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Home My WebLink AboutBuilding Permit #156 - 19 BOXFORD STREET 9/2/2008 I 14O R TFC BUILDING PERMIT o '"D 24 bf..,, .a..tb Op TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ` Date Received �SSACHU`�� Date Issued: '� IMPORTANT: Applicant must complete all items on this page LOCATION )AeOl Sr, 2L�'/ Prin PROPERTY OWNER •¢ Print MAP NO/ PARCEL:- ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Iteration No. of units: Commercial r, replacement Assessory Bldg Others: Demolition Other Septic Well floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: 6F-ectf d.Ycr �,c2,� 5 Phone: 4S2 z&(/e->— Address: CONTRACTOR Name: f�' Phone: Le- c Address: d'0 (1711 Supervisor's Construction License: Exp. Date: j!' ?�Ck;> Home Improvement License: 1 Exp. Date: ' /c'� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ yS FEE: $ I Check No.: S o �- — Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access o the g ran fund ignature of Agent/Owner Signature of contra Location No. Date MORTM TOWN OF NORTH ANDOVER • • ; Certificate of Occupancy $ �ssu�sEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # y 2 , 461 Building Inspector i 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 'i INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments I I Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREDEPARTMENT -Temp Dumpster on site. yes no Located at 124 Main Street I Fire Department signature/date COMMENTS I +I 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.s1oo-s1000 fine NOTES and DATA— (For department use I ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 r 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 a Building Permit Application Workers Comp Affidavit .Q-, Photo Copy Of H.I.C. And/Or C.S.L. Licenses ,0, Copy of Contract d Floor Plan Or Proposed Interior Work ❑ . n�.n e ng Aff0ftts 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 2.2008 tkORTH TO" of No. dover, Mass., O COC ICMEWICK 7� 0RATED P-' 2 4 BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D BUILDING.INSPECTOR THIS CERTIFIES THAT....... ....... A'.. ......................................... Foundation has permission to erect................. ...................... buildings on .../...�.........�,�..Q.# /!�r.... ..................... Rough to be occupied as.......�..�.�......�P.�.... ..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 c'� Final T PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESSCONSTRU - ---. S TS Rough .......... ..... . ............................... r Service .__.. BUILDING INSPE-CR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place o'n the Premises — Do Not Remove Final No Lathing or D■ 7 Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. -60www�" on,and Standards Board of Building R e isor License Construction Sup , Licensi:: CS 87.608 Bi,o a e 6R�19ti6 Tr# 14909 Exi#jAjon 61712 09 F�estia�t�on `00 FRANK E CART 107 GLEN RDN; Commissioner WILMINGTON, MA 01887'-` ��te Vo�nmzontueolC�y o�,/�4�� Board of Building Regulations and Standards lug HOME IMPROVEMENT CONTRACTOR Registration,: 143793 Exp�rafiaorl g13/2010 Tr# 272822 fTyke ."Ind FRANK E.CAR .A FRANK CARTA4 y 107 GLEN RD WILMINGTON,MA 01887 �` Administrator II "Irvoll Can(ircalli It. We can buil r 107 len Rd \V11m1w_,1on. MA 0 1887 978-76 1-87'20 Contract HOMEOWNER: Gene &Carla Hunt LOCATION: 19 Boxford Street,N. Andover,MA 01845-3219 (978)687-2342 REGARDING: Master Bathroom Renovations Master Bath: Remove existing wall board. Move window per plan that is approved by homeowner. New doors and bi fold doors around washer/dryer will be added. All items below to Ma State Building Code. Electrical- Add new wiring for new bathroom. Circuits will be added for GFI's and 2 new recessed lights. New low noise remote high cfin exhaust fan with timer will be added and piped to the exterior of the house. Shower,water resistant light will be added. All light and electrical trim will be new and color to customer choice. Plumbing-Existing plumbing will be inspected. Shower valve and head wall will be installed along with sink drain and hot and cold water feeds. Toilet location will stay where existing feed is. New toilet flange will be added. New sink and toilet valves to be added and all piping to toilet and sink to be new from wall. Feeds appeared to have been brought over for original prep. If new feeds need to be run additional coast may incur but that will be discussed with homeowner. Insulation-R 15 insulation to be installed in exterior walls. (thickest available for 2x4 construction) Walls- New laundry walls will be built to create larger closed in space and doors for laundry. Laundry to stay in same location. New blue-board and smooth skim-coat plaster will be installed over insulation and studded walls and ceiling. Shower doors:Neo angle doors that come with neo angle set will be installed. Tile: New tile floor will be installed to customers choice. Standard configuration. Diamond or other pattern will be at additional labor cost. New toilet, sink vanity and sink top will be installed along with wall vanity. Includes placement of towel racks and toilet paper holders Allowances Master bath: Vanity Faucet $ 100.00 ea Toilet $ 250.00 Sink Top $ 350.00 Vanity $450.00 Floor tile $ 2.00 pr sqr ft 45 ft ea Mirror $ 150.00 ea Shower Valve $ 150.00 ea Shower/tub $450.00 Shower doors $ 350.00 Window $ 350.00 Estimated Cost as per quote: Master Bath $ 14,495.00 Down Payment $ 4,830 Payment Schedule: 1/13 down payment 1/3 upon rough plumbing/electrical 1/3 upon completion Painting not included in quote. Separate paint quote can be added. Cartane/Carla H Micaven Bathrooms �d Q / August 4, 2008 Frank Carta Micaven Bathrooms 107 Glen Road Wilmington, MA 01887 Hello Frank, Here is the signed contract and our down payment of$4,830.00.We are also forwarding a copy of the quote we received from Peabody Supply of North Andover. There are a few questions they had for you (highlighted), please contact them directly so that the order can be completed. Note that we have chosen a square base for the shower. If products are ordered soon, they should have everything in stock after Labor Day. A couple of questions: Does your quote include the in-wall ironing board and will you order it? Also,does it include the recessed light fixtures and the exhaust fan? Please let us know if there is anything else we need to do to prepare for the work in September.We look forward to working with you on this project! Best wishes, Carla Ramos/Gene unt 19 Boxford Street No. Andover, MA 01845 Tel. 978-687-2342 The Commonwealth of Massachusetts I Department of Industrial Accidents Office of Investigations 600 Washington Street U , ` Boston, MA 02111 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Hanle(Business/Organization/Individual): {ea2� L� &-&I- Address:— City/State/Zip:_Lz J6& 5 OA4 QdMPhone #: 9,W �W/ 9 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors ?;?Erl am a sole proprietor or partner- listed on the attached sheet. 1 7. ❑ 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 S. ❑ 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 11.0 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#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submitthis affidavit indicating they are duliig ail 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. I am 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 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 her ce der the pains d ent es of perjury that the information provided above is true and correct Simatur Date: d 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-contractor(s)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 for 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. Shouldyou 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 pen-nit/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"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 burn 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. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia