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Miscellaneous - 59 APPLETON STREET 4/30/2018 (2)
59 APPLETON STREET 210/037.6-0034-0000.0 Date..... b1`!..'... .(.!..��.......... �r►ORTH, TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION �c�c�ss T Lhis certifies ......... that . �l�U r�vc t4 { ................ ............`? ........................:...................................... has permission for gas installation ....... 21 inthe buildings/of...................�..................... .................................................................... at...3 .;��t'f .ay.......�T,, North�Andbver Mass. Fe� vLic. No. ....... ....... ...........,... ........................... GAS INSPECTOR Check# ' U667 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY North Andover_ _ _— � MA DATE 12116115 ! PERMIT# JOBSITE ADDRESS 59 Appleton St :OWNER'S NAME Mark Duncan GOWNER ADDRESS 59 Appleton St � � _ ___� � TEL 508-726-2817 _ ;FAX TYPE OR OCCUPANCY TYPE COMMERCIAL _ EDUCATIONAL RESIDENTIAL.+' PRINT CLEARLY NEW: + RENOVATION: REPLACEMENT: _ PLANS SUBMITTED: YES NO F APPLIANCES-1 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER I BOOSTER i ' CONVERSION BURNER _a J COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE —_J -- _. , . i --- -- .; ; - 1- -- ., - - --' FRYOLATOR ' FURNACE GENERATOR _1....J GRILLE i _ _ _! INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN j POOL HEATER ROOM I SPACE HEATER _ ; _ _ _� _..__� .�-1 �_.j _ ROOF TOP UNIT _ J i ? TEST i UNIT HEATER t UNVENTED ROOM HEATER WATER HEATER ' OTHER J _ i INSURANCE COVERAGE have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO _ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY .—! BOND - OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER -1 AGENT .._ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Richard Bowman LICENSE# 13496 SIGNATURE MP 1i MGF _.., JP t JGF _ LPGI _ PARTNERSHIP _ -.'# COMPANY NAME: Bowman PI_umbing.Services ADDRESS 6 Home St CITY Bradford N u STATE MA `ZIP 01835 TEL 978-994-6207 FAX __ _ t CELL 978-994-6207 EMAIL BPSMASTER@�OL.COM \vx- ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES _ Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: S PERMIT# _ PLAN REVIEW NOTES I I DD @n6@g Webb, P.E. ERmcRura1 Eng0nam Roaftg,HA 09865/ (781)779-9330 STRUCTURAL AFFIDAVIT Project: dd. ionrat�� �19 Appleton StreetL7 Ando_ver August 11,2007 Building Inspector North Andover 1600 Osgood Street North Andover,MA 01845 Dear Building Inspector, I, Daniel Webb, P.E. was retained to serve as the engineer of record for the above- referenced project. In this capacity, I reviewed the original architectural drawings, performed structural calculations, and prepared structural framing plans. I completed a final inspection on August 8,2007. On the basis of this work, I certify that to the best of my knowledge, information, and belief, the structural work associated with the above-referenced project complies with the structural provisions of the Massachusetts State Building Code 780 CMR-6, with my original framing plans and approved field modifications, and with accepted construction practice. Please feel free to call if you have any further questions about the structural work on this project. Regards, ����N OF Mgrs �lo� DAM gW Daniel Webb,P.E. ctu y .4 752 Date.!�...... ..... ... &oRTH '°�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ~r ,SS�CMUSE� s This certifies that �� C n ......................................... ............:.!..9...�..v........�....<...«......�... ........ has permission to perform . .7........................... wiring in the building of....'� ....A 7 7/1.......OX'.'.......................... at. pI ' ....... ✓ s''� .................. .Noot Andover,Mass. Fee/0-r�......... Lic.No. E-3 I � .. ............. .... ........................ .... . . ....... . . . ELEGTRI AL NSPE R Check # 3 7444 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. P ' , BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked AZ- .[Rev. leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 6/7/07 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 59 APPLETON ST Owner or Tenant VALLENTE RESIDENCE Telephone No Owner's Address 59 APPLETON ST Is this permit in conjunction with a building permit? Yes X No❑ (Check Appropriate Box) Purpose of Building BEDROOM AND BATH ADDITOU4 . Utility Authorization No. Existing Service 100 Amps 120/208 Volts Overhead X Undgrd ❑ No.of Meters 1 New Service Amps Volts Overhead a Undgrd No,of Meters Number of Feeders and Ampacity 2- 15 AMP CIRCUIT 1-20 AMP CIRCUIT. Location and Nature of Proposed Electrical Work: VALLENTE RESIDENCE 59 APPLETON ST WIRE NEW ADDITION Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 2 No.of Hot Tubs Generators KVA No.of Luminaires 3 Swimming Pool Above ❑ In- ® o.o mergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets 6) No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of election and Initiating Devices No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals:p Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection v No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Waterof No.of Heaters KW No. Signs Ballasts Data Wiring: No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring• No.of Devices or Equivalent OTHER: Attach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: 2400.00 (When required by municipal policy.) Work to Start:6/6/07 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless y the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) I certify,under lite pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: GUILLHERME MONTEIRO ELECTRICIAN LIC.NO.: E30608 Licensee:GUILHERMRE MONTEIRO Signature X.1C.NO.: E30608 (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 978-618-7508 Address: 15 BOLTON ST HUDSON MA 01749 Alt.Tel.No.: 978-618-7508 *Security System Contractor License required for this work;if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. Owner/Agent PERMIT FEE. $ Signature Telephone No. H.. Date.9 .U.?. .f.. �� f NORTH o� '` •° TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION gs9SSAC NUSEt . . . . . . . . . . . . . . . . . . This certifies that . �Jnf?�'�! !j . /� has permission for gas installation . . . Ph ./9.0:7. . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . .. North Andover, Mass. Fee. �.° o. _Lic. No.��1.1. 5. . .�`.�.11%. . . . . G INSPECTOR Check# 6134 MASSACHUSETTS UNIFORM APPUCATON FOR PERVIPT TO DO GAS FTrnNG (Type or print) Date ?,P70►'YlAge /R, aoo 7 NORTH ANDOVER,MASSACHUSETTS Building Locations .3�9 /g/�PLG7�/7 eeT Permit# _ rc Owner's Name Amount$ a New Renovation Replacement Plans Submitted a cn w w a0 v, x 4 O w w c4 p O C z H y V U w x Z EF rig a cY, � d W W � � d x a x w OG � � A F x z W > W a F E. v� Z O z W O 46 x a x o x 3 c .da ° a° > a a0. F o SU B -BASEM ENT ! BASEM ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR STH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or-�ppe) nn Check one: Certificate Installing Company Name CZkAA2A1e(r— i'�itn�lR:ho d Cly 4 L7`.� . Corp. Address 1 �C'�'IP�4s�1�i` ElPartner. 8 Business Telephone _ Firm/Co. Name of Licensed Plumber or Gas Fitter _ /4/lL�s �j /(/ 9► 7` INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No� If you have checked ves,please indicate the type coverage by checking the appropriate box. Liability insurance policy ®' Other type of indemnity D Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner El Agent 1 I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General L ws. A4, By: Signature of Licensed Plumber Or Gas Fitter Title 13 Plumber a/8 9 City/Town 1:3 Gas Fitter License Number 171 Master APPROVED(OFFICE USE ONLY) 13 Journeyman Location No. _*J l/ Date j 1 a TOWN OF NORTH ANDOVER 1 ;• LA Certificate of occupancy ncy $ Building/Frame Permit Fee $ �,b''•"''<� Foundation Permit Fee $ Ss�C U Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL rj$ S Building Inspector �1 2 815198 08:59 25.00 PAID 1 L G Div. Public Works Location ` No. ' Date NORTH TOWN OF NORTH ANDOVER y f 1 0 ?0•,,`,o .••ti0 9 Certificate of Occupancy $ Building/Frame Permit Fee $ ' Foundation Permit Fee $ Ss�cHusE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ t TOTAL $ r r Building Inspector r 1'MMS 3M:59 25-00 PAID + Div. Public Works Z, R1A I E'ItNil IT NO. ® —APPLICATION I'OIl 1'1?RR11'h '1'O 13UIL1)********No R'I' I ANI)OVI�.I nl\1'No . t• I.i)I.N0. Q� 2. Ill.(Y)IIUUt (r11'NIIvoill' DA Ill, IMOK PAC /T IN t. stiB DIV. I NI-N(r. 1 111 A Ill INJL I't IltlY ISI:1 x Bt III I IRJ(i �- ^ _ _ NO. "ISIOPIL$ l)WN1:R'S ADDRESS BASI?.11-141 OI(SLAB ST (���A �- �' ``�� �/'� ���^.—��'- 3 LTi--------------- >Rl'LIll F.('1'SNA1.11:N S171.(HIL(x)t1IKIM:Rs - ----.__..-.---,..---- lit Ill I)I:R'S NAnIE SPAN 1)151 ANCI-..1()NLARFS 1 13UII DING DINiFNSI(NJS OF SII 1.s DIS I ANCL I K(),I S I RIA,I DIt'll Nsl(Nds(x:I os 1 S 1)ISIANCLI-R(,)ti101LINES-SINES REAR - 1)lt.11iNSIINJSofGIRDERS AREA CN:LOF IRO MAGE IILI(-,I111A I:OUNDAIION T1IICK NESS --- IS BI HIDING NEW 51/1-01 I(X)I ING x 15 BUILDING ALTERATION IS BUILDING ON S(.X_ID<R Fit I ED LAND \1`II L Bt)tl.DIN(;CONF(MIM TO RI QA lIREMEN I S OI CODE IS I3UILDIN(;Co NNECI EI)1 O TOWN WA1I- — -- BOARD([APPEALS ACI", IF ANY IS 13111L1)INGC(NJNECI1 1) 10 IOWN SEWLIt IS Bt11LDI NG CONNECI LD 1 O NA I URAI.(;AS I.INL INS we-ilONs 3. PROPER 1'Y INFORAIA PION I AND COSI / ES 1. 1311X1. COSI' ------ + PAGE I Fit L(x1ISF.cll(NJs 1-3 LS r. Bl lx;. ClrSl PER SI). FI. ES I. Bllxi. (-OSIPER WXX1 EI Wi RIC KIF I LRS MUST BE ON(X ITSIDE OF 13UII.DIN(i IlC ' 1{h SLIT IC PLkMI I NO. --_—_ -- --- A1'lACI IEI)GARAGES Nwsl ccNJFOKM I-()srATEIIRE REGI 11AIIONS a. Arritovu-1) 131- L Y PI-ANS L1l1Sl [if-FII ED AND APPROVED BY 13I111.DING INSPLCI(Ni BIIII.DIN(:INSI'F.CT(III DA 11:1 11 IA) \`\ \ \ OWNERS I EI a A 1 (,ON I R.I I I N q-R (11.) \v b b "(.NA. 111th_(>F 1 IN'IJI:It 1)li All I I IINtI/LD AIH N I PI I(T.II 11;R AN I I I) p 19 Town of North Andover NORTH OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES A . . 146 Main Street North Andover, Massachusetts 01845 �,'•�:::,; ,y WII.I.IAM I SCOTT �SS�cHuS�t Director In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number 57 f ( is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by NIGL c 1 11, S 150A. The debris will be disposed of in: (Loci ion of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Once of the Building Inspector. I BOARD OF APPEALS 689-9541 BLM..DING 688-9545 CONSERVATION 688-9530 HEALTH 688-9340 PLANNING 688-9535 I F to 0 o � Andover I� O - L No. S'�� * _ Im e� � 199 * _ dover, Mass., D s LAKE '9A_COCH ICHE.1ICK S E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System 10 ��� � � BUILDING INSPECTOR THISCERTIFIES THAT.......... ....... ......................... .................................................. ....... ........ ......... ....................... Foundation has permission to erect 4.'14'........ buildings on .........30. . . �It �...... .... ... .... ..... ... ................. ...... ..... Rough to be occupied as R M e . .i / ����.......... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 INSPEC'T'OR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final �/ � PERMIT EXPIRES IN 6 MO THS ELECTRICAL INSPECTOR Rle s UNLESS CONSTRU N S C Rough Service . BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rou Display in a Conspicuous Place on the Premises — Do Not Remove Finalh } No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. BUILDING PERMIT NORTH O�tt�eD TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ op # Permit N0: Date Receive PPR 14C 'jsq�DRATED "��5 r, SSAC HUSH Date Issued: �s�'�� IMPORTANT: Applicant must complete all items on this page LVLATIO yy ,. ��w+ 52 ""' , ➢:`'p. ✓K/� a �. $ & kuy kFC/�'� idF Via; P03 � �WNR.n7'Cb MAP NQ` ��PAIEI Zbl`l ..DIS R1CT . H1STRIC-DSTIICts Dnp >. TYPE OF IMPROVEMENT PROPOSED USE - Resiqj6ntial Non- Residential ❑ New Building Vbne family V<ddition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ri ptic M C11t?ell � ( ldodli e` [arads �terslled3stct er/SeMRM DESCRIPT ON OF WORK TO BE PREFORMED: i Identification Please Type or Print Clearly) OWNER: Name:_ 4 Phone: Address: k 1.0,4 - G, ���%'� 1,1114 & �NTRACTflate n� ft ". Add ,r " . Superior's nstrurr iodnse p date .:. ,. Home;lm rem�nt �cnse: .aoo a � ARCHITECT/ENGINEER Phone: Address: �.� L141; r/d I ��' . ��✓�q 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: $ FEE: $ `a:3 101, Check No.: yJa / Receipt No.: 190 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Location � �✓ � 5�,,._ No. Date 1.67-7" ,.ORTIy TOWN OF NORTH ANDOVER O ' Certificate of Occupancy $ ,Ss�M�sEt Building/Frame Permit Fee $ i Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2011 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan tamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT F111 COMMENTS TE REJECTED DATE APPROVED CONSERVATI COMMENTS Q DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(s ptic tank,etc. ❑ Permanent Dumpster on Site ❑ Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT �errrp Dumpy r on site ,,ye ' ono ' Located at 124 M(in Street FNre ©eprtmnt siigna#ureldatelow w CQMMEI�TS... p x \ ru ntrax morcross loly/Z006 b: 02 PAGE 011/011 Fax Serv�re�r-� AI/OI:U® T�F� kTE 1Nll �►N DATE(MM1DdYY) PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DAVIS DAVIS & MOODY INS HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 40 KENOZA AVE ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. Po BOX 949 COMPANIES AFFORDING COVERAGE HAVERHILL MA 01831 COMPANY A THE TRAVELERS INDEMNITY COMPANY INSURED COMPANY TWOMEY & LEGARE CONTRACTING B INC COMPANY PO BOX 366 0 NORTH ANDOVER MA 01845 COMPANY D 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 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LT DATE(MRI)DWY) DATE(MM\DDNY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMHOPAGG. $ CLAIMS MADE F_�OCCUR. PERSONAL BADV.INJURY $ OWNER'S&CONTRACTORS PROT EACH OCCURRENCE g FIRE DAMAGE(Any one tire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINEDSINGLE $ ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDU LED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per Accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND A STATUTORY LIMITS EQ/A EMPLOYER'S LIABILITY (UB-5647042-2-06) 09-18-06 09-18-07 THE PROPRIETOR! EACH ACCIDENT $ PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ OFFICERS ARE FXEXCL DISEASE-EACH EMPLOYEE $ OTHER 71SCRIPTION OF OPERATIONSILOCATIONdEHICLESIRESTRICTIONS(SPEOAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. C <TIFIC�ATE HOI:p, CANCEl,UITIQN ... ......::.: 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 TOWN OF N ANDOVER LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 27 CHARLES ST LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. N ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE A r'r 40 fJl b O�tPORA1 kbf 1993'; BOARD OF BUILDING R License:. CONSTRUCTION S Number: CS 067560 � 4 , Birthdate: 10/25/1966 _ ' Expires: 10/25/2007 Restricted: 00 SHAUN M TWOMEY 61 PATROIT ST ,4 N ANDOVER, MA 01845 /J Commissioner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:,136779 Expiration: 8126/2008 Type: Partnership TWOMEY+LEGARE CONTRACTING INC. SHAWN TWOMEY 61 PATRIOT ST. N.ANDOVER,MA 01845 Deputy Administrator ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J Applicant Name: -T1kMM12f Site Address: 3q N <'t Applicant Address: -rWQHLj hmiti-s3 City/Town: /4i�DoOGYL 2� GAct,l M 1A, aQ Use Group: A D 1 !!f? Date of Application: Z�•t9� Applicant Phone: 2-0 2— Applicant Signature: Compliance Path(check one): ❑ Prescriptive Package(Limited to 1-or 2-family wood frame buildings heated with fossil fuels only) Package(A through KK from Table J5.2.1b): Heating Degree Days(HDD.)from Table J5.2.1a: (For items d.through i.,fill in all values that apply from Table J5.2.lb:) a. Gross Wall Area sq.ft f. Wall R-value R- b. Glazing Area` sq.ft. g. Floor R-value R- c. Glazing%(100 x b+a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE ❑ Component Performance: "Manual Trade-OW'(Limited to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet,if applicable] ❑ MAScheck Software Attach Compliance Report and Inspection Checklist printouts Q" NANCY rwoMEY ❑ Home Energy Rating System Evaluation No.6957 Attach Home Energy Rating Certificate(HERS rating score must be 83 or higher) R ❑ Systems Analysis OR ❑ Renewable Energy Sources Of Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a.Gross Wall+Ceiling Area 1l3a q.ft. b.Glazing Area' ?41-sciA. c.Glazing%(100 x b+a) ADDITION with Glazing % (c.)up to 40% may use 780 CMR Table J1.1.2.3.1 below: MAXIMUM U-value MINIMUM R-Values Fenestration' Ceinns? I Wall Floor Basement Wall Slab Perimeter Depth 030 1 R-37 I R-13 I R-19 R-10 R-10 4ft I Glazing Area may be either Rough Opening or Unit dimensions. 2 Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e.-not compressed over exterior walls,and including any access openings.) ❑ "SUNROOM"addition(greater than 40% glazing-to-wall and ceiling gross area) Attach"Consumer Information Form"from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved ❑ Denied ❑ Date of Approval/Denial: Reason(s)for Denial: (provide additional details as needed on back side) TWOMEY & LEGARE CONTRACTING, INC. Professional Building / Remodeling P.O. Box 366 North Andover, MA 01845 North Andover 978.685.7447 Haverhill 978.556.1547 CONTRACT 1. Date of Contract Signing: 2. List of documents part of this agreement: A. Contract B. Specifications (see Exhibit B) C. Drawing(see Exhibit C) D. Payment Schedule (see Exhibit D) E. Limited Warranty(see Exhibit E) F. Notice of Cancellation 3. Parties to Contract: A. Contractor: Twomey&Legare Contracting,Inc. Shaun Twomey/Doug Legare Federal Id#: 04-3610112 Address: P.O. Box 366 North Andover, MA 01845 Contractor Registration No.: 136779 B. Homeowner: Rick Dimarzo &Beth . Al lavj�e 59 Appleton Street SV North Andover, MA 01845 (978)687-3343 3/20/07 4. Description of work to done and the materials to be used: See Specifications(see Exhibit B) 5. Total amount agreed to be paid for work to be performed under the contract: 6. Time schedule of payments to be made under the contract, finance charges for late fees, if any. * See Payment Schedule (see Exhibit D) *Any deposit required to be paid in advance of the start of the work shall not exceed one- third of the total contract price or actual cost of any material or equipment of a special or custom made nature,which must be ordered in advance of the start of work to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of all parties. 7. A. Date work is scheduled to begin: See No. 14 B. Date work is scheduled to be substantially completed: See No. 14 8. Notice: A. All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor and subcontractors shall be registered and that any inquires about acontractor or subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration One Ashburton Place,Room 1301 Boston, Massachusetts 02108 Telephone No. (617)727-8598 B. For contractor's registration number,see top of first page. C.Homeowners have a three-day cancellation rights under MGL c 93 §48;MGL c 140D § 10 orMGL C 255D § 14 as may be applicable (see attached Notice of Cancellation). D. For owner's warranty rights, see 780 CMR R6 and MGL c 142A. 9. There is no lien or security interest on the residence as a consequence of this contract. 10.Permit Notice: A.The following permits will be required in connection with the work to be performed on your property: Building-Electrical -Plumbing B. It is the obligation of the contractor to obtain these-permits as the owner's agent. 2 D.Insurance-Contractor agrees to provide evidence of liability,worker's compensation and other risk insurance.Owner agrees to provide copy of hazard insurance as is required by contractor to coordinate policies. Owner: 2 Lj&V uolz�h�- Contractor. Notice: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. 3�07 Owner Date Contractor D UM 3hJ-6 --7 Owner Date Contractor Date 4 Payment Schedule - Exhibit D Job Total $102,500.00 Payment Balance 1 st Deposit on signing($5,000.00) $15,000.00 $87,500.00 Day we start ($10,000.00) 2nd Completion of exterior demo $15,000.00 $72,500.00 &completion of foundation 3rd Completion of weather tight addition $25,000.00 $47,500.00 4th Completion of all plumbing, electrical $20,000.00 $27,500.00 roughs, &insulation 5th Drywall &plaster $10,000.00 $17,500.00 0 6th 80% finish work and flooring $10,000.00 $ 7,500.00 7th Substantial completion of project $ 7,500.00 Final/sign off Sign `/� Date j Z Allowance Page 1. Kitchen&Bathroom tile -material only $ 850.00 2. Hardwood $3,200.00 3. Painting- interior&exterior $2,900.00 4. Light fixture $ 300.00 5. Plumbing fixtures $1,900.00 Si - 2-S � Date b , 1 Specifications-Exhibit B Addition With full Basement 1. Provide addition to residence at 59 Appleton Street,North Andover,Ma in accordance to plan provided by Owner, these specifications shall prevail. Addition to include new: Full Bath, Master Bedroom, deck, and extend eating area. 2. Excavate as required for full foundation with 2 Cellar Windows with screens 3. Foundation height to be same as existing to match floor height 4. Damp proof foundation with asphalt by Contractor 5. If ledge is encountered, ledge removal cost is not included&damaging unmarked underground utilities(not included) 6. Contractor to install sump pump 7. Basement will have 4"concrete finish floor with vapor barrier 8. Demo existing deck and shed in backyard and relocate electrical&plumbing on wall that is being removed 9. Structures to be built per plan in accordance with these specifications 10. Walls to be 2x4 construction 11. Subfloor to be 3/4"Advantec plywood, 50 year warranty 12. Wall sheathing to be 1/2" OSB 13. Roof sheathing to be 5/8" CDX plywood 14. Install ice&water shield 3 feet up from eaves 15. Roof addition with 25 year shingle by Builder- Color by Owner 16. Wrap exterior walls with tyvek house wrap 17. Siding to be Cedar Shakes 18. Zle addition to code-R19 walls, R30 ceiling,R19 in floor Sign Date 0 1 -2- 19. Contractor is responsible for all exterior painting 20. Contractor is responsible for interior painting 21. Create 8' opening to New Addition 22. Patch any areas opened up&re-plaster 23. Save Kitchen floor and blend as close as possible 24. Drywall in Addition&remodeled areas to be '/2 Blue board with unical plaster 25. All new interior trim to match existing 26. All new door knobs to be schlage brass 27. New flooring in Kitchen to be tile - match as close as possible 28. New floor in Bath to be tile- See Allowance Page 29. Master Bedroom and closet to be hardwood 30. Contractor to provide a pt deck with steps to grade off new sliding door 31. Kitchen cabinets&countertops to remain 32. Landscape by Owner 33. Construction plans by Owner 34. Standard closet pole and shelf 35. Permits and Inspections by Contractor Sign Date Plumbing Specifications-B1 1. Contractor to provide heating and a/c off new unit 2. New unit will be in new Basement 3. Provide plumbing necessary for new Bath 4. Contractor to purchase fixtures-Bathroom: sink, faucet, vanity,toilet, shower unit, & shower head (Contractor will set up an appointment at the supply house) Sign Date Electrical Specifications - B2 Contractor to provide: 1. 4 recessed can in 1 Bedroom 2. 4 ceiling light fixtures- fixture by Owner 3. 1 outside flood light- by Owner 4. 1 porch light-by Owner 5. 1 porch outlet 6. 1 769 RF Nutone Bath vent/light -by Contractor 7. 2 Porcelain Basement lights 8. 1 can in shower 9. Outlets per code 10. 60 AMP sub panel 11. Existing wiring in house to remain the same 12. Owner to purchase light fixtures- list provided by Contractor Sign Date OWpw� WON *V4.ORTH And TOVM of over No. �a over, Mass., 5 0 COCHICHEWICK RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........e,&4........... ► .................................................. ............ Foundation 0..... .........04 ......C. ........ Rough has permission to erect........................................ buildings on �".. .42A 0 Chimney to be occupied asAK...4.0fAtA40.14...... OA..................so ......NAW..... provided that the person accepting this permit shall in eve conform to the terms of the application n Final 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 ul tfliir)� PERMIT EXPIRES N 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S Rough ...................... ................. ............ BUILDING INSPECTOR Service ? Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.:_ 33 7� 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 J- ❑ Notified for pickup - Date Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. i 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 Addition Or Decks � /.Building Permit Application ertified Surveyed Plot Plan Workers Comp Affidavit 4 oto Copy of H.I.C. And C.S.L. Licenses ®' Copy Of Contract Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan P P And Hydraulic Calculations (If Applicable) ass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products New Construction (Single and Two Family) T ❑ 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 ❑ Engineering Affidavits for Engineered products 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 The Commonwealth of Massachusetts Department of Industrial Accidents Ogee of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aanlicant Information Please Print Legibly Name(Business/Organization/Individual): Address: , i City/State/Zip: Phone#: ' AVIi Are employer?Check the appropriate box: 1• am a employer with 4. Type of project(required): �_ ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6• ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet.x 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑D molition working for me in any capacity. rkers'comp,insurance. [No workers'comp. insurance 5. We are a corporation and its 9• Building addition required.] officers have exercised their 10.[1 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbingrepairsairs or additions self.[No workers comp. c. 152,p 1(4), and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. 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-contactors 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: 0 �,� �✓ Policy#or Self-ins. Lic.#: c37w I/7Ze1c-;- � "'U p �_9ZI ,/ Ex iration Date: Job Site Address: �2 /I/ 11 G � City/State/Zip: Attach a co of the workers'copy kers 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 under t pains and penalties of perjury that the information providedabove is true a d correct. Si nature: Date: `7 Phone#: ( r Official use only. Do not write in this area,to be completed by city or town oJjiciaL 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#: