Loading...
HomeMy WebLinkAboutBuilding Permit #1096-16 - 131 SANDRA LANE 5/1/2018 L �OF?Ty BUILDING PERMIT4. D ,b�tio TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ;; m" If oR K Permit No#: Aa - Date Received A�R�TEo PPpy�S C14 SS Date Issued: IMPORTANT:Applicant must complete items on this.page LOCATION Print PROPERTY OWNER JU14N14 jJj j1Q ���404,LL Print 100.Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes. no . TYPE OF IMPROVEMENT PROPOSED USE f ` Residential Non- Residential ❑ New Building 04 One family El Addition El Two or more family El Industrial X Alteration No. of units: El Commercial ILRepair, replacement ❑Assessory Bldg ❑ Others: Demolition ❑ F 1 -,� -- ❑ Other _ ;1N ' ._�. Wefla ds, ed ss,l .;ood a n;, t® ❑ tees Wi r c}tt 4F a �Se er - -- t DESCRIPTION OF WORK TO BE PERFORMED: Rei' OV& E.A, SrNC_ KjTC,4Qj Cjj3jAje7 ' nNjg, L iNdL_S VN1 pA 'i'1t.�� ACK oS�Cf�•s Identification- Please Type or Print Clearly f OWNER: Name: Jnw�A ► I-� Ati MAN Address: i�c�r.� 4144 Phone: ` ?-1- Address: ( 3 ( S'n Npo_a Ajl +f�NZ�C. {1c�ME I �v�Ld�MFN'T r`t�C I Contractor Name: �ErVPJ IS �A IL 21A L,,r-. Phone: �I - � 03 3 : i Email: c (a(g&Ck-(3M Cyel 0 m ent mt I Cum Address: 2- S TyLe-S OIz. . �d U_/� 4�'1 O i 966 3ASupervisor's Supervisor's Construction License: 09I'J(S" Exp. Date: (^7Z { fq � 2© 17 Home Improvement Licenser (`�g3 Exp. Date: f� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 13 Z -FEE: $ 160 Check No.: I %12( Receipt No.: �� NOTE: Persons contracting with unregistered contractors do not have access�t e gua ty fund J Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL x. Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools 11well El Tobacco Sales ❑ Private(septic tank,etc. ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY I INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS I r I CONSERVATION Reviewed on Signature I I COMMENTS HEALTH Reviewed on Signature COMMENTS i I I I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature&IDate Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPgR+}Imo"TTernp Dumpster on sits Loeated at 124 Main Street -�°-- Fire De partme.. signature/,dater Fc... .?. ^'..t Rr..�+v.Jr..r.++rJ11..L.e:3:��.RLSL�11'Y.'+:1M vrT1'}�,i -�SYh • a Dimension Number of Stories: Total square feet of floor area, basedon Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Deter location, mast or service drop requires approval of Electrical Inspector yes No i DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA,-- (For department apse) ❑ Notified for pickup Call Email Date Time Contact Name 3 Doc.Building Permit Revised 2014 i Building Department i forms to be filled out for the appropriate permit to be obtained. The following is a list of the required 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 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 4, Copy Of Contract Floor/Cross Section/Elevation Pian Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) 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 J 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 41 Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And { Hydraulic Calculations (If Applicable) Copy of Contract 4 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 j must be submitted with the building application Doe:Building Permit Revised 2014 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost 113,,2'7 0.010; m $ - $ 159.24 Plumbing Fee $ 19.91 Gas Fee 100 comm. $; IO'G.GG, Electrical Fee $ 19.91 Total fees collected $ 299.05 131 Sandra Lane 1096-2016 on 4/29/2016 Kitchen Remodel NORT1j Town of _ Andover 0 1:116 L2 No. - 1 oLAKG h , ver, Mass, 1saCOCNtCMl WIC.[ y1. s°R�tED r`Pa�,�S U BOARD OF HEALTH Food/Kitchen PERMIT T L D Septic System THIS CERTIFIES THAT °"G �G �S BUILDING INSPECTOR Ja/Vell, �GN� Foundation has permission to erect .......................... buildings on ..�s/.................................................................. Rough to be occupied as .................:..G.:.`. �G til C�`Y... S:::'!:Q. / ....."....................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T RTS Rough Service ........... ........ .. .. .. �BUIL­­ ...................... Final G INSPECTOR 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. k Dennis Parziale y _ Ph: 781-771-6933 r. t � Fax: 978-587-3364 License#CS 091968 Home Development LLc HIC Reg#148734 2 Styles Drive Fully Insured Peabody,MA 01960 PROPOSAL Submitted to: Tara Haas & Johnathan Mandell 02/15/2016 Phone: 978-394-3614 Job Name: 131 Sandra Lane Job Location: North Andover,MA 01845 Date of Plans: To be scheduled We hereby submit specifications and estimates for: KITCHEN RENOVATION(24' x16') Permits: Contractor to obtain permit. Demolition: Remove all cabinets, all wall tile above cooktop, all flooring and existing subfloor down to floor joist. Remove wall board between upper and lower cabinets to allow smooth surface for back splash tile. Plumbing: Done by others and not included in this proposal. Insulation: Insulate cold walls where wall board has been removed only as needed. Wall Covering: Install Y2"blue board and finish with smooth skim coat plaster. Interior Trim: Install new matching wood trim on all openings and window above sink. Install new matching base trim. Cabinetry: Install new cabinetry and accessories. Cost of labor only to install is included. Painting: Paint all new trim 2 coats, and walls 1 coat. Wood Flooring: Install new hardwood prefinished oak flooring in kitchen and dining room 2 i Tile: Install back splash tile supplied by homeowner. Note: Cost of cabinetry, accessories, hardware and appliances not included. To be supplied by homeowner. Note: Any alterations or deviation from above specifications involving extra costs,will be executed only upon written orders and will become an extra charge over and above the estimate. Responsibilities of the client/homeowner:Although, Atlantic Home Development, LLC uses extreme care and caution while working on your property, it is the responsibility of the clientlhomeowner to remove and keep safely all valuables,fragile belongings, heirlooms etc. during construction and renovation. Contractor assumes zero liability on this matter. Responsibilities of Atlantic Home Development)LLC:A11 work will be executed in a neat and eorkman like fashion. Dust walls will be erected as needed. Premises will be cleaned on a daily basis, all construction debris will be contained and removed from premises. Notice: All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza,Suite 5170 Boston,MA 02116 Phone:(617)973-8700 Homeowner has the right to cancel this contract in 3 days from date of acceptance under MGL c 93s,48;MGL c 140 D s 10 o r MGL c 255 D s 14 as may be applicable. Not all above notes may apply to your specie application. WEPROPOSE: hereby to furnish material and labor-complete in accordance with above specifications,for the sum of Thirteen thousand two hundred seven dollars 111170.00 Payment to be made as follows: $6,2 70.00 at start, $4,000.00 during and$3,000.00 upon completion. Do not sign this contract if there are any blank spaces t✓:i f Date of Acceptance: / C1.cGdl /T _ , � Signature: 1 Authorized Signature: Signature: AFTER 30DAYSA FINANCE CHARGE OF 1.5%PER MONTH, 18%ANNUALLY, WILL BE CHARGED ON THE UNPAID BALANCE. 3 The Commonwealth of Massachusetts f Department oflndustrialAccidents " /a I Congress Street,Suite 100 ' Boston,MA 02114-2017 yV;y�t www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNIITTING AUTHORITY. Applicant Information (� Please Print Legibly Name (Business/Organization/Iddividual): J']'o�A& O F_%J L uP meAj L L C Address: Z -S A YL&. Q . City/State/Zip: 'P FiA&oy l `�R: 019 6d Phone#: Sl ' �4 l—0 V Are you an employer?Check t&appropriate box: Type of project(required): 1.❑i am a cmployerwith employees(full and/or part-time).* 7. ❑New construction 2.&am a sole proprietor or partnership and have no employees working for me in 8. [A Remodeling any capacity.[No workers'comp.insurance required.] 3.FJ I am a homeowner doing all work myself[No workers'comp.-insurance required.]t 9. W Demolition 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11_.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ t 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.F1We are a corporation and its officers have exercised their right of'exemption per MGL c. 14.❑Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating 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 state whether or not,those entities have employees. If the sub-contractors have employees,'they must provide their workers'comp.policy number. Iain an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job 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 MGL c. 152,§25A is a criminal violation punishable by 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.A,copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby ce under tli pai and penalties ofpei jury that the informationprovided above is true and correct. Zo Sign e: Date: LI/ j Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." ' An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.". Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and-phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents fbi confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensatioii policy,please call the Department at the number listed below. Self-insured companies should'enter their - self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"lob Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext.7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia Massachusetts Department of Public Safety Board of Building Regulations and Standards s License:,CS-091968 Construction Supervisor � Int t e +eli. ;DENNIS S PARZIALE 2 STYLES-DR PEABODY MA 01960 Expiration: Comrraissioner 06/27/2017 _ S OZ. _ Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR gistration: .118734 Type: xpiration, -=40'_-17 w. Ltd Liability Corpor ATLANTIC HOME DLVELOPMENTRit Iti r-1 - DENNIS PARZIALE 2 STYLES DRIVE `1,, ;_ !R%` gam, •PEABODY,MA 01960 Undersecretary Location �?� ->�''' `arc fi ��� •' No. /i% r /(� Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ K Foundation Permit Fee Other Permit Fee $ TOTAL Check# Building Inspector