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HomeMy WebLinkAboutBuilding Permit #668-11 - 89 HERRICK ROAD 4/5/2011Permit NO: Date TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION IMPORTANT: J must Date Received all items on this r� 22 Print MAP NO: PARCEL:, O'—ZONING DISTRICT: Historic District yes o` Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family 0 Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p Se tic p -Well' # • pA. D Flood laim ❑ Wetlands p'_ 0 Watershed'Distr ct, l] Water/S,ewe ° OWNER Address OF WORK TO BE PERF 0 CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Z� ?J� Exp. Date: Home Improvement License: I' 5 b Exp. Date: r7 a 1 ( -2— ARCH ITECT/ENGINEER ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT., $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ FEE: $ a�® Check No.: oL Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swunmmg 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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Com Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS Located 384 Osgood Street no 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 2008mi 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 rin g g Affldavlts 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 10TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit i all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Locatiorw,O� No. kz, e Ll— Date SZI �OR,M TOWN OF NORTH ANDOVER 9 Certificate of Occupancy Nus Building/Frame Permit Fee $ Foundation Permit Fee $ r Other Permit Fee $ J TOTAL Check # 24u% -db Building Inspector 7O z WD 9- O"a oa � o w � v cn o U � a b o w o r� U G w A. o cww" G w o c� cnw" oCZ w ii. - W cn - 0 cn ui am C2 2 :a o , CJ CJ t� mcc:A :OAC .a :r o � o LCD :m y � i m C -W 0 $ c y EE Z :.E ® O C.3 tscm A •�� me E � CL= a !CM � y > 3 •. •: C m 'Cc U) 0 C C C O O 'CD O w U CLL3 m y r/) t t O cm c O Q 'O ' CL== m PFL1 O O -4 CC -32 y O C3 �W•�Z O •+ C � O C Q m : ■- O C •p t„ 3 N F- w vi o$~ m Z COD .� LL .y m A W O F- y �C = Z ac �E ca fl v `D o ®� c g. ND O' m 'fl 0:6 COD .0 cm F� .0 r0.■ d w m i v O O 6. O co 0 E m• L O s Z . C. 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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(les) 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 CONTACT NAME: NORTH ANDOVER INSURANCE AGENCY, INC. PHOE A/CN No, Ext: (978) 686-2266 F, No): (978) 686-6410 AC ADDRESS: cfernandez@nafins.com M.J. FOSTER INSURANCE SERVICES 163 MAIN STREET RODUCERCUSTOMER ID #.RODDEN CARPENTRY PRODUCER-CUSTOMER INSURERS AFFORDING COVERAGE NAIC# NORTH ANDOVER MA 01845-2508 INSURED INSURER A MERCHANTS INSURANCE GROUP 23329 RODDEN CARPENTRY INSURER B :HANOVER INSURANCE COMPANY 47 PRESCOTT ST INSURER C ACE PROPERTY CASUALTY INSURER D 2/01/2012 INSURER E NORTH ANDOVER MA 01845— 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. INSR ACCORDANCE WITH THE POLICY PROVISIONS. ADDL S B AUTHORIZED REPRESENTATIVE POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDNYYY) (MMIDDIYYYY) LIMITS A GENERAL LIABILITY BOP1054995 2/01/2011 2/01/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS -MADE FxI OCCUR / / / / MED EXP (Any one person) $ 15,000 PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 / / / / POLICY 7 PRO LOC / / / / FLL $ 500,000 B AUTOMOBILE LIABILITY ADN8336670 07/16/2010 07/16/2011 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 100,000 ANY AUTO ALL OWNED AUTOS / / / / BODILY INJURY (Per accident) $ 300,000 X SCHEDULED AUTOS PROPERTY $ HIRED AUTOS / / / / (Perracdent)AMAGE 100,000 NON -OWNED AUTOS / / / / $ $ UMBRELLA LIAB OCCUR / / / / EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE / / / / DEDUCTIBLE _ $ / / / / $ f RETENTION $ / / / / C WORKERS COMPENSATION WC46393120 01/01/2011 01/01/2012 XWC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N / / / / ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? ❑ N/A / / / / (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 100,000 If yes, describe under / / / / DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 77 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009109) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD 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 120 MAIN STREET NORTH ANDOVER MA 01845- ACORD 25 (2009109) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD F R O M RODDEN CONSTRUCTION 47 Prescott St. , North Andover, Ma. 01845 office 978 687 2934, cell 9783370690 PROPOSAL Page No. 1 of 1 Pages We hereby submit specifications and estimate for: Supply materials and labor for a total kitchen renovation. Remove existing cabinets, counters and plaster ceiling. Electrical will include new recesed lighting and the installation of additional outlets. Plumbing will include reconnecting the appliances and installing a new sink and faucet supplied by owner. New plaster ceiling to be blueboard and plaster skim coat. Granite counters by others. No painting is included. All permits will be supplied and all job debris will be removed. Work to be done for a fixed fee of 1500.00 plus time and materials. All materials and subcontractor billing will be at cost with no markup. We hereby propose to furnish labor and materials - complete in accordance with the above specifications, for the sum of Thirty thousand estimated. dollars ($ 30000.00 ) with payment to be made as follows: Job start = 5,000.00. All other payments to be made as work progresses and invoices are submitted. All material is guaranteed to be as specified. All work to be completed in a` workmanlike manner according to standard practices. Any alteration or from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the agreements contingent upon strikes, accident or delays beyond our control. ThisVTF acceptance days and it is void thereafter at the option of the undersigned. _J Authorized Signature 0 1 U3 ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. ACCEPTED: Signature U DATE 03/22/10 Signature -Z Contractors Forms Form No. EZ 110 PROPOSAL SUBMITTED TO: PHONE 978 683 0036 DATE 04/05/2011 NAME Jack Garvin JOB NAME STREET 89 Herrick Rd. STREET CITY North Andover CITY STATE STATE Mass We hereby submit specifications and estimate for: Supply materials and labor for a total kitchen renovation. Remove existing cabinets, counters and plaster ceiling. Electrical will include new recesed lighting and the installation of additional outlets. Plumbing will include reconnecting the appliances and installing a new sink and faucet supplied by owner. New plaster ceiling to be blueboard and plaster skim coat. Granite counters by others. No painting is included. All permits will be supplied and all job debris will be removed. Work to be done for a fixed fee of 1500.00 plus time and materials. All materials and subcontractor billing will be at cost with no markup. We hereby propose to furnish labor and materials - complete in accordance with the above specifications, for the sum of Thirty thousand estimated. dollars ($ 30000.00 ) with payment to be made as follows: Job start = 5,000.00. All other payments to be made as work progresses and invoices are submitted. All material is guaranteed to be as specified. All work to be completed in a` workmanlike manner according to standard practices. Any alteration or from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the agreements contingent upon strikes, accident or delays beyond our control. ThisVTF acceptance days and it is void thereafter at the option of the undersigned. _J Authorized Signature 0 1 U3 ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. ACCEPTED: Signature U DATE 03/22/10 Signature -Z Contractors Forms Form No. EZ 110