v n ^a L�4 8R., a -rVlu�r aE k 17 � 7 wW -17 � w 4� 1 4c,' ' ARA - - ! • ARES � 1 ABso Trow'/ N �;_,,.�" ,.�---_._-.-' "! "� .-900 3.F. "1 �O S.F. ...✓ .;''� _ 1 I 4. 1500 t. Ul Aleallp `�.. Z• � - z-,4�..at -.\�� / ,� '�' -moi I, All t 1AVA14 hu rz,E .� ._ 178. 4 7 zo Date.��. . . . . . . . . No 4. 7 S TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING SSACHUS f / This certifies that . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at. . . . `. .?. . . . r. . . .I .� :. .'. r . . . ., North Andover, Mass. Fee.2 c' . . . . .Lic. No.. . . . . . . . . . . . . . I . . . . . ... PLUMBING INSPECTOR Check # .' WHITE: Applicant CANARY: Building Dept. PINK:Treasurer i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) LO O �.�t Wass. DatePerrmmi-t # _ Building Location `�� �Tt'cl�P Owner's Name L`/C�C3fa �f?c�y (� $/Y} Type of Occupancy Residential New CI Renovation ❑ Replacement s.Submitted: Yes ❑ -No-ID FIXTURES i z N N v, o z h O W W )e J N R . 2 G 2 N (K N (;4 (;4 ' �I U. o W a N i ¢ ~ a w a nj M Z o ta a w Q _ o a a x X a M 0 x x x Q T H r w N o c n J _ o a LL w �s� 3kb Z y O a z O O < N - - w O aO a: CLmQa J N LL 0 D p L: N SUB-BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR �ftj 33RS ' I 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name Heritage Htg. &Plg. Co. Inc. Check one: Certificate Address 35 Pleasant Street EX Corporation 714 Stoneham, Ma 02180 ❑ Partnership Business Telephone 781 —4.38-776_ C7 Firm/Co. Name of Licensed Plumber Gordon Switzer INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes R9 No O If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy IN Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner El Agent ElSignature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with ail pertinent provisions of the Massachusetts Stale Plumbing Code and;;Pllunm�b pte �Gen.elal L ws. By Si ature o cen Title Type ofLicense: Master(X Journeyman❑ City/Town $3 2 2 APPROVED(OFFICE S ONLY) License Number__ BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER t 1 PERMIT GRANTED DATE 19 PLUMBING INSPECTOR R a � Town of North Andover o� NORrk Office of the Conservation Department Community Development and Services Division 27 Charles Street s �ckus< North Andover,Massachusetts 01845 Alison McKay Telephone(978)688-9530 Conservation Associate Fax(978)688-9542 December 31, 2002 Resident 30 Timber Lane f AaS, aaq, a0a North Andover,MA 01845 RE: Violation of the Massachusetts Wetland Protection Act (M.G.L. C.131 S.40)and The North Andover Wetlands Protection Bylaw (C. 178 of the Code of North Andover). Dear Resident: This department has recently observed yard waste materials (logs, slash, &leaves)in a wetland drainage area at the corner of Bridle Path and Timber Lane. This material is prohibited from being placed within a wetland and its 25-foot no-disturbance zone per state and local wetland protection regulations. Your neighbors at 225, 224, and 200 Bridle Path have also received notification, as it is not clear who is responsible for the dumping activities. I This department has the jurisdiction to require such materials to be removed from these protected resource areas and their associated 25' no-disturbance zones as it is considered an "alteration" to the resource area. An "alteration"includes, but is not limited to, the placement of fill (including yard waste materials),excavation, or regrading (Section H. (b)of the North Andover Wetland Regulations). Wetlands and their buffer zones are not an appropriate location to deposit yard waste or any other material. In accordance with the provisions of MGL c.40 s.21D and Section 178.10 of the North Andover Wetlands Protection Bylaw any alteration of a wetland resource area or the buffer zone is punishable by a fine of up to $300 per day. The North Andover Conservation Commission has determined that the responsible party shall remove the material to a location outside of the 25- foot no-disturbance zone. A fine will not be levied at this time. Current snow cover conditions may affect removal attempts at this time. Removal of debris materials shall occur as soon as possible, when the snow cover has melted. The material shall be removed by February 1, 2003. An inspection shall be made after this time to ensure compliance of this removal. If the material can not be removed by this time due to continuing snow cover events,please inform this office so that we may grant an extension. Thank you for your anticipated cooperation. i BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Sincerely, :- Alison E. McKay Conservation Associate Cc: Julie Parrino, Conservation Administrator NACC members File I i i I i