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Home My WebLink AboutBuilding Permit #59 - 67 SETTLERS RIDGE ROAD 7/22/2009 BUILDING PERMIT NORT11 q `Stereo a• ti0 OWN OF NORTH ANDOVER - APPLICATION FOR PLAN EXAMINATION r Permit N0: J Date Received �4p�R,T[O Date Issued: �" ZZ �SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION 7 Pri PROPERTY OWNER 06-VI. 4�•-Q,,,P6rf Pnnt MAP NO: PARCEI1j% ZONING DISTRICT: Historic District ye no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne famil Addition Two or more family Industrial A eration No. of units: Commercial epair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District tater ew DESCRIPTION OF WORK TO BE PREFORMED: a ✓e 0 Identification Please T e or Print Clearly) OWNER: Name: /� ,fid )4 -A ya:f Phone ?77 60' -5'LWO Address: CONTRACTOR Name: CaidkWo4A Phone: Address: 26 Supervisor's Construction License: D�'� t?3 Exp. Date: !I—1 a-fit-0l I Home Improvement License: /a?6 d Z Exp. Date: 2 a 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: $ FEE: $ Check No.: Receipt No.: 0 a -- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owne Signature of contractor 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 Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street 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 21 A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2009 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 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:Building Permit Revised 2008 f t Location �— No. 5 Date NORTp TOWN OF NORTH ANDOVER 3? ° 0 F 9 4 ` Certificate of Occupancy $ Building/Frame Permit Fee $ ACMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2Gl� v �r Building Inspector i.10RTH Town of 4Andover 0 2Z , 0 y Z dover, Mass., T 0 LAKE COCHICHEWICK 7,9S01'?4T E D 7 �G BOARD OF HEALTH Food/Kitchen Septic System PERMIT T.. D1 BUILDING INSPECTOR THIS CERTIFIES THAT DA..%��A. TOP h �...... ..................................................................... ............................• •••••••• ••• Foundation has permission to erect........................ buildings on ...6�.......... f b� Rough to be occupied as........rwa�cceptlng .' '�!,�........I................0 4�.....16............................: Chimney ... .... ...................................................... provided that the pars 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 0.00. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TRU S TS Rough ............. Service BUILD 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. The Commonwealth ofMassachusetts - DePartmerat of Industrial Accidents z Ojfh-e of Iim�estiQatiions b 600 Nrashington Street 1,44.M 11 Boston, MA 82111 c www nuws.gov/din . Workers' Compensation Insurance Affidavit Builders/C Applicant ,nfflrffiation ontractors/Eiectricians/Piumbers __ / Please Print LeQibl Nagle(Busincss/orpoiza6arJ[ndividual): `/�O le- /• ea y Address: City/State/Zip: Phone#,g7p 6 t;s- �• _ Are yo�,,a, mp{oyer?Check.the appropriate box: 1.( J I employer with 4 FX ject(require): ❑ 1 am a general contractor and I Ployees(foil and/or part-time).* have hared the sub-contractors []Nowconstruction 2.❑ I am.a.sole proprietor or partner- listed on the attached sheet,i deling ship and have no employees These soh-contractors have working far me any opacity. workers' comp.insurance. iitiorl[No wadcers'comp.iastlratice 5. ❑ We are a corporatism and its ng addition required] officers have exercised their ical repairs oradditions 1 am s homeowner doing all work right of exemption p•,r MGLumbin myself [No-workers'comp. Q 152, §1(4)t and-we have no .. g rept or additions insurance required.]t .employees. [No workers' 12•❑Roof repairs comp. insurance required.] 13•❑.Other "Any applicant that checks bo>#I must also fill out the section below showing their wortcets'iiom t Homeowners who submit this affidavit indicating they are dorm an p°t'Nt�policy infomtation ;Contractor that cheek this box Mat Mbehed an additioasl rhea show �d then him outside contraetots most submit a new afndavit indicating such. irrg the name of the sub-contractors and their workers'carp.an an emsuryer beat is providing:workerr co ensadon F p.lir;irSom�a6on. information. mP �nsuranrefor my employees: Below is the Pak andja site . Insurance Company Name: C Policy#or Self-ins.Lie.#: G y -1. e" G Job Site Address: JCr'' < 'ale CitylState/Zip: 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. 1S2 tmrt lead to the ir=tposition of criminal fine up to$1,500,00 an ones-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and operiabin ffin 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 e investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties efPerjury that the infnrmciioR provided above is true and coned Si Date: ✓V, o"do Phone#: �ol•• j O},j°icial use only. Do not write in this area,m be ! mp et ed by city or town officia City or Town; Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Cierk 4. Electrical Inspector 5. Plumbing Inspector 6.Othez Contact Person: " Phone#: Information a nd Iistructions Massachusetts General Laws chapter 152 requires all emp 3oyers 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 of hire, - expnss or'implied,oral or written." )` An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and includir-kgthe legal representafivcs of a deceased employer,6r the receiver ortrustee of an individual,partnership,associatiozr or other legal entity,employing employees.*However the owner•of a dwelling house having not more than three apa rtrnents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling hor:.se or on the grounds or building appurtenant thereto shaU not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or-local Geensing agency shall withhold the issuance or renewal of license or permit to operate a business or *o construct buildings in the commonwealth for any applicant who has not produced acceptable eviidence.of compliance witls the insurance coverage required." - Additionally, MOL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the pmformenee of public work- until-acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the corTtrac€iing authority." Applicants Please,fill out the workers'compensation•affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s),address(es):alnd phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not rmpired,to cant'workers'ocmmpmsation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also Ere sure to sign and date the affidavit. The affidavit should be returned to the city or town that the.application for the permit or license is being requested,not'ihe Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please can the Department at the nur .nber.listed below. Self-insured coarrpanim should enter their self-insurance license number on the'appropfiate tine. City or Town Officials Please be sure that the affidavit is complete also printed legibly. The Department hes provided a space at the bottom of the affidavh for you to fill out in the event the Office of'Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/iicense number which w-ilI be used as a reference number. In addition,an applicant that must submit multiple permit/lieense applications in any given year,need only submit one affidavit indiceting•eurrew policy'information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A -ally of site affidavit that has bean 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 fi>t= permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or parmit not related to any business or commercial venture 0-e. a dog license or permit to bum leaves etc.)said poison is NOT required to complete this affidavit. Tho Office of investigations would like 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Basion., IIIA 02111 TeL #617-7274900 ext 406 or 1-8.77-MASSAFE Fax#617-727-7744 Revised 5-26-45 www,mass.gov/dia 6/24/2009 3:17 PM FROM: MTM MTM Insurance Associates LLC TO: 978-682-1221 . PAGE: 018 OF 027 ACORD,„ CERTIFICATE OF LIABILITY INSURANCE 6%24%2009"' PRODUCER (978)681-5700 FAX: (978)681-5777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MRM Insurance Associates, LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 575 Chickering Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover MA 01845 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A:Charter Oak Fire 25615 COTE AND FOSTER CONTRACTING, INC. INSURERB:Phoenix Insurance Company 25623 20 AEGEAN DRIVE INSURER cTravelers Indemnity 25658 UNIT #15 INSURERD:S H Smith Insurance METHUEN MA 01844 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 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 HAVEREDUCED BY PAID CLAIMS, INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER D DATE MMIDDIYY DATE MMIDDJYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY RR'E E (RENTED 300 000 PREMISES Ea.."o.ce $ A CLAIMS MADE aOCCUR I6803SONS396COFOS 12/31/2008 12/31/2009 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV IN LIRY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS_COMPtOP AGG $ 2,000,000 X POLICY JET I I LOC I� AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000'.000 X ANY AUTO (Ea accident) B ALL OVMED AUTOS BA970K396608SEL 12/31/2008 12/31/2009 BODILYIN,AJRY SCHEDULED AUTOS (Per Person) $ HIREDAUTOS BODILY INJURY NON-OVNJEDAUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ _ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY 1,000,000 OCCUR FICLAIMSMADE AGGREGATE $ 1,000,000 $ C DEDUCTIBLE ISFCOP969H355AIND08 12/31/2008 12/31/2009 $ RX RETENTION $5,000 $ D WORKERS COMPENSATION AND X TM1RSLRTIT OR EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBEREXCLUDED? WC7455340 6/20/2009 6/20/2010 E.L.DISEASE-EA EMPLOYEE$ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT Is 500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSfVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTIBPECIAL PROVISIONS Certificate holder as listed below CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of North Andover EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL North Andover Town Hall 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Main St. FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE N Andover, MA 01845 INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /� �`/� P MacDonald CPCU, CIC JIOI/!/'7 ACORD 25(2001108) 0 ACORD CORPORATION 1988 INS025(oioil).oea Page 1 of 2 'N'lassachusctis - Depal-1111011t 4 Public 5atet� 4 Board of Building Regulations.and.Standar(is. Construction Supervisor License License: CS 85173 Restricted to: 00 WILLIAM T FOSTER 65 COACH DR DRACUT� MA 01826 Expiration: 11/10/2010 ( umnrissiuurr Tr#: 6023 nd Stan ards Board of Building Regula ions a One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvemen Coptractor Registration Registration: 107602 j; Type: Private Corporation 9 Expiration: 8/5/2010 Trl/ 272878 COTE & FOSTER CONT. Steven Cote 20 Aegean Dr Unit 15 3 Methuen, MA 01844 F J e j Update Address and return card.Mark reason for change. Address Renewal E] Employment El Lost Card DPS-CA1 f3 50M-07/07-PPC88490pp -- ✓lie -L�om.,rao�.uue¢�.! o�./�cwacu,�ucaetla Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 107602 One Ashburton Place Rm 1301 Expiration: 8/5/2010 Tr# 272878 Boston,Ma.02108 Type :Private Corporation k COTE&FOSTER CONT, Steven Cote p 20 Aegean Dr Unit"15-.<- '""'� Not valid without signature Methuen, MA 01844 Administrator FOSTERu� s CUSTOM BUILDING + REMODELING This agreement made this day of v ,year Two thousand and Nine by and between Cote and Foster Contracting, nc. hereinafter called the Contractor and David and Sarah Torrisi,hereinafter called the Owners,witnesses that the Owners intend to remodel the existing kitchen, close two windows, change casement window,open wall between living room and kitchen with half wall and square columns. Remove closet for cabinets,change living room tile to hardwood and remove wall and blend into family room finish. Now,therefore,the Contractor and the Owner,for consideration hereinafter named,agree as follows: ARTICLE 1 The Contractor agrees to provide all the labor and materials to do all things necessary for the proper construction and completion of the work shown and described on drawings. The drawings and specifications are the basis of the contract. ARTICLE 2 In consideration of the performance of the contract,the Owner agrees to pay the Contractor, in current funds as compensation for his services hereunder kitchen work total $31,710.00, family room total $6,910.00,total cost$38,620.00 to be paid as follows: Payment 1 - $2,000.00 at the signing of contract. Payment 2 - $8,000.00 at the start of cabinet and wall removal. Payment 3 - $8,000.00 at the start of rough mechanical work. Payment 4- $8,000.00 at the start of plaster work. Payment 5 -$8,000.00 at the start of floor coverings. Payment 6-$4,620.00 at the completion of project. ARTICLE 3 Final payment on contract amount as agreed above to be paid within ten(10)days of project completion or occupancy. If final payment has not been made within this time a 10%charge per month on the balance due will be charged. All minor punchlist items will be complete as part of the one year warranty on the finish product._ Failure to pay balance within ninety(90) days ma result in legal action: Initial 20 Aegean Drive • Unit 15 • Methuen,MA 01844 Tel:978-682-6518 • Fax:978-682-1221 www.coteandfoster.com i ARTICLE 4 Additional work above and beyond the contract agreement. All additional work done to be quoted at the time the client requests the work. The work will be done and billable at its completion. The client has ten(10) days to pay the additional cost after he or she has been billed for it. Initial In witness whereof they have executed this agreement the day and year first above written. D id orrisi, Owner Sarah Toni , Own r Steven M. Cote William T. Foster DBA Cote &Foster DBA Cote& Foster