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Home My WebLink AboutBuilding Permit #270 - 478 BOSTON STREET 10/15/2008 W BUILDING PERMIT "°DT"qti TOWN OF NORTH ANDOVER 0 ~ w 9 APPLICATION FOR PLAN EXAMINATION Permit NO: 270 Date Received ^TED A ' �SSACNus�� Date Issued: MPORTANT: Applicant must complete all items on this page 1-0GAME)ON 44 try 0�1�11 - Ant g .n SAP Ta70 ,'R:C t 26, 1NG JI 7R�1.1Jd s# is �str� t s so tr adt ;e i l yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building <4pe family Addition Two or more family Industrial Alteration No. of units: Commercial �Eair, replacemen Assessory Bldg Others: Demolition Other pticlll �oodplain wt ds mJistract " iter/ �wex DESCRIPTION OF WORK TO BE PREFORMED: lee'-1 G (l! -P Q q d e- r'O IAJ Identification Please Type or Print Clearly) OWNER: Name: a �y M u c! a, /17 Q -1-e- s! ,L� Phone: 9 7,1- L -P Address: Y 7 o✓'l c L Sl.r r 'eve 1� 4n 7-T� lare /,Cryt - rtt� eAA d AJ • y ,r-� i per � ar"SConi sfruction 1LJicense, xalD e 4 - - - 77 orerrer�t .icer� - J b ' ` expae m ARCHITECT/ENGINEER Phone: 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: $ -C FEE: $.01 ��6 _— Check No.: Apf—rx Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sraaure A etlrr�er;� r, = S ��ture of crata-ato� - . Location No. —9 70 Date Zo NORTH TOWN OF NORTH ANDOVER f 9 • ; ; Certificate of Occupancy $ �ssxs�t Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2R6u � _� 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 Signature COMMENTS `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: Located 384 Osgood Street E ESTera� ? rSIer, zite vis TO cae �ai> tret CC' 1lt= T4 { 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 21 A—F and G min.$100-$1000 fine NOTES and DATA— (For department use a ❑ 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 ❑ -B-uilding Permit Application -- - ---- ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract Li Floor Plan Or Proposed Interior Work Li 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 ❑ 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) 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 o 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) L3 Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products j 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 2.2008 NORT#q 0 of 6Andover No. Z 01. dover, Mass., o a� COCHICHEWICK V ORATED F' �� 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..................:. � � ... G!'. , .Ct:................ .. !'.... .......................................,r.......... Foundation hasp ...................... buildings on permission to erect................. ...y7� .. ...o>.y.......La ......................................... Rough 1 O to be occupied as.......: ..........................s'•seq�� 14lay., Chimney ................................................................................................................................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. qj PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS ' Rough sjZ..... /lr .................................. Service BUILDING INSPECTOR Final Occupancy Permit .Required to Occupy. Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner f Street No. SEE REVERSE SIDE Smoke Det. Page No. 1 of 3 Pages Proposal M.G. HALL CONTRACTORS, INC. Custom Building and Remodeling 286 Park Street North Reading, MA 01864 (978)664-1656 FAX(978)664-2363 E-Mail: mghallcontractors(cDverizon.net Home Improvement Contractor Registration#100804 Expires 6/23/10 Construction Supervisor License#CS 040752 Expires 9/28/09 PROPOSAL SUBMITTED TO: PHONE: 7AT 978-390-6477 (Cell) Ga & Marc Matchett 978-682-7488 25, 2008 STREET: 478 Boston Street CITY,STATE AND ZIP CODE: North Andover, MA 01845 KITCHEN REMODEL We hereby submit specifications and estimates for: Obtain permit Complete removal of all demolition and construction materials generated by M.G. Hall Contractors and their subcontractors Owner to remove kitchen cabinets and flooring down to sub-floor i Demolition j Remove kitchen window Framing Frame for refrigerator at existing pantry opening Screw down sub-flooring Windows Install one customer-supplied Marvin kitchen window in existing opening Patch siding around window with customer-supplied mahogany clapboards as needed Move kitchen window to new location (Extra - $1,000.00) A finance charge of 1'/M per month((18%per year)will apply to all accounts over 30 days past due.In the event collection activity is required.the customer shall be responsible for all costs associated with collection,including reasonable attorney's fees. We Propose hereby to furnish material and labor—complete in accordance with above spacfications.for the sum of: Twenty thousand eight hundred -Dollars ($20,800.00) Payment to be made as follows: $6,700.00 to start $6,700.00 when 50% complete $6,700.00 when 95% complete $700.00 upon completion. Extras will be billed as ordered and are payable upon invoicing. All material is guaranteed to be a specified All work to be completed in a workmanlike J� manner according to standard practices. Any alteration or deviation from above Authorized �.[& l`[/ specifications involving extra costs will become an extra charge over and above the estimate Signature: and will be paid for upon completion.All agreements contingent upon strikes.accidents or delays beyond our control.Owner to carry fire.tornado and other necessary insurance.Our Note:This proposal may be withdrawn by us if not accepted within Thirty(30) days. workers are fully covered by Workman's Compensation Insurance. Acceptance of Proposal-The above prices specifications and conditions are sabsfadory and are hereby accepted.You are authorized to do the work as specified.Payment will be Signature: made as outlined above. /r Dale of Acceptance: r /` v- O Signature: FNTFPFn' .ALIG 1 1 2008 Cl SPECIFICATIONS Page No. 3 of 3 pages Notes: Builders Warranty attached. No allowances for painting, staining or installation other than specified. No allowances for anything not specified in this proposal. Tile price is carried for basic the work as described. There may be extra costs resulting from owner's selection of special patterns, feature tiles, angle patterns, special or thick adhesive, etc. Extras will be billed as ordered and are payable upon invoicing. Final design decisions or changes that impact the schedule may be billed as an extra. Final payment cannot be withheld for delays in delivery of owner's selections of plumbing, lighting fixtures or tile. M.G. Hall will allow $100 holdback per fixture not available upon completion of project, but may be forced to charge for return visits for installation. Customer agrees not to withhold final payment unjustifiably and recognizes that contractor is not responsible for menial tasks related to the project. Due to the volatile building materials market, M.G. Hall reserves the right to pass along price increases not considered at the time of this quote. M.G. Hall will make every effort to communicate openly regarding any increase which might affect this project. Fully licensed and insured. Neatness assured. All work guaranteed. M.G. HALL CONTRACTORS, INC. THIS PAGE BECOMES PART OF AND IN CONFORMANCE WITH PROPOSAL FOR: Job Name The Matchett Job Submitted by Date 20_ (INITIALS) Accepted by: 11WAO Date0 (INITIALS)' Accepted by:—YA'f 17 Date720 (INITIALS) The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name Usines Organization/Individual): e- Address: .7 #1-4 u 4('- f'6 -« 4 City/State/Zip: N G-4-x., M i-t Phone#: (971) l- G y- / 6—�6 . c/fit Are you an employer?Check the appropriate box: Type of project(required): 1.al am a employer with P 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ [v�'Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hue 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 their workers'comp.policy information. 1 am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: 7"e c 4,,a /oL n,,L,/,-c.1 c t- o Policy#or Self-ins. Lic.#: T w C 3 o P6 o Expiration Date: Job Site Address: 7 d' 130 s I d e c City/State/Zip: /✓o. A cJa-1 e- A 0/PI/Ir 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. Ido hereby certify r the pains and penalties ofperjury that the information provided above is true and correct Signature: �z 12�&z Date: /o /i y/o e- Phone#: (9 7 f) 4 C V- / 6 S.4 Official use 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: Fax Server 6/3/2008 10 : 46: 47 AM PAGE 2/002 Fax Server ACORD DATE(MM/DD/YYYY) TM. CERTIFICATE OF LIABILITY INSURANCE 0610312008 PRODUCER Phone: (781)933-3100 Fax (781)933-904E THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SALEM FIVE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BOYLE INSURANCE SERVICES,LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 445 MAIN ST BOX 606 ALTER THE COVERAGE AFFORDED BY THEPOLtCtES 8ELQ1A7, WOBURN MA.01801 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: The Employers Fire Insurance Company 20648 MG HALL CONTRACTORS INC INSURER B: ONE BEACON INSURANCE 286 PARK ST INSURER C: The Employers Fire Insurance Company NORTH READING MA 01864p Y 20648 INSURER D: Technology Insurance Co INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW H?'JE BEEN ISSUED TO THE INSURED NANSIl .ABOVE FOR THE FCLICY PERIOD INDICATED, NOTIhOTHSTANDING 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 DESCR?RED HEREIN IS SUBJECT TO ALL THE TERMS, EY.CLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATELIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L' SRI ADIY TR 11%18 L TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICY EXPIRATION LIMITS DATE fMMWDrM DATE IUWDDfM GENERAL LIABILITY 7100231340000 04/27/08 04127/09 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGETORENTED PREMISES E'=_') a 000urence $ 600000, CLAIMS MADE[�] OCCUR MED.EXP(Any one person) $ 5,000 A PERSONAL E,ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,=0,000 GEN'LAGGREG.ATELIMfTAPPLIES PER:I PRODUCTS-CCAPP/OPAGG. $ 2,000,000 POLICY JEC LOC AUTOMOBILE LIABILITY FBIE64228 04/27/08 04127/09 COMBINED SINGLE LIMlT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS AUTOS (Per person) $ X B X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Perecdcdent) PROPERTY DAMAGE $ (Per acadent) GARAGE LIABILITY AUTOONL`(•EAACCIDENT $ ANY AUTO OTHER THAN EA.ACC $ AUTO ONLY: AGG $ EXCESS!UMBRELLA LIABILITY 7100231340000 04/27/09 04/27/09 EACH OCCURRENCE $ 4,000,000 X OCCUR 1-1CLAIMS MADE AGGREGATE $ 4,000,000 C $ I DEDUCTIBLE I $ RETENTION$ WORKERS COMPENSATION AND TWC316830800 04127108 041127109 X IrITTy X or>ieR EMPLOYERS'LIABILITY D E.L.EACH ACCIDENT $ 500 000 ANY PROPRIETORIPARTNERlEXECUTIVE , OFFCERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 540000 If yas,doscrlbo urdar SPECIAL PROVISIONS below E.L.DISEASE-POLICYLIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAR URE MG HALL CONTRACTORS INC TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY f*IND UPON THE INSURER, 286 PARK ST IT'S AGENTS OR REPRESENTATS'JES. NORTH READING MA 01864 AUTHORIZED REPRESENTATIVE Affention: Gerard F 8o Jr ACORD 25(2001108) Certificate# 15461 Q ACORD CORPORATION 1988 i i l Y4 Boar o k-, m aho s a oar"'"Ts"� v Construction Supervisor License License: CS 40752 + Birtii".%9/28/1960 t: rill;—VrC.Mn=iVd8/2009Tr# 5710 n0 MARK G HALL 12 UPTON AVE N READING,MA 01864`•'='.• Commissioner ,p� ✓!2C TDOM7/IIZOOtIIJP�U�L dL i/�/C(Idd(!C/LGLQCCC6 �\ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 100804 Board of Building Regulations and Standards Expiration: 6/23/2010 Tr# 267834 One Ashburton Place Rm 1301 Boston,Ma.02108 Type: Private Corporation M.G.HALL CONTRACTORS,'INC Mark Hall 286 PARK STREET ,µ,Q NORTH READING,MA 01864 Administrator Not valid without signature 607 -11 '0. 9 __41 KACViVV '3;t l 3 w r- �C .off � x1gefN) A v� W/�C-A�tk,:;:TAbur= WD T/ I rill t .--r7Z r7 -50 DRAWING NO: j APPROVED: Aa;k AIN Z CUSTOMER: USTorA N ETRY BY; SCAL �"= FT. �I � G^��-fCrs�-a,�a�v�� THIS IS AN ORIGINAL DESIGN AND REVISED: / L � 1 Z -7.�LCM S MUST NOT BE RELEASED OR COPIED ALL DIMENSIONS&SIZE DESIGNATIONS r SUPERSEDES DRAWING GIVEN ARE SUBJECT TO VERIFICATION �T8 �D�JfIA - UNLESS APPLICABLE FEE HAS BEEN PAID OR JOB ORDER PLACED. NO Jb JOB SITE AND ADJUSTMENT TO FIT ,/ dNrnE/ K l DESIGNER- JOB CONDITIONS. ll/�/T f'vY�-' `