HomeMy WebLinkAboutBuilding Permit # 2/27/2017 BUILDING PERMIT of 40 RT" 4
TOWN OF NORTH ANDOVER
�
APPLICATION FOR.PLAN EXAMINATION ',
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Permit No##: Date Received
�SSACHuS�K
Date Issued: ''+
IMPORTANT:Applicant must complete all items on this page
777777777777777777
LOCATION O '`
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PROPERTY OWNER -W
_._
�'nnt � 1�0 Year Structure - yes '
MAP�_PARCEL. .. ZONING DISTRICT Hrstor�c District .. yes.
. . . ._:; . . . . ..;_ Ma hap Village .-...Y�
chine Shop n.
TYPE OF IMPROVEMENT PROPOSED USE
Resi tial Non- Residential
❑ New Building [9,,6ne family
[I °dition
El Two or more family ❑ Industrial
Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑ Well ❑ Floodpfain Il Wetlands I] Watershed District
El Water]-SevVer
DESCRIPTION OF WORK TO BE PERFORMED:
o
Identification._ Please Type or Print Clearly
OWNER: Name: / f Phone: �•�/
Address: s'c'S i �„� 57— wvle, P&V6 Ix"'d
Contractor Name: iu Phone: M_;"6 d
Address � _, 1_4UA, _ �dL
Supervisor's Constructlor< License .. �-- _ 1 _ Exp.` Dates
Horne lmproYerrrnent.License: Exp:' Date: ` . ....
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE'SCHEDULE:SULDING PERMIT.$12-00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASE25.00 PER S.F.
€ dotal Project Cost: $ C FEE: $ '
Check No.: 3 7? Receipt No.._ l
NOTE: Persons contracting with unregistered contractors do not have.access to the guaranty fund
S�gratur ofAgentlOwner Signature of contractor'
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
IYPE'�p SEWERAGE DISPOSAL
Public Sever ElTanning/Massage/Body Art ❑ Swin g Pools Ll
well ❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private{septic tank, etc. 1 Pennanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
IALTH Reviewed on 2 S iq natur
AO
COMMENTS lUa _45 40 CUM [j24 Q_ S e,�` ( S )` cn fI N .
Zoning Board of Appeals: Variance, Petition No: Zoning Decisionlreceiptsubmitted yes
Manning Board Decision: Comments
Conservation Decision: Comments
Water &Sewer Connection/signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT -- Temp Dumpster on site yes no
located at 124 Main Street
Fire Department signature/date
COMMENTS
........... ................................... -------- -----------------------------------------------------------------------------------------------
OORTH
Town ofli_At, -- ve'kr du V
0 0
No. a_
0"Lo" ver, Mass, 0 1
0
BOARD OF HEALTH
Food/Kitchen
PERMIT T L10F Septic System
...................
THIS CERTIFIES THAT ....M.kf......kovicM.............S.................... ...I .... BUILDING INSPECTOR
SO4 ........
has permission to erect.......................... buildings on ......... OV Foundation
00ft Rough
It �,AfAl
to be occupied as .......F!1 1.11k .W.
.......... A.1.x..... .A4.0....... r..Pr;T-:;.4 Chimney
provided that the person accepting this permit shall in every respec 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
PER EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR,:
UNLESS, CONSTRUCT] AR Rough
Service
.............. woo..................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Rgquired t® Occui2j: 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.
GMELCH INDUSTRIES INC
PO.Box 193
Merrimac,MA 41860
February 11,2017,.
Rick&Nathasha Vance
325 Boston Street
North Andover,MA
Pa meat Schedule
i. Deposit $21,000
2: Rough Inspection $14,000.
3. Plastered $18,950
4. Completion $16,900
TOTAL $70,850
? *Building permit not included.Permit fees due upon issue of perrnit.
Gmelch Industries Inc. Home Owners
Michaelouioheras Rick&Natasha Vance.
CS 79450.
HIC169157
211Gs2�'k7 : Gmai)-Third FloOr
Third Floor.
Michael Kouloheras <mkoulie@grnaii.corn> Tue, Jun 28, 2016 at 1:52 PM
To: Natasha Vance <natashavance1105@gmail.com>
Vance
325 Boston St
North Andover. MA .
I'm pleased submit the following bid for your review. Pricing is based on site visits on May 6, 2016 and June 15, 2016.
And as well as attached floor plan approved by Natasha at 6115. The scope of work to include the following
Third Floor
-all labor and materials to construct new walls and ceiling per layout
-foam insulation in walls and ceiling(deduct$5526 for fiberglass) .
41 3rd floor interior finish to match existing
-oak capped wall an family roorn side of stairwell
-gas keted access door to area over master bedroom
-new oak handrail and stairway skirt boards
-windows seats at 2 front windows
-paint walls and ceiling customers choice of color
-all labor, install materials, and prep for bath and shower the ,
the and grout supplied.by homeowner
-$1200 bath vanity allowance
»$1500 shower door allowance
41500 carpet allowance.
-3rd floor wired to code
-six.6" sloped led cans in family room and fan in conter
fan supplied by homeowner
install smoke detectors where:needed by code.for new addition
wire customer supplied fan/light in study
-wire bathroom light over vanity,shower can, GFI outlet and fan/light
wire customer supplied sconces at 2 window seats
relocate 2nd floor heat return and ductwork as needed
a -install.new duct work for third floor and balance system.
-tough and finish plumbing for new bath completed per code .
-math fixture allowance$825
ii Misc
supply and install new keyless lock on master closet
.-relocate garage door controlstv;;
-add light in master hedroomLa&ata linen closet
-add three outlets in the master.closet above the dressers
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� �� t�s� �-eta•le�ih-;m.e,r.�-in�ta�ao�ac�'-
Total$74 8- `f . . "` x
building permit not included
Natasha Vance<natashavance11a5@gmali.com> Mon, Jul 11, 2016.at 9:.17 AM
To: Michael Kouloheras <mkouiie@grnail.com>
Cc: "Vance, Rick L" <Rick,L.Vanc;e@ehi.com>
https:llmaiLaaoale.coml�naillu/t)/?ui=2&ik=B2ecb4<3cle&view=nt&seamh=inbox&th=155BMa�Ad27715&siW=1559323dp02da0aF3t sIm1=158�243tiit10kG 3&s... 1!G
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156'/<in
345 1a in - --
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unfinished
Storage Area Existing Finished Garage
644.58 ft= -
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113.76 ft'
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—---—-----------------------------------------------------------
648 in
238 in
76 nn
52 in
57 in Kitchen
Island
61-19 ft2
Family room
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12.24 ft 1026.18 ft,
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co 179.55 ft'
Living Room
in
167 in
167'A in
119%a in
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IBM
1110
910.69 ftz
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"" Cathedral Ceiling from
Chimney Cathedral
- Master Bedroom
Passage
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47"
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186 in
VOID - angled roofline VOID
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The Commonwealth of Massachusetts
Department of IndustrialAccidents
I Congress Meet ,5r�ite 100
!
M �2017
Boston,MA 02
www rnass.gav1dia
13Workers' Coiaperasation.bsurantceTSTavit- �TrTTNG AUTHOsSt��Y triciansll'Iwbbers.
T073EFZLED�4'I r ease Print LgdbI
A Iicant wormation
dividual . ( • i 1 G`
Name(BusinesaloigariizatianlIu )'
Address:
City/Statc/Zip:
Are you an emploper?Checkthe appropriate box:
Type of pxo�ect(-Tecluired):
7.
employees(fu11 andlor part bine).*
❑ dw construe on
1,01 am a employer with g Ramodeliug
2,0 Z Saar a sale proprietor or partnership hand have no employees working for me in 4. El DeIl1011tio7
any capacity.[No workers'comp.insurance required.]
doing all work mysel€[Na workers'comp_insurance regaired.j i 10❑Building addition
3,E]S am a homeowner
contractors to conduct all work on any property- S wrll ❑Electrioal repairs or a dditiop s
4.❑I am.a homeowner and will bo hiring -,
ensum that all contractors either baveworkers'compensation insurance or are sole 2.j,?kfflUDing re airs or additiozl�
proprietors with no emglbye6s.
5_❑I ant a general contractor an Z have hixedthe sub-contractors listed onthe attached sheet.
13•.❑E.bo£repaixs
hese sub-contractors have employees and have workers'eourp.inmraace# 14. Other
6.[]We area corporatiogand its,Officers,have eXeroisedtheir right of exemption per1V1GL c.
152,§1(4),and We have no employees.[No workers'comp.insurance required.]
0.t the Section sh-Wing their workers' m � ma
heksit cabelow outside n#ractosustsubm� newaffidavit indieatingsuch
*Anyapplicantthatb # dtdalwnrkandthenhire
i 1jera,owzers who submit.thisof .aviindihng#heyaraouag
ontractors
tContractors that check this bOi f uuava tachcdemployn additional they t provide thein workeme comp SPolicy number. d state whether of not those entities ave
employees. Ifthe sub-contrz
Z am an employer that is pr'ovcding-Workers'compensation insurancefol'ray employees. Below is the porky and)0h site
information.
Insurance CompaayName:
��• ExpixationD4.tel
Policy#ox Self-ins.Lic.#:. ry
.r U. City/State/zip:_14
rob Site Address: thopoticY number and expiratiou date).
Attach a copy o£ttte^vvoxi�exs'compe?rsatian poiiey declaration page(shoving
Failure to secure coverage as requiredurrderMOL o.152,§25A is a criminal.violationpuuisbable by a e UP to$1,500.00
one ear im rlson�nent,as vPell as civil penalties in the form of a STOP e O ORDfnVestigations of the DIA for insurance,
a
andlar rk Y p of this statement may be forwarded to the Off€ Of
day against the violator.A copy
coverage verification.
do rzereliy cerfify under tliepains andpenalties ofperjury that the information provided above is true arra correct
Date:
Si ature:
Al
Phone :
Official use only. Do riot write in this area,to be completed by city or town official.
PerzuictlLicense#
City or Town:
issuing Autho YRY(circle One): ` ector 5.plumbing Insp ector
].Board.offfealth 2.EuildingPepaxtment 3.CitylTovu Clerk d•.ElectxicaZXnsp
6.Other
Phone#-
Contact Person:
i
I DATE(MMIODNYYY)
ACCOR" CERTIFICATE OF LIABILITY INSURANCE
2/21/2017
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 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 .
PRODUCER NAME:C Peter Bevelaqua
Norwood Insurance Agency, Inc. PNONE (978)372-5921 1 LFA
Exth VCX
N 1:(978)521-0242 L
L
293 Main E-M
Street ADDRAIESS,peterbevelaqu0comeast.net
INSURERS)AFFORDING COVERAGE NAIC#
Groveland MA 01834 A:Safety Insurance Comm 39454
INSURED -INSURER B;Hartford Underwriters Ins.-ARWC 80411
Gmelch Industries, Inc. INSURER C;
61 Lamoile Ave INSURER D:
INSURER--- E
--- ----
lBradford MA 01835 1 INSURER F
COVERAGES CERTIFICATE NUMBER:CLI722102703 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.
rINS-R POLIC;�—'FF 10-6-L—ICY-EXP
L'TRI TYPE OF INSURANCE I LIMITS
TR ......POLICY NUMBERMMIDR tMMIDDNYYYI
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
-UAMWG-97U1ff ERTF'6-'-' 50,000
_
A CLAJMS-MADE OCCUR f�RE
_NtSES_LE�4_occurrenc9J-- $ —
BMA0022238 6/10/2016 6/10/2017 MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER�
_�ENERAL±99REGATE 2,000,000
POLICYF PRO- 2,000,000
JECT LOC PRODUCTS-COMPIOP AGG $
OTHER: C Birqffr)910 LMIT $
AUTOMOBILE LIABILITY Ea ac dent 'E $ ------
P-'O'-cu�
YL;;.c kieml
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
r_pt__I
AUTOS AUTOS PROPERTY
7
'0
NOWOWNED PROPERTY DAMAGE $
HTY
HIRED AUTOS AUTOS (Par accident)
UMBRELLA LIAR HICCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED 1---FRETENTION§ $
WORKERS COMPENSATION T OTH-
AND EMPLOYERS'LIABU,ITY YIN STATUTELEE---
ANY PROPRIETOR/PARTNERIFXECUTIVE E.L.EAC�AC(CIDENT $ 100,000
OFFICER/MEMSER EXCLUDED? NIA
(M 0 100-x,000
B andatory In NH) 0814ECCM1743 1/11/2017 1/11/2018 E.L.DISEASE-EA EMPLOYEE $
if Les,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS IVFHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
CERTIFICATE HOLDER CANCELLATION
mjkphoenixhomes@comcast.ne SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Building Inspector ACCORDANCE WITH THE POLICY PROVISIONS.
North Andover, NA 01945 AUTHORIZED REPRESENTATIVE
Peter Bevelaqua/PB
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
INS025(201401)
s
Massachusetts Department of Public Safety i
Board of Building Regulations and Standards
License: CS-079454 y`
Construction Supervisor2.
a
MICHAEL J KOULOHERAS
77 PLEASANT VALLEY RD
AMESBURY MA 01913,
1
i
i
Expiration:
1 Commissioner 08/0812018
61;itfirclxurrr1/�1. o� Lf
Office of Consumer Affairs&Business Regulation
'F� r OIVIE iIVIPROVEMEI�T CONTRACTOR
egistration 169157 Type:
Expiration 5l2012Q17 Individual
MICHAEI,KQULOHE'RAS ,
J.
MICHAEL KOULOHERAS
' 77 PLEASNT VALLEY RD ;
I AMESBUR ; MA 01913 j
Undersecretary I
3