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HomeMy WebLinkAboutBuilding Permit #544 - 74 STONECLEAVE ROAD 4/16/2009Permit NO: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF IMPROVEMENT PROPOSED USE Resid ntial Non- Residential ❑ New Building Q-6ne family ❑ Addition ❑ Two or more family ❑ Industrial 4or�lteration No. of units: ❑ Commercial ❑' Others: ❑ Repair, replacement ❑ Assessory Bldg ❑ QkMolition ❑ Other Septic 1i11:;1t', Fcicda�� IWetla�Isn <, ��aterf� 13stntpb�s �'- ,� h ✓.x 5 F S'. 1' �',°' 3' moi` p�} PTLON OF WUKK i u tit PREF Rivir-u. Identificat,iio4g Please Type or Print Clearly) OWNER: Name: ��y�� elall Phone: W (® i d Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. 6 Total Project Cost: $ ���� FEE: $�99 Check No.: �(& J -?— Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to t guaranty fund 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 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 ❑ 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 s Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Well ❑ Private (septic tank, etc. Tanning/Massage/Body Art ❑ Swimming Pools ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR AFF INTERDEPARTMENTAL SIGN 00=r DATE REJECTED PLANNING &-DEVELOPMENT ❑ COMMENTS USE ONLY t< ;M 1, j DATE APPROVED DATE REJECTED DATE APPROVED CONSERVATION F1. ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street Driveway Permit 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 21A—F. and G min.$100-$1000 fine Doc.Building Permit Revised 2007 Location ,7NL L'lC'4Ye— ��t No. Date / ri D MORT1y TOWN. OF NORTH ANDOVER O F A 9 Certificate of Occupancy $ Building/Frame Permit Fee $ s�cwus l I Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # l� 2 1 9 5 4 - Building Inspector w m x o w° vro- ' a v) 0 w z � b a w x El C2 v c U w 0 w � a a � w O a U a w m c2 v) ro w O a m a�' cn w E. F w � w w v C wg 2 cn 0 E c o m c Cd O C G L) C) CL CL. d C c W Q L co Y r Y z Ots CL r,n p y _00 O 0 O „� aF * o c �O a , E N O y z _cc = o �y� � W E� U av m Cf) y - m L Z 30.1 Of fr\ ® �S� O• C = m 1-�1 V 4 V H O 0 Z .`moo.... vs o. O c Om N O C •C = m�3 N m C*13 go LLJ .ce atC!c Z LU .E O Gam M OL - COD a m��fl zCA .0 moo E-- S CL.- m ::No •I O O co O Z o. O y � C I CCM CD ca ,ca y me Q Y/ = E m m O CD CL = O� � � L o a CL CM< co c� o �p Cc R J 'O .0 Z s co C.3 y C C y I } 11 1 | / ( I | 1-1-1 PFI 171 1-1 --r--T-[-- | / / / [- -- -' | oil --i | F� -TE_I ' ! -r-T -�-- -- -�-- -�--------�-- -T--- ------------ -' -|--'------r--|--'- - - ` --[� '-'| --|--'--' - --r- /--/- -- - --r-�--- --�-'i--F -_-- Al' - The Commonwealth of Manachuseft Department of Industrial Accidents QKiee of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name (B Address: City/State/ZiX/14, A&4-2 .L Phone Are An an employer? Check the appropriate boa: 1. I am a employer with 4. ❑ I am a general contractor and I employees (full and/or -time).* 2. ❑ I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. (No workers' comp. insurance 5. ❑ We are a corporation and its required] 3. ❑ 1 am a homeowner doing all work officers have exercised their right of exemption per MGL myself. (No workers' comp. c. 152, § 1(4), and we have no insurance required] t employees. (No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 mast also fill out the section below showing their workers' compensation polity information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside conimciors must submit i new affidavit indicating stx h. tCormactors that check this box must attached an additional sheet slowing the mite of the sib eorihaetas and thea workers' co policy information comp. po cy lam an employer that is providing workers' compensation insurance for my employee& Below is the policy and job site information. _ Insurance Company Name: Policy # or Self -ins. Lic. #: e�ZC 42 /12— 19! Expiration Date: �� a Job Site Address: / City/State/Zip.-X0A4t. zVWVr 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 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 this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify and th ains and enaldes of perjury that the information provided above is ire and correct Si attire- Date• lL J Phone #: Offleial use only. Do not write in this area, to be completed by city or town offleid 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 #. ACORD. CERTIFICATE OF LIABILITY INSURANCE DAT2008 1 D/YYYY) 06/25/2008 10:29 PRODUCER (800) 225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C. Church, Inc. 40 Kenoza Avenue Haverhill, Avenue 01830 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TYPE OF INSURANCE 800-225-1865 POUCYEFFECTIVE E POUCYEXPIRATK)N INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A Arbella Protection Insurance Company Twomey 1L• Leeare Contracting Inc P.O. Box 366 INSURER B: INSURER C: North Andover._ MA 01845 INSURER D: INSURER E: MERCIAL GENERAL LIABILITY !17CLAIMSMADEaOCCUR 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 HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD' TYPE OF INSURANCE POLICY NUMBER POUCYEFFECTIVE E POUCYEXPIRATK)N LIMITS GENERALLIABIUTY EACH OCCURRENCE S 1,000,000.00 MERCIAL GENERAL LIABILITY !17CLAIMSMADEaOCCUR RNTED PREMSESGE To aEaccurence S 100.000.00 MED EXP (Any one person) S5,000.00 PERSONAL 8 ADV INJURY S 1,000,000.00 A 8500012700 6/22/2008 6/22/2009 GENERAL AGGREGATE S 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S 2,000,000.00 POLICY PROJECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT S (Ea accident) BODILY INJURY (Per person) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE S (Per accident) GARAGELIABILITY - AUTO ONLY -EAACCIDENT S OTHER THAN EA ACC S ANY AUTO AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR LICLAIMS MADE AGGREGATE S S S DEDUCTIBLE S RETENTION S WORKERS COMPENSATION AND I WC STATU- OTH- Y MI R EMPLOYERS' LIABILITY I ANY PROPRIETOR/PARTNERfEXECUTIVE E.L. EACH ACCIDENT S E.LDISEASE -EAEMPLOYEE S OFFICERIMEMBEREXCLUDED? It yes, describe under SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS GL Cert CERTIFICATE HOLDER CANCELLATION City of Haverhill SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 4 Summer Street DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Haverhill. MA 01830 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE P ACORD 25 (2001/08) Client # 5458 Mst # 08/09 Cert # © ACORD CORPORATION 1988 ACORD. CERTIFICATE OF INSURANCE PRODUCER DOHERTY INS AGENCY ELM STREET PO BOX 198 ANDOVER. 11A U181U 22YMX INSURED TWOMEY & LEGARE CONTRACTING INC PO BOX 366 NORTH ANDOVER, MA 01845 COVERAGE DATE (MWDDIYY) 12-16-08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A TRAVEL ER5INDEMNITY COMPANY COMPANY B COMPANY C COMPANY D THIS IS TO CEP.TIFY THAT THE POLICIES OF INSURANCE LISTEU BF10VN HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONOIriOrN OF ANY CONTRALT OR OTHER DOCUMENT WITH RESPECT TO WINCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANDCONDmoNS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDIY rf) DATE LIMITS GENERAL LIABLITY COMMERCIAL GENERAL CLAMS MADE OCCUR. OWNER'S && CONTRACTOR'S PROT. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULE AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTOS EXCESS LIABILITY UMBRELLA =ORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY LIB -02904934-08 THE PROPRIETOR; PARTNERS/EXECUTIVE INOL OFF.CERS ARE: X EXCL OTHER GENERAL AGGREGATE PRODUCTS-CAMP/OP ARG. $ PERSONAL && ADV. INJURY $ EACHCCCURRENCE $ FIRE DAMAGE Any one tire; MED. EXPENSE 'Any one pars3n) $ COMBINED SINGLE LIMIT $ BODILY INJURY (Per Perscn) $ BODILY INJURY (Per Accident) PROPERTY DAMAGE S AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EACH OCCURRENCE $ AGGREGATE $ oe-18-08 09.1809 STATUTORY LIMITS EACH ACCIDENT $ DISEASE - POLICY LIMIT $ DISEASE -EACH EMPLOYEE $ X 500,000 500,000 500,000 DESCRIPTION OF OPERATiONSILOCATIONS/VEHICLES+RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIORCER14FICATE ISSL;ED'TO THE CUT:TIFICATE HULDER tWFECII.N'G v,0RKY9S CO.WPCOVERAUE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF TH£ABOVE 099SCRISM POLICIES SE CANCELLED BEFORE THE CITY OF MFFH-UEI\ EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO VAI_ 10 DAYS WRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT ? i PLEASANT STREET FAILURE TO W..IL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 0= ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. .METHUEN, MA 01844 AUTHORIZED REPRESENTATIVE ACORD 25.5 (3/93) Charles J Clark Bourd'ot Building Pegulati ns and Standards -, HOME IMPROVEMENT CONTRACTOR Registration: 136779 Ezp rat gm,'. 8.QW010 Trf 272934 Typ*:.Par�rzra yip TWOMEY + LEdO t ONA-AdTING INC.. skAwl-nVOMEY..- . 61 PATRIOT ST. N. ANDOVER, 44A 01840-' .. `Adm i&trstor Styndards an ^` �iaeRlat'Or and Board of Bu►iding ervisor License rf �' Construction Sup 0 756 L;ase CS 1966 Tr# 6403 r;trthnate10125! To: Clyde & Joan Hall 74 Stonecleave Road No. Andover Ma. 01845 f,? s� r March 30, 2009 978-686-2348 Thank you for the opportunity to quote the following project. The TWOMEYAND LEGARE CONTRACTING price is based on our discussion on March 18, 2008 concerning your project at the above address. The following is a description of work as discussed. • Renovation of home consisting of new kitchen • Demo 1. Strip drywall 36 inches up off floor at kitchen window to add 1 new casement window. And At stove area for any plumbing or electrical. 2. Overlay kitchen and dining room ceilings for new lighting locations. See allowance page 3. Cut holes in existing kitchen walls to feed new circuits for area. 4. Remove post between kitchen and dining room for island eating area. 5. install new window in same opening. 6. Repair the floor area at cabinet base. 7. Tile floor in existing kitchen / dining and hall floors to remain. 8. Remove all old cabinets and prep walls for new. ( supplied by contractor) • Carpentry 9. All permits and inspections by contractor 10. All painting by contractor. (in kitchen area) 11. Match all new interior trim as close as possible 12. All trim to remain the same in dining room. 13. Replace all exterior trim and siding removed for new window and door. 14. Allowance for design included in cost of project. No charge 15. Pantry opening to remain same size at this time. ( it will change due to new design ) 16. Prep opening in dining area for new single active french door. 17. Insulate areas disturbed by contractor or subcontractors. 18. Owner responsible for removal of personal property in work area. • Plumbing 1. All heat to remain the same. 2. Supply all water and drain pipe needed for new kitchen. 3. New shut offs on water lines • Electrical 1. Supply all electrical demo and new wiring needed for new areas (see allowance page) 2. Additional charge for any smoke or cot detectors. • Window specs 1. 1- new Anderson C -N 235 casement window kitchen • Exterior Door Specs 1- sing active Anderson French door with screen. • Interior Door Specs. • none • Drywall 1. All drywall patches and plastering associated with project by contractor. 2. New ceilings will be sand swirl plaster. ( see allowance page) • Flooring 1. Repair only 3. See allowance page. • Painting 1. Paint - Kitchen & dining area. 2. Blend exterior as close as possible. 3. Owner needs to remove items off walls prior to the start of the demo. • Disposal 1. All related debris removed by contractor. If not listed in these spec sheets consider that it is not included in your project. © Allowances 1. Electrical 2. Kitchen appliances 3. Light fixtures 4. Cabinets 5. Granite with backsplash 6. Tile for repair mat/labor 7. Sink and faucet 8. New kitchen ceiling $ 2,600.00 by owner $ 200.00 $ 14,750.00 $ 3,200.00 $ 275.00 ,$ 1,200.00 $ 600.00 V� Project Total and Payment schedule $ 4 0.00 1St signing of contract � � $ 10,000.00 �`��� $ 34,550.00 2nd The day work starts $ 8,000.00 $ 26,550.00 3rd Completion of plumbing Electrical roughs 4th Install of cabinets no tops 5th 90% of painting and finish work 6th Substantial completion of project and final sign off. $ 10,000.00 $ 9,000.00 $ 6,000.00 $ 1,550.00 $ 16,550.00 $ 7,550.00 $ 1,550.00