HomeMy WebLinkAboutBuilding Permit #722 - 317 HILLSIDE ROAD 5/12/2006pORoT"
% TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
,SSACMU`t
Permit NO: v Date Received:
*-O—�
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
Print
MAP NO.: ";).S_ PARCEL:
771T+ ♦ ATT TTQU "U IDITi7 T11PVC
ZONING DISTRICT:
HISTORIC DISTRICT YES ❑
A Irl.' 1 -til" U01: Vl' LV1LVal+v
TYPE OF IMPROVEMENT
--- - ----- ------ -
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ AI eration
Noof units:
D Assessory Bldg
epair, replacement
U Commercial
❑ Demolition
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREF RMED
Identification Please Type or Print Clearly)
OWNER: Name: St���G� �i�Gdr`� Phone:
Address:
CONTRACTOR Name: /C�/a. - - iGi.�- %t`, Phone: C o
// V
Address: Ca� /✓.� �i�a >< ��a // ,�/�'�.��i ����i/��
Supervisor's Construction License: ! c�Il Exp. Date: a
Home Improvement License: Exp. Date: Q4'
ARCHITECT/ENGINEER Name: Phone:
Address:
Reg. No
FEE SCHEDULE: BULDING PERMIT. S .00 PER 51000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost :$ ��6 x10.00=FEE:$l�
Check No.: Zq z— Receipt No.: 1 "I 1 "l
Page Iof4
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
Addition Or Decks
❑ Building Permit Application
❑ 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)
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
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 DEPARTNIEN'rMFOR`105
I'oge 4 of'4
Building Setback (ft.)
Front Yard Side Yard
Rear Yard
Required
Provided Required
Provides
Required
Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
Total square feet of Floor area, based on Exterior dimensions.
NOTES and DATA — (For department use)
Page 3 oI'4
Doc: INSPECTIONAL SERVICES DI -PAR fMLNT:BKORM05
(* ca(cd AW..Ian 'qob
TYPE OF SEWARGE DISPOSAL — Swimming Pools
�I/ Tanning/Massage/Body Art 1_J
Public Sewer
To
Sales Food Packaging!Sales -'
Well
Permanent Dumpster on Site
Private (septic tank, etc. ❑ Electric Meter location to
project
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of Contractor
'—'4g9
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
r
r
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Zoning Board of Appeals: Variance, Petition N
Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Water & Sewer connection signature & date
DATE REJECTED
❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
DATE REJECTED
DATE REJECTED
Comments
Comments
Temp Dumpster on site yes_ no Fire Department signature/date
Building Permit Approved and Issued by: n �'g'" 1
Page 2 of 4
DATE APPROVED
DATE APPROVED
11
0
DATE APPROVED
Location 5P- 4 � I d -z--
No. Date 5117—)Oc�
Of TOWN OF NORTH ANDOVEk%--
Certificate of Occupancy $
Building/Frame Permit Fee s 92,
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # C, gz,-
1 3 Z!2 -Y�
Muilding inspector
PROPOSAL
TWOMEY & LEGARE CONTRACTING, INC.
Building & Remodeling
SHAUN TWOMEY Kitchens - Baths - Custom Woodwork
(978W6-7447 Complete Interior/Exterior Carpentry
NAME OF OWNER: Chris & Susan Nobile
ADDRESS OF JOB: 317 Hillside Road North Andover, MA 01845
TEL: (978)686-8814 DATE OF PLANS: NONE
We hereby submit estimates for:
Proposal #2
1. Remove old tub - shower
2. Remove vanity, toilet, & medicine cabinet
3. Demo walls as necessary - leave map walls
4. Install tile supplied by Owner
5. Install vanity and medicine cabinet supplied by Owner
6. Toilet and shower unit by Contractor
7. Bring plumbing to code for new shower unit & new shutoffs for toilet & sink
8. Electrical to code with four plug GFI - new fan light kit by Contractor
9. Shower door by other - not in project
10. Create some type of shelving next to shower
11. Blend ceiling as close as possible without disturbing map on walls
12. All painting by Owner
13. Permits and inspections by Contractor
14. Disposal of all waste by Contractor
15. Allowance for bath fixtures $1,400.00
Job Total - Material & Labor $9,200.00
Payments
1st Deposit on signing $4,000.00
2nd Completion of drywall $3,000.00
3rd Balance on completion $2,200.00
NO. P0606
DATE:
DOUG LEGARE
(978) 556-1547
We Propose hereby to finnish material and labor - complete in accordance with above specifications, for the sum of: ($9,200.00) dollars
Payment to be made as follows. See above for payment schedule
All material is guaranteed to be as specified All work to be completed in a
workmanlike manner aocording to standard practices. Any alteration or
Authorized
deviation from above specifications involving extra costs will be executed
Signature
only upon written orders, and will become an extra charge over and above
the estimate. All agreements contingent upon strikes, accidents, weather or
delays beyond our control. Owner to carry fire, tornado and other necessary
NOTE: This proposal may be withdrawn
insurance. Our workers are fully covered by Workmen's Compensation
by us ifnot accepted within 29 days.
Insurance.
Acceptance of Proposal - The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are
authorized to do the work as specified. Payment will be made as
outlined above.
Date of Acceptance: J c?
Signature
Signature
MRY 04 2006 8:27 978 556 0285 P.1
KightFax Hartford 5/4/2006 9:07 PAGE 003/011 Fax Server
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PRaoucEa
DAVIS DAVIS & MOODY INS
40 RENOZA .AVE
:F.II, � �7?L yl;:r4 E (ul4(iDU�VV)
s, � r ..f \I Si.�Y.� ( DAT
ONLYCAND CONFERS NO RIQKrsUPON TTHE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT Ai{IIEND EXTEND DR
ALTER THE COVERAGE AFFORDED EtYTHE POIIGIES� BELOW.
COMPANIES AFFORDING COVERAGE
HAVERRILi, MA 01830COMIPANY
A THE TgAVF
INSURED
COMPANY
TWOMEY, SHAUN & TZGARE, DOUG
B
DBA 'TWOME;Y & LEGARE
P C BOX 3622
NORTH ANDOVER M.4 01845
COMPANY
C
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD `f
INDICATED, NOTWIT11137ANDNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTNEeR 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, LRMITS SHOWN MAY HAVE BEEN REOUCED BY PAID CLAIMS.
LTR
LT
TYPE OF INSURANCE
PC LICY NUMBER
POLICYEPPECTIVE
DATE (MM%CD%YY)
POLICYEXPIRATION
DATE(MMOMYY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERA'- UA81L(TY
7 CLAIMS MACE QOCCUR.
GENERAL AGGREGATE $
PRODUCTS-CCNPiDP AGS, g
PERSONAL S ADV. INJURY
OWNER'S a CONTRACIORV FROT.
EACH OCCURRENCE $
FRE DAMAGF_ (Any oM fire) y
MEO. EXPENSE (Any one person) 4
AUTOMOBILE
LIABIUTY
ANY AUTO
COMBINEDSIN6lE $
L#IVI{I
ALL OWNED AUTOS
BODILY INJURY
SCHEDULEDAU708
(ParPeroonf $
HIRED AUT09
NON OWNED AUTOS
BODILY INNRY
(Per kcident) S
L�
PROPERTY DAMAGE S
GARAGE LIABILITY
AUTO ONLY . EAACCICENI S
ANY AUTO
OTHER 7HAN AUTO ONLY: 1's i,y';;,4.i'S''%:!':<'•fl;::i:,
EACH ACCIDENT g
AGGREGATE ;
EXCESS
LIABILITY
EACH OCCURRENCE
UMBRELLA FORM
AGGREGATE T
OTHER 7HAN UMMLLA FORM
A
WORKER'S COMPENSATION AN0 NM
PLOYER'SURBILRY
(UB -939x165-0-05)
09-18-05
09-18-06
STATUTORY LIMITS i;
E:
EACH ACCIDENT9r)rl 111111,
THE PflOPRIETORI
PARTNE%fEKECLl71VE IN'L
OFFICERS ARE:Fx]EXCL
04EASE—POLICY LU17 $
O[SE0.SE— EACH EMPLOYEE g
OTHER
LCRIPT(ON OF IONS! ICLE B RIC C L Frims
IS o Y PRIOR CBRTIFI ISSUED TO THE C 0.?IFICATyy'B HOLD R AFFECTING WRWR5 CObIP COVSpAGE.
.n,. +,.., �..•..v...r• .. ,..., 7j .�... ai .: }n r. 2.IA.., i ......... ..
_i.v .... ..-;` ......s ..d<> .. 2. .:... ... `s^:. ... .j �... .t ... S,t? ,l. ,..5.34.-. t,
SHOULD ANY OF THE ABOVE DESCRIBED PCLICIES BE CANCELLED BEFORE THE
CITY OF NO ANDDVSR
BLDG INSPECTOR
27 CHARLES ST
NO ANDOVER MA 02845
EKPIRATION DATE THEREOF, THE ISSUING COUPANYVYILL ENDEAVOR roMAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAIIE:DTOTHE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OSUGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
yye�ttye�ay
RUG 01 2005 10:42
978 556 0285 P.9
D -D CERTIFICATE OF LIABILITY INSURANC�zzaD D
oAD6/2g 5
PRODUCER
Davis, Davis a Moody
40 Kenoza Avenue
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED 9Y THE POLICIES BELOW.
DATE MMlDD I
Haverhill MA 01830-
Phono:978-373-1347 Fax:978-556-0285
INSURERS AFFORDING COVERAGE
INSURED
INSURER A: Arbella Protection InrauranaO
INSURER S:
06/22/06
INSURER G'.
Twomey & Le are Contracting
P.0 box 366
North Andover MA 01843
INSURER D:
INSURER 5
vvrar«+vw
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 5E ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN tS SUBJECT 7O ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIA(ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY
p
GATE MN/DD I E
DATE MMlDD I
LIMITS
EACH OCCURRENCE 6 1 000 000
FIRE DAtaAGE(Anyone fire}
A
X COMMERCIAL GENERALLIABI-ITY850DO12700
06/22/05
06/22/06
MED EXP (My one person) $5,000
AUIZED RESENT I
CLAIMS MADE 7 OCCUR
PERSONAL S ADV INJURY S 1 000 ODO
GENERAL AGGREGATE $2,00-0,000
DEN'LAOGREQATELIMIT APPLIES PER:
PRODUCTS -COMPIOPAGG $2,000,000
POLICY PRO LOC
JECT
AUTOMOBILE
LIABILITY
ANYAUTO
COMBINED SINGLE LMIT
(Earzrotidanq S
BODILY INJURY
(Per person) 8
ALL OWNED AUTOS
SCHEDULED AUTOS
ODDLY INJURY S
(Per accfdert)
HIRED AUTOS
NON -OINKED AUTOS
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
AUTOONLY- EAACCIDENT $
OTHER THAN FAACC $
ANY AUTO
AUTO ONLY: AGO $
EXCESS LIABILITY
EACH OCCURRENCE$
AGGREGATE Ib
OCCUR [] CLAIMS MADE
f
I
$
DEDUCTIBLE
I
$
RETENTION S
WORKERS COMPENSATION AND
TORY LIR4IT9 ER
EMPLOYIDW LAGILITY
EL. EACH ACCIDENT $
E.L. DISEASE -EA EMPLOYEE $
E.L- DISEASE - POLICYLIMIT $
OTHER
I
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLEStEXCLUSIONG ADDED BY ENDOMEMENTISPECUIL PROVISIONS
Carpentry - 3 stories or less
CERTIFICATE HOLDER I N i ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
NORTH A
SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
GATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -1Q— DAY8 WRITTHN
NOTICE TO C TIFICATE HOLDER NAMED TD THE LEFT, BUT FAILURE TO DO SO SMALL
CITY CF NORTH ANDOVER
IMPOSE OBLt ATIONDRLIAEALITYOFANYKINDUPONTHEIN'URERIT9ABENT80R
27 CHARLES STREET
NORTH ANDOVER MA
REPRE NTA E6
AUIZED RESENT I
ACORD 26-5 (7197) OACORD CORPORATION 1008
N.
BOARD OF BUILDING R
License: CONSTRUCTION S
Number: CS 067560
Birthdate: '1012511966
Expires: 10/25/2007
Restricted: 00
SHAUN M TWOMEY
61 PATROIT ST t,
N ANDOVER, MA 01845.
Commissioner '
' ✓fie "C�omvixa�uoea.�i o�./f�aaa-c/u�ee%I`
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration:, 1.36779
Expiration 8126/2006
<type Partnership
TWOMEY +,LEGARE`CONTRACTtING
SHAWN TWOMEY
61 PATRIOT ST.'
N. ANDOVER, MA 01845 Administrator
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