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Home My WebLink AboutBuilding Permit #1267-2016 - 105 FOXHILL ROAD 6/6/2016 NORTFI BUILDING PERMIT o`I'LED 'a q10 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 70 / E � —`� Date Received �6 � 04 M Permit No#: � A°''Areo gSSHCH�15�� Date Issued: 06 �� IMPORTANT: Applicant must complete all items on this page LOCATION Print .PROPERTY OWNER / � I ��'4 4 5 Tn 1�r E Print 100 Year Structure yes no MAP �� PARCEL: ZONING DISTRICT: Historic District yes no E Machine Shop Village yes no I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial p'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: i ❑ Demolition ❑ Other D Septic;, ❑UVells FloodplaniWetlan -47 ct ' Vllater/Sevver _ 0 _m.._ _ _ _ ,_g w . - __ . , ., .- _� ,I DESCRIPTION OF WORK TO BE PERFORMED: 4-b a / t Iry ' � w�•�-fit Identification- Please Type or Print Clearly OWNER: Name: / H %� ^�£ Phone: i Address: _O 5 7� Phone: Contractor Name:�� r � Pho � Email: b-/ Co -1--e u1v 5 i' C'�r-o Address: a £� �,r �J'z i�-C TUf n truction License: / 73Exp. i Supervisor's Co Date:s, J� Home.Improvement License: /d 12 a Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. M FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 17� , 1�4 FEE: $ I � Check No.: Receipt No.: 30�� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund nerkf Location Ct No. lf'+ Date e94�5l • . TOWN OF NORTH A JDOVER Certificate of Occupancy $ Building/Frame Permit Fee f Foundation Permit Fee $ Other Permit Fee $_ TOTAL K$} f Check *5 *50' 460 _ Building Inspector j F Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ j {, TYPE OF SEWERAGE DISPOSAL Public Sewer El •Tauning/MassageBody Art ❑ Swimming Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY i INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ r COMMENTS i CONSERVATION Reviewed on Signature COMMENTS. � ,\�.W\�!.-t;,�\.aj y:,.S a `:.`F h.1'1`T ~.a� w�R\ ,"�„�� ••c HEALTH Reviewed on Signature COMMENTS l Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPi4R�TMEN1 em p Durnpster 'Located at 1P24 Main Street � ��`' _ x `,�� ° �' �"j' v �-, Fire Dpe artment si gnature/date r” ...5'a� y -i: `'G� \ "' j•a 4 '7 L!.°r,,,tg°� ac6 v.��• t .�r 14 i t •'!— r #�f.. ,4 .COMMENTS . , e > t. . . sir " ,� t��x #..•""� a *�w'�` Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, wast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) I i i i ® Notified for pickup Call Email Date Time Contact Name _ Doc.Building Pennit Revised 2014 I i Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits 4. Building Application Permit A lication Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 4 Floor Plan Or Proposed Interior Work � Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses _Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) 4 Mass check Energy Compliance Report (If Applicable) ;� Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application 4. Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doe:Building Permit Revised 2014 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 7/6„9622.00) m $ - $ 923.54 Plumbing Fee $ 115.44 Gas Fee 100 comm. I$ VON) Electrical Fee $ 115.44 Total fees collected $ 1,254.43 Foundation 100 105 Fox Hill Road 1267-2016 on 6/6/2016 Convert dining and living room to a bedroom and bath r 1 NORTH - _ , . ver o No. � z h ver, Mass y > > T O A- COC LAKE HIC N[WICK V S V BOARD OF HEALTH Food/Kitchen- PERMIT T LD Septic System .. ire.. . ... THIS CERTIFIES THAT ..... BUILDING INSPECTOR . . . . . ........ .......... .. has permission to erect .......................... buildings on ... .. ..,fir..... .. . .1.4 Foundation .. .... Rough .. Chimney to be occupied as ..!<..�R.�IiP..� .... ... . .Nl.!�I/ .. .. .�/�Ir�o..... v provided that the person accepting this permit shall in every respect conform to the terms of the ap ication 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TION Rough Service .. .. ... . ........... .. Final BUILDING IN CTO GAS INSPECTOR Occupancy 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. FOSTER-�� CUSTOM BUILDING + REMODELING This agreement made this 26'day of May, year Two thousand and Sixteen by and between Cote and Foster Contracting, Inc.hereinafter called the Contractor and Heidi Gladstone,hereinafter called the Owners,witnesses that the Owner intends to convert dining room& living room into a bedroom and bathroom at the address of 105 Fox Hill Rd.,North Andover, MA. Now,therefore,the Contractor and the Owner,for consideration hereinafter named, agree as follows: ARTICLE 1 The Contractor agrees to provide all the labor and materials to do all things necessary for the proper construction and completion of the work shown and described on drawings. The drawings and specifications are the basis of the contract. ARTICLE 2 In consideration of the performance of the contract,the Owner agrees to pay the Contractor, in current funds as compensation for his services hereunder$76,962.00 to be paid as follows: ,Payment 1 - $20,000.00 at signing of contract Payment 2 - $10,000.00 at completion of framing and demo Payment 3 - $15,000.00 at completion of rough electric& plumbing Payment 4-$10,000.00 at completion of plaster& insulation Payment 5 -$10,000.00 at completion of wood work Payment 6 -$7,000.00 at completion of carpet Payment 8 -$4,962.00 at completion of space ARTICLE 3 Final payment on contract amount as agreed above to be paid within ten(10)days of project completion or occupancy. If final payment has not been made within this time a 10%charge per month on the balance due will be charged. All minor punchlist items will be complete as part of the one year warranty on the finish product. Failure to pay balance within ninety(90) days may result in legal action. I 20 Aegean Drive • Unit 15 • Methuen,MA 01844 Tel: 978-682-6518 • Fax: 978-682-1221 www.coteandfoster.com ARTICLE 4 Additional work above and beyond the contract agreement: All additional work done to be quoted at the time the client requests the work. The work will be done and billable at its completion. The client has ten(10)days to pay the additional cost e e or she has been billed for it. d, 1 G Initials: 1� In witness whereof they.have executed this agreement the day and year first above written. Heide Gladstone ner Steven . Cote DBA Cote& Foster The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/iia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lel ly Name(Business/Organization/kdividual): o t�U 5 7'L-cZ /Z' Address: City/State/Zip!u Are you an employer?Check-the appropriate bo . Type of project{required): 1.[] I am a employer with 4Xatn a general contractor and I / b, ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.* ?- .[Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor mein an ca aci workers'comp.insurance. 9, Y P ty. []Building addition [No workers' comp.insurance 5• We are a corporation and its required.] officers have exercised their' 10.E]Electrical repairs or additions 3.[3 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp: c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t employees.[No workers' 13.❑ Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicatiag they are doing all work and then hire outside contractors must.submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employeex Below is the policy and job site information. Insurance Company Name: �)P) '�C `` Z�� U 5 7—,v- �� -��/ S Policy#or Self-ins.Lic.#; Expiration Date: tl Job Site Address �� rUX 11VI,c L ;P,/> 0 City/State/Zip: /V d�7`-f� �o✓� i Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. Ido hereby cert' under he pains andpenaliks ofperjury that the information provided above is true and correct Signature: z Date: Phone Official use only. Do not write in this area,to be completed by city or town off City or Town: PermWLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other . . yy I Al_ • �l/� ��1�nzxrina/%/r a n.;saclf lcl/� ` Massachusetts -Department of Public Safety nice of Consumer Affairs&Business Regulation Board of Building Regulations and Standards ME IMPROVEME�NT CONTRACTOR �Uei�uuiiiunoul�c;iriSui f egistration 1,6602 ,,_, Type: License: CS-085173 Expiration�'•8i5/2016{ Supplement COTE 8 FOSTER COAT a1=i' WILLIAM TFOS��R >r- 65 COACH DR h WILLIAM FOSTER t .. DRACUT MA 0126 i It 20 Aegean Dr Unit 15 *e6uen,MA 01844 .' Undersecretar ,��_..�i'ii}�� y .�,.�..� �J Bxpiratio y� Commissioner 11/10/2016 1