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HomeMy WebLinkAboutBuilding Permit #612-12 - 88 HILLSIDE ROAD 2/23/2012TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: y 4o)R T ANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER ,(-ky S Unit # �Ie Print MAP NO: PARCEL: /� ZONING DISTRICT: Historic District yes -no Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition 0 Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p -he ® RUE- ���y � ;� � }arVJa p o d ui� �® etlands" �PWU�W402aerARC ..Z ct .'` ll (,/, 9, A e 4�-C V J7_' 1. _ svI 4,rUCOK iggA-n IiD �✓� ( r) t= Q (� �vaL d &Lrk if,-(( lkl c&J ('i� c P l �l�✓�vS _(Identification Please Type or Print Clearly) OWNER: Address WA CONTRACTOR/ /Name: n(f j��,.. , (,�,�, Phone: Address: Supervisor's Construction License: 5' S Exp. Date: Home Improvement License: f 8 Exp. Date: ARCHITECT/ENGINEER Phon Address: Reg. N _ 9-29 6 (g-� C s?c-Z, FEE SCHEDULE: BULDING PERMIT. $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $_ !Aa go FEE: $ � Check No.: ��/G�' Receipt No.: !9 1// NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 1� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑Swimming Tanning/MassageBody Art ❑ 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 PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comm 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 lyes ion, mast or service drop requires approval of Electrical InspectorNo DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine Doc:.Building Permit Revised 2011 Jundmi 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 o 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 theBoard 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 rnust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Location No. Date Check#_w 25041 TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL --60 4 Building Inspector '+-y ft,.a+l0411SStiC$S Reo %Y. c vtENT CONTRAmy on CTOR n. o Registration X65582 Expiration 3/2!2012: Tr# 294059 � Type Corporation NEW13URYFORT HOME IMP.RO\lEMENT ANTHONY LOWTHl'_ F2 11 LUNT ST NEWBURYPORT lu1A01950,�,. Undersecretary 0e*j flrlit't➢t d►t Public 'Siff t% $c:tiatrtl of Buiitlirts;,R -e-go.11tiojis <tntJ S,lat�a4f tt t45 �> Cons ruction Sub` ervisor License License: CS 85395 ,1 ANTHONY J LOWTHER�� PO BOX 1265 { NEWBURYPORT, MA 01950 Expiration:, 12/17!2012. t',+�rinii:�i„n�r• 9530 Trt: Newburyport Home Improvement Services LLC Po Box 1265 11 Lunt Street Newburyport MA 01950 978-618-6302 Jem Property Group 88 Hillside Ave North Andover MA Insured by Hub International Licensed MA CS85395 RIC 165582 We hereby submit specifications and estimates for work to be performed and Materials to be used. 1. New kitchen cabinets Stainless appliances and granite in kitchen. 2. Repair and refinish hardwood floors. 3. New bath fixtures in 2'h baths with new relocated master bath 4. New windows in front of house. 5. New heat and ac 6. Repair roof. 7. New interior doors and hardware. 8. Remove extra asphalt, fill in old pool and regrade 9. New rear 6 ft slider door to replace French door in family room 10. New interior paint 11. Minor landscape 12. Fix electrical with new breakers and trims and lighting. 13. Skim coat garage floor and install 21olly columns in garage. 14. Fire place TBD $40500.00 See payment schedule Extras New windows in bedroom $6-700 estimate Fix top of chimney and cap$ TBD Hydro seed $? TBD Any and all paint touch ups are the homeowner's responsibility Any extra work or changes will be a cost of time and materials agreed upon by both customer and contractor. 0 6 �ix-� oov,o Construction related permits: The contractor under provisions of the general laws is required to apply for and obtain all construction related permits unless customer requests permit on their own. The contractor shall not be deemed responsible for delays in the work described in the agreement caused by regulatory, permit granting or inspection agencies, agencies, authorities or Individuals On Site Signage: Contractors shall display a business sign on location while work is in progress. Work Schedule: Contractor will not begin work or order materials before the third day following the signing of this Agreement, unless specified here in writing. Contractor will begin work on or about 2-21-12-lOBarring any delay caused by circumstances beyond the contractors control, the work will be completed by4-17-12 .The owner hereby acknowledges and agrees that the schedule dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered violations of this Agreement. Warrantv: Acceptance of this contract — I have read this document and except the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payments will be made as outlined above. You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Cancellation must be done in writing. I HEREBY CONFIRM THAT I HAVE READ AND UNDERSTAND THE ABOVE TERMS AND HAVE FREELY SET MY HAND AND SEAL BELOW. Signature: ! Date Managing Member Newburyport Home Improvement Services LLC Signature: +��S T Date �- Z v 2. Customer 0 Q n. I--c— 0 O z O y � C •p- ev c O.G.. �: ed cD N \`E a \: o n C a v o CD h � m� •p T m W A �mo cc H m m � =CD O Q! p C Its m g v tv >Z O 0 C In `- mCD C fl.w O *O•' h m S~ i tv s 0 0 �, c ... .y A R C C :s i 'E caL- C3 10 � •c CD CL cD m.0 Go .0 W a- 0 y �O • z S CL 1= if yL... h O i CO C O c CD G: C> 32C m O CD G •C N CD r 0 Z 0 cm zoo U 0 COz u CO R CD O ai ■ L CD z p. O H ® c CD cm ca G CD LA c E mCD 0 CD m 0 0 d a �a c y 0 .6" C ccC ■V J .0 co C z CD ci y R C CL CO2 G LLI LLI U) 19 W W U) O OF a ' o U a w w a v E q 00 CO w° cn w° U w w �n w ww" m cn cn 0 O z O y � C •p- ev c O.G.. �: ed cD N \`E a \: o n C a v o CD h � m� •p T m W A �mo cc H m m � =CD O Q! p C Its m g v tv >Z O 0 C In `- mCD C fl.w O *O•' h m S~ i tv s 0 0 �, c ... .y A R C C :s i 'E caL- C3 10 � •c CD CL cD m.0 Go .0 W a- 0 y �O • z S CL 1= if yL... h O i CO C O c CD G: C> 32C m O CD G •C N CD r 0 Z 0 cm zoo U 0 COz u CO R CD O ai ■ L CD z p. O H ® c CD cm ca G CD LA c E mCD 0 CD m 0 0 d a �a c y 0 .6" C ccC ■V J .0 co C z CD ci y R C CL CO2 G LLI LLI U) 19 W W U) A COR©,. Client#: 82154 NEWBURYPOR4 CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF I 02/02/2012 NFORMATION 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: N tfie certificate fioider is an ADDITIONAL INSURED, the poliey(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 certiftcate does not confer rights to the certificate holder in lieu of such endoMITI tls). PRODUCER HUB int'l New England (WILSB 299 Ballardvale St , Wilmington, MA 01887 INSURED Newburyport Home Improvement Services Attn: Tony Lowther PO Box 1265 Newburyport, MA 01950 CT NAME: Diane Keenan PHONE N Ext 9978-661-6635 aC Nc 866-460.8786 ADORIESS: diene.keenan(Whubinternational.com INSURERS) AFFORDING COVERAGE NAIC 0 INSURER A: Commerce Insurance Co 34754 INSURERS: Travelers Indemnity Co of Ameri INSURER C : INSURER D : INSURER E : COVERAGES CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE RNAMED BEEN ISSUED TO THE INSURED ABOVEVISION EFORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IS SUBJECT TO ALL THE TERMS, IN TYPE OF INSURANCE X0- —DL UB POLICY EFF POLICY EXP INSR POLICY NUMBER MMJDD/YYYY MMIDD OMITS A GENERAL LIABILITY BBWHJW 9/06/2011 09/06/2012 X COMMERCIAL GENERAL LIABILITY EEDAACMMHqq��OEECCCrURRENCE $1,000,000 CLAIMS MADE l OCCUR PREMISESOEa NTED occurrence) $1 OO,000 MED EXP (Any one person) $5 000 PERSONAL S ADV INJURY $1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY jE� PRODUCTS - COMP/OP AGG $2,000,000 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO Ea accid;;t)$ ALL OWNED SCHEDULED BODILY INJURY (Per person) $ AUTOS AUTOS NON -OWNED BODILY INJURY (Peracadent) $ HIRED AUTOS AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EXCESS LUU3 CLAIMS -MADE EACH OCCURRENCE $ DED ION $ RETENT AGGREGATE $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IHUB7092X814 6/23/2011 03/03/201 $ X WC ST OTH- OFFICEWMEMBER EXCLUDDED? ECUTIVEY/N� N J A ITUMli- MITS FR — E.L. EACH ACCIDENT $100,000 B (Mandatory In NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $100,000 DESCRIPTION OF OPERATIONS bet ow E.L. DISEASE - POLICY LIMIT $500OOO DESCRIPTION OF OPERATIONS / LOCATIONS J VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space is required) Evidence of Coverage Member, - officer, sole proprietor excluded. Evidence of Coverage - 24 Hewitt North Andover,MA. 01845 Avenue, CERTIFICATE HOLDER ceulrcr r eTrn., Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 Osgood Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover, MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01 SEENTAle TITIVEE UT� ACORD 25 2010/05 ©1988-2010 ACORD CORPORATION. All rights reserved. ( ) 1 of 1 The ACORD name and logo are registered marks of ACORD #S673088/M584096 DK001