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HomeMy WebLinkAboutBuilding Permit #648 - 35 OLD CART WAY 4/8/2013TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 4". Date r - % 1 /IMPORTANT: ADDlicant must complete all items on this page LOCATION -41 0. 1 l Leh Print PROPERTY OWNER h4Cf / Print 100 Year.Old Structure yes' n0 MAP NdJ67 PARCEL: 61/,ZONING DISTRICT: Historic 'Dlstnct yes no Machine Shop Village Yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 00ne family ❑ Addition ❑ Two or more family ❑ Industrial 'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer DES RIPTION OF WORK TO BE PERFORMED' � t?� aAj► Fs �,raIv,�10 �► pDotv— U Please Typtor OWNER: Name: 1<4600 Ig -1-0$( / t317c, C Address: O/cf (-et w4 f Clearly) S, 4? �Jj9/-/Is " ?,eeve-c--1 CONTRACTOR Name: 7� P�ho�n/e: Address:�0 //r �v� it it✓ tt�st> )y%5� t3 F'73 Supervisor's Construction License: Exp. Date: Home Improvement License:/ 7 � Exp. Date: - ARCH ITECT/ENG I NEER ate: ARCHITECT/ENGINEER Phone: Address: Reg. No. 3k FEE SCHEDULE: BULRzr ERMIT: $12.00 EER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: C FEE: $ 31?q z Check No.: (��QL?�� 0�\-5) Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to th g ran and ;Signature of Agent/Owneure of contractor - Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ r 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 0 1 Private (septic tank, etc. Permanent Dumpster on Site ❑ ' THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANKING & DEVELOPMENT COMMEN CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED nEl DATE APPROVED Reviewed on Signature Reviewed on Signature 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: FIRE DEPARTMENT - Temp Dumpster on site Located at;1k,Mair.Strdet - Fire ©epar4inenf�sigriatu`relaatd. COMMENTS Located 384 Osgood Street Yes no 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 E3 Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fohowing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application a 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 o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit E3 Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) Lj Engineering Affidavits for Engineered products j NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o 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 subm;tted with the building application Doc: Doc.Building Permit Revised 2012 Location Date No. ( z TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL Check # P, Z-6 22�(p � 16/ 26257 Building Inspector rf L= r Z x J x Y. O O o m C G1 \ a OG) Al- E aJ ?O N U r,c N O G N Z C7 Z m L= r Z x J x Y. O O o m C G1 \ a OG) Al- E aJ ?O N U r,c N O G N Z C7 Z m O O "O O LL L ago O K C L U C 11 O0 u ui N Z O Z co95 J d L t O w C l.L w 0O W N Z a U G J W L neo O OC V 'Z GJ In C Il W O 1U N Z N L =3 O w m` C U- Z '+i Q a 0 1L G) 7 ca Z +, (n G1 ❑ y O E Ln n CC3 o Cc �a G� cc= ma � o F y V r S M. y .•+ C �d 4. t i (v W •O JE V Q _ v10i y.+ y CL J M � d �m a ca L- rn Immmm A. O �o 0 0 U) c : cc E- U) 42) Q E .� , c OCL to 3 a0 yoo ' .N 3 rn Ir?CLL vc • 'w •� m wm _ -4 U:., ctm L .y tm • 0 C Ctoo = Q Lca O N CL ~O O mco LU t W_ O -0 - O O y O ;5u) C O .=� -&- _ Z oC o O W i v CAUM) - 00 so- a 0moo 2 z G co z CO w CLX LLIH W C 0 a z Z GO Cl) V Z C.) U) J a 0 w O E i z O N O ._ W Q N — .E m m CL Cc O+ d v D O m O a CL 0a O _ •CL O U)z a baO CL 0 to U) C c CLU 0 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 33,250.00 m $ - $ 399.00 Plumbing Fee $ 49.88 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 49.88 Total fees collected $ 598.75 35 Old Cart Way 648-13 on 4/8/2013 Change Kitchen Cabinets, Change Window, Upgrade Lights Martin Provost Carpentry 40 Pillsbury Rd. Sandown N.H. 03873 978-857-4598 ESTIMATE DATE: APRIL 4, 2013 BILL Bruce & Roberta Fox TO 35 Old Cart Way No. Andover Ma. 978-666-7636 ORDER DATE ORDER NUMBER JOB , KITCHEN RENOVATION ITEM # .:. DESCRIPTION QUANTITY REMOVE CABINETS $1,200.00 ROUGH CARPENTRY AND DEMO $1,600.00 INSTALL WINDOW LABOR ONLY $800.00 FINISH CARPENTRY $1,200.00 INSTALL CABINETS $2,000.00 __._...__ .. .. - ... _._. ........_..._..._.. SHEET ROCK REDO ENTIRE KITCHEN CEILING, AND SUPPORT _.... ....... . BEAM $2,500.00 ELECTRICAL ALL ROUGH WIRING AND WORK BOXES TO CODE. FINISH FIXTURES BY OWNERS. TEN RECESSED LIGHTS, ONE OVER $3,500.00 TABLE, THREE OVER ISLAND PLUMBING, RELOCATE FOR NEW SINK LOCATION AND DISH WASHER, ADD WATERTO FRIDGE. SINK AND FAUCET SUPPLIED BY $1,500.00 OWNERS. PATCH TILE FLOOR $400.00 REMOVE ALL CONSTRUCTION DEBRIS __...._.... $375.00 .... ...._.... ... PRIME AND FINISH PAINT, WHITE CELING, ONE COLOR ON WALLS $1,000.00 �iJtiiL Jil iyy � i}y;+ice: NUDE STONE COUNTER TOPS SUPPLIED AND Ai T T'T rT T1ST f VT—T;TTi (• - room m V a � o Av; t w��mD mho 3s flag pLL¢Cz09g X2213.0a .Q viSt jz has 2°�m d �� � F o Bmt-Qat¢ c 3g E "�` o a R CCOGC %lo tr.S YS iLri" _g +Drl ie m z Awa Id 1. o 0 N M� A w CIlk i I Q r i71+m 3 oozw zz z ,, F Gj z z z 0 u' O tlt mots a � W ,7 FOui La �� K 2Qip LL M d LU Ul 001- st169 O O t�4" 4j i�si �Zutt1 oza o=QC3 FCO 0a t9>(}�Gi CtwOT Apr 4 2013 9:41 P.01 OF LIABILITY INSURANCE DCERTIFICATE 4/4/2013 TIFICATE IS, ISSUED'AS A MATTFR OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI8 CERTIFICATE DOES NOT 'AFFIRMATIVELY OR NEGATIVELY. AMEND, EXTEND OR ALTER'THE VS •COERAGE AFFORDED BY THE POLICIES' ,V� BELOW.. THIS .CERTIFICATE OF 1NSURANCE DOES NOT CONSTITUTE A CONTRACT. BETWEEN THE ISSUING INSURER(S); AUTHORIZED., REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the.pollcy(ies) must be endorsed. If SUBROGATION IS.WANED,'sub)ect to the term's and conditions of the policy, certain policies may require an endorsto endorsement- A Statement on this certificate does not confer rights the certificate holder In' Ileu of such endorsement(s). .PRODUCER INSURANCE SOLUTIONS CORPORATION' 60' .Westville Rd P1ai,Stow NH 03865 CONTACT L. th:La St. AM&nd NAME: lm PHONE (603)382-x600 PAX IC ,.(603)302-2034 MAIL . estatxard@ isaineurea , com INSURERS AFFORDING COVERAGE NAI¢ A INSURER A Merchants 23329 IN$URHD Martin IJ. Provost 40 Pillsbury Rd ' sandown NH 03873-2703 INSURERS -I'M 1na=ance Cpm an 15997 INSURERC: INSIIRERD: INSURER 0; I RERF: MTAMLi W- L1 3lnu_fN' m Wl wl_ti IIIN mllmmFR' 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 VVHICH THIS CERTIFICATE MAY BE ISSUED OR MAY. PERTAIN, THE INSURANCE. AFFORDED BY THE POLICIES YESCRIBED HEREIN IS 'SUBJECT* TO ALL THE TERMS,: EXCLUSIONS AND,CONDITIONS OF SUCH POLICIES'., LIMITS SHOWN MAY HAVE BEEN REDUCED 13Y PAID CLAIMS. INSR .. TYPE OF INSURANCE •' ADOL UBR POLICY NUMBER POLICY EFF POLICY EXPLTR •LIMITS. G£NERALLIABILITY EACH OCCURRENCE S 1, 000, 000 $ 500,000 '. X 'COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 15, 000 A CLAIMS -MADE Fx1 OCCUR ra& /20/2013 /20/2014 PERSONAL & ADV INJURY• $ IncludLad GENERAL AGGREGATE $ 2,000'.000 GEN'L AGGREGATELIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2 , 000 1. 000 $ PRO-. LOC X POLICY JECT AUTOMOBILE LIABILITY frEk COM01i en G 500,000 BODILY INJURY (Per pera06) $ B . ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS x'•HIREDAUTOS X AUTOSED 0111319 2/8/2012 2/5/2013 BODILY INJURY (Per eccldent) $ P DAMA Peracoidenl $ Uninsured molorist'combined $ SOA 000 UMBRELLA LIABOCCUR HCLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ F_XSF.0 UAB 0 D RETENTION $$ WORKERS COMPENSATION VVC STATU- GTN - PR AND EMPLOYERS' LIABILITY A14Y,:PROPRIE.TORJPARTNERIE(ECUTIVE E.L.EACH ACCIDENT $ EL DISEASE %- EA EMPLOYEE $ OFFICER/MEMaRR EXCLUDES 7 (Mandatcry in NN); N / A EL DISEASE -POLICY LIMIT $ Hy' v�s desc6bc.undar RIPTION OF OPERATIONS OEBcbelow ,DE6CFi1P710N OF QPEjtATIONS (, LOCATIONS /,VEHICLES (Attach ACORD 101, Addhlon4l Remarks Schedule, If,more space Is rcqulred) 1 (978) 6136-9542 North' Andover Building Dept 1600 Osgood Street North Andover, MA I I ' er_ARr1,2K 12114fl1A61 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE I THE EXPIRATIbN DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE nthia St. Amand/CLS!;'''`', 1988-2610.ACORD'CORPORATION.: All rlghts reserved. INS025'(20iQM.0+• The ACORD name and logo ere registered' marks of.ACOkD`