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Home My WebLink AboutBuilding Permit # 4/8/2015 I 2 mm tkORTH BUILDING PERMIT t 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Z „ Permit NO: 1L Date Received �9SSACHU`-'��9 Date Issued: IMPORTANT: Applicant must corn Tete all items on this page 41 LOCATION tint PROPERTY OWNE77R Pntnt; . MAP NO: PARCEL ZONING DISTRICT: Historic District yes na Machine Shop Village yes rro TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ eration No. of units: ❑ Commercial _-P-Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other [i Septic ,,❑Well []Floodplain Wetlands ❑ Watershed District , ❑Water/Sewer Ale • B�`' Identification Please Type or Print Clearly) OWNER: Name: t°Z,2 Phone: Address: CONTRACTOR Name: , Phone: "` ji7 Address: Supervisor s Construction License Ex Date: f Home IrnprouernientLtcense ": Exp Date: , c ' 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: $ 6 _ FEE: $ Check No.: Receipt No.: ' u'2-1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner` Signature of contractor '16,11,4�,_ F 0ORT1 Town ofE ndover 0 ® h ver MassjApioi W 2015 COC NIC MIWICK �.9 A�RATED S lI - BOARD OF HEALTH ERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT .....e.m4o. ,, ,, ,,,,,,,,, BUILDING INSPECTOR has permission to erect . b 'Idin S On .. Foundation ......................... .... .. .a....... ...Irl. . t.�t..... ...... Rough __ 11 k ib .�to be occupied as ... .�. ............1. .... .. . ....M.. , .`. ...�.............. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the applica to MIT' 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 IT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTION ST RTS Rough ..,......... Service .. . r%,. ........ Final BUILDING INSPECTOR GAS INSPECTOR ccupancV Permit Required t® Occupy Bu Rough Islay 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. TWCNAEY & LEGARE C ON I R A C I MG INC , o view "Couldn't your home use a little TLC?" Specializing in residontial additions 87 Belmont Street, North Andover, NIA 01845 HIC #136779 North Andover - 987.685.7447 Facsimile- 978.685.7446 EXIMIT B Proposal/Specification Homeowner: Contractor: Twomey&Legare Contracting,Inc Dawn Casale 87 Belmont St. 130 Middlesex St. North Andover, Ma. 01844 North Andover, Ma. 978-609-2856 The following is a description of work as discussed. Renovation of Kitchen 1. Remove existing cabinets and dispose of. 2. Install a couple of the old cabinets into the laundry room. 3. Relocate power for range. 4. Correct any other electrical issues. 5. Relocate water lines,and drain line for sink. 6. Complete insulation. 7. Complete all dry wall,and plaster.] 8. Install new cabinets, and tops. 9. Counter tops to be laminate post form tops. 10. This price includes 6 feet of cabinets,and counter tops outside. 11. Reuse existing sink,and faucet. 12. Venting for range hood to be self venting. Use old range hood. 13. Blend paint as close as possible 14. Conti-actor to obtain all building permits, &inspections. 15. Contractor to dispose of all debris. 16. E isting floor to remain. Sig Date. Allowance Page Cabinets & Tops ------------------- $2,725.00 Plumbing ---------------------------- $1,200.00 Electrical ---------------------------- $800.00 Job Total & Payment Schedule J®b 'Total Balance 1St signing of contract $3,500.00 $7,460.00 2nd Completion of plumbing $3,000.00 $4,460.00 electrical roughs. 3'd Completion of install of cabinets. $21500.00 $1,960.00 4th Substantial completion of $1,960.00 project and final sign off. Sign A Date 1 � / G °' .. .......�..Wu......_.." ., �� it a SB 30WC _ � t j ail-^ l;o i <� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . d 600 Washington Street Boston, MA 02111 `�M 5�•y� www.mass.gov/dia Workers-' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le_obly Name (Business/Organization/Iudividual): Address: City/State/Zip: IV, #IM- /M1 '' Phone #: 9 2X _7 el V 2 Are y an employer? Check the-appropriate box: Type of project(required): 1. I am a employer with4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ E] Remodeling ship and have no employees These sub-contractors have 8. E] Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers'-comp.insurance 5. ❑ We•am a corporation and its required.] officers have exercised their 10_❑ Electrical repairs or additions 3.❑ I am a homeowner doing aL1 work right of exemption per MGL l l.❑ Plumbing repairs or additions myself. [No workers' comp.- c. 152, §1(4), and wehaveno 12.❑ Roof.repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showingtheir 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 'tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is the.policy and job.site information / Insurance Company Name: T/Z/a ✓�L-��c-j % C1 o E iration Date: �" Policy#or Self-ins.Lic.#: b M > �1 / xp Job Site Address: / 6/ r� City/State/Zip: N x A,/ 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 die violafor Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA-fdr insuxaM-e coveragti verification. I do hereby certify linder thepains andpenalties ofpeijury that the informationprovided above is true and correct Signature: Date: Phone#: � �I '" /• 751-1 Oficial 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): X_Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: RightFax C3-1 1/13/2015 5 : 44 : 51 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) T-_M 1171FICATE 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 BYTHE 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 and endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: DOHERTY INS AGENCY INC PHONE FAX PO BOX 1985 (AIC,No,Ext): (A1C,No): 21 ELM STREET E-MAIL ANDOVER,MA 01810 ADDRESS: 22YMX INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS INDEMNITY COMPANY OF AMERICA TWOMEY&LEGARE CONTRACTING INC INSURER B: INSURER C: INSURER D: PO BOX 366 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 ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM\DD\YYYY) (MMADDIYYYY) LIMITS '... GENERAL LIABILITY EACH OCCURRENCE $ rGENTL MMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE �OCCUR. PREMISES(Ea occurrence) ED EXP(Anyone person) $ ERSONAL&ADV INJURY $ GREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ ICY F]PROJECT F]LOC RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND XWC STATUTORY OTHER EMPLOYER'S LIABILITY YM UB-029OM994-14 09/18/2014 09/18/2015 IMITS ANY PROPER ITORIPARTNER/EXECUTIVE Y N/A E.L.EACH ACCIDENT OFFICER/MEMBEREXCLUDED' $ 500,000 '.. (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 H yes,describe under ',.. DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERT[FICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD 5T. BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT4 IVE NORTH ANDOVER,MA 01845 = ACORD 25(201D/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. Client#: 13298 TWOMEY6 ACORD. CERTIFICATE OF LIABILITY INSURANCE 1/12/201 5 Y� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 1985 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 21 Elm Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Andover,MA 01810 INSURERS AFFORDING COVERAGE NA1C# INSURED Twomey&Legare Contracting,Inc. INSURER A: Arbella Protection Ins Company PO Box 366 INSURER B:INSURER C: North Andover,MA 01845 INSURER D: 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. NSH LTR N R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE ATE(MI011001M pUCYAT RATION L141RS A GENERAL LIABILITY 8500043255 06/22/14 06122/15 EACHOCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100000 CLAIMS MADE FE OCCUR MED EXP(Any one person) S5 000 PERSONAL 8 ADV INJURY S1,000,000 GENERAL AGGREGATE s2.00_0 000 GENT.AGGREGATE LIMIT APPLIES PER: PRO QUCTS•COMPIOP AGG $2 000 000 _CTX POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Porperson) $ HIRED AUTOS BODILY INJURY $ '... NON-OWNED AUTOS (Per accidenl) PROPERTY DAMAGE $ (Poracddent) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESSNMBRELLA LIABILITY EACH OCCURRENCE S OCCUR 0 CLAIMS MADE AGGREGATE f•_11 $ 1 S DEDUCTIBLE I R S RETENTION $ S WORKERS COMPENSATION AND IVC STATU• DTH- - EMPLOYERS'LIABILITY 4RYLlER ANY PROPRiETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S OFFICERlMEMBEREXCLUDED9 II E.L.DISEASE•EA EMPLOYEE $ yyes,doschbo under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Covering operations usual to Twomey&Legere Contracting,Inc... CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 1600 Osgood Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO 00 SO SHALL North Andover,MA 01845 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRNTA VE ACORD 26(2001/08)1 of 2 #S31415/M30577 DML 0 AC CORPORATION 1968 Office of Consumer Affairs&Business Regulation � t7ME IMPROVEMENT CONTRACTOR 1 t egistration: 136779 Type: Expiration: 8/2612016 Partnership TWOMEY+LEGARE CONTRACTING INC. SHAWN TWOMEY 87 BELMONT ST. N.ANDOVER, MA 01845 Undersecretary CS-067560 SHAUN M TWOMEY 61 PATROIT ST N ANDOVER MA 01845 J. .w 10/25/2015 1.;:'` CS-055108 DOUGLAS J LEGARE 79 GARY AVE HAVERMLLMA 01830 09102/2016