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Building Permit #1003-2016 - 36 COLGATE DRIVE 3/26/2016
F v ZN•Z5 < . NoaT OE,«ao 1N BUILDING PERMIT TOWN OF NORTH ANDOVER � • APPLICATION FOR PLAN EXAMINATION Permit NO: �'D Date Received Date Issued: 3 C l �9SSACHUS IMPORTANT:Applicant must complete all items on this page LOCATION Z( COligle- Dhivc. IV, /1hdoV{y- Pdnt PROPERTY OWNER �:H c �- �C�r� �-loye Print MAP NO: Oil PARCEL:M l ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE II Residential Non- Residential ❑ New Building One family ❑f ddition ❑Two or more family r1 Industrial Alteration No. of units: ❑ Commercial ! Repair, replacement ! !Assessory Bldg ! ! Others: ❑ Demolition ❑Other ! ! Septic i i Well Floodplain Wetlands i ! Watershed District i"Water/Sewer �,GrS�tc,L� c�-, new 00t)US rLoom Der Q)r-K s 1A)o4 4 1 r CI-Je a- new rdw `)q' 6,4-j avv) bah erect. (�-ncvotv- _-e �sa�� Mv3 Root, Identification Please Type or Print Clearly) 1 OWNER: Name: f TV K-c Phone: q78- ro l S Address: '3(. Ccl m c., brie CONTRACTOR Name: Phone: SU2 Sal 9635 �ona.�har O'S.,►l�v�� Address: Prcv,vcr,Ce- x,11 YLt} 14AW fl,&C- rVi ( 03 Ell Supervisor's Construction License: Cs-d76c,43 Exp. Date: ac16 Home Improvement License: ct 4%f q Exp. Date: y�3a�arl ARCHITECT/ENGINEER F-%X 1Eh4:t,&k,"4 Phone: 17b- q(-)_" 43 1 Address: `� s tvt- Led3 n N�x,14 , rAA Reg. No. r FEE SCHEDULE:BULDING PERMIT:512.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. " Total Project Cost: $ �oZ_ �3� o o FEE: $ o / �� "' I Check No.: Receipt No.: NOTE: Perso s contractini with unregiste red contractors do not have access o the guaranty fund Signature of Agentlowner� Signature of contractor -�---- I � J t `s L � • � Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISxM Public Sewer Tanning/Massage/Body Art Elmm Swiing Pools Elwell Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF o U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION' Reviewed on Signature COMMENTS HEALTH Reviewed on_- Signature COMMENTS I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments r, • Conservation Decision: Comments o. i - Water& Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: 'Signature: Located 384 Osgood Street FIRE DEPAR�T�tMENT Ternp ster on sit- es Located at 1r24a N Streetl, Fire Depa,�men sia� tur/da et "®,�IV1�,ME�TS _yam 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) i I ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 r I ` I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. I 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 a. 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 1 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 OTE: 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:Building Permit Revised 2014 Building Department � I 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 4. 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 i 4. Certified Proposed Plot Plan 6 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 OTE: 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:Building Permit Revised 2014 NORT1y Town of 2 ndover No. * - h ver Mass Al cocH�cMtw�cw 1' Ll BOARD OF HEALTH Food/Kitchen PERIT T LD Septic System �� ` C BUILDING INSPECTOR THIS CERTIFIES THAT ............ �................�............. .. . ... k Foundation ------ has _-- has permission to ere .......................... buildings on .340 akew................................. - �^_ , �,,� 'gl to be occupied as .. ... Chimney1 rL. a�'�'� f 3G.y�� lF `� provided that the person accepting this permit shall In every respect conform o rms o e application Final' l on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, AI ion and �p Construction of Buildings in the Town of North Andover. � S�6., . MBI G7INSPE /OR/ ir f �� Rough f L < L! VIOLATION of the Zoning or Building Regulations Voids this Permit. Q �} 7 LY s PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSCTOR UNLESS CONSTRUCTION STARTS ough 0 q-Zz t Service ............................. ..::r:............................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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 Enter construction cost for fee cal - North Andover Fee Cakulatlon Construction Cost 2,830.;00 m $ - $ 993.96 Plumbing Fee $ 124.25 j Gas Fee 100 comm. C$; 100,00 Electrical Fee $ 124.25 j Total fees collected $ 1,342.45 36 Colgate 1003-2016 on 3/26/2016 Creat Bonus Room Over Garage I NORT#1 Town of OLA- �+► ver, Mass, Adn coc"IcHewIcw y1. �9S 1?ATED U BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR PER THAT . �.... ..... .... ..................................... THIS CERTIFIES ........... .... ... .. ............. ......�.. .. IT L D ..C1I a. Foundation has permission to ere ......................... buildings on . .�. ••••••••••••••••••••••••••••••••• cmRough to be occupied as ....... . .... . ..... .... ... .. ........ .. ........... Chimney provided that the person accepting this permit shall in every respect conform o rms o ILlicatappion 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 CONSTRUCTION STARTS Rough Service ... . . .. . ............................... ............... � Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in Conspicuous Place on the Premises es Do Not Remove Fina' p Y a p No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 1 JOSCON Management, BUILDING&REMODELING CONTRACTOR MASSACHUSETTS HOME IMPROVEMENTS CONTRACT This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners.Seek legal advice if necessary.Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-91341187 or 14188-283-3751 or on our website. Homeowner Information Contractor Information Name Company Name Mr.&Mrs.Hoye Joscon Management,Inc Street Address(do not use a Post Office Box address) Contractod Salesperson/Owner Name 36 Colgate Drive Jonathan O'Sullivan CilylTown State Zip Code Business Address(must include a street address) North Andover,MA 01845 185 Atlantic Avenue Daytime Phone Evening Phone 918.618.9209 City/Town State Zip Code Email:mhoyel lOgmail.com Salisbury,MA 01952 Mailing Address(It different from above) Business Phone Federal Employer ID or S.S.Number 603489.1568 61.1403121 Home Improvement Contractor Reg.Number 159444 Expiration date 4-30-2016 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to complete,specifying the We,brand,and grade of materials to be used,use additional sheets if necessary.) The following Scope of Work has been figured on plans by Harborhouse Designs,LLC dated 1-22-16 Work to include removing the roof system above the garage,install a knee wall to gain additional ceiling height,constructing a new roof system,finishing the room above the garage,staircase and mudroom. Project allowance amounts are listed below and will be finalized once all selections have been made. Addendum A(Estimate Breakdown) Contract has been figured on a Cost Plus 15%Overhead and Profit. • Building permits per the Town of North Andover. • Disposal of all construction related debris. • Job site cleanup up and debris removal. • Demolition work to include the removal of the existing roof structure over the garage,second floor garage walls and selective demo throughout the work area. • Remove and re install the garage doors as needed. Allowance listed. • Rough carpentry to include the construction of a new roof structure,new exterior second floor walls and mud room modifications. • Roofing to be asphalt shingles. Color to be similar to existing. An exact match may be hard due to the age of the existing. • Insulation per code: R-21 batt insulation exterior walls,R-30 batt insulation garage ceiling,treads to have rigid board,garage exterior walls R-15, sloped ceiling R-38 insulsafe blowing insulation and air sealing. • Drywall work to include the garage walls,ceiling,mudroom walls,mudroom ceiling and the family suite. Drywall to be finished ready for painting by others. 5/8`drywall per code in the garage, Install new Harvey Classic double hung windows per plans. • Install new vinyl siding at the front of the garage and to the left side of the garage. Re use the existing siding along the back and the right side of the garage. • Exterior door adjustment per plans leading out to the deck. This is needed to allow for the stairs to work. { P • Interior carpentry includes the following: Install a new fire rated garage entrance door,interior doors per plans,baseboard molding,�and window I door casings. • Misc.carpentry work has been figured for the removal and replacement of the drywall in the new room adjacent to the kitchen for a mechanical chase from the basement. Install closet shelving per allowance,install the bar area cabinets. Cabinet allowance listed below. • Staircase finish to include trim and handrail Stair tread finish to be for carpeted stairs. • Plumbing work to include code upgrades,re working the existing plumbing and installation of the new plumbing fixtures. Work to include the bathroom. Plumbing fixture allowance listed below. • Heating has been figured on installing baseboard heat coming from the existing boiler. AIC not figured at this time. Window units may be the best approach for a cost savings. • Bathroom to have a vanity with a top. Allowance listed below. • Flooring: family room and stairs to be carpeted and the mudroom I bathroom to be ceramic tile. • Electrical work to code and to include the following. 1. Garage area: demo existing wiring,add switching for(4)4'florescent strip lights,add receptacles to code for the door openers and general use and heat detectors to code. 2. Mud room: demo wiring,add switching for flush mount lights,provided by owner,add receptacles to code,upgrade sub panel and sub feeder to code,add smoke detectors to code,replace back flood light with motion sensor. , 3. Family suite: add receptacles and switches per code,add(6)5"recessed lights,add wiring and support for(2)ceiling fans,fans provided by owner,add 20 amp circuit for the window AC,add vanity light,GFI,fan/light in bathroom,add smokes per code,add coaxial cable with wall jack and circuit for mini fridge. Allowances listed above: • Building permit @ $1,100.00 • Bathroom vanity including the top @ $300.00 • Garage door adjustment @ $1,200.00 • Shelving materials $150.00 • Plumbing fixtures: o Bathroom shower unit @ $600.00 o Shower valve and trim @ $185.00 o Toilet @ $250.00 o Vanity sink @ $90.00 o Vanity faucet @ $75.00 • Flooring: o Bonus room&stair carpet @ $2,784.00 o Mud room&bathroom materials @$5 stf $900.00 Total for the above project scope of work and specifications: $82,830.00 Required Permits— Building permit Proposed Start and Completion Schedule-The following schedule will be adhered to unless circumstances beyond the contrador's control arise. (Owners who secure their own permits will be excluded from the Guarantee Fund provisions of 3-30.16 Date when contractor will begin contraded work. chapter MGL ha r 142A. c 07-16 Date when contracted wo*will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform thework, i h thematenmaterial n labor specified above for the total sum of.$82,830.00 (� Payments will be made according to the following schedule: $8,283.00 10%Deposit Upon signing contras. (not to exceed 113 of the total cont and price or the cost of special order items,whichever is greater) $16,566.00 20%Upon the start of the project $16,566.00 20%Upon the of the completion of demolition and the start of the frame. $16,566.00 20%Rough inspections completed and the start of insulation $16,566.00 20%Drywall complete and the start of carpentry I $ 8,283.00 10%upon substantial completion of the contract (Law forbids demanding full payment until contend is completed to both party s satisfaction) The following material/equipment must be special$0 to be paid for NIA ordered before the contraded worts begins in order to meet the completion schedule.("")$0 0 be paid for IIA NOTES:0bid*dftiancedwFMLAW tRftlhtanydepositordaWWrm#edbybconha brbdnwmkbeg'atismay MUM the gre W ol(a)awed of MAW axdrad price a @)b ackW cost of any VW a#mentor arson made material which must be specialorW a advarmb mod m Widie. y•b� y gpro>ndedbytlrermrrtra Mogss(dbarmsofthevrmrmrlymudbeattKedlotlreoont 4 Subamtractas-Thecodradoragreesbbesoleyrespo Obram arrofbewakdesairdrega&mof8readmofanythed parfylsuboabacbr ut w 4tea kaft.Thecodacbrbm8wragreesbbesclelyrespo Aford pap tsba8 mbmtadasbr mwbrblsaWI&u*tisq mmnt. CordractAmpbnoe-Uponq ng,ihbdoamnentbecomesa a dWoderlaw.Unless*am raidaftfisdoaanent,the ao WshagnotbobatanyCamordwseedyeeredhasbeenpbardontheresidence.Reviewbeb8owingaa immandr*es arretu�►bebresgmgbisoor�ct. MmlbePOW kdosi ltheembed.Takeonebreadandidywimtwde.Askpftlson hMisWear. Make sure the a�ador las a void flame�pro+rement Can6ador Regisba6an.The law r�res mast home in�ravanent ax�hadas and s Wfttasbberegisbre *toDmbofHanebnprouementCorb&Reg Mm.You mayin*about=ractor regab&byw*bbeD mcbratl8 M PkA Room5170,Boson,(dA 02116or4cdng611f=or8W2W757. QUoestheaxitradorhaveir nce?A theCor�ador faldsWeancecompenyn=dm so#dyou amcon6rmaaraage,oraskb seeaa�pyafalproofofnsur�ce'dognr�anf. M wyourightandrespa MbK Readb krporbrdIrdar*n onto rea msideofab mandgetaafroftheCaner (Moth Mm hpmmtW radaLaw. You mgcancelbagree wlkhasbeen*datapbc *fffwnffieamta Ws nomwl pbceofbusmess,prauided yet no8f b contradarinwr8irg�hish�ermab of6ceabrancAo�oebyomirurymail posbd,bybansentorbydefivay,notkrterihannrdrdgirtofNre 8urid buseassrbyblo�wirg8reeg oftlNsagre�t.SeeYiealbdrd no6oeafcanceldonbrmbranea6onoftlrsright. DO NOT SIGN TMS CONTRACT IF TI RE ARE ANY BLMSPACESIII Two identical copies of the must be completed and signed.Oneshould go to the h mebwner The other copy shout be kept by the contractor. Homeowner's s signature Date Date i i Contractor Arbitration The Home Improvement Contractor law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor.The same right is not automatically afforded to a contractor,however.The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below.This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A. Homeowner's Si ctor's Signature NOTICE:The signatures of the parties above apply only to the agrentthe parties to alternative dispute resolution initiated by the contractor.The homeowner may initiate altemative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(.e.MGL chapter 93A)may not be waived in any way,even by agreement.However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law.Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law.The contractor is responsible for completing the work as described,in a timely and workmanlike manner.Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials.In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose.An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights.If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable:One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor.Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure.However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work.Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of"A Massachusetts Consumer Guide to Home Improvement'contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at http:/twww.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at http://www.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration:http://db.state.ma.usihomeimprovemenMicenseelist.asp For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-6524800,508-755.2548 or 413-734-3114 I JOSCON . • • • • BUILDING & REMODELING CONTRACTOR 72 PROVIDENCE HILL ROAD 185 ATLANTIC AVENUE Atkinson, NH 03811 Salisbury, MA 01952 603.489.1568 508.523.9635 DATE: March 25, 2016 Hove Residence ADDENDUM A(Estimate Breakdown) The following Estimate has been figured on plans by Harborhouse Designs, LLC dated 1-22-16! Work to include removing the roof system above the garage, install a knee wall to gain additional ceiling height,!constructing a new roof system,finishing the room above the garage, staircase and mudroom. Once all items are selected and construction methods have been established a final proposed amount will be presented. Project allowance amounts are listed below and will be finalized once all selections have been made. 1.0 GENERAL CONDITIONS $3,110.00 Project management/supervision Job site dumpsters and debris removal Job sitegeneral labor and cleanup Temporary protection during the project Post construction cleaning Architectural drawings 2.0 DEMOLITION $3,830.00 3.0 SITEWORK $0 4.0 FOUNDATION $ 160.00 5.0 MASONRY $0 i 6.0 STEEL&FASTENERS (Include in Carpentry-Frame, Division 7.0) $0 7.0 CARPENTRY-FRAME $ 15,500.00 A. LABOR $7,000.00 B. MATERIALS $8,500.00 i 8.0 CARPENTRY- FINISH $5,308.00 A. LABOR $2,890.00 B. MATERIALS $2,418.00 Carpentry items include: Interior doors,window/door trim, baseboard, vanity cabinet install. f I 9.0 DOORS&WINDOWS $2,380.00 Install labor included. Harvey vinyl classic units. 10.0 THERMAL&MOISTURE PROTECTION $ 13,150.00 Includes Siding, insulation and roofing. 11.0 INTERIOR SHEATHING $6,000.00 Drywall 12.0 PAINT&STAIN $ 13.0 CABINETRY(use allowance amount below) $Listed below A. Countertops $Listed below 14.0 MECHANICAL SYSTEMS $ 15.0 PLUMBING&HEATING $8,500.00 Fixtures listed below 16.0 ELECTRICAL $4,700.00 17.0 FLOORING Allowance listed below $0 Tile $1,754.00 Includes labor(Tile material allowance listed below) Tile backer board materials and labor included. 18.0 SPECIALTIES $0 19.0 ALLOWANCES Building permit $1,100.00 Bathroom vanity including top $300.00 Garage door adjustment $1,200.00 Tile materials $900.00 Carpet $2,784.00 Shelving materials $150.00 Plumbing Fixtures $1,200.00 SUB-TOTAL.......................................................................................................... $72,026.00 OVERHEAD&PROFIT......................................................................................... $10,804.00 TOTAL...................................................................................................................$82,830.00 i MISCELLANEOUS NOTES: The Commonwealth of Massachusetts Department of IndustrialAccidents X Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Aaolicant Information Please Print Lekibly Name(Business/organization/individual): o$Gx-- Address: tea- Pro'v,Jen<< �4(ll ny City/State/Zip: /•4k%,so:. N}f Q"�Zit Phone#: Are you an employer?Check the appropriate box: Type of project(required): l.d/ I am a employer with, _employees(M and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. kRemodeling any capacity.[No workers'comp.insurance required] 3.E]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.0 We are a corporation and its officers have exercised their right of bxemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicantthat checks box#1 must also till 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have I 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 niy employees. Below is thepolicy and job site information. //�� Insurance Company Name: /`tY Policy#or Self-ins.Lie.#: q f �l �"fy Expiration Date: U/g i(0 Job Site Address: 3 CCity/State/Zip: Attach a copy of the workers'co enation policy declaration page(showin the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerlik under thepains and penalties ofperjuty that the information provided above istrueand correct LSi afore Date: ��Y ' Phone#• �D �3- �l t� - � &G e) O t use only. Do not write in this area,to be completed b city official f.� Y Y p tl'or tmvn o 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#: I n—,,o_-avG _.isu-Lance agen._. !ib -1U4 4833 I PAGE. 1/ 1 li CERTIFICATE OF LIABILITY INSURANCE -_1/10/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFW NO RiGNTS UPON THE CERTIFICATE HOLDER TRS CERTIFICATE DOES NOT AFFIRMTIVnY OR NEGATIVELY AMEND, EMD OR ALTER THE COVERAGE AFFORDED BY THE POLR'OEg BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND TW CfRnF1CA g HOLDER. —MPORTMr- If 1W - --- eta ar en CA ) MW Oo t►ntuDtaae. IF 81lBROGATION IS WA—WD, au6]ect the tbntlrl ow cen�rta Df the policy, certain poltctee EW teA im an endoraemeW. A ctatanrent an this caMmte does not confer csALgWte fielder In tier of-Ich andorsement(a). H8M9 to the PIWQII K ADVANTAGE 11518. AMCY INC. NAft- PAUL DBVIN .«.........— . .... .y..—... .v._. �+uut 384 PLEASANT VALLEY STREET PHONE © ...- . 1_1055 �,Nab4T8-T8A-4833 WTUM, N& 01844 noDRess„ ` , areuaEattyArINarw+>�aAGE I NAk�e A:ARSffiLLA MOTECTF0# mg. 1N01NID __..— J0sow M1.MGS an xtgC. its: _ I 72 PROVIDME BILL am Ct�VERA FoumF: CE-RTtF4FA1 Nt�N18�R; REVISION NUMBER: THIB t9 IN01CAiED. HE TO CERTIFY THAT TPDUcI-3 OF; INSVRANCS LISTED BELOW HAVE OEM ISSUED TO THE 1NSLiRED NAMED AggVl FOR THE POLICY FERIOi) NOTIAIIll,WrANDM ANY REQUIREMENT. TERM OR OONNTION OF ANY CONTRACT OFt OTHER DOCUMENT YVITH RESPECT TO LA911CF1 Tiit6 CERTIFICATE AWAY BE wGUED OR MAY PERTAIN. THE 1148URANOE AFFD�EO of THE POLICIES DESCRIBED} N f8 Bt RES C ALL me its, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES'am .LIMITS SHOWN MAY HAVE BEEN REMMED BY 7146PAID OL CI tTft TtPt!OM tNluNr,Nce tlgtn rasa PetlGYNilq - - A OWERALuaeamumrm 050005S690 05/�i fly/3�t � 000f040 COMMERGALGENERALLUIDILITY PRE a 100,000 _ ClA4K8NAD! �OCCUR MMM(weaenem i 5,000 _.. .. ........_ ..___ _ j t+�nsoru�a�Dyiu411Rv i1000,000 cEAL?GCREGATE SENEAGGAEsnT9 i 2,000,000NTL : 1 PROW=-COMpmFAep a 2�OOD,000 WUOY LOC i s Aliroxrm�Luaenm AW AUTO tEaaedt�,D, - Ems: ^N„ ALL ovuNEoMCNEOu.En 9CD,LY Nuuav Iae. JAIoeAcro BODLYlR+'(parAUMS Autos LALM6 oCatraES6 LU9CLAW&MADE T RETENTION S A ND EMMMERV LP Yin 9121461013 0/05/2 10/05/201 _ Toart>terte X Eft = AWPROPRIETORIPARTNERIE McuTryElt��-- _ CEF'OER118AMEKOLI Dv yt "MIA E.LEACHA000VIT s 1;000,000 E.L DISEASE•EA EMPLOYEE s 1.000.000 E ca�oFapnrAnaNsamw . ._.. F—LCISEA.—POLICYuNIT s 1.000,000 OE3CRWWNOFOPMTMNi/LOCA7MMfYEHCM=AthACMI&I.ACIWAMIRMaeAs Bemdule u mpg,.lA' 8[JZ IIB $ Rffi4DDBLING CONTRACTOR CERMFfCATE Ftt3t,WR CANCELLATION TOW OF DORSH Ai�7OMR uul:==G DZPARTMSNT WOULD ANY OF THE AME OEWI@HEO POLICIES BE cAWA l an WTW THE EXPIRATION DATE THOWDf. NOTICE WLLL HE DELIVER® IN 1600 OsooCc Snu= ACWRDAHCE wlfN THE POLICY PROVISM& WILE1=0 20, StITTL 2035 NORTlt ANDOVER !4A01845 AUTHOR=ss ." • .. tst�2DID TCMD GORPWATIOW AD r r:xsved AC4RQ 28(TOittt The AGORD name WO IWQ ate Ngi9 and maft of ACOM f + n t « 4 � �fe�innrurcruaen�ll c�C7`rri.;n�frr,;°/t; met of Consumer Affairs&Business Regulation . R ME IMPROVEMENT CONTRACTOR. 4 istration: 159444 Type: . E f rat:4! 012016' Private Corpo i t JOSCON MANAGEMENT INC. -JONATHAN O'SULUVAN f 72 PROVIDENCE HILI RD. ATKINSON,NH 03811• Undeisecretary • w Massachusetts Department of Public Safety Boar of Building fagulations and Standards Comtruction Supervi%or License: C"T7 "3 JONATHAN OSU�-,) 185 Atlantic Ave "bury MA 01%2 i �� - �f Expiration Commissioner i Location No. tt'>- Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector s V co cm y 3 u. >+.�.. t OV!'w ../. 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Lo w 14,co �_12" OVERHANG _ ARVEY293 AT ALL EAVES ---- -- o - 0 HARVEY 2941C HARVEY2941C.iZ Vcr - Z w _EXISTING DOOR 0 . ---/--RELOCATEDLu Uj __ _ :INSTALL CONTINUOUS HEADEI �2- 1-3/4" x 11-1/4" LVL's `---._- w (EXISTING - _ - }. 0 Q © PERGOLA 00 NOT SHOWN)_ (r�J _ ocn co [m-n _ 0 CL:c L3 EZA co ME3mr C3 C3 C3-m y WALL SEGMENTS SURROUNDING GARAGE DOORS TO BE CS-PF BRACED WALLS IN ACCORDANCE WITH ' SECTION R602.10.4.1.1 OF THE 2009 IRC " � J® PH BEAR ELEYMIQN FRONT ELEVATION y F .-o SCALE.-1t4' = 1" Q -- SCALE: 1/4" = 1` U" � cd; SHEE 9 SHEET W � m W qv 2x1(7 RAFTER 2x4 COLLAR TIES 16" O.C. z TIGHT UNDER BEAM O a DORMER fit �- ®w Y ROOF co Ix sc 6-1/2� 0 coo' - TIE' Q m _-._ _ a L 2x8 JOIST 12 10 tY aC E i DEMO a JOISTS, - o H2.5 u 9 DE AND r WALLS , ;` a2x6 STUD '°" TIE 4 MO ; ; RAFTERS WALLS V- z nw , r w ------------ ----- DEMOr NEW 2x8 n° TRIM ?'(JPS OFEXI - - W rW ,4 'v STING_...,,..� �D � 3:LALLY COLUMNS EMO EXISTING GIRDER UJ o NEW 4-2xio Tw I EXSTING GIRDER RiM TOP OF COLUMN ' Q E- IST \-AS RE"Q'D FOR DEEPER W 2x4 GARAGE WALLS _ GIRDER AND INSTALL cl SPRINGFIELD PLATE ui - w >- u 1 4U l — _ cn EXISTING LALLY COLUMN , o c� TI cu L SCALE%14 = J,6 ,.�V_„� T� IV A (P OPO Fns JO H P. 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