HomeMy WebLinkAboutBuilding Permit # 4/19/2016 %%0RTVj
BUILDING PERMIT 0 0
TOWN OF NORTH ANDOVER
--7APPLICATION FOR PLAN EXAMINATION
Permit NO: 2 Date Received
Date Issued: A us
IMPORTANT: Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building "ne family
El Addition 11 Two or more family 1-1 Industrial
El Alteration No. of units: 11 Commercial
Q5,Repair, replacement El Assessory Bldg 1---1 Others:
I--] Demolition 11 Other
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Identification Please Type or Print Clearly)
OWNER: Name: /4111f Phone:2: -0e,2:z--.2
Address:
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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.
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Total Project Cost: $ FEE: $ 'Q
Check Na.: Receipt No.: 7'c") .2
NOTE: Persons contracting with unregistered contractors do not have access to the gu antyfund
ay
Signature of Agent/Oftet-
'Sigriature ofcohtractor��',,
NORTH
Town of Andover
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BOARD OF HEALTH
Food/Kitchen
r11E R MIT LD Septic System
THIS CERTIFIES THAT &/V C�F�`( BUILDING INSPECTOR
.......... .. ...................... .....:... ............. .... ..... .......................
. . . .... .... ..
. ' Foundation
has permission to erect ...... buildings on .... /
Rough
to be occupied as ...................... !} ................................................. 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 IN 6 MONTHS ELECTRICAL INSPECTOR
LESS CONSTRUCT STARTS 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 Approved by the Building Inspector. Burner
Street No.
Smoke Det.
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Cutlery Divider
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UF696 as baseboard on island sides/back °O
FP9648 cut and applied to sides on site j 4
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Dayton Painted White j
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i IQR8 to be used at base of toe kick j -4
SM8 to be applied vertically against
exposed wall cabinets on site
- - Crown: UF1.596/CVM8
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UF696 as baseboard on island sides& back NI,
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Soft Close included
Cabinets not drilled for hardware "
Client responsible for all measurements.
Please verify dimensions prior to ordering. c�
NOTE:
Ta ensu e acc��racy client is responsibte and Pias
vet ed all dimensions.Any changes atter the
order has been placed wit[resLttt in a restocking fee.
130 Centre St. Proposal
Box C-1
Danvers, Ma. 01923 978-423-8463
Hanz & Mary Van Deventer 4/4/2016
150 Hillside Rd.
N. Andover.
Project Description Total
This Proposal is for the following work. 37,840.00
Kitchen remodel
Scope of work;
We will apply for the proper town permits.
The areas outside of the work areas will be protected from dust and debris.
The existing fixtures and appliances in the kitchen will be disconnected and
removed.
The kitchen and fireplace room will be demo'd down to the studs, subfloor and
the ceiling joists.
The flooring in the hallway to the front door will be taken up.
The wall between the two rooms will be removed.
We will close up the wall from the kitchen to the diningroorn as shown on the
plans.
The wall from the fireplace room to the livingroom will be opened up leaving a
couple of feet of wall to keep some of the baseboard heat on.
We will saw cut the right side of the chimney to make it the same width as the
left side.
The walls will be insulated with R-15 fiberglass batts.
The walls and ceiling will be blueboarded and veneer plastered to a smooth
Total
Signature
mfgoodwincompany@gmail.com
Page 1
Mass.CSL #081670 Mass. HIC #105 029
130 Centre St. Proposal
Box C-1
Danvers, Ma. 01923 978-423-8463
Jmw
Hanz & Mary Van Deventer 4/4/2016
150 Hillside Rd.
N. Andover.
Project Description Total
finish.
We will install 2-1/4" oak flooring in the kitchen and hallway. It will be sanded
and polyurethaned.
We will install the cabinets, moldings and hardware according to the plans from
Cliqstudios.com.
We will install new baseboards and trim out the window and doors to match the
rest of the house.
We will install all of the appliances.
Electrical:
Our electrician will rewire the kitchen to bring it up to code and for the new
layout.
8 recess lights with LED trims will be installed and put on a dimmable switch.
3 pendant lights over the island and I over the sink.
Wire in the two toe-kick heaters.
Receptacles for the countertop, gas range, dishwasher, garbage disposal,
refrigerator, microwave and island.
All of the appliance will be wired and installed.
A subpanel will be located under the kitchen area to accommodate the needed
circuits for the remodel.
Plumbing:
Total
Signature
mfgoodwincompany@gmail.com
Page 2
Mass.CSL #081670 Mass. PLIC #105029
130 Centre St. Proposal
Box C-1
Danvers, Ma. 01923 978-423-8463
Manz & Mary Van Deventer 4/4/2016
150 Hillside Rd.
N. Andover,
Project Description Total
Our plumber will rough in and install an island sink, install new shut-offs and
install a sink and garbage disposal under the window, extend the gas line to the
new stove location and install the gas stove with gas shut-off.
Remove the baseboard heat leaving a couple of feet to the left of the back door.
rough-in and install two toe-kick heaters under the cabinets.
The dishwasher, garbage disposal and two sinks will be connected.
A water line for the refrigerator will be installed and attached.
Total
Signature
mfgoodwincompany@gmail.com
Page 3
Mass.CSL #081670 Mass. HIC #105029
130 Centre St. Proposal
Box C-1
Danvers, Ma. 01923 978-423-8463
Hanz & Mary Van Deventer 4/4/2016
150 Hillside Rd.
N. Andover.
Project Description Total
All rubbish will be removed from the premises.
References are proudly given upon request.
Town permit fees are additional and will be billed separately.
The homeowners will provide the cabinets, appliances, plumbing fixtures,
pendant lighting, cabinet hardware.
Painting is not included but can be added if desired.
To supply & install undercabinet LED lighting will be an additional $1200.00
All work shall be completed in a workmanlike manner according to standard
business practices. Any deviation from the above specifications involving
additional labor and/or materials shall be executed upon written authorization
and may be an additional charge.
Total: $ 37,840.00
Payment Schedule;
A deposit of$ 11,350.00 is due upon starting.
A payment of$ 11,350.00 is due upon completion of plaster.
A payment of$ 11,350.00 is due upon major completion of cabinet and molding
installation.
Balance of$ 3,790.00 is due upon completion of the project.
Total
Signature
mfgoodwincompany@gmail.com
Page 4
Mass.CSL #081670 Mass. HIC #105029
130 Centre St. Proposal
Box Cwt
Danvers, Ma. 01923 978-423-8463
-zW=
Hanz & Mary Van Deventer 4/4/2016
150 Hillside Rd.
N. Andover.
Project Description Total
Acceptance of Proposal;
Contractor: Date:
Homeowner:- 1�1� , Date:
01",/ - ze-�,-
NOTE: This proposal may be withdrawn by either party within 72hours of
signing.
Total
Signature
mfgoodwincompany@gmail.com
Page 5
Mass.CSL #081670 Mass. HIC #105029
130 Centre St. Proposal
Box C®1.
Danvers, Ma. 01923 978-423-8463
�mm
Hanz & Mary Van Deventer 4/4/2016
150 Hillside Rd.
N. Andover.
Project Description Total
Total $37,840.00
Signature
mfgoodwincompany@gmail.com
Page 6
Mass.CSL #081670 Mass. HIC #105029
The Cofnmomvealth of.lt4"assachusetts
Department of Industrial Accidents
Office of Investigations
' 600 JVashington Street
Boston,MA 02111
ivww.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le 'blv
NaMe(Business/Organization/Indiv'dual): ie �L
Address: 7
City/State/Zip:
Are you an employer?Check the appropriate box:
1. I am a employer with 3 4• ❑ I am a general contractor and I Type of project(required):_
employees(full andior part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I aim a sole proprietor or partner- listed on the-attached sheet. 7. aRemodeling
ship and have no employees These sub-contractors have g• ❑Demolition
working for me in any capacity. employees and have workers'
[No workers'coma 9. Building addition
[� p.insurance comp.insurance.t� - g
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercisedtheir i l.❑plumbing repairs or additions
myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no - -
emplo.ees.[No workers' 13.❑ Other
comp.insurance required.]
*Any applicant that checks box:I must also fill out the section below shoring their workers'compensation policy information.
t Homeom-ners who submit this affidavit indicating they are doing all ur1k and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet sho v.ing the name of the sub-contractors and site whether or not those entities have
employees. If the sub-contractors have employees,they must proNide ih-air workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my emplo}•ees. Below is the policy and job site
information.
Insurance Company Name: -,fes �/ � v
Policy#or Self-ins.Lic.#:_ 15,1715/ Expiration Dag
Job Site Address:�����/�j_e_ City/State/Zit):
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 may be forwarded to the Office of
_Investigations of the DLA for insurance coverage verification
I do hereby certify under the pains and penalties of perjury that the information provijdeed above is true and correct.
�Signature d% ��,�- Date
Phone#:
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
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS-061670
Construction Supervisor
i
MICHAEL F GOODWIN
7 HOLT RD
EPPING NH 03042 '
CA— Expiration:
Commissioner 08/08/2017
/rs mer Affairs
&�Bu af'ss Regulation
License or registration valid for individul use only
Office of Consumer Affairs&Busibess Regulation g
A OME IMPROVEMENT CONTRACTOR before the expiration date..If found return to:
egistration: 105029 Type: Office of Consumer Affairs and Business Regulation
xpiration: 7/16/2016 Individual ! 10 Park Plaza-Suite 5170
1 Boston,MA 02116
MICHAEL F.GOODWIN JR. !
f
Michael Goodwin s
7 HOLT RD. 4
EPPING,NH 03042 Undersecretary Not valid without signature