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HomeMy WebLinkAboutBuilding Permit # 11/2/2016 ixORTH BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received C — GRATED ___ P Permit No#:_ _ ___ I ��`�acwus�-c pate Issued: _ — g0 �T��: Applicant nxust complete all Mems on the page TION WNER O no POPERT' Print ;, �'; iy�7p"fear Strucfure Hrstorac District �! fVIP+P i� PARCEL. zU ING D1�TRiCT: — Lachine whop Village yep no TYPE OF IMPROVEMENT _ PROPOSED USE _... ____ ___- _ Non- Residential Residential _ _�.__ — CJ New Building �R(5ne family industrial 0/addition CY Two or more family I.7 Commercial----. __.. No. of units: Others: __.�°Alteration __�. -w---- �a�ssessory Bldg �— [I Re"pair, replacement [� Repair, o Other _ emoli_ tior7_ _ __ � Ll Watershed District C7 Septic p Well —__. ri Floodplain C�V1/etlands o /S Waterevuer _ _ _ _ __�. DESCRIPTION OF WORK TO BE PERFORMED: �,. Print Clearly Ldent f catioDplease Type orphone'. � C711uNER: VIJ Address: _ ._ J 7 Phone - Contractor Name' '" ti -- Email: w Address: " Exp. pate: Supervisor's Construction License: Exp ®ate Home Improvement License: Phone: ARCH ITECT/ENGINEER__._...'._..._--- — Address: --------- PER$1000.00 OF THE TOTAL ESTIMATED COST.BASED ON$125.00 PER S.F. FEE SCHEDULE.;BULDIIVG PERMIT:$92.00 _� FEE: $—__ Total Project Cost: Receipt No.:—..—..-- Check o.:,__..— __.---.Check No.:— ��. – �� g �cr�c �T(�T"�',; �����nns c�r�tt>r•ccctan�; With rcnrc�,��`.�tc�^eco contractors cic� not �ic�xxc access tot/iL �cc����zt � __.. Signature of_contractar C�;rin,atk Grp of ,went./Owner— _— NORTH q own of � _ 6Andover O ". CO No. ♦ * V"4071r, 7— ver, Klass, / • iZ — � 0/� COCNICI4 .. P � AT IrE.o S U BOARD OF HEALTH PERMIT. T LD Food/Kitchen Septic System THIS CERTIFIES THAT M A es V� BUILDING INSPECTOR has permission to erect .......................... buildings on ....4ATft..5...4' .J'.. . ..�.......,� Foundation p ....!!�!!!4AOV......f�� `......,w/. � .Astor L� chime Rough t0 be occupied as .. Chimney provided that the person accepting this permit shalt 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 ELECTRICALINSPECTOR .- UNLESS CONSTRUCTI TAR Roue ........, .�.� Service .... ............................ BUILDING INSPECTOR Final GAS INSPECTOR OccupaneV Permit Required to Occupy Buildinz 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. ......... ............ .............. ............... ............. ....................... ................ ............ ,3 March 22, 2016 To Whom It May Concern, Please be advised that I am working with 4 Construction Services, Inc. and Mr.lose L. Vega, principal and owner. I will assist in the permitting process and job oversight at all the appropriate benchmarks and inspections. I will make myself available to discuss building codes or plan changes at any time the building official having local jurisdiction deems necessary. I have attached a copy of my Massachusetts Construction Supervisors License as well as my Lead Paint RRP and OSHA 10 certifications. Please do not hesitate to call me at 978 697-1317 if you have any questions or need to clarify my role in the permitting process. Thank you in advance for your anticipated cooperation. Sincerely, Myles C. Burke CS-105552 4Seasons Construction Services, Inc. (978)72645-00/4scinc@91Y)a -4.'Offi Customer Name: Telephone: Service tocation: Moe machRour (97&.37,6-4629 32 S a u n d e rs,St F,eet,U Andover,;MEA 0 1 ESM4,51 - li Proposal Date: Contractor., Sub-Contractor: 10/28/2016 Myles E. Burke JL Vega/4Seasons Construction Services, Inc. This proposal will come into an agreement when both parties sign as a binding contract. This project is to commence on October 31,2016. The time frame to complete th is;project is faur,(41 weeks from the start date unfess defays-arise due to inspections and/or inclement Weather. Any additional upgrades will incur separate charges OrPlease note this t6tdi does not include:countertop,cabinets,norsVidiny door*. The total for this project in Labor and Materials is$15;650;00. 1.) Bathroom:new bathroom with a toilet and sink;take down existing exterior door and close it up; add new walls; new electrical; new door;and new plumbing. 2.) Kitchen: renovate kitchen-open the wall that divides the kitchen with the dining room to make an open console;close existing entrance to the living room;Add a LVL between kitchen and pantry; dining room will convert into the kitchen,existing kitchen will become open useable space with hard wood floors;add 5 new electrical breakers with G1=1:for the *countertoplthe new plumbing. 3.) Plumbing:plumbing charge of$3,500.00 includes gas4ine,dishwasher, kitchen sink, bathroom sink, and toilet. 4.) Window: remove existing kitchen window and replace with a *sliding door with a 6 x 10 deck .pressure-treated; install aLVL over sliding door. Date Due Amount Due November 4, 2016 $3,912.00 November 11, 2016 $3,912.00 November 18, 2016 $3,912.00 November 25, 2016 $3,914. Signatu'r4e Date, tt-actor Print Name Contractor ':c' 8i-grTiture Date CJfe ni"t C. )Mnt)NaTn �Cflefit 1.90 Haverhill Street, #355, Methuen, MA 0184/1 Jackson �7, 0 D Material Receipt LUMBER & MILLWORK Transaction # 215 Market Street 10 Industrial Drive 67 Haverhill Rd 900443 Lawrence,MA 01843 Raymond,NH 03077 Amesbury,MA 01913 Date 1 Time Phone: (978)686-4141 Phone: (603)895-5151 Phone: (978)388-0366 11/01/2016 8:27 am Fax: (978)687-5841 Fax: (603)895-5152 Pax: (978)388-9824 Location LAWRENCE Sales Re resentative Chas Diaz Customer Copv Bill To: Ship To: CASH SALES LAWRENCE, MA 01843 (978)000-0000 000000000 Customer# Order# Order Date Oper Purchase Order Ship Via i 1 421047 11/01/2016 200 CUST PIU LN# Item Number Ordered Shipped Description IUM PricelUnit Extension 1 LVL716 1 1 1 314 X 7 114 X 16' LVL EA 51.35 51.35 Location: WH-D4L-001 SIGNATURE: ( ) Special order and manufactured merchandise is non-returnable Tendered Amount: Customer agrees that any amount not paid within 30 days of 60.00 Tax: 3.21 invoice date will carry interest at the rate of 1.50 per Change Total: 54.5 month and further agrees to pay all costs incurred in 5.44 Paid: 54.5 collection, including reasonable attorney's (ffees. Due: 0.0 Page 1 of 1 Cash 19/1/2016 Town of North Andover Mail-HIC License-4Seasons Construction Services,Inc. ..... NORT,fl AN Paul Hutchins <phutchins@northandoverma.gov> Massachus�ils HIC License - 4Seasons Construction Services, Inc. 1 message 4Seasons Construction Services, Inc. <4sc.inc@gmai1.com> Mon, Oct 31, 2016 at 1:39 PM To: phutchins@northandoverma.gov Please see attached HIC License for Jose Luis Vega 14Seasons Construction 2 attachments liff. Y EE G. IMG 1984.JPG 146K y .aF R� , IMG_1986.JPG 213K https:l/mai I.google.com/mai 1/ca/u/0/?ui=2&i k=7d85827aOb&view=pt&search=i nbox&th=1589 bd38c7dcfe8l&s i m 1=1581 bd38c7dcfe8l 1/1 -,,The Cominonwealth q f Massachusetts nepartment of IndiustrialAceldents n ", I Congress,S'h'eet,Suite Xaa d4 20X7 X�'astox�,1VXA 0211 � www.mass,gov/dra t Wo leers'Comp ensatianlnsurauceAffidavit:Builders/COnixac4axs/�+lectriciaxis/�'X�xnTaexs. TO:IM,MED WITII'THC I'EWMxI"I�1VG AT3TE{OS�Ty. �!Iease)L'xint La 'bl ,A ''licant Xxi#'axm.atian � a]11e(Bzzs%xaess/C)rgahizatioRftdividuall):____n hone, OWL cit __ . T] ;ew fle appraprlafebox: yp: .o,1 f pta�ro'jCeac�ts�(�e�q�uoiixxe d); txeyou an employer?QhecTt l.[]iamaemployerwith �_ em to ees full and/orpazttime.* . 2.L-1 f tun a sole proprietor or partnership andhave no employees working forme in $. � emodelo any capacity.[NO Workers'comp,insurance required.] 9. E]Demolition 3.[:]X ani a homeowner doing all work myself [No workers'camp.insurance required.]t 10 L�Building addition or and will be hiring contractors to conduct all work on my proporty. 1 will 1 LE]E]ectlical Tepalx.'s or addi ig�xs 4.E]1 am a hameawrt L onsurothat all contractors eitherhave workers'compensation insurance or are solo 12��:pltlxnbing xepaus or additions proprietors with no employees. f.�l attached sheet. �.�'Z am a genezal contraotor and I have hired the sub-confrartors listed on the 13%[]f�'aofrcliairs These sub-contractors have ernplayees and have workers'Damp.instuance t l.ti. Otlxer . S.[_]We are a corporatiart?nd xis.officers have exercised their rigYif of exemption pet MGl c. ' 152,§1(4),and rate have na employees.[Na workers'comp.insurance required.) — - - - . *Any applicant that checks�oic�#1 zriust also frit out the section below showing their workers'compensatianpolicy infazmatiarr. i Homeowners wlxo submrt k st attached an additional t indicating they are sheeshowing the name ot'ttx oing all Worka,nd then hire outside c ontractor�s and state wrs must h the or a now no thaseen itfehava h tContractors that check this —— --= employees, fftho sub-contractors have employees,they must provide their workers'comp.policy number. elow is floe pvliry orad job site X am an efnployep float is pr'ovidiragworlcers'compensation insurance for°nay employees. irafor^rraatiorx. -. _� insurance Company Name: Expiration Dstte Policy#or Seldins.Sia.# City/State/Zip: , 0".. rob Site Address:_ Attach a copy'Of-the��xX�exs'.caaupensatzaan policy declaration page(showing the policy���e a o�Up�a$0500 00) l Failure to secure coverage as required under MOL o.152,§25A is a criminal violation pxmts y ER and a RnO Of up to and/or one-year imprisonment,as-well as civil penaltiche forwarded to the Oftto offu O gat oris of the DIA.or insura)nco a day against the violator..A copy of this statement may coverage verification. .f do hereby cert rrn triepains°an enalties Ofpelyury tliat tfle injbrmat!OW roplded alcove is tr°tze an,, orr'ecz Date: Signature- _____67 Official tale only. Do root write in 11149 area,to he completed t)y city ori tolvn off tial: City or To vn- Permit/fxcense# ._ :[ssuiugAuthoylty(circle ane): ' tyT 1.Board afHealtlx 2.buldingl7epaxtznent 3.Cii'o'wn Clexlr ,Exectx°iteaXXnspector 5.Pxxrminglnspectax 6.Other Phone Contact Ae Commonwealth of Massachusetts Department of IndustrialAccidents ' S s 1 Congress Street, Suite 100 Boston,lf�lA 021142017 - '� w www.mass.go-v/dia •p 41M syi�9 _Woo vers' Compensationjusurcance Affidavit:Puiidexg/C a3 COs �trxaxansl uznbexs. TOBEF LED W1rTHTEM' PERM'T`}n4 Please xint 1,0641Y A "'licant ixrfoxmation ', Name(Businessl(5rgathationlbadivid/ual): to/Zip; �lif� u_ n �OIN4Phone City/sta , Are you an eruployer?Check the appraprlate boat: Type of project(x•equired)l " employees(fall and/or part-time)."' 7. I�eViW'cCi]�StTllatioxk 1.n I am a employer with— . 2A. 1 am a sole proprietor or partnership and have no eruplcyees Working forme in $. Ei emodel�g arry capacity.[Noworkars'comp.insurance required,] 9. 0 I]etnolitiOn 3.E]i am a homeowner d"ting all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.❑I aur a homeowner andwili be hiring contractors to conduct all work onmy property. twill 11❑E]cc#i.Cal repatt's or a dditiQp5 ensure that all contractors either have workers'compensation insurance or are sole re airs or additions proprietors with no euiploye6s. 12T P� g p 5.❑1 am a general contractor end I)rave hired the sub-contractors listed on the attached sheet. 11E]Roof repairs These sub-contractors bane employees and have workers'camp.insurauce.t tri,Q Other &.❑ e aro a oorporatimi and its,of 6.ts have exercised their right of exemption per MGI..c. and VV have no empldydes.(Ido workers'camp.insurance required.? � ow showing their workers' *•Any applicant that cheoks tabk 41 davi indica g they are doingDUMG sectio -,Vwork andthen hire outside contractors compensation m Must submit a new affidavit indicating such. i Homeowners who submit•tl is affr, . tContractozs that checkIfiis aBOX tnu5t ctors have tatol'e es$they mus provide their workeerrs,of policy number.�d stafie whether oFnotthose ent'sties bavo employees. If the sub-crx# X am an errzployer'tf�tat is pND7�idZPtg7�3�Dr162rSr compensation insurance-for my employees. -Mow is tlzeporacy aridj�oti Site infor)nadon. / Insurance Carnpany Name: -C) P ExpirationDate' Policy#or Self-ins.Lit.#:. fob Site Address: � 5 .S T C�itylState/Zip: dt'' date). Attach a copy of the yvorkcys, comEpensatiou policy declaration page(shoving tTae policy number and expixatioxi Failure to secure coverage as required under MGL penalties irfi,§25A is a the forts of a STOP WORK DRDERnal-violation Iand.a fine f uli to $250.00 a and/or one-year ixnprisonmont,as veli as civil p f this Statement may be forwarded to the Of4xco of investigations of the DiA for insurance day against the violator.A.cagy o coverage verification. .r Jo lier eliy cert ander tliepains andpenalties afperjury that the information provided wave is true and correct Date: `/� Si ature: �® one;#?' . Official use only. Do rzotwz`ite in this area,to be coizzpleted by city or town official. Permit/License# City orTownz issuing Authority(circle one): 3.City/To,wn Clerk Q•.Electricalinspectox S.Plumbing inspector l..Board.of health 2.Building pepaxttnent 6.Other Phone#: Contact Person: 0DATE IMMIDDIYYYY) ACORV CERTIFICATE 4F LIABILITY INSURANCE ��. 10/31/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO 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 INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,Certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: Eric Jansen Hasbany&Regan Insurance Agen A/C No Exti: 978-685-3188 FAX Nol: 978-685-9460 254 Pleasant Street E-MAIL ss: Gime@hasbany.com Methuen,MA 01844 INSURER(S)AFFORDING COVERAGE NAIC H INSURERA: Utica First Insurance Company INSURED INSURER B: ACE-American Insurance Compa 4 Seasons Construction Service INSURER C: Safety Insurance CIO Jose Vega INSURER D: 190 Haverhill St Methuen,MA 01844 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !LTR TYPE OF INSURANCE [NSD V D POLICYNUMBER MMIDDIYYYY MMIDDffYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ENTLD CLAIMS-MADE OCCUR PREMISES DAMAGE T(Ea occurrence $ 50,000 MED EXP(Any one person) $ 5,000 A Y ART506388601 01/23116 01/23/17 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 NOTHER: L POLICY 0jE' �LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY MBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ 100,000 C ALL OWNED XSCHFDUIED 6233955 06112/16 06/12117 BODILY INJURY(Per accident) $ 300,000 X AUTOS AUTOS N11-OWNED PROPERTY DAMAGE $ 100,000 X HIRED AUTOS X AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ ElEXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ER STATUTE X ER _ ANY PROPRIETORWARTNERIEXECUTIVE YIN E L.EACH ACCIDENT $ 1,000,000 B OFF ICERIMEMBER EXCLUDED? ❑Y NIA 6S62US-2E69854-8-16 02104116 02/04/17 Mandatory in IVH) E.L-DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Site Improvements,Inc.is included as additional insured on General Liabilty Policy owner(Jose Vega)has elected to exclude coverage for himself on his workers compensation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Aima Negron ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD I CS;%/r� l�(iO71Xal[narle'rc^rrCI�BB rr���6drf,Jrec✓rrr1C/(pit Office of Consumer Affairs&Business Regulation ( HOME IMPROVEMENT CONTRACTOR e: Registration, .183820 Expiration: 11/1612017 Corporation 4 SEASONS CONSTRUCTION SERVICES,INC. � , JOSE VEGA 190 HAVERHILL ST#355 METHUEN,MA 01844 Undersecretary P C MODWYEALTH Or IMASSACHUSETTS : om f BOARD OF v' 04, 'pi, ;' Div.of Profe ioil'st UC uaC � ISSUES THE FOLLt1V�� NG REAL IESTATE: i,:IJ'Lf��,E �� �^ y q', y rye; �^ q�'y /� ( w l f i ` r wet i YLCS E 1S 1(f . FAYE M r-rIlSRKE: , 66 CRYSTAL COURT u I-IAVIr fl1 LL . 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