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HomeMy WebLinkAboutBuilding Permit #307-14 - 212 BRENTWOOD CIRCLE 10/2/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: bi ✓ Date Received Date Issued: —dl�1-7, I ORTANT:Applicant must complete all items on this page 77 LOCATION cor' G PROPERTY OWNER F v 'Rrint- .1'Yea r'�Old Structure 1MAP,NO � IP.ARCEL: ZONING I7IST�RIGgTHistonc District` yes - `(Nllachine:Sho.Uilla t t Ku s es' TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �S?3— ��'+. f:YY , T/ fttj Fg ❑-Septics �Wel �' _ ' ❑ Floodplairi'�• 0 Wetlands ' ' ' Watersh1.ed isttrrlictt� : err Ste"sr, Lz ❑iWater/Sewer .,dA x ,�_► v, DESCRIPTION OF WORK TO BE PERFORMED: � � -- pin r S. ► f�G Identification Please Type or Print Clearly) OWNER: Name: :370* 3 -t- # 0ie-1.46 Phonea-7 .2�5� 3-7 Address: gl�pov rI —� Cir" r•' -+ st •+k P,-y++e.r`.�#... ' '" s' "� -IEC 'f°Y'v 'F�a '- arw'"rt....�assir4+ ?43.jrrk.""; 4 { �3' A70— "CONTRACT- me OC)G �- f �' Phone 6 "Supervisor sConstructlon Licens_e�� 3 —� � _' �ExppiDate J-6 � F 33—„ uny„'°---Y./`♦� �:['i7+�r"a+++k�.i fir. !Vi4 St 3 J Ntl *+"Y�. +Y �..I,.'4 �' '; S -V ,y. yy'K I I t 67M” �lmprovement Licenses is -�_a ���._r. " f,- x� Exp Daate. ARCHITECT/ENGINEER Phorig" 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: $ �� FEE: $ Check No.: Receipt No.: 21f-1 i NOTE: Persons contracting wit nregistered contractors do not have access to the guar(inty fund Si nature:of A ent/Owner Signature of.contractoIle . Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ,L Z„ jrP A w o O c—Q 12- Location No. 1U f� Date o • TOWN OF NORTH ANDOVER • S�,T��D`�7`6¢s • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ ^` Other Permit Fee $ TOTAL $ Check#� 2U r` , U i f! i 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 .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 Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit ]DPW To`va. Engineer: Signature: Located 384 Osgood Street FIRE DPARTMF_NT =Temp Dumpster on site yes. . no Located at 124 Main Street Fire Department signature/date COMMENTS 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Rooting, Siding, Interior Rehabilitation Permits ❑ Building Permit Application j Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract o 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 Hydraulif Calculations (If Applicable) ❑ Mass check Energy Compliance Report(If Applicable) 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 In aji 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:I\SPEC"rfo\,\L SERVICES DEP.\RTME\'r:01TORM05 Pace 4 nr-f tkORTyTownofAndover No. - `t zoz 2.61Y O - LAN# h ver, Mass, coc Mlc.*—.cN �9S RATED t1 BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .....9`5064.......T•e.VWQ.4AA.%......................................................... BUILDING INSPECTOR has permission to erect buildings on ..&Rn...rt,�-v.06 A (Nwar. Foundation �� .................... ...................... ......... Rough to be occupied as .... tv.1► ...11. .1 ... .C ..1.. ..�4 ..... .... ............................ Chimney provided that the person accepting this permit shall in eve respect conform to the terms of the application e P p p 9 p every p pp� 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 CONSTRU N TS Rough Service ......... .. ........................................................... Final BUILDING 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. SEE REVERSE SIDE oa ROBERT LANGEVIN � . Building& Remodeling, LLC Homeowner Information Contractor Information Name Company Name Street Address(do not use a Post Office Box address) Contractor/Salesperson/Owner Name < 1 P-C.2-t 7- . V'i lj City/Town State Zip Code Business Address(must include a street address) r ova Q IKVV -7q5- Dsr Daytime Phone. Evening Phone City/Town ' State Zip Code -7 i- - 3' rG/I�P, Mit o l FY' '- Mailing Address(It different from above) B ©`� Federal Employer ID o&1X6NT6b�� , Home Improvement Contractor Reg.Number Expiration date Lnw requires thnt most home 611 ++ improvement contractors have , '., a valid registration number f IIJ The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of 79 ate when contractor will begin contracted work. MGL chapter 142A.) 3Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule cr-E, The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum op? ;L-7 (*) Payments will be made according to the following schedule: $ by / / or upon completion of $ by / / or upon completion of $ upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ ^^—e to be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ �1to be paid for NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is an exuress warranty beine provided by the contractors 56 No❑Yes fall terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Contract Acceptance-Upon-signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,Na 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not I ater than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE AN 'BLANK SPACES!!! Two identical copies of the contract must be completed and signed. One copy should go to the ho owner. The other copy should b kept by the contractor. 1 )'Iolcowner's Signature Contractor's Signature �o 1.2 �3 �� i 21 L3 Date � Date � p E a ROBERT SLANG EVIN ®®® Building& Remodeling, LLC 795 Dale Street North Andover,MA 01845 (978)685-3607 HIC#111990 FID#26-0816298 www.LangevinBuild ing.corn John&Michelle Temullo 212 Brentwood Circle North Andover,MA 01845 Job Description Remodeling of living room • Demo brick veneer and designated partitions • Construct new exterior walls according to your plans • Install new door and windows provided by you • Build up floor level to conform to existing floor • Insulate floor,walls, and ceiling in affected area to code • %2 X 6 cedar clapboard siding and pvc trim on exterior wall • Frame new interior walls according to plans • Blueboard and skimcoat plaster on interior walls Permit,all cleanup and trash removal 9 Massachusetts-Department of public Safety --° Board of Building Regulations and Standards _ �f3tt4l.rU.f:Ii4)£I.�,14�311"115#iT' License CS-002685 ROBERT M LAkEVIIH 795 DALE S'11r' N ANDOVER MA 01845 Expiration JA Corrrrrtssionar 02/24/2014 ' �te �ha � Offiee of Consumer Affairs&Bdsinesso HOME IMPROVEMENT CONTRACTOR Registration: r�.11990 y Expiratron 2i-41/2013 LLC Type: ! BERTLANG �11BLOG$TQIWpLDING LLC. ROBERT LANG 1; 795 DALE ST N ANDOVER,MA 01845 � - Undersecretary 4 The Commommalth ofMassachuseft .Dept dr dW&W.4cddents Dice of rove gations 600 WaslkfiTWn Street � Bostor>;,M,4 02111 wrvw.mamgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Y. 'hI Name{Businewjorganzano„/lt,dividWy:f-4; i2T 1-• �/� u 8 t�� �" 1-1- C Address: --7q-S Are you an employer?Check the appropriate bo= 1.❑ I am a employer with 4- Ellama general contractor and I Type of Project(required): employees(hU and/orpart-tine).* have?lined the sob-conbactors 6. ❑New construction 2 I am a sole proprietor orparmer- listed on dre attached sheet 7- faRamodeliag . and have no employees These sub-contractors have woddng for mein airy capacity. employees and have worbus' ' [Nti ovotdseas'comp.insurance �smp.ins:iraac;er# 9- addition required-] 5.❑ We are a corporation and its 10-11 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have their I I.0 Phrmbimg repairs or additions , - . . -. mysel£`[No grocers chmp; . right ofexemption per.MQ, insurance regtrirecl.]# _ c.152,§I(4),and we have.no 12-0 Roafrepairs employees:jN0 W0dWe - 13_0' ea insurance required.] •nny appt;cant that dtedts bM#1 Alm M on the swfan bebw shw*jug theirwadms•=MPMMbM Por►cy Edon. t Nortxowaas wbo submit this ittdieetiog they ate doing all watt mM ibeo bfre outside nm -submit a new affi&vit indieatingmtch. rCoacr.UMS that check this h=—zt.auadrd M add'itiona1 sitertshowing Ste dean artbe sub-not tradozs and stain wLedux ascot dense entities bane �PbY Ird-mb-mntreaors have pWYu,they m=prooi&&w wMjM&cMP.PojMY I=an employer chat isprmridiug workers'cornpettsaSott►ttsuraneefor my employees Below is Ae vo&y and job site information. . Insurance Company Name: Policy#or Self-ins.Uc.#: hcpira6an.Date: Job Site Address: Citylstatt:/Zip: Attach a copy of theworkers'compensation policy declaratiou page(showing the policy number and expiration date). Failure to secure coverage as required nmder section 25A of M,GL 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 civtil penalies 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 txrpy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido Hereby c u Chep ' and penalties afPeljury drat file information provided above is true and correct Si tore _ Date: Phone OBIChd use onl3c Do rat write in this area,to be completed by efty or town off,-e aL City or Town: PermidLicense# Issuing Authority(circle one)_ 1.Board of Health 2 Building Department 3.CitylTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: - Phone#k. I S'-5 7/8" 1 ............. i 1 -T----..---- - - _••---•�- j BOST AREA 1 ------------ I I I I 1 I i I 1 1 1 1 I I 1 --------i 1 --- I --- ---Y 1 1 t I 1 1 I 1 1 1 1 1 I I 1 I 1 I 1 I 1 I 1 I I F ILY ROOM I I:. I 1 I iTH ------- ---�` ------- ------------ I .------------------------------ -------- _, 1 1 1 I f 1 I 1 1 1 t 1 1 1 1 f 1 1 1 8'-5 7/8" I I