The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #249-13 - 80 CHRISTIAN WAY 10/1/2012 `9 BUILDING PERMIT of ,tiec "gtio TOWN OF NORTH ANDOVERrt'' "'`- APPLICATION FOR PLAN EXAMINATIONso Permit NO: 3 Date ReceivedAr �9SSACHUS�� Date Issued: IMPORTTA/NT: Applicant must complete all items on this page LOCATION Yc;) ---- Print PROPERTY OWNER J ��e-(0�/ Print MAP NO:/PARCEL /3 ZONING DISTRICT: Historic District yes n Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial teration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Idpntifica ;/ Please�� e or Print Clearly) % /x"/Z7 /A 7 OWNER: Name: ��i�--� /� Phone: Address: a, �/uD /n� /'�✓� CONTRACTOR Name: ezllfl-�— // t Phone: > Address:_ t55s'7 4yoals' e, 1% Supervisor's Construction License: 0 Exp. 'Date: Home Improvement License: b a2 Exp. Date: 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: $ /00 ©O FEE: $ 2-0 ,Z)'-O Check No.: �,�h�- Receipt No.: 4.5-76 3 NOTE: Persons contracting with unregistered contractors do not have access to theuaranty and Id Signature of Agent/Owner Signature of contract SVLocation !}"V C oe A,,, lu No. '�Ie// Date �U/! / Z— ® ' TOWN OF NORTH ANDOVER 16e Certificate of Occupancy $ Building/Frame Permit Fee $ fC'?u Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# i 25763 uilding 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 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/Sinature& 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 Y 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 NOTES and DATA— For department use ❑ Notified for pickup - Date ........................................................._._..........._....._.............................----........................................._..__._._........................_........................_........................_....................._............................._...._................................._.......................................---.................................._........._._.................. Doc.Building Permit Revised 2008 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o 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) o 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) o Copy of Contract ❑ 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 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 2.2008 I Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 10,000.00 m $ - $ 120.00 Plumbing Fee $ 15.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 15.00 Total fees collected $ 250.00 80 Christian Way permit 249-13 on 10/1/12 Bathroom Remodel tAORTH Town of t a ndover No. � o �^HE h ver, Mass, CoCHICHEWICH A�4^TEe) ►Pp,�,�� S u BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System f � l�� 2 BUILDING INSPECTOR THISCERTIFIES THAT ...........�,I................ ...:............. 4E-:................................................................ Foundation has permission to erect .......................... buildings on ....�..................:�.7� ...�...�... ................... Rough tobe occupied as ......................... .........................-e......c.(�........................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 CONSTRUCTIO RTS Rough Service .................... . .... .....: .-P....,..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE aa4-4., qji"Q'�'et eowuluu)- Uan PROPOSAL Rev. 1 Jim Sherlock 80 Christian Way North Andover, MA 01845 (C) 978-434-1767 jimsherlock25@yahoo.com August 30,2012 Master Bathroom Remodel Work to be completed includes: • Demo of existing floor. Removal of existing toilet,tub and vanity. • Complete all plumbing required. • Complete all new electrical, including new Panisonic Vent unit, switches and plug. • Install vanity and tub. • Install new tile floor. • Install new baseboard heat cover. • Install new baseboard. • Install DenseSheild tile board on floor. • Replaster in around tub and tub walls. • Install new closet door. • Install new beveled glass mirror behind vanity. • Install new towel bars etc. • Removal of all debris. TOTAL LABOR AND MATERIAL $ 7,125.00 Note: This quote does not include any plumbing fixtures,vanity, tile, Grout or granite. Terms: $2,375.00 upon signing of contract(not to exceed 113 of total contract price) $ Work to begin on $4,750.00 when job complete Job to be completed on // i "A Submitted by: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C)508-265-3115 (H)978-704-1165 North Andover,MA 01845 All Home Improvement Contractors shall be registered.Inquiries about a contractor relating to a registration should be directed to; Registration Division,Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor.Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. 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 outlined above. DO NOT SIGN THIS CONTRACT IF THER ARE B A K SPACES! Date �� 7�,�' Homeowners Signature Date .�0 /vt Contractors Signature i Dig p &x/14ZW, v:tv�ojry PROPOSAL Rev. 1 Jim Sherlock 80 Christian Way North Andover,MA 01845 (C) 978-434-1767 jimsherlock25@yahoo.com August 30, 2012 Master Bathroom Remodel Work to be completed includes: • Demo of existing floor. Removal of existing toilet,tub and vanity. • Complete all plumbing required. • Complete all new electrical, including new Panisonic Vent unit, switches and plug. • Install vanity and tub. • Install new tile floor. • Install new baseboard heat cover. • Install new baseboard. • Install DenseSheild tile board on floor. • Replaster in around tub and tub walls. • Install new closet door. • Install new beveled glass mirror behind vanity. • Install new towel bars etc. • Removal of all debris. TOTAL LABOR AND MATERIAL $ 7,125.00 Note: This quote does not include any plumbing fixtures,vanity,tile, Grout or granite. Terms: $2,375.00 upon signing of contract(not to exceed 113 of total contract price) $ Work to begin on $4,750.00 when job complete Job to be completed on Submitted by: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C)508-265-3115 (H)978-704-1165 North Andover,MA 01845 All Home Improvement Contractors shall be registered.Inquiries about a contractor relating to a registration should be directed to; Registration Division,Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel:617-727-3200 ext.25239 All building permits required will be the obtained by the contractor.Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. 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 outlined above. DO NOT SIGN THIS CONTRAgT IF THER ARE . - BANK SPACES! r� Date d 7(Z Homeowners Signature Date Jac' Contractors Signature 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS-072173 CHRISTOPHER F3tIVET 207 WINTER ST s N ANDOVER Mk 01845 r 1 " "'' Expiration Commissioner 06/02/2014 -su OiTice of Consumer Affairs&Ole Regulatir;: -5� '==- HOME- IFROVEMENTCONTnRACTOR Registration: 139962 Type: Txpiration: 9/8/2013 Individual R TOPHER F.RIVET CHRISTOPHER RIVET 2G!WINTER ST. N.;ANDOVER,MA 01845 Undersecretary ® DATE(MM/00/YYYY ��® CERTIFICATE OF LIABILITY INSURANCE OP ID NEMA 02/07/12 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 Macdonald & Pangione Insurance NAME: PHONE FA P.O. Box 428 (Arc,No,Ext): I(AIC,No): 104 Main Street ADDRESS: North Andover MA 01845 P ODUCCUSTOMER CHRIS-5 Phone:978-688-6921 Fax:978-688-5350 INSURER(S)AFFORDING COVERAGE ( NAIC# INSURED INSURER A: Preferred Mutual Ins Co 15024 Christopher Rivet INSURER B: 207 Winter St. North Andover MA 01845 INSURER C: INSURER D: INSURER E: 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. ILICY EFF NSK TYPE OF INSURANCE I INSR I WVD; POLICY NUMBER �(MM/DD/YYYY)I(MM/DD/YYYYPOLICY EXP) LIMITS GENERAL LIABILITY EACH OCCURRENCE 1S1,000,000 A i COMMERCIAL GENERAL LIABILITY j j CPP 0180 57 01 05 109/26/11 09/26/13 (,P'REMISES(Ea occurrence) IS100,000 CLAIMS-MADE _X1 OCCUR I MED EXP(Any one person) s 5,000 PERSONAL&ADV INJURY I $ 1,000,000 ' GENERAL AGGREGATE s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG I s 2,0 00,00 0 f X l POLICY i PRO- JECT LOC I i I S AUTOMOBILE LIABILITY { I ( { COMBINED SINGLE LIMIT I$ (Ea accident) ANY AUTO { { { { BODILY INJURY(Per person) S ALL OWNED AUTOS i I 1 SCHEDULED AUTOS BODILY INJURY(Per accident)`S J I I I � I PROPERTY DAMAGE j S HIRED AUTOS I (Per accident) S NON-OWNED AUTOS 1 ( I i . 1 I �S UMBRELLA LIAB 1 OCCUR ( I EACH OCCURRENCE I S EXCESS LIAB j CLAIMS-MADE AGGREGATE s DEDUCTIBLE j S I I RETENTION $ j I I I S WORKERS COMPENSATION1 I WC STATU- 011-1- AND EMPLOYERS'LIABILITY Y/N I TORY LIMITS I I ER ANY PROPRIETORIPARTNER/EXECUTIV I ELEACH ACCIDENT $ i OFFICER/MEMBER EXCLUDED? E/A E.L_ ' (Mandatory in I;yes,describe under i E.L DISEASE-EA EMPLOYEES ndII � DESCRIPTION OF OPERATIONS below f { I E.L.DISEASE-POLICY LIMIT j s DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder as listed below CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover AUTHORIZED REPRESENTATIVE Osgood St No Andover MA 01845 ©19,888-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization/Individual): Address: City/State/Zip: Phone#: Fre n employer?Check the appropriate box: r7. e of project(required): a employer with 4. ❑ I am a general contractor and I oyees(full and/or part-time). have hired the sub-contractors ❑New construction C211-ama sole proprietor or partner- listed on the attached shget.t Remodeling nd have no employees These sub-contractors have 8. ❑Demolition ing for mein any capacity. workers'comp.insurance. g F1 Building addition orkers'comp.insurance 5. ❑ We are a corporation and its ed.] officers have exercised their 10.El Electrical repairs or additions homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.0 Other Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. Expiration Date: "�' / Job Site Address: �� City/State/Zip: 4, /V o//�.Q 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. I do hereby certify der a pains aldes ofperjury that the information prov7� 77 iand correct Signature: Date: � Phone#: Official use only. Do not write in this area,to be completed by city or town official. 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#: