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HomeMy WebLinkAboutBuilding Permit #634-16 - 23 SULLIVAN STREET 11/20/20159 EU /a) -7 -/5 - BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#:b-:,b4-1U Date Received Date Issued: 11 /,2"D �- TANT: Applicant must complete all items on this LOCATION o? 3 (-kkvW Pn�T r PROPERTY OWNER 7_102 , �1tJA) L24-r-62brEJ Print 100 Year Structure yes no MAP �� % 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 -KAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑ Well ❑ Floodplain El Wetlands ❑Watershed District El Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: i rr7 o iJ F /_ �Ic X / 57 7-7 14- G J4<'/ 7r -k1 -in 11,f 7- UF TU 4J -7`EAZ Identification - Please Type or Print Clearly OWNER: Name: -t7 07 -1- L1,-5,4 _7 -1q -C Q LJ t.5 Phone: Address: 5 LJLL1 V -i4 A( c- 7 - Contractor Name: aL 54 ,5 T-E/Z Phone: F in a i I. h i // k 0.0 1-7f .g-Ar� 14--0 5 7-f- l2 , Lo m Address: Supervisor's Construction License:—Exp. Date: / Home Improvement License: / 1� 9 410 A Date: JP - .S — / 6 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: $ �� 9�3 ' FEE: $ Check No.: �Receipt No.: cam[ ��— NOTE: Persons contrWting with unregistered contractors do not have,,access to the guaranty fund 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 PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature, f CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed o Sianature COMMENTS Zoning Board. of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments d f Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: z FIRE DE ' Locatea 364 Usgood Street PARdTMEN mp Dump ter ontsit `Nyeg .: i'R.. .�nO7 1Cte at 12h4 Main Street ' ""� t" "" Fire' De art Ment s gnatu e l to C®MMENTS 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 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 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 OTE: 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/Cross Section/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 OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products TOTE: 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 Doe: Building Permit Revised 2014 (-�o & I � % v A-�� % r Locatiorr,'�,� No./Z 3�4 ---,ffgg Datell 12.4>1 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $a* Foundation Permit Fee Other Permit Fee TOTAL $ Check #V—T 71 A Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 921983:00 m $ _ - $ 1,115.80 Plumbing Fee $ 139.47 Gas Fee 100 comm. $ - 100.00 Electrical Fee $ 139.47 Total fees collected $ 1,494.75 23 Sullivan Street 634-2016 on 11/20/15 Remodel Kitchen, Repair Basement due to water damage Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 92,983.00 m $ - $ 1,115.80 Plumbing Fee $ 139.47 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 139.47 Total fees collected $ 1,494.75 23 Sullivan Street 634-2016 on 11/20/2015 Kitchen Remodel and basement repair m r 1�O I� 1 J W 2 LL O m Oa) -0 O LL Ln U �Y O. V) W O d Z Z m C y -O C O LL L � O c. C E L U io C LL p V N z Z co C J d t j OC d' to LL O H Z V V(� W L bn O 2' BOJ i v V) io C LL O U Wa Z H ..0 O K to C LL F- W Q W LL 41 C O co O z +-' v +�+ V) w N O E V) ® c r- 0 O «� cQ ,l M 0 O L) N ac)E Q 0 N Z. O ••� 4 0 O 7 �0. c 1� r: o. L a=�3 N ry L �, m dr > _ L. CON d O O O N 0 -0 S V C -0 N N Q 4 � Q c "- - �N c o s N 3 c cH• L_ CL Qd _M �o c c m — o cn O"2m N .+ t = W O -0 +r O O LLJ P: LL •� N C ELM .0N W U m '_ U m O -0 w y- 0- CD • _ ICL N •= ' O F- s Z Q. O U a� a N N O N c as m 0 CD c 0 N d s O z O Q J O i 0 L- O w E O O CD Z N O ^� O W Q •E CD O �+ C 0 o cO Q• a 0 - cm M ca V J -0 •Q O .a: C Z c •C ;t+ i CL U) 0 , This agreement made this 1P day of October, year Two thousand and Fifteen by and between Cote and Foster Contracting, Inc. hereinafter called the Contractor and Tim & Lisa Jacques, hereinafter called the Owners, witnesses that the Owners intend to remodel the existing kitchen and repair basement due to water damage at the address of 23 Sullivan St, North Andover, MA. Now, therefore, the Contractor and the Owner, for consideration hereinafter named, agree as follows: ARTICLE 1 The Contractor agrees to provide all the labor and materials to do all things necessary for the proper construction and completion of the work shown and described on drawings. The drawings and specifications are the basis of the contract. ARTICLE 2 In consideration of the performance of the contract, the Owner agrees to pay the Contractor, in current funds as compensation for his services hereunder $92,983.00 to be paid as follows: Payment 1- $10,000.00 at signing of contract Payment 2 - $18,000.00 at ordering of cabinets Payment 3 - $10,000.00 at start of demo Payment 4 - $12,000.00 at completion of framing, rough plumbing and rough electrical Payment 5 - $15,000.00 at completion of plaster and insulation Payment 6 - $15,000.00 at completion of tile floor install Payment 7 - $10,000.00 at completion of cabinet & counter install Payment 8 - $2,983.00 at completion of project ARTICLE 3 Final payment on contract amount as agreed above to be paid within ten (10) days of project completion or occupancy. If final payment has not been made within this time a 10% charge per month on the balance due will be charged. All minor punchlist items will be complete as part of the one year warranty on the finish product. Failure to pay balance within ninety (90) days may result in legal action. Initials -6 , ARTICLE 4 Additional work above and beyond the contract agreement: All additional work done to be quoted at the time the client requests the work. The work will be done and billable at its completion. The client has ten (10) days to pay the additional cost after he or she has been billed for it. Initials %%� In witness whereof they have executed this agreement the day and year first above written. Tim Jacques, Owner Steven M. Cote DBA Cote & Foster Lisa Jacques, Owner �351,�. 31�" 107-''" oces �1 m 8�s 0 SoQu�� tvp°w 'o> > o o Z o W Q (`3� Qi o s w0 O LLQ YD MZ f� WU UR mG 3a a w Fcwio °¢ �wWaO v pyo gw o¢Woa 20 w mW N7� >$w oag �m�3 U N oog cr o g III 'M zwos 0 ¢��I �XN Z 99 yf�� LLN1N �LLUJZWQ fO �+O �w UowU ; Me p 3 NQ o� z M " STD-DR30 LL CL t* p 3 W Aa c+� A m col 0 � 0 0 Ch Cl) o U bio 00 '�'a m ani b o� N as "off �b a� 0 " "O EL b Ha°O�"o a 01 m C'� �ox� z�U V)iu�4 x U �o u O m co ti y Nod a o Cf STD-DR30 ""°° Q co U. CL w m vE M m c+� m 0 � 0 Ch U m N as rTTN V/ T t0 M N CIO V.. �0 zo� CL1, o �L DO o r. Aa N AI C) M rTTN V/ T t0 M N �0 zo� DO r. Aa AI 0 \ � # is k zg !w » o « § & \ \_I ;E« \<0 .§ { §o (moi >&� k h. § $ « - _■ ���■_ ■� �� ' —_ ■ � �_� ■ ���■ � w . is k zg !w » o « § & \ \_I ;E« \<0 .§ { §o (moi >&� k h. § $ « - The Conunourvealth of Massachusem Deparhnent o, fIndustrrical Aceidena ®. f.�e ofInvesdgations I Congress S'tr ee4 Suite 100 Boston, MA 021142017 w4m rr ms gov/d Workers" Compensation Insurance Affidavit: Builders/Coimtlractors/Eiectricians/P'I berg App licant formation Please Print Legibly NaMe (Business/Organization/individual):'- Address: C�D qE Cc4.ff�'e• City/State/Zip -,,4S 7?7t Uf h' , A69- 0 1PAf A Phone #: Are you an employer? Check the appropriate box. Type of project (required): 1.0 1 am a employer with 4.effI am a general contractor and I 6. ❑New construction employees (full andlor part-time). have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet 7. remodeling ship and have no employees 3�ese sub -contractors have 8. ❑ Demolition workingfor me, in an capacity. Y P nY• employees and have workers' insurance. t 9. ❑Building addition [No workers' comp. insurance required.] comp. 5. E] We are a corporation and its 10.n Electrical repairs or additions �. ❑ I am a homeowner doing all work officers have exercised their h 11. Plumbing airs or additions g re P myself [No workers' comp. right of exemption per MGL 12.❑ Roofrepairs insurance required.] t c. 152, § 1(4), and we have no 13.❑ Other employees. [No workers' coml?. insurance regtured.l =Any applicant that checks box 61 must also M out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hive outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp, policy number. i are. an employer that is providing workers I compensation insurance, for my employees. Below is the policy and job site 3s�o8r'rzatu.'lE. /� • Insurance Company Name: Policy # or Self -ins. Lia #:G DD �{ 3 % Expiration Date: I,/ — Job Site Address: �ULL City/State/Zip: A6 Q_ 7W 4w -D 0 ✓i=AL, Attach a copy of the workers' compensation policy declaration Mage (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 advisedthat a copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. I do kereby cea� under the pans andpena&W gfp! ja that the irz�omadon provided above is tme and correct Phone #: ®, f Bial use only. Do not write in t3zis area, to be completed by city or town officinal City or Town: Permit/Licenase # Issuing Authority (circle orae): 1. Board of Health 2. Building Department 3. Cityfl'own Clerk 4. Blectrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phime k A� O CERTIFICATE OF LIABILITY INSURANCE DATE (M MID YYY 6/3/2015 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTANAME, C Victoria Lowes, CISR MTM Insurance Associates 1320 Osgood Street PHONE fAIc.(978) 681-5700 F No: (9T8)681-5777 E-MAIL vickiel@mtminsure.com. INSURER(S) AFFORDING COVERAGE NAIC 9 INSURERA:State Auto Insurance North Andover MA 01845 INSURED INSURERs.AIG Casualty Company INSURER C: Cote & Foster Contracting, Inc INSURER D: 20 Aegean Drive INSURER E: Unit 15 Methuen MA 01849 1 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 & 15-16 WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/D LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR F EACH OCCURRENCE $ 1,000,000 GE RENTED 300 , 000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 BOP2722545 12/31/2014 12/31/2015 PERSONAL &ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: X POLICY ❑ JEC LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Contractors Plus Endl $ OTHER: AUTOMOBILE LIABILITY FO ENNED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ 20,000 A ANY AUTO ALL AUTOS X AUTOS BAP2370166 02 12/31/2014 12/31/2015 BODILY INJURY (Per accident) $ 40,000 X X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Par accident $ Medical payments $ 5,000 UMBRELLA LIAB EXCESS LIAR HOCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICER/MEMBER EXCLUDED? I N I (Mandatory in NH) If yes, desoibe under DESCRIPTION OF OPERATIONS below NIA WC004962937 6/20/2015 6/20/2016 PER OTH- STATUTE R E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLO $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 A Property Coverage BOP2722545 12/31/2014 12/31/2015 Business Personal Property $40,491 Scheduled Equipment ROP2722545 12/31/2014 12/31/2015 Contractors Equipment $169,928 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder as listed below This certificate of insurance represents coverage currently in effect and may or may not be in compliance with any written contract. Town of North Andover 384 Osgood Street North Andover, NA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE P MacDonald CPCU, CIC�y ... U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD INS026 (2o14o1) - - Details The Official Website of the Executive Office of Public Safety and Security (EOPSS) Mass.Gov Home State Agencies see Details er: ddress 2: ity: DRACUT tate: MA pcode: 01826 Page 1 of 1 License No: Ub-u35l 13 License i ype: uonstructlon 5upervlsor Profession: Building Licenses Date of Last Renewal: 10/23/2014 Issue Date: Expiration Date: 11/10/2016 License Status: Active Today's Date: 12/3/2015 Secondary License: Doing Business As: Status Chanae: uocumentum © 2011 Commonwealth of Massachusetts Close Window Site Policies Contact Us http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1&license_id=274118& 12/3/2015 Office of Consumer Affairs & Business Regulation - Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs & Business Regulation (OCABR) Consumer Affairs and Business Regulation Home Consumer Rights and Resources Home Improvement Contracting HIC Registration Complaints Registration # 107602 Registrant COTE & FOSTER CONT. Name Steven Cote Address 20 Aegean Dr Unit 15 City, State Zip Methuen, MA 01844 Expiration Date 08/05/2016 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search © 2012 Commonwealth of Massachusetts. Mass.Gov® is a registered service mark of the Commonwealth of Massachusetts. Home Improvement Contractor Registration Home Page https:Hservices.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=7575 12/3/2015 90111 ,f 54" 1v 5" - 87" 1" 1� 34 2 33.1 �- W W CA) w v w w w co w w w _ w Nl_ w .O 0 CD g �a ez,,0. L+ _ . :O �• �, Im p O N o r* O A �i4 • GJ W W w o a' 0 p 00 i O W CID .1 W I I 00 \ 1 CA) LT1 00 C� CA. Cri n vs o OD N N_ w Oij Ica 00 04 4 w AI� AI � 0 � o � CD N aCID�� O ice' c� 00_ 4 CD b vCD, Cy' b a C� °CDa p y� Jo ar w CD O N �a o W� A � N LA � NN