HomeMy WebLinkAboutBuilding Permit #313-15 - 26 EASY STREET 9/26/2014 BUILDING PERMIT 00NORTH t�IED ,6�1• TOWN OF NORTH ANDOVER 3� y ° O A APPLICATION FOR PLAN EXAMINATION * .T Permit No#: / J: Date Received �q A°R,T.o SSACHU`�� Date Issued: I P TANT:Applicant must complete all items on this page LOCATION Print _ PROPERTY OWNER _ -c _F Print 900 Year'Structure yes no MAP PARCEL ZONING DISTRICT: Historic District ye no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial y Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition- El Other ❑ Septic ❑ ell ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer ESCRIPTION OF WORK TO BE PERFORMED: a� cap-! Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Namel"R\/vt.ULPhone:. Address: I IU Supervisor's Construction License C54(P s('0 2 _ u Exp. Date:_ 3 �a31 I�� Home Improvement License: _.C�3_,5 s_ Exp. Date: ARCHITECT/ENGINEER Phone: 3 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: $ � � , FEE: $ Check No.: I �1S Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor i Ve Locatio No. — Date q,! TOWN OF NORTH ANDOVER . Certificate of Occupancy $ .'° Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 28070 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS 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 DPW Town Engineer: Signature: Located 384 Osgood Street ,FIRE DEPARTMENT = Temp Dumpster on site yes no . Located at 124 Main Street Fire'Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 C1pRTly Town of E 1� ndover No. * oh ver, Mass, COCNIC No WKK 7i�s R�{tED P'P��,�� U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ...................... .... ..... ... . ..... .. ..... r........ ... BUILDING INSPECTOR has permission to erect ........... buildings or>pf, ..EASI. ......0, ...... ............. Foundation Rough to be as occupied p� ...................C.1144611U.le �..............ON.. ... ...... Chimney provided that the person accepting this permit shall in every respect conform to the terms of th 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR I� UNLESS CONSTRUCTI T .:.gip Rough Service ...............Itmoof...... ................... ................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Promises — 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. Back River Development, LLC 231 North End Boulevard Salisbury_ , MA 01952 (978) 852-3733 CONTRACT To: Jeff Hart Date: September 21,2014 Re: Kitchen remodel SCOPE OF SERVICES • Remove and dispose of existing kitchen cabinets • Supply and Install new cabinets • Install cabinet hardware • PAYMENT SCHEDULE: • 7,500 upon execution of contract • 7,000 upon completion of Scope TOTAL PROJECT COST: $14,500.00 L IQ Jift Hart, Homeowner WiMain Perris,Back River Development, LLC DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 9/26/2014 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 certificate holder in lieu of such endorsement(s). PRODUCER CTA Paula Peltonovich M P ROBERTS INS AGCY INC P,vHONE EXt: (978) 683-8073 FAX A/C!No:(978) 683-3147 1060 Osgood Street E-MAILs:Paula@mprobertsinsurance.com North Andover, MA 01845 INSURER(S) AFFORDING COVERAGE NAICs INSURER A:MERCHANTS INSURANCE GROUP INSURED BACKRIVER DEVELOPMENT, LLC. INSURER B: 231 NORTH END BLVD INSURER C: SALISBURY, MA 01952 INSURER D:COMMERCE AND INDUSTRY INS CO 978-852-3733-Bill INSURER E 978-804-9383-Brian I INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 DAMAGE TO RENTEIT_ I CLAIMS-MADE CI OCCUR PREMISES Ea occurrence $ 500,000 X PRIMARY & BOPI080037 06/20/14 06/20/15 MED EXP(Any one person) $ 5,000 A NON—CONTRIBUTORY Y PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY CI JECT F LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED Ea accident) E LIMIT $ 1,000,000 ANYAUTO 06/20/14 06/20/15 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BOP1080037 A AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATIONP R X H- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WCC50050123452014A 08/15/14 08/15/14 E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBER EXCLUDED? F-1NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe und DESCRIPTION OFeOPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION JEFF HART SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 26 EASY STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATI ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD z: 1�ft Massachusetts -Department of Public Safety . Board of Building Regulations and Standards-, Construction Supervkor License: CS-065674 WILLIAM J FIERI* ter. 28 BACK RIVERAD t 4 Amesbury MA 0013 4 )Ivan` Expiration Commissioner 03/23/2016 Office o�Conme° ud�tnestg` s w IMPROVEMENT CONTRACTOR HOME Registration: Type: 9 x73255 Yp Expiration 940a0,14 Individual, %B!kJA YNCH r s r•, BRIAN LYNCH - # F. 31 SEVEN STAR RQ = _ moo GROVELAND, Undersecretary