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HomeMy WebLinkAboutBuilding Permit #650 - 272 BRIDGES LANE 5/28/2009Permit NO: Z<S—D Date Issued: �C'0 LOCA BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received �� a 7 IMPORTANT: Applicant must complete all items on this paLye I W PROPERTY OWNER h/�C cc -J" ? / 191.2,S Print MAP NO f�1� PARCE : t 22ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial 0 Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: /-5� pew Se �- Identification Please Type or Print Clearly) Q 29-' &W& - 41 OWNER: Name: In]/o -i- 1:9-r177,7vr L/t hiD6 Phone: Address: 4L7a /1// 41-2�&wI CONTRACTOR Name: Bmw 6 If 44bl!'J-t 6477.2 Phone: 0171- T) q -,3,33 Address: 7 iJd J44n —'-� 10dny,� rs Mt d19,9 Supervisor's Construction License: 0 733 7 b Exp. Date: 9'1.3114 Home improvement Licenser 103017 Date: 7/7 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 06/)0 ° FEE: $�� nod , l v Check No.: 13.E 96 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ignature of Agent/Owner Signature of contracts-[ Location--� 22 No. 4 '�� ell, V Date 14ORT" TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ -11�-6 �3 CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL s Check # Z 3 2 9,,,' 2 2 "Building Inspecto r6l FA Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS 1 DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition Planning Board Decision: Comments Conservation Decision: Comments Zoning Decision/receipt submitted yes Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Usaood 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 MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 2.2008 � O U tx w w a x U oLIDa o a uCl)G w w z o °o a o o xCd a c w o c o co w cn w c� U w n: w" w cn w" w w w cn cn 0_ CA co c V iW p ccIII E CD ; CD A Z ,o = cs E *'�'� • v o. co r f'� pW 3 y o v) �.i/� CD cm ,1t Qu W .+ m v I O C ►- o n [.. y G '� co E c Z to o o W g ca CIO CD �. s cl a' ,Nc° U L O co * aC43 cc E 7� O J+ ,Ww 416 y g. 3 W h -��_ m c o L o. W — ca 7 ix ca cv o cp0 _ �. �y w y C� W �m o acs � m ev ev y �, o °C (n CJ —J 'O cm CM"c y a rd c Z 0 °s 6 � y w v' Z o U E -a cm cc C o CL = O= m `m=3 N C ~ „Du tN m .�. ~ m cc W S....�t ' ui O �r F. •� cz `� = o V� — COS h _O cm C3 4D 0 COD CL CD CL 0 2152 M20 CD H t CM a dim � The Commonwealth of Massachusetis Department of industrial Accidents Off ce of Investigations 600 1 frashington Street Boston, MA 02111 www -mms gov/dia . Workers' Compensation Insurance Affidavit Builders/Contractorsmiectricians/Plumbers 2101lilcant_ Information Name (Business/orgmiza6annndividual):_ Address: qty/State/Zip: . Phone #:. Are you an employer? Check.the appropriate box: I. ❑ I am a employer with 4. ❑ I am a general contractor end I _ Type of project (requires: employees (foil andJorpori-time).* 2. ❑ I am .a.sole proprietor. or have hired the sub -contractors Iisted 6. Q New constJvciian partner- ship and have no employees on the attached sheet i These soli -contractors have 7• ❑Remodeling working for in g arty capacity. [No workers' comp, insurance workers' comp. insurance. 5. ❑ We are a corporation and its 8• Q Demolition g, Buildi Q ng addition 3. ❑reqcored-] 1 am a homeowner doing all work officers have exercised their right of exemption per MGL 1Q•Q Electrical repairs or additions 11.❑ Plumbing repairs myself. [No•warkers' comp, insurance. iret c, 152, § 1(4), and we have no or additions 12.F1 Roof repairs -required.] •employees. [No workers' camp. insurance required.] `Any applicant that checks boi# I USE also fill out the section wow showing their workers' bompensatimi T Homeowners who submit this affidavit indicating they doing 1317 Other policy information /C are all work end then hire outside contractors must submit a nontractors that check this box must -_--teed an additiowl shear showing. Ehe name of the sub. contractors and (heiew affidavit indiaetiag such.r wow' pcticJ ir{mation. comp.I am an erpioya- hais provdingworkers' compensation nsurawefor a PtoY infomatoneeBelow is the Policf' andjob site Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: Cit}'lStatelZip: Failure to Attach a copy of the worketa' compensation policy declaration page (showing the policy number and expiration dattej. secure coverage as required under Section 25A of MGL C. 152 can lead to the imposition of criminal penahies of a fine up to $1,50Q.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 hereby certify under the pains and penalties of perjrcry that the information provided above is true and conrct Official use oaly. Do not write in this area, In be completed by city or town off rxal City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2 Building Department 3. Cit)/Town Clerk 4. Electrical Inspector 6.Otber 5. Plumbing Inspector Contact Person• Phone #• ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID C OATE(MMlDD BFMURPH 05/20/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION POLICY NUMBER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Thomas Gregory Associates Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 601 Edgewater Drive S235 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wakefield MA 01880 AUTHORIZED SENTA Phone: 781-914-1000 Fax:781-246-2601 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERAA Arbella Protection Ins. (A) INSURER 8: BF Murphy Plumbinq Heating, Inc &Browns Kitchen & Bath Inc 72 Holten Street Danvers MA 01923 INSURER C: INSURER D: INSURER E: PREMISES(Eaoccurence) $ 300000 %.0 V MIMMUM0 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMM LTR RULF NSR TYPE OF INSURANCE POLICY NUMBER POLICY E DATE MM/OD/YY ICY EXPIRATION DATE MMfDD LIMITS ANDOVER MA REPRESENTATIVES. GENERAL LIABILITY AUTHORIZED SENTA EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR 8500025389 06/01/08 06/01/09 PREMISES(Eaoccurence) $ 300000 MED EXP (Any one person) $ 50 00 PERSONAL &ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GENLAGGREGATE LIMIT APPLIES PER : PRODUCTS - COMP/OPAGG $2000000 POLICY JPE4 LOC Emp Sen. 1000000 A AUTOMOBILE LIABILITY ANY AUTO 99770400002 06/01/08 06/01/09 COMBINED SINGLE LIMIT $ 1 000 OOO (Ea accident) X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) X X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO HAUTO OTHER THAN EA ACC $ ONLY: AGG $ EXCESS/UM13RELLALIABILITY EACH OCCURRENCE $ 1000000 A X OCCUR CLAIMSMADE 4600025390 06/01/08 06/01/09 AGGREGATE $ 1000000 VDEDUCTIBLE $ RETENTION $10000 $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE 9095020607 06/01/08 / /08 06/01/09 X TORY LIMITS I ER E.L. EACH ACCIDENT $500000 OFFICERIMEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE 1500000 E.L. DISEASE - POLICY LIMIT $50()000 SPECIAL- PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS l.tK 1 IP 1l.A1 t MULUtK CANCELLATION ALUKU ZO (ZUUTIUi) _yG�,,. _ \ /X�ll © ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAL 10 DAYS WRITTEN TOWN OF ANDOVER NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 978-623-8320 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ANDOVER MA REPRESENTATIVES. AUTHORIZED SENTA ALUKU ZO (ZUUTIUi) _yG�,,. _ \ /X�ll © ACORD CORPORATION 1988 9.�-uclpai-t neni of runic J2ttetN oard of Building Ret;ulationv,tinil Standards Construction Supervisor License License: CS 73375 Restricted to: 00 BRIAN F MURPHY 11 KENMORE OR DANVERS, MA 01923 o-- "' Expiration: 9/3/2010 Commission,,. Tr#: 2299 lie -�omrmza�zusea/,C/ o�./�iaaaac�u�,lta Board of Building Regulatiodds and Standards HOME IMPROVEMENT CONTRACTOR Registration:., 103611 Expirtion a .`,719/2010 Tr# 271116 Type Private Corporation BROWN'S KITCHENii CANT ER BRIAN MURPHY 72 HOLTEN ST.a.�Gi-�r-� Danvers, MA 01923 a Administrator 4 If 10 1,6 bw IS -Sib wood ILILos TO rt.A Wk o W'I5'1'; A ro 31 If 10 1,6 bw IS -Sib wood ILILos TO rt.A yl A If 10 1,6 bw IS -Sib wood ILILos TO rt.A w to � 611 50 LV w to � 611 50 ' 't,,&n d (Bat. h Cent' In1c. 72 Holt �r0`A1 n S � en Street Danvers, NIA.- 01923 KITCHEN: 3-31-09 a. clo'e off closet b. open closet back into basement stairs — C. supply and lnstuil U-1. diningroom and kitchen d. remove � all between hen wind w o dining room side wall / re -use window e. move kitchen le Widow: supply and install window new trip f, frame for where windows were removed and installed (using Aze g. repairs to siding trimboard) Floorin : see attached sheet Plasterin attached et see ttachedsheet Heating: b d a. remove base oar b. install l (one) kickspace heater (2 if needed)oi in needed) Install l (one) vacuum (unit supplied by owner)( Pip g Plumbin : room wall b' for sink to dining tra) a. b C. e. f. move plum ingermitted, venting will be ex vent: bow venting ( if not p connect 2(two) ice makerskitchen sink, one 1 (one) bar sink, 1 supply and install the following: far faucet Kone) kitchen faucet,; ed garbage disposals install 2(two) owner supe venting duct for hood to side wall Caber_demo existing kitchen cabinets a, b supply and install new kitchen cabinets C. knobs ainted with cherry island Door s d. Tedd Wood Visions cabinets p Madison others can be chosen. The wood °wilhood haveccroswn moldiar other choices available)anl e counter top with Brown's nista Co=_ supply and install new gr supplied tile backspla.sh rice crow Crown- For around the room has not been included, we will p and then we can quote labor based on choices Custom Quality since 1964 - us 978-774-3333 www.BrownsKB.c Browns 2Utchen et Bath .Center Inc. 72 Holten Street Danvers, MA. 01923 KITCHEN: 3-31-09 C en a. clone off closet b. open closet back into basement stairs c. supply and install trim d. remove wall between dining room and kitchen e. move kitchen window to dining room side wall / re -use window f. frame for new triple window: supply and install window g. repairs to siding where windows were removed and installed (using Azek trimboard) Flooring: see attached sheet Plastering: see attached sheet Electric: see attached sheet Heating: a. remove baseboard b. install Kone) kickspace heater (2 if needed) Install Kone) vacuum (unit supplied by owner)(no piping needed) Plumbing: a. move plumbing for sink to dining room wall b. vent: bow venting ( if not permitted, venting will be extra) c. connect 2(two) ice makers d. supply and install the following: Kone) kitchen sink, Kone) bar sink, 1(one) kitchen faucet, 1(one) bar faucet e. install 2(two) owner supplied garbage disposals f. venting duct for hood to side wall Cabinets: a. demo existing kitchen cabinets b. supply and install new kitchen cabinets c. knobs d. Tedd Wood Visions cabinets painted with cherry island Door style still Madison others can be chosen. The wood hood chosen increased the cost other choices available) these cabinets will have crown molding to the ceiling. Counters: supply and install new granite counter top with Brown's installed, owner supplied tile backsplash Crown: For around the room has not been included, we will price crown once chosen and then we can quote labor based on choices Custom Quality Since 1964 978-774-3333 www.BrownsKB.com Brown's 2gtchen dt Bath. Center Inc. 72 Holten Street Danvers, MA. 01923 FAMILY ROOM: t. Carpentry: a. supply and install bookcases / wall units on both sides of fireplace. These right now have base cabinets with doors 18" deep and wall cabinets a total of 60 x 48ht x 13" deep, all shelves with a valance. There are fillers to go to the side wall. Crown above and mantel b. install TV bracket and TV c. supply and install base trim d. We will blueboard and plaster over brick above mantle where TV will be installed. Wires will be behind plaster. Floorin : see attached sheet Electric: see attached sheet Plastering: see attached sheet Heatin : none Plumbina: none Air Conditioning: move 2(two) AC ducts LIVING ROOM: Change to office Carpentry: a. demo stairway and tile flooring b. frame for french doors c. frame to close off opening to new kitchen d. supply and install new french doors e. supply and install wall trim Plastering: see attached sheet Electric: see attached sheet Flooring: see attached sheet Heating: none Plumbing: none Air Conditioning: move 1(one) AC duct Custom Quality Since 1964 978-774-3333 www..BrownsKB.com Browns 2'tcFien eZ Bath -Center Inc. MUDD ROOM: 72 Holten Street Danvers, MA. 01923 C en a. frame out to vacuum system (size can be adjusted at time of construction) b. build out floor c. build 1 step d. insulate outer walls e. install coat hooks f. re -use existing exterior door with new hardware (knob) g. frame doorway from mudroom into kitchen (no door) Flog n&. Browns installed, owner supplied tile Electric: see attached sheet Plastering: see attached sheet Plumbing: none Heating: none PORCH: Carpentr: a. frame for french doors b. hardwood floors Flooring: a. demo floor b. hardwood floor Plumbiniz: none AC : add 1 air conditioning duct Electric: see attached sheet Plastering: see attached sheet Custom Quality Since 1964 978-774-3333 www.Browns.KB.com Browns lUtchen d� Bath Center Inc. 72 Holten Street Danvers, MA. 01923 Electrical: Installed wiring throughout the house Office: 1. wall or counter outlets to code 2. (1) telephone jack 3. (1) cable TV jack 4. (6) 5" Juno type recessed lights, controlled by a dimmer Basement Stairs: 1. (1) 6" recessed light controlled by existing wall switch Living Room: 1. (6) 5" Juno type recessed lights controlled by a dimmer 2. (1) cable TV j ack 3. (1) 110 volt recessed outlet 4. remove existing wiring in the way of construction Mud Room: 1. (1) set of 3 -way switches 2. (1) overhead light (owner supplied) 3. wall outlets to code Bathroom: 1. relocate existing overhead light 2. relocate washer and electric dryer outlets 3. remove wiring in the way of construction Sunroom• 1. replace (1) ceiling fan (owner supplied) 2. (4) sloped 6" recessed lights controlled by a dimmer Custom Quality Since 1964 978-774-3333 www.BrownsKB coni Browns Vichen dT. Bath Center Inc. 72 Holten Street Danvers, MA. 01923 Kitchen; lL remove existing wiring in the way of construction 2. wall outlets to code 3. (1) overhead table light (owner supplied) controlled by a dimmer 4. (3) pendant lights (owner supplied) controlled by a dimmer 5. (8) 5" Juno type recessed lights, controlled by a dimmer 6. (1) overhead sink light (owner supplied) controlled by a dimmer 7. (1) 110 volt wine refrigerator outlet 8. (1) 110 volt refrigerator outlet 9. (1) dishwasher wiring 10. (2) disposal wiring 11. (1) hood fan wiring 12. (1) electric cook top wiring 13. (1) single oven wiring 14. (1) wiring for double oven and microwave. 15. counter outlets to code including in island 16. (1) vacuum jacks 17. (1) wiring for kick space heater 18. Install Seagull low voltage xenon mini track lights under the kitchen upper cabinets, controlled by a dimmer. All electrical wiring wil tie into the existing electrical service. Subfeed panels will be and extra cost. Additional Electric: Custom Quality Since 1964 978-774-3333 www.BrownsKB.com Browns 2Utchen eZ Bath Center Inc. 72 Holten Street Danvers, MA. 01923 1. replace (1) 1" floor foyer light fixture (supplied by owner) 2. replace existing outlets and switches throughout 1 st floor 3. replace (1) master bath light fixture (supplied by other) 4. (1) Panasonic heat/fan/light/night light 5. replace (1) 1St floor %2 bath ceiling light (supplied by owner) 6. (2) 110 volt GFI wall outlets in basement 7. (1) 110 volt GFI wall outlets in garage 8. (2) glass cabinets wiring with mini low voltage tracks 9. (2) wall outlets left and right of fireplace 10. (2) office internet jacks 11. (2) family room internet jacks Custom Quality Since 1964 978-774-3333 www.BrownsKB.com Brown's 2Utchen aZ Bath Center Inc. 72 Holten Street Danvers, MA. 01923 BATHROOM: C en a. frame to move laundry out b. supply and install bead board: standard type, same as 2°d floor bath (height to be determined by owner). c. supply and install trim d. re -use frame for bi-fold doors, supply and install new doors e. install shelving over washer and dryer Flooring: a. demo existing floor b. Brown's installed, owner supplied tile Plumbing: a. move laundry connection b. remove toilet c. supply and install new comfort height toilet d. remove existing vanity e. supply and install new pedestal sink and new faucet f. supply and install a mirror Electric: see attached sheet Plastering: see attached sheet Hea+tf)q'. Replace 6caGcbmt-cL - The to*J10r the .complete j.ob s stated above is : -�i, o () 0 C,' U� L, 4 ncim L t b CLT 6z) �nn� i5�0n0— TA. Custom Quality Since 1964 978-774-3333 www.BrownsKB.com ` Brown's Kitchen & Bath Center Inc. 72 Holten Street Danvers, Ma. 01923 Bill To Hibbs, Linda 272 Bridges Lane North Andover, Ma Deposit on Kitchen Invoice Date Invoice # 4/3/2009 Dep. on Kit Alp Description Amount I Total 15,000.00 $15,000.00 1