Loading...
HomeMy WebLinkAboutBuilding Permit #603 - 6 BIXBY AVENUE 3/13/2013 1, I vi' f �iORTN � BUILDING PERMIT TOWN OF NORTH ANDOVER ° 40 APPLICATION FOR PLAN EXAMINAT O _ « Z a Permit NO: a Date Received t Ar— Date Issued: f2, 1.342 CHU I V1 ORTANT: Applicant must complete all items on this page srT � .iIt ., k OCATtin ION " "PROPERTY OVIfNER � MAP NOS BARGEE Zfl71NGISTCT Histor�cstr�ct', �re `ao < �17 fUlachine�hopVillage TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ ne family ❑Addition Y rwo or more family ❑ Industrial ❑Mteration No. of units: 3 ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ©Septic ❑;1Nel _ ❑Fi'codplain ❑1 We#lands ❑ Wat�ie shed IJisnct � ,_ 0 Watery ewer v � Rewmje Am- , lfdv�, hew base cabs 441gJ RA4,rvy,* new W_d_$0 r Identification Please Type or Print Clearly) OWNER: Name: f)lAfZk M 71' Phone: 9 >0' - `t23-&BQ Address: 33 In/�9-t. 2 Jz(� Nof('G, lg�uvG� CONfAACTrJR eri`ie '9 e >Phone 1�6 Ilk ft t ` Address a lV6� t9'k�" Stapotvisor s Constriction 1_cense Exp Date ( Ira 4 Hame.lmprovemet License % Expiate gym. iIt� E ARCHITECT/ENGINEER Phone: +a 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: $ �>o,000, 00 FEE: $ Q Check No.: f 4 2-4-5f _ Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to t e gu anty fund ... _ _ .- -. Signature of Agent/Ownar ,.r/c ,�,(�, SJgnaturip of contractor C . � a .4 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued,- IMPORTANT:Applicant must complete all items on this page LOCATION. Print PROPERTY OWNER Print 100 Year Old Structure yes no MAP NO PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building D One family ❑Addition D Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement D Assessory Bldg D Others: ❑ Demolition ❑ Other D Septic D Well' p Floodplain ❑Wetlands D Watershed District . Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: i i Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: _ Phone: Address: Supervisor's�C.onstruction License: Exp. Date: Home Improvement License: Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature sof Agent/Owner ~ _ Signature cf contractor _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location G No.ella3 —1-2 Date 3 3 . • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $Zw�ld Foundation Permit Fee $ Other Permit Fee $ r TOTAL $ I; r' i[ (� �F Check# '6 26204 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ i 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 Q Planning Board'Decision: Comments to Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Towb Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMsil1' - Temp Dumpster on site yes no Located at'124 MainStreet Fire Departirnerit-signgture/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 P4(AOV4V uy� I vL (/n/ ,T— G n 1 d (vim OvwaJ ® Notified for pickup - Date I Doc.Building Permit Revised 2010 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 iNOTE: All dumpster permits require sign offrom Fire Department prior to issuance of BldgPermit 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 subm;tted with the building application Doo: Doc.Bui!ding permit Revised 2012 NOR7ry - r Town of North Andover s R= Machine Shop Village Neighborhood ConsetvatiouDistrict Commission �''�•,..,.�•',y 1.600 Osgood Street Nordi Andover UA 01845 4SSACHUSEt b r Application For EXCLUSION From Certificate to Alter Certain alterations are excluded from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicants for exempt projects must fill out the form below and submit to the Commission Chairperson(contact info below). Date: 3113113 Contact Name&Address: 1 IO,RK tZRTTS Pig cog4V(4( IOW _ 33 oL 1 AIO fit &41kr- Met Project Address: 446 )?IgV Avg Project Description(attach additional pages,if�needed):j t �PF taCf ,q AW(( b�ihlkk 'VV 1 T�1 M tl.'t 4 I hQ 604- cdawQ t�'IkGty Oly-lk I r ,hllBanc S'11 n0114 Re&oLe+ rPp(acP 7 &Y"t biat+ti Av,4'uas5 Exclusion From Review Requested For: Gfodc" ❑ 1.Interior Alterations existing conditions including materials, design and dimensions. ❑ 2.Storm windows and doors,screen windows and doors. ❑ 9.Replacement of existing substitute doors,substitute siding or substitute ❑ 3.Removal,replacement or installation of windows with new materials that are gutters and downspouts. substantially similar to the existing condition. 4.Removal,replacement or installation of window and door shutters. 10.Replacement of original fabric windows or doors with substitute ❑ 5.Accessory buildings of less.than 100 windows or doors that maintain the square feet of floor area. architectural integrity with respect to form,fit and function of the original ❑ 6.Removal of substitute siding. windows or doors. ❑ 7.Alterations not visible from apublic ❑ 11.Reconstruction,substantially similar in way, exterior design,of a building,damaged or destroyed by fire,storm or other disaster, 8.Ordinary maintenance and repair of provided such reconstruction is begun architectural features that match the within one year thereafter. MSV NCDC Page 1 Current Chair.Liz Fennessy,77 Elm Street,lin(tafennessyOyahoo.cont,978-688-2915 NORTH 9 - . do 0� Town of North Andover Machine Shop Ve Neighborhood Conservation District Commission * � � -•* illag NQS»,rs• Et�y 1600 Osgood Street North Andover,MA 01845 SAGHUS Application For EXCLUSION From Certificate to Alter For Items 9,10 or 11,provide the following documentation: Photos/drawings of existing doors, windows or siding, as applicable X Description/Catalog Cuts of proposed materials to be used for doors, windows or siding Plan and elevation of reconstruction for Item 11 Determination: This project is determined to be X exempt ❑not exempt from review by the Machine Shop Village Neighborhood Conservation District Commission. Projects that are not exempt must complete the Application for Certificate to Alter, available from the Building Department and be reviewed by the Commission. Determination made by: Signature Lizetta M.Fennessy Neighborhood Conservation District Commission 27 March 2013 Date MSV NCDC Page 2 Current Chair:Liz Fennessy,77 Elm Street,lizettafennessy�ahoo.com 978-688-2915 i I I BROSCO Window Units III T m .. .; .:.. Rough Opening 1'-10" 2'-6" 2'-9" v s — �Sash Opening 1 75/e' 2 35/e' 2'-: 'Glass Size 16' 24" 27' 1_i_ 3'-5"IT-1116' 16'x 16' 24'x 16' - 4'-1"{3'-9'120' - 24"x 20' - 4'-9"G4'-5'124' - 24'x 24' 2T x 24' Windows shown with optional Wood Grille patterns. Rough Opening 2'-0" 2'-3" 2'-6" 2'-9" 3'-0" 3'-6" —ash Openigg. 2.6 5/a' - - 2'-9 5/e 3 3 5/a 'Glass Size 6' 7' 8' 9' 10' 12' FM rM_ EM 3'-1"12'-9-17- - - 8'x 7' 9"x T - I - 3'-5"I3'-1'18 6'x 8' - 8'x 8' 9"X 8' 10'x 8' - 3'-9"IT-5-19' - T x 9' 8"X9, 9"X 9' 1o'x 9' - 4'-1"I3'-9'110' - - 8"x 10' 9"X 1T 10'x 10' - 4'-5"14--l-111' - - 8'x 11' 9"x 11' 10,01,11' - 4'-9"74'-5'112' - - 8'x 12' 9'x 12' 10'x 12' - 5'-1"�4'-9'113' - - 8'x 13' 9'x 13' 10'x 13' - 5'-5"15'-1'114' - - - 9'x 14' 10'x 14' - 5'-9"15'-5' 15' - - - 9'x 15' 10'X1 12'x15' 6'-1"$A's 16' - - - - 10'x 16' - Low"E"Energy Panel Tilt'N Clean Unit– Unit Dimensions,other Rough Openings %1 BROSCO's Low"E"Energy and Unit Options can be found at the end Panel is available on most of this Double-Hung Section. single thick glass(SSB)units to provide better energy efficiency. ,i';?•'r 'Note: Energy Panel Sash are Replacement Sash Available Low"E" uniquely profiled to accept the Energy ;;a Energy Panel. Energy Panels Panel cannot be applied to existing SSB sash. `Glass sizes are approximate.- 8 a t BROSCO Window Units e Casing Options(Primed) OPTIONS Clear Cedar f 1 , Brickmould Casing Flat Casing Flat Cape Cod Flat Casing (standard) —11/16"x33/4'Head&Sides Casing —1'/16"x 33/4"Head&Sides 11/4"x 2" (Primed Composite) "/m"x 41/z" —1'/,6"x 33/4°Head Casing (Primed Composite) (Primed Composite) w/11/16° 3/4'Sides —1'/,s"x 5'/a'Head&Sides x 3 —1'/16"x 5'/a°Head Casing •Naturally decay resistant Clear w/1'{,6 x 33/4"Sides Cedar Sill (Primed Pine) •Sill and casing completely caulked •Casing applied with stainless steel fasteners Main Sill w/Standard Sill Main Sill Nosing/Connector w/Optional Historic Sill (Primed Composite) Nosing/Connector Moulded Urethane Window (Included with Basic Unit) (Primed Composite) Head&Trim Extension Jambs Insect Screen Long Sill Horns (Clear Pine) 69/16°Wall (applied or K.D.) _ . . . White aluminum full screen with plastic On"NO CASING"orders, comers and charcoal fiberglass mesh 33/4"horns will be used Wood Grilles unless otherwise specified. Cam Sash Lock ,.--- Simulated Divided Light Sash L�J Available Wood or Composite Sash Shipped K.D.and Poly-bagged complete with fasteners White is standard. ter_ Contact your grilles are set-up).(Picture 9 P)• Brasstone is optional. BROSCO Dealer 14 Enter construction cost for fee cal- North Andover Fee Cakulation Construction Cost 20,000.00 m $ - $ 240.00 Plumbing Fee $ 30.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 30.00 Total fees collected $ 400.00 6 BixbyAvenue 603-13 on 3/13/13 Remodel Apartment 6 Kitchen, Bath, Demo Attic for Insulation ArONORT1i 11 U1s _ ®fie 0 No. ® 1 - V. h ver, Mass, 3 I3 [OC LAKI NIC"IWICK y1. S u BOARD OF HEALTH Food/Kitchen PER.MI* T T LD Septic System THIS CERTIFIES THAT 1! �Gl.1.�i ,,,,,,,,,,,,„ •,,,,,,,,,,,,,,,,,,,,,,,,,,,, BUILDING INSPECTOR ..... . .. ....... .... .................................... ..�...�.�. has permission to erect .......................... buildings on ......... ...... ..... ................................. Foundation •� Rough N O YL.. 4 o to be occupied as ..................................... ...}.......... .... ..., .......... :...��..( ►.!�... P• Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relatin tohe Inspection,Alteration and Construction of Buildings in the Town of North Andover. a. 'D4, yJ;hQv�S' PLUMBING INSPECTOR G✓/l Ajl �`�” F Z m Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. fjs�'D� e. -Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT/19N ST TS Rough Service .................. .. ........................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE <Z4 The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations I 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): Rff cpAmI2 Cd t'ip w Address: City/State/Zip: Al, 464ne.r 941/ Dl 9t Q Phone #: Are on an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 3 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. E] Building addition [No workers' comp. insurance comp. insurance.'- required.] nsurance.+required.] 5. ❑ We are a corporation and its 10.E] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *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: Policy#or Self-ins.Lic.#: G 00 4 S5VOQ0IZ Expiration Date: 11)/ '1?0)3 Job Site Address:— 411(P)81 Q1x6 Ai)e City/State/Zip: ti. V,-{ N4 0l9gj 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 certify under the !ins and enalties o er'ury that the in ormation provided above is true and correct. Signature:[ _ _ Date 12... Phone#: 9 �8_(A?__ 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#: j I "a 'r �,j a .l J2�lOO�IJt//9z0'I2u/P.�GW2 F/y, �•"7,LLd6�6. Office of consumer Affairs&BI(smess Regulation 1 HOME IMPROVEMENT CONTRACTOR Registration: A17532 Type: Expiration: �1b/A/2014 Private Corporation, RA CONST COiINC MARK RATTE x; 33 WALKER RD i NORTH ANDOVER MA 01845;" Undersecretary Massachusetts- Department of Public SAO% Boars! of Buildin- Regulations and Standards Construction Supervisor License License: CS 43865 N MARKS RATTE ) 11 BARRINGTON DR ' ANDOVER, MA 01810 • �-�— —��j� Expiration: 5/8/2013 Commissioner Tr#: 16044 r; 1 RECEIVED 10/18/2012 10:05 • 9786824982 RATTE CONSTRUCTION 10/ 18/2012 10 : 24 : 10 AM 8740 ® 02/02 CERTIFICATE OF LIABILITY INSURANCE DATE 100/18/2/18/201122 THIS 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 HOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: I£ 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(s). PRODUCER CONTACT MTM Insurance Associates LLC MM' PHONE rAr 1320 Osgood Street AUC.No.Ext): wc.so): E-IRn North Andover, MA 01845 ADDRESS: PRODUCER C'TUKER IDD. INSURED INSUREDS) AFFORDING COVERAGE ERIC D Ratte Construction Co Issumm A:A.I.M. Mutual Insurance Co 33758 :.SURER B. 33 Walker Road mvIRER c: Unit 2E INSVIUM D; North Andover, MA 01845 INSURED E: INSUxmR r: COVERAGES CERTIFICATE NUMBER: REVISION NUEBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DDDICATED. 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 AFFORDED BY THE POLICIES DESCRIBED BERRIIt IS SUBJECT TO ALL TEE TEEMS, EFCLUSIONS AND CONDITIONS OF SUCH POLICIES. LffiTS SRoWN MAY RAVE BEEN REDO=BY PAID CLAffi. z4 TYPE OF INSURANCE POLICY NUMBER EDLIM Err POLICY ESPLIMITS IIERAU/**Tr) ODVss/mr) GENERAL LIABILITY EACH ocCiRANce 6 IICLWIERCIAL GRNBRAL LIABILITY DAMAGE TU A®TLD 6 PmARSSs(ee.0etaaence) CLAIIe HAD. �oecoR RED ESP (Any enc Person) 6 PERSONAL c my:OwY 6 GEN'L AGGREGATE LIMIT APPLIES ER: GENERAL AGGREGATE 6 POLICY ❑PROTLCT❑LOC PRODUCTS-COMP/OP ANG 6 6 AUTOMOBILE LIABILITY COLE LIMIT 0.AM (ee maidens) 6 AOWED AUTOS BODILY MUM (Der Den—) 6 FiSCI@DW.ED ATTOS BODILY IY.nRY(Pe[acoidet) 6 QHIRED AGNS PROPERTY DAMADE (Per asPide•t) 6 NON-CUNlD AUTOS ❑ 6 6 ]WIBRLLLA LIAR f OCCUR EACH OCCURRENCE 6 [].=SS LIAB ❑CLAIMS MADE AGATE 6 DEDUCTIBLE 6 �RETl NTION 5 6 WORKERS COMPENSATION AND EMPLOYEES LIABILITY ® Lma THE PROPRIETOR/PARTNERS/ A EXECUTIVE OFFICERS ARE E.L. eaCH ACCIDENT 6 500,000 ® incl ❑ excl 6004550012012 10/06/2012 10/06/2013 E.L.DISEASE-POLICY LIMIT 6 500,000 L.L. DISEASE-EA EMPLOYEE 6 500,000 COMMENTS DESCRIPTION Br OPERATIORS OR LOCATIONS: CERTIFICATE HOLDER CANCELLATION TOWN OF ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE THE LDD?IRATION DATE TH30REGF, NOTICE WILL BR DeLIVXRED IN ACCORDANCE WITH TBE P.O. BOX 99 POLICY PROVISIONS. ANDOVER, MA 01810 AUTHORIZED REPRESENIATrYt 1863