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Home My WebLink AboutBuilding Permit #534 - 12 MIDDLESEX STREET 1/30/2007 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION o�<��° OL t Permit NO: 53 Date Received + _ � r ^]/ S g1TED Date Issued: 3a /r SACHS IMPORTANT: Applicant must complete all items on this page LOCATION & I Ie-re sC SP/e«l— nt PROPERTY OWNER ' /�/�G4144rr I. Print MAP NO.: q PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑ One family ❑ Addition ❑Two or more family ❑Industrial Alteration No. of units: Ki Repair,replacement ❑Assessory Bldg ❑Commercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTI N QQF WORK TO BE VREFORMED �.J n � Identification Please Type or Print Clearly) OWNER: Name: fa��d' � (,c/P,d Pic Phone: Address: ) 2. KA idd [e5(4 54rec 4- CONTRACTOR Name: y i S c d Phone: Address: q11 Ic S- re e-4 L Supervisor's Construction License: CS d 5� `� Exp. Date: 7 Z-1"- 2-100 Home Improvement License: MU,?7C7 Exp. Date: /G -L8-a�?e 7 ARCHITECT/ENGINEER Name: 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 I QQ K Check No.: V/'"-5 0 ReceiptNo.: Page 1 of 4 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools El Sewer Well F1Tobacco Sales ❑ Food Packaging/Sales [I ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contractin th unregistered co Tactors do not have access to the guaranty fund Signature of Agent/ ne e Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ i COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Y FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS 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 Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided --Required—T— Provides RequiredProvided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC..Ian.2006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 BuildingPlans One To Be Returned to Include Sprinkler Plan And ( ) p Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report 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:BPFORM05 Page 4 of 4 Location fo? ^G�l��' Sr` No. 'S3 Date /--?o `o NORTH TOWN OF NORTH ANDOVER O f s Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHU a Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 119960 Building Inspector NORTH '9 own of over 0 ' No. % 3 -- _= - 0 LA o �` dover, Mass., 3y a�-- COCMICMEWICK V S RATED �i BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ., BUILDING INSPECTOR THIS CERTIFIES THAT...... ..................... ....... .�.J. .......................-............................... Foundation has permission to erect........................................ buildings on .�at..rn/.l l �.....c., .................................... Rough '006' Av .. • t0 be occupied as... • 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 0('04 — PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTI ELECTRICAL INSPECTOR Rough ............. Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. Owner / Contractor Agreement THIS AGREEMENT,made this Twenty Sixth day of January 2007 by and between Brad and Wendy Wakeman,hereinafter called the Owner,and Victor J. Tudisco , hereinafter called the Contractor. For the consideration hereinafter named,the said Owner covenants and agrees with said Contractor pertaining to renovation work in second floor baths, as follows: FIRST: Remove all plumbing fixtures, electrical fixtures,wallboard and flooring. SECOND: Install 2 fan/light/heat units, supply and install 1 shower light, supply and install 2 Andersen casement windows. Rough in electrical switches ,outlets, and vanity sconces. Install owner supplied shower base. THIRD: Insulate/Re-insulate where necessary and install vapor barrier. Install 1/2" moisture resistant sheetrock thoughout and tape, finish, sand and prime. Install '/2" durarock wallboard to shower walls and install Owner supplied tile and grout. Install new underlayment to floors and install Owner supplied tile and grout. FOURTH: Install new stain-grade interior trim(window&baseboard)and finish to match existing. Paint walls with finish coats. FIFTH: Install Owner supplied vanities and countertop. ELECTRICAL: Install 2 fan/light/heat combination, overhead shower light,complete all rough-in wiring connections,Install Owner supplied vanity lighting. SIXTH: The Contractor shall pay all Sales Taxes Old Age Benefit and Unemployment Compensation Taxes upon the material and labor furnished under this contract,as required by the United States Government and the State in which the labor is performed. SEVENTH: The Contractor shall take out and pay for Workmen's Compensation and Public Liability Insurance as required by the Owner,Architect,or the State in which the work is performed. EIGHTH:No extra work or changes under this contract will be recognized or paid for, unless agreed to in writing before the work is done or the changes made. NINTH: This contract shall not be assigned by the Contractor without first obtaining permission in writing from the Owner. All Sub-contracts shall be subject to the approval of the Owner. i i 1 i IN CONSIDERATION WHEREOF ,the said Owner agrees that he/she will pay to the said Contactor, Twelve Thousand Four Hundred Twenty Five Dollars($12,425.00)for said materials and work. Said amount is to be paid as follows. $4,000.00 upon start of project. $4,425.00 upon completion of drywall. Balance of$4,000.00 due upon completion of all work. The Contractor and Owner for themselves,their successors, executors,administrators and assigns,he by agree to the full performance of the covenants of this agreement. Owner Contractor MA Construction Supervisors License#CS 069595 MA Home Improvement Contractor Registration# 140370 Y DAC I1AriTFOItD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 Do of ( A) POLICY NUMBER: (GS60UB-3601 B43-A-06) RENEWAL OF (GS60UB-3601643-A-05) INSURER: HARTFORD UNDERWRITERS INSURANCE COMPANY '• NCCI CO CODE: 80411 INSURED: PRODUCER: TUDISCO, VICTOR GOULD INS AGCY 4 SPRING STREET MERRIMAC MA 01860 7 MARKET SQUARE AMESBURY MA 01913 Insured is AN INDIVIDUAL Other work places and identification numbers are shown in the schedules) attached. 2. The policy period is from 09-03-06 to 09-03-07 12:01 A.M. at the Insured's mailing address, 3. A. WORKERS COMPENSATION INSURANCE. Part One of the policy applies to the Workers Compensation Law of the states r ( 1 listed here: MA ~� B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: 500000 Each Accident o.° Bodily Injury b Disease: $ 500000 Policy LimitBodil Injury by Disease: � 500000 Each Employee ee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, If any, listed here: m®. COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A o D. This policy includes these endorsements and schedules: o� SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE o� 4. The premium for this Polley will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required Information Is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 08-25-06 WC ST ASSIGN: MA OFFICE: ORLANDO DA HTFD ' 05G PRODUCER: GOULD INS AGCY 22TDG 008229 00-36,000 cf enclosed space (MGL C.112 S.60L) 1A-Masonry only 1G-1&2 Family Homes Failure to Possess,a current edition of the MassMchLwb State Building Code is cause for revocation of this license. Ir .v DIG SAFE CALL CENTER: (888)344.7233 s_ j T License or registration valid for i individul use only,7 before the expiration date. If found return to: µ Board of Building Regulations and Standards t: One Ashburton Place Rm 1301 Boston,Ma.02108 j r ` Not v d without signature itT U 10DI A Won 3WH . x' � lassureps�a�I8�-3!►i�aS f�' � q r 8G AW- F{E O'zff6 I'll WS ---- WSM—UnS 1 k USWO