HomeMy WebLinkAboutBuilding Permit #863-14 - 65 BEAR HILL ROAD 5/30/2014V- tan ,a 'N
BUILDING PERMIT 3? g�';:.
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: to Date Received °9a .,•.. +`
•11 oq^rao ��`�qy
Date Issued:
9SSACHU`��S
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Identification Please Type or Print Clearly)
OWNER- Name: �. i�(l�! /��c �I(, _ t
Phone: q ��-�v o00
Address:
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, $ vvv . --" FEE: $ f �fj•D�%
Check No.: fm. Receipt No.: ;Z��2,G
NOTE: Persons contracting Nith unregistered contractors do not have access to the guaranty fund
Permit NO:
Date Issued:
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
IMPORTANT: Applicant must complete all items on this page
LOCATION,.s
t.
PROPERTY OWNER Print
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
❑ 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
❑ Watershed District
❑ Water/Sewer
DESCRIPTION OF WORK TO BE PEK1-UKmtU:
Identification Please Type or Print Clearly)
OWNER: Name: Phone: °
AAAnnoo-
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date: -
ARCH ITECT/ENGI NEER
ate:
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.
Total Project Cost: $ JS 4D D, av FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
f
Signature�of Agent/OwnFr��� Slgilature_.__�___of�contractor
Plans Submitted lLj Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans
Location
No. Date
Check #-293Sz-
D'6 2 6
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee $ 0
Foundation Permit Fee $
Other Permit Fee $-
TOTAL $
,E rui!diing Inspector
.Plans Submitted ❑ 'Plans -Waived -11- . Certified Plot Plan ❑ .Stamped Plans F1
TYPE-:OF-SEWERAGEDiSPOSAL"
Public Sewer ❑
Tanning/Massage/BodyArt ❑ ..
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
:Food Packaging/Sales ❑
Private :se tic tank etc._
P � -• - :.
9
-Permanent Dempster on Site ❑
=THE -FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED:
PLANNING & DEVELOPMENT: ❑
COMMEN
DATE. APPROVED
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH
f
COMMENTS
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Pla=:ging Board Decision:
Comme
Conservation Decision: Comments.
Water & Sewer Connectionisi_gnature & Date Driveway Permit
DPW Tow2 Engineer: Signature:
Located 384 Osgood Street
FIRED PAR Il ; :�9gT -. Tern.p Dumpster on .site yes no
Located -at 124 Mair Street'Fire D Pi-rtmei►`it'-sighdtE,'re/daitd'Y
COMMENTS—Y''
Dimension-
Number
imensio -Number of Stories:
Total land -area, sq. ft. -
Total square feet of floor area, based on Exterior dimensions.
ELECTRICAL: -Movement of. Meter I-ocatroti, 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.$10041000.fine
NU I Lb anti UA I A — (For clepartment use
D Notified for pickup - Date
Doe.Building Permit Revised 2010
Building Department
°The fol''awing is'a list of the.required.forms to be. -filled out-for:the appropriate. permit to be obtained.
Roofivg, Siding, Interior Rehabilitation Permits
Building Permit Application
o Workers Comp Affidavit
o Photo Copy Of H.I.C. And/O'r G.S:L Licenses
u Copy of Contract
o Floor Plan Or Proposed Interior Work
u Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off. from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
o Certified Surveyed Plot Plan
L3 Workers Comp Affidavit
E3 Photo Copy of H.I.C. And C.S.L. Licenses
u Copy Of Contract
a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
o 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)
o Building Permit Application
a Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
o Mass check Energy Compliance Report
o 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 apwr al 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
Doc: Doc.Building Permit Revised 2012
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ -
$
180.00
Plumbing Fee
$
22.50
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
22.50
Total fees collected
$
325.00
65 Bear Hill Road
863-14 on 5/28/2014
Extend 1/2 Bath /Laundry Room into garage
Rightfax C3-2 5/23/2014 8:37:03 AM PAGE 2/002 Fax Server
CERTIFICATE OF LIABILITY INSURANCE(15/2312014
DATE (MM/D D/YYYY)
T.MMiGERTIFICATE 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(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require and endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
CONTACT
NAME:
PHONE
FAX
DANIEL OROURICE INS AGCY
429 HIGH ST
(A/C, No, Ext):
(A/C, No):
E-MAIL
ADDRESS:
MEDFORD, MA 02155
7857W
INSURER(S) AFFORDING COVERAGE NAIC N
INSURED
INSURER A: TRAVELERS INDEMNITY COMPANY OF AMERICA
DONOVAN, JOSEPH DBA JOSEPH DONOVAN CONSTRUCTION
INSURER B:
INSURER C:
INSURER D:
43 ACROPOLIS RD
INSURER E
LO WELL, MA 01854
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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
AFFORDED 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.
INSR
LTR TYPE OF INSURANCE
ADD
L
SUB
R
POLICY NUMBER
I
POLICY EFF DATE
(MIADDIYYYV)
POLICY EXP DATE
(MNADDIYYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED $
PREMISES (Ea occurrence)
CLAIMS MADE F__1OCCUR.
N�
ED EXP (Any one person) $
ERSONAL & ADV INJURY S
GEN'L AGGREGATE LIMIT APPLIES PER:
ENERALAGGREGATE $
POLICY Q PROJECT Q LOC
PRODUCTS - COMP/OPAGG S
AUTOMOBILE LIABILITY
ANY AUTO
COMBINEOSINGLE $
LIMIT (Ea accident)
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULE AUTOS
(Per person)
BODILY INJURY $
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE $
(Per accident)
UMBRELLA LIAR
0
OCCUR
EACH OCCURRENCE $
EXCESS LIAR
CLAIMS -MADE
AGGREGATE $
DEDUCTIBLE
$
RETENTION $
$
A WORKER'S COMPENSATION AND
EMPLOYER'S LIABILITY YM
UB4890PB3A-13
10@1/2013
10/21/2014
X
WC STATUTORY
LIMITS
OTHER
ANY PROPERITORIEXCLUDED? R/ExECLRIVE
OFFICER/MEMBER EXCLUD�
N/A
E. L. EACH ACCIDENT $ 100,000
(Mandatory in NH)
It yes, describe under
E.L. DISEASE - EA EMPLOYEE $ 100,000
E.L. DISEASE - POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTMCATE HOLDER AFFECTING WORKERS COMP COVERAGE.
THE WORKERS' COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR DONOVAN. JOSEPH.
CERTIFICATE HOLDER CANCELLATION
LINA HUNTER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
65 BEARHILL RD BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENT/,j: VE t
NORTH ANDOVER, MA 01845 ,. ;
ecnan or t"snmct rls APflOr1
- .--• _• .—I- ur ML ur%u I%1Vts-ZU10 AaunU COHPCI RATION. All rights reserved.
'6r irtrr (liti • rfsi;rlt,
`w.
Office of Consumer Affairs& Business Regulation
.'-20LIE i,MPROVEr LENT CONTRACTOR
".'I
agIstration, 155879 Type:
v 'xpiratton: 511512035 DBA
JOE DONOVAN CONSTRUCTION
JOSEPH DONOVAN
43 ACROPOLIS RIS. �a
LOWELL, 'a A 01854 Undersecretary
License or registration valid for individul 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
"y t.3assachusetts - Oepartmt nt of Public Saszt•j
:.: Board of Build;ng Requict ons and Standard:,
License: 05-002
JOS22H ru
43A, �tfl:�LIS:jD
WVJELLMA a'.-85.4,
Com rtissaoner tbs1ZZ12016
Unrestricted - Buildings of any use group which
contain less than 35,000 cubic feet (991M) of
enclosed space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For DPS Licensing information visit: www.Mass.Gov/DPS
v -JOE DONOVAN
CONSTRUCTION COMPANY
43 Acropolis Road, Lowell, -MA 01854
(978) 453-6209 0 (978) 804-8415
Hunter Lina Hur
Li Be uraterHiii Rd. Quality Custom Carpentry
Roofs - Additions - Remodeling
No. Andover, MA 01845
DATE DESCRIPTION
May 14, 2014 Contract to do the following work for: Lina Hunter
Expand existing half bath -laundry room into garage:
-Remove toilet, vanity, laundry doors, existing tile floor, laundry closet.
-Demo walls for expansion.
-Remove existing exterior door in garage
-Install new door in existing bath window location
!� -Install new window in previous door location
y' -Expand floor into garage to accommodate the relocated laundry room
-insulate walls and floor where needed
-Sheetrock walls and ceiling-
G
-Paint exterior
I _ -Install new ceramic the floor - $4.W sq ft allowance
-Rehang laundry louvered doors ,ucw-do0A-S
! -Trim window, doors and baseboard
-Re-attach toilet and vanity
-New electric work included
-Move exterior light and outlets and interior lights
-Relocate 220 for dryer
-Provide plumbing work to relocate washer
-Install new storm door on exterior
f -Replace siding where needed
-Paint exterior of disturbed area
-Provide permit
-Remove all debris from job -site
AMOUNT
TotalCost ......................................................... j $15,000.00
Payment Schedule
-$3,500 Deposit
-$3,500 After rough inspections
-$3,500 After drywall complete
-$4,500 After completion of job
TAX
TOTAL.
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