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Home My WebLink AboutBuilding Permit #449 - 48 MONTEIRO WAY 2/23/2009 BUILDING PERMIT of NORTH rD TOWN OF NORTH ANDOVER m C? 4` ' ` » 16 O APPLICATION FOR PLAN EXAMINATION e� Permit NO: Date Received R4Tl p� D♦PP,�� t SS "Us Date Issued:—2L- J'6 1 IMPORTANT: Applicant must complete all items on this page LOCATION F�jnt PROPERTY OWNERo�n htytCX q C ,� .�1 Print MAP NO: ., PARCEL'=&—ZONING DISTRICT: Historic District yes b B 6tI btu Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building 1"One 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 DESCRIPTION OF WORK TO BE PREFORMED: Identificationease Type or Print Clearly) _ OWNER: Name: a� V,,\v\ 0 V,A EQ Phone: t Address: ' CONTRACTOR Name�'t'\1�\k\ \.R `\w� Phone: � 5��' J ON Address: L�, o �` �\ �- (b Supervisor's Construction License: CS L� '3—%3J Exp. Date: Home Improvement License: � $ Exp. Date: r1 �•D 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: $ �J� _ C1 � . �� FEE: $ �y Check No.: / Receipt No.: �l f-- 3 NOTE: Persons contracting with unregistered contractors do not have access to t guaranty d Signature of Agent/Owner Signature of contrac- 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 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 .y 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 FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 924 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 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 ❑ 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 2.2008 Location /'IVOh*eel-d No. Date -D� NORTH TOWN OF NORTH ANDOVER f 9 • ; : Certificate of Occupancy $ cMusE`A Building/Frame Permit Fee $ Q Foundation Permit Fee $ ¢- Other Permit Fee $ TOTAL $ Check # �t!/ 2 Building Inspector c to TH '9 Tovm of No. 4 y ,.., 0 LA o dover, Mass., COCMICKEWICK "ATED P �5 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 1 BUILDING INSPECTOR THIS CERTIFIES THAT.......... ....... .................................... .................... ....... ........................................ Foundation has permission to er ct..... ................................. buildings on . �ro................................. Rough to be occupied aSNsI................... ....................................................................................... 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Y- PERMIT EXPIRES ONTHS Final UNLESS CONS ELECTRICAL INSPECTOR ARTS Rough ..... ...................................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove R Rounal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ACORD 1et CERTIFICATE 4F LIABILITY INSURANCE DATE21/2008 10/21/2008 PRODUCER (978) 352-8000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Georgetown Insurance Agency, Inc, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10 West Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES DELOW. Georgetown MA 01833- INSURERS AFFORDING COVERAGE NAIC# INSURED INS ERA-providence Mutual Broadway Kitchen & Tile; LLC INSURER B: 326 So. Broadway, Unit 6 INSURER C: INSURER D: Salem NH 03079– INSURER E: COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOD'L POLICY EFFECTIVE RA N LTR TYPE OF INSURANCE PORGY NUMBER DATE MMIDDIYY DATE(MMMDNY) LIMITS A GENERAL LIABILITY to be issued 10/21/2008 10/21/2009 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY =,GrSES RENTED $ 50,000 CLANS MADE X�OCCUR / / I I MED EXP axle ) $ 5,000 PERSONAL&ADV INJURY 5 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY PEC LOC AUTOMOBILE LIABILITY I I I I COMBINED SINGLE LIMIT ANY AUTO (E,e accident) S ALL OWNED AUTOS I I I I BODILY INJURY SCHEDULED AUTOS (Per p—n) $ HIRED AUTOS I I I I BODILY INJURY NON-OWNEDAUTOS (Par accident) $ PROPERTY DAMAGE (Per mddeM S GARAGE LIABILITY AUTO ONLY-FA ACCIDENT S ANY AUTO OTHER THAN FJAACC $ AUTO ONLY: AGG $ EXCF.SSIUMBRELLA LIAMUTY I I I I EACHCC RRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S DEDUCTIBLE / I / / $ RETENTION $ WORKERS T S EMPLOYERS'LIABILITY AND I I / I T U RS OT ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACHACGOENT S OFFICERN"BER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ I yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNENICLESIEXCWSIONS ADDED BY ENDORSENENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS wmTIEN NOTICE TO INE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY MND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZE REPRESENT VE ACORD 25(2001108) m ACORD CORPORATION 1 S88 fN3025(otoeyae Paan i n<9 1 2008-10-2116:24 GEORGETOWN,INS 9783527719 Paget Broadway Kitchen & Tile 326 S. Broadway Salem, New Hampshire 03079 Ceramic Tile, Marble, &z Granite Hardwood floors,Kitchen Cabinets,Granite counter tops. 603-894-0088 Date: December 29,2008 To: John and Linda Carven 48 Monteiro Way North Andover,MA 01845 Subject: Proposal for kitchen remodel. Dear Mr. and Mrs Carven, Broadway Kitchen and Tile(BKT)proposes the following scope of work. BKT to order Diamond Cabinets in Cherry,int, Qr Bayport Door Style,in the Harvest color,whichever is chosen and initialed, Upper cabinets (36") to be arched,plywood ends,DTU and premium guides. Upon arrival of cabinetry BKT will unpack and inspect for defects or damage. Once cabinetry has passed inspection construction will begin. BKT will remove and dispose of existing cabinetry. BKT will remove and dispose of existing ceramic tile flooring. BKT will remove non-bearing walls around refrigerator. Electrical work will then begin based on customer and electricians agreement. BKT to repair all walls disturbed by demo and electrical work. Additional charges may apply if scope of work enters cellar, BKT to skim coat ceiling in kitchen,eating,and back hall area. BKT to paint ceiling and walls in kitchen and eating area. BKT to install cement board sub-floor for proper tile installation. BKT to install diamond cabinets and granite countertops. BKT to install customer supplied hardware for cabinetry. trY• BKT to order,supply and install tile chosen in the kitchen,eating and back hall area.Tile chosen is the 13 x 13 Murcia Merango. Customer to approve template for countertops. Under cabinet lights to be installed by electrician. Small crown moulding to be installed between upper cabinets and ceiling. Customer to supply(2)pendants for electrician to install over island. Valance to be installed between the two cabinets at sink area. Electrician and Plumber to install appliances. BKT to supply and install new kitchen window over sink. Electrician to supply 8 recessed lights 5"black in kitchen. Each switch to be controlled by a rehostat. All electric will be to code.Outlets to be located in the closet by family room, 1 on each side of island,and one at the coffee maker area. Water to be relocated to the refrigerator at new location. Customer to apply for building permit. Customer has approved a 20/20 design plan. Z Contract Price: Cherry Bayport $ 31,999.00 Terms: 40% deposit 20%at cabinet delivery,20% at cabinet completion 20%at total completion. Accepted: i John Carven Date: Accepted: - Linda Carven Date: i U 9 Accepted: p George Kenney Date: d a ✓lie &I.2 meuealm P/'/M ra,<j eta ' 1l i9 Board of Building Regulations and Standards , •. N1aSSacljosetts- Deltartntent of Public Safety HOME IMPROVEMENT CONTRACTOR Board of Building Regulation" acid Stuntlards Registration: 133648 � Construction Supervisor License Expiration' 7/23/2009 Tr# 130090 42333 p License: CS Type: Individual Restricted to: 00 DONALD R.PERKINS DONALD R PERKINS DONALD PERKINS 4 MEADOW ST#B 4 MEADOW ST.APT#S NATICK, MA 01760 NATICK,ILIA 01760 Administrator Expiration: 8!22/2010 Tr#: 3248 C.)ntill k krncr License or registration valid for individul use only before the expiration date. If found return to Board of Building Regulations and Standards One Ashbdrton Place Rm 1301 Boston,Ma.02108 0 "—i Not valid without signature 'L The Commo)zwealth of Massachusetts Department of Industrial Accidents r IK t � t7� !lY/lJ Office of lnve'va'. io R ; 600 W ashinvon Street Bostosz, MA 02111 WW143." ass.g0v1dia Workers' Compensation Insurance.Aff'1day.It_ guilders/Contractors Au ectriciataslPlumbers Iicant Information Please. Prinf Leaib}�, Name (Business/Organization/individual): Address: v Clty/state Are you an empioyer?Check the appropriate box: 1.❑ I am a employer with 4. ❑ 1 am a Q Type of project(required): em to ems full and/or art-time .* have hir—d the contractor and I P Y�� ( p ) d the sub-contractors b. ❑ New construction 2 1 am a sole proprietor or partner- listed on the attached sheet 7• ❑ Remodeling ship and have no employees These stub_contractors have working for me in any capacity. workers' comp. insurance. 9. Demolition [No workers' comp. insurance 5. ❑ We are a corporation and its 9' ❑ Building addition 3•❑ required.] officers have exercised.their 10E Electrical repairs or additions I am a homeowner doing all work right of exemption per MGL 1 I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, 1(4) and we have no insurance required.] t employees. [No workers' 12•❑ Roof repairs comp, insurance required.J 1.3-❑ Other *Any appii ant.that checks box#1.must also fill out the section below showing their workers'compensation policy information. Homeowners who submit.@tis aiidevit indicatie_•they ars i:oir-- I v;�r;;&Iiu than hire cutsida cantraationcturb;must submit a Conttactors that chcc} this boy must arra hed an additional sheet show"[[_the name o...:sub-cor,nctors and their work=,ncv atnuavit Indic tir. fa- gs ch. comp,policy infotmatior,. I am an evnployer thw is providing workers'compencatiorc insurance for 'a Lo e�. information mp y _s Below is the poficy and job sue Insurance Company Name: Policy#or Self-.ins. Lic.#: Expiration Date: .lob Site Address: Attach s copy of the workers' compensation Policy deciaration City/State/Zip: pae (showin,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 5250.00 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 herebp certify under a pains and pent} .o rjurl: that information provided abo a a tru and correct Si-nature: Date: Z3 &1Y Phone,k: Offecial use only. Do not write in this area, to be completed by city or town ofciaL Cite or Town: Permit/License Issuing Authority(circle one): 1. Board of Health 2. Buiiding Department 3. City/Town 6.Other Clerk 4. Electrical Inspector S. Plumbing Inspector Contact Person: Phone k Information nd Instructions Massachusetts General Laws chapter 152 requires all empioyers 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 includizf.g the iegal representatives of a deceased employer,orthe 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 ap af-finents 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"every state o r local licensing agency shall withhold the issuance or renewal of a license or permit,to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence oif compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evid.Afice of compliance with the insurance requirements of this chapter have been presented to the coritracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es) and phone number(s)along with their c„-rtincate(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 LLCOr LLP does have _ employees, a policy is required Be advised thatthis affici;.avit maybe submitted to the Department of industrial ustrial Accidents for confirmation of insurance coverage. -Also be sure to sign and date the affidavit. Tne,affidavit should be returned to the city or town that the application for the permit or iicense.is being requested.not the Department of Industrial Accidents. Should you have.any questions regi rdingy the iax•, o-if you are required to obtain a workers' compensation policy,please call the Department at the nfzaziber.iis+wd belay;. Self insured co,,,panies should enter their self-insurance license number on the arpropria—_ line. City or Town Officials Please be sure that the affidavit is complete and printed I--ibiv. The Department has provided a space at the bottom of the afndavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fit] in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitthcense applications in arty 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 Iicenses. A new affidavit must be filled out each year. VhIhere 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 burnleaves etc.)said person is NOT required to complete this affidavit. The Office of investigations would like to thank you in advance foryour cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax numbs.:, The ComrnonWeadlth of Massachusetts Department of Industrial Accidents Office of IIIvestigmtiions 600 'Wash ngton Street Boston, ISA 82111 Tel. # 617-727-4100 e)ct 406 or 1-877-MASSA FE Revised 5-2645 Fax 4 617-727-7749 v�Fwv�'•mass.g ovldia • xr PERMIT NO. APPLICATIO FOR RMIT TO BUILD`= I ORTIt ANDOVER, MASSE; Pwc>![ t. LOT NO:_. 2_ RECOR%0F OW(VERSHIP, (DRAT—E--I800K :PAGE 20N .. .. stis DIV: LOT = J l I 1 PURPOSE or SOIL NQ OWNER-f NAME NO.OF GTORIJEW y IIZE. OWNER'S AOORt R[ N fASEMENE OR!L'!? :r ARCHITtCT'S NAME ;rf� \ tits d/,rL_GOR.TIM\tRt .. IST 2H0. ]RD fU1LOCR'f NAME /,� Y ri ,� �� _ ,, ,�/} DISTANCE TO NEAREST BidILOING (�// G(/f'w DIMENSIONS OF !ILLS , DISTANCE FROM STREET - • POSTS -' DISTANCE FROM LOT LINES- SIDES REAR GIRDERS, AREA OF LOT FRONTAGE HEIGHT Or FOUNDATION THICKNESS s 19 ■UILOIyd NEW SIZE OF FOGTING x IS BUILDING ADDITION MATERIAL Or CHIMNEY 1 IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF COPE If BUILDING CONNECTED TO TOWN WATER BOARD OF APPEAL! ACTION. IF ANY IS BUILDING CONNECTED TO TOWN !EWER If BUILDING CCNNECTEO TO NATURAL GAS LINE INSTRUCTIONS 2 PROPERTY INFORMATION LAND COST _ 8911 BOTH SIDE! } EST. BLDG. COST e2Q 4 PAGE 1 FILL OUT SECTION! I - i EST. SLOG. COST PIR SG. FT_ PAGE 2 FILL OUT SECTION! I - 12 ' EST. BLDG. COST PLt ROOM SEPTIC PERMIT NO. ELECTRIC MET9PS MUST Bt ON OUTSIDE OF BUILDING 4 APPROVED BY S ATTACHED GARAGES MUTT CONFORM TO STATE FIRE REGULATIONS PLANS MUST 89 FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ILDING INBrtCTO/ SIGR •Or OWNIF/R AUTHORIZED AGENT F E E OWNERTELI I• PERMIT GRANTED CONTR.TEL 1 < e� CONTR.LIC.1 G/J /0 ..1 3 �� .1 F NORry Town of over O = L zb �j L, dower, Mass., 19 9 cocHicnewicK ��• •9s Oq.,E DspP`y BOARD OF HEALTH PERMIT T Food/Kitchen Septic System fI ``'' pp p BUILDING INSPECTOR THISCERTIFIES THAT......................................... v. r.! .................. ...C7J!-- .lL, 4 -............................................... Foundation - Q has permission to4nct......�: :........)buildings on ........ ........A:0!�?.��.of..............0..6-X......... Rough tobe occupied as..............................................v. ../1.1�-.(............. �.,1. .. .................................................... Chimney provided that the person accepting this per hall in every respect conform to therms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR Rough ...................... ,...................... .. . Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street NQ. Smoke Det: