The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 3/26/2016 OORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#:Aq ' Date Received— S C us Date Issued: �� IlYI�'ORTANT:Applicant must complete all items on is page LOCATION 3 0 A N170VL-,P, 6Y 121�-—< 75 Print PROPERTY OWNER S-rf-,Pf4Ay,)iF- Print 100 Year Structure yes no MAP PARCEL- ZONING DISTRICT: Historic District yes no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ne family F1 Addition o Two or more family Ei Industrial �.,atmrn_ No.of units: u Commercial E.Repair,replacement Li Assessory Bldg F1 Others: Demolition 0 Other L7 Septic ' Well eja6d 26R��ki L." DESCRIPTION OF WORK TO BE PERFORMED: -r-F- igcj: f RZr-lw) JtP,4�fn 0,D Identification- Please Type or P int Clearly OWNER: Name:5-rE-F'H R)f C-7-0 1—Ph'F- Phone:q2,F27L/0C09 Address: Contractor Name: A )6:-'- /- VV?r-J Phone: 'r � Email: Address: YlAA- Supervisor's Construction License: Exp. Date:, -7 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$lZoo PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F. C�C, Total Project Cost:$ 1Kz%10C1- FEE:$ Check No.: Receipt No.: NOTE: Persons contraefin with unregistered c tra tors do not have access to the guaranty fund in�i �c ra Rtnrp of con Towno NORTF/ L Andover o No. ?,oh ver,Mass, A-qq coc .��• 7�S RATEO�.PP•�'�.y U BOARD OF HEALTH PERMIT T ILD Food/Kitchen Septic System S ` BUILDING INSPECTOR THIS CERTIFIES THAT..Y�)OM4;��........ ......Iri.o. .... ............... -e foundation has permission to erect..........................buildings on �. ••••• •S! Rough to be occupied as.......... .. ....... �.1�I�l R'�i�........................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES 16 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION 7TS Rough Service F".•^r.................... Final ILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin 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. Smoke Det. s ROBERT LANG VIN MINN Building&Remodeling,LLC 795 Dale Street North Andover,MA 01845(978)666-3607 HIC#111990 FID#26-0816298 www.LangevinBuilding.corn Job Description Stephanie Harrington and Stephen Naroian 230 Andover Bypass North Andover MA 01845 Bathroom Remodel All necessary permits Hall and stairway floor protection for the duration of the job Complete lead safe demo down to the studs and subfloor Rough plumbing-tub will remain in place and toilet location stays in place-Vanity location will move to outside wall between windows Old dresser will be modified to accept a drop in sink and serve as the vanity Wiring as described in accompanying David Electric job description New plywood subfloor and durock floor the backer Upgrade insulation in walls and ceiling to code Blueboard and skim coat plaster on walls and ceiling with durock the backer in the tub area Roof vent for ceiling fan and wall vent for dryer Tile on floor and on tub walls(allowing$5 per sq ft for the cost of tile) Two fifteen light passage doors,laundry cabinet,door and window trim,wood panel wainscoting approx.halfway up the walls,baseboard molding,and laundry shelving .. t Finish plumbing and electrical work All cleanup and trash removal The cost of these items will not be included in this agreement: New sink and faucet,new toilet,shower valve,and light fixtures If you decide to replace the tub and add an adjacent linen closet,the added cost will be $1000 plus the cost of the tub If you choose electric radiant heat under the tile,the added cost will be$850 The electrical work calls for a 20 circuit sub panel but if it is determined that an entire new electrical panel is needed the added cost will be$450 The cost of painting is not included r~; l Signed-1, i.,' ! Date _ Signed _ `- C Date ROBERT LANG VI Building 8, Remodieling Homeowner Information Contractor Information 7"'t Company Name f-,c>66KT- RF-M0D,4-j-,NC- 31--Address�*-.W.e�P.�l Off-�Box.ddl.,) ---- Contractor/Salesperson/Owner Name .2-- 3 9---At,)DC3 Vic-2 V` j-S 75 Q,OY3 City/Tow. State Zip Code Business Address(must me lode a street sddross)----- At') CV.4C -�N027-H-At,1r>oVf-:K VV\A 017V-�- -7-/�5- 1 — ", D A " C) R,4-5- PAPA�6-51 -7 Daytime Phone City/Town '9- Zip Code -1-2 9' -7 1/ c-9' -6-9-6- - -7- -- 91-27 ?6-o-7 6-C 6-VqF Mailing Address(It different from above) Business Phone [Federal Employer U)or S.S.Nimbus 11-J.,--Contractor Reg.Number E pirntm date ,maw. no emrcr,erors tm.e -7 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheetx if nucessarvJ Required EPennits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will Permits -The and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractors control arise Required 7 y n will ,P0 d (Owners who secure their own permits will be low r 0� L(Owners excluded c r._t excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work, -l G 7L c Ptr I MGL chapter 142A.) 'late when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of. Payments will be made according to rile following schedule: S A _yo __C�C, price the,cost items-,of orderite ,whiclic,,is tcr) S-6-'�on—C-) or by or upon completion of P I-A--5 6- -----4)9'x" or upon completion of Pon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special ordered before the contracted work begins in order to meet the completion schedule.(*'") $-------TTtrpzdd for NOTES:(")Including all finance charges(")Iaw requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)me-third of the total contract prim or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule, ExpressWilrEanty -Is an c ' wall. bem ,vidi,r] let."? 'e$( he all terms 21 The walyanty must be attacd to the e2mract) Subcontractors-nie contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third parry/subcontractor utilized by the contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for Materials and labor under this agreement Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence.Review the following cautions and notices carefully before signing this contract, Don't be pressured into signing the contract.Take time to read and fully understand it.Ask questions if something is unclear. Make sure the contractor has a valid Rome hil-mtomcat QW-t-D-i—pp.The law requires most home improvement contractors and subcontractors to be registered with the Director of Horne Improvement Contractor Registration.You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. Does the contractor have insurance?Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"Proof ofinsurance"document. o Know your rights and responsibilities.Read the Important Information on the reverse side ofthis form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not late i notify the third business day following the signing of this agreement See the attached notice of cancellation form f r than an explanation of alher,light.11mg,ollic DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! T-ideaticille. O.copy should g.t.rte h.— .The otter copy should bckept byflec..,— Tiollierwrier's Signature Contractor's Signature Dale Date 795 Ga!e Street Porth Andover,MA 01845 LZ 3 G A N D Ov:r-'(Z u3�d'A-s S d J w 3` Jn Sr47� 011/1-T ti 7 MnaC4vM H Acc Rca® CERTIFICATE OF LIABILITY INSURANCE 3 M! �.. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIO14T9 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:terms en c the coni f the holder is rte n POl dRS may require�an a dorsa(ant.A statement on itis CertificateMust be a clorsed. if ATION IS doees not cooter rights to the ect to Ne terms antl wnditlons d the policy,. p y eerthft.holder in Hou of such endorsement(s. Edvrdrd W Nays PR6DUCER NAME: Hays Insurance Agency Inc. PHONE (978)686.3162 PAS N,;(978)689.9425 36 HawUlDme Ave. nDD L haysinsuranca�comcast.nat IN6URER3 AFFOA.)NG COVERAGE HAICR Methuen Ma 01896 INSURER A:Norfolk&Dedham Mutual Fire Insurance Company INSURE. INSURIND: Robert Langevin INSURERC: 795 Dale St ...UREA D: ,_,_,......__.. NSURERS: North Andover Me 01845 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT INE 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 0E ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I`6R --- 'OU LIMITS TyPE6FINSURANCE a POuCYNU—R NOD. X COMMERCIALGENERALUAR[UTYFACN OCCURRENCE S 1,000'000' OCCUR MISE$ rnmoal S 100400. GLAIM&MADE❑ ME.EXP(AEa CmanY PM 0—� S 5,600. A R051435TA 10/2512015 1012572016 PERSO-4ADVINJURY E 2,O0D.000. GUNERALAOOREGA% 5 2.000,000. GEN/AGGREGATEtIMii APPLIES PER: 2,000,000. pCLIGYO J�E40'T LOC PRODUCTS-COMPIQP AGG S S OTHER: COMBINEoeiN n g AUTOMOBILELWRIIITY 9..c A iI BODILY INJURY(PvrpdnON S ANYAU70 -- ALL OWNED SCHEOULEO BODILY INJURY(PareGdGv+Ni 5 'A18 AUTOS PPRDPE.YDA N S HIRED AUTOS AUTOS b VMEAELLA LIAO OCCUR eAGNOCCURRENCE S EXCE6E-9 CLAI—MADE AGGREGAYE b S DEDREiENfiONS PER OTN- WORXERe SAT'" STATUTE I AND EMPLOYERIVYERS'UADILItt YIN E.L.EACNACC30ENT R E 0111111111111"S"ACLUDED'%EDUfIYE �NIA yMandatdry In NN) E1.018EA6E SFA EMPI.DYEE 5 Ityyes,de6CAV WWvr EL.DISEASE.POLICY 1,90 5 DEECRI-0-OF OP nON9 ediPw CEECRWnoN of oPERAT1ON3 f LOCATIONS M"ICLEs(aCORD 101,Ad4lvonai Ramarke 9cbeeuiv.maybe dNatNa4 Nmory apawle ravwrv4) CarpanUy CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TNS EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTRORREDREPRE�2014 ORP CORP. ON.All rights reserved. ACORD 26(2014701) The ACORD name and logo are registered marks of ACORD The Commonwealth of-Massachusetts Department of Industrial Accidents gut:), wtvivanass.govIdia 1 J" Office of Investigations 600 Washington Street �Nii;it g kMil' Boston,MA 02111 t, Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Q'� �y� n /Please pPrint Legibly Name(Business/Organizationllndividual):)\O.Bf-f �AT-C—E VI tJ Ijj-1D`Y � F—VOO D1e--1—I N� Address:-79S DA's ST City/State/Zip: Phone#: 7 G 76 3 7 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.� m j aa sole proprietor or partner- listed on the attached sheet.f 7., Ite�odeling !` ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers'comp.insurance, g, E]Building addition [No workers'comp.insurance 5. ElWe are a corporation and its required.] officers have exercised their 10.E1 Electrical repairs or additions 3.❑I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 131-1 Other comp.insurance required.] "Any applicant that checks box#1 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 avid their workers'comp.policy information. I am an employer that is providing workers'cotnpensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: _ Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert" under I pains antipenatties ofperjury that the information provided above is true and correct. Signature !{_ Date: Phone#• 7 6 3 6 C)_7 Official use only. Do not write in this area,to be completed by city or fawn 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#: Massacaase s 3;z o Board or"Building Regulations and 3ndirds License_CS-002685 _.. ROBERT M LANGEVIN - 795 DALE STREET _ NORTH ANDOVER MA 01845 - ^:�ssone 02/2412018 EM' s'—OBice of Consum Affairs&Business Regulation ij%*HOME IMPROVEMENT CONTRACTOR -;Registration: 111990 TYPe: „-Expiration: 2f1112017 LLC ROBERT LANGEVIN.BLDG 8,REMOLDING LLC, ROBERT LANGEVIN 795 DALE ST 4 - N ANDOVER,MA 01845 ----z-t— Uuderseeretary