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HomeMy WebLinkAboutBuilding Permit #511-2017 - 50 TURTLE LANE 11/15/2016Aly (�Y A424 .+b Lp Permit NO:szl-goa Date Issued: /t- 11 - BUILDING PERMIT �± TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received ff -/3: A06 !6 IMPORTANT: Applicant must complete all items on this LOCATION 50 - I—v4Q L-1 1 Print PROPERTY OWNER VA(- k G -A J Print MAP NO: �Q I(—PARCEL: ZONING DISTRICT: Historic District yesno Machine Shop Villaqe 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 lepair, replacement ❑ Assessory Bldg ❑ Others: Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer l GC ci~�-�- . Alb (,,-9/( ,/Z°-4ov4 ( u,- CC- ey,1 H L,Lg 4v-- c -40 -t --x pfd - g) (!�:e sg ptp- C), - Identification Please Type or Print Clearly) OWNER: Name: Phone: Address CONTRACTOR Name:Phone: q7Y7(w2 IN', ki I L a!b(—P— Address: L(c� Atc),,it, PL4Vtg-,t1 S4. 8g -,WS /U oar? Supervisor's Construction License: 6S —0f)11q3 Exp. Date: Home Improvement License: Exp. Date: 10 ZO-2 12016 ARCHITECT/ENGINEER neve, Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 2 �� �� �D FEE: $ 3 o cl Check No.: Receipt No.: 3 it F3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor 1 Permit No#: Date Issued: BUILDING PERMIT - TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION', Date Received LWORTANT: Applicant must complete all items on this page _�... r —' .,._`—'tit`, --r'> >, _..,_.... .;..,,-dry.=.y.,.. .—.. `r- --•.--.—.-�� -- — ..v,r � � .�.._.. � .�,,,.. r. Iry . PROPERTY -OWNER Pnnf; 1 DD Year StFuctLF es no tMAP :l?ARCEL ZONING DISTRIC-T .�. Historic Distnct? _ eyes' ..no _.. Machine Shop Village -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 ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic Well ❑Floodplain El Wetlands D Watershed Distnct- O Water/Sewer s _ DESCRIPTION OF WORK TO BE PERFORMED: Identification - Please Type or Print Clearly OWNER: Name: Address: one: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. I_ '>rotal Project Cost: $ FEE: $ Check No.: Receipt No._ NOTE: Persons contracting with unregistered contractors do not have: access to the guaranty fund L ._.._..__..__.__. S`ignatu e of_Agerit/Owher ' Signature df contractor. y Plans Submitted ❑ Plans Waived Ell Certified Plot Plan ❑ Stamped Plans ❑ TYPE bF SEWERAGE DISPOSAL Public Sewer ElTanning/MassTanning/Massage/Body Art F1Swimming 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 e U FORM PLANNING & DEVELOPMENT Reviewed On COMMENTS Signature, CONSERVATION Reviewed on Sianature i ,HEALTH COMMENTS Reviewed on nature 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 :3134 Usgood Street FIRE DEPARTMENT = Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date t COMNPEN-1- S rt F -)imension 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 MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine No Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. - . 1 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/Cross Section/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 DOTE: 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: Building Permit Revised 2014 Location SO 7 UR T L F- L `��• No. 611 - A 017 Y - Check #36 / Date go/ TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ .30 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �./ Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 25,766.00 m $ - $ 309.19 Plumbing Fee $ 38.65 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 38.65 Total fees collected $ 486.49 50 Turtle Lane Bathroom remodel 511-2017 on 11/15/2016 v C � N n 0 O CD O -0 CL o CL�• N vCD CD C Z3 cr CD CD O CD C O CD CO C I � v U) O 0 Z 0r-IOO O CD O CD 0 r' m X a 55 ''m^ V+ Z < o 0 -0 o Z5 y= O CD y y L1 :5. "'O 0 2- 'CDL o 0 • m O _r+�=X z O (=-a y. O = y rt is- T. 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LLL If I v 8 L Zb 00 A II 1 ro —V—' - O r= r co v\� J t �.zv�xw o•o�o�c'�---„ 3•adnn n m Z in �r£L,OaN m n74 m �� V LLL If I v 8 L Zb 00 A II 1 ro —V—' - Proposal October 17, 2416 Carl and Kathy Scheone 50 Turtle Ln North Andover_ MA 01845 (978) 688-1898 We are. pleased to quote you on remodeling your bathroom. All work is fully insured and all t. -ash created by Cabinetry By Design will be removed by Cabinetry By Design. Second floor 3/a Bathroom and closet: Carpentry: Remove existing. vanity, shower, and sho- er walls to ceiling. Strip floor to sub floor. Repair floor as needed.. Prepare floor for tile. Insulate, blue board patch and plaster room as needed. dent exhaust fan. to exterior. Dura - Rock shover area for tile. Block walls for grab bars and accessories. Install vanity and accessories. All work as =1 code. = ; Plumbing: Disconnect existing fixtures remove and cap. We have carried a $2,673.52 fixture allowance (Salem Plumbing bid `s221€18 38)_ Install all fixtures rough and finish. Rework drains to toilets as needed to bring up to code. All. -work as per code. Electrical: Disconnect existing and rough bath as per plan and code. Supply and install one Panasonic fan light centrally located_ (2 rm 3 in bathooin closet) recessed lights locations to be determined and instal l (1) wall fixture `Y� tr <c Y supplied by homeowner above }unity. Switches and outlets as needed. All «work as per code t<-ing into existing service.. Vanity, Closet cabinetry and Granite: We have carried a $5.900,00 vanity allowance for vanity and box storage cabinets, owner to select. Supple and install mid -price point granite counter top _'_ _ -f as per plan complete with any standard edge and. " back splash owner to select. 'File: Tile floor using owner supplied the and grout. Amount needed is 40 sq fl. Tile shower - alls to ceiling using otic ner supplied the and grout. Amount needed iq ft. lristal �atnelr��a t Proposal continued nextpage Cabine ry BV Design — 56 YPutnarrr St — Donvers, ' M 01923 — (97x) 74-0002 (Proposal .continued) 'Nothinv other than stated move is included. No shoLver doors; tile, grout, accessories or paint included in quote. Total Cost: 525,766.00 'Option — Remove adjacent bathroom Moor, prep and install owner supplied tile, (standard sq pattern) 5,.1,800.00 Terms: 30% down. 30% upon starting. 30% at end of week ?, 10% upon completion per bathroom 00SAI. 4- �_ Owner D"vri r Jim P illips, President HIC License =15283 Daze k `7 2—C-, f �, Date Date Selections: Wood: B,if Door: 0.3, ve Color:�Sab �e Countertop: Granite Hoe: Standard Hardware: TBD Scheone 10/24/2015 Cabinetr j- By Design — 56 ,-_ Putnam St — Danvers.. JI -M 01923 — (9 78) 774-0002 The Commonwealth of Massachusetts Department of Industrial Accidents 4 Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www. mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ( Please Print Legibly Name (Business/Organization/Individual): Address: 7" ©�"N'� f u l v4 p " 2'3 Phone #: Are ou an employer? Check the appropriate box: 1. VI am a employer with 3 4. ❑ I am a general contractor and I employees (full and/or part-time).* 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.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' coma. insurance reauired.] -77q -Cw2 Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. F] Plumbing repairs or additions 12. ❑ Roof repairs 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 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: 4sL'-;)cz 60. _ Policy # or Self -ins. Lic. #: UJ LVL 3132Y10 Expiration Date: Job Site Address: City/State/Zip/ 6A,� AA8C / �4�} Y7 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 certifyynder the pains and penalties of perjury that the information provided above is true and correct. Phone #: r 9 7V -77V - 0w -z 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 #: 1/14/2016 10:17 FAX 978 532 2217 CROSS INSURANCE Z001 Q ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDN" 11/24/2016 IIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE 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 policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(5). PRODUCER `UNIALA Lauren Goldman NAME: Cross Insurance -Peabody PHONE (970) 532-5445 FAX Na. (970)532-2217 139 Lynn£ield Stre6ti ADDRESS.lgoldman@crosaagency.com Peabody MA 01960 (NSURERAMAin Street America Assur. Co 29939 INSURED IN5URERS;NGM Inaurance CO 14708 Cabinetry by Design Inc.- INSURERC:Ne6CO Ins Co 56 N PLJTNAM ST IN411RFR0 DANVERS MA 01923-2058 1INSURERr- COVERAGES CERTIFICATE NUMBER:CL16111491815 REVISION NUMBER: 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 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDE=D BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE b 13R POLICY NUMBER POLICY EFF MMIDO ExP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR UPT3936H 3/1/2016 3/1/2017 EACH OCCURRENCE S 1,000,000 N trrencel S 500,000 PREMtp MED EXP (Any one Person) $ 10,000 PERSONAL SADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - K POLICY E LOC OTHER' GENERAL AGGREGATE S 2,000,000 PRODUCTS • COMP/OP AGG S 2,000,000 Employment Precllces LlabAl(y S 10,000 B AUTOMOBILE XX LIABILITY ANY AUTO ALL OWNED % SCHEDULED NON -OWNED HIRED AUTOS AUTOS M9Z34944 1/29/2016 1/29/2011 COMBINED SIN LE LIMITg 1 000 000 Ea accider�i i r BODILY INJURY(Par persan) $ BODILY INJURY (Per eccldenL) S PROPERTY DAMAGE S Per occident PIP -Basic $ 6,000 UMBRELLA LIAR EXCESS LIAR _H OCCUR CLAIMS -MADE EACH OCCURRENCE s AGOREOATE 8 DEO RETENTIONS S C WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORMARTNER/EXECUTIVE OFFICERNEMBER EXCLUDE07 ❑ (Mandatory In NM) IIee, deserbe under DESCRIPTION OF OPERATIONS below NIA WWC32297BB 10/11/2016 10/11/2017 - o T T T ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101. Addltlonal Remerke Schedule, may bo attachad If mora spaca (s raqulrad) (978)668-9542 Town of North Andover 120 Main St North Andover, MA ACORD 25 (2014/01) INS025 (201401) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Lauren Goldman/MD1 14-1 (:F- 0 1983-2014 :F.01988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 5 W 07.18.2012 Rw f-fS2"9 ss Massachusetts - Department of Public Safety Board of Building Regulations and Standards ^------ & . an»e.�ai ut`ucii �uYiEi viSfii �snar License: CS -081143 cE't'7 :S I) , f 9 t1=PEUIJ I ObK S r l o TEVAMURY MR 0 -r Expiration Commissioner 06/16/2017 �1e �ca�r�sze�Lcue�clCj ef'C�/llcrs�acfic,el .� Office of Consumer Affairs & Business Regulation HOME IMPROVEMENT CONTRACTOR Type: Corporation 1� m -_,__=:Registration Expiration fS2838 10/02/2018 Cabinet B Des` ",'c Cabinetry Y � _.> Richard Brown' _== 56 North— Danvers, MA 01923-'- Undersecretary Registration valid for individual use only before the expiration date. if found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 Not valid without signature