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Home My WebLink AboutBuilding Permit #861 - 217 BRENTWOOD CIRCLE 6/28/2007 BUILDING PERMIT NORTl6 O�ttuzO 06 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ��SSACHus�t�� Date Issued: IMPORTANT Applicant must complete all items on this page � a i c ii'6 At " €€zl t's+ a '^;•,�. t + •xa"'' ':¢T h,� Pr{ t b §d 5 s� y y+�= t�-i- `#a. nw Sze., g -z PRQPERTY 4W151ER tr ro 4 v .Af• 1 "'n %aa Cys ' '` .cr.« 9,m� -^. € y"'r -aa•..�,�`�r.a"�n t z ?r .i' :k r � a � � � 7•v v� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building K One family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial X Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other F'1':'4:E�a-11q"S63---:W1- DESCRIPTION x �" 3 n, e ,.� �N _ tla0ft- � f Waters ct 0-iggic_ OF WORK TO BE PREFORMED: r /� R�'✓1?G'�4'/ . h1 /yor Qaa iraO/ � &�Iolee IV ��7Jx�v�eS are.. �y iH �� Soso loCuOh Identification Please Type or Print Clearly) OWNER: Name: P/ck 11i4,4pI n) Phone: y7V 70?-1- Address: t CON� ACTORaC ��Y�� Add e.9s§� �+ .� M- i.r��A`w✓ s��, - a� � zs 3'�..�„��a*"fi izt,.i,a `�'�"` 1'- � �� '?��k• � Sperv�sor's Consttuct�oncense � x Escp eF '� '� x s -k 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: $ /5, 720, a 0 FEE: $ Check No.: � '2 Receipt No.OS 9� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner � Signature of contractor r Location- No. No. Date &/2q1� N°RTh TOWN OF NORTH ANDOVER � s 4 Certificate of Occupancy $ '',S'•^^ t��' Building/Frame Permit Fee $ I cNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ a rr11r- Check # - 2 G':) ' i //4 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 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 Nater& Sewer Connection/Signature&Date Driveway Permit DPW TovvL, Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Tern ' Dumpster on site Yes no Located'at 124 Mair 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. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application j Workers Comp Affidavit j Photo Copy Of H.I.C, And/Or C.S.L. Licenses j Copy of Contract ❑ F1oor'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 Hydraulil 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 all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of :%ppeals 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 Dnc:I\SPF:C'TIO\AL SERVICES DEPARTNIENI'MIFORN05 Pa^e 4 44 ,OORTH Town of 11% No. P6 * it o . �` dover, Mass., �4 7 T Q LAKE COCHICHEW.CK V 7�AQRATED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System �Ow I• • BUILDING INSPECTOR THIS CERTIFIES THAT &OF l..I.IIs. /1............................................. ............ .. ........................... f ....................... Foundation 011 F has permission to erect.... buildings on...mow ... !..I..i4/ Cl%!.C./...... Rough to be occupied as..........Ct .. ,l�a......../�/ Chimney provided that the person accepting this perm' shall in every r sp ct con orm 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION loop TS Rough ......................... ...... .. . ...... ..................... Service B LDING INSPEC Final Occupancy Permit Required to Occl.cpy 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. i f � � 978-423-8463 Estimate,,,,,,,..,., - Nick Modigliani 4/19/2007 217 Brentwood Circle N. Andover, Ma. Description Total This estimate is to do the following work in the two 2nd floor bathrooms. 1 S, 700,00 Hi Nick, This is the updated estimate for remodeling the two bathrooms as discussed. I have included supplying and installing(2)6" recess lights with white trims in the hallway bathroom and(2)for the master bathroom. $200.00 for each bathroom. I have also decided to replace all the sheetrock in the hallway bathroom and blueboard and veneer plaster the walls and ceiling like we are going to do in the masterbath at no additional cost. If you have any questions please give me a call. Thank You, Mike Project#1, Hallway bathroom, Apply for permits. Disconnect fixtures. Take out all fixtures and tae up all tiles and flooring down to the subfloor. Eliminate the electric strip heat. Install the new tub fixtures,tub,ceiling fan/heat unit. Repair and patch all walls and ceiling. Install wonderboard on the floor, install the tile and grout. Total Signature CSL 4081670 130 Centre St., Suite#5, Danvers, Ma. 01923 HIC 4105029 Pagel 978-423-8463 ��,� �. � n Estimate 0 ® 0 �Mo � 0A Nick Modigliani 4/19/2007 217 Brentwood Circle N.Andover, Ma. Description Total Install the new vanity,medicine cabinet, light over the medicine cabinet,toilet and faucets. Install pine baseboard and door casings. Prime and paint the bathroom, one coat of primer and one coat of finish. Take away all trash. Total Estimate: $ 15,700.00 Payment Terms; A deposit of$5300.00 upon starting A payment of$5300.00 upon starting of sheetrock. Balance of$ 5100.00 due upon completion Total Signature CSL#081670 130 Centre St., Suite#5, Danvers,Ma. 01923 HIC #105029 Page 2 ✓ � The Commonwealth of Massachusetts Department of Industrial Accidents Ogee ofInvestigations 600 Washington Street Boston,MA 02111 l Workers, Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers ui des/Contractor A licant Information s/Electricians/Plumbers / Please Print Le 'bl Name(Business/Organization/Individual): C 4, � 1A Address: 7 //o// ,e li City/State/Zip: SE Phone#: Are you an employer?Check the appropriate box: 1•® I am a employer with_-/ 4. ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).+ have hired the sub-contractors 6. 11 New 2.❑ 1 am a sole proprietor or partner. listed on the attached sheet.t 7. ®emodelin construction ship and have no employees These subcontractors have g working for me in any capacity. workers'comp. ' 8• ❑Demolition [No workers'comp. ' insurance. 9• ❑Building addition p insurance 5. ❑ We area 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.❑ myself.[No workers'comp, c. 152 10), Plumbing repairs or additions insurance required.]t employees.y (No workers 12.[]Roof repairs COMP.insurance required.] 13•❑Other 'Any applicant that checks box#I must also fill out the section below showing their workers'co information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating!Contractors that check this box must attached an additional sheet showing the name of the sub-contract�otrs and heirworkers, g such. I am an employer that is providing workers'compensation insurance for my employees. Below isthe policy andjob s'te licy information rnformatwn. J Insurance Company Name: Policy#or Self-ins.Lie.#: 3B0 9��to� Expiration Date: Job Site Address: 7i'Gn�wpp r'c/c I Attach a copy of the workers'compensation policy declaration a e(Showingr�heoltctp m�ido�/er a Failure to secure coverage as required under Section 25A of MGL o 152 can lead to the imposition of nm aber and prratioa date). fine up to$1,500.00 and/or one-year' as well as civil penalties in the form of a STOP WORK ORDER and a f of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Officee R an of a Investigations of the DIA for insurance coverage verificationthe of Ido hereby certify under the pains and penaldes of perjury that the information provided above is true and c Si nature: - Direct: 7 `��5, Date �-��-d� Phon #: 41� 3 FOther only. Do not write in this area,to be completed by city or town uJ�4ciaL n• Permit/License# ority(circle one): I. Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector on• Phone#: B(31ftW'O BtHLDING R1 6ULA11t3NS I t acet�s� AGN STRUGTION WRERV! i0k Number . 081+;70 � :,; �,r Strthd�te �$f08119E'i5 z Exp�tes ,o8/U81 407 7r oto, 14 I R`e trtdted tla j ° MfCHAEIYF GbDV1tIN j 7�ib7..T f�D =:BPO NG, NIS"(l3D42 . �or�lrglssWner"` s -\ hoard of Building Regulatwns mid Standards License or registration valid for indnidul use only,V HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to f Registration:„105029 Board of Building Regulations and Standards Expiration 7776/2008Tr# 124616 One Ashburton Place Rnt 1301 r r Type. Individual Boston,Ma.02108 - t.�_ MICHAEL F.GOODWIN JR Michael Goodwin :7`t)t f RD. tiPPING,NH 03042 - Administrator Not valid without signature