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Home My WebLink AboutBuilding Permit #125 - 548 SHARPNERS POND ROAD 8/12/2009 TOWN OF NORTH.ANDOVER / APPLICATION FOR PLAN EXAMINATION Permit NO: I Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION S— V8_ S� l�t ✓ r'/ tJ l . Punt PROPERTY OWNER �� 1� _,:="C-�-Z.t � 1�`�� .� � Print .. :MAP NO:' PARCEL://zb'NING DISTRICT: Historic Distract yes_ no ' :Machine Shop Vlag , ryes 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 t/ Assessory Bldg Others: Demolition Other Se11 p#ic Wel[ Floodplain Wetlands` WatershedDistrict Water/Sewer ., DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: C 4Ld,44— f. ,✓ Phone: (::�r 7 0 _YL(f Address: S 'l `v� s �1- 'tS ?0114:> -,CONTRACTOR Name:_ t � �`L-?C.` ..,Phone: � 7 tCt uOr Address: V:2t Supervisor's Construction License. - s'' Ex �5flate: y Home.ImprovementLicense:_}` /d'C• Exp. Date: ` � c 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. e , Total Project Cost: $ FEE: $ � Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund i gnature of Agent/Owner _ Signature of;contracto 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 lPlanning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -.Temp Dum"pater on osi#e ,yes Located at 124 MainStreet 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 i i NOTES and DATA— For department use f I ❑ 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 j ❑ 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: Doc.Building Permit Revised 2008 I Location No. Date t' Of MORTPI TOWN OF NORTH ANDOVER � F9 Certificate of Occupancy $ �cHusE Building/Frame Permit Fee $ � s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # O 225:/_G Building Inspector OP IDDATE(AANIDD/YYYY► ACORD,. ITY INSURANCE FLQST-1 OB 12 09 CERTIFICATE OF LIABILXI4 pRooucER THIS CERTIFICATE 18 ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SegreVe & Hall Iasur.Ataeoc.ZnC HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 305 North Main St. &Udover NA 01810 MAIC 9 Phone:978-975-1300 8ax:970-975-7596 INSURERS AFFORDING COVERAGE 41360 INSURED _ — INSURER A: N*ftl1■ •rctxtioo see• Ge. -,,, INSURER e: Com grce insurance Co. 39754 INSURER C: R1ichard Fluet Contracting Inc- INSURERD fQathueadwh path - 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 CONDYLION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR AMT PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE IJMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMBS 7 - GEN`L TYPE OF INSURANCE POLICY NUMBER DATE M/D DAT DIYYEACHOCCURRENGE f1000000 GENERALLIABILITYf100000 X COMMERCIAL GENERAL LIABILITY 8500034727 06/12/09 06/12/10 pREMISEs(Eloeeurenoe)MED EXP(Ary one ver,-c^) $5000 CLAIMS MADE [Y]OCCUR PERSONALAADVINJURY $1000000 GENERAL AGGREGATE S2000000 PRODUCTS-COMP10PAGG $2000000 AGGREGATE LIMIT APPLIES PER: POLICY PR LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ (Ea eedaenq ANY AUTO ALLOWNEOAUTOS BODILY INJURY $100000 12/01/08 12/01/09 (perveraon) g X SCHEOULE13 AUTOS XV14 6 0 4CARAOC DALROS BODILY INJURY $300000 (Pre uddena -OWNED AUTOS PROPERTY DAMAGE $100000 AUTO ONLY-EA ACCIDENT $LIABILITY OTHER THAN EAACC 1$ AUTO AUTO ONLY', AGGOCCURRENCEUINBRELLA LIAB0.ITY r AGGREGATE $ _ OCCUR I CLAIMS MADE $ DEDUCTIBLE $ RETENTION S TORY LIMITS ER WORKERS COMPENSATION ANO A EIfPLoymwLIABILITY 910434 03/31/09 03/31/10 E.L.EACHACCIDENT $500000 ANY PROPRIETORIPARTNER/EXECUTIVE E.L.DISEASE.EAEMPLAYE $5000oa OFFICER/MEMBER EXCLUDED? •- ITyyee,deewlMluntler E.L.DISEASE-POLICY LIMIT 5500000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPEGU►L PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF TME ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North A,mdover DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAR DAYS WRITTEN Attention Brian. Leathe NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 1600 Osgood Street IMPOSE NO 09UUTION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Building 20 REPRESENTATIVES. North Andover MA 01845 AU 0 R 9 Qj(l,LT C;E/L. ®ACORD CORPORATION 1968 ACORD 25(2001108) i iNI'assachusetts- Department of Public SafetN Board of Building; Regulations a.dd Standards Construction Supervisor License License: CS 50710 Restricted-to: 00 - RICHARD A FLUEI ,3 102 BRIDLEaPATH Lf METHUEN, MA 01,844 Expiration: 4122/2011 Commissioner Tr#: 13093 i �,�e �anvazonurea.� a��/�aaccc`ivaella Y,,,� Board of Building Regulations and Standards BIOME IMPROVEMENT CONTRACTOR Registrat pn 106620 ExQdatton 7%24/2010 Tr# 270996 w, Typ. Private s,i Corporation RICHARD FLUETCp{a;fRACTING;,i BNC. Richard Fluet � 102 Bridle Path Lani?. Methuen,MA 01844 Administrator •�� The CommOrrrvealfh of Massachusetts Departmerrf of Industrial Accidents Eti'"s ace of Investigations 114. . lid; 600 Nlashington Street Boston, MA 02111 "nVW "UWx govldia , Workers' Compensation Insurance Affidavit: Bjunders/coatraatorslE�iectriciaas/PiQmbers ADO MMt Information Please Print Le�ibi Name(Business organizadon/Individual): Address: o 11I L R7 CityLState/Zig: Phone#:� ��J Fsh employers Cheek.the appropriate box: employer with �`--r 4. ❑ I am 8 T�of PrVf�(regnire�fj:gemeraicontsactoT and I - ees(foil and/or part-tune).* have himd the sub-cortirac ors 6. construction sole proprietor or partner. listed ori the attached sheet 3 7. �:Remodelingd have no employees These sub-contractors haveg for me in any opacity, workers' comp.insurance. 8• Q DemolitiontkErs'comp. iasrrrance 5. [] We ea-e a corporation and its Btulding addition d.] officers have exercised their 10.Q.El�ic 3.❑ I sin a homeowner doing all work rightal repairs or additions of axein on myself iNo-workers'co Pti P�MCiL 1 l Z Plumbing rrpairs or additions j c- 1S2, §!(4�'and-we have no insurance-required.].t ernplcryecs [No workers' 12.[�Roof repairs COMP• irmuranco required.] I3.1]ether `�4 applicant tient checks boxy t must ab:o fin out the section below showing theiraarkerc''o =�o'neo"'uO�who submit this aft'idavit indicating they ars � orupeirsetiori policy infnnnatioa Ca Mt tors that check this box must �o� wing and then hire ousido contractors must submit t.aeiv affidavit indi sn ari�Titiaaal alas showing.rite name of the sub. °atia6 such.' cort�ators and their worker'MUMP.FoEic in I crrt.ar:errpioPer first is;orao worl"a-s'V s tarraetion. uaformradom ; g` f zxurrawe for OryBello ,.W.ML site . Insurance Company Name: Policy#or Self-ins. Lie.#: C1 `i 0 .30� Fxpirafion Date: 3 31 i] Job site 'Alm S Rd PP� n y Attach a copy of the workers' com / Crty/Statci��; r �.l v �d/ peQsation policy decfaratioo page(showing the policy number and expirafioa date) Failure to secure coverage as required Lander Se�ion 25A of . fine up to S`1,5D0.00 and/or one-year unprisonm MOL c. 152 can lead to the imposition of craminal prnaltim of a, Of up to$250.00 a as Weil as civil penalties in the form of a SMP WORK ORDER and a fine 3 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 c under paiazs nd err o .e fiat the informatwii provided above is tame and¢orrery 5i Date: �a-/U Phone �d c7 E only. do not write sn this are¢, be co 1nv etadby ctty or town offnz [n: Permit/License thority(circle one):Health Lguildierg DsparEauent 3.City/Towu Clerk 4. Electrical Inspector5. Plumh[rrg poor Insson• Phone#; Information a. nd Instructions- Mass:achuseds General Laws chapter I52 requires all emp Ioyers 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 dhire, express or implied,oral or written." An employer is defined as"an individual partnership,amc:)diation,corporation or other legal entity,or any two or more of the'fore ping engaged in a joint enterprise,and includir-itg the legal representatives of a deceased employer,orthe receiver erbwstee•of an individual,partnership,associatiarn or other legal-autity,employing employees. 'However the owner•of a dwelling house having not more than thee=apa_rtmarit5 and who resides therein, or the occupant of the dwelling house of another who employs Persons to do maimtmmce,construction orrepel wa on such dwellinghouse or on the grounds or building appurtenant thamtio shall not b-cc:ausc of sucb employment be d=ned to be an employer." MGL chapter 152,§25C(6)also states that"every state as-local 6edusing agency shag withhold the issuance or renewal of a Reemse or permit to operate a business or *o construct building in the commonwealth for any appficam who has not produced acceptable evidence oir compliance with the insarance'coveragge required" Additionally, MOL chapter I52, §25C(7)states"Neither t She commonwealth.nor any of its political subdivisions shall enter into any contract for the perfnmuance of public worse until-acceptable,evidence of compliance with the insu rm= iequirsments.of this chapter have been presented to the coTtmotvng authority." Apphceutts Please fill out the workers'compensation•affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply,sub=cont:sctor(s)name(s),wWress(es):austd phone number(s)along with their eertificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Pwtnerships(LLP)with no empioyms otherthan the members or pmt►ers,arc not regimed,to carr work='c3-inpensation insurance. flan LLC or'LLP does have ampioyees,a policy is required. Be advised brat this afrrdiavit may be submitted to the Departam t of Industrial Accidents for confirmatian of insurance coverage. Also Ewe sure to sign and-date the affidavit The affidavit should be returned to the city or town that the Pplication for tile permit or Howse is being requested,not'the Department of Industrial Accidents. Should you have arty question&regi-ding the law or if you are requimd to obtain a workers' compensation policy,please-call the Department at the nurmber,listed below. Self insured companies should enter t mir self-inm=71 license aumbzr.on deo appropriate ice. City or Town Officials Please be sore that the affidavit is compiete and printed 6p;ibly. The Departmert'hes provided a space at the bottom of the affidavit for you to fill out in the event the.Office of Investigafions has to contract you rzgarding the applicant. Please be sure to fill in the jommit/license number will be used as a reference number. In addition,an appH=jt that must submit multiple pmmiit/ficense applications in any givan year,need only submit one affidavit indicating-cutrent policy information(if necessary)and rmdw"Job Site Address"the applicant should write"all locations in (city or tovmm)"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 afrndavrt is on file for futwe permit or licenses. A new affidavit must be Mad out each year. Where ahome owner or citrin ii obtaintin9 a tic:.-iso'or permitnot related to any business or commercial vsrd= C.& a dog license or pormit to bum leaves etc.)said pmsori is NOT required to complete this affndaviL The Office of Investigations would Ince to thank you in advance for your cooperation and shouldyou have any questions, pleas~do not hesitate to give us a call The Department's address,telephone and fax number. The Commonwetdth of Mamacbusetts DepaT1Mzr)t of 132dustiW Aczidcxits mice of Envestig-'stziions 600 Washington Street Boston, MA 02111 TeL#617-7274900 6= 406 or 1-977-MASSAFE Fax#61 7-727-774 Revised 5-2b-05 WWW-Mass. Ov/ X28 , g r. NORTH Town of o * dover, Mass., • 1 2 • y T 0 LAKE COC NIC ME WICK V S RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THATcselt... �^............ ............................................................................................ .... Foundation rr has permission to erect.......................:................ buildings on... ....... ....... ...a Rough to be occupied as....1.q......... .w O NSW --"� Chimney provided that the person accepting t is 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 Final PERMIT EXPIRES IN 6 ONTHS ELECTRICAL INSPECTOR UNLESS CONSTR STARTS Rough . .......... .......................................................:......... Service BUILDING INSP TOR 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 Street No. SEE REVERSE SIDE smoke Det. RICHARD BRIDLE RIDL PATH CONTRACTING,INC PROPOSAL METHUEN,MA 01844 Date Estimate# 6/2/2009 42 Name/Address KEVIN&MAUREEN CALLAHAN 548 SHARPNER'S POND RD. N.ANDOVER,MA.01845 o V'_0� \,Jj Description INSTALL 19 HARVEY WHITE CLASSIC DOUBLE HUNG VINYL REPLACEMENT WINDOWS WITH FULL SCREENS,LOW "E/ARGON GAS GLASS,FEDERAL PACKAGE TO MEET TAX INCENTIVESS310.00 EACH REPLACE WINDOW ABOVE SINK WITH NEW TWO LITE HAVEY VINYL CASEMENT WITH SAME GLASS SPECS.$725.00 OPTION TO EXTEND WINDOW OUTWARD WITH I"X 12"PINE.ADD$400.00 REPLACE ROTTED SILLS$85.00/SILL REPLACE ROTTED 908 CASINGS ON WINDOWS$40.00/SIDE REPLACE 4 PCS.OF 908 AT SLIDER AND REAR DOOR-INFILL ROTT AT REAR DOOR WITH PLASTIC,REPLACE SIDING ON SIDE OF REAR DECK AND 2 SMALL PIECES FRONT OF HOUSE,REPLACE 2'SECTION OF I"X 6" $300.00 WORK TO INCLUDE;INSTALLING,INSULATING,AND TRASH REMOVAL. REPLACE FRONT STORM DOOR WITH NEW HARVEY WHITE SOLID CORE DOOR UNIT.$425.00 PROPOSAL IS VALID FOR 30 DAYS. EXTRAS OR CHANGES TO BE COMPLETED AT A RATE OF$75.00/HR.MAN Finance Charges on Overdue Balance 1 1/2%/MONTH "1 PRICES REFLECT AVAILABLE DISCOUNTS. o 3 JTotal $6,615.00 Signature c Phone# Fax# E-mail 978-685-7010 978-685-7010 RFC102@COMCAST.NET it ,..