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Home My WebLink AboutBuilding Permit #433 - 64 PHILLIPS COMMON 11/29/2006 s TOWN OF NORTH ANDOVER NORTIl APPLICATION FOR PLAN EXAMINATION 0 4.1"° 16Atio t° A APPEI® �Djceived Permit NO: Date Issued: \1J}] IMPORTANT:Applicant must complete all LOCATION Print PROPERTY OWNER Rhea- S i maN -Sko ley _ Print MAP NO.: 5 '$ PARCEL: ZONING DISTRICT: V` TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE I" Residential Non-Residential ❑New Building ❑ One family VA'ddition ❑ Two or more family ❑Industrial ❑Alteration No. of units: ❑Repair,replacement ❑Assessory Bldg ❑Commercial ❑Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED f�dd.,+.o#,- Of R Lead RaoM inclLdl'4o 0. bct.jehldorv, � Deric s Identification Please Type or Print Clearly) 9� 68S-� 6 • Name: $� +,,,—Slok,r Phone: � � `>' OWNER. _� mo � `/ Address: E!h J 11,F s (zom m0t I CONTRACTOR Name: keP�ec>7ose (3�`�Jers LNC Phone: C9'I8) f!oS 'SOg6 Address: 153 h1n izU Sk- mcM,tcu M n Supervisor's Construction License: CS 0'7 y y h 8 Exp. Date: 1 / 2Y./ aDo�l t Home Improvement License: 1 y 5 O LiZ Exp. Date: 2 2 I'�ooe ARCHITECT NGINEE Fra k) ,s G)Iciou Name: Phone: (9 f7 8) 6 8S X06 Address: G,S Auer' S? Me-th ue Reg.No. � Z FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 595, O0 _FEE:$ W) '7 Check No.: f �3 Receipt No.: Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales 11 lPermanent Dumpster on Site Private(septic tank_ ,etc. ❑ Electric Meter location to p� -- - project NOTE: Persons contractingtf{: uriregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor_ In � Plans Submitted ❑ Plans Waived ❑ i Cert feed,Plot Plan ❑ mped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY I� INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOP NT F] ❑ � . 11 COMMENTS �I ATE REJECTED DATE APPROVED ' CONSERVATIO COMMENTS I; DATE REJECTED DATE APPROVED HEALTH ❑ _ ❑ ~` COMMENTS - r FIRE DEPARTMENT - Temp Dumpster on site yes . ,-i/u -_no ? `- Fire Department`signature/date I COMMATS. - Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments 9 Conservation Decision:.-_._ Comments Water& Sewer Connection/Signature&Date Driveway Permit Building Setback (ft.) Front Yard Side Yard Rear Yard Require Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Cr Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC.Jan.2006 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks Li( Building Permit Application or Surveyed Plot Plan i Gr Workers Comp Affidavit d Photo Copy of H.I.C. And C.S.L. Licenses ®' Copy Of Contract Z Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) - g' Mass check Energy Compliance Report (If Applicable) ON PJANS I. New Construction (Single and Two Family) L3 Building Permit Application Li Certified Proposed Plot Plan o 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) ❑ Copy of Contract j o Mass check Energy Compliance Report 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:BPFORM05 ,- Page 4 of 4 Location7 �/ No. � Date TOWN OF NORTH ANDOVER �q• 3: ' �t ~ s + • : Certificate of Occupancy $ sACNUs t� Building/Frame Permit Fee $ `� Foundation Permit Fee $ Other Permit Fee Qlv TOTAL $ Check #/ 1983 l Building Inspector tAORTH Town 0 t 4Andover 0 4,3 _ - __ 43 0 AKE dover, Mass npzo-m 0 L COCHICHEWI K AT `s BOARD OF HEALTH Food/kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......A.414e........v?** am -.6344 ........................................... Foundation .......................... buildings 0 . .. has permission to erect .. ..... e j�t��jr ....... .. Rough to be occupied as.. Chimney .-AW......... ......A..... provided that the person accepting tliis*pe**r*&Shall in every re pact 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 Z 11� PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU 0 S, S% Rough ........ Service ........ . ............ ... ......... ...................... R 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 Street No. SEE REVERSE SIDE Smoke Det. 1 64 Phillips Common North Andover, MA 01845 November 29, 2006 Town of North Andover Building Department 1600 Osgood Street North Andover, MA 01845 Dear building official: This letter is in response to your request for a letter from the homeowner's association stating their approval of the proposed project at my home at 64 Phillips Common. The neighborhood association has been inactive now for several years. There are no regular meetings and no elected officers. The current cooperation among homeowners is simply to collect dues and provide funds for the landscaping and maintenance of our common areas. Therefore, I don't think there is an official entity that exists to provide the approval you've asked for. Your records should indicate that other additions and renovation projects have been done in the neighborhood in recent years without the involvement of a neighborhood homeowners association. There have been no grievances within the neighborhood with respect to any of this work. Sincerely, r04 . ? Rhea Simon-Skoler Construction Contract DIUa-t A. Date of Execution October 25,2006 B. Parties Contractor: Steeplechase Builders, Inc. 153 Maple Street Methuen,MA 01844 (978)688-5036 MA Home Improvement Contractor Registration# 145042 Federal Identification#20-1906118 Contract executed by: Christopher D. Smith Joseph M. Clementi Principal, Director of Planning Principal, Production Manager Steeplechase Builders, Inc. Steeplechase Builders, Inc. Homeowner: Rhea Simon-Skoler 64 Phillips Common North Andover, MAO 1845 C. Project Address 64 Phillips Common North Andover,MA 01845 D. Project Summary 1. 22' x 26' Great Room 2. New Bathroom,Mud area and Pantry 3. New Sundeck approx. 24' x 18'6" 4. Side Deck Approx. I P x 7' 5. Kitchen Cabinets and Counter Tops E. Project Cost $267,595.00 X g__4 Ho eowner Signature(s) Date �as-OG C ctor Signatures Date I w 7 I + BOARD OF BUILDING REGULATIONS License CONSTRUC7I N SUPERVISOR I f Number CS':: 074478 3 B1rthdate 01/2411964`.. . .. Expires 01/24/2007 Tr.no: 6264.0 Restricted 00 JOSEPH M CLEMENTI . 153 MAPLE Sl' ' METIIUEN, MA 01844 :/ Commissioner o,✓l�aaaczc�zcaet�s Board of Baiddiug_Regalatioas and Standards HOME IMPROVEMENT CONTRACTOR Registration:..,145042 Expiration °2/2/2006 Type. Supplement Card STEEPLE CHASE BUILDERS,INC: JOSEPH CLEMENT 153 MAPLE ST METHUEN,MA 01844 Administrator The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 i www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �4cepkC SE 600clers IficoryoeterA Address: 15 3 fb .olc. 5+ City/State/Zip: h0,4hL 1U MA. 0)?Y4 Phone #:Ll 7g) gf'g-5036 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ 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. VWe are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ 1 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' 13.0 Other comp. insurance required.] *Any applicant that checks box#I must also till 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: &S.S-e-&—INSUradice Co. Policy#or Self-ins. Lic.#: 3C a y T ly Expiration Date: 1 06 Q 7 Job Site Address:(Dy Ph�, ll:ef l nnntnou City/State/Zip: NOe+K 14NaOKi 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 tine 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do herehy certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: /I'J Date: / - 1 -06 Phone#: �71r) 6 k tk— 034 Official use only. Do not write in this area,to be completed by city or town glflcial. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: DCT-26-20060HU) 12:09 W. C. Sullivan Insurance Agency (FAX)9783732281 P. 001/002 ACOS, CERTIFICATE OF LIABILITY INSURANCE 10/26/2006 PRO ILICM (978)372-2790 FAX (978)373-2281 THIS CERTIFICATE IS ISSUED ASAMATTEROFINFORMATION Su I I i van Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 487 Groveland Street HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Haverhill, MA 01830 INSURERS AFFORDING COVERAGE NAIC$ INsuaen Steep I e ase Bu I I ders, Inc. INSURER A• Essex I nsurance Comea2X 39020 153 Map I e Street INSURER 8: Methuen, MA 01844 INSURER C: INSURER 0: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,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 HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OFUMRANCE POLJCYNUMBER POLICIIIFCEC7IVE POLICY09IRMTION UNITS OENlRALUAMUM 3CQ4464 01/06/2006 01/06/2007 EACH OCCURRENCE s 1,000.000 X COMMEROAL OENERAL LIABILITY DAMAGE TO RENTED $ 50.000 n ►IFAa uw CW MS MADE �OCCUR MCO EXP(Any one person) i A PERSONAL J:ADV INJURY S 11000.000 G£NERALAGGREGATE i 2,000,000 GEMLAGGREGATE LIMIT APPLIES PCR: PRODUCTS.COMPIOP AGO S 1,C)00.000 POLICY '0- LOC — JECT AYTOMOBILE NA11ILn1 COMBINED SINGLE LIMIT ANYAUTO (eaacddang s ALL OWNED AUTOS BODILY INJURY OCHEOULED AUTOS (Perperwn) _ WIRED AUTOS BODILY INJURY = NON-OWNED AUT03 (Per adddenQ PROPEPYY DAMAGE 3 (ParaccIdenl) OARAOEIAA�LJIY ' AUTO ONLY-EA ACCIDENT f ANYAVTQ EA ACC 3 OTHERTNAN AUTO ONLY: AGG S OICES301UMBREUAUABWTY EACH OCCURRENCE % OCCUR F-1 CLAIMS MACE AOOREOATE s $ DEDUCTIBLE S RETENTION S $ 1NORIIeR8COMPV48AIMAND WCSTATU• OTH. eMPLOTERV LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE E-L EACH ACCIDENT = r OFFICEROMEM13EREXCLUDED? C.L.018EME-EA EMPLOYE s II Yee,deeallle under SPEGAI PROVISIONS Wow C.L DISEASE•POLICY UMIT S OTHER DESCR PTIDN OP OPERATIONS I LOCATIONS/VEHICLES(09CLUSMS AOWM gY 0MMEINL'NT l SPECML PR=ONS encral Contracting CERTIFICATE HOLDER CA CE LAT ON 3HOULO ANY OF THE ABOVE 093CRMO POLpWC3 BE CANCELLED BEFORE THE 9"IRATION GATE THEREOF,TH8188U1NO INSURER YYRLENDEAVORTO MAIL 20 OAYSWIOMNNDMITOTWECERHPICATVHOLDER KAMMrOTHE LEFT, Rhea S i Bron-Sko I er VW FA%AM TO W&SUCH NOTICE OHALLMPCSR NO OOUOATION OR WI UTY 64 Ph i I i ps 'Common OF ANYIUNO UPON INE INSURER.ns AGENn OR RE:PRESENTATIVEL North AndOVCr, MA 0184$ AUTHORBFAREPRESENTATIVE Diane Fraiol i/DNF ACORD 25(2001108) WACORD CORPORATION 1988 I