Loading...
HomeMy WebLinkAboutBuilding Permit #773 - 299 MIDDLESEX STREET 5/25/2007BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received V►ORTFI OF�t�ac �6q�0 O �^ F• ; DESCRI OWNER: Name: Address: r� PM ARCHITECT/ENGINEER - Phone: Address: Reg. No. r FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON PER S.F. Total Pro1'ect Cost: $ �� � �© FEE: $ ��� --T C� Receipt No.: � 0heck No.: 1 J NOTE: Persons contracting with �Jund contractors do not have access to g/ranty,� r ' to .A e // // 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 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 ❑ 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 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 ❑ 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 recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 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 COMMENTS HEALTH COMMENTS Zbning Board of Appeals Planning Board Decision: Conservation Decision: DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED DATE APPROVED ❑ ❑ Variance, Petition No: Zoning Decision/receipt submitted yes Water & Sewer Connecti Located at 384 Osgood Street Comments 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 Doc.Building Permit Revised 2007 Location '25 Ge No. -1 T q Date S d TOWN OF NORTH ANDOVER y Certificate of Occupancy $ _ tt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # (� 2©240 V Building Inspector dl 0 W W c � o •mac caC.) CL, =m s _o • CF �. �t 4 E s E o~ m c� E y m yr C in m daoD ym� ame o cm amt 'o CD o� m `C L nO C Q = m m r 3 IV CO) W .� �.. •N CL= .16 ro W C Z yr C.3 .Q 0 O O C O _Ce ` O F- t rte. d r m �! O O 'ON C� y CD C40 E co CLas 4r O y 0 COO O CL c h 0 W N W LU ce W N a a a w QQ v J o LE a ci Mit` '•o � Jlra. (porn)rt.�frll�,�zl�t-.��raJJRCftu, BOARD OF BUILDING REGULATIO License CONSTRUCTI �UPER,�it . - _ _ :! rr Number CS A827111 Birthdate: 11/05/1956 11/05/2007 7-. 0Expires: i r Restricted: .00 MICHAEL P LORANGER 27 KILMARNOCK ST WILMINGTON, MA 01887 Commissioner 'i Board of Building Regulations and Standards I HOME IMPROVEMENT CONTRACTOR ............. �J Registration: 143724 Expiration: 7/23/2008 Type: Private Corporation CONSTRUCTION ARTISAN, INC. MICHAEL LORANGER 27 KILMARCK ST WILMINGTON, MA 01887 Deputy Administrator —I— -_ Construction Artisans,_Inc. Remodeling and 13uilding with Perfection 27 Kilmarnock R. Wilmington, MA 01887 Mike Loranger, Pres. MA Builders Lic #7 082711 b Home lmpr.Reg 0143724 Tel: 978-821-4432 Fully Insured (Liability & WC) Mile@ConstructionArtisans.com ww"I.ConstructIOnArtlsilnS.Colil Scott and Lori Gisetto 299 Middlesex St. N. Andover, MA 01845 Tel # 978-794-4481 Finish attic, 1 Bedroom and 1 bathroom Insulation: R13 walls, R30 ceilings Floor: 2" by 8" 16: 0. C. Ceiling Height TY Ir z6V 25,40 Contractor: Construction Artisans, Inc. Michael Loranger 27 Kilmarnock St. Wilmington, MA 01887 Construction Supervisor.Lic #: 082711 Expires 11/5/07 HIC Registration # 143724 Expires 7/223/08 80/£ZZ/L saa!dx3 bZL£P6 # uo►leals!6a8 0IH LO/9/d d sandx3 6 dLZ80 :# 0!7 aoslnaadnS uollonalsuoj L8860 dW `uol6uiw/!M 'IS )loouaewl!>f LZ aa6ueao7 laeyolW .oul `suesgry uo►lonalsuoj :aoloealuoo 'O'O :9d „8 /(q „Z :aool_4 s6u!l!ao O£a `sllem £ia :uollelnsul wooayleq k pue wooapa8 d `ollle ys Lqj k8titi-ti6L-8L6 # lal 5ti860 VYV `aanopuy *N 'IS xasalPP!W 66Z ollas!O !JO -1 pue llooS . 'ai- structi on Artisans, Inc. Remodeling and Building with Perfection Tel. 978-821-4432 Estimate/Invoice for Home or Office Repairs and Improvements Last Name Gisetto Home # 978-79-4481 Date First Name Scott and Lori Work # 978-852-3551 2/18/2007 Street L 299 Middlesex St. Cell # 781-883-4450 Scott's cell Job # 2 City, State N. Andover, MA Zip Code 1 01845 1 Cust. # 263 Scope of Project' Finish Attic Itemized Project Description(s) Materials Labor File for all necessary permits, submit plans and meet with Bldg. Inspector. Remove flooring and remove all insulation. Install 14' 2" by 8" between existing 2" by 6" joist per Bldg. Inspector. Install new 3/4" plywood flooring. Install temporarily with a few screws for removal for rough wiring, plumbing as needed. Rough wire and rough plumb. Add 2" by 4" to angled walls to allow for R-30 Insulation. Frame walls per attached framing plan. Frame for bathroom. Plumb per attached estimate from Kevin Scott Plumbing. Install 2" by 8" collar ties. Rough wire per code with lights, outlets and switches. Meet with inspectors during rough inspections. Insulate walls with R-13 and Ceiling with R-30. Install Hardy board on bath floor and in shower and bath tub area. Hang blueboard then apply skim coat plaster. Sand walls and ceilings then prime and paint 2 coats. Install outlets, switches and lights. Liven all electrical items. Tile and grout shower walls, tub walls and bathroom floor. Install doors, wood trim, casing and baseboard. Paint all doors and trim 2 coats. Install all bathroom fixtures. Finalize connections. Meet with inspectors for final inspections. Homeowners to supply all bathroom fixtures, flush mount lighting, bathroom tile. All other flooring mat. And labor not included. Payment Schedule Deposit prior to start 35% _ $18,000 Payment 2 = 20% when Flooring is complete = $8,000. Payment 3 = 15% when "Rough" Framing, Plumbing and Electrical is complete = $6,000. Payment 4 = 15% After blueboard and plaster = $6,000.' Payment 5 = 10% after all finish carpentry = $5,000.. Payment 6 = 5% after all painting and final inspections and job is complete = $3,600. Materials and Supplies: Materials Selection, pick-up and delivery. Included Debris Removal and Disposal Fees Included Permits and Inspection Fees Included Job to start March 5, 2007, completion date will be May 31,2007 Total Estimate Mat. + Labor $46,600.00 Total Due: $46,600.00 Customer Signaturevt \ Date !� 7 Mike Lic # # 082711 0 MA Builderss Lic Home Impr. Reg # 143724 27 Kilmarnock St. Wilmington, MA 01887 Office Hours: 7:00 AM - 7:00 PM Monday thru Sunday Email: Mike@ConstructionArtisans.com Web: www.ConstructionArtisans.com FEIN # 20-0706881 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 s. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Informs Name (Business/Organization/Individual): Address: City/State/Zip: G Pri Are you an employer? Check the appropriate box: 1I am a employer with _� 4. El am a general contractor and I V employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t listed on the attached sheet. These sub -contractors have workers' comp. insurance. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. tR Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. f 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 providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Cvwlk 0 0 e % Policy # or Self -ins. Lic. #: ��(,�(; /,3 / /2� - Expiration Date: �U Job Site Address��/'6 � City/State/Zip:. w 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 cgxerage verification. Ido hereby certify under the pWnsl raltie of perjury that the information provided above is true and correct. Official 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 #: SUMMARY OF INSURANCE Prepared: 05/01/07 rage For: ..'Construction Artisians, Inc Mike Loranger 27 Kilmarnock Street Wilmington, MA 01887 978-821-4432 Wilmington Insurance Agency Five Middlesex Avenue Unit 14 P. O. Box 1010 Wilmington, MA 01887-0580 978-658-3805 Coverage Amount Company Policy No Eff Exp General Liability I Scottsdale Insurance Co scP0511831 05/03/07 05/03/08 Occurrence General Aggregate 2,000,000 Products/Completed Oper. Aggr. 2,000,000 Personal & Advertising Injury 1,000,000 Each Occurrence 1,000,000 Damage to Rented Premises 300,000 Medical Expense (Any One Person) 10,000 Workers Compensation Granite State Insurance Co WC2313772 05/07/07 05/07/08 Named States: MA Employer's Liability Each Accident 500,000 Disease - Policy Limit 500,000 Disease - Each Employee 500,000 Additional Coverage/Endorsements ' See Attached Rating Information Work Comp Assigned Risk Granite State Insurance Co WC2313772 05/07/07 05/07/08 7 L -#. '.YE... .•1F.. 'GT ' 4'{� , 5 '.. f'� t. .' heli. - R"Y'1.�k 4Sw i'* t 'J". 5 }y:.•^ ? '`.y���`y _ �4 '"�'' ,�rwpf �r� 'tel^ T K C �� �i' d:lf r -x .'C4„vunn,. _a., ,�. �'i. :.''sl�.�r...;.:�Y�i�'.�,L�'�..!...'�'��,."a