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HomeMy WebLinkAboutBuilding Permit #687 - 263 CANDLESTICK ROAD 4/25/2007BUILDING PERMIT TOWN OF NORTH ANDOVER " APPLICATION FOR PLAN EXAMINATION Permit NO:I Date Received Date Issued: In G 14 ' ' TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑_New Building One family 0 -Addition Two or more family 11 Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ({ .� _ .•z.Y 3, �'!a'#" ami tr �'�� �G��' ��y.�.�E,R" +'��,,f,'P�t `�'.��.{�� � v� � �gy�,yv„,lah fi�,'^�3�s.�i �',Y;ta. (.��`-�a`�i,'Y'lk.�j+'�'. eXp /{� i�°��"',��'3w �.. �i �Y."h'°" �.-�'��.� K' ,s"z' i g"y: �z2 i Y �s'Nz�l' •N ! .,�,� A°�i'�' ,,{t ` �t' £� w�c � 8XF'�`S'."''`rfi' � '-'. � �'M -�-a•'ti. ^.".�.. s� �`�i.. .•� ..1r?€3 X.5 , r'�`'��. ^�; 6 �N .f i:: a"'�`Y. .�� .,"'t^.I•: re .vF I DESCRIPTION OF WORK TC1 BE PREFORMED: T"k s�.-Vj' # 7-"'3'e'4 AA T vr�n+i ra+inn PIPaea TvnP Ar Print f 1Parlvl y ! 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: FEE: $ Check No.: iV t� Receipt No.: NrOTE:. Persons contracting 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS a DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zonin ard of.A ..PP eals: Variance, Petition No `. 9 _ . BoZoning Decision/receiPt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street 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 4 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 o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract a 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 o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o 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 o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o 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 recordin must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 v 0 b CO r� i W tv ui d. c� o ` C H O C V V CL ACL c Cum =CD :• m = CD O CD Ea � m o VF; .2 y o m c� � o cm �O — • o c MA co 0 3 (n N C O N C m .O N •t' N —yOr w m W o, = ORcc "l c `oma m C3 y O v Z O C 0 C O. O \ = O s m_, O ~ � y � COD t W c •- .CA C=L 2 1 WE szow o V d OOH o C Z w a�= 32 7 C a z 0 U ov 2 0 O co • v CD Z a O y o I CD Cm o•— CA •fl — y O O •1 m m CD 0 co t O� 3� O O � � M: CMa c Cc CIO a� zCD V N� � C — C COD 0 0 U) LLI U) W cc W U) v w E chi � w q w w c U x x w a w iaw a a w �: G w o cY. c w «� z cn 0 C/) ui d. c� o ` C H O C V V CL ACL c Cum =CD :• m = CD O CD Ea � m o VF; .2 y o m c� � o cm �O — • o c MA co 0 3 (n N C O N C m .O N •t' N —yOr w m W o, = ORcc "l c `oma m C3 y O v Z O C 0 C O. O \ = O s m_, O ~ � y � COD t W c •- .CA C=L 2 1 WE szow o V d OOH o C Z w a�= 32 7 C a z 0 U ov 2 0 O co • v CD Z a O y o I CD Cm o•— CA •fl — y O O •1 m m CD 0 co t O� 3� O O � � M: CMa c Cc CIO a� zCD V N� � C — C COD 0 0 U) LLI U) W cc W U) Ee 0 Q Member. National Kitchen & Bath Association National Association of Home Builders Merrimack Valley Chamber of Commerce Better Business Bureau Member # 02361 Massachusetts Home Improvement Contractor Registration # 119849 Massachusetts Construction Supervisor License # 069118 rance Coverage: ysville We are proud to provide you with the following services: Custom Remodeling & Additions Custom Finish Work Architectural Design Structural Engineering Interior Design Lighting Design Landscape Design ,s7 r► CHRisuANBuiLDERs Design & Remodel y� b 4a �P/ James & Mary Nania January 10, 2007 263 Candlestick Road No. Andover, MA 01845 978-685-6629 FULL MASTER BATH RENOVATION Reconfiguration and total update for master bath. Area Specifications 1. Set Up & Permits Set up equipment, dust barriers, floor protection, Building plans, obtain building permit, Portable toilet, 2. Floor Area Remove existing tile floor and underlayment Install underlayment , Tile allowance $4.00 per sq. foot. , 3. Wall Area Remove existing wall covering and insulation Remove (1) window and block off opening Frame blocking in wall for fixtures Insulate exterior wall New tub platform w/tiled surface $4.00 the allow. Install 1/2" moisture resistant sheetrock Install 4" x 4" tile walls shower $4.00 tile allow. Install (2) Andersen Windows double hung Wonder board on shower and whirlpool platform 4. Ceiling Area Install 4" x 4" tile on ceiling of tub area Smooth out textured ceiling 5. Woodwork Trim Install new 2 %2" casing and 5 %2"baseboard 6. Electrical Install (2) new GFI outlet Install (4) recessed lights 65watts Install (2) new wall lights allowance $100.00 each Install (1) exhaust fan unit with out light 7. Heating Relocate baseboard heat to new location Install (1) A/C duct drop Christian Builders, Inc. www.christianbuildersinc.com PO Box 652, Reading, Massachusetts 01867 Tel: 781 944-6124 Fax: 781942-9327 Ee Contractor Initials -,J Homeowner Initials U IUK* Page 2 of 9 8. Plumbing Demo existing piping; install new plumbing piping for toilet, sink and tub. Install (1) circulation pump Install new toilet with seat allowance $327.00 Install (2) under mounted sinks and (2) faucets allowance $500.00 Install clear glass chrome frame shower stall with new Symons shower faucet, $1,200.00 Install (2) 36" vanity cabinets with granite countertops allowance $3,450.00 Install (1) soaking tub 5' no jets with faucet $1,500.00 9. Painting Painting walls and ceilings (2) coats Latex finish Benjamin Moore .Painting trim and woodwork (2) coat Oil finish Benjamin Moore 10. Specialty Items Install (2) framed mirrors allowance $300.00 Install (1) towel bar, (1) paper holder, (1) grab bar (chrome finish) 11. Clean Up Clean up and removal of debris Dumpster 15yds Price $ 35,815 Contractor Initials -,J Homeowner Initials U IUK* Page 2 of 9 O PAYMENT SCHEDULE N The Owners shall pay to the Contractor in respect of said work and materials, the sum of Thirty-five thousand eight hundred fifteen dollars and zero cents subject to additions and deductions as herein provided, to be paid as follows: Paymmnts due upon the following events: Amount Signing of contract $15,000.00 Completion of demor0tion & window insUlkation $9,854.00 Completion - Installation Shover & Tub Completion - Installation Tile & Cabinets Completion of Painting Total of Contract $35,815.00 These prices reflect material costs as of January, 2007. Due to the pending nature of the work involved, material costs may cause changes to payment structure above and total payment amount. Contractor Initials J�," Homeowner Initials U/ "IT Page 4 of 9 L91 N PROJECT SCHEDULE (Start date will be secured by the signing of this contract and payment of deposit.) Starting Date: Estimated Completion Date: Week of February 26, 2007 Week of March 26, 2007 Approximately (4-6) weeks, not including delays and adjustments for delays caused by additional time required for Change Order work, and other delays, unavoidable or beyond the control of the Contractor. The work to be performed under this contract shall be commenced upon the acceptance and signing of the contract and after receiving a building permit. NOTE: CHANGE ORDERS WILL ADD EXTRA CONTRACT DAYS TO PROJECT SCHEDULE AND MAY INCREASE THE COST CONSIDERABLY. This space left intentionally blank ZVI Contractor Initials Homeowner Initials 44 Page 5 of 9 ------------ ;-T� f o..v.narzu e W i`i r/'..'t�� Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 119849 Expiration: 9/7/2007 Type: PRIVATE CORPORATION CHRISTIAN BUILDERS, INC JOHN JANOWSKI 30 AZALEA CIR READING, MA 01887 Administrator **.—I%— =- UN I C lmm, v..•, • • • • , ACRD O,, CERTIFICATE OF LIABILITY INSURANCE 05/23/2006 PRODUCER (781)942-2225 FAX (781)942-2226 THISCERTIFICATE ANDCONFERSO R GHTS UPON THE CERTIFICATE AS A MATTER OF ON Gilbert Insurance Agency, Inc. HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 137 Main Street ALTER THE COVERAGE AFFORDED $Y THE POLICIES BELOW. Reading, MA 01867-3922 INSURERS AFFORDING COVERAGE NAIC # INSURED Christian Builders, Inc. INSURER A: HARLEYSVILLE/WORCESTER INS CO. 26182 30 Azalea Circle INSURER B: Reading, MA 01867 INSURER C: INSURER D: INSURER E: VERAGES ATHE POLICIES OF 1NSURAqCE LISTED BEL:)W HAVE BEEN ISSUED rNY REQUIREMENT, RM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W TH R SPECTOTO WHICH LTHIS CER IO CANE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SR OD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION UL C88E7436 05/19/2006 05/19/2007 EACH OCCURRENCE $ _ 1,000,0 GENERAL LIABILITY DAMAGE TO RENTED $ 100__0 tfPy X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) S S,0 CLAIMS MADE a OCCUR PERSONAL & ADV INJURY S 1.0001C A GEN'L AGGREGATE LIMIT APPLIES PER: RO POLICY n JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCESSIUMBRELLA LIABILITY OCCUR a CLAIMS MADE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? OTHER WC8E7436 05/19/2006 I 05/19/2007 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL GENERAL AGGREGATE S 2, 000, 000 PRODUCTS - COMP/OPAGG S 2,000,000 COMBINED SINGLE LIMIT S (Ea accident) BODILY INJURY S (Per person) NJURY Sent)TY DAMAGE Sdent)NLY - EA ACCIDENT SHAN EA ACC AGG ft SNLY: SCCURRENCE 5ATE S S S S E.L. EACH ACCIDENT $ 100,00( E.L. DISEASE - EA EMPLOYEE S 100,001 E.L. DISEASE - POLICY LIMIT S S00,001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AG OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE CHRISTINE C. AMENTA'�... ACORD 25 (2001108) FAX: (978)623-8320 ©AC6RD CORPORATION 19, / The Commonwealth of Massachusetts uvDepartment of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www masxgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Awflicant Information jj Please Print Le ibl fll Name (Business/Organization/Individual): rt S t� Address: 36e— ik Cit /State/Zip: �#Aad ,1 Phone Are you an employer? Check th appropriate box: 1me. p�I am a employer with 4. ❑ I am a general contractor and I employees (full and/or p -time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t. employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. X9emodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # I 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. I am an employer that is providin workers' compensation insurance for my employees'. Below is the policy and job site information. ,� / _ I t _r / T „ Insurance Company Name: ,TUi j e Policy # or Self -ins. Lic. #: +Jes) G /O Job Site Address: .20 Ca Expiration Date: ;JdJ�ty/State/Zip: c n 111 V- r 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 hereby certify under the pains of perjury that the information provided Oficial use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License is tru and correct. 67 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 #: