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Home My WebLink AboutBuilding Permit #269 - 55 LINDEN AVENUE 10/5/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO Date Received Date Issued:,/6"5�� IMPORTANT: Applicant must complete all items on this page LOCATIONr n t h Ale Prit PROPERTYOWNER !tJ S . 13.(' cnh cis Print MAP NO: Z_ PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential,—, Non- Residential New Building r- One familyl Addition ` 71wo oror more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Vtler/Sew Septell ic Floodplain Wetlands Watershed District ,r�DESCRIPTION OF WORK TO BE PERFORMED: 17l VajZe e7laJ �c,,�i�lf , 6_45/0,,1_.I'" e—,14i en? filsiJ r -le -4yX// /> x ��err le ?ewo vt ofd J- `o a,//J zza/l Q✓J Identification Tlease Type or Print Clearly) OWNER: Name:_ _ QSPhone: Address: \ 3 V CONTRACTOR Nance: . ` G�'/ �X Phone: '77c?- 6'ge SY6 Address: y� vc' "Supervisor's Construction License: Exp. Date: //� ' ZC,iu' Hume 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: $ 47 G,y, UU FEE: $ Check No.: Z� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of AgenUOwner Signature of contractor 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 �P Workers Comp Affidavit 6V Photo Photo Co Of H.I.C. And/Or C.S.L. Licenses J) 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 , L3 Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses L3 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) L3 Building Permit Application o Certified Proposed Plot Plan L3 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 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 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: Doc.Building Permit Revised 2008 i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL I 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 Reviewed on Signature COMMENTS HEALTH Reviewed on Signature i! COMMENTS 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Terrp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date 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 L C' -514, /so. ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 Location �✓ `!'�""'� No. Date / o MORTFr TOWN OF NORTH ANDOVER 0 w D � ' Certificate of Occupancy $ "O Building/Frame/Frame Permit Fee $ skMusE 9 — Foundation Permit Fee $ E Other Permit Fee $ TOTAL $ Check #/ v V 22467 . Building Inspector x40RTH Town , of 4Andover . 0 .:� - No. c� _ z--- = dover, Mass., Z- 0 LAKE COCHICHE WICK ADRATED C7 `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System / BUILDING INSPECTOR THIS CERTIFIES THAT I f �,,( �d ......... 4.6.5.......................................................... Foundation has permission to erect........................................ buildings on ....�....r.......... ..... ............ Rough to be occupied as.....,/..�.r.................. .. '�� S Chimney ...................................... 'T /..................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final 330-2- - PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR ST TS Rough ....... .. .................................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. 4" .N SILVA LIGHTNING BUILDERS 48 LINDEN AVENUE NORTH ANDOVER,MA 01845 (978)688-5464 ON (617)799-4585 C CONTRACT AGREEMENT I,Emanuel A. Silva of Silva Lightning Builders will perform work on 55 Linden Ave North Andover,Massachusetts 01845 for the sum of Seventeen Thousand Six Hundred Ninety Dollars and 00/100 cents. ($ 17,690.00 ) WORK TO BE COMPLETED: Kitchen Renovation Carpentry Work • Remove existing appliances. • Remove existing counter tops. • Remove existing cabinets. (uppers/bottoms) • Demo entrance between kitchen and dining room. • Reframe opening for wider entrance. (6"max) • Trim out new entrance. (same as existing casing) • Install new cabinets. (homeowner supplies/as described in layout) • Modify ceiling trim work. (in order to run vent pipe) Electrical Work • Disconnect existing dishwasher wiring. • Disconnect and relocation of existing wiring. • Blank plate existing outlets. • Rewire for 2 gfci outlets. • Rewire for dishwasher. • Install 1 circuit for fridge. • Install 1 gfci and relocate hood • Install sub panel to existing panel. Plumbing Work • Remove existing sink. • Rough in new water lines in new location. • Rough in new drain pipe in new location. • Rough in new vent pipe for sink. • Move gas line for stove to new location. • Install new sink in new location. (homeowner supplies) PAGE 1 OF 3 .4 4: ✓ • Hook up new bar sink in existing location. (homeowner supplies) • Install sink faucets. (2) (homeowner supplies) • Install water line for dishwasher. (homeowner supplies dishwasher) • Install drain pipe from dishwasher to main drain. Interior Staircase • Remove existing treads. • Remove existing risers. • Remove existing skirt boards. • Cut and'install new skirt boards. (homeowner supplies) • Cut and install new treads and risers. (homeowner supplies) • Cut and install new scocia molding to under treats. (homeowner supplies) • Remove existing wall board and studs on lower section wall of stairway. (in order to open side wall) • Reframe lower o er section of wall. (header/end post) • Cut and install board and plaster. • Install new handrail with balusters in open section. (homeowner supplies) Contractor will supply permit. Contractor will supply materials listed. Homeowner will supply materials listed. Contractor will dispose of debris made. Contractor will not paint or stain. Construction Supervisor License No. 65791 Northland Insurance Co Home Improvement Contractor No. 120334 (Liability Insurance)Policy#CP596364 FULLY INSURED Associated Industries of MA Mutual Insurance (Workers Comp)Policy#VWC6002902022008 Any other work that needs to be done that is not explained on this Contract Agreement will be executed only upon written order from the Contractor and signed by both parties becoming an extra charge over the agreed amount. PAGE2OF3 COSTS CARPENTRY ELECTRICAL PLUMBING p/D Labor: 10,700.00 Labor 2,650.00 Labor 3,350.00 Total 725.00 Stock: 265.00 Stock .00 Stock .00 Total 10,965.00 Total 2,650.00 Total 3,350.00 TOTAL COST 17,690.00 PAYMENTS Deposit on signing.(10/01/09) 200.00 (locks job in for start date of job) On start of job.( 10/05/09) 5,500.00 Halfway through job 7,000.00 When job is completed 4,990.00 (Job will take about 4 weeks,subject to change depending on inspections,counter to fabrication or additional work ) P � p capon (Approximate start date of October 5,2009 subject to change) I,Vas Brachos,have had the opportunity to read the above and understand the terms contained therein and by signing this Contract Agreement I agree on paying Emanuel A. Silva of Silva Lightning Builders for the work itemized above on this Contract Agreement. S LIGH DERS B �- Emanuel A. Silva,Contractor Vas Brachos,Homeowner PAGE 3 OF 3 DATED: OCTOBER 1,2009 i LVL9 :#al iau nssinnu .) 010Z/8Z/11 :uoileaidxq 917810 VIN '2:13AOGNV N 3Ad N3GN11 817 VA11S d 13nNVA3 00 :ol papulsaa 16L99 SO :asuaol� asuaol-j JoslAJadnS uol;onilsuo0 sp.m.purlS pur. suoilr,ln'. uiplin8 }o p.iro8 �1a.1rS �ilgnd .lo auau�l.rr.dia - sllr�sny�r.ssr.�,�i Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration, 120334 Expiration 11/26/2009 Tr# 260548 SILVA LIGHTNING BUILDERS 3, EMANUEL SILVA 48 LINDEN AVE. r N.ANDOVER, MA 01845` _ Administrator The Commonwealth of Massachusetts I k�fj Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): S,I It/G� 0 1j !►ir)C �cJa��C�p/.S Address: y Ci°nd eA Avc City/State/Zip: �i el d,611 r,, O/ r'5- Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1. �ama with / 4. ❑ I am a general contractor and I 6. E]New nstruction employees full and/or part-time).* have hired the sub-contractors ( P ) 2.❑ I am a sole proprietor or partner- listed on the attached sheet. I modeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their ME]Electrical repairs or additions 3.❑ I am a homeowner doingall work right of exemption per MGL 11. Plumbing repairs or additions P P ❑ g P myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 1311 Other Any applicant that checks box#1 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 isproviding workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Ida�rs< Policy#or Self-ins.Lic.#: 6 0 U Z q 0 Z o 2 Expiration Date: �Z' �'' Job Site Address: S 6+'nen " /ye Ci /State/Zi : /�°1(.i�6 yr MA h' p � G/Sys' 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 certinderthe pains and en s of perjury that the information provided above is true and correct Si ature Date: Phone#: 7 IY6 Y 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express'or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-05 www.mass.gov/dia File name:KITCHEN BROWN 2 Your note: DateI manic Scale:Print to 9 Scale:Print to fit paper size Dimension:13'6"x 25' Raw" `x � f > i 1f� z S 1 is I s: .. � t. r _ { z File name:KITCHEN BROWN 2 Your note: loan Scale:Print to fit paper size Dimension:13'6"x 25' 1 2 8 1' i r .7777 r -7 r +P 14 i I Y t ;$ t .o. v .. A [ y w er r r, d I File name:KITCHEN BROWN 2 Your note: �® Da Dimension: imension:13' 6"x 25' s F I f f l 41, w m, �+� k; fpm•T✓ ..^dy.. :'� 1 1 i d r File name:KITCHEN BROWN Your note: Dimension:13'6"x 25' -c oil toga 4:110 So,Whays too Map : i jj S , k n t M zooms ohms to ON f {g �.. . 55 4 ) ' Y