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HomeMy WebLinkAboutBuilding Permit #194 - 67 FOSTER STREET 9/17/2008 BUILDING PERMIT c* "o DrH TOWN OF NORTH ANDOVER ° . y APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received RAn, �SSACHU`��� Date Issued: IMPORTANT:Applicant must complete all items on this page _ = -=`£.- -ate `r.�. '• -L`'�'+ ,a i-u-c� ,:,1 �=` .. .r:-- *ter PPRAVAB KYN TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne family Addition Two or more family Industrial Alteration No. of units: Commercial repair, replacement Assessory Bldg Others: Demolition Other 'i= yS�77��tac � 1 � a � d � � ersheDrso � -=��•" �s.x:r+-�3����'�"� § w :5��x.^at'�`"„_ DESRIPTION OF WORK TO BE PREFORMED: ��lirrU Identification PITC se Type or Print Clearly) OWNER: Name: , /,�' Phone: Address: oZVz�s v`t � i ff ��o, 41u ooy69,- z.��-_s��'�r 11����0 ���i+l��i -1 —����#�� �` � .�.��'•'a� ��,k...�.cx��� ��r; �� �'s�ss�' ���"��"`���� .y��r z�- �"e�-,��— "'.t�--� �� ��,J�rLs. .'�.f �°^ns�`�=5��"§c�';z""''"•�`�-� -�.� r "`aA'a-�r„ _.- ��a,� .��.� s. .'w�C'�dr. `� ��t�� ��7).i/,l t�`��� e�'.1����A/��� 3..xF-�c-�'�`-. T's' P2"''v 3.i`���v-+i� ,i� 2?'�T}��4&.''. }i�'�� �''r�• _,—. '� ,•-�r �"'��, " � .fit�#� t.�-_ � ^�� ��,"°:,. ,�A ��� <; �-.r_'��` �, atm t x� � ���- ..t „-— -....` fig- a'z„x^ `�` �� �x. a,.,--':,a,..•- s' �.,-,, `-' t,t— -'k-nr. �'''a^' 'r`"' - „� u °t` j .,�, 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: $ D g— FEE: Check No.: Receipt No.: Q NOTE: Persons contracting with unregistered contractors do not have access to the ar ty fund Srtr =�f1en#/Canrn�r = Location ";/ -.;z f'c�s�"�--•� No. ,��17 Date Q MORTq TOWN OF NORTH ANDOVER . - F 9 �. " Certificate of Occupancy $ s 00 <w�i��. ♦ � ' ;�s'•^°E<� Building/Frame Permit Fee $ CMU`+ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # V J 2 . 5 -1 \J Building Inspector 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS I DATE REJECTED DATE APPROVED HEALTH 4 COMMENTS 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 Located at 384 Osgood Street FARE#D ,�p►F2T�IYIT ler� ur�pster fi`r site firespi­ o LocatB at` Mair�sr�ee � ;: k i F= AMI 4T' qtr �r.t z`i- s $�`". ? C` ,A�^'ry > ✓qM`A '"xi,,..Sh,.� :- 2 'yam. r,.K� "',v^ x a & ,r .-+"+ r rrz. a k ^ 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 I 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 I i ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 Building Department j The following is a list of the required forms to be filled out for the appropriate permit to be obtained. i 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 Li 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) ❑ iviass check Energy Compliance Repan (If Applicable) ❑ Engineering Affidavits for Engineered products 9 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 i ❑ Engineering Affidavits for Engineered products y i 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 NORTIy c 04" o f Andover No. /9 o yY dower, Mass., ' o T O - IAKE COCHICHEWICK V S RATED PPG �5 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING.INSPECTOR THIS CERTIFIES THAT........ .... ...... -------A&vc_7700 Foundation has permission to erect................................. buildings on ...16.7. Rough t0 be occupied as... Chimney /I .................. ... . .a.. .... Chimney provided that the person accepting this 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR_ ON ARTS Rough W...... Service 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 Na. SEE REVERSE SIDE Smoke Det: PROPOSAL Matt&Pam Rivet 67 Foster Street North Andover,MA 01845 (I)978-258-2580 September 12, 2008 Work to be completed in kitchen remodel to include: Permit fee, Two 20 yard dumpsters,Demo of back hall kitchen and eating area. Installation of all electrical fixtures,switching and appliances per plan. Complete all necessary plumbing. Install two new 9 light Fiber Classic Exterior doors. Complete necessary leveling of ceiling and floor. Strap ceiling. Install new Red Oak flooring, sand and apply three coats poly. Install new blueboard and plaster. Install all cabinets with crown molding.Install Two new 4'-0"Undpair . interior 6 panel pine(back hall)Install all new interior trim on doors and windows. Re-trim out exterior of kitchen window. Install new baseboard. TOTAL LABOR AND MATERIALS $28,165.00 Cabinets $ 10,500.00 Granite $ 2,000.00 Total project cost $40,665.00 Terms: $9,400.00 to start project $9,365.00 after rough electrical has been completed $9,400.00 upon completion of the project Submitted By: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C) 508-265-3115 (IT)978-794-1165 North Andover,MA 01845 ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outline4abo�ve.o '6 Date Signature Date/ Signature ACORD,� CERTIFICATE OF LIABILITY INSURANCE °04/0/2o 8 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MacDonald 8t Pangione Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 428 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 104 Main Street North Andover, MA 01845 INSURERS AFFORDING COVERAGE MAIC# INSURED Christopher Rivet INSURER A: PREFERRED MUTUAL INS CO 15024 207 Winter St. INSURER B: N Andover,MA 01845 INSURER C: INSURER D: 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 COND(TION_OF ANY CONTRACT OR_OTHERDOCUMENT 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. SR W R TYPE OF INSURA14CE POLICY HUMBER PUUCY EFFECTIVE POOLICY EXPIRATION LIMBS A GENERAL LIABILITY CPP 0140 57 0105 09/26/07 09/26/08 EACH OCCURRENCE $ 1,000,000 AGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence $ 100,000 CLAIMS MADE FRI OCCUR MED EXP(Any are person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1.000,000 X POLICY PRO Loc AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY' $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Peraccident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ S DEDUCTIBLE S RETENTION $ $ WORKERS COMPENSATION AND WC STATU OTH- Y LIMITER EMPLOYERS'LIABILITY E.L EACH ACCIDENT $ ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes describe under SPECIAL PROVISIONS below E.L DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder as listed below CERTIFICATE HOLDER CANCELLATION SHOULD AHY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE'EXPIRATION t Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN } 120 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR No Andover,_MA 01845----___ — _- _-- REPRESENTATIVES. AUTHOMM REPRESENTATIVE ACORD 25(2001/08) ©ACORD CORPORATION 1988 l ac wr nWa weuur[ Oj MassacHmew Dep�l Of bzdL ub'tQdAcddmts ' Office of Invedkagons 600 Washington Street Boston,MA 02111 r www M=S gov1did ' Workers'.Compensation Insurance Affidavit: BuMerstContracborslElectriraans/Plumbers APPAcW Information Please Print Legibly Name(Businesstorpnization/Individual):. Address: ,10 7 ?7_ City/State/Zip: 1.6� XAJ,001sroz AUDift1fPhonel.• � �o'��- J /��• Are.you an employer?Check the apppr'iate box: Type of project(bra,, 1.0 i an a employer wft ' :, 4. I am a general contractai and I , employees(fall and/or part�).a have hired the 6. Q New Construction2.�an a sole proprietor of pmtxw fisted on&e-attached sheet. 7: debug - and have no to These sub-cox��have ship employees - 8. ❑Demolition working for me in ant capacity. employees and have warms' [No workers'coup. comp.honma�•t 9. []Buddmgaddih°n ` wed.]. 5. We are a corporation and its 10.0 Electrical repairs or additions . 3.❑ I am a homeowner doing all work have exercised work - 11.Q Plumbing repairs or additions n&of exemptimper MCI. myself[No workers'camp- 12.Q Roof insurance required.]t c.152,§1(4), andwe have nD - employees.[No workers' caw.komance r' -] -Any applicant diet dmlm box#1 nwst also fill out the section below showing their worms'compensation policy infotaatiou. t Honieownas who=*=a this affidavit mdmahag they arc doing all work and thea hue outside conusctms imm submit a new affcdmt radio sting mAL ICMWdcIM that check this box must attached an additional sheet showing the name of the sub-oonuactocs and state whether or not those entities have employxs. If the sub-conuactois.bave employms.they must pmvide Sara works rs'comp.policy number. r am.an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ®/�1 /�� / j��'✓s --_ Policy#or Self-ins.Lic.#: ����7'Gf O, Expiration Date b Job Site Address: i Vii'? City/Stabe/Zip: a r(/No�� A/: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure_to secure coverage as requiredunder 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$250.00 a day against the violator: Be advised that a copy -of do sWoment may be forwarded to the Office of Imestita(ions of the DIA for insurance coveraee verification. . I do hereby Cei fauff of-pf7m7 dw the inforrmation provided above is arae and correa ® . Date: Ojfcial:use only. Do not write in this area,to be completed by city or town offlaw . City or Town•' PermitUcense# Issuing.lathority(circle one): J.Board of Health 2.BWWft Department 3.Gity/rown Clerk 4.Electrical Inspector 5.Plumbing Inst 6.Other Contact Person- Phone#: t Information and Instructions Massachusetts General Laws chapter 152 requires all employdrs to provide.workers'compensation for their employees. pcusuant to tris statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." r An eraploygr is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enmeiptise,and including$ie legal representatives of a deceased employer,br die receiver ortrustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the.occupant of the dwelling-house of another who employs persons to do mom,construction or repair work on such dwelling house or on the grounds or building appurtmunit thereto shall not because bf such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states dist-ever ►state of local.licensing agency shag withhold the issuance or renewal of a license or permit to bperaU.2 business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 1-52,125CM su tes'"Neither the commonwealth nor any of its political subdivisions shall eater into any contract for-the perfomsanoe of public work unO acceptable evidence of compliance with the insurance requirements Of this chapter have been presented-to the contrasting authority." Applicants Please fill out the workers'compensation.affidavit coripletely,by chwJdng the boxes that apply to your situation and,if necessary,-supply sub-aintiactor(S)name(s),address(es)and Phone mmnber(s)along with their certifica>e(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members orrputmrs,are not required to carry worersk 'compensation insurance. If in LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to die Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the pernYit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law.or if yon.are required to obtain a workers'- compensation policy,please call=the Department at the number listed below. Self-insured companies should.enter their self-insurance license member on the appropriate:line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to comet you regarding.the applicant. Please be sure to fill in the perroMcmae number which will be used as a reference minter. In addition,an applicant that must submit multiple permit1license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations-in (city or town)."A copy of the affidavit$tat has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fubae pew.or licenses. Anew affidavit must be fined out each year.Where a home owner or citizen is obtaining a license or permit not relat:ed.to any business or commercial venture (Le.a dog license or permit to biim leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would h1w to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts DTaifmont of Industrial Accidents Offlce of investigations 600 WashiagWn Street Boston,MA.02111 Tel.#617-727-40M ext.406 or 1-877-MASSAFE Fax#617-727-7749 Revised 11.22-06 www.mass.govldia 3 go 318 TB' tY tY484� 30' 15' 30' 12' 3 �728� 41" 0 80- 33' 774_ 38' 4 2' ,,,; 4' 3 1 W3021 32' 147' ��\\ .3 1J3038 t. r - 2 B024.3 Bt2R.2DXFWr O 1 _ v I v c + t m o COPbg Height 91 12 1' l__, t , mm o -- - ---T --- ---- ------- n fi' i i v - :'. {: - - ___�_�—__��_ J.yam—` � _.__—_.—....__ _..-_�.._—...�__�_-_•_ 1151 zo Vendor.Kraftmaid Door Style:ChorryVU10 Square 3dwep tan and panels on both sides of fig.cut to M 10-space off left side oftvbWm is 3 114'and Hnth: autumn blush the spam of rigth nide if Y - Wood Species: Cherry Cabinat Heighi:QW.38-h wags 4-wood PanoM534 and omnB to be pieced Imre.feed Construction: st..d.,d, furniMe ptywood lidos on to cut m f3. 11-scall wb 2'ogouBida—Ing of bay window open oras ray Drawn—PRmda:DBBRFXS::h.runner Door Pulls: 5-rocersad tea ag around isR3M ore at end of Dre—,P.P.: run by stove 6- ed y filler to be placed hare.cut to fit - Designer.Linn CI-i— L-;BedfoN 1907 7-cut fiPer to M or 3 12' overlay fig is available - - (p)803.518.9go0 irneeded. -. tQ 803.518.9901 - t-aU ez:paseO ares era hun(tu:o PN 8-09 w 11 and base R0 to R or U Polar Customerown measure W.to fit height 38' ma0-1 aware that they are fogy reapot.xta for ntza and M. only using one by.,of moleinq and ane pc for fight rail 0-sink brae i.car t—d of .We. Customer Sfgrwbao: 24sland(all side).baso and x 11 at amt of stove and t—insides by wi d—.all have dem doors. X Ali dimensions_size designations given are This is an original design and must not be Designed: 12/27/2007 subject to verification on job site and released or copied unless applicable fee has Printed: 12/27/2007 adjustment to fit job conditions. been paid or job order placed. Massachusetts- Department of Public Safety ' Board of Buildin�o Re'-ufations and Standat•ds . Construction Supervisor License License: CS .72173 Restricted to: 00- CHRISTOPHER 0_CHRISTOPHER F RIVET m; . 207 WINTER ST N ANDOVER, MA 01,845 i r Expiration: 602010 ('uuunisimc r Tr#: 25403 ',F a c �ze T10rriVto7ttl�eau�L ✓lLIXaQQ�ic�4P6 h Board of Building Rp'guiations and Standard~ S +4 — HOME IMPROVEMENT CONTRACTOR ., Registration:, 139962 Expiration: gf8/2009 Tr# 132286 Type Intlivdual CHRISTOPHER F RIVET,, I CHRISTOPHER RIVET-';' 207 WIt4T..ER ST.: ATr — N ANOOVER;MA 01845: Administrator