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Home My WebLink AboutBuilding Permit #595-11 - 121 CAMPBELL ROAD 3/8/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: / Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION I Z l/ Print PROPERTY OWNER ,// Print MAP NO: 16*-5 PARCEL: 03 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial (iteration No. of units: ❑ Commercial ` ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �0 Septic ❑W,ell y ""�` Jy`' 0 Floodplain X11 W, lands ` S` ter`❑"W�dte shed District ❑;Wate`r/Sewe_r rserK arc l �_ ,* = 1r DESCRIPTION OF WORK/TO BE PERFORMED: �lGli %v+ � �T ®tet �✓�G� ��c�� /,�o � t- /�l�S lc-- l�Gv Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: —� .�• /`�ll�u Phone: Address: l® ll �f K /`��`�- "� Supervisor's Construction License: �D Geo Exp. Date: Home Improvement License: S-l � Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PE MIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED CO��STTi�BASED ON$125.00 PER S.F. Total Project Cost: $ �Z f `L� FEE: Check No.: Receipt No.: 3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Si nature g .�. oenOwner Signature of contact/ r - —�- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ . TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ I Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS i CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Plap,ning 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 Location Ae4znr�Of � / No. S9Lr' /� Date �! MORTIy TOWN OF NORTH ANDOVER 3?O:t �ao 1yO O F � 9 Certificate of Occupancy $ ♦ i • °mob+.. '•'• ' ___��' � ;,SSACHUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 3 9 8 Building Inspector r nun .�i i Ala:1' # 8Z4b912840 LT ISTON, ME 04243-1377 DATE: 03-22-2011 t FOLLOWING ITEM(S) THAT WERE DEPOSITED INTO ACCT # 8245912840 HAVE BEEN RETURNED UNPAID. WE HAVE E. SITED YOUR ACCOUNT AS INDICATED BELOW. THE ASSOCjATED A-ES WILL BE REFLECTED ON YOUR MONTHLY ANALYSIS *S =T IENT. IF YOU HAVE ANY QUESTIONS ORR C RNS, PLEASE CONTACT US AT THE NUMBER LISTED ABOVE. CHECK # DEPOSIT DATE CHECK AMOUNT REFERENCE # 00000000092 03-18-2011 146.00 000301001339 TOWN OF NORTH ANDOVER DEPOSITORY ACCOUNT 120 MAIN ST NORTH ANDOVER MA 01845 TOTAL ITEMS) 1 TOTAL AMOUNT 146.00 ----------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------- *211274450* ---------------------------- -- ---*211274450* ��++ 03/22/2011 NSF - --- - .. . - -- --- ------ 604001632 a r-q *211274450* R"` C4`�r•.`dF�`7L This is a LEGAL COPY of your C3 03/14/2011 check. You can use it the 1\ 604001620 a `hGr��Pt/�GH,� �•�3 F/zZ same. you would use the This is a LEGAL copy oryour ti f�!a.-. �ir1/�+ �� 0092 Y Y CO check.You can use it the .`/�f felt.�l/�fv? �1•/.yll / srwn,°0 V original check. Cr r-q some way you would use the RETURN REASON-A M original check. N\ ' NOT SUFFICIENT FUNDS a m RETURN REASON—A u,m F tot4a %C.liz e, 4Aw,,<6cC-- $� / O NOT SUFFICIENT FUNDS 111 a C3 F9 oo �3 C3 .4 Ln tt' r-q Lm T Bank of America—%I C3 ACHP0411MMU ,- � For FU 6i ':0110001381: 0046354225541 d rud 41:011000 138': 0046 3 54 2 2 5 5411'009 2 .1100000 0.600.1, 41:0 L 1000 L 381: 0046 3 54 2 2 5 5411'009 2 .1100000 L 460011 00 b L ry) , 4 c-LJ Ippotlito, Mary From: Ippolito, Mary Sent: Monday, March 21, 2011 11:43 AM To: Tierney, Gail Subject: BOUNCED CHECK? I GOT A CALL A FEW MINUTES AGO FROM A CUSTOMER WHO THINKS HIS CHECK MAY HAVE BOUNCED. CHECK#92, FOR $146.00 FOR BUILDING PERMIT—FOR 121 CAMPBELL ROAD. I ENTERED IT ON THE BUILDING DEPT. BALANCE SHEET ON 3/10/2011. 1 GAVE HIM YOUR PHONE NUMBER. Mary Ippolito, Building Department Town of North Andover 1600 Osgood Street Bldg. 20,Suite 2-36 North Andover, MA 01845 phone:978-688-9545 fax: 978-688-9542 miPPolito(@townofnorthandover.com 1 .. i. Item Description Qty. Each Total fundeklain Bathroom Refuse removal dumpimg runs $300.00 reframing call it.. no new window yet $600.00 millwork vanity, medicine chest,window&door trim,towel bar $400.00 millwork bead board wainscotting $800.00 r insulate walls and ceiling new door call it... $175.00 hardware call it... 40.00 shelfing in linen $200.00 paint one coat primer,two coats finish $� plaster call it... $800.00 electrical __ . .---_._--guess- $1,8 plumbing guess �/ $1,000.00 the call it... / tI $600.00 materials call it... � %$400.0 , insulation call it... $125.00 management $2,000.00 Subtotal $10,040.00 contingency 1,000.0 Subtotal $11,040.00 Profit&O.H. 41 100.00 Total $12,140.00 V 1 I G r $300.00 $600.00 $400.00 $800.00 $200.00 $200.00 $600.00 $2,000.00 $1,100.00 $6,200.00,no contingency I Pelland Building 69 Northend St. Peabody, Ma. 01960 978-397-8122 License#90640 Exp. Date: 5/20/12 H.I.C. registration 159959 Exp. Date: 6/11/12 Date: January, 23, 11 Agreement We propos to remodel the 1St. floor bathroom as estimated at property located at North Andover Massachuse� r Scope of Work V1.) Demolition necessary to provide space in first floor area as to include new shower, linen and remodeled bathroom. Remove all wall and ceiling coverings as to prepare for new plumbing and electrical, new insulation and new blue board and plaster. Dispose of any"and._all refuse associated with the project. l ) Reframe as needed to provide new wall area , shower and linen closet. v 4.) Install new bead board;chair rail an ase trim throughout. Trim out new entry door and window to match existing house or to riient's_:eque--Q- - .) InsfaITnew-shelving-/-4 n_linen-closet 6.) Paint room'with ownedprovided primer and paint. One coat primer, two coats finis. 7.) Have project-ready for all follow on su�contia�tors, i.e.. plumbing, electrical, tile and plaL. 8.) Coor 'n a with all subcontractors, suppliers and inspectors as needed. pv 45 � Said work shall be completed for the sum of Contingency Clause Not included within the above amount, but, included in the project estimate is an additional $1,000.00 contingency clause. This amount is to be utilized in the event of over runs as i pertains only to Pelland Building. Subcontractor's bids are held as they i 1 r are unless unforeseen conditions or customer elected "extras" come into play. As with subcontractors, extras desired by the Owners as they pertain to Pelland Building will also be billed as extra. Pelland Building Roles & Responsibilities 1.) Provide the Owners with an itemized estimate 2.) Provide the Owners with copies of slips for all pu chased materia_ is , _A.) Pull the building permit &act as,the contracJ _ record. 4.) Ensure a high degree of workrpanship. 5.) Supervise the work of all subcontractors on the project and ensure a high degree of .-- workmanship 6.) Coordinate with all subcontractors, materials suppliers and inspectional services as needed and requireVJ - 7.) Clean the site on a regular basis, make sure property is safe for the Owners throughout the project. 8.) Inform the Owners as to any situation that may cause a delay in the flow of work. 9.) At the close of the project ensure the site r _ee o any_constru ion related am t re ials or equipment. — Owners Roles & Responsibilities 1.) Make payments directly to Pelland Building/ ark Pellan as outlined in the payment schedule of this document. 2.) Make payments directly to subcontractors upon the approval of Pelland Building. 3.) Clear through Pelland Building any change orders prior to any work being done. Payment Schedule $400.00 upon signing. 2.)$966.68 upon completion of demolition and framing. 3 ) .66 upon completigD, hinn &electrical "rou hed out". 4.)-$9e6-66 upon completion of blue boa[d-& plaster 5.)-$966-e6 upon completion bead board installation. . s ,33 6) _6_upon�Lnoletion—of--' arnt 7.)-$968-66 upon completion"punch listn.n 33 � S t Acceptance The above terms and conditions are deemed acceptable; we hereby enter into this agreement this 23`"day of January, 2011, you are hereby authorized to begin work. Do not sign this contract if there are any blank spaces! Identical copies should go to the Owner and Contractor Owner r-v 4 !t! Date: i I Pelland Building Date: You may cancel this agreement if it has been signed by a party thereto at a other than an address of the seller which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of the agreement. Permits Required The following permits will be required to be pulled for this project: 1.) Building Permit 2.) Electrical Permit 3.) Plumbing Permit Note:It is the obligation of the Contractor to pull the building permit as the home owner agent.Owners who pull their own permits or deal with unregistered contractors are excluded from the guaranty fund provisions of MGL c.142A. Contractor Registration Inquires g q i I Note:All home improvement contractors and subcontractors shall be registered and any inquires about a contractor or subcontractor relating to a registration should be directed to: Director:Home Improvement Contractor Registration One Ashburton Place,Room 1301 Boston,Ma.02108 617-727-8598 Unless otherwise noted within this document the contractor shall not imply that any lien or other security interest has been placed on the residence. Arbitration The contractor and Home owner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract the contractor may submit such dispute to a private arbitration service which has been approved by the secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in M.G.L.c. 142A. Contractor / G `— Date: Z-�� Owner Date: Notice: HE SIGNATURE OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLMENT INITIATED BY THE CONTRACTOR.THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPERATLY SIGNED BY THE PARTIES. Acceleration of Payment Homeowners financial insecurity-A contractor may not demand payment in advance of the dates specified on the payment schedule in cases where the owner deems him/herself to be financially insecure. Contractors financial insecurity-In instances where the contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to the continuing of the contracted work. Withdrawals from said account would require the signatures of both parties. If you have any general questions or need additional information about The Home Improvement Contract Law,contact; Consumer Information Hotline Commonwealth of Massachusetts Office of Consumer Affairs and Business Regulation 10 Park Plazas,Room 5170 Boston,Ma 02116 PELLAND BUILDING 69 Northend St. Peabody,Ma.01960 978-397-8122 Fax 978-531-5274 markjpelland@pellandbuilding.com ............................................................... January22,2011 References 1.)Gary&Judy Peabody,Marblehead,large family room addition,front porch,reside and reroof house,partial remodel of kitchen,convert garage into bedroom.781-631-7825 2. James Liston To eld New attached two car garage.978-887-8657 Topsfield, I� g 3.)John&Linda Silva,Peabody,family room addition,978-531-1690 4.)Jon&Dianne Vedder,Reading,2nd floor addition.781-942-2920 V- 5.)Larry&Patty Giangregodo,W.Peabody 10'x18'bathroom addition,978-535-3269 JJ (�64)Thomas&Roberta Sanchez,N.Reading,11t floor kitchen addition.978-664-1440 7.)Roman&Ellaina Zotman,Swampscott,family room addition,781-592-2058 8.)Richard Royer,Peabody,attached 2 car garage,978-531-1513 V .)Jim&Novaleigh Kruppa,rebuilt entire 2nd level of cape,reside house.2nd project,entire gut and model of kitchen and 1st.floor 781-944-1411 /10.)Chris&Kathy latrou,Peabody,remodel of bathroom,2nd project,remodel basement.978- X I 977-7 34 11.)Laura Mezzanottie&Chris Codair,153 Weyland Circle,North Andover,basement remodel, daytime,978-538-8277 12.)Robert Hoff,44 Lexington,Ave Glouster,978-525-2228.Just a small project,crown moldings, millwork,etc. 13.)James&Kristen Leduc,unlisted,8 Brentwood circle,Danvers.Large family room addition, kitchen renovation and front and back deck.I'll try to get an e-mail address so you can contact them. 14.)Maria Kaba,25 Sprague St.Peabody,basement renovation,the floor,new plaster walls and ceilings,new bath.978-828-6068 15.)Peter Maglliaro '� Itilass�achusttts_ Board of B Department uildin<. of Public Sateh Constr " Regulations License: action Supervisor License I °ce nse Restricted. CS 906gp to: 00 MARK J PELLAND 69 NO RTHERN STREET PEABODY, MA 01.960 I i C•°pjhlissione. Expiration: 5/20/2012 - - - --__ Tr#: 24510 Offike o Lans erA, HOME IMPROVEMENTairs g smesscgnra CONT Registratio'n: 159959 RACTCI' t, piration 6/1 TYPO Ex ]/2012 = QBq J P �ND`BUILD�1HG_ s rx ! RK PELLAND � 1 hOF�THEND STi w 69 PEA`B(JDy MA 01960:: I - Linden sccret�r.'y: . The Commonwealth of Mass'achus'etts Department of Industrial.Accidents Office oflnvestigations 600 Washington Street Boston,MA 02111 kqty www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/FIect:ricians/JPlumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Z/lff l 2 Address: C C/'i ra n City/State/Zip: WQ�i ��(, /�1� :, v L Phone#: `� ��— — l•Z-,— Axe you an employer?Check the appropriate box: Type ofproject(required): 1.❑ I am a employer with 4.full F1 am a general contractor and I 6. ❑New construction m to ees and/or part-time).* have hired the sub-contractors [2. I am sole proprietor or partner} listed on the attached sheet.? 7. E]Remodeling . ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition. [No workers'comp.insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑Electrical repairs or additions ' required.] v 3.❑ I am a homeowner doing all work right of exemption per MGL 11.El Plumbing repairs or additions myself. [No workers'comp. c.152,§1(4),and we have no 12.❑Roof repairs insurance required.] employees.[No workers' comp.insurance required.] 13.n Other *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 isproviding workers'compensation insurance fol my employees Below is the policy ancz'job site information. Insurance Company Name: p Y Policy#or Self-ins.Lic.#: Expiration Date: rob Site Address: City/State/Zip: 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 flue of up to$250.00 a day against the violator. Be advised that a copy ofthis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penaltiey ofpeYjury that the information provided above is true and correct. Signature: Date: Phone#: Official use orzly. Do not write in this area,to be completed by city or town official City or Town: Permit/hicense# Issuing Authority(circle one): x.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact-Per son: Phone fl: