HomeMy WebLinkAboutBuilding Permit #477 - 338 BLUE RIDGE ROAD 2/8/2008TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
One family
Addition
Two or more family
Industrial
Alter ion
No. of units:
Commercial
eplacement
Assessory Bldg
Others:
Demolition
Other
Septic Well
Floodplain Wetlands
Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED:
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Identification
OWNER: Name:
Address: 3 3S M - UG -
WA
6,12,15
Address:
Type or Print Clearly)
79 5-5-7- N/y
Supervisor's Construction License:Exp. Date:
Home Improvement License: Exp. Date: 6/05
ARCHITECT/ENGINEER Phon
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: $ 5 �• FEE: $ a J--) —
Check No.: ��35 7 Receipt No.: J,0 5215
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfiund
Signature of Agent/Owner Signature of contractor
Location '53k blue 24A Q x2. at .
No. �I'�—' Date"
NORTp
TOWN OF NORTH ANDOVER
Of�o ,•'�ti.0
t.
a
+
Certificate Occupancy $
+ i ,
of
� tt�
;,S'•CHus
s►cM
Building/Frame Permit Fee $r-
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
2 0 :
'Bu`ilding 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
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
4
Planning Board Decision:
Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
Located at 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 - Date
Doc.Building Permit Revised 2007
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
Li 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
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`� Boardot`Buifdirr ����e�ru t
Ixe
g 'gntations and Standards
HOMBtMPROVEMENTj
CONTRACTOR
Registration;
137742
cptrat'", 1/212009
TYPe: tndividual Tr# 126542
t BRIAN
i CESATI
BRIAN! CESATI
f 104 DANIELS Rq,
ROt<VL Ey, MA o1969
Adminlst'r•atoa•
Board o1• B0ild t �;, Rcg t ns acrd Standards
Construction Supervisor License
C5 80778
xpi t�jb12912009 Tr# 7589
BRIAN S CESATI
104 DAME 'L `RD Commissioner
R WLEYI MA 01969 _
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
W
600 Washington Street
` Boston, M!4 02111
www.mass.gov/dia '
Workers'. Compensation Insurance Affidavit: Builders/Contractors/Electrici
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the .occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "ever state or local licensing agency shall withhold the issuance or
renewal of a license or permit to,bperate�a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 162, §25C(7) states "'Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for, the perforrnance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If -an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if youare required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permittlicense number which will be used as a reference number. In addition, an applicant
that must submit multiple permittlicense applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone -and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02.111
Tel. # 617-727-4900 ext.406 or 1-877-MASSAFE
`
Revised 11-X22-06 Fax # 617-727-7749
www.mass.gov/dia
02/08/2008 11:56 9789757596 SEGRE'VE HAI_ PAGE 02/02
a oRo CERTIFICATE OF LIABILITY INSURANCE TORRRl'_1H °A02 08 8'
PRODUCER THIS CERTIFICATE IS ISSUECI AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Segreve & Hall insur.Assoc .Ina HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
305 ,North Main St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Andover MA 0.1810
Phone:978-975-1300 Fax:978-975-7596 INSURIERSAFFORDINGCOVERAGE MAIC#
INSURED _ INSURER A: Arbaale DraC�Ck ee isa. G^p. w
INSURER B: - v
TOrrissi Con. truct�.On Inc. INSURER C;
110 Haverhil Road STE 364 INSURER D:
Amesbury bM 01913
j INSURER E;
V V CKALSC.7
THE POLICIES OF INSURANCE LISTED BELOI°J 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 OFSGRI$ED HEREIN IS SUBJECT TO ALL THE TCRMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. Ar,GP.EGATF_ LIMITS SHOWN MAY HAVE ESEN REDUCED BY PAID CLAIMS.
LTR
INQ
TYPE OF INSURANCE
POLICY NUMBER
BATE MMIDD/YY
DATE MMlppJ1'Y
LIMIT$
Main 2treet
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KI UPON THE INSURER ITS AGENTS OR
GENERAL LIABILITY
REPREStNTAT1VE3.
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $1000000
A
x{ COMMEP,CIALGENERALLIABILITY
CLAIMS MADE LX] OCCUR
8500034294
i 06/08/07
06/0$/08
PREMISES Meoccurrenco $ 500000
MED EXP (Any ore person) t 5000
- PERSONAL & ACV INJURY S 10 0 0 0 0 0
•�, W
GENERAL AGGREGATE s2000000
'
GEN'L AGGREGATE LIM(i' APPLIl;$ PER;
POLICYjE (— LOC 71
PRODUCTS • COMPJOP AGO $2000000
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AUTOMOBILE
4
LIABILITY
ANY AUTO
j
-- --
COMBINED SINGLE WAIT
(es ec.9dent)
-
$:1.00000
A,
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_
ALL OWNED AUTOS
SCHEOULEDAUTOS
98917.400001
09/03/07
09/03/08
$ 3 0 0 0 0 0^
BODILY INJURY
(perpemw
'—"--•--- --••
HIRED AUTOS
NON -OWNED AUTOS
I
..._.._
BODILY INJURY
(Per a'xidert)Y_...... ..-.^..
$100000
$
i71
PROPERTY DAMAGE
(Per 9crIOnt)
Ij'G�AARAGE
LIABILITY
AUTO ONLY - SEA ACCIDENT
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OCHER THAN EA ACC
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EXCESWUMBRELLA LIABILITY
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RETENTION $
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WORKERS COMPENSATION AND
EMPLOYERSLIABILITY
ANY PROPRIETOR(PARTNER/EXECUT!VE
OFFICER/MEMBEREXCLUDED?
If re dC*4rlbo undor
SPECIAL PROVISIONS below
I
910189
05/02/07
05/02/08
7W 41MITS i ER
E,L. EACH ACCIDENT 3500000
E.L. DISEASE - EAEMPLO*e 5500000
•^^---..... .,.W._.^
E.L. DISEASE - POLICY LI IT 1 $ 5 0 0 0 0 0
OTHER
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bESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLAS I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROV13IONS
RE: Crosby Rea;idence 338 Blue Midge Road North Andover
CtFi f II+ICAIE WILDER CANCFI I ATInN
NORTRAN
SHOULD ANY OF THE ABOVE DESCRIBED POLJCILS @@ CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
Town of North Andover
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Building inspector
Main 2treet
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KI UPON THE INSURER ITS AGENTS OR
North Andover MA 01845
REPREStNTAT1VE3.
AUTHORIZED REPRESENTATIVE
Lawrence 7. Hall
AUUKU L'J (LUUIIUN)
f,,/ r ry t7 CORPORATION 1988
FEB 08,2008 13:14 SEGREVE,&HALL I 9789757596 Page 2
TORRISSI CONSTRUCTION INC.
General Contractors
110 HAVERHILL RD Suite 364 Amesbury, MA 01913
Toll Free: 877-388-6100 Fax 978-388-6121
W W W.torrissiconstruedon.com
January 17, 2008
Employer ID: 20-4752446
Home Improvement Contractors Registration: 127852 Expiration date 1/18/09
Construction Supervisors License: 066961 Expiration date 3/11/08
Sales Person: Noel Torrissi
Ms. Laura Crosby
338 Blue Ridge Road
North Andover, MA 01845
(978)-557-9914
Proposal for Bathroom Renovation
Contractor will Supply Labor and Materials for the Scope of Work Listed Below Unless
Noted
Scope of work:
Interior Site Prep
• Contractor will install a tarp runway to protect floors in areas of house unaffected
by construction.
• Contractor will set up plastic barriers for dust protection.
• Plastic barriers will have zippers for entrance and exit.
• Contractor will clean site daily.
Demo
• Contractor will remove tile from walk-in shower and from walls of bathroom
around Jacuzzi tub.
• Contractor will remove existing sheetrock from exterior wall around window
where tile was removed.
• Contractor will remove Jacuzzi enclosure and tub.
• Contractor will remove interior walls as noted during homeowner meeting. Note:
Existing walls next to the tub will be relocated inwards approximately F in total
for both walls, allowing for a larger shower stall to be installed. This will also
allow for more space on the right side of the toilet.
• Contractor will remove remaining plumbing fixtures from existing bathroom
including shower valve, vanity, vanity sinks and toilet.
• Contractor will remove existing lighting fixtures, switches and receptacles from
bathroom, with the exception of the ceiling vent fan, shower light and the
recessed can lights and trim kits in the vanity alcove.
• Contractor will remove existing baseboard trim. Note: Existing window trim will
remain.
• Contractor will remove mirror from vanity wall.
• Contractor will remove existing tile floor & sub floor.
• Contractor will remove forced hot air heat register from bathroom duct.
Framing
• Contractor will install new a 2"x 4" walls on either side of the tub enclosure as
discussed above. Walls will be constructed as per code.
Windows
• The existing double casement window and trim in the bathroom will remain.
Plumbing
• Contractor will install homeowner supplied plumbing fixtures including new tub,
double lavatories and toilet. Sinks and toilet will have new supply valves and
flexible supply lines installed. Any new water piping required for new tub style
will be installed as per code.
• Contractor will install a field fabricated copper shower base pan and new drain
kit. Note: Weep holes in the shower drain assembly will be left open to ensure
any water between the shower pan and the mortar bed will be directed to the
drain.
• Note: This proposal assumes homeowner will be installing comparably equivalent
fixtures to those that presently exist in the bathroom. In the event homeowner
purchases fixtures different in configuration, installation or function from those
presently installed, there will be an additional charge to the homeowner. An
example would be the addition of body sprays in the shower stall.
Heating
• Contractor will install a new white heating register in bathroom.
Electrical/Lighting
• Contractor will install new receptacles and switches in bathroom. All switches
and receptacles will be reinstalled in the same locations.
• Contractor will install a GFCI receptacles the bathroom.
• Contractor will install homeowner supplied overhead lighting fixture.
2
Sheetrock
• Contractor will install new MR (moisture -resistant) Greenboard on top half of
new walls that will be installed on the tub side and new shower stall ceiling and
'/2" sheetrock on new partition walls facing toilet.
• Contractor will install Durock® or equal backer board on lower portion of walls
around new tub and on all walls of shower stall.
• Contractor will finish Greenboard and sheetrock to a smooth, paint ready surface
and blend seam between backer board and Greenboard.
Tile
• Contractor will install and slope a mortar bed on the new copper shower pan for
proper drainage.
• Contractor will install homeowner supplied tile and grout on walls and floor of
shower stall and around inside of new tub enclosure.
• Contractor will install new homeowner supplied tile and grout on floor of
bathroom.
• Note This price is for standard tile installation matching style and design in the
existing bathroom. If the tiles supplied by homeowner are different sizes, if there
is a differing pattern or border or if they are installed on an angle there will be an
extra charge to homeowner.
Finish Trim
• Contractor will install homeowner supplied vanity.
• Contractor will install homeowner supplied kick panels under tub enclosure.
• Contractor will install baseboard trim to match existing
• Contractor will supply and install a new vanity mirror. Note: Mirror will be based
on a plate -glass blank that will be trimmed with a custom fabricated, painted
wood frame with picture -framed 45 degree mitered corners. In the event the
homeowner desires additional custom millwork on mirror, there will be an
additional charge to fabricate unit. Note: The new mirror will be sized to fit the
vanity alcove that presently exists.
Interior Doors
• The existing interior doors will remain. Contractor will supply and install new 5-
kuckle, concealed bearing, brushed nickel hinges Q per door) and brushed nickel
door knobs.
Painting Interior
• Contractor will prime ceilings and walls
• Contractor will paint ceilings with white ceiling paint
• Contractor will paint walls with two coats of eggshell wall paint
• Contractor will paint trim with two coats of semi -gloss
• All paint will be Benjamin Moore and the colors will be selected by homeowner
Debris
Contractor will remove all debris from site at completion of bathroom renovation.
Permits
• The following permits are required. It is the obligation of the Contractor to secure
such permits as the homeowners agent: building, electrical and plumbing
• Note: Homeowners who secure their own permits or contract with unregistered
Contractors are excluded from the Guaranty Fund provisions of MGL c. 142A
Insurance
• Contractor will have a certificate of insurance provided to the homeowner upon
request
Warranty
• There is a one-year warranty on Contractor's labor
Starting and Completion Dates
• Contractor will start the project on a mutually agreed upon date. The renovation
will be completed within 4-5 weeks from starting date. Note: if there are delays
that are out of the Contractor's control, the completion date will change
Extra work
• There will be no extra work performed without an extra work order signed by
both the homeowner and Contractor.
Daily Work Schedule
• All work will be done between the hours of 7:30am and 5:00pm Monday through
Friday
4
4- ,
Total Cost of the Master Bath Renovation $15,171.89
With Payments as Follows
I" Payment of $1,500.00 at Signing Paid January 25, 2008 check #3520 $1,500.00
2nd Payment of $2,000.00 at Start of Demo
3rd Payment of $3,000.00 at Start of Plumbing
4th Payment of $1,000.00 at Start of Electrical
5th Payment of $2,000.00 at Start of Sheetrock
6th Payment of $3,000.00 at Start of Tile
7th Payment of $2,000.00 at Start of Painting
8th Payment of $671.89 at Completion of Renovations
Note we have to give them the discount from the coupon I told them we would work
it out with them when the project is in Progress.
Paid February 6, 2008 Extra for Plumbing fixtures Check #3528 $4,600.00 this is not
thef 1#
m
ontractor's Signature Date
-a �)
Homeowner's Signature 0 Date
Homeowner's Signature Date
Note: all home improvement contractors and subcontractors shall be registered any
inquiries about a contractor or subcontractor relation to a registration should be directed
to: Director, Home Improvement Contractor Registration
One Ashburton Place, Room 1301
Boston, MA 02108
617-727-8598
Arbitration: the Contractor and the homeowner hereby mutually agree in advance that in
the event the Contractor has a dispute concerning this contract, the contractor may submit
such dispute to a private arbitration service which has been approve by the secretary of
the executive office of the consumer affairs and business regulations and the consumer
shall be required to submit to such arbitration as provided in M.G.L. C. 142A.
Contractor: Homeowner:
Date:
Date:
Notice: The signatures of the parties above apply only to the agreement of the parties to
alternative dispute settlement initiated by the contractor. The owner may initiate
5
I
alternative dispute resolution even where this section is not separately signed by the
parties.
Notice of Cancellation: You may cancel this transaction, without penalty or obligation,
within three business days from the above date. If you cancel, any payments made by you
under the contractor will be returned within ten business days following receipt by the
owner of the cancellation notice.
I hereby cancel this transaction Date: Signature:
(u
BBB
■s
MEMBER
MERRIMACK VALLEY
CHAMBER OF COMMERCE
ARI'
NA"ON O. is$OCI ATION 011
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