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Building Permit #480 - 177 ROSEMONT DRIVE 1/12/2010
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 4D Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION", b51�N40 tzT Zay , G32- PROPERTY OWNERP_nniki' f MAP NO: b PARCEL:._ ZONING.`DISTRICT Historic District , yes no Machine Shop Village: ves ' no TYPE OF IMPROVEMENT PROPOSED USE Residential. . Non- Residential New Building <ne famil Addition Two or more family Industrial Iteration No. of units: Commercial Others: Repair, replacement Assessory Bldg Demolition Other Septic Well `: < Floodplain Weflands Watershed `Distri,cta ` Water/Sewer utaL,rur i 1Un Ur wUKK I U 13E PERFORMED: L A Identification Please Type or Print Clearly) OWNER: Name: fqAY Phone: Address: '1 . CONTRACTOR Name:,,t 1 one: - t, Address: g©a t4-1 i� C Supervisor's Construction License: Exp.. Date zto J-6- :Home Improvement.. cense: I �t'7Dr'�.= i=Yn ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $1200 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ ► FEE: $ 1.0 2: X i ^ 72 05� Check No.: Receipt No.: 2Z—:4-3� NOTE: Persons contracting with unregistered contractors do not have access to the gyWanty fund nature -or HgenvuwnP(1°Signature of Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL DATE REJECTED DATE APPROVED Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site c COMMENTS THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM - DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT r COMMENTS CONSERVATION Reviewed on Signature S n Y't COMMENTS HEALTH Reviewed on _ Signature' 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 D$W ,T'�o*- EHgineer ` Signatu6: f 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 ❑ 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 o 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: Doc.Building Permit Revised 2008 Location No. qko Date 10 TOWN OF NORTH ANDOVER Certificate Occupancy $ of CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 22739 Building-lnspktor m m m m VI m /♦omw YI m v C � CO2 n 10 0 CD n Z CO2 r CD o n. 'c CO2 O .� D CD dc 0CL Q CD CD CD w w 9. C� CD CO) O 'coo to CD I � v y O 'O Z CD O � CD O CD I B r cn O cn cn cn 2 7� r-� zz r� V / C O W �� 00 , = b7C77n ~ EL- y o O H = ?' y O�®O m a C7 m n C2 r" C) T O Cy . CA G C CD �p,.►d O Fn - CD M �CD y CO) =r a: O CD —I a I O y m O Z— C2 0 LA=r y ✓ J =0 ,Co a~� O =r 1 8. m CO y �0 d y =r: aCS : �, � r.7 CD C t0 O y ,r y H d O CD � : •—s 1 ^' n ® o Y� CDO H CD 0. A d r W IW M .o CVS: O y � O . C2 O O � O :\r • o 4,'W Cn CC/ z b7C77n ~ av ?' S. f D O Cl1 Cil H w r" C) w r � G C O c�i) p x ° N 1 -3 i:0-� ICL 0 c BEACON CUSTOM BUILDERS PROPOSAL October 26, 2009 Mr. & Mrs. Suman Patel 177 Rosemont Drive North Andover MA 01845 RE: Kitchen Remodel We are please to submit the following proposal for work necessary to meet the scope of work requirements for the proposed renovation of your kitchen at 177 Rosemont Drive in North Andover, Massachusetts. This scope of work was developed by Beacon Custom Builders in conjunction with the homeowner after several site visits during September and October 2009. Preparation: 10 Secure Permits and Approvals necessary .for.construction. 20 Remove and dispose of existing Floor Finishes. 30 Remove and dispose/donate existing cabinetry. _ 40 Remove and dispose/donate existing appliances. Electrical: 10 Supply materials and install additional recessed lighting as necessary (up to six (6) new fixtures). 20 Supply materials and install feed for new exhaust ventilation system proposed above island. 30 Supply materials and install to (2) new GFCI outlets at island. 40 Supply materials and replace existing counter top outlets as required. 50 Supply materials and install New Dishwasher outlet as required by Mass. Electrical Code. 60 Supply materials and install New Xenon Direct Wire Under Cabinet Lighting to all new Wall Cabinet under surfaces. 70 Supply materials and install New Xenon Direct Wire Interior Cabinet Lighting to all new Glass Wall Cabinets. 80 Supply materials and install New Wall Oven (listed separately under appliances). 90 Supply materials and install New Microwave Unit (listed separately under appliances). 100 Supply materials and install New Franke Garbage Disposal (listed separately under appliances). 110 Supply materials and install Electric Radiant heat sub floor with programmable thermostat beneath ceramic tile finish. Plumbing: 10 Supply materials and install New Sink Drain Plumbing. 20 Supply materials and install New Ice/Water Line at Refrigerator location. 30 Supply materials and install New Franke RXX-160 Double Bowl Sink with integral shelves. 40 Supply materials and install New Franke WD751 B Waste Disposal at Sink. 50 Supply materials and install New Franke FF1600 Satin Nickel Pull -Out Faucet. 60 Supply materials and install New Dishwasher Supply and Drain Lines. Page 1 of 2 800 Main Street • Holden, Massachusetts 01520 Voice (508) 829-5004 • Facsimile (508) 829-5409 • www.beacondevelopers.com Custom Cabinetry: 10 Supply cabinetry and install new Beacon Custom Cabinetry in Cherry with Edgemont Door in Full Overlay. Please refer to Custom Cabinetry order form and attached drawings for further details. 20 Supply and install New Drawer Pulls from Beacon Hardware Catalog (choice TBD allowance of $10.00 per pull) Interior Finishes: 10 Supply materials and install New Porcelain Tile Floor (EMA 63Z61 R). 20 Supply materials and install New Glass Tile Backsplash (RS67 Mudslide Blend). 30 Supply and install Custom Granite Tops (color TBD) 40 Supply and install New Drawer Pulls from Beacon Hardware Catalog (choice TBD) Appliances: 10 Supply appliance and install New Electrolux EW23BC701S Counter Depth Refrigerator 20 Supply appliance and install New Electrolux E30EW75GPS 30" Wall Oven 30 Supply appliance and install New Electrolux EE130MO45GS Microwave 40 Supply appliance and install New Electrolux RH36PC60GS 600 CFM Hood 50 Supply appliance and install New Fisher Paykel DD24DCTX6 2 -drawer Dishwasher 60 Supply appliance and install New Electrolux EW30GC55G Cook Top Total Base Project Budget $85,670.00 Exclusions: 10 Any other items not specified above We appreciate the opportunity to supply a proposal for this project and hope that we may participate in its construction. Please keep in mind that this project will require approximately 20 days to complete. If you have any questions or comments or would like to meet and discuss this project further, please feel free to contact me at your convenience. Sincerely, Philip Montalto Beacon Custom Builders (508) 889-6373 Direct (508) 829-5004 ext 101 Office Page 2 of 2 800 Main Street • Holden, Massachusetts 01520 Voice (508) 829-5004 • Facsimile (508) 829-5409 9 www.beacondevelopers.com 7 §o«/ \&;B 77�§�\ \�0 . �§( $a§� �0 \0. 0-0 . I o§§� /k _.§ f y /faE fE§i =\ ■;I �nA CEJ =A, \§§ A 0.� § 0mak � \� F\ � ?% �\ f 2 � �\� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, M4 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address:C City/State/Zip: V AFu an employer? Check the appropriate bog: 1. am a employer with g_ 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for in any capacity. workers' comp. insurance. . [No workers' comp. insurance 5• ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ construction 7. Remodeling 8. ❑ Demolition 9. ❑ B 'lding addition 10, Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other * 4:.•; applicant that checks box #1 a'sc fill out the section below showing their workers' co en= policy iaformation t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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 is providing workers' compensation insurance f r my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self --ins. Lic. #: I Expiration Date:0-5 /, n Job Site Address: �� —] T(25,F,44V f -r 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 fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do heroby:��under th�a,in&wndpenaltry that the information provided above is true and correct. 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 Iicensing 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' carnpensation 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 for confirmation of insurance coverage. Also be sure to sign anddate 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' compensation 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 permittlicense 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 "Job 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 bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any, questions, please do not hesitate to give us a call. ' N The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents. Office of fnv°esdgations 600 Washington Street Boston, MA 0.2111 Tel # 617-7274900 ext 4.06 or 1-877-MASSAFE Fax # 617-72.7-7749 Revised 5-26-OS-ANm.mass.gov/dia Custom( Address: c" �o BEACON CUSTOM BUILDERS I CUSTOM CABINETRY ORDER Contractor: Beacon Custom Builders 800 Main Street, Holden MA 01520 Date: THISGREEMENT ade the above date by and between Beacon Custom Builders and Gl/)'n -PC , hereinafter called the Owner. / c SCOPE OF WORK: Beacon Custom Builders and the Owner for the considerations named agree as follows: Beacon Custom Builders shall design, supply & deliver the following cabinetry as determined by Owner. CUSTOM ORDER SPECIFICATIONS Manufacturer Wood Specie Finish Color Finish Sheen Hinge Style Door Style�G} Overlay Construction's Drawing Reference Other CONTRACT PRICE for the above indicated cabinetry includes shipping, and sales tax. $� �sJ' 7 PAYMENT AGREEMENT Payments of Contract Price shall be made as follows: 50% due upon placement of order, remainder upon delivery. Signed and accepted this day, Customer Signature Date Order Deposit Amount $ Order Deposit Date j r Beacon Custom Builders !15ate 800 Main Street • Holden, Massachusetts 01520 Voice 508-829-5410 • Facsimile 508-829-5409 • www.beaconcustombuilders.com BEACO ' N TIMOTHY 0.0 MAIN HOLDEN, Office 6f�}� - Consikiiier' \_ff�. flhsine9s,Rogtdaqqn HOME; IMPROVEMENT CONTRACTOR Registrgtlon:P, 154705 Expiration-- ?V212011 Tr# 286689 nrntinn 0 10 T«'1 -T-.!Mg,�T-HY,;MONT-ALTB-,;�-� _0�]'RNHARVA 014 0 �6 !j: Bc 7 0 10 T«'1 -T-.!Mg,�T-HY,;MONT-ALTB-,;�-� _0�]'RNHARVA 014 0 �6