Loading...
HomeMy WebLinkAboutBuilding Permit #422-14 - 28 LINCOLN STREET 11/12/2013 .1r G� X10 RT#1 qti BUILDING PERMIT a Q. , ,.,, o o TOWN OF NORTH ANDOVER t � APPLICATION FOR PLAN EXAMINATION " Permit NO: Date Received A�RATFO P�` Date Issued: �� �SSacNus�� I PORTANT:Applicant must complete all items on this page LOCATION 30 L+'n C4 I n 5' N h d o y e r /r l q 4 l S y Print, PROPERTY OWNER u h'�1 ��uy 051 Print MAP NO:�)—d PARCEL: ZONING DISTRICT: Historic District yesno Machine Shop Village yes(no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial X Alteration No. of units: 1 ❑Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District X Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: MCI rn"61 K cay o 51 S. 1S. Phone: �b 3- S&o - 1995 Address: `a' l..�r1cohl Sf N. 14ndov(-r 1�70 Olyls- CONTRACTOR Name: Phone: 978' T°LJ- 3779 �efu�te 13v�Iif'nv aracPPlo `�g LLQ , on LcI4nL Address: I ">T L ,(7 c o lli 51 Ct4,c b y,-57, 4,? , D l y;L o Supervisor's Construction Licenser>_ 1066-10 Exp. Date: s-_ 7- )-016 Home Improvement License: 1 -76 1 �-„7 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$100,0.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ d. KdOO FEE: $. Zd Check No.: Receipt No.: . Q NOTE: Persons cohtr ct ng with unregiste ed contractors do not have access to the guaranty fund Signature of Agent/Owner l/)/9 p1 Sign ture�of contractor _ TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION - Print PROPERTY OWNER_-_ s __ - Print 100�Year Old Structure yes •,nog MAP NO: _ -- PARCEL: . _ ZONING DISTRICT NistoficUstrict' yes, =no - Machine Sfiop Vi=llage yes,,, rio. 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 IJ Septic 0 V11ell ❑ Floodplain O;Wetland"s, ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CON..-RACTOR Name: Address: Su.pervisor''s;Construction License _ _ Exp. Pate; t._ 11 Home Improvement,License: _... ..__ . _ _ _____ Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund gnaturetiof Ageh'. weer _ �___.: S�gpat'ure of contractor: Plans Submitted L.j Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 1 t Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF=:S> WERAGEDISPDSAL Public Sewer ❑ Tanning/MassageBodyArt ❑ Swimming Pools ❑ Well Tobacco.Sales ❑ FoodPackaging/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 Si9 nature COMMENTS HEALTH Reviewed on Signature jCOMMENTS 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'Tows Engineer: Signature: -- 84 Located 3 Osgood Street FIRE-DEPARTMENT -TempDumpster on site yes. . no Located-at,.124Mair,-,Street Fire-Departmerit '. 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 - Date Doc.Building Permit Revised 2010 Building Department The fol owing is'a list of the required forms to be filled out for the appropriate.permit to.be obtained. Roofing, Siding, Interior Rehabilitation Permits L3 ` Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. ,Licenses o Copy of Contract ❑ 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 o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses Li Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Copy of Contract o 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 apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Bui?ding Permit Revised 2012 Location, No. — Date Z i • - TOWN OF NORTH ANDOVER fir Certificate of Occupancy $ r Building/Frame Permit Fee C Foundation Permit Fee $ Other Permit Fee $ ED 'rOTAL Check#/ 27088 Building Inspector E Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 44,000.00 m $ - $ 528.00 Plumbing Fee $ 66.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 66.00 Total fees collected $ 760.00 30 Lincoln Street 422-14 on 11/12/2013 Bath and Kitchen Remodel i 'i NORT11 Town "' _ Andover O to No. Z iL _ Y - 2 I� h , verq Mass, 11 l 12 A3 cocMicnew�cK �1' AERATED S V BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT M.AALA/.......... .6.k................................................................. BUILDING INSPECTOR has permission to erect buildings on . ..... Foundation Rough tobe occupied as .......... 1.: .-....... ..........Gly ... ..................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final ��� • PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT RTS 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 i ,� �%fc�anrnrrirrr.•cri�l�nf"j�rr.;.,er•�rur/� � Office of Consumer Affairs&Business Regulation SN' i7OME IMPROVEMENT CONTRACTOR ? tegistration: 1761,27 Type: t ,. %Expiration:' #8t19t5 LLC DELUXE BUILDING AND REMODELING LLC. DONALD LEBLANC 138 LINCOLN ST ._- _ FITCHBURG,MA 01420 Undersecretary r i t f Massachusetts - Deoa,`ment of ;uo:•c Safety L Bead of 3zu.icti3g -?egulatio s ana Star+aaras Con.tructinn Super%kor _icense: CS-106510 DONALD L EBLAK 138 LINCOLN STREET Fitchburg MA 0120 ,.,� '- , ,.<;;=• oxo 'at o- �J''�""' 0512712016 ���+massianer Unrestricted-Buildings of any use group which contain less than 35.000 cubic feet(991m3)of enclosed space_ i Failure to possess a current edition of the Massachusetts . State Building Code is cause for revocation of this license. For DPS licensing information visit: www.Mass.Gov/DPS The Commonwealth of Massachusetts _Print Form Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information n / / Please Print Legibly Name (Business/Organization/Individual):Z)Clvi e L.. �v�����g ,f�Prnaj�/,it y L.L Ls �h)rl eSk rt G Address: 5-t City/State/Zip: rr h bur L01a. O! Phone#: 1?7 7- $O 1V - 3 7 7 q Are you an employer?Check the appropriate box: Type of project(required): L® I am a employer with 1 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' insurance.: 9. F1 Building addition comp.[No workers'comp.insurance P• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 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 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: 'Ke- fry,y e l n r S Tn:>u r w n c e Co m,0 q a,`e,5 Policy#or Self-ins.Lic.#: (o . u 3 - 5617(06 $-/ 3 Expiration Date: $--y-- /I/ Job Site Address: 'tl 6 Q 5�' City/State/Zip: A �i1C�©v el' M q. 0105- Attach 18 y5- 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 u to$1 500.00 and/or one-year e year imprisonment,as well as civil penalties in the formof a STOP WORK ORDER and a fine of up to$250.00 a da against the violator. Be advised that a co Y g of this statement may be forwarded to the copy y Office of Investigations of the.DIA for insurance coverage verification. I do hereby ET51A under the pains and penalties o er•u that the information provided above is true and correct Simature: Date ',- l�©v�/ -er F Phone#: 7g- 70 - 3 7 T? Oficial 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#• w Deluxe Building & ]remodeling, LLC CONTRACT FOR CONSTRUCTION/IMPROVEMENTS Owner: Mania Kavosi Builder: Deluxe Building&Remodeling, LLC N_ Property: 3018 Lincoln St.North Andover Ma. 01845 The OWNER and BUILDER(collectively,the "Parties")AGREE as follows: I. The Work The Work subject to this Agreement is [ ] New Construction or [X] Improvements to the Property, more specifically identified in Exhibit A (Proposal), which is expressly part of the Contract Documents. II. Time The Work is scheduled to begin on/about November 11, 2013, and anticipated to be substantially complete on/about December 20,2013. III. Contract Price The total amount to be paid for the Work pursuant to this Agreement is $22,000 . The Parties acknowledge that this Price is estimated and based on information known to the Parties today, and might later be modified or amended as necessary due to reasonable unforeseen circumstances or subsequent agreement of the Parties. IV. Construction Procedures Builder shall supervise and direct progression of the Work with the degree of skill and attention equal to or exceeding the usual industry-standard. Builder shall secure and pay for the building permit and other permits, licenses and inspections required by law or governmental agencies and necessary to complete the Work, excluding plumbing, electrical, and mechanical permitting. V. Insurance Unless otherwise provided, Builder shall procure and maintain, from a company or companies lawfully authorized to do business in the jurisdiction in which the Project sits, insurance for protection from claims for damages including as applicable (1) compensation of employees or for employee benefits, (2) due to bodily injury, including death, and (3) damage or injury to third-party property—other than the Work or the Property itself—that may arise out of or result from the Builder's operations and completed operations under the Contract. A certificate of insurance itemizing the coverages will be provided prior to commencement of Work upon request. VI. Warranty Builder warrants to Owner as may be required by G.L. c. 142A, and also that materials and equipment furnished under the Contract will be of good quality and new condition, unless the Contract Documents specifically require or permit otherwise. Builder further warrants that the Work will conform to the requirements of the Contract Documents and be free from foreseeable defects. This warranty does not extend, however, to defects inherent in the nature or quality of the materials or Work, or as otherwise specified by the Contract Documents. Builder's warranty also specifically excludes remedy for damage or defect caused by a person or entity other than Builder and those expressly authorized by him or under his direct direction or control. Alterations to the Work not directly attributable to Builder, improper or insufficient work or maintenance by others, improper operation by others, and normal wear and tear under normal usage in the industry standard is similarly excluded from this warranty. VII. Disputes Massachusetts law shall apply to disputes arising under or related to this Agreement, the Work, and/or the performance or breach of the Agreement. VIII. Right to Cancel An owner may be permitted to cancel this Agreement within three (3) days of its execution, pursuant to G.L. c. 93, § 48, and c. 140D, § 10, and/or c. 255D, § 14, as applicable. The signatures of Owner and Builder below indicate they have reviewed this Agreement in full, they understand its terms and conditions,and they voluntarily wish to enter into this Agreement. DO NOT SIGN IF THERE ARE BLANK SPACES ABOVE Deluxe Buildin��&Remodeling,LLC Owner Don Leblanc,Owner/Head Carpenter Dated: 3Dated: D 7AAO�V 13 2 Deluxe Building & Remodeling, LLC Pir®p®saO Quality,Integrity&Efficiency DATE November 7, 2013 j 138 Lincoln Street Quotation# 119 Fitchburg, MA 01420 Customer ID Kavosi 978-804-3789 Bill To: Proposal valid until: December 17,2013 Mania Kavosi Prepared by: Don LeBlanc, Owner& 28 Lincoln St. Head Carpenter N Andover Ma. 01845 License#CS-106510 603-560-1995 H.1.0#176127 mania.kavosiOpfizer.co m DESCRIPTION AMOUNT Deluxe Buliding&Remodeling, LLC hereby proposes to perform the following scope of work: All Labor and Disposal of Debri includedo mf`/• o-p,Nal13 First Floor; Demo existing full bath, Demo existing Gally kitchen,demo oqe bedroom VI, Install new kitchen complete in existing dining room with approximatley 12'of counter/cabinefs L-shaped, base and wall cabinets, laminate counter, r n. BATHROOM; move bath tub wall approximatley halfay into pantry,insulate, blue board and plaster, install new vanity,sink,toilet and 2 piece 5'tub/shower,vent fan, light,towel bar,toilet paper holder. Build 2 closets in 2 seperate bedrooms with bi-fold doors and flourescent lighting inside closets. Install washer dryer hookups with cabinets above, install approximately 192 sq ft of ceramic 12"X12"tile on bathroom, kitchen,laundry and back hall floor. Paint kitchen walls and trim. closets, bathroom, laundry painted completely. The only materials included in this proposal are as follows:framing lumber,sheetrock and plaster, nails,screws,electrical boxes,electrical wire,plumbing pipe and fittings,gas pipe and fittings. Cost of permit to be reimburst to DB&R TIME ESTIMATE 30 days TOTAL $22,000 `Payment schedule: $7,000 Due upon contract agreement. $7,500 Due upon completion of plaster before Paint. If you have any questions concerning this proposal, contact Don at 978-804-3789 or don@deluxebuildingandremodeling.com We look forward to working with you!