Loading...
HomeMy WebLinkAboutBuilding Permit # 8/26/2016 "ORTN BUILDING PERMIT pF�TLtn ba�0 TOWN OF NORTH ANDOVER ~ APPLICATION FOR PLAN EXAMINATION " s ^ Permit No# 303l _�L_ Date Received e„us �ty Date Issued- IMPORTANT: Applicant must complete all items on this page LOCATION �V — Print PROPERTY OWNER QU ri hr4p� _l, }n ® Print 900 Year Structure yesOno MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non, Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 9Itepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑] Se tic ❑1lell ❑ Floodplain I Wetlands ❑ Watershed D1str�ct [�Water�5�wer �-u DESCRIPTION OF WORK pTSO BE PERFORMED: Wa f;W A5, g £d 361 Identification- Please Type or Print Clearly OWNER: Name: Phone: }- .3 20 Address: a v v) Contractor Name: J Phone: q Email bL r- c Address: "J2-C41 i 1, a n 4 ► 1 c S i UG'Z�1 Supervisor's Construction License: Ds s Cff 4 Exp. Date: Home Improvement License: Exp. Date: 2`x..20# ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PE $1000.00 OF THE TOTAL ESTIMATED COST BASED ON 125.00 PER S.F. 64 Total Project Cost: $ � FEE: $ Receipt No.: -7� Check No.: p _ . NOTE: Persons contracting with unregistered contractors do not have access t guaranty fund n Y X.,- ti %4®RTy '� oven of � 4 AT. b over no k�' h 0% 0- 7n ver, Ma OBw1a coc"Ic"C wtc R S U BOARD OF HEALTH ERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT . ............ BUILDING INSPECTOR has permission to erect ... buildings on ......r,.,.`.' ,. ��/�.r�, Foundation .................... ... .... .. ....... ....... ... Tacceptingg Rough to be occupied as . .... . .��.... .. . f I 0Chimney provided that the person this #Permit7hal in every espect conform to the terms of a 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 UNLESS CONST ;IONT Rough Service .. .... .... ..... ....... .... ...... . Final BUILDING IN 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. MIGUELIN CONTRACTING INC. 289-291 ESSEX STREET, LAWRENCE MA 01840 978-794-1182 Cell 978-420-8052; Fax 978-327-5599 *ROOFING*SIDING*REMODELATIONS*BOILER *LEAD PAINT REMOVAL*ASBESTOS REMOVAL CONTRACTOR LICENSE#175629 MAXIMO GUERRERO CS-089346 DELEADER CONTRACTOR#DC001924 FREE ESTIMATE-FULLY INSURED E-MAIL: migruelincontaractlatol,com PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME: Jean Carlos Almonte 57 Autran Ave. Phone: 857.234-8050 North Andover Ma 01845 DATE: August 19, 2016 We hereby submit specifications and estimates for SCOPE OF WORK: Repair The house Walls ceiling living room floors: new floors Install insulation blue board plaster and finish All floors, bathrooms and cabinets. Knock down two walls in the kitchen and living room. Staircase and front door. Install a new siding on the front. Basement: Staircase down to the basement. Break the walls and put sheetrock in the basement. Put five windows in the basement. Put a new ceiling in the basement. Bathroom Install new toilet, new sink, new bathtub and walls. Roof: Install new roof. Ladder in back area. Doors front and back. Put the interior doors. Retouch the walls. Walls: Install insulation blue boardplaster, and finish. JOB TOTAL: $55,050.00 The propose hereby to furnish materials and perform the complete labor according with above specifications, for the sum of: Payment to b made as follows $25,025.00 is require to star work. Balance upon complexion $25,025.00 NOTE: MAKE CHECK PAYABLE TO LUIS MIGUEL TEJEDA/MIGUELIN CONTRACTING INC. All material is guaranteed to be as specified, all work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by workmen's Compensation Insurance. Thank you for your business and look forward to our relationship. Authorizedq_ _ "f 8/I9/I6 Signature Date: Luis Migu 1 Jejeda HIC Jean Carlos Almonte ACCEPTANCE OF PROPOSAL the above prices, specifications and conditions are satisfactory and are hereby accepted. You ar authorized to do the work as specified. Payment will be made as outlined above. Signature:�C' ofyh(J Date of acceptance: 71 � Massachusetts Department of Public Safety `.WIf3 Board of Building Regulations and Standards License:CS-109251 Construction Supervisor JOSSERY DIAZ 7 NORTH STREET HAVERHILL MA 01830 Expiration: Commissioner 0111312019 �. The Commonwealth OfHpffff chuselts .Z .) z . epi-ptMeut offfidusirial.Aceldents •_., tl I Coragvesv aSVeet,,S`aate 160 011 r Boston,HA. 021142017 , www.mas .go•v/dirx o lzexs'Compensation Insurance Affidavit:$nilders/ContractorsLG+Xeetriciansll'Z burs. TO 33B YILED WffR TBS PYff TIlNC AT3TB:OR=' Applicant 7nformati ori 'ieasa Print �e ' T Name(Business/OrganizatioN(fudiv%dual): $ Addross:s: 2 City/sw,/zlp. L-awc-tr cc- !"lU1 Phone#: 20 d5-Z, Are you an empIoyer?Check-Wa ap 'ropxiate box: Type of proiect(.veq=ed) 1.❑Y am a empinyerwith ! employees(fnll and/or part-time). 7. Q Neer ooiistruetiou I am a sole propdetoz or partuorsbip and have no employees working forme in. 8. em o delirig any capacity.[No workers'comp.insurance required 9, Demolition 3 Tam ahomeowmrdoiugall work myself Iffo workers'comp.-insurance zequirad j t 10❑P.Ui g addition. ti.n I am a hemeowmex and vri71.be hiring contractors to conduct 01 wozk on my properEy. T wiU 11.[]Bloo.�cal.repairs ox.a[-ddiflons ensuro that all contractors either have vrorkers'compensation insurance ar aro sole ,r • proprietors- thY'oemployees. Ii[j 5.df am a ge]aezel contractorand f have hizodtbe sub-contractors Jisted on tbn attached sheet. I ,'p Roofiepaixs These snb-coniractorshave ezmplayees amdhave workers'comp.iristuance.� 14.E]Ofh.eF S.E]Weare acorporatignpditsofgers•haveMore!Sc4their rightO 'e�cemption perMGLc. undx�ehaveno.ein 14YeF. oworkers'eomp.insurancoxegniredj �r.P - ,. , •Anyapplicantibat cheoksbox4l must alsoM outthe sectionbelov(sho,iviugt-heir•workers'compe,nsauonpolicyWormatiom i Homeowners who subn;jtt�k aEddantindicatingthey are doing allwaikand then1dre outside contractors must s4bmit a new affidEntindicating su& tConiractors that checkthh box mnetattaehed an addi#.onal shut showing the name of the sab-contractors and state-Whether or not those entities have employees.Ifthe sub cor7tac[iizs have employees,47iey must pravidethair workais'comp.policy number, I am an emj)70yeP th at is.PFOVIding-pvor•Aer•s'compensation MSUYaneefor my employees.'Below 1S thepolicy andjob site in . t fmatio72. A - -7 Insurance CoznpanyName: Q Yr L� e` C I'olioy#or Self ius. ic.#: G f o !S Expirat on Date: ,� Ciwstate/Zip: a cr � 5 Tal,Site Address: - Attach a copy mfthevvo�rkers' cb-mtpepsationpoltey declax'ationpage(showmgthe po-Reynum-ber"a expiration date). Failure to secure aoV&age as requixed under MOL c. 152, §25A,is a criminal violation punishable by a fine up to$1,500.00 and/or one-,year:imprisonmeztt,as Well as civil.p enalties in the form of a STOP STORK ORDER and a flme of up to$250.0 0 a clay against the violator.A,copy Of'this statement may be forwarded to the Office Of Investigatlans of'the DIA for insurance coverage verlfi catiton-. X do J2exeby ceriify u N e p:,mni penalties afpe'jary that the rnfor•madon.provided above is��e and correct Sr afore: - Date: Phone#: Official Use only. Do not-tvrite in this area,to be completed by city or torvrz of�ciai< City or Town.- PermlbLieonse# Issuing Authority-(cixcle one): i x.Board oxffealth 2.BuRdhtgDeparjU ent 3.CitylTown Clerk 4.Flectticai mpector 5.PlumbingWpector 6.Other Conta.ci Person,: 3%03ae#: ------- Office of Consumer Affairs and Business Regulation t 10 Park Plaza - Suite S 170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 175629 TYpe: Corporation Expiration: 5/24/2017 Ti# 266019 MIGUELIN CONTRACTING INC. LUIS TEJEDA 291 ESSEX STREET LAWRENCE, MA 01840 Update Address and return card.Mark reason for Change. SCA 1 20M-05/11 � E Address E] Renewal E Employment Lost Card r'��r (pr,7lr7>/riIlRrBrl��lL O%(%/��7JJCIC�LLsCI�J Office of Consumer Affairs&Business Regulation License or registration valid for individul use only i HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: , 175629 Type: Office of Consumer Affairs and Business Regulation Expiration 6/24/201.7 Corporation 10 Park Plaza-Suite 5170 y Boston,MA 02116 MIGUELIN CONTRACTING INC.,_. LUIS TEJEDA 291 ESSEX STREET LAWRENCE,MA 01840 Undersecretary Not d with6it signature jV/24/2016 12:57PM FAX 5087556412 THOMAS WOODS INSURANCE 00001/0001 I i C¢" MIGUCON-01 LBIGELOM CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDIYM) 8/24/2016 THIS CERTIFICATE I$ ISSUED AS A MATTIR OF INFORMATION ONLY Aldp CONFERS Np RIGHTS 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 INSURERO),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT. If the Certificate holder is an ADDITIONAL INSURED,the pollcy(Ies)must ba endorsed, If SUBROGATION IS WAIVED,subject to the terms and Conditions of the policy,certain Pollcles may require an endorsement, A statement on this certifrcato does;not Confer rights to She certificate holdor In Ileu of such endorsemon s, PRODUC♦wR N Thomas J.Woods Insurance Agency Inc. N MC 20 park Ave p"oNt' 508 755-5944 WorceYter,MA 01803 MArL AIC N 508 755-6412 -info Woods!nsUrance.com INSURER 9 AFFORDING COVERAGE NAIL p IN8ugED INSURI-RA t MaXUm Indemnitv CO INSURlIR s;Miscellaneous Miguelln Contracting Inc INSVRI!RC: 289.291 Essex St Lawrence,MA 01840 lNauRc'•R n 1NSUROR 8, COVERAGESINSUR[[R I': CERTIFICATI NUMBER: REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IS5UED To THE INSURE©NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOGUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRI85D HEREIN 15 SUBJECT TO ALL THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .TERMS. TR TYPE OF INSURANCE POCKY NUMBER rtIMIIYYV DDMMo IQrvyyY I x GOMMERClgL CENf:RAL LIABILITY LFMITS CLAIMS-MADr= El OCCUR BDG3005358.03TACH OCCURRENCE s 1,000,000 03!25/2018 03125!2017 P �A S 100,x00 MED EXP An one anon 11000 GFN'L ACG-E(3gTE LIMIT APPLIC$PER: PERSONAL S ADV INJURY 11000,p00 POLICY D jECQ ❑ LOC GENERALAGGRECATc s 2,000,000 OTH R' PRODUCTS-COMPIOP AGG S 2,000,000 AUTOMOBIL11 UAOIUTY S MEIN IN4L LIMIT ANY AUTO aOlder 5 ALL OWNED "CHEDUL3=6 BODILY INJURY(Perpenqn) y Y AUTOS NON OWNED BODILY INJURY(Par noeldem) s HIRED AUTOS AUTOS A n AMAX S UM6FILLLA LIAS OCCUR S exC835 LIAO EACH OCCURRENCE y CLAIM$.MgOE .. ACGR[GATE S D!«D RETENTION 5 WORK�RB COMPENSATION y AND EMPLOYrRB'LIAMUTY Y! ANY PROPRICTORMARTNGRIEXECUTIVI: OFFICERIMCMEIER EXCLUDED � NIA E,L,EACIi ACCIDENT S (Mandatory In NH) Ir as doacnlbe under E.L.DISEASE-CA EMPLOYEE S DFS RIPTION F------- 8 p -AT8 General Liability CPL105090E.L DISEASE.POLICY LIMIT S 03/25/2016 0312512017 POLLUTION LIA13 1,000,000 D213CR1pTION OF DPERgTION31 LOCATIONS/VfiHIC4C9 (ACORD 101,Addlttonal Romarko 60edula.may be altethud tf Mote npAca fa tequftod) POLLUTION LIABILITY INCLUDES LEAD A ASBESTOS REMOVAL e CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE Ot~l.iVIRI;D IN 1600 Osgood St ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,!VIA 01845 AUTNORtZEC RRPRE$ENTAnVE ACORD 25 2014!01 1988-2014 ACORD CORPORATION. All rights reserved. S ) The ACORD name and I090 are registered marks of ACORD