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HomeMy WebLinkAboutBuilding Permit #463 - 88 FARRWOOD AVENUE 12/13/2006Permit NO: Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applicant must complete all items on this page LOCATION D frxf( �Vyrg 4yr, Print PROPERTYOWNER IJOk�I�S MC',C, a G I _ C Print MAP NO.: 4 dd 15 PARCEL: TVPF AND INF. OF R1111,DING ZONING DISTRICT: HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE i Residential C" ❑ New Building ❑ Addition N Alteration TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition N Alteration 00ne family ❑ Two or more family No. of units: ❑ Industrial ❑ Repair, replacement ❑ Demolition ❑ Assessory Bldg ❑ Commercial ❑ Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFOR] ins -►1) new CO)Apt4eK K&(4 a+Ac) 0)Y1;�9 (dav�l Identification Please Type or Print Clearly) OWNER: Name: Oov5 lqtS M o chef d P Phone: 7P 1- q 6ZAP(1c1' Address: r 0 0�rA/%Wd "d l ylt- 41? CONTRACTOR Name: U S Pro o &,-4 Sc,(v,'( e s W1-3ff-G73S1 Address: b ` 1wc, nJ y) Sy, 4t o 0 Mv.,! 1 dep'1 IV/ A OZ, 1 L/k Supervisor's Construction License: Exp. Date: Home Improvement License: 1(-1-7 16 7 Exp. Date: 6)1S-&-7 - ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE: BULD/NG PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ - ©O FEE:$f 3.d Check No.: Receipt No.: Page I of 4 Locationkt 1w D 40/r, 11Y4� No, l... Date r '� M�RTM TOWN OF NORTH ANDOVER Certificate of Occupancy $ `) s,cNusEBuilding/Frame Permit Fee $ Foundation Permit Fee $ AV Other Permit Fee $ TOTAL $ Check # / l ✓ 19871 Building Inspector TYPE OF SEWERAGE DISPOSAL Public Sewer F1Tanning/Massage/Body Art E]Swimming Pools ❑ Well F]Tobacco Sales ElFood Packaging/Sales El Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ Electric Meter location to project 1►T/lTT _ f. . •.� 1 L. RC1 -13 cv eructing wan unreglsrerea contractors do not have access to the guaranty fund Signature of Agent/Owne y Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEVELOPMENT ❑ COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Building Setback (ft.) Front Yard Side Yard Rear Yard- ardRequired Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA — For department use Page 3 of 4 Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC. Jan1006 ■ 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 U/ Building Permit Application d Workers Comp Affidavit u/ Photo Copy Of H.I.C. And/Or C.S.L. Licenses Y Copy of Contract w,/Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 Page 4 of 4 ✓ '' � '�7f � C"�---ail ? 39 Famvood Avenue, Unit #1 North Andover, Massachusetts 01845 Telephone (978) 685.4434 Fax(978)685.052, December 11, 2006 To Whom It May Concern: Mr. Douglas Malhado resides at 88 Fanwood Avenue Unit # 8 North Andover, Massachusetts 01$45. He bias requested a letter from, Heritage Green Condominium Association stating that we give him permission to renovate his unit The renovation must be in accordance to the Construction Rules of Heritage Green Condominium Trust and Town of North Andover's code. The plumber needs to provide the Association with a letter stating what he is doing, what was thtarted, ere before the work was s That after the heating pipe is removed that the heat adequate to perform to accepted industry standards, itt�wil as Proposed Unit unit as necessary, be ary, If the above conditioners are in compliance with the Town of North Andover and Construction Rules of heritage Green I see no reason why the work cannot be completed. Please feel free to call me if you have any questions ar concerns before a permit is issued Sincerely, „ Rosann Cxofolo Assistant Property Manager Heritage Green Condominium Trust Cc: File -'oard of Trustees I, E65 L -Z99 l8G "l yVy 'Janopuy n yN 9L4zo vw'aso layy Iffft- r. lm3S WeUdfl Ll l ; uayoli>, sel6noa ll dZaN r 101 — -10� 290,eer r�� �I Z w O O FM4 1 rA W A oc ao cc Cc 0000 =ID cc S 'om :a1 E a ti ' WZ 04.Q O Y: l <v W yr m 1 J F o Q u QO h ,�: •: •� Z f NG o w c r � E a mm o z ti z U) . 21. 0.3 ��CA r� o� ::c oco)N W O W may U m E ,o C m o _ v mCD (� oCCD ob so w 0 C C H nC C = m 4D 3 N �mca Aml �� _w H .vm, atmc Z � r Cuj 3 `m v�v� O 5 � 0 COD CL CL o = w d vs m 1 -to O O f- t $ _ /�-� ..m � -kq", U O 0 v TIT CO) CD CD am C. CD 0 Q ccEL- Cie O O O CL CO) 0 ev c cc ME CO2 ,moo ev � 3 .o O o t �a O C. ca O .O CD Z s CDCLC44 c LLI W W W oc W U) v u v cn 94 0 A � vC 'b o w o w v x U w" a W a o nG G ii a w � o 0: u G w" a a � aG r w r� w W Via+ Acn r o cn rA W A oc ao cc Cc 0000 =ID cc S 'om :a1 E a ti ' WZ 04.Q O Y: l <v W yr m 1 J F o Q u QO h ,�: •: •� Z f NG o w c r � E a mm o z ti z U) . 21. 0.3 ��CA r� o� ::c oco)N W O W may U m E ,o C m o _ v mCD (� oCCD ob so w 0 C C H nC C = m 4D 3 N �mca Aml �� _w H .vm, atmc Z � r Cuj 3 `m v�v� O 5 � 0 COD CL CL o = w d vs m 1 -to O O f- t $ _ /�-� ..m � -kq", U O 0 v TIT CO) CD CD am C. CD 0 Q ccEL- Cie O O O CL CO) 0 ev c cc ME CO2 ,moo ev � 3 .o O o t �a O C. ca O .O CD Z s CDCLC44 c LLI W W W oc W U) CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YY), 03/21/2006 PRODUCER Al Ponte Insurance Agency Inc 819 Cambridge Street Cambridge, MA 02141 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CERTIFICATE HOLDER. THIS DoE NOT AMEND, EXTEND OERS NO RIGHTS UPON TRAL ER THE COVERAGE AFFORDED BYITHEE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A.I.M. Mutual Insurance Co LETTER A INSURED US Property Services Corp 6 Pleasant Street Unit 217 Malden, MA 02148 COVERAGES 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 RESPECTTO 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. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY) DAT POLIC��6i LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY LAIMS MADEE:::pCCUR OWNER'S & CONTRACTOR'S PROT. $ $ PERSONAL & ADV. INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one tire) $ MED. EXPENSE (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ EXCESS LIABILITY MBRELLA FORM THER THAN UMBRELLA FORM EACH OCCURRENCE $ AGGREGATE $ A WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ � PARTNERS/EXECUTIVE OFFICERS ARE: EXCL OTHER \ 6007410012006 01/27/2006 01/27/2007 X WC STATU- OTH- TORY LIMITS I IER EL E $ , EL DISEASE--POLICY LIMIT $ 500,000 EL DISEASE--EA EMPLOYEE $ 100 OOO DESCRIPTION OP OPERATIONS/LOCATIONS/VEMCLES/SPECIAL ITEMS WORKERS' COMPENSATION COVERAGE APPLIES TO MASSACHUSETTS EMPLOYEES ONLY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE UIS. Property Services, Corp. r G Pleasant Street, Suite 504 Ilden, MA 02148 x ' h Iv General Information Proposed by: U.S. Property Services, Corp. Office Hours: 6 Pleasant Street, Suite 504 Telephone: Malden, MA 02148 Fax: Submitted To: New England General Services Work Performed At: Attrt. Douglas Machado 88 Farrwood Ave. North Andover, MA 01845 ` (781) 962-8045 W:Description: Interior PROPOSAL NO. 3255 PAGE NO. 1 t?AiE 11/30/06 Monday — Friday: 8:00am — 4:00pm (781)388-0738 (781) 388-0788 88 Farrwood Ave. North Andover, MA 01845 Work Description We h4eby propose to furnish the materials and perform the labor necessary for the completion of the work described herein - and td commence on the date listed above: Install new cabinets and countertop between kitchen and dining room - where half -wall used to be ' Remove 4' of heating equipment to make room for new cabinets and countertop III'.Exceptions HVAC Carpeting Electric Fire Alarms / Sprinkler Systems All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work, and completed in a substantial workmanlike manner for the sum of One thousand two hundred and 00/100 Dollars ($ 1,200.00 ) Payments to be made as follows: 1/3 deposit, 1/3 work in progress, 1/3 at project completion *Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. **Note — This proposal may be withdrawn by us if not accepted within 30 days. Respectfully Submitted Frank Gomes On behalf of U.S. Property Services, Corp. The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. P yments will be made as outlined above. Date l �� 3o — otl 2 Signature Date Signature U.S. Property Services, Corp. - Tel: 781-388-0738 - Fax: 781-388-0788 www.uspropertyservices.com • info@uspropertyservices.com ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 6/7/06 PRODUCER AL PONTE INSURANCE AGENCY INC. 730 CAMBRIDGE STREET CAMBRIDGE, MA 02141 617-492-7600 THIS CERTIFICATE I5 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, INSURERS AFFORDING COVERAGE NAIC# INSURED US Property Services Corp 6 Pleasant Street Malden, ma 02148 INSURERA: Western World INSURER B: INSURER C: INSURER 0' 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 HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM ) DATE(MMlDO/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1 OOO OOO COMMERCIAL GENERAL LIABILITY ICU PREMISES (Ea ocurence) S 50,000 CLAIMSMAGE l=1 OCCUR MED EXP (My one Person) $ �j 000 A r— NPP871520 1/19/06 1/19/07 PERSONAL BADVINJURY s 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG S POLICY jEa LOC AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (EeecrAwt) S BODILY INJURY (Perperson) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Perseeident) S HIRED AUTOS NON-OWNEDAUTOS PROPERTY DAMAGE $ (Pereccidenl) GARAGE LIABILITY AUTO ONLY -EA ACCIDENT S OTHERTHAN EAACC $ ANYAUTO AUTO ONLY: AGO i EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE S OCCUR CI CLAIMSMADE S S DEDUCTIBLE RETENTION $S WORKERS COMPENSATION AND TORY LIMITS I I ER E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPRIETORMARTWRIEXECUTIVE OFFICERNEMBER EXGWDED4 E.L. DISEASE • EA EMPLOYE S E.L. DISEASE - POLICY LIMIT S If yes, deacribounde r SPECIAL PROVISIONSbobw OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS IVEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PR5VISIONS ........� ..ten... a.cR nr wn � c nvw�n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT101 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAILI. 0 _ DAYS WRITTEN 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations uv� 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ' / Please Print Legibly 4A Name (Business/Organization/Individual): � PfOP 4� kljy ! U f Address: - 6 MAJC",14 54. svl, � L Iil ' City/State/Zip: M, -h Li> 1"M oZ7f-)T Phone#: Are ypu an employer? Check the appropriate box: 1. I am a employer with 3 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 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.] officers have exercised their 3111 am a homeowner doing all work 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 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box #I 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. y� J _ Insurance Company Name: A , •� % ! i44 Y14 -LiiS k lot fit- r �,(j'✓�E%%t t'1'J Policy # or Self -ins. Lic. #: 6 G�7 `�l i�G � 00'b Expiration Date: % 7 Job Site Address: fWend � Y City/State/Zip: N/, d"idrwrmm 0 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_ceftify under thepains andpenalties ofperjury that the information provided above is true and correct. Phone#: V 7s:1-3kf.:0 V9 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 #: I Information and Instructions Massachusetts General Laws chapter 152 requires all employers 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, express 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 including the legal representatives of a deceased employer, or the receiver or trustee 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 maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a 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 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and 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 required to carry workers' compensation 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 be 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 the Department of Industrial Accidents. Should you have any questions regarding the law or if you 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 number 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 contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license 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 that 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 future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The 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 Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia