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HomeMy WebLinkAboutBuilding Permit # 4/20/2016 0ORTI-1 BUILDING PERMIT D TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Date Received Permit No#: AC US Date Issued: IMPORTANT: Applicant must complete all items on this.page LOCATION (2 ("j Print PROPERTY OWNER ( llr) Print 100 Year Structure yes no D' — MAP PARCEL: DISTRICT: ZONING Historic District yes no Machine Shop Village yes. no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ---i One family El Addition 0 Two or more family El Industrial '453 Alteration No. of units: [I Commercial aRepair, replacement El Assessory Bldg El Others: Demolition 0 Other .o ern lit e DESCRIPTION OF WORK TO BE PERFORMED: T ' L rV o,L,��' �c i A4f 3, IS V'�L ix)v Identification- Please Type or Print Clearly OWNER: Name: (-,)s Phone: Address: Contractor Name: M, 2, t Phone: C _)3 tWNJ Email: Address: CYLLS Dil,,, Supervisor's Construction License: 09, 19(2 Exp. Date: Home Improvement License: L/ Exp. Date: i ARCH ITECT/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: $ FEE: $ Check No.: Receipt No.:_— NOTE: Persons contracting with unregistered contractors do not have ace e guarahtyfiind WE- 5 W =77,77,F7 D-19 tL NORT1i �9 Town ofAndover O 0 r No. 0 6 � z , ver, ass, �e- 6 �/- COCNtCNlWICK �1. J�ps RATED U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT .'" f� G �S BUILDING INSPECTOR ........ ................................................................................................................... has permission to erect buildings `S��v�i� ��`"�� Foundation pg ..�s�/................................................................... Rough to be occupied as `, c ����... �: .4� :' ?::?....................................................... 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 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTIO T RTS Rough Service ........... .. .. ..�BUIL Final G INSPECTOR GAS INSPECTOR Occupancy hermit Required to Occupy Building 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. k 11h: 781-771-693"'J" Fax: 978 687-3364 License#CS 091968 Home Development LLC HIC Reg# 148734 2 Styles Drive Fully Insured Peabody,MA 01960 PROPOSAL Submitted to: Tara Haas & Johnathan Mandell 02/15/2016 Phone: 978-394-3614 Job Name: 131 Sandra Lane Job Location: North Andover, MA 01845 Date of Plans: To be scheduled We hereby submit sl-)eczfications and estimates for: KITCHEN RENOVATION (24' x16') Permits: Contractor to obtain permit. Demolition: Remove all cabinets, all wall tile above cooktop, all flooring and existing subfloor down to floor joist. Remove wall board between upper and lower cabinets to allow smooth surface for back splash tile. Plumbing: Done by others and not included in this proposal. Insulation: Insulate cold walls where wall board has been removed only as needed. Wall Covering: Install Y2"blue board and finish with smooth skim coat plaster. Interior Trim: Install new matching wood trim on all openings and window above sink. Install new matching base trim. Cabinetry: Install new cabinetry and accessories. Cost of labor only to install is included, Painting: Paint all new trim 2 coats, and walls I coat. Wood Flooring: Install new hardwood prefinished oak flooring in kitchen and dining room 2 Tile- install back splash the supplied by homeowner. Note. Cost of cabinetry, accessories, hardware and appliances not included. To be supplied by homeowner, Note: Any alterations or deviation from above specifications involving extra costs, will be executed only upon written orders and will become an extra charge over and above the estimate. Responsibilities of the elient1homeowner:Although, Atlantic Home Development, LLC uses extreme care and caution while working on yourproperty, it is the responsibility of the clientlhomeowwer to remove and kRep safely all valuables,fragile belongings, heirlooms etc. during construction and renovation. Contractor assumes zero liability on this matter. Responsibilities of Atlantic Home Development,LEC.All work 4411 be executed in a neat and workman like fashion. Dust walls will he erected as needed. Premises will be cleaned on a daily basis, all construction debris will be contained and removed from premises. Notice: All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of ConsumerAfairs and Business Regulation Ten Park Plaza,Suite 5170 Boston,MA 02116 Phone:(617)973-8700 Homeowner has the right to cancel this contract in 3 days from date of acceptance under MGL c 93s,48;MGL c 140 D s 10 o r MGL c 255 D s 14 as may be applicable. )Vot all above notes may apply to your specific application. WE PROPOSE: hereby to furnish material and labor- complete in accordance with above specifications,for the sum of Thirteen thousand two hundred seventy dollars RI270.00 Payment to be made as follows: $6,2 70.00 at start, $4,000.00 during and$3,000.00 upon completion. Do not sign this contract if there are any blank spaces 4 49 Date ofAcceptance: Signature.- -(7- L Authorized Signature: Signature: AJTER 30 DA YS A FINANCE CHARGE OF 1.5%PER MONTH, 18%AAWUALL Y, RILL BE CHARGED ON THE UNTAL0 BALANCE. 3 The Commonwealth of Massachusetts r f Department oflndustr"ialAccidents - F 1 Congress Street,Suite 100 Boston,MA 02X14 2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): _ L lL C Address: A yt-Ei City/State/Zip: e€;A ba©/ f:11 Fl; (319 6 d Phone#: IT - J (P 0,V Are you an employer?Check the appropriate box: Type of project()required): 1.❑1 am aemployerwith employees(full and/orpart-time).* 7. Q New construction 2.&1I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] ' 9. Demolition 3.0 I am a homeowner doing all work myself.[No workers'comp..insurance required.]t 10 []Building addition 4.C]I am a homeowner and will be hiring contractors to conduct all work on my property. I 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.C]I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E]Roof repair's These sub-contractors have employees and have workers'comp.insurance.t 6.Q We are a corporation and its,officers have exercised their right of exemption per MGL c. 14.0 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. Homeowners who submif 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer Mat is providing wor kef s'compensation insurancefor my employees.'Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lia#: Expiration Date: fob 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 Office of Investigations of the DTA.for insurance coverage verification. f do hereby cq y under thIgpings andpenalties ofperjury Haat the information provided above is true and correct. Signature: Ljl z Date: Phone#: eci -33 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#: Massachusetts Department of Public Safety J` Board of Building Regulations and Standards License: CS-091968 Construction Supervisor ; ,. DENNIS S PARZIALE ��• '. 2 STYLES DR PEABODY MA 01960 s J} Expiration: Commissioner 06/27/2017 C��e �po��znaa�zcaea�t>L o�C�/li��uri�cc�ttve!!� WeME Office of Consumer Affairs&Business Regulation IMPROVEMENT CONTRACTOR gistration: 148734 Type: piration 10119/2017, Ltd Liability Corpor ATLANTIC HOME DEVELOPMENT'LLC DENNIS PARZIALE 2 STYLES DRIVE - PEABODY,MA 01960 Undersecretary