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Home My WebLink AboutBuilding Permit # 3/2/2017 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIO �u Permit NO: � y � �' � " Date Received tl Date Issued: ` I I t°ORTANT: Applicant must complete all items on this page LOCATIONU— ,903kol L!�111. , 41,6, e,�( 'MA Print,. ,.� PROPERTY OWNER ',. Print 100 Year Old Structure yes � nco MAP NO: PARCEL: ZONING DISTRICT:' Historic District yes no Machine Shap Village yes no -_-- TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 11 New Building ne family D Addition ❑Two or more family ❑ Industrial Cl Alteration No. of units: El Commercial pair, replacement 11 Assessory Bldg Li Others: D Demolition El Other - - ----- - ----- ❑'Septic ❑ Well 0 Floadplain D Wetlands 0 Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: NNW jiec y mi , &'41 3��yea s � ' «r� "spy 11 (k2am,, I lderntification PI7,-Zl e'I - 3'Pa or�Print e��r15') OWNER: Name: °°1 Phone: Address: 81, Vit, CONTRACTOR Name: * ^y ° hhAJi Phone: q1 9,,4`' Address: Supervisor's Construction'License I Exp. Date: l Home Improvement License: Exp. Date ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.,BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ P 5, oo FEE: $ L , Receipt No.: °� Check No.: _ NOTE: Persons contracting with unregistered contractors Flo not have access to guaranty fund I' Signature of AgenVOwner Signature of contractor .. Plans Submitted �.1 Plans Waived ❑ Certified Plot Plan S amped Plans 19 Town o1`1 z 4 ndover . ® .0 No. , a q 0 ^K, h ver, Mass, •� r1 1�A71 coc.�icMew�cR ti' S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System - THIS CERTIFIES THAT v, i► ' l ......... O A.. .....MAI Cry BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .......1,0 .......6.0S,��......' % ., ......... .. Rough to be occupied as ......Now.......SA&*fA,9&4r.........�.�:w.....afP�I. �.,..�..�� Chimney provided that the person accepting this permit shall in eve respect conform to the terms of the lir�ation p p p g p every p pp 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 MONTHSELECTRICAL INSPECTOR, UNLESSTI T Rough Service ................. . ...................................... Final BUILDING INSPECTOR GAS INSPECTOR —ecupancy 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: miguetincontract@gol.com PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME: JEAN ABOU AZZI 106 BOSTON ST. ANDOVER, MA DATE: January 13, 2017 We hereby submit specifications and estimates for: SCOPE OF WORK: GF,,NERAL REPAIR: PUT SHEETROCK ON THE ALL HOUSE OVER THE EXISTING SHEETROCK MAKE ALL ELECTRICITY TO THE HOUSE IT WILL INSTALL NEW ELECTRICAL PANELS AND ALL POWER LINES. THIS INCLUDES ALL LIGHTS IN THE HOUSE AND FANS IN THE BATHROOMS PUT NEW HEATING AND CENTRAL AIR PUT HARDWOOD FLOORS INSTALL CERAMIC IN THE BACK PORCH REPLACE THE FLOOR OF THE PORCH THE OLD WOOD FOR NEW WOOD, THIS PORCH IS ON THE BACK ON THE RIGHT SIDE MAKE THE PORCH GOING TO CLOSE THE WALLS AND YOU WILL LEAVE THREE WIMDOWS IN THE PORCH REMOVE KITCHEN CABINETS AND ARE TO BE PUT BACK REPLACE THE OLD STORE IN THE YARD EXISTING AND WILL MAKE A NEW ONE FINISH AND PAINT BASEMENT: MAKE THE NEW BASEMENT, PUT FRAMER, BLUE BORD AND PLASTER INSTALL TWO NEW ROOMS INSTALL STANDAR SHOWER REPLACE FLOOR WITH CERAMIC IN§TALL LIGTH IN THE STANDAR SHOWER FINISH AND PAINT PLUMBER WORK DO PLUMBING INSTALL 50 GALLONS OF HOT WATER FINISH AND PAINT BAR: REMOVE SHINGLE WALL IN THE BAR PUT SHEETROCK FINISH AND PAINT JOB COST: $95,000.00 NOTE: THIS COST NO INCLUDE SHOWER, TOILET, SINCK AND LIGHTS 1 JOB TOTAL: $95,000.00 The propose hereby to furnish materials and perform the complete labor according with above specifications, for the sum of; 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 co trol. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by workmen's Compe ati n surance. Thank, ou f your bu ess and look forward to our relationship. Authorize Signature__ __.__..---...- Date:_ 1/13/17 Luis guel Tejeda J - bou zi ACCEPTANCE OF PROPOSAL the above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature: _.__...._._....._....._ Date of acceptance:.._,._._-__-._1/13/17 4i i The commonwealth of.Massachusetts DeeavtMeat af11 dustrialAceldents t 1 Congress 02114-2017,�`u;�e 10 0 1 Bostan,AIA02 �� 0 7 -www.mass go•v/dia `0, kerb, compensailonCusuxa�aceA1TmRI''MR-f"ONGA xi-1O:RIT=trXcza�s/�'xr�mi7axs. x0I3M .Please print Le 'lErl , �Iicant Ill brwatiO4 Name(Biisiness[biganuatiozalinclivi(Iual): — Address;_� _ Type okzpro7ect(�eclaiaedl)� ' Ase-you an employer Check tIi o approprsata"box: k `l_ �Iqd- C6nst.C'ACt1DIl 1,El a employer with____.- . `npioyees(full and/or part-timv), g, `emodelit%g 2.�ImaasoleproprietorcrparfnershipandhavenoomployeesWorkingforrmin —( e a �loa any capacity.[NOworkes'comp,insnranco reciuired.] k i 3.E]T am ahomeowner doing all workmysell [No�varkers'camp,insurancerequired,["f' 10 ElBuilding addition 4.L�T am a homeowner and will bo biting contractors to condnci all v�ork on say proporty. Twill I I FI R feaic�T 5 or. c:ddi�Io7zs F ensurotiratA contra Abis eitlrerhavewozkers'compensation insuran000rare solo MER- PI- mDb9''re:P*s or,additions attached shack L]Rbofr pr 'etarswithna empinyees, L i 5. am a general cantraotox anal T�aave biredthe snb-contractors lisked onthe 13 eliairs These sub-contractors have employees andhavoworkers'comp.insntauce-� 4. } 1 Other —— d,�We are a cazparatioli and ifs,ofdoers have exercisedtheir rigLL of'exeraption perM�G. t—@ 152,§1(4),and welzavena employees.coworkers'ramp.ansurance.rognired_I a lioantthatchecks o fl must LR l�out the sectionbel w so howmgtheirworkexs'eornpensat3an poficy infozrnatiozn � pp �, ,r j. i FTomeowners who submit-this, damtt lied an additional sh shawl name o the sub thy are doing all-work andc ontraetors and.stato wh the or not those ntit eow affidavit bs have }contractors that check this liox _ — employees. Tf�tla©sub-oontsacforshayeomployees,thoymustprovidetheir workers'comp.polioynurulaer. ,.. ex'tlzcztis pr aviclir�g7 o ers'eon2��ensataon MSUFancef ra my7 e1xz�7oyees, 3eZast�is tliepalic�an jobsite I ant an erax a p Y Ins rranae CoMpaaayNamo —-- I'ailay#ar elf ins.Lia. ' t"i $"M ,, CitylStr�telGip: Tob Site A,ddxesS:_ page, A.ffacla,a copy of-th.ewq':kers' caxnpepsationpolky deelaratioxe a e shams��polzcsh�lo y a�b UAbA'AA, P to $1,5U0-0 Uat ) }vaiJ�:a to secure Ca`cr©xage as reclixi�:ed un:derMGL o.7.52,§25A.is a criminal vxo. p, andlor one•'yeax imprisonment,as•well st civ ept maybe forwarded to the Ile forin of aSTO-.e�of O fn OR'[�EkZns o fther I IA:'or hasmanco a daft against the violator,A.Capt of this statem �. cover0yoxage Vexi oatian. __ _ _ ----- — -- --- --= t. — ----- t7aat the zn ar nzation i avzded above is true an Z car red° Y clo%2erehy ce.�t, under'tri txin ar2cl'PelrceZties af"perjury f officia use Ti Zy. Do notm ite in M11 area,to he comyZetecl7�y city or ta'Wra a ezal,, City or 7'0-WJ.- Lss-E.d gAutlxoxAly(circleoxre): ' 7..l3anrd.a:��Cealil2 2.I:3r�i:LE[iza,g:llepaxtrzxex�.f 3.C".xty/`l.�'awn Clerk 4.I lectrical l`xrspecfax 5.7'IrnaxttloizrgxnsPec€ox 6. AC 0� MIGUCON-01 LBIGELOW CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDBmYv) 8/24/2016 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). PRODUCER CONTACT NAME: Thomas J.Woods Insurance Agency Inc. PHONE 508 755-5944 FAX 20 Park Ave Arc AIC. rc No):(508)755-6412 Worcester,MA 01605 E-MAIL info@woodsinsurance.com EDMADRESS: INSURERS AFFORDING COVERAGE NAICII INSURER A:Maxum Indemnity co INSURED INSURER B:Miscellaneous Miguelin Contracting Inc INSURER C: 289-291 Essex St INSURER 0: Lawrence,MA 01840 INSURERS INSU RER F: COVERAGES CERTIFICATE NUMBER: REVISION DUMBER: THIS 1S 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. INSR TYPE OF INSURANCEADDL POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMlDD1YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE F OCCUR BDG30DS368-03 03125!2016 03/2512017 PREMISES DAMAGE TO RENT rtence $ 100,000 MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 11000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO- JECT LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY CGMBINED SINGLE LIMIT $ Ea aocidenE ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED Pa P.ER DAMAGE $ HIRED AUTOS AUTOS UMBRELLALIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY STATUTE ERH ANY PROPRIETOR)PARTNERIEXECUTIVE YIN N!A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE _$ If yes,describe under DESCRIPTION OF OPERATIONS betow E.L.DISEASE-POLICY LIMIT $ B General Liability CPL105090 03/25/2016 03/25/2017 POLLUTION LIAB 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) POLLUTION LIABILITY INCLUDES LEAD&ASBESTOS REMOVAL CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE 1 O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD NOTICE NOTICE n W TO TO ., w EMPLOYEES EMPLOYEES y �w r / y e The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114 -- 2017 617-727-4900 — http://www.state.ma.us/dia As red by Massachusetts General Law, Chapter 152,Sections 21,22&30,this will give you notice that ISwe) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ZURICH-AMERICAN INSURANCE GROUP NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBflO 0 MA -022 4-1450 ADDRESS OF INSURANCE COMPANY (6ZZUB-OG31068-3-15) 09-17-15 TO 09-17-16 POLICY NUMBER EFFECTIVE DATES DEGNAN INSURANCE AGENCY 85 SALEM STREET LAWRENCE MA 01843 NAME OF INSURANCE AGENT ADDRESS PHONE# MIGUELIN CONTRACTING INC 291 ESSEX STREET MOM o LAWRENCE o� MA 01840 EMPLOYER ADDRESS .�.. mom— EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANS DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the a= provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services ��-- provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 'Tn RT' PncTFTI RV FMPT .AVER Office Of Consumer Affairs and Business Regulation t. 10 Park Plaza - Suite 5.170 Boston, Massachusetts 42116 Home Improvement Contractor Registration j Registration, 175629 TYpe: 'Corporation Expiration, 5/2�F/2�9 7 Tr# 266019 MIGUELIN CONTRACTING INC. LUIS TEJEDA 289 ESSEX-STREET LAWRENCE, MA 09844 Update Address and return card.Mark reason for change. SCA 1 r, 2oM-osn / [ Address [I Renewal E] Employment Lost Card i.�a.»\ ��r' �nrrry�rn�rrrMrrr�/�nrC.''�llrrrl:Jrrc�rlJC//J � w'— Office of Consumer Affairs&Business Regulation ! License or registration valid for ludlvidul use only 3 HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration- 17M9 Type: ()free of Consumer Affairs and Business Regulation Expiration: 5/2412017 Corporation 10 Park Plaza-Suite 5170 yis�° Boston,MA 02116 MIGUELIN CON TER '0 ING INC:;;`:; � I , LUIS TE JEDA ;.,.....;; ; 291 ESSEXSTREET LAWRENCE,MA 01840 Undersecretary Nat d wjitt signature p Massachusetts Department of PcnliC Safety Board of Building Regulations and Standards License: GS409251 Construction Supervisor JOSSERY DIAZ 7 NORTH STREET HAVERHILL MA 81830.. - Commissioner Expiration: 01/1312019