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Home My WebLink AboutBuilding Permit # 10/31/2016 %AORTFI BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 4 PermitNo#: Date Received ACHJS'� Date Issued: ---------- IMPORTANT: Applicaiit must complete all items on this page LOC pf)n x, PROPERTY OWNER , no ri P -nt,,/", —iboy yes y no, 'Higto�ic,Dlstrjbt MAP, PARCEL: ZONING DISTRICT Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE -------- Residential Non- Residential El New Building 0 One family 0 Addition El Two or more family 0 Industrial [.1 Alteration No. of units: [-J Commercial ac 11Others: ,�-',Repair, replacement 0 Assessory Bldg D Demolition D Other El Septic 0 Well El Floodplain F]Wetlands D Watershed District El Water/Sew'er —----- DESCRIPTION OF WORK TO BE PERFORMED: Identification - Please Type or Print Clearly Phone: 40'�) i.1 )L),3 OWNER: Name: L,rj"? Address: Contractor Name- f2 Phone. Email: Address: 1413--r(4 1,A.) tU4 Supervisor's Construction License: -Exp. Date: 11, !:!2Te Improvement License: Exp. Date-, 44 ARCHITECT/ENGI NEER 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.: ist , . Receipt No.: 3 00 NOTE: Persons contracting will, y"iregistered contractors ito Piot have access to,the arantyftnd Signature of contractor- 8ignature,of?Ngeqt/Ovvner 7-, $ �pRTry '9 own of * s ndover O C, h ver, Mass, ATED U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT ....... . r ..tC.....`��. ............................................... _. BUILDING INSPECTOR e Foundation has permission to erect .......................... buildings on .... ,... .., l .... .. ...= Rough to be occupied as ....Mir..am"C4.,. ..... �.,�irftzto . Chimney provided that the person accepting this permit shall i every resthe terms of the lication pp Fina[ 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 COSTU N ST Rough Service .. ZBUTDING ..... Final INSP OR GAS INSPECTOR Occupancy Permit Re uired to Occupy Ruildin 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. RICHARD FLUETCONTRACTING, INC, 102 BRIDLE PATH LANE PROPOSAL METHUEN, MA01844 Date Estimate# 10/13/2016 642 Name/Address TiE JON h 41 BEAR HILL RD. N.ANDOVER,MA.01845 Description KITCHEN,UPDXI'E PLUMBING AND ELECTRICAL PER ATTACHMBNTS,REPLACE WINDOW ABOVE SINK,WITH NEW HARVEY WHITE,VINYLTWO LITE SLIDER WITH ENERGY STAR RATI,"D GLASS ANDSCIU3ENS.INSTALL 2 1/4" WHITE OAK HARDWOOD FLOORING SANDED WITH THREE COATS OF POLY IN KITCHFN AND LIVING ROOM,INSTALL ONF"ANDERSEN PS510 WHITI-,VINYL SLIDER WITH S(-,'RF-',I,',N AND WHITE HARDWARE,INS'"I'ALL CABINETS As PER SKEFCH DATE[)4/27/2016.MEW-U2W-DRXWAU�WITH SMOOTI I FINISH OVER EXISTING C1,'1LING.R1,,C0NNF,CT VENT OVER STOVE S . PROVIDE 36"CASED OPENING BETWEEN DINING ROOM AND LIVING ROOM,NEW WOODWORK AND WALLS TO BE PAINTF-,D OR STAINED TO MATCH EXISTING(..)SING TWO COATS OF BEN MOORE PRODOC"I'S. SUPPLY PERMIT AND TRASH REMOVAL. OWNER TO SUPPLY;CABINE'I'S,'['Ol'S,SINK,FAI)CF,'I',CO(,)K'rOP,OVI-I'NS,I JOOD VENTED WITH EXISTING DUCTWORK. PROPOSAL IS VALID FOR 30 DAYS. EXTRAS OR CHANGES TO BE(.",'OMPLF1TE,D AT A RATE O1'$90.00/I-IR/MAN. MA. LIC. 50710 IIIC.# 1(16620 FINANCE CHARGE,OF ] Vii; 1/2%PER MONTH FOR UNPAID BALANCES. PAYMI--,NTSCHEDLILE,;$742,00 WITH ACCEPTANCE,$15,000.00 DAY WORK BEGINS,$5000.00 WITf I COMPLETION OF ROUGH INSPECTIONS,$5000.00 WITH COMPLETION OF CABINETS BEING INSTALLEJ), BALANCE'UPON COMPLETION. Total $27,742.00 Signature ---------- Phone# Fax# E-mail 978-685-7010 978-685-7010 RFC 102@,)vcdzon,ne1 I mg 77 .: — i i { 30" r n t3t � - > _ € 2 E j F 244 - _ zi i F Double 3 Lb 91 I s1 j 2 1 _ Glass Pn l m Walt e 2}Roil 0 U,T, v t iz UTI_f L. C — (4)Rail Out Trays �- ------------ -- - - -- ___- s -- ----------' 77 111309024RT C CD339324 1304-24 " H Q = i 1 t ` t, „ - nrE _� ��- 144" ,The Commonwealth of Massachusetts N. x Department of IndustrialAccidents h 1 Congress Street, Suite 100 tl --.201I — � Foston,MA 02114 -rvtvw mass.gov/dia Wovkers' Compensation insurance A.fdavit-Bnilder"�s/Coma'actors/FZec#lcians/Plixmbers, TO 1.3E Fff EX)WyrECTM EERMITTTNG A OTkORt7 Y- please Print Le 'bI .A "'licant Information t Namo(J3usiness/big &ation/, d'vidual):_ Address: __.. ad " "'1 Phone City/State/Zip: -- -- - hype of project(required); Are you an ernployeri Checicflie appropxlatelaax: em 10 ees full and/or part '/. 1`dW'd6nsti'I`1ctlox7 1, am a employer with -- p y 2.l1 am a sole proprietor or partnership and_have no employees Working for me in $. Remodeling any capacity.[NowarkeIs,romp,insurance required.] 9. Demolition. 3,[j S am ahomeowner doing all workmys'If phTo workers'comp,insurance required.]t 10 Building addition 4.�S am a homeownrr andwrll ba fairing cantiactors to conduct all work ozz my Property' Swill 1 ]eetrical rep,Ihs or a.dditig xs ensure that all contra�tbrs either have workers'compensation insurance or are sole proprietors with no eiripliryees. 1.2r :`Pluinbng repairs or additions S. S am a general contractor and S have hired the sub-contractora listed on the attached sheet, 13-.EjRo6frepairs 'These sub-contractors have employees and have workers'comp.izrsurance t 14. Otlxer {,LI We are a corporatio;.and its.of icdrs,have exercised their right of excerption per MCTL c, 152,§1(4),and Wo'have;no employees.[No workers'comp.inpuranco required.] *Any a licantthata�dau rlaeak bcrxd#]rciustalsnfillouithesrctianbelowshowingtheirworkers'compensationpolicyfbmituation. pP "i S-Someowners who submik�this it hxdicating they arc doing all work andthen hire outside contractors musE submit a new affidavit indicating such. tContractors that check this 13ax rixusE attarlird arr additions(sheet showing tho name of the sub-conhactors and state whet3xar or nottlzosc;emit}es;Fave tContr oto Shat hecksub-cniractors have employees,they must provide their workers'camp.policy number, oyees �Xarnarzerxtplvyej't7zatispravidt'rtg�taotic�,'s'cormpensationinsur�anceformyemplbyeeS. �`el'ozvisthepolicyarzd.jofrsite irzfarrnation. M ,_. �._. • Insurance Company Naano: lFxpixati Policy#or Self-ins'.Lic.#�: i �� •, " onDate: Job Site Address.-1--t—L-1.2ti, co �>pen—satron policy tm declaration Page(showing'the tpolicy number and expirationdate). Attach a copy ofthevorkers nal to 0-00 under A is a cri Fatiluro to secure coverage as required as civil penalties in§25 farm of mS IOI'xWOW<bRDER and a fin ofup to $2500.00 a and/or one-year'imprisonment,as well day against the violator.A copy of this statement may be foryvarded to the Offxco of Investigations of tho:DIA for iIasuraaxee coverage verification. Zcla hereby eel � az s a , of. e 7try that the information rovidecial ove is err e atz cajrect. . .. ... "�,.•, :Date: % t� �. •..�y,. � Sanaturo. C1 ffxczar use only. 1Ja rzot rvr°zt�irz t7izs ct%'ect,to he completed by city or town gf eial permit/I.Liceuse# City or Town: — — --� Issuing Authority(circle one): :L.Board oflleallh 2.Building Department 3.City/Town Clerk 4.L+lectricalluspector 5.Blumbiuglnspectar 6.Other ----- Phone Contact OP Iq: P1V DATE(M"'DD1YYYY) ,d►�o CERTIFICATE OF LIABILITY INSURANCE 10/2512016 THIS S TiFiCAT- 15 1ISSUED EOR NEGA(T VEL.Y AMPIND,RMATION r P.XTEND OR ALTER 7H COVERAGE AFFORDED AND coNFIERS No RIGHTS UPON THE ABY THE POLICITE HOLDERES IcACRRTIFEERTI E ROES BELOW. T}I18 CERfilFICA'fI5 OF [INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE 13�st11NG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE C5RTIFICATE HOLDER. IMPORfiANT: I theelfof the pv[iCy,l certalnDpohcoesAmaY requEe'3n endorsement. A statement front hIs ertl lcate does not rOnfe Drightglto the {he terms and conditions certificate holder In lieu,of such endorsemen s . NTA PRODUCER NAME: X Segreve A Hall Insur.Assoc.inc PtiCN � AIC No 305 North Main 5t. eodRLss: Andover, MAO 1010 RD R FLUET-1 Michael L,Segreve C TOME D#: INSURERS AFFORDING COVERAGE NAiC 41360 C INSURED Richard Fluet Contracting Inc. INSURER A; 'Oni 2l protection Ins.merce Insurance GO.Co. 34754 102 Bridle Path Lane rNSURlc14�- m Methuen,MA 01844 INSURER C: INSURER O INSURER E iNSVRE I+: COVERAGES (CIES CERTIFICATE N CE LI R: REVISION NUMIDER: 0 TO THE INSU NAMED ABOVE FOR THE POLICY 'I"HI5 i3 E.CNOTWIT115TAN[JING ANYi REQUIREMEOF INS NT, TERM OR CONDITION STED vOFOANY CONT5EN IsERACTT OR OTHER DOCUMENT WITH RESPECT To WHICH THIS IN, THE INSURANCF= A5FORD5D BY THE INBIGAT CERTiFC A MAY BE ISSUED OR MAY OF S CH POLICIES.LIMITS SHOWN MAY HAVE 9 EK REDUCEDlBY PAID CLAIlVI3� HEREIN 15 gUE3�EGT TO ALL THE TERM EXCLUSIONSp CY 1 F Y LIMITS YR TYPE OF INSURANCE POUCY NUM15P MM DIY MMI13 YYYY $ 1,000,00 EACH OCCURRtNCE GUNFRALUA131LITY 05/12/2015 0614212018 6 '100,00 8500034727 PRE ISEB nCCtl ncd r 0,00 A X COMMERCIAL GENEPAL��L•1IA131LITY HIED EXP Any one Prrreonl $ CLAIM34AADE FRI OCCUR 8500034727 0$112(2016 01111212017 PERSONAL.&ADV INJURY $ 1,00-0,00 GENER2'()()0'0(2'()()0'0(ALAOGREGar& $ PRODUCTS-COMPIOPAGG $ 2,000,0( GEN'L AGGREGATE LIMIT APPLIES PER: $ X POLICY PRO- LOC COMBINP-0 sINOLE LIMIT $ AVTOMO611-E LIABILITY (FA aacidoll) BODILY INJURY(P2rP91100) $ Y 1000 ANYAUTO BODILY INJURY(Per Qcc(aent) s �-300,0€ ALL O WNED AUTOS 5 100,0 PROPERTY DAMAGE � B X SGHEDULEDAVTOS 1400 1210112095 12/0112016 (PERACCIDENT) X HIRED AUTOS $ X NON,OWNED AUTOS $ EACH OCCURRENCE $ UMBRELLALIAB OCCUR AGGR500rzE $ EX0F$&LIAR CLAIMS-MAGE, $ DEDUCTIBLE $ RETENTION 5 WC STA U- OTH- WORKER5 COMPENSATION 500,1 AND EMPLOYERS'LIABILITYE.L.EACH ACCIDENT $_„_,�. A ANY PROPRIETORIPARTNERIEXEOUTIVE Y 0313112016 03131/2017 EL.DISEASE-EA EMPLOYEE 1i 600,(� NIA OFFICEtRIMEM05R EXCLUDED? (r Y 22DO51660 500,( (Mandatary In NH) G L.AI5j%SE•POLICY LIMIT S If aa,d9aCriba under D $CRIPTION OF OPERATIONS belOW DESCRIPTION OF OPImRAT10NS f LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schadule,It more eP900 is retjultad) ref; 41 Bearhill Road No.Andover,Nla CANCELLATION CERTIFICATE HOLnER NORTHAN SHOULD EXP EXPIRATION DATE VTHEREOF, NOTICE POLICIESE DF-SCRIJaED WILL CDE C THE DELIVERED I Towel or North Andover ACCORDANCEWI`fH THE POLICY PROVISIONS. Building Deparment 1600 Osgood St. AUTHORIZED RpPREBFNTATIVE North Andover,MA 01845 ®1988-2009 AGORD CORPORATION. All rights reserved ACORD 25(2009/09) The ACORU name and logo are registered marks of ACORD massacnuserrs -ileparzmenT Or i-uDlic satety f�Tle a�n.yrulae?ue cf� e C �r�,56ac�uJel4s Board of Building.RegulaiiOns and Sta- darcis --4 �- office or�C0nsuwerAffairs&Business wgulation Type: Re istratton .106629 Expirati8 Private Coparatiat RICHARD A IFLLHOME IMPROVEMENT CONTRACTOR License: C5`.i-00r 7a_1ti 0 lr 102 BRIDLE PAUi. RICHARDFLUETCONTRACTING-INC. ' METHUENMA $184 Richard Fluet 102 Bridle Path Lane _ :� ._ _' .� x— ! :aJ.�, & « Expiration Methuen,MA 01844 Undersecretary � Commissioner 04/22/2017