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HomeMy WebLinkAboutBuilding Permit #547 - 109 LEANNE DRIVE 3/15/2010 NORTH BUILDING PERMIT o ""C' <6 TOWN OF NORTH ANDOVER ., °'A APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ^rep (� �SSACH�1`��� Date Issued: '�� IMPORTANT:Applicant must complete all items on this page LOCATION 1 tai L44� . . V^, -• Print PROPERTY OWNER Leis it ss e f-J rint MAP NO; PARCEL: ZONING DISTRICT: Historic District yes Rn Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New BuildingOne famil Addition Two or more family Industrial Iters ' No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Se tic Well Floodplain Wetlands Watershed District Water/Sewe !� DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: L,,;-,.c f,-Usse" Phone: L-yo - foe 3 Address: k o"L �-e�•� (3�,;�-� ' CONTRACTOR Name: 11�_.�.:., f'.�:.,,,�.,,�,., Phone:(S-1 0 149 -533S- Address: 49 - 33S-Address: �- * -. t�v , r1,� a a/ Supervisor's Construction License: 053 60 "r Exp. Date: L. t Home Improvement License: va\.Y"t Exp. Date: Z,l% b ARCHITECT/ENGINEER �&J,,r..--c Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1 ;Di)-d FEE: $ Check No.: -,� - �o Receipt No.: ?iTt 'NOTE: Persons contracting with unregistered contractors do not have accSignature of Agent/Own ¢yW Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE SEWERAGE DISPOSAL =Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM P r � DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS R 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 Srreet FIRE DEPARTMENT -,Temp Dumpster on site yes no , Located at 124 Main`Street• ^ Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: 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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ 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 ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location/09Tri a No. Date NURTN TOWN OF NORTH ANDOVER 00r Certificate of Occupancy $ CMusEBuilding/Frame Permit Fee $ —� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # L�44& 2G � 5U x �� Building Inspector i N©RTH Town of �. 19Andover SI/7 o = LAKE = dover, Mass., COCMICMEMCK �DRATE D `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT............0.0........le...... 1in....................................................................................................... f Foundation has permission to erec ..................................... .. uildings on .1..�...�........L� .NKK-G..R.....�D, . ......................... Rough 1. to be occupied as.......&Aamok......... .........e! !d.✓..�9..7�.01�1............:::::.::..:: Chimney ...................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 3Z PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR C O STARTS Rough ............ .................................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocatpy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 169 ford PM)WE'mPV2MUYP�TPH:h And ver,MAt 01845 Building Contractor FAX:978-688-7207 Proposal TO: Lou&Marilyn Rissen 109 Leanne Drive All Harte improvemert Contractors and SubcontWors engaged in horn improvement oontrac",unless North Andover, Ma. 01845 sPedficalN exerrrpt from regi by Provisions or Chapter 142A of the general laws,must be registered with the Connor wealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Improvernent Contract Registration,One Ashburton Place, Fror m Kevin Murphy Room 1301,Boston,MA 02108.(617}727 8M CC: Date: 1/9/2010 Job: Bath renovation Date of plans: None Architect: None Location: Same Section 1-Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 2/1/10. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 3/30/10.The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11-Warranty The Contractor warrants that the work famished hereunder shall be free from defects in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup,the Contractor shall,at his own expense,forthwith remedy,repair correct,replace,or cause to be remedied,repaired,or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section 111-Scope of Work 1 Mevin Mun7by Page 2 of 4 Building Contractor 169 Boxford Street North Andover,MA 01845 PH:978x8.5335 FAX 978-688-)000( General Building permit will be provided by contractor. Proposal is to renovate existing master bath area. Demolition Existing tile floors and shower area will be removed. Existing plumbing fixtures and vanities will also be removed. Plumbing Plumbing required to remove and replace all fixtures in bath area will be provided. New copper pan for shower will be supplied and installed.Other plumbing fixtures to be provided by owner. Electrical Electrical work required to replace existing fixtures, and supply / install new fan unit will be provided. Surface mounted fixtures to be provided by owner. Heating/Air Conditioning Existing heat/air conditioning to remain. Insulation Existing insulation to remain. Plaster Walls/ceiling will patched/plastered as required. Interior Trim/Doors Any interior trim will be supplied and installed as required,to match existing, around new fixtures/vanities. Floor and shower walls will have undedayment/durarock supplied and installed for installation of new tile. Painting No allowance has been made for any painting Flooring Tile floor and shower walls will be installed.Tile materials to be provided by owner. Waste Removal All demolition/construction debris will be disposed of by contractor. Hevsaa I�Yii mrphy Page 3 of 4 Building Contractor 169 Bo)ftd street North Andover,MA 01645 PH'976588-5335 FAX 978-688-)O= Other Allowances Existing shower door will be removed and reinstalled. No allowance has been made to supply a new door. Owner to provide new vanities. 'P 'a v • Uearnhm Mmuphy Page 4 of 4 Building Contractor 169 Boxford Sheet North Andover,MA 01845 PH:978-688-5335 FAX 9780000( Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ...... ...... ... ... ... ... ... ....$ 11,000 Payment to be made as follows: Percenta e/ltem Description Amount 1 Permit obtained $2000 2 Tile complete $6000 3 Job 100% compete $3000 Total 3 $11,000.00 Notice:No agieennent for Home improvement contracting work shall m re a down payment(advance deposit)of more that one-third of the total contract prioe of the total arnota of all deposits or payrnents which the mor must r alm in advance,to order andlor otherwise obtain delivery of special ander materials and equipment,whichever is greater Contractor: Kevin Murphy 169 Boxford Street No.Andover, MA 01845 Registration No: 101874 Section V—Acceptance Acceptance of Proposal—I have read this document and accept the prigs,specifications,and conditions stated. I understand that upon signing,this proposal becomes a binding contract You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date CtJY) Z Z �G( O Signa t Date The Commonwealth of Massachusetts JQN Department of Indusitial Accidents Ofpc.e of Invesfteliens 600 Washington Street Boston,MA 02.111 www masstigov/dia Workers' Compensation Insurance davit: Builders/Contractors/Elect lici2o iumbersb Nmamt Iluf tion Name _ Q,�� � �� �\ �, h__ s Address: ti (� �'l Phone -- ! tattaL1 �_ - Ci S ty p� - 1.re yets an employer?Cbeek the'a"o*rWe box: T"m of project(v"alred): I atm a employer with 4• ❑ 1 am a general amtrwwr and 1 6. Q New construction m1ployees(full and/or part liras).* have hired the sub-oomusclors 7 ❑ Reutodding ❑ 1 am a sole propricarr or pub m- listed on the attached sheet ship and have no avloyces Thi sub-contractors have S. ❑ Demobt6m working for tyre in my capacity workers' corm. insurance. 9. (] Budding addition (No workers'coMP. insurance S. ❑ We are a corporation n and its 10.❑Electrical repairs or addictnus required.] officers have exercised their riot of exengton per iMGL 11.❑Pwhing repsiors ox addidms .❑ I Am a honmoowaer doing all work 12.[:] Roofrepain c. 152,1 l(4),and we have no unsru o ns OW.] t (M workers � 13.[] Other comp.kswance required.) UW splr*w do cbseb boat A l i'.Wm also so act flee seatios below 8 tbm Worters'no tion Poky mfmWm !lorosow"m WW sob"*&b vft dwy m daft so wmt and*es hm outside comraaoro am*srb mt a mw o idavd>adkw"sash. :ansroebts that rLeolt this bwc most atladyed th s1 1 sheat shower t#a nsatrs of the snb-enure and#miv W"l1= sox penny Wbr union. asM art mgdovlw dw is ken,camptnraatfon. me fist,may mgA"aaa Below it tlte.pe tclr eadjob sUt tforr�tJen. � ttLltana Conglany Now—L.--4, l olicy#or Self ins.Lic.#: ,C,�G V1/L-1 G D ) Bxpisation Dane: )b Site Address: n l -�^� I�••^'•• CitylstaldZip: —/- ►ttrteb&copy of the w�orit+ctrs cosapeesrKio�pdleT declwmaom page(sbowisg tie policy cumber mW exphrion dela). skill"to soon covernge as mqutW wrier Section 25A of MGL C. 152 can lead to the imposition of criminal penalties of a one up to 51,500.00 and/or otro-Yew iMr t,as well as civil penalties in the form of a STOP WORK ORDER and a fine f up to$250.00 a day agailnst%e vialatar. Be advised that a copy of this statemmt may be forwarded ro the Office of avestipdom of the DIA for itmlunmcc coverage vaifim ion. akr kwwby srrrdsr d w pelt and Pe tory Mwtlha Gefayrtadar pr»viikd aborec Is hue read sweets Ec � Do Nei tw,fre in r�area,to be Comped by�or coram Pular[ =vthor" n: lernrN/L3cense# (drde osis): Reaft 2.BUMUS Department 3.Ckylfown Clerk 4.Electr-ieat Inspector S.Plumbing Inspector per i°'�#: Hca' CERTIFICATE OF LIABILITY INSURANCE `�'R(WAMMYY"' 7209 ( J11W91 THIS CERTt VATS I$ ISSUEp AS A MATMR OF WORMATWN M.P, Robowto tns�+>*mm A may ONLY AND comp RS NO FIGHTS !IRON THE CERTIFICATE 1050 Oagood.st"ot HOLDER. THIS CERTIFICATE DOES NOT ND EMND OR nth Andovw, DIA 0184E TBR THLE COVERAGE AFFgRDED BY aPOl.�cnm BELOW, INSURERS AC4;O WWO COVERAGE MAIC 11 tNeue-R sMaT a: WNBUMRQ rn NOM ANDOVER, M!1 02848 INtURt?h Q cOVERAW 71 PQLiGEBQFMMWRN LI�{iwCt� NVNAVE i199L16D�b1MlWWWWWOMMPORTMFOLICYPERM INDICA1�p�W �NdfWt1H3TANOIAG ANY UM II' I M QR N QF AMY GOMR�C7 OR 0TWR OtX311M�!1 wlili fid 7t]YtRdChl TF1S CBR flF1CATE fr14Y BE ISBU®OR MAY M THE 1�19LNRAI&At ?SY THE FOLUIB OESCMgD MEN 18 8G6J6CT TO ALL t TBRM$ �i.t18fON8 AND t�UNDfPI0N8 OF SUCH Pf3,OM AGORMAIM LMM SHDIMV MAY HAVE OEM PtEM M)DMIDOLAN6. 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