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Home My WebLink AboutBuilding Permit #191 - 23 ELMWOOD STREET 9/10/2007 ` BUILDING PERMIToNo DT b�ti TOWN OF NORTH ANDOVER 3Au 4`~'`- ``~'.'° o APPLICATION FOR PLAN EXAMINATION ° � Permit N0: Date ReceivedK Art �SSACHU`�� Date Issued: '10 IMPORTANT: Applicant must complete all items on this page LOCATION F= 1W\Rkb0J PotJ PROPERTY OWNER Print MAP NO: (V PARCEL: ZONING DISTRICT: Historic District yes ind Machine Shop Village yes Mn TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial epair, replacemen Assessory Bldg Others: Demo i ion Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIP ION OF WORK TO BE PREFORMED- (3A yoo i + �eces�a Idntifi ration Please Type or Print Clearly) Phone' ► ` � OWNER: Name: ,etre 0,01;eV Address: E 1w,wa,cA CONTRACTOR Name: Qltot\ OY' w�cy..v Phone: ` Address: ee �- Supervisor's Construction License: Exp. Date: t � Home Improvement License: ' Exp. Date: ARCHITECT/ENGINEER WA Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ � .r`c� FEE: $ G/ Check No.: Receipt No.: o NOTE: Persons contracting wit u re 's ed contractors do not have access to t e fund Signature of Agent/Owner Signature of contractor Location OL5y No. r Date - �(�`0 '' 40RTN TOWN OF NORTH ANDOVER F • LA ' Certificate of Occupancy $ ��a",^°•'t'�' 9 Buildin (Frame Permit Fee $ s�cMusE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ' 205b3 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS t s Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on sit yes no Located at 124 Main Street Fire Department signature/date t { COMMENTS i 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 i ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 r Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 '4PR-6-2005 03: 113P FP0J1:PH=INEUF INSLI,'PNCE Fifa 9783720431, TO:161:139742e75 I 7 ACORD 4. CERTIFICATE OF LIABILITY INSURANCE DATE(11Px:00YYYrl (4 X07 Paoouc R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Phaneuf Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 1296 HOLDER. T141S CEATIFICAT°E DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TIME POLICIES BELOW. Haverhill, Ma . 01831 INSURERS AFFORDING COVERAGE �{ _i NAIL u IHSVAEo t,5i$Ut7EliA National Grange Mutual Michael Ryan Norman DBA _ Y +NsURERe Acadia insurance I Norman Properties & Developement INSURER 10 Kelleher Ave. MSURERC: Plaistow! NH 03865 )roSURER E COVERAGES THE POLICIES OF INSURANCE LISTED OELOW HAVE.BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY FERIOD INDICATED NOTVu7THSTANDING ANY REOUIREM NT,TERPR OR CONDITION OF AN`!CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURMIC£AFFORDED BY THE.POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOIIYN MAY HAVE SEEN REDUCED BY PAID CLAIMS !LTR 6 L PpLtCV EPFFCTNE POLICY EXPIRAT)Dk POLICY k4ti�d9IER ur+Irs GF.NEAAL.LIABILITY I I I EACH OCCURRENCE S 5001000. A ' COMYERCIALGENERA[LIABLiTY j MP 092417 j 11f29/0611/29/07IPAEAtt PREMISES left .. 500,000_ CLAIMS WADE X-Y1I _ OCCUR' (MED FXP fAa One P4 IION 15 10,00. {�PERSONAL 4 AwI ULJHY I$ -500 F 000,n.} ! FGENI ERnt r.QQAEGATc {S 1 /�""�' �_�_V''yy stN-L AGGREG"ATE LRAIT APPLIES PER i !PRODUCTS�COAsPi'JP AGG fi 1 r 0 0 0 r C o 0 X–X ( A POLICY{ PACS- – AUTOR700aLE LIAWLITY ! r COMBINED SINGLE 00 !s ANY AUTO i Omwwj) ALL OWKSD AU10S !8CDILY fNJURY ( SCHEOULEQ AUTOS HIAEDAUTOS BODILY PILIURY _y NOW-OWNED AUTOS IPaaccrP,unt) j[ PROPERTY DAA?AGE 5 1 � •(Prl Acsatlanl7 —GARAGE LIABILITY , j 'AUTO ONLY-EA ACCENT $ i ANY AUTO I 1EA ACC S --i !OTH>:R THAN — i AUTO ONLY AGG 5 EXCESS�Um3RL•LLA LIAEFCITY 1 { EACH OCCURRENCE S 7 OCCUREllG A7eAst�oE i AGGREGATE r _f DEDUCTIBLE - ` WORAERB COitPEA°SATt±)N AMO I Y.0 BY'ATU {OTIC. j EW.PLOYER9'LIA87UTY WC28-28-000193—I AIV PRQPRiETQP,rARTNE'AtEXECIfTDUE 00 r 02/14/07 ,7 02/14/ ()8� E L EACH ACCIDENT _ 4 !O=ICERmIEUSER EXCLUDED? tE L DISEASE-En EMALOYC•E jUpncnen ands+ IAL PROL'IStONS betav 7 E L DISEASE-POLICY UMIT I. I OTHER i 1 DESCRIPTION OF OPERATIOHB f LOCATIOHSI YEHtCLES f EXCLUSIONS d00ED BY ENOOFt$EMENT t$PECtAL PROVLR.tONS r, Carpentry Dwelling CERTIFICATE 14OLDER CANCELLATION SHOULD ANN OF THE ABOVE DESCR13ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE T7±EAECIF,THS ISSUING INSURER WILL ENDEAVOR TO FAIL f L/ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER N4E4EO TQ THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OSUOATON OR LIALRIUTY NY WINO UPON THE INSUREH,I.3 AGENTS OR REPAESEHTATN AUTHOP�i$ER REF �t ATrif ACORD 25 1,7001100) / ®ACORD CORPORATION 1986 NORTy v 0 LA o d®ver, Mass., g 11 COCMICMEWICK RATE D PP sMUM BOARD OF HEALTH Food/Kitchen y Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... .. ................. ...................................................................................... Foundation has permission to er ct........................................ buildings on ...17—W..... b1P I ! *. ..t :. ....................... Rough a......... . Chimney to be occupied as.. P�.� ...... � .. ..Q .......�........ ®s�'eti...... E � ........... 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. �'�� ... o PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 9"- Final wry PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU O S TS Rough ..... Service BUILDING INSPECT R 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 Udall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. ESEE 6REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information `� ` Please Print Legibly Business/Organization Name: (2 + vw,�A '+ � C��' Ic;6 Address: �L C (�ie�' A\,' City/State/Zip: �+�` �� t .+L) fJ Phone#: Are you an employer?Check the appropriate box: Business Type(required): 1. I am a employer with employees(full and/ 5. ❑Retail �y or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment 2.❑ 1 am a sole proprietor or partnership and have no 7. ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers' comp.insurance required] S• ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4),and we have 10.7 Manufacturing no employees. [No workers' comp. insurance required]* 11.F1 Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees.[No workers'comp.insurance req.] 12.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensal ion policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policv infornratlon. Insurance Company Name: /A C C..N`�� - _y l V\( Insurer's Address: City/State/Zip: 191 K -7 c) fle i Policy#or Self-ins. Lic.# NYC ��'� t� �.�� Expiration Date: vD'161 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do herebv certify,urr erthe ains and.p r-a ties of perjury that the information provided above is true and correct. Signature: `((j, ;l/-(J (fjf ��" Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4. Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia Board of Building Regulations and Standards - Construction Supervisor License License: CS 87851 Birthdate: 9/23/1980 Expiration: 9/23/2009 Tr## 2544 _. Restriction: 00 3 MICFII�EL R NORMAN 10 KELLEHER AVE PLAISTOW, NH 03865 Commissioner 071ae tLo'om naaxuwc a a� El�tiuwac/au fella Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 151799 Expiration: 7/5/2008 Type: Individual MICHAEL NORMAN MICHAEL NORMAN 10 KELLEHER AVE ..,CLa.... PLAISTOW, NH 03865 Deputy Administrator i c�fs'!o i �R•e� � I 00 Ch- 4 NORMAN P R 0 P E R T I E S &ADEVELOPMENT-J 000 MA CS License#:87851 MA HIC#: 151799 Real Estate Broker MA/NH Project Address: Danielle 23 Elmwood Road North Andover,MA Home Renovation Proposal We hereby propose to furnish the permits,insurance, labor,and materials to complete the following addition project as described below: Foundation,Framing,Roofing, Siding,Insulation 1. Repair 15'x 12' sunroom off the rear of the home a. use existing foundation and poured concrete floor b. dispose of all demolition debris 2. 2"x6" exterior wall construction,2"x8"roof construction with plywood sheathing 3. 2"x6"pressure treated sills 4. 1/2 fir plywood sheathing for roof,7/16"OSB sheathing for walls,Typar vapor barrier a. Rubber Roof b. Vinyl Soffits 5. Typar side of existing house 6. Fully insulate exterior walls and ceiling 7. No Siding included,just Typar Vapor Barrier 8. Dryer vent to be installed Windows,Doors,Slider&Interior Finish 1. Customer chosen windows per allowance 2. 31/2" colonial baseboard trim,21/2 colonial window trim 3. 1/2"Blueboard&Plaster finish,no paint included 4. 1/4"Sheetrock in Kitchen 5. One 6'Anderson French Slider with screen 6. Reframe opening from kitchen to living room 7. Install louver door to access utility room-see attached spec sheet from Home Depot Plumbing&HVAC 1. Install duct work to add head from existing furnace into sun room Electrical 1. Per Electrical Building Code 2. Ceiling fan with light in center of room-(52" Hampton Bay Mediterranean-Nickel) 3. Including one dedicated circuit for 42"wall mounted electronics Flooring(see allowances) 1. Hardwood:Sun Room .1! L77- . .� -Y.r c ✓ s - _ .P PR ® PE RTI ES & DEVELOPMENT t Allowances: • Windows: $1500-Anderson 400 Series Double Hung-Vinyl Exterior/Woo Interior • Roof: If roof can be salvaged and not reframed and reroofed a credit of$1300 will be deducted from the final payment • Flooring: 1. $3.50 sq/ft for prefinished hardwood in sun room-customer to choose We hereby propose to furnish the plans and approvals in accordance with the specifications above for the sum of: ($18,650.00)Eighteen thousand six hundred fifty dollars. Payment as follows: Project Start date: $2,000 for kitchen work and scheduling Start Date on Sun Room: $8000 Rough Ins Inspected: $5,000 Job Completion: $3,650 Start Date: End of August 2007 A= All material is guaranteed to be as specified. All work to be completed in a substantial workmanlike manner according to specifications submitted,per standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. If either party commences legal action to enforce its rights pursuant to this agreement,the prevailing party in said legal action shall be entitled to recover its reasonable attorney's fees and costs of litigation relating to said legal action,as determined by a court of competent jurisdiction. All ledge and other unsuitable excavated material to be remov at cost over the contract price. Authorized Signatures 9/04/2007 ACCEPTANC OF PROPOSAL Signature Signature Date of Acceptance S. F '. ao F� s E� Vii" ix`�1N