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Home My WebLink AboutBuilding Permit #235 - 124 MIFFLIN DRIVE 9/20/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION o`t-'t_.o 0e - '• ° OL 2 FO t Permit NO: 3 Date Received 0, Date Issued: � �/ O �9SSACHU`�� IMPORTANT: Applicant must complete all items on this page LOCATION �Z�'( ��Fc.�-► �� Print PROPERTY OWNER NCL,,c�, "F0 Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building bOne family ❑ Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other D Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: � Phone: Address: k 2 CONTRACTOR Name: Phone: Lny,) Address: k lu'k 20 i_.#uv. - � ' �rt" L\Jy�.)f tti b-,Ak L", k.._ G l�4 Supervisor's Construction License: 3 [�`�� Exp. Date: L. 0 Home Improvement License: ' -1%l Exp. Date: 11 t_ _`t•k D-7 ARCHITECT/ENGINEER Name: Phone: "'-� Address: Reg. No. -- FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED OSTBJ ON$125.00 PER S.F. Total Project Cost S V-4-2—.(;,o 0 FEES q Check No.: 3 Receipt No.: Page I of 4 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) o 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 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 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools 11 Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project ` NOTE: Persons contract'ng with u 'stez do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waiveded Plot Plan ❑ Stamped Plan THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS 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.) P4 4t, Front Yard Side Yard Rear Yard Required Provided Required L Provides Required Provided 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 Jan2006 Location No. . r Date NORTh TOWN OF NORTH ANDOVER O?Oi��•o I°,h00� rN �° .,; �'erttftcate vf•Qcs�pancy $ .�— _ _ E Building/Frame Permit Fee MUS Fou daucrrflermtt-Fee Other Permit Fee $ _ TOTAL $ Check # Building Inspector NORTH ovm Of tAndover 10 No. ; r C A O over, Mass., ' Z L • 0 COCMICMEWIC11 � �d AORATE D �'?YL\��5 `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..........1M.I.A. ..........F ................................................... ""' i "" Foundation has permission to erect............................. buildings on ....t1;.Y.......... ..... .t.. i//..fir ........... .......... • Rough to be occupied as... !�...... � .� �.i�. 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 N96 40000 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC . ART Rough ............... ............ ........... Service . ... . . .. ...... .. .... . ..... . BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. r O 3,etKevin MwWhy WhAnd1oeMA 01 345 • PH:97414494M Building Contractor FAX:978-688-7207 Proposal TO: Mike&Nancy Ford 124 Mifflin Drive All Ham impmwnerx Contractors am 8ul)=Vr11CUX$ North Andover, Ma. 01845 +fes "ofCnepWr 142A of rre general Irma,mrst be W1h the C=MWWeaAh of Massachuaefls.IWAiee about regiatreaon and Status ftW be mese to re Director,H" I=ron: Kevin Murphy ImMmnat Car*W RegiWAion,One Ashburton Place. Room 1301,Bofn,MA 02108.(617}7276598 CC. Dates 8/22/2006 Joh Kitchen Renovation Dabs of 8/06 Arcwftft None mor: Same Section 1-Work Schedule Contractor VAN begin the work or order the materials before the third day following the signing of this ag writing contractor will begin work on or about 10/15!06. reement, unless specified hens in Barring belay caused by circumstances beyond Contactors control,the work will be completed by 12/15/06.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 II-Warranty The Contractor warrants that the work furnished hereunder shall be free fmrn defects in materials and workmanship for a period of 1 year folkymtg complebon and shah 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 atter completion of any job, including cleanup,the Contractor shall,at his own expense,forthwith re replaced, such damage or such ��Y� pair correct, replace,or cause to be remedied,repaired,or a9 defect in materials or workmanship. The foregoing warranties shalt survive any inspection performW in connection with the agreed-upon work. Sectloe III—Scope of Wolt 1 J Kevin Murphy suitaie g caatm"Or Page 2 of 4 169 eadad$Vest NOM Andover,two mays PH:978688,W FAX:978,6WXXXX General Building permit will be provided by contractor. Proposal is to renovate existing kitchen/dining area as shown on plans from Jackson lumber. No allowances have been made to renovate other sections of existing house, basement, or build deck. Demolitlon Entire kitchen and dining area will be completely gutted. All floors, walls, and ceilings will be removed and disposed of. Buliding All framing materials required to remove petition between kitchen/dining arra will be provided. Eight Anderson windows will be provided as shown on plans. Siding around new windows will be supplied/installed to match existing. Electrical Electrical work required to wire kitchen area to meet code will be provided. Ten recessed lights have been included.Additional fights can be added at a cost of$75 per light Phone/cage/computer lines will be roughed in by electrician, to be connected by their service provider at owner's expense. Existing electrical service will be replaced/upgraded to 200 amp. Surface mounted fixtures to be provided by owner(ceiling fan etc, ) . Hoofing/Air Condli ioning Existing baseboard heat will be repaced / relocated as required. Toe kick heaters will be provided under new cabinets to properly heat renovated areas off of existing zone. No allowance has been made to replace existing boiler. No allowance has been made for any air conditioning. Plumbing Plumbing required to relocate kitchen sink and dishwasher will be provided. Heat lines to second floor area will be relocated as required to allow for installation of new cabinets. Kitchen sink/faucet to be provided by owner. Insulation Exterior walls will be insulated to meet code. ( R-13) Piaster Walls and ceilings will be blueboarded and skimcoat plastered. Ceilings to match existing,walls will be smooth, Closets will be textured. Interior Trim/Doors Interior trim will be supplied and installed to match existing.Two eight inch round columns will be supplied / installed between kitchen/dining area. Flooring Hardwood floors will be supper installed, and finished in kitchen and dining area(to match existing) Kevin Meshy Page 3 of 4 Budding Contractow 169 80)ftd Street Nodh Mdover,MA D1845 PH:9786885335 FAX:97SM8-XXXX Other Allowances Backsplash will be tied.An allowance of$500 has been included for materials. Items Not Included There have been no allowances made for any interior or exterior painting. No allowances have been made to supply kitchen cabinets or countertops. Waste Removal Ail demolition/construction debris will be disposed of by contractor. t Kevin May Page 4 of 4 SaHdhag Contractor 169 eodord street Nath AndPrer,MA 01045 PH-978688.5335 FAX 97&88&XXXX Section IV--Price Sch®duie We hereby propose to furnish material and labor--complete in Accordance with above specifications for the sum of...... ... ... ... ... ... ... ... ... ... ....$ 42,500 Payment to be made as follows: PercentikOftm Description ,amount 1 Permit obtained $2500 2 Demolition complete $10,000 3 Plastering complete $10,000 4 Cabinets / Interior trim installed $12,000 5 Floors / Tile complete $5000 6 -j-0b1 00% complete $3000 Total 6 $42,500.00 "Notice No agreernark for Honeln>prouerrery°DAB work"104re a down POYrnent advenw Paymffb wtKb the oorxactur n*make in advance,to order anchor dterwoe obtain ( )of more Uelegwpm of the towl oorrW pine of Ule totd amoui of ait depoeib« delivery of epettiN order rreleriaia and eo�rprnarf,wtriderer a geder Contractor Kevin Murphy 169 Boxford Street No.Andover, MA 01845 Registration No: 141874 Section V--Acceptance Acceptance of Proposal—I have read this document and accept the prices, 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 " �v v Date Signature jiig Date —qj C� The Commonwealth of Massachusetts Department of industrial Accidents Office of Investigations I14i ;/ 600 Washington Street Boston, MA 02111 www mass. ov/dia t g Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Agplicant information Please Print Legibly Name{litecin�wslt)ranir�ttionllndiviclual}:� -� �.� .__.._ M__ -- Address:_._�. City/State/Zip: Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1-0.1 i am a employer with. � _- 4. ElI am a general contractor and 1 d. [] New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. pRemodeling ship and have no employees These sub-contractors have 8, [] Demolition working for me in any capacity. workers'camp. insurance. q- ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.E] Electrical repairs or additions required.] 3.❑ 1 am a homeowner doing all work right of exemption per MGL i 1.❑ Plumbing repairs or additions No workers' comsel myself c. 152,§1(4),and we have no y � * p 2 employees. , k o workers' I- ❑ Roof repairs insurance required.] 13.❑ Other comp.insurance required.] —.. _...____-__ *Any applicant that checks box N I must also till out the section below showing their workers'compensation policy information. t HomeovAttis who submit this affidavit indicating they are doing all work and then hire outside uintractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the subs ontractors and their w(wkers'comp,txdicy information. I ani an employer that is providing workers'compensation insurance for my enspfoyees. Below is rhe policy and job site information, insurance Company Name:__G Iter. Policy k or Self-ins. Lic, #: p _ . — -- Expiration Date:_._... �.��-------- Job Site Address: '�K r�� LZ) City/State/Zi 4 .,—L-..,..,,_, 'a1. d lS145- 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 NIGL 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$250.00 a day against the violator. Be advised that a copy of this statement inay be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido he by ce c er t r s an o ' t the information provided above tic true and correct. Si e - Phone It: ckl Y/ ...... F ul use ooh+. Do not write in this urea,io be cnnWleted by city or town a�ciai.r Town: Permit/Licenseg Authority(circle one): rd of Health 2. Building Department 3.City/Town Clerk d. Electrical Inspector S. Plumbing Inspector er ct Person: Phone R: r rtu'I .1-;.r. KobertS InSurdnce FAX N0. :19786833147 Jul. 18 2006 11:19AM P1 CERTIFICATE OF LIABILITY INSURANCE ►RLa R THIS CERTIFICATE I8 I991!!D Aa A MAMA OF INFORMATIOMI M,P.ROB6RTS INSURANCE AGENCi INC. ONLY AND COWNS "0 RIGHTS UPON TME CERTWWATE 1060 OSGOOD STRSET Wna". 7H16 CER'W " OM MOT AMM, CXTENO OR ALT" TW CO MRM AffORDlD sY THE NORTM ANDOVER MA 01845 FOUCIEs IdFa.Ow. 7 - 7 mu" MG COVERAGE""""�" 'MVXN MURPBY BUILDING 6 XMD$LING AY�jAM A ----- ;NAICS . _._._PRpVIDEN mAa,RNI�: 168 DOXFORD STREET I o s•..,. i_9.tR�INCE _ NORTH ANDOVER, MA 01845 *AMM m.. -----� -�; COVERAM EHE POLICES OF INSURANCE LISTED BELOW HAVE SEEM{188L1ED TO MUM MIMED MOVE FOR THLI rOL Cr Mm MIOICATlO•NOMM"STANMI C AAIY RLgUORGAMT,TE>:M OR COMORWN OF ANY CONYRwCT On OTWR DOCUMENT WITH Ae3PlCT TO WNM.N THIS VATIFICAlh mAv At 18"D OR MAY PEATAW.THE 04LAMNOE AFf KM BY THE POLICIES DEBCRIBE'D HEREIN IB SUBJECT TO ALL THE MMB.EXCLUA�CNS MIO.COAI rrog8 CW SUCH POUCft1.ARGREOATE MW33P OMMAY NAV!&CEN RQOUM BY PAVO CLAIM& coo= POLsw AULmoe AA Y—I•I�A i 1KNInw wIKiTv umts _ (I X ol"okk I.WWTY O 106 �I.1 000.r 00� CLAWSMA09 ocC1Xl f vARl o :,d„ans. Q�000 A i __.._j_.+ . _ 5�000 CPP0060868-01 11/22/05 11/22/06 LsnovwuRY _ 0 0 OiTI AGGREGATE 0lrfl AGORlMT!UAMT APMyEJ`PM; r l 00 � ►a1cY nla La IMtOpA:TA-CwwoPA00 AtTTONONAJII.IAMILITY A+wnuro TLAn` "'"' L 500,000 ALLOMrIDALftft SCILTri1=AVPOs GOOILY R4AINY ltirMM�nI s B HOWAJ1M 7AN0277013509 1/23/06 1/23/07 � �T+OMAIEGAUTGG GoaLr IrsuRY • lrsrsfaeup s .........._....... AAgN41TY DAMAGI' O'aAedearp s GARAGN Luss.m MITOOMY^AACCf N ,f ARrAvra + A , o*reA nu., RAAW. ~.�..�. AumoHfr. El(CEst�lulsglU,n LIM4nr AIiW s EAefi OCCIAlRSMYe s i I GCCVIP �CLAMO LADE � � AGGIIRpAT! _ I OEOUCrlLE RETA!Af110R � � _ a10Ru1RSCCSA�1sIr10MAr0 i lAOLOYCMY tWNL1Tv 'r?!I!'uM/ri R !N Awf"",.ro"T""Naw" MUM 530339 7/01/06 7/01/07 AL.EACMAoejW}/T = 50Q0oQ w►msAAAnIAne AAnum1 In...A.e•Ilroer ILL.GMASE.EA�Layo. ^,i- - S00.000 ePaGALAROYNgnsAAsw OMlR l.L,DWr.Ael.roLrCYL.M s5go.000 OCXIPTIGNOr OPCIf1fTWMP LOCATION IVEOMMI ORMARMWO ADMOW DIOCIgp�IINT��MCIAL*1LOYg1011! fi 7 + I CERTIFICATE HOLM CANC.ELLATIOl1 TOMWC"AKY Gf TME ASOW of 0WO POLICIM all CAl oftL G WOMt net�MMAATNfIv I� OF ANDOVER, MA URT 'ITN Tf ,TMR WAX4 NP-Mw WALL VR1UVOR TO PAUL 10 a,vA VAIITFN f !lQ1ATLLTT sTRESx ` ANDOVER, MA 0181 Q MOVICI rG y-wr►neAa.OAocn NAf1fO TO TW LWt,sur iAW.W. LO WU BUILDING DEPARTMMT 0100s!Ho MOAT"OA UANMY OF ANY WIMW vpt*Trcrt rs OR i ANRpN/TA MJTNORQ�G ATNF ACORDi i1ZOQU00) CAC-MD CORPORATION IS" NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: u hL. ^ (_;.� N')- .".A is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by NIGL , 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: (Location acilit Sign of Pe it Applicant Fire Department Sign off: Dumpster Permit Date