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Home My WebLink AboutBuilding Permit # 4/8/2016 BUILDING E IT �� gaq�=D '�960 TOWN OF NORTH ANDOVER6 APPLICATION FOR PLAN EXAMINATION Permit NO: � � �� ' Date Received *q '7 °NAr- Date Issued: cHus�� — hk PollANT:Applicant must com lete all items on this paEe LOCATION >4aW S4 reef Print PROPERTY OWNER PeA e.r and Les l i ic Ka1a,.�XS VI Print MAP NO: PARCEL ZONING DISTRICT: Historic District yes (no o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential ' Non- Residential ❑ New Building t-One family ❑Addition ❑Two or more family ❑ Industrial "Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic ❑Well ❑Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer 1 ,54 Wa : to-move ,e)C',s{'tnc, - )z+ums . wo.11 z v of floor surfaces•, eAes6l +4 C KA peCLcw s l y%14 . Identification Please Type or Print Clearly) \ OWNER: Name: L"�i e kcda rarsL Phone 1�1�, 31®- fI'm Address: CONTRACTOR Name: Phone : &5 r-Ose-or a6irwwrks Address: . g we6f im)h slcr n ac A Mer r r %c a., H 1h d I gbb Supervisor'sConstruction License: Exp. Date: Home Improvement Licenser Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDIHG PERMIT:$92.00 PER$9000.00 OF THE TOTAL ES77MATED COST BASED ON$925.00 PER S.F. Total Project - $ Z`{t 0(5 - to FEE: $ 2-`(o 40 Check No.: a Receipt No.: 3 6 2-2-- NOTE: Persons contracting with unre istered contractors do not have access to the guaranty fund Signature of Agent/Own , ignature of contractor %AoRTH Andover Town of )L2 0 ® — --� _ 1z 7 ' `q�. h , ver, ass, coc Nlcn@WICK 1' LA0 RANor— TED S U BOARD OF HEALTH Food/Kitchen Pi: Rml I LD Septic System 0 a THIS CERTIFIES THAT .AWC01t .. ® BUILDING INSPECTOR . ... . .. .. .... .. has permission to erect buildings on ... Foundation ........................ ... ....® ..... ..... ... ... . ........... ................ ... Rough to be occupied as p� .... . . ... ... ............/.s..... .... ............ ....... 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN T ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S Rough Service .................... ..... ......... .................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street,Building 20, Suite 2035 North Andover,Massachusetts 01845 Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Pleaseprint DATE: /7 A JOB LOCATION: )O_via �>t V-664 Number Street Address Map/Lot HOMEOWNER ej" 0A L&S 1'e Kajo-46,VS Vi _4 (q TO 3 q 0-_17 2,q Name Home Phone Work Phone PRESENT MAILING ADDRESS b C_L"4 reet �6y-4 hkl� ovew MA City Town State Zip Code The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two family dwellings and to allow such homeowners to engage an individual for hire who does not possess a license,provide that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one-or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 CMR Section I IO.R5.1.2) The undersigned"homeowner"assumes responsibility for compliance with State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 8,2015 Form Homeowners Exemption BOARD OF A111PEA1 S688-9541 CONSERVATION 688-9530 HEAUF11 688-9540 PLANNFNG 688-9535 The Commonwealth ofMassachusetts F Department ofXndustrialAceidents " - X Congress Street,Suite 100 d Boston,MM 02114-2 017 ...y�;� www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Elee.tricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Informationf rr,, Please Print Lenibly Name(Business/Organization/Individual): ��i}e.Y C��d Le I t h� G 4� , Address: habaS n(�KS cell �oOaE City/State/Zip: Mov" A ndAyoc, NA Phone#: Are you an employer?Check the appropriate box: Type of project()required): 1.F-1 I am a employer with employees(full and/or part-time).* 7. Q New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. L�Iemo delirig any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp..insurance required.]t 10 0 Building addition 4. am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These siib-contractors have employees and have workers'comp.insurance.t 6.Q We are a corporation and its off gers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no.employees.[No workers'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 submif this affidavit indicating they are doing all work and then hire outside contractors must s4bmit a new affidavit indicating such. tContractors that check this box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-con`trad6rs fiave employees,1hey must provide their workers'comp.policy number. I am an employer that is pioviding work6s'compensation insurance for my employees.'Beloiv 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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Offco of Investigations of the DTA for insurance coverage verification. I do hereby certify under the pains d enalties ofperjury that the infor'rnation provided above is true and correct. Si nature: C Date: (p Phone#: 0 �O Official 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: iu TOILET-1 6OL-BATH-1 i 27KPD.SINK i i i All dimensions_size designations This is an original design and must Designed: 41412016 given are subject to verification on s a,q not be released or copied unless Printed: 414/2016 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. ii Kalafarski -existingI All(no dims) Drawing#: 1 Scale : 0 1/2" = 101I i W2142R C { t TOILET-1 EXP.SH.B-01 i i I vs�� _ �"""wBI i i All dimensions_size designations20This is an original design and must Designed: 4/4/2016 j 1 given are subject to verification on H N u LC.;E, not be released or copied unless ;Printed:4/4/2016 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. I I Kalafarski -bath All (no dims) Drawing#: 1 Scale : 0 1/2" = I'll Westminster Woodworks 8 Westminster Road Ed"'stil"Ilate Merrimac,MA 01860 Number E200 dresclierd@cotiicast.net 978-912-1945 Date 4/4/2016 H.I.C. Reg. 4177436 Expiration- 12/09/17 Bill To Ship To Leslie Kalaf-arski 45 Dana Street North Andover,MA 01845 Terms Project 20%at acceptance,60%at start,20%at completion 2nd Bath Remodel Description Quantity Price Tax] Amount Demo-remove and dispose of all items 1.00 $800.00 $800.00 from step-in shower area Prep-prepare all surfaces for tub and tile 1.00 $500.00 $500.00 Shower tile-provide,install and groat 80.00 $22.50 $1,800.00 Plumbing-provide and install tub,shower valve,tub spout and trim,new pedestal 1.00 $1,780.00 $1,780.00 and faucet Hardware-provide and install new hotel 1 $180.00 $180.00 style,curved shower rod and rings Signed with da�- J-0 Signed with date: Amount Paid $0.00 Discount $0.00 Amount Due $5,060.00 Shipping Cost $0.00 Sub Total $5,060.00 Sales Tax 6.25%on$0,00 $0.00 Total $5,060.00 Westminster Woodworks E",v-,ham ate 8 Westminster Road Merrimac, MA 01860 Number E199 drescherd@comcast.net 978-912-1945 Date 3/17/2016 HIC. Reg. #177436 Expiration - 12/09/17 Bill To Ship To Leslie Kalafarski 45 Dana Street North Andover,MA 01845 Terms Project 20%at acceptance,60%at start,20%at completion Bath remodel Description Quantity Price Taxi Amount Demo-remove all items from existing space including drywall.Remove interior 1.00 $2,200.00 $2,200.00 wall between toilet and shower area. Prep-prepare walls and floors for new 1.00 $2,000.00 $2,000.00 fixtures and surfaces Floor tile-70 square feet,installation and 70.00 $15.00 $1,050.00 grout Shower the-80 square feet,installation 80.00 $22,50 $1,800.00 and grout Wall the-100 square feet,installation and 100.00 $20.00 $2,000.00 grout Vanity and linen cabinet-provide and 1.00 $1,200.00 $1,200.00 install cabinets Granite-provide and install granite top for 1.00 $650.00 $650.00 vanity Plumbing-provide and install:shower 1,00 $2,910.00 $2,910.00 base,toilet,faucet,shower valve and trim Electric-provide and install:vanity light, recessed lights,recessed shower light, 1.00 $1,720.00 $1,720.00 fan/light and rework receptacles and switching as necessary Custom glass shower enclosure-meausre 1.00 $1,600.00 $1,600.00 for,provide and install Hardware-provide and install bath 1.00 $800.00 $800.00 hardware Carpentry-crown moulding 1.00 $420.00 $420.00 Paint 1.00 $900.00 $900.00 Other-permit and disposal $320.00 $320.00 Westminster Woodworks 1'1,"Stimaht� 8 Westminster Road Merrimac,MA 01860 Number E199 drescherd@comcast.net 978-912-1945 Date 3/17/2016 H.I.C. Reg, 4177436 Expiration- 12/09/17 Bill To Ship To Leslic Kalafarski 45 Dana Street North Andover,MA 01845 Terms Project 20%at acceptance,60%at start,20%at completion Bath remodel Description Quantity Price 1 Tax] Amount Signed with date: Signed with date: Amount Paid $0.00 Discount $0.00 Amount Due $19,570.00 Shipping Cost $0.00 Sub'total $19,570.00 Sales Tax 6.25%on$0,00 $0.00 Total $19,570.00 ( "�'"'a`% 0.f d•JF�fr?U7d aS�d^�d 0��o-"d'✓A��'fJ�a d"cf do'Jd`�®Y/.ia1��d Office of Consumer Aff'rairs&Rosiness Regulation License or°registration valid for individul use only HOME IfId11rF8CJV lM1flI NT CC1N 1"FACT"f)I" before the expiration date, If found return to: Registration: 177436 T'ylae: Office of Consumer Affairs and Business Regulation xpiration: I.P./g/201-1 D13A 10 Park Plaza..Suite 51 701 .,,.� Boston,MA 01116 WESTMINSTER Wt;)C>IT1JtVC7RKS DAVID DRESCHER 3 WESTMINSTER ROAD MEfiI IMAC, MA 013601 Undersecretary of valid without signature