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Home My WebLink AboutBuilding Permit # 1/30/2017 t4oRTF1 BUILDING PERMIT ' °"`� " " •° e°� ° TOWN OF NORTH ANDOVER. APPLICATION FOR PLAN EXAMINATION �n Permit NO: .,,_�2 6k- Date Received �.0 AT80A�0-fir "9SS.4C FW Date Issued: � � ei IMPORTANT: A licant must cam fete all items an flus age LOCATION Print PROPERTY OWNERt °0(. ,, . ., , Print MAP NO: PARCEL:_Zn ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Nan- Residential Cl New Building [ One family ❑ Addition :7 Two or more family ❑ Industrial Alteration No. of units: w:l Commercial Ei Repair, replacement d Assessory Bldg D Others: u Demolition o Other Septic 1:1 Well E:1 Floodplain F-.1 Wetlands t:] Watershed District Cl Water/Sewer 16 Identification Please Type or Print Clearly) OWNER: Name: '" .. - , Phone; Address: CONTRACTOR Name: Phone: L3 ,,. 01 ;'tJ D -�, Address: t " � �, ( a too Supervisor's Construction License: e. 5 °° 1 r 0 Exp. _Date:_ Home Improvement License: 16 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. PER$1000.00 OF THE TOTAL EST! FEE SCHEDULEa OST BASED ON$125.00 PER S.F. :BULDlNG PERMIT.'$12.00 C Total Project C st: $� FEE. $ y CheckNOTE: Persons contracting Receipt Na.: �� NO acting r unregistered contractors da not have access to the guarantyfend Signature of Agent/Owner ___ Signature of contractor a . tkoRTH oven of � Andover 4. 0 to No. _ ` _Y _ ft- h ver, Mas O LAKE L OC.tlC N!WIC K Al U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT . j.... ,.�,/f�.$A...R ................. 1 ,� BUILDING INSPECTOR ..... .... . ..... .. ! ..e .. ... . .. has permission to erect ...........................buildings on ... .�..... .......... r,'. Foundation ' V Rough to be occupied as ..wr. ...�... y 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 CONSTTION Rough Service .. ...... . ..... L .......I... .... Final BUDING .NSCTO GAS INSPECTOR Occupancy Permit Required to Occupv Buildin Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Mall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. J;i ;>% C.,,.,L 49.0J 6�� u w in t U5. Contractor Agreement THIS AGREEMENT made the 261' day of January, 2017 by and between McNulty Construction.Company Hereafter called the Contractor and Brendan and Amy Doucette, hereinafter called the Owner. WITNESSETH that the Contractor and the Owner for the considerations named agree as follows: Scope of Work. The Contractor shall furnish all materials and perform all of the work on the property at 182 Raleigh'Tavern Lane North Andover,Ma 0 t 845 Work Performed The demo and complete renovation of existing kitchen. The renovation will be completed as per plans provided by homeowner see attached). The price includes all labor re uired to complete the full renovation. Any changes to the work re nested or any unforeseen factors discovered during the renovation will be discussed on an individual basis written out on an individual work order Contract Price The Owner shall pay the contractor for material and labor to be performed under the sum of $15,500.00, Progress Payments Payments of Contract Price shall be made as follows 1/3 upon the signing of the contract. 1/3 when the renovation is approx half complete and the final payment upon completion. Signed this 26`—"`day of January, 2017 Owner Contractor 1804], � I 87 n" 50"-- — ' f W 1833 L W3633j . i SW4833B R AMY BRENDAN DO[JCETTE wLLToa9.75" N. RA.'„l faH�TaArIER�!LN. !II B18.1.. DB18 `�llsysr , EWB21FHP' `S'S � s tV.Airl ANDOVER, A ®1 845 ,�--19"WIDe I j � 19.75"WOO 2411OPENENG 30"RANGE HOOD ; N i m Z 3 CEILING HEIGHT 90" INSTALL HEIGHT 87" [7 — O � a m w rt MFO(WALLS&TALL CABINETS) CU70LJT:_r`__ iQ LEAVES 1"NAILING STRIP FOR MICROWAVE I" SOFFIT AND CRDWN --'" .. ._._. ,.-.._._..._._ .-'—"-.,...-_.. __...._. _.-._.-. a '.._. ._.._.. - ------------- I--- ---- ------ - � o x m`. m 3a,5"wioe 34.5 w of k ro _' 01 B33RT B33 BMWD27 6 I rq m (q 2 --------------- I PARTS: fr`�--�---t SP96 5-3/4SOLID 4"X 96"(SOFFIT BOARDS) 5-LGCROWN(LARGE CROWN) I + 1-BP96(ISLAND BACK PANEL) + i 1-M OC96(OUTSIDE CORNER M LDG) 1-M BS 1 0(BASE TRIM) 2-M BS8(BASE TRIM) Ii 3-TK(TOE KICK MLDG) N1 E TK WB1834.5-R WB3634.5 �r CLIENT APPROVAL DATE I;U W 1887 R W 1833 R— W3633 UW 1887-] ]! I CG Intl CG MI �3 1131" All dimensions size designations CUTTING EDGE DESIGN i This is an original design and must Designed: 10/27/2016 given are subject to verification on 125 HIGH STREET not be released or copied unless Printed: 10/27/2016 job site and adjustment to ft job STUDIO .105 applicable fee has been paid or job conditions, MANSFIELD,MA 02048 order placed. 508.339.5050 Doucette,Amy-Brendan 6A.kit All Drawing#: I No Scale. The CommonweaXth ofMassachusetts Department of.Industrial Accidents I Congress Street,Suite 100 Boston,MA 02.114--2017 www.mass.govldia Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO m r,ILED WITH THE PERMCTTING AUTHORITY. A "fo lieant rmation n/I Please Print Le ib Nall e(Business/Organization/lndividuaI).. r k 1' C r�V� ��?jot C_�1 to Q Address: J yi.u �zty/State/Zip: r'C)6o 'hone#: ! (9 Are yeu an employer?Check the nppropriate box: Type of project(required): 1.Q I am a employer withemployees (full and/or part-time).* 7. ❑New construction 't.vi am a sole proprietor or partnership and have no employees working for me in 8. Vkemodeling any capacity.[No workers'comp.insurance required.] g, [1 Demolition 3.E]i am a homeowner doing;all workmyself.[No workers'comp.insurance required.]t 10[ Building addition 4.❑i am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.Q Electrical repairs or additions ensure that all contractors either have workers'compensatiou insurance or are sole proprietors with no employees. 12.LJ Plumbing repairs or additions 5.FJ I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 14. Other 6,Q We are a 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.] *Any applicant that checks box-41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the 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. lam an employer that isproviding ivorlrers'compensation insurance for my employees• Beloly is thepolicy and job stte E Information. 1 Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: CitylStatelZip; Attach a copy of the worlters'compensation policy declaration page(shoving the policy number and expiration date). Failure to secure coverage as required under MGL e. 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 WORD ORDER and a fine of up to$250.00 a i day against the violator.A copy of this statement may be forwarded to the Offices of Investigations of the DIA.for insurance I coverage verification. I do hereby cey'lify it, er`lie paints acrd talo of erj ry drat it:e infot'ntation pr'oprrled above is trite and correct. Signature-, A` Date: Phorte#: � 2 c -------------- Official use only. Do not write in this area,to be costtpteted by city ar totVrt of,(ictal. d City or Town: Permit/License# Issuing Authority(circle one): { 1.Board of Health 2.Building Department 3.City/Town Clerlc 4.Electrical Inspector 5.Plumbing)inspector 6.Other Phone#: Contact Person: ORO� DATE(I+EMIDDIYvrv) AC CERTIFICATE OF LIABILITY INSURANCE 1/27/2017 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 15 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 endorsernent(s). CONTACT Mary White PRODUCER NAME: Joseph A. Curley Insurance Agency, Inc. , (781)245-0033 F No;t781726t-14$0 PHONE 35 Albion Street M..,maryw@curleyins.com ess:'aryw@curleyin®,com INSURER 9 AFFORDING COVERAGE; NA[C# 'Wakefield MA 01880-2811 INSURERA:Main Street America Ins. Co. 29939 INSURED -INSURERS! Mark McNulty, D8A INSURERC: McNulty Construction Company INSURERD; 122 Walnut Street INSURERE: Saugus MA 01906 INSURER F: COVERAGES CERTIFICATE NUMBERklaster 2016 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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. Il7R ADD[ UBR POLICY EFF POLICY EXP LIMIT'S TYPE OF INSURANCE OLICY NUMBER rXCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 404,004 DAMAGETOREN $ 500,000 ACLAIMggMnal— S-MADE a OCCUR EMS Ea:c MPT6414N 5/6/2016 5/6/2017 MEO EXP(Any one person) $ 10,804 PERSONAL&ADV INJURY $ 1,000,000 GENE RAtAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑JECT LOC PRODUCTS-COMPIOPAGG $ 2,000,000 Employee BeneStls $ OTHER: roMeMED SINGE1 LIMIT $ AUTOMOBILE LIABILITY Ea a nl BODILY INJURY(Per person) I $ ANY AUTO ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AVTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident HIRED AUTOS AUTOS a UMBRELLALIAB OCCVR EACH OCCURRENCE 3 EXCESS LEAS CLAIMS-MADE AGGREGATE $ $ OED RETENTION$ WORKERS COMPENSATION KU7E I I♦TRH AND EMPLOYERS'LIABILITY Y!N E.L.EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE ❑NIA OFFICERIMEMBER EXCLUDE=D? E1.DISEASE-EA EMPLOYE $ (Mandatory in NH) If yes desulbe under E,L,DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below E I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 401,Additional Remarks Schedule,may be attached If more space Is required) i Residential Carpentry I CERTIFICATE HOWER CANCELLATION monultyac@comcast.net SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE Town of Worth Andover North Andover, MA 0�845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3 ACCORDANCE WITH THE POLICY PROVISIONS. UTHD E REPRESENTATIVE ®1 B-20114 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD INS026(201401) i i Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-101644 Construction Supervisor MARK S MCNULTY 122 WALNUT STREET SAUGUS MA 01906 i �..v� Expiration: Commissioner 07/29/2016 i 4— -Office of Consumer Affairs&Business Regulation IMPROVEMENT CONTRACTOR egistration: 162258 Type: xpiration: 219/2017 DBA MCNULTY CONSTRCTION COMPANY MARK MCNULTY 122 WALNUT Sl SAUGUS, MA 01906 Undersecretary 1 I