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HomeMy WebLinkAboutBuilding Permit #301 - 183 FRENCH FARM ROAD 10/18/2007 yORTH BUILDING PERMIT °F TOWN OF NORTH ANDOVER �? 'y°'`- `_�' T` °` APPLICATION FOR PLAN EXAMINATION Permit NO: Q J, Date Received "°gwTeo►� � �SSNCHUS�� Date Issued: a �� IMPORTANT:Applicant must complete all items on this page ltd VATJ 07 1 am0 OP" N,= V1413WN PAft: 071»GTJ1TRIOT `` " is3oric his#rac# ` � es4s hog s r; A 54, z Mactiire Sfiop�Iailage Iles no�j TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building = One family Addition Two or more family Industrial AI No. of units: Commercial Re air n Assessory Bldg Others: Demolition Other etic' � WII `F •,.F1ood�lam � Wetlands 't V1r'a#erst�ed Distr+c# x ri tater/.-6ewer r,,„_ r,` f .,•fir-. `< i met. :r >"s ,r DESCRIPTION OF WO K TO BE PREFORMED: M C - Identification Please Type or Print Clearly) OWNER: Name:__ Phone: - �7 Address: iv 15 211 M, zCO�T#�ACTOR Naraie' -t.a �`�.+�� ��=_ "/��t��� qhs©rye - �Y ��,�� ,t�✓ y � � , Adclr JIM"t ryf T Suprvis©y-- `Cons#�-ta on, �cen�e � p date j Home lrprovernert icerase. . _---. Ex Date .., .. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:/$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ i�//0, 6 660 FEE: $ Z�o Check No.: Ila U Receipt No.: ® NOTE: Persons contracting with unregistered contractors do not have access to ranty fu ��, S..!gnature of Agen#/Owner= = t Signature of tcontact Location 93 No. I Date °RTM TOWN OF NORTH ANDOVER • ; : Certificate of Occupancy $ ,SSACNUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ n_ Other Permit Fee $ TOTAL $ Check # ice v 20707 Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH 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 Located at 384 Osgood Street FIRE EPARTMEIVT P. Dumpster on site yes` no Located at 124 l�lairi street ;Fre De partrnerats�gnat»weydate CO.MME'NTS I 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 2007 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 ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 NORTH 0 of o over �,o LA o dover, Mass.,A) l� d COCHICHEWICK RATED PPa��S `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System oom�1 C �. BUILDING INSPECTOR THISCERTIFIES THAT.........I �...................................................................................................................................... Foundation has permission to erect. buil gs on .j. ..... �M.. ".0.. Rough to be occupied as........ ... ...+�..... ..... ..... ...... w............. Chimney !� provided that the person accepting this permitshall in ery 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 01(' 00 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU S ART Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy 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. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): UL,+;,,�� Address: City/State/Zip: (/&,V C)l 'Phone #: ! 10 —C;L Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑ New construction _ employees(full and/or part-time).* have hued the sub contractors 2.5:11 am a sole proprietor or partner- listed on the attached sheet. 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 required.] officers have exercised their 10.[] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 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. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob 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 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for'nsurance coverage verification. I do hereby certif n the pains and pen. t' s perjury that the information provided above/is true and correct Si nature: VDate: Phdrt�#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: BoaMff"I 1:icense or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 15017$ Board of Building Regulations and Standards Expiration: 311412008 One Ashburton Place Rm 1301 Type: Ltd Liability Corporation Boston,Ma.02108 GROUNDS UP HOME IMPROVEMENT&CONSTRUCTI JULIEN PLOURDE 51 LYNDALE AVENUE METHUEN,MA 01844 Administrator Not valid out signatu e BOARD OF BUILDING REGULATIONSI" TiON SUPERVISORLicense: coNsTRuc Number. CS 091890 Wnthdate-01/1811961 Expires:01/18/2009 Tr.no: 91890 Reshicted: 00 TM JUILIEN G PLOURDE 51 LYNDALE AVE METHUEN, MA 01844 Commissioner Grounds Up Home Improvement and Construction LLC Estimate 51 Lyndale Ave Methuen,MA 01844 Date Estimate# Customer Name and Address 9/5/2007 119 Tim Lacourse 183 French Farm Rd North Andover Ma 01845 Project Upstairs bathroom r... Description Labor Total Materials to complete job 13,722.00 Total labor for job 7,956.00 Job Details: Demo entire bathroom including wall between bath and closet. Rough plumbing for toilet,sink,shower and tub.(800.00 allowance for sink and toilet) Rough electrical to include light over tub,light in shower,2 wall sconces for sink area,light fan unit in ceiling and wall receptacles. Lay new toung and grove 3/4 plywood for subfloor. Frame shower walls and move doorway into bathroom. Insulate exterior and plumbing walls and floor. Blueboard bathroom complete and plaster. 1/2"Cement board on floor and in shower walls and ceiling. Prime and 2 coats of paint on walls and ceiling. Tile and grout floor,and shower.(a 6.00 per square foot allowance for shower and floor tiles) Apply headboard panels to bottom half of bathroom and top with chair rail. Install bath door,trim window and apply baseboard. Paint all trim with 2 coats. Install shower door.(400.00 allowance for door) Finish plumbing to include Existing claw foot tub,Shower hookup,Toilet and sink hookup.(800.00 allowance for faucets and drains) Finish electrical to include chandelier over tub,light in shower,2 wall sconces for sink area,light fan unit in ceiling and wall receptacles.(250.00 allowance for wall sconces and chandelier) Install fireplace mantle behind tub. Build custom headboard cabinet between shower and toilet. All construction debris will be removed via dumpster. All work is guaranteed for one year from the time of completion. Total $21,678.00 Payment terms 1/3 at start 1/3 midway 1/3 at completion Any changes to this estimate will be charged for time and Signature materials Signature Phone# Fax# E-mail Web Site 978-208-1900 978-208-1901 groundsup@comcast.net www.groundsup.net