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Home My WebLink AboutBuilding Permit # 6/6/2016 A,AORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 � APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received 06 S s 9C6-0US�� Date Issued: TAI�iT A he ant must complete all items on this page J � IIVIPOI2 pp p LOCATION Print 100 Y Ono Prin ,, PROPERTY OWNERra� � " � � �""� ear Structure yes MAP 0 a PARCEL: ZONING DISTRICT: _ Historic District yesMachine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family Li Addition El Two or more family ❑ Industrial ,®"'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other / r :,/ M'111111,"', / r / r � � lG ❑ r r rr/ r // / � / DESCRIPTION OF WORK TO DE PERFORMED: ('�'()A-V� ,P' P'._. Z)/ ✓ rear C ./ V r II a "A b 6 r'�1 i" At T-V 771 Identification- Please Type or Print Clearly OWNER: Name: / r r -r ;.... :., Phone: Address: P — — Contractor Name:(� 7LOD V `..� -r1-P1 Phone: ».'... ....w Email: erg/ Address: ca f ._. t 7./ r .. :. Supervisor's Construction Licenser µ� Exp. Date: Home Improvement License: o '2 Exp. Date: ,.�.. ..,... ,�, ..._ � 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 Projekt Cost: $ � , FEE: $ Check No.: Receipt No.: 04(00 NOTE: Persons contracting wid, unregistered contractors do not havelaccess to the guaranty fund Si11 an11 ature,cof 11 Ag-ent/O mIIner gnatur .. Y tkoRTH Town ofr• , Andover ® ® , � h ver, Mass, T 0L41111" COC MIc"t-ICK RqrE® U BOARD OF HEALTH Food/Kitchen- PF= RMMIT T L � Septic System 00JTHIS CERTIFIES THAT ..... .... ... ..THIS INSPECTOR has permission to erect .......................... buildings on ... ..:. .. ..... Foundation Rough to be occupied as Chimney provided that the person accepting this permit shall in every respect conform to the terms of the ap kation 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 MONTHS ELECTRICAL INSPECTOR UNLESST TI®N Rough Service ... . ........ ... Final BUILDING INS CTO GAS INSPECTOR Occupancy Permit Required to 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. e6 �0 R .........Y', C U ST 0 M B tj 1 1, D 1 [1,1 G i f� E N/t 0 F) E LING This agreement made this 26th day of May, year Two thousand and Sixteen by and between Cote and Foster Contracting, Inc. hereinafter called the Contractor and Heidi Gladstone,hereinafter called the Owners,witnesses that the Owner intends to convert dining room & living room into a bedroom and bathroom at the address of 105 Fox Hill Rd.,North Andover, MA. Now,therefore, the Contractor and the Owner, for consideration hereinafter named, agree as follows: ARTICLE I The Contractor agrees to provide all the labor and materials to do all things necessary for the proper construction and completion of the work shown and described on drawings. The drawings and specifications are the basis of the contract. ARTICLE 2 In consideration of the performance of the contract,the Owner agrees to pay the Contractor, in current funds as compensation for his services hereunder$76,962.00 to be paid as follows: Payment 1 -$20,000.00 at signing of contract Payment 2 - $10,000.00 at completion of framing and demo Payment 3- $15,000.00 at completion of rough electric & plumbing Payment 4- $10,000.00 at completion of plaster& insulation Payment 5 - $10,000.00 at completion of wood work Payment 6- $7,000.00 at completion of carpet Payment 8- $4,962.00 at completion of space ARTICLE 3 Final payment on contract amount as agreed above to be paid within ten (10)days of project completion or occupancy. If final payment has not been made within this time a 10%charge per month on the balance due will be charged. All minor punchlist items will be complete as part of the one year warranty on the finish product. Failure to pay balance within ninety(90) days may result in legal action. 20 Aegean Drive - Unit 15 - Methuen,MAO 1844 Tel: 978-682-6518 - Fax: 978-682-1221 www.coteandfoster.com ARTICLE 4 Additional work above and beyond the contract agreement: All additional work done to be quoted at the time the client requests the work. The work will be done and billable at its completion. The client has ten(10) days to pay the additional cost �Ier I Zo'he or she has been billed for it. Initials: In witness whereof they have executed this agreement the day and year first above written. Heide Gladstone, wner "0' ............ 'Steven d Cote DBA Cote & Foster The Commonwealth of Mass achusefts Department ofIndustrial Accidents Office ofInvestigations 600 Washington Sty-eel Boston, ,MA 02,111 Of www.mass.govIdia Workers' Compensation Insurance Affidavit: Riiilders/Contractors[Electricians/Plumbers Applicant Information Please PriALLggMy Name (Business/Organization/Individual): Address:— Cily/State/Ziprl-Q 6,/A-4hone 11: Are you an employer? Check the V appropriate bo Type of project(required): 1.[1 1 am a employer with 4. 7!1 am a general contractor and 1 6. E]New construction employees(full and/or part-time).* have hired the sub-contractors 7. ff Remodeling 2.0 1 am a sole proprietor or partner- listed on the attached sheet. : ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. workers' comp.insurance. 9. r] Building addition [No workers' comp. insurance 5. El We are a corporation and its I O.E]Electrical repairs or additions 3 EJ required.) officers have exercised their . 1 am a homeowner doing all work right of exemption per MGL I).[I Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4),and we have no 12.E] Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box ill must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, lContractors 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'coiWensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: (-14 P Policy#or Self-ins.Lie. Expiration Date: Job Site Address: City/State/Zip: lv Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration Failure to secure coverage as required under Section 25A of MOL 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 tip 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 DIA for insurance coverage verification. Idohereby cern y under lae pains and penalties ofperjury that the information provided above is true and correct. 4e�, 7212�z Sign re: Date: Phone#: 4 2� -1 &/ 5-/ P QJJ1cial 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): I. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Cr ((r�nr3icirfc�rrr�/� ;-l�uu,r�rlrisrl/5 massa hu e s _e"q irtm nt of Publl( ffice of Consumer Affairs&Business Regulation jBoaidl of f; Building � ME IPIIPROVEMENT CONTRACTO .}.} E..It IISLt I.11 n SU pui-i\f)f egistration: 107602:. Type: License: CS-0851'73 Expiration: 8/5/2016 Supplement COTE& FOSTER CONT. WILLIAM T FOSAR ';- 65 COACH DR w' WILLIAM FOSTER DRACUT MA 0A26 - ris 20 Aegean Dr Unit 15 g l` Methuen, MA 01844 Undersecretary Expiration 11/10/2016 Commissioner t