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HomeMy WebLinkAboutBuilding Permit #470 - 461 SUMMER STREET 12/12/2011TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0:9�0 Date Received a Date Issued: / IM PORTANT: Applicant must complete all items on this Dave LOCATION/ e .,z Print PROPERTY OWNER T na,L,4en -/- /r vs%y x Unit # Print MAP NO: 16,g -PARCEL: ZONING DISTRICT: Historic District yes n Machine Shop Village ye no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE v Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition 9 Other Sept`ic0' Well t®IFlood lam ® '��W g p, Wetlands Vol District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: �•.S� Qsrsc���7 r � /1 Fae�r: //� �o©r� QnL &,ole k a vT 12. o o o-, (Identification PIease Type or Print Clearly) OWNER: Name: J-eorr,�rex ¢- Iv is-rY /�'oaC Phone: 97Y- 7z�- 9-/73 Address: .sv ,.7,vee jr7 CONTRACTOR Name: 6 1,4 *W Phone: X0,3 -.38z- 46v �Fr Address: ,Z 37 herih _C7,- Supervisor's iSupervisor's Construction License: 9 Home Improvement License: /3p51y12 H 6-39,6,5- Exp. 3ffGs Exp. Date: y-9-iz Exp. Date: y- 2g- - /Z ARCHITECT/ENGINEER Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT: $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ 32, oo °= FEE: $ 3 Check No.: % Receipt No.: ��- NOTE: Persons c tracting with unregistered contractors do not have access to the guaranty fund 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. 9 Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION COMMENTS HEALTH 5 COMMENTS Reviewed on Signature Reviewed on Signature t., Zoning Board of Appeals: Variance, Petition No: Zoning Decisionlreceipt 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 124 Main Street Fire Department signature/date 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 ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi 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) ❑ Mass check Energy Compliance Report (If Applicable) o 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 o 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: Doc.Building Permit Revised 2008mi Location Al No. av Date J9AL NORTN TOWN OF NORTH ANDOVER _ • OL .. D '�s •"'°' t<�' J�CHUS Certificate of Occupancy Building/Frame Permit Fee $ $ ' r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 24878 Building Inspector vCKIIt-W.AIt LUMI NOTAFFMMATIVELY OR NEGATNELY AMma •• ••� .,c rn,a 1 BELOW �g CEiYIiFICATIE tNSLOiANCE oGFs CpNSTiiti� A CO ON'tR A MR � COQ RAGE AFFORDED B1f THE pMjC g REPRE�EIrA,TIVF.,JR PRODUCER, AND W CERnRCAT9 HOLM. BETYYEEN Tt1E ISSUING INSURER{9), AUrWMZED the tan and cod 60M of u* panty, eartain cortificota holder h 6E of such oWarsIpR ower a�0 0§96ed gtmt forth Andov93CP MA OIE145 IURED .OTAL BA 151T SOLUTIONS W 151EW L4WSHIRE INC ?38 MAIN STRLiF.T mta►rsTOV, HE! 03865 0- "WwArm, mepouc3ges) nusibe elldol5l0, If SUBRocAiION Is WAIVED, auhjeCt to Toy requim 911 ant*mment A atailelmit on this caWromb acres not confer Eghla b gm msuREla<sI AF•PpgpNG cOvE19AC+t: _ IllsuaEaa • II�RCHAt:T, f � �� . — LwLLK Ii 6: t6p; chi;U!1t9 Mutual Insurance Co _ INWREI0; NU11113Eif: REV•I51ON NUMBER. UYCIV\VF's --- • - -- - -- - THIS IS reoTWIFYfHSTMT Ar THE G R�OF Q1� EW u � � OTS OF �CONTRACT ISSUED 0 OTTHE ooCUUM WITH P CTE To wMCH tike INDICATED.ME CERTIFICATE.tMy CENd01T►p�lS OF MAY A@I POLICIES, I,llA17'S 3M�IOWN MAY HAVE BEGN 1RED�UC:EEDCBY P � I� HEREIN {9 SU6Jt CT TO ALL THE TE EXCLi1S10NS IAMllf4lf�1 I Y-�ff (IMVIIfJdYyY: V� _ GENWALLu�eUrn 09147905 X caWEKJ&GENErALLAQlLl7Y s ® OCClgt --- ..�w11tAPPUESPER 8 wranaelLe+uAa►uty ANYAM ZHEDULEO � AUTOS AUTOS X AUTOS MIMED I.� RREOAUTd9 AUTOS Ula IO AOX OCE SS LIA9 vwlc; �O'IERS LVI®14f� AND i _—... Q,.anA�RA OCCUR NI Nen E* wrro nrr seal) E 5 PF.RSOML8,ADV IIIWRY a 1000 I I PRODUCTS 5--2�,Uuu.w•,_v_ S INEO 'N LMIR S 110000 B/17/11 6/17/1.21. (EaooUdelt+ -- CA92043924 apodYNURt'(plarpamvn) eODa�RY(Parwcld"o•— PE�- m aoogei� _ 6 F,ACN occu � s S AWMGATE WC gTAiU OTN" r EL. D13FA9E -POLIGY LIMR 3 �, ACM 751, AaaWW {LOOMSrmtlu Sclledlla�l/mu•=P� are tib! DESCRIPTION OF pPeRAlMINS I fAf VB�Co CAN �� 1FtCA'TE HOLDER SHOULD ANY OF TME At��DEBORIS r4 FOLIO WILL 6EN � eco m! T� a1lwlunON DA71A T aovtslons ,Cam Or SOP�� ACGoRoM0E WITH '11I@ PQWC 7A Si?Orr= ROM Auwami' w wpm$ N71A I DO)M)RD. Mh 01921 04 N All dg� ®198ti4010 ACORD COR N. ORD S ae6 logo art ragisterad Meft Of ACORD The IAC >E -Mail; ACORD 25 (2010106) Fax: Phone: T%4 1CT,n1 .1in\i i UTrl-nT T7n- -T •°—a o c � o O O "~ vOV O. C A O ;= O O ' CD y � • Ea L CD C = t5 yO/ O. EE 0 :mss c .. 0 ilk Ca 0 mcm c ca c— L o 3y � � a C O -0 '= C d1 R E"0 m o a� ® y m Li I o coa CL 0 0� 0. 60i y w F3 o O. = L O -r .. O • y -O c = O y_.+ O H O O' CD W_ CA *-"= Z O AID = rt• � •N O.,�OC C=m C 7 +' uj cc 'E: o C y w m o �i c COD O. m O Z A . L y 7 H r y0. O._.. m 0 CO O U O v TIT P4 4-4 • ra .,w 2 V O O O O v Z � O. O CO) W CD ca W Q .� e O O �ECD 0 co m m CL. ~ = to � O � � � 0 0 Cc O d Q. CMCC ca Cc co V co ca Z0 CL � C3 CO) C c C C c CLW is o w° ar. 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CMCC ca Cc co V co ca Z0 CL � C3 CO) C c C C c CLW is Ceiling Tile- /� L -Channel' Joists 16" OC €' fl uMB um stop Fire Stop 112" Alf Fire - Intumescent Caulk/Foam ro Panel Biscuit with Long "L" _Q r A: Insulated Wall Panel t, = Acoustic Ceiling Use "U" channel 1i U -Channel to span the void between joists = _ Base Trim X11 + - - u— - f � � Ceiling Tile- /� L -Channel' Alf ro Panel Biscuit with Long "L" A: Insulated Wall Panel Baseboard Trim U -Channel rikyl za #1 i" t& �ruus Metal Batten Strip Vinyl Cover Inside Vinyl Corner ( Inside Corner s`�-,,� � .♦. ��2 ice/ i '� _ • Y1 l � \11`I OtAl Corgi Kz III a if i I I � I 1 Inside Vinyl Corner Fireblocki�gCon Fasted SIhd Crowfi j I .. p )' ! etal LChannel 1 ` I ! I t flrywlall Screw,;=:: sr• - i � is � i � + � � Y ��� '`� r �+r•+•.' _.. Metal Batten Cover, and V 1 Sea'r 7yl p ! Metal P8 el Biscuit,, with Arm rir o i , " I •I C ; �� ' Fibergjass { 2 Hdur Sheeting ted \ Electncal,`Bozes� `\ ! f i ' Conventionally Fastened R-13 Insulated , Thermell)ry Flooring Wall Panel _ Drywall Screws Metal The simplicity of the TBF system For Basement Mall finishing �\ troy &&_# J2 to Masonry Anchor The Commonwealth ofMassachusetts Department oflndustria[Accidents Office oflnvestigations 600 Washington Street Boston, MA 02111 yY www.mous-gov/ciia iplicant Information Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers • - - +. va..uv 1 1111E .L1G (�JA Name (Business/Organization/Individual): Address: City/State/Zip: �%.:sTo ui Ny a.3 SGS Phone Are you an employer? Check the appropriate box: 1. M I am a employer with rfr v,,a 4. ❑ I am a general contractor 2• ❑employees (full and/or part-time).* I am a sole proprietor or and I have hired the sub -contractors partner ship and have no employees listed on the attached sheget. t These sub -contractors have working for me in any capacity. [No workers' comp, insurance workers' comp. insurance. 5. ❑ We are a corporation and its 3. ❑required.] I am a homeowner doing all work .officers have exercised their right of exemption MGL myself. [No workers' comp. per c. 152, §1(4), and we have no insurance required.] i employees. [No workers' comp insurance ' d ' Type of project (required): 6. ❑ New construction 7. ❑ Rem.odeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Plumbing repairs or u.dditions 12.❑ Roofrepairs requue .] 13.❑ Other Any applicant that checks box #1 must also fill out the section below showing tfieir workers' compensation policy mformation. I Homeowners who submitthis affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. tConfract ors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers° �nr,,,,,r, ..: v �_� < urn un employer that is providing workers' compensation insurance f information. or my employees. Below is the policy and job site Insurance Company Name: /17t�1 f/S C�,mP'�S 01-;1 . Policy # or Self -ins. Lic. #: WG yam- 4(j— Expiration Date: /d - Job Site Address: y6l S�rn�P� �p– Attach atopy of the woCity/State/Zip: 141� rkers' compensation policy declaration page (showing the policy number and X�sration penalties K mQ �l�ye� Failure to secure coverage as required under Section 25A ofMGL c.152 can lead to the imposition of criminalenaltie atea 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 of of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA, for insurance coverage verification. r do Izereby certify under thepains artdpenadties ofperjury that the information provided above is true and correct. -79-- ,/7y - "Y 3? e F vrr��d�t� use only- Vo not write in this area, to be completed by city or towofficial City or Town: Permit/License rr Issuing Authority (circle one): I. Board of Iffealth 2. Building Department 3. City/TovVn Cl' 4. EIec 6. Other txical inspector S. PIumbing Inspector /,2 -/Z - // Contact Person: ' Phone #: k 14 :j m m I 0 Hri m (A > M C) m 0 --1 A CO CID cn aj it ri. (.n co e 5— 2 ILI j( ✓t L ^. I Total Basement Finishing of NH { We make Basements Beautiful.! ! www.tbfnh.com 1-877-237-0507 603 382-6098 238 Main St, r Plaistow, NH 03865 FAX 603 382-2403 F 159412 alFor OfficeUse Onlycm E5 BASEMENT giTo Finshing afNeivHampshire B F14 2" Z�o &Uw! T PROPOSAL DATE: 11130/2011 r SUBMITTED TO: Rusty Fox ADDRESS: 461 Summer St North Andover MA 01845 JOB LOCATION: 461 Summer St North Andover MA 01845 f System Features Evert-ast Perimeter Wall System White 76 EverLast Partition Wall wl Metal Studs Evertast Insulated Partition Wall System Everl-ast Non4nsulated Wail White 86 ZenWall 6 Panel Primed Door Knobs 2 Lowered Door - Knobs Bi -Fold Door Knobs 2 6 Panel Door Knobs Prestige Ceiling 2'x 7 Finished Linen Ceiling 7 x 2' 525 Box -out Ductwork 54 Girders 11 Painted Ceiling Evert-ast Basement Window 3 Egress Window System SunHouse Basement Window 2 Base Electrical 1 Electrical Sub Panel Outlets, Switches & Jacks 19 Electrical Smoke Alarms 1 Recessed Can Lights 12 7 x 7 Lay In Florescent Light 1 Nevada Window Hand Rail Wall Mounted Left 1 Open Mahogany Stair Railing - White Half Wall 1 Structural Permit & Electrical Permit 1 Basement Pop out up to 700 sq. ft. Dumpster Access Panel Decorative Post Surrounds 1 Modify Existing Ductwork Electrical Baseboard Heat 200 sq. ft. SaniDry XP Air System FloodRing FloodChek Hoses UltraSump Battery Back - Up Pump Full Bathroom Package Half Bathroom Package Sewage Ejector installation ThermalDry Carpeted Flooring - Charcoal ThermalDry Tiled Flooring - Sandstone MillCreek Flooring - Rosewood Plain ThermalDry, The basement wall and finishing system is not a basement waterproofing system.Water problems are the responsibility of the Buyer.Mold, mildew, and fungal growth can occur under certain conditions.While the materials used in the basement wall system are mold resistant, the Contractor cannot control the conditions under which they occur.There are no warranties against mold, mildew, and fungal growth by the Contractor or Manufacturer other than the Manufacturers warranties, if any, provided with the products installed under this Agreement.The majority of the components of this basement finishing system are constructed from mold resistant materials to eliminate a large part of the food source that promotes mold growth.This system is mold, water, stain, and fire resistant.Buyer hereby requests, and Contractor, an independently owned and operated dealer, agrees to install the products and perform the services at Buyer's address provided herein.Buyer agrees to sign a completion certificate upon completion of the services and installation of the products.THE TERMS AND CONDITIONS ON THE ATTACHED ADDENDUM ARE INCORPORATED HEREIN IN FULL.BY SIGNING BELOW, BUYER AGREES TO THE TERMS AND CONDITIG 1S OUTLINED ABD ON THE ATTACHED ADDENDUM TO THIS AGREEME T. Authorized signature: I V—IVrN Date L, \ "i_'" EMAIL: rusty8876@gmail.com HOME: 978-7295173 WORK CELL: FAX: APPROX. INSTALLATION DATE: APPROX. COMPLETION DATE: ij (weadrer 8 materials pemittingj f r r of DETAILED DRAWING ATTACHED SERVICES NOT INCLUDED 1. Moving of Drains, Gas Lines or Oil Line 2. Painting or Staining (Unless Specified) 3. Modifications to Heating Duds or Security Systems (Unless 4. Carpentry or Gosst Shelving 5.W aterproofing (Unless Specified) 6. Work required by Budding Officials not listed herein 7. Any items or work not specifically listed herein Total Contract Price $ 32000.00 Deposit With Order 33 % $ 10560.00 Payment on Measure % $ Payment on Start % $ Balance Due on Substantial Completion % $ Total Amount of Balance to be Financed $ R financed, balance is payable in monthly installments of approximately $ per month. Owner will pay said amount plus such interest and credit service charge of lending institution payable directly to the lending institution loaning such monies to'Owner and will execute a Retail installment obligation and any documents required by such lending institution in connection with said loan. Acceptance of Proposal. The above System Features, prices, spadicetions, terms and conditions, and Customer has received a copy of the X attached Addendum are satisfactory and are hereby accepted by Buyer. Contractor is hereby 'Basement Finishing Science" book autirorized to do the work as specified herein. Payment will be made as outlined above. Customer is aware of the Terms and X Conditions.Signature X: Date �� �l � Signature X: Date PAUL 1 UI- b