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Home My WebLink AboutBuilding Permit #350 - 70 HUCKLEBERRY LANE 10/21/2011 L TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: O_ Date Received Date Issued: ' IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER RA. G.. 1 C, I y —M U-N Unit# Print MAP NO:��PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village ye no 100 year-old structure yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial I ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other (]"Septic D Well' 1'F1;odplaii3 ❑ Wetland'ss D! Watershed;IDistiict 0 Water7Sewer, DESCRIPTION OF WORK TO BE PERFORMED: 0.)C 4- e 00e 'LSCS S � (c► � (Identification Please Type or Print Clearly) OWNER: Name: PL A Ck-�v — c.. Phone: Address: �c ccs CONTRACTOR Name: Phone: Address: S� i Supervisor's Construction License: !a 3 6& S Exp. Date: 12 1�,p Home Improvement License: 1b �� Exp. Date: 1R-12S I.:zd I 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: $ l.3,�0 0 FEE: $ ��IO Check No.: .3 Receipt No.: 1 �C) NOTE: Persons contractin w t e t ontractors do not have acce tot g r unci ,Signature of Agent/Owner ; : Signature of contractor: J 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: Doc.Building Permit Revised 2008mi L. 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 servicedroprequires approval of i Electrical Inspector Yes 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 I I. ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi VS Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer K 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 Sionature COMMENTS HEALTH Reviewed on Sionature 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 Location f IVGf-� No. � "" Date NORTp TOWN OF NORTH ANDOVER f w a : : Certificate of Occupancy $ CNUst<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /�-�� 24740 Building Inspector NORTH TO" of And to No. gj-6 _ •z� •� � z � � 10 �►� � t1 o Y dover, Mass., O LAKE T COCHICHEwICK V `Ll,9s0"'�ATED BOARD OF HEALTH Food/Kitchen PERM .IT T D Septic System BUILDING INSPECTOR THIS CERTIFIES T111111111 iflpill HAT.............. !......�.......... ....... . .... .............. ................................................................ Foundation has permission to erect........................................ buildings on ......... .. ... .�.'"Ins LAWO.... Rough................... ....to be occupied as.......K..1.. ..... .......... �A!r!!vT..........S�1.I.!*........t''6008.. . *....... 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 j PERMIT EXPIRES IY6M THSELECTRICAL INSPECTOR UNLESS CONSTRUARTS Rough ............................ 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 No. SEE REVERSE SIDE smoke Det. 1 ItEITANO GENERAL CONTR.ACTORS 56 Pleasant Street Methuen, MA 01844 Phone/Fax: 978-688-3944 Company Email Dave@DavidReitanoRemodel.Com Proposal Date:9/22/2011 Submitted To: Mr. and Mrs. Cusato-May 79 Huckleberry -Lane N.Andover Mass. 03079 Home: 508-246-4465 Work: Mobile E-mail Job Description: Kitchen Remodel We hearby submit specifications and estimates for : Removal of exsisting kitchen cabinets and tile floor. Exsisting plaster walls and mouldings etc. will be salvaged New kitchen lay-out will resemble exsisting . Electric will be updated to code including independent line for micro wave . Sink,dishwasher and garbage disposal will be loacted in exsisting locations,..water supplies will be salvaged,..drain above floor line will be replaced. All walls and ceiling disturbed during construction will be repaired Cabinets will be installed as shown on plan including mouldings and counter tops. (granite) Floor will be replaced with a tile material All debris will be removed from job-site. Above total cost $21,350.00 r � r *Contractor is responsible for allowances mentioned,anything that exceeds these allowances- Homeowner is responsible for. *Homeowner is responsible for paint and stain *$100 credited to Homeowner for suppling to contractor before and after photos on work exceeding$2000.00 *Please review this proposal carefully for any items which may be missing. Contractor is not responsible for items not mentioned here. *Please do not hesitate to contact us if you have any questi Thank you for considering us for this projec�- v, David Reitano Workmanship Completely Guaranteed/Gaurd Insurance—policy—DAWc226669 Guard Insurance Liabilty—policy-DABP100985 Contruction supervisor license CS23365 Home Improvement contrator license 108782 (Please sign and return one copy) Signature: Date: — -- - 1554" --—-- --- — ----}` 35" N -- 87— ____— o 2 32 , N I I I i,Mlfb VV=I YQ1lDi 0WI!!4241 I ROLL-OUTS n \ Cabinets hung at 96" With fascia and crown to ceiling Particle board constrruction Diamond Prelude PULL-OUT Gilcrest Maple OLLOUTS PANTRY p .A _ Toffee Finish N ;, Smart Stop Drawer Guide CV MODIFIED FULL OVERLAY BASBOARD MOLDING Go TILT-OUT oo I ;_� $ SINK FRONT a I ! ON BACK OF PENINSULA i DBL TRASH PULL;-OUT sic LO Viatera Quartz Color: Palermo Eased Edge NO B/S Gem meals to � .% 44 N N I i I co Go All dimensions size designations given are This is an original design and must not be Designed:8/27/2011 i subject to verification on job site and released or copied unless applicable fee has Printed: 6!27/201 1 co _ adjustment to fit lob conditions. been paid or job order placed. -� o. 0 i r L Nsm_custo-may final.kit All Drawing if: I I: Massachusetts- Department of Public Silfety - Board of Buildint, Relirulations and Standards Construction Supervisor License License: CS 23365 -Restricted to: 00 DAVID REITANO 56 PLEASANT STREET METHUEN,MA 01844 Expiration: 12(4/2011 Trr: 11861 a i Office o usamer atrs Bess a on HOME IMPROVEMENT CONTRACTOR Regis>rd#ion:. 108782 Type: Expiration: AYM012 Private Corporatio D - - "REMAND. REMQDIt F�BUIi:D David Reitano 56 Pleasant St Methuen,MA 01844 "-== Undersecretary ACORD CERTIFICATE OF LIABILITY INSURANCE DADDnY) TM 07/19/1119/11 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 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(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 COMPANIES AFFORDING COVERAGE PAYCHEX INSURANCE AGENCY,INC. COMPANY 150AMGUARD 150 SAWGRASS DRIVE ROCHESTER,NY 14620 COMBPANY INSURED DAVID REITANO CO CANY DAVID REITANO BUILD&REMODEL 56 PLEASANT STREET METHUEN,MA 01844 COMPANY D 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. O TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LT DATE(MWDDIYY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PRODUCTS-COMP/OP AGG $ PERSONAL 8 ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS'LIABILITY DAWC226669 06/11/11 06/11/12 X IORY LIMITS We sTAru- oR THE PROPRIETOR/ EL EACH ACCIDENT $ 100,000.00 PARTNERSlEXECUTIVE INCL EL DISEASE-POLICY LIMIT $ 500,000.00 OFFICERS ARE: �X EXCL EL DISEASE-EA EMPLOYEE $ 100,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF LYNN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWN HALL DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY LYNN,MA PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Department of Industrial Accidents �f ' Office oflnvestigations W 600 Washington Street Boston MA 02111 _ www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print LeL3,iblv Name(Business/Organization/Individual):7::pCLV, c Address: �' � c� -�'� � j Le City/State/Zip: 10e /� �� 1q,1 Phone#: F7 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 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. ❑Building addition [No workers' comp.insurance comp.insurance. # required.] 5. ❑ We are a corporation and its 10.❑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.] c. 152, §1(4),and we have no 131-1 Other employees. [No workers' comp.insurance required.] "Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. zContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have ;mployees. If the sub-contractors have employees,they must provide their workers'comp.policy number. F am an employer that isp iding workers'compensation insurance for my employees Below is thepolicy andjob site Wformation. _ Insurance Company Name: A cd,e k J_ S' r ?olicy#or Self-ins.Lic.#• K) Expiration Date: fob Site Address: 71 C_ City/State/Zip: y Attach a copy of the workers' compensation policy4eclaration page(showing the policy number and expiration date). ?ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a :ine 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 )f 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 ins ance coverage verification. do hereby rti u er th penalties ofperjury that the information provided abov is true and correct. iiertature: Date: OF0� 'hone#: f 7V_3_3 d - TZ D Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: /4, w Cc J� Permit/License# Issuing Authority(circle one): 1.Board of Health JF2.Building a artment 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Ken Thompson, Inspector of Buildings Phone#: 617-972-6480