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HomeMy WebLinkAboutBuilding Permit #549-13 - 4 STACY DRIVE 1/31/2013BUILDS PERMIT TOWN OF Kii H ANDOVER A APPLICATION FOR PLAN EXAMINATION .�� Permit NO: Date Received �sSwc►+us�� Date Issued: IL I RTANT: Applicant must complete all items on this page LOCATION �J '�-ti f%r 0" — I Print PROPERTY OWNER -Te(C4 (3",e - --- Print MAP NO: PARCEL:00145' ZONING DISTRICT: Historic District yes ..� Machine Shoo Vitlaq t yes ; no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial 4 Repair, replacement ❑ Assessory Bldg ❑ Others: Demolition ❑ Other _i Septic 1-1 Well r- Floodplain Wetlands I- Watershed District I Water/ , wet Identification Please Type or Print Clearly) 781 —t(2'4 -n6 zz- OWNER: Name: 5fCr4SL��Phone: �� Address: ( , [[ P—A 4,yJ oj,-r 1JX O CONTRACTOR Name — 1 lyltr Prn�✓tiC� ..Phone: 60-3ct6-6ns PAQ(; /— (.A.S tr✓c�ry��o1l Address: Supervisor's Construction License: c S _ 10 4,3 k 3 Exp. Date: it 7 1z., i Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No, FEE SCHEDULE. BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL WIMATED COST BASED ON $125.00 PER S.F. Total: Project Cost: $ 66 S-3, 2 O FEE: $ en -0-4 Check No.: Receipt No.: I NOTE: Perso s co tr tin ith unre 'ste contractors do not have ac ess to he guaranty fund Signature of Agent/Owner Signature of carttractor 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 PLANNING & DEVELOPMENT11 COMMENTS DATE APPROVED CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMfJIENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes _ Planning Board Decision: Comments Conservation Decision: Comments Wafer & Sewer Connection/Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster onsite yes. no Located at::124 MainStreet Fire Department signature/date ' COMMENTS s, b 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.$10041000 fine NOTES and DATA — (For department use El Notified for pickup - Date Doc.Building Permit Revised 2010 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 Li 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 app�-.al 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 4 5;;c un bLv j No. Date 3 Check 4- 26133 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector CA m m m y m CO) v m o0 00-0o U) -h� N N r _ < .a >C 0. • O m n _0 0 O m a n m oO C -, r► Q o m rt -w O S '* ID N O y �• O Q. 2) O CL C O U3 to_O U) O Or. CD O oo s CD M Z N O � Z CL o o (a co ' = rn 70 0 -0 Qom= Cl)— zo; O .y, a O rn o � � c rt NCL S. Z %< n CD U) < a o °1 O C� cp o o CL = o v, vcD —i� Q O< COD CD O- mill ��< .. �• C Cl) Co CL Cr `C CD -i Z m N CD O ID D .s O Z�y� T o r W U O Q_ CD It=to ; U) tn " � '* o v O cin Z c_ 3 O3: c y Co - N: CD'V n O n CD p c, o CL - m �v �i O y 4 N Ln p7_T 3 c 0 (D 3 77 5� Z7 �' 0 c V1 5' 0 < c T 70 0 N c '%'..j T a oV 0 ,.0 •c V1 T m 0 -0 0 (D zCL m3 v N F/ mV 3 fD X71 CL N O." �►�� 7C o 3 T m H ? m U� c 3 W �. c ' W > D 0 e m ~ � � �= Z OT 70 m 1 Z `m Z mVA C' D W W GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS, ADDRESS, AND PERMIT (COPY 0K)..or no inspections INSPECTIONS: (Minimum) Excavation, Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain - pipe/stone/fabric filter/cover and outlet connection. FRAME: Fireblock - over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters - watch bearing at walls. Ridge & Hip - Provide proper connections. Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate. Stair stringers - watch cuts and heal support. Joist hangers - fully nailed w/ hanger nails. Sill plates 2-2X6 (1 PT) w/sill seal. Girts - solid brick or steel plate bearing at foundations '/ " air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances - stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior (not in soffit). Firecode S/R wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8% of floor area. 'h of required glazing shall be openable. Bedrooms required min. 20x24 egress window or door. Vent attic spaces - "proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing - Smoke Chamber - Finish Smooth parging, clean joints, 8" solid @ combust. DECKS: Lag to house, provide flashing. Rails min. 36 " high, Baluster max space 4" on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re -inspection fee - $30.00 (Be Ready). Certificate of occupancy required prior to occupying structure. Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost $ 61653.20 m $ - $ 79.84 Plumbing Fee $ 9.98 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 9.98 Total fees collected $ 199.80 4 Stacy Drive 549-13 on 2/1/2013 Kitchen Remodel The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations U 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ylCr Wvkcf- h Address: `l u 4a ,C( & �o n f N H_ O� 6 5 a Phone #: Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part -tune). * have hired the sub -contractors 2 \ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ required.] ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: 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 certify under the pins and penalties of perjury that the information provided above is true and correct. Phone #: (,,r),� —3 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Zp Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other 125/811 6-2 1/8" 0 00 .N£.9 321/211 48' c O aw v _O -+ c O L L 7 (A V c O '� cCL L d O c O 4 O E L A c O O r ufA � 'c 'i N ,w \ 14- 00 -OO Nps 000 pec Op E _ 000O oocE Z E%- O G1d ,v+i3E c� 0 3 0 'cMCC'c0 0 0 6 IM 0 c ILI E ._ Sm: 0=0% VQN4mMN mobv �co It O0 M .O -p '� N O . O O iLiLJJ >Wc0 ie) .C(D v 0 2 aCL c oM M O s w U -o N ov- N Y M Ev— M+ N cc .O -p '� N O . O O iLiLJJ >Wc0 ie) .C(D v 0 Om M X o � r M o CO i\JN D N I X U- oEp •�- X .0 Q M .0 N co T- M Y 0 co d' Y (0 Cf) 0 M 0 (f) 0 M 0 C v X Y a O 4 - LL U) N N (0 Y ti _ N m N N a U o 0 c Y L _ LO �W.0 coom N c rn LL Y M 9 rA .0 0 0 'G c� o. 0 v U .D U cj Q a� roo r O ti _ N m N N a Y c a N +, S C. L © � D N r c D N�� ❑ C,4 _ ` N ©� U ® ® �w _ a Q M O ® M e Z M 9 rA .0 0 0 'G c� o. 0 v U .D U cj Q a� roo r D i 75" U) 7q—n O z�J i1 y r1 `� iP • n. v i � Q. c Q- � C) a o �d PT V '• a D i 75" U) 7q—n O z�J 2• O Q- 0CD C a OW `< '"�' 3 0 m OCD v� N 0 �oo�' - 0-n"000 "1 o f1 f Ln 'L7 � a t J MJ �I OE 3 _ XO :S=IV)4 WCAAN IIL f1 W 0 IJ w --- ai X M'I M f c� tin uj C O yr 0 0 Q L Q. d cc= 0 y+ _ O U) v Q. L y d d ++ AW 4. .0 � J rt+ O O CM CL z L +•: iCL mCD O ) O _ d M �. y o O N1 O 0 0 O �ay E o cc �o yz CL y c O _ o c •�An 3 c, = � co cc�y 0 C = O H Q t7 L C L CC .O 2 F- m Q y Z cn O en 0.V m cc O z 0'0— .y O O d z Li 1— y . ;5y C O Q tZ a cr O L) N LL •� � .0 p J Ip+ Q. 0 V O C7 Q Q C7 z CL z z V w oOC ap to D v O m i (7 oC C E J LL t m a W U O Y •1-i to c6 v z \ U "O L C L .0 spp CU dD 3 •U .� CU Y O Q 7 v O 0 :EC C c LLL _ n LL W U LL d' LL d' Ln LL Q' LL m N In c� tin uj i z m CD Z W a w F- LU a 0 a 'Z V zo: Z m a O U Z O cn ujJ 9 LE El 0 a s H y W W ce W U) C O yr 0 0 Q L Q. d cc= 0 y+ _ O U) v Q. L y d d ++ AW 4. .0 � rt+ CM CL cn J y L +•: iCL mCD O ) _ d M �. y o O N1 O 0 0 �ay E o cc �o yz cn y c O _ o c •�An 3 c, C.CL� ) � co cc�y 0 C = O H Q t7 L C L CC .O 2 F- m Q y N cn O en 0.V m cc O W 0'0— .y O O d .F - O Li 1— y . ;5y C O Q tZ O *o o o O L) N 0-0 d •� � .0 p J Ip+ Q. 0 V i z m CD Z W a w F- LU a 0 a 'Z V zo: Z m a O U Z O cn ujJ 9 LE El 0 a s H y W W ce W U) Palmer INNOVATIVE CONSTRUC17ON www.Palmerinmvaflveconstnmtion.com Terry Stabile 4 Stacy dr North Andover, Ma 01845 Certified Lead Renovator # R -I-18499-10-02896 Mass License CS -106313 HIC Registration # 172600 Fully Insured Send To: Palmer Innovative Construction 4 Wallace St Newton, NH 03858 603-396-6285 Tyler@palmerinnovative.com Muer Project # I Estimate Date Estimate Expiration Di 0#otal 1 1/10/13 _#_ 1 2/15/13 16653.20 Project # Scope of Work Phase 2 Demo and removal of debris in Kitchen 1775.00 Plumbing allowance Cut out, frame and trim window for bar in kitchen wall Installation of new cabinets (includes cabinets 939.20) 14139.20 Installation of counter tops (includes counter tops 264.00) 1614.00 16653.20 Comments: *Permits for all work to be extra cost. Homeowner to supply all materials. Down payments will be based per project line and be 20% of project line cost. . **That all home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, MA 02116 Phone: (617) 973-8700 a. any and all necessary construction -related permits; b. that it shall be the obligation of the contractor to obtain such permits. c. that owners who secure their own construction -related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. such arbitration a vided in MG Owner: Contractor: Total Owned 6 > 6653.20 cs�m rettor+ - JIM Massachusetts - Department of Public'Safety Board of Building Regulations and Standards Construction Supen icor License: CS -106313 TYLER PALMER 4 WALLACE STREETS Newton NH 03858 Expiration. Commissioner 01107/2016 I ��e �n��:�rza�iueatll n���LaJJac�ulctf �L\ Office of Consumer Affairs & Business Regulation I ME IMPROVEMENT CONTRACTOR egistration:.172600 Type: LT2, . xpiration:.7/11/20.1.4. DBA PALMER INNOVATIVE CONSTRUCTION ;z TYLER PALMER E 4 WALLACE ST NEWTON, NH 03858 � Undersecretary , ,t i /J 1 1