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HomeMy WebLinkAboutBuilding Permit # 1/4/2017 BUILDING PERMIT O �Yssa 6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION '- permit No#: Date Received t ��pa�nreo gip` SSAC wl51- Date Issued: LUTORTANT:Applicant mast complete all items on tbis page Pant 4 PROPERTY OWNER Pnr€t [30Year 5t ructu yes np MAP ,PARCEL ZONING DISTRICT H� tortc Dtstr�ct yds o `� �'�' Macl�tne.5hopVillage y_es too TYPE OF IMPROVEMENT rResjd ROPOSED USE ntial Non- Residential 0 New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No_ of units: ❑ Commercial epair, replacement 0 Assessory Bldg ❑ Others.- 11 thers:❑ Demolition ❑ Other 5elatic. Cl V1Tel[ - D Floo'cljafain O 11Vetariels-� D lfl]atershecl Dtsncf DESGRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly OVVNER: Name.- J ^v\ I I Phone: C aF YJ Li .�r ESA. ~ Address: 4 antraefior hlm i_ -__ _ _ Phone:. r. - JA Supervisor's Cons:.ruction License _ y`. T `as I �cp k DateE Hamc;lirio_vment LEGenseExp Da _ ARCHITECT/ENGINEER Phone: Address: Reg. leo. FEE SCHEDULE:BULDWC PERIV 7,'$/12 00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F. -jotal Project Cost: FEE: Check No_: - Receipt Na, NO'T'E: .Perss on c ' it unregistered contractors do not iz ave_access to the guar arty fund ,NORTH own of 3? Andover . 0 . . 0% No. _ soh , ver, Mass,LAKII �q0 RATED J" S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ......0 4.Y.1..*. �.` �. .. .....05AI BUILDING INSPECTOR ........ ..in. ......Y. . .�Y. '.Y .. . ..... � Foundation has permission to erect .......................... build.ings on ...... .� ,.,,,, i is .C. .� ...... ...... .. ........��. e� � 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S Rough Service ............... ... .. . .. .. . .......... ........................... Fina BUILDING INSPECTOR GAS INSPECTOR OccupancyOccUpancy Permit Required to Occupy Buildink , Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Miall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. r ' I B North Andover Health Department (ommenity Development Division Date: December 20, 2016 Time: 2:00pm BOH Inspector: Michele Grant Tenants Name: Mike Flemming Phone Number: 978-893-6370 Location: 456 Summer Street Owner: Nassan Hussein Phone Number: 978-885-0448 Address: 8 Cop erfield Drive Nashua NH. 03062 Regulation Findings Violations 105 CMR Deadline Corrected 410.750 Faulty and Inefficient Heating-Furnace, Baseboards, Radiant 24 HRS K,L, 0-3 Wall Boards Wwe-V,9 Produce complete analysis on Heating System 24 HRS 410.750 No Carbon Monoxide Detectors,No Smoke Detectors 6 HRS Y (N) Fire Department was called 410.750 Drier Vent is not vented properly-Vent is routed into the 24 HRS (B) garage 410.750 Multiple Electrical Deficiencies throughout the home. 24 HRS 0-(3) Hire Licensed Electrician to evaluate and repair Broken Windows in Kitchen and Basement 48 HRS Fireplace has not been cleaned in 5 yrs. Yearly maintenance 48 HRS is required. Clean by a professional PER B UILING, FIRE, PLUMBING AND ELECRICAL YMXY�uu PER FIDE DEPT. AND PLUMBING INSPECTOR: Door must be removed in basement due to lack of makeup air All Plumbing and Electrical must be done by licensed contractors with permits. Per building code Building Commissioner requests a building permit to be pulled by a Licensed GC x = Y Building Commissioner requests a copy of the sign certified letter that has been delivered to the tenants,regarding illegal bedrooms in the basement. Page 1 of 2 North Andover Health Department— 120 Maio. Street, North Andover, MA 01845 Phone: 9 78. 688.9540 Fax: 978.688.9543 AVID HOULE CONTRACTOR Invoice 15 Griffin St. Number: 1760 Methuen,Ma. 01844 1 Date: January 04, 2017 r Bill To: Shur To: HUSSAN HUSSEIN IHUSSAN HUSSEIN 456 SUMMER ST f 18 COPPERFIELD DR � IN.ANDOVER, MA 01845 { NASHUA, NH 03062 I � I I I � _ P4 Number H 4SSAN -- pate Dept. P Description G Amount 1-4-11 REPAIRS REMOVE DOOR IN BASEMENT, FIX TWO 400.00 ..0 ,.. , .117iVE; VENT FOR DRYER VENTED OUTSIDE, REMOVE RADIANT PLUG IN HEAT OFF WALLS, FIX COVER I PLATES ON OTHER HEAT. ANY PLUMBING OR ELECTRICAL WILL BE DONE BY LICENSED PEOPLE I l 8 OWNER CRATE ' .i 2 I CONTRACTOR C7. ATS /�._... H.I.C. r T� / .• I I I I I I d I � Total 1 $400.001 I I i a, N 4s sEc'WI p MN CE,ma at �i�� 'F; �fry�6r.� i�arr04�aaabaru?� 9� �,, y�����i'fl/ TT �E,Ts' DRIVERS LICENSE" liSA� dS4f 1, 2 DM THUEN MA 4 8 . 5 00*24-2W Nev07.4552949 I I ^ { Bass chctsetis Department of public Safety Board of Building Regulations and Standards License: CS-104457 i.,onstruction Supervisor ©AVID A HOULE 15 GRIFFIN ST .METHUEN IIIA 01844 y r-"JZ n CA— Expiration: Commissioner 43/04/2018 License or registration valid for individul use only cJ/e`(n,,,urarr,ucrr�//r :1 sration date• 1f found return to: �L.\_office of Consumer AfWrs&Business gcguiation before the exp CTOR Office of Consumer Affairs and Business Regulation .. -�pmF IMPROVEMEtdT CONTRA Type: 10 Park Plaza-Suite 5170 ila. —,= egistrat►on: 484168 Boston,MA 02116 C =;:° § 3!512047 individua{ :t=xQiration: KURT LEDbUX KURT i.EDOUX 428 NIGH 5T - `' --'-- !+lot vali without sign re LAVVRENCE,MAGI$41 undersecretary The Commonwealth of Massachusetts ..__ . Department of Mdustrial Accidents - = I Congress Street, Suite 100 Ilosiota; 41,4 02114-2017 . . w wwtiumass.gov/ilia N 11'arkers' Compensation Insurance Affidavit: Builders/Contractor-s/Electricians/Plumbers, TO BE FILED WITH THE PCRMMINC AUTHORITY, e Applicant Information Please Print Le ibl Name (Business/Organization/Individual): Address: f City/State/Zip: Oi l Phone A/amo ployer?Check the appropriat box: Type of project(required): 1. ployer with employees(frill and/or part-time).` 7. E]New construction 2. le proprietor or partnership and have no employees working for me in $, ❑ RemodelIng ypcity.[No workers'comp.insurance required.] 9. El Demolition 3.E]1 am a homeowner doing all work myself.[No workers'comp.insurance required.]' JOE] Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I I.❑Elect€•ical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.[]t am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.F-]Roof repairs These sub-contractors have employees and have workers'comp.insurance3 14. Other 6.nWe area corporation and its officers have exercised their right of exemption per MGL c. 152,$1(4),and we have no employees.(No workers'comp,insurance required.) i Any applicant that checks box Hk must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and(lien hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of rhe sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number, I am an employer tltrtt is providing workers'compensation insttr•ance for•my employees. ]below is the policy andjob site information. Insurance Company Name: _ Policy#or Self-ins. Lic. #: Expiration Date: _ Job Site Address: City/State/Zip: is Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGI.,c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. C do hereby certify under the pains antipenalties of perjtrry tltrtt the information provided above is true and correct. Signature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town of,ftciat. City or Town: Permit/License# Issuing Authority{circle one}: 1. Board of Health 2. Building Department 3.City/Town Clerk 4, Electrical Inspector S. Plumbing Inspector G.Other Contact Person: Phone#: Information and Instructions Massachusetts GexteralLaws chapter 152 requires all employoxs to provideworleers' compensation for their eA-p�6yees. Pursuant to this statute,an employee is dufmod as"__.every person in the service of anothox underany contract ofhitc, express or i replied,oral or writton.' � a An.empZoyerid d'offied as"am in.cHviduat pactxtership,assn cia-tion,corporation or other legal entity,or any two or more of the foregoing engaged k a johit onterprho,and including the legal representatives of a deceased employer,or the receiver or.trastde P,fan.individual,partnership,association or outer legal entity,employing employees.,However the ovMer of a dwelling house having not more than three apartments and who resides therein,or the occupant:of the dwelling house of another vrho employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds orbuilding appuxtenant thereto shall not because of such employment b6 deemed to be an,employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall witUold the iss€tance or renewal of a license or permit to operate a business or to construct buildings in the conmonwealr'lr for any applicant-whd has not produced acceptable evidence of compliance with fdze insurance coverage xac"aa-ed." Additionally,MUL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter intp any contract for the perfor-tuartce ofpubho work until accoptab Io oviduaca of compliancewith tho i imitauce reguiroments of this chapter have b(eDn presented to the,contacting authority." .Applican-ts Please ft]l-out th workers' compensation affidavit completely,by chocking the boxes that apply to your situation and,if nmcessary,supply su-b contraotor(s)namo(s),address(es)and phone mmber(s)along width their certi$cate(s) of insurance. Limited-Liability Companies(LLC)orLitnitedLiabilityPartnerships(LLP)withno employees,other flianthe members or partners,are notrequired to carry workers'compensation fil=anoo. Tf an LLC orLLP does havo employees,a policy is required. b a advised thatthis affidavit may be submitted to the Department of Industrial Accidents fox confw cation ofinsurauce coverage. Also be sure-to sign and date tete aff dadt The affida-vit should be returnod to the city or town that the application for the permit or liconso is being requested,trot the Dc�artment of d. lrudustrial.=Accidents. �hould you have any questions regardingtho law or if you axe xegat mdto obtain,a-workers' compensatioApolicy,please call the Department at the number listed below. Self-insured conipanies should enterthch: self iusurance liceztse number ontho appropriate line. City or Town Officials Please be sure tliattho affidavit is complete and printed legibly. The Department has provided a space atthe bottom of the affldavit for you to fill,out in the event the Office,of Investigations has to contact you.regarding the applicant. Please be sure to M in the permit/license numbmr which wffl be used as a reforence number_ 1u addition,an applicant that must submit multi plepennit/Rcense applications in any givmn year,treed only submit one affidavit indicating cuT ent policy information(ifnecessaty)and i mdor`fob Site Address"the applicant should write:`all locations in (city or town)."A copy of the affidavit that has been officially stamp ed or marked by the city or town may be providectto rho applicant as proof that a valid affidavit is an file for tuttue permits or licenses. A new affidavit must b a Mod out each i year.V&axo a home owxter or citizen is obtaining a license or pezn iit not related to any business or comm oxcial veatuxm e. a dog license or permit to burn leaves etc.}said person is NOTxequixed to complete this affidavit. Thu Dopartment's addross,telephone and fhx number: The Commonwealth ofMassachusetts Dcpaitnaent of IndwLrialAccidents 1 Coxtgross Stoat, Shite 100 Boston,MA 02114-201.7 Tel.#617-727--4900 ext.7406 at Z-877•-MA.SSAFE Fax# 617-727-7749 Revised 02--231.5 www.mass_govldia