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HomeMy WebLinkAboutBuilding Permit #639-14 - 323 CHESTNUT STREET 3/18/2014TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �11 ] Date Received Date Issued: b 1 q IMPORTANT: Applicant must complete all items on this page LOCA l . OT. - MAP NO: V_11 PARCEL: t ZONING DISTRICT: Historic District yes Machine Shoo Villaae ves TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial AI ration No. of units: Commercial epair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identifications Please Type or Print Clearly) OWNER: Name: Phone: Address: -5 � 7 l�✓41 �W f/T, CONTRACTOR Name: IIF Phone:'' Address: Supervisor's Construction License: 617,4117 3 Exp. Date: Home Improvement Licenser /.7 77x�z Exp. Date: ARCHITECT/ENGINEER 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: $ �J�,`�.� FEE: $ Check No.: / �n / Receipt No.: zl� Al NOTE: Persons contracting with unregistered contractors do not have access to the guaraptyfAnd nature of Agent/Owner Signature of contracto �1711, Y Location��' No. Check # /7u 27353 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ L 7 Foundation Permit Fee $ Other Permit Fee $, TOTAL $ r-' 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments '4a Water & Sewer Connection/Siqnature & Date Driveway Permit DPW Town Engineer: Signature: Locatea J64 vs ooa Street FIRE DEPARTMENT - Temp Dumpster on site yes A 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 - 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) 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 ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) a 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 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 145650.00 m $ - $ 175.80 Plumbing Fee $ 21.98 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 21.98 Total fees collected $ 319.75 323 Chestnut Street 639-14 on 3/18/2014 2 Bathroom Remodel `Z W r r L x J LL O Q CG N L U !_ \ O 0 v + v N U O. N p V Z Z J m C O "p 7 LL L tO 7 C C E V _ tC LL cc O w z Z m J a L j W _ M LL z O a z V J W L D W V i (/�) _ � LL cc O a Z Q L j _ ro LL z W Q W W LL O1 � m y N V) + UJ Y N O R R O cc ie E r y c rz O O <u W L- C Q' QO CL R w G1 R L N 4)0 0 U' ° _ > =c y m a = -mt O �Eoo N O O c CD> c. a •� as 0 O L ® R � •w am ' O O _ CM C H _ Q i L R O = O N ~ O to W R LUW = 'a+s+ O O .� 1-- 0 2L :E .2 z LL.10% N C O L 'E O u 5v `Z H 4Q n 2w Mo' c OCkm R+OLcO t� O_OCUQJ > O W :a cn0 Q z V •+ Cl) GC x z wO �C-) �w a z D �V N w •,v 0., W O Eo o z 0 � i a 0 N .E m m CL N � O �+ v D o � O � CLQ CDa --0 :� V_ J .M O a �z O V N CL U) 0 Deb & Sean Callagy 323 Chestnut Street North Andover, MA 01845 Cell 603-361-8743 Deb Cell 603-860-1868 Sean Home 978-688-9863 dacallagyI kyahoo.com shrink58kyahoo.com March 2, 2014 2°d Floor Full Bathroom Remodel Revised Work to be included includes: • Acquire Building Permit • Demo of existing bathroom. • Complete all required plumbing. • Complete all electrical. • Install vanity and tub. • Install new blueboard and plaster. • Install DenseShield Tile board on tub walls. • Install tile on tub walls. • Install DenseShield tile board on floor. • Install new tile floor. • Install new baseboard heat cover and baseboard. • Install new toilet paper holder, towel bars. • Removal of all debris. LABOR AND MATERIAL $ 7,700.00 Install new Andersen TW 400 Double Hung Window Window with Interior & Exterior Casing $ 525.00 Labor $ 200.00 TOTAL LABOR AND MATERIAL $ 8,425.00 Note: This quote does not include any plumbing fixtures, vanity, tiles, grout, granite, or paint. Terms: S 2,800.00 upon signing of contract (not to exceed 113 of contract price) I $ S 5,625.00 when job complete Submitted By:. Chris Rivet MA Lic 4CS072173 HIC #139962 207 Winter Street (C) 508-265-3115 (H) 978-794-1165 North Andover, MA 01845 All Home Improvement Contractors shall be registered. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor. Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices, specifications and. conditions are satisfactory mare You are authorized to do the work as specified. Payments pr ll b de Date Date*G Homeowner Signature Contractor Signature C'`orxtracior 14rbifration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action (as an 'alternative to court action) if they have a dispute with a contractor. The same right is Aot automatically afforded to a contractor, however. The contractor would have to resolve any dispute he/she has with a homeowner.iu court- unless bosh parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Rome Improvement Contractor Law. The contractor and the homeowner hereby inutaally agree in advance that in the event the contractor has a dispute concerning this conteact, the contractor may submit the dispute to a private arbitration which h been approved by the Secy - the e ce of Consumer Affairs and Business rte n d the co shall be required to submi to ' rovided InNassachusetts General Laws, chap Homeowner's Signature n tors ttitre NOTICE: The signatures o£the parties above apply only -to the afire ofthe 'es to alternative dispute resolution initiated by the contractor. The homeowner may initi ertiative pate resolution even where this section is not separately signed by the narh'ec. Z, " �q, �� Pzr�lz- 3 -D ��°`mat 1L L✓� ZLS 5i s Deb & Sean Callagy 323 Chestnut Street North Andover, MA 01845 Cell 603-361-8743 Deb Cell 603-860-1868 Sean Home 978-688-9863 dacallagyl gyahoo.com shrink58@yahoo.com March 2, 2014 1 st Floor Half Bathroom Remodel Revised Work to be included includes: • Acquire Building Permit • Demo of existing bathroom. • Complete all required plumbing. • Complete all electrical. • Install vanity. • Install new blueboard and plaster. • Install DenseShield tile board on floor. • Install new tile floor. • Install new baseboard heat cover and baseboard. • Install new toilet paper holder, towel bars. • Removal of all debris. LABOR AND MATERIAL Install New Andersen TW 400 Double Hung Window Window with Interior & Exterior Casing Labor Install Beadboard TOTAL LABOR AND MATERIAL $ 5,200.00 $ 525.00 $ 200.00 $ 300.00 $ 6,225.00 Note: This quote does not include any plumbing fixtures, vanity, tiles, grout, granite, or paint. Terms: $ 2,000.00 upon signing of contract (not to exceed 113 of contract price) $ 4,225.00 when job complete Submitted By: Chris Rivet MA Lic 4CS072173 HiC 4139962 207 Winter Street (C) 508-265-3115 (H) 978-794-1165 North Andover, MA 01845 r° All Home Improvement Contractors shall be registered. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor. Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are reby accepte You are authorized to do the work as specified. Payme w' e as Iou ne ove Date 3LLIYHomeowner Signature % Date 3 7 /� Contractor Signatur Contractor Aabif ration The Home Improvement Contractor Law provides ihomeowners with the right to initiate an arbitration action (as an alternative to court action) if they have a dispute with a contractor_ The same right is nOt autematically afforded -to a contractor, however. The contractor would have to resolve any dispute he/size has with a homeowner.in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the home ex hereby inutnally agree in advance that in the e the contrac has ' ute concernin this c n 10-t, c tractor may submit the dispute to a priv the Se of e ate arbi fiun whic as b n approved by ec Office of ConsumerAfairs and Business Re and the c tom bitr on provided In M4.2A assachusetts General Laws, berequired .. meowlices Signature C rn's Si e NOTICE, The signatures o£the pasties above apply onlyto the e 't o£ihe parties to aiternatitJe dispute resolution initiated by the contractor: The homeowner may ' section is not separately signed balternative dispute resolution even where this by the r,arHp.q Massachusetts= Departmentof Pubfic Safety, V S: f_Rpaid 6f Buiiding'Regul-atlons and Construction Supervisor Stai ar�>a, t License: 6S-072173 ' CHRISTOPHER F4UVET" 247 WINTER ST : � N ANDOVER MA.01 4 ° ✓.: JJ� ":"`` Expiration Commissioner 06/02/2014 �•�e �rn���n.R�uueallr: oJ'�/%2�a�:rac/%uselld a Office of Consumer Affairs & Business Regulation i 19 ME IMPROVEMENT CONTRACTOR Registration: 139962 Type: xpiration: .918/2015 Individual CHRISTOPHER F. RIVET CHRISTOPHER RIVET 207 WINTER ST. j N. ANDOVER, MA 01845 Undersecretary N OP ID: SHHE ,a`coRl7' CERTIFICATE OF LIABILITY INSURANCE DAT 09130D/YYIY) 09/30/13 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 Phone: 978-688-6921 CONTACT NAME: Macdonald 6& Pangione Insurance Fax: 978-688-5350 P.O. Box 428 PHONE FAX (.C. No. Ext1: 1 (A/C, No): E-MAIL ADDRESS: 104 Main Street North Andover, MA 01845 Michael Pangione PRODUCER CHRIS -5 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC # INSURED Christopher Rivet INSURER A: Preferred Mutual Ins Co 115024 207 Winter St. North Andover, MA 01845 INSURER B: INSURER C INSURER D: CPP 0180 57 0105 INSURER E: 09/26/14 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. INSRTYPE LTR OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CPP 0180 57 0105 09/26/13 09/26/14 O R DAMAGE pREMISEsT(Ea occurrENTEDence $ 100,000 CLAIMS -MADE Fx_] OCCUR MED EXP fAny one person) j $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE I$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000 X POLICYF-1 PRO LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Ea accident) _ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ -- SCHEDULED AUTOS HIRED AUTOS - PROPERTY DAMAGE $ (Per accident) $ NON-OWNEDAUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE I $ EXCESS UAB CLAIMS-MADEJ DEDUCTIBLE $ RETENTION S I S WORKERS COMPENSATIONWC STATU- I 0TH -I AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE TORY LIMITS ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N I A E.L. DISEASE - EA EMPLOYEEI S If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St No Andover, MA 01845 AUTHORIZED REPRESENTA IV I Michael Pangion ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/ilia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: c City/State/Zip: %t �,4j�,. �, f �;y r� Phone Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I mployces (full and/or part-time).* have hired the sub -contractors 2. I am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurmce. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3 . ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c.152, §1(4), and we have no insurance required.] i employees. [No workers' comp. insurancerequired.j Type of project (required): 6. ❑ New construction 7. ['Remodeling S. ❑ Demolition 9. ❑ Building addition 10. El Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box til must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. ,Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. rain an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. _ Insurance Company Name:r/��L'�� i!/a' %_ Policy # or Self -ins. Lie. 9: Expiration Expiration Date: Job Site Address:��^1Y'S�/{��%i�' �� City/State/Zip: 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 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. 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 cert tt der to paints and p alties of perjury that the information provided above is true and correct. Sienature: � � Date: Phone #: .`�`� ';tee Z11—:r Official ttse 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 S. Plumbing Inspector 6. Other Contact Person: Phone #: