HomeMy WebLinkAboutBuilding Permit #649-15 - 91 FULLER ROAD 2/12/2015Permit
Date Issued
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
IMPORTANT: Applicant must complete all items on this page
LOCATION I ! t,.11 !r . !C /V/ / 641e/ �
PROPERTY OWNER—Z--
MAP
WNER MAP PARCEL:
Print 100 Year Structure yes no
ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residpofial
Non- Residential
❑ New Building
Lj,,6ne family
❑ Addition
❑ Two or more family
❑ Industrial
eration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
❑ Water/Sewer
^DESCRIPTION OF WORK
BE PERFORMED:
identification - Please Type or Print Clearly
OWNER: Name:
Address:
Contractor Name: -S-cc,/ Phoned 0
Address: :;L-
Phone: 417 -
Contractor
/7
Supervisor's Construction LicenseExp. .Date: zz�zl�
Home Improvement License: _ /,, � S 7 _ _ Exp. Qate:
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: $"� �� a
FEE: $
Check No.: Receipt No.: I.,'Q ffg3
NOTE: Persons contracting with unregistered contractors do not haveaccess to the uaranty fun
Signature of Agent/Owner ��,,,:� �� Signature_of con l
Location
No. 141(, Date
WT I
Check #
4 , - I .,
C- U '.- Q Z)
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee s.
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Building Inspector
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE'dF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art ❑
Swunming Pools 0
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
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
f
r
Signature_
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No:
Planning Board Decision:
Comme
Zoning Decision/receipt submitted yes
Conservation Decision: Comments
` Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
Locatea 3t54 uS ooa Street
FIRE DEPARTMENT - Temp 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
NU I t5 and DATA — (For department use
❑ Notified for pickup Call Emai
Date Time Contact Name
Doc.Building Permit Revised 2014
r
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
o Building Permit Application
❑ Workers Comp Affidavit
o 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
o Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
a 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)
o 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: Building Permit Revised 2014
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
�1
$: 1535;w%.00
m
$ -
$
186.00
Plumbing Fee
$
23.25
Gas Fee 100 comm.
$:
100..00
Electrical Fee
$
23.25
Total fees collected
$
332.50
91 Fuller Drive
649-15 on 2/12/2015
Master Bath Renovation
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Department !
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Boston., /
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City/State/Zip: YG/� t�t� /� U -� / `� Phone #: C� �'�I /J C .2 7 1
Are you an employer? Check the appropriate box:
employer with
yees(full and/or paw time)*
1, 71am
4. ❑ I am a general contractor and I
have nedthe sub -contractors
2. sole proprietor or parte er
listed on the attached sheet.
slop and'have no.employees
These sub -contractors have
.
working forme in any capacity.
workers' comp. insurance.
5. ❑ We axe a corporation and its
[No workers' comp. insurance
officers have exercised.their
xequired.]
3. ❑ 1 am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c. 152, §1(4), and we have no
insurancerequixed.) i
employees. (No workers'
comp. insurance required.]
Type of project (required):
6. ❑ New construction. f
7. [C.�4mm- odeling
8. ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
II.[] Plumbing repairs or additions
12.0 Roofrepairs
13.❑ Other
xAny applicant that checks box#1 must also fill out the section below showingtheirworkers' compensationpolicy i formation.
f'Horneowners who snbmitihis affidavit indicatTgthey Bre doing allworK and then hire outside contractors must submit a new affidavit indicating such.
TContractors that cheekthis boar must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
X am an employer that isproviding workers' compensation insurance for my employees Below is thepolley and joh site
information.
Insurance Company
Policy i# or Sol£ ins. Lic.
Expiration Data:
Job Site Address; City/State/Zip:
Attach a copy o#the workers' compensation -p olley declaration page (showing the policy number and expiration date).
-_ Failure -to secure coverage as regghedunder Section 25A ofMGL o.152 can lead to the imposition of criminal penalties of a
:- — -
f uo izp io $1;500,00 U00-onbuyear iinprisorimenfi-as _well as ci _penalizes=in: the fom� of a S'H'OP -4VORI ORDEA and a ante_ _—
of up to $250.00► a day against the violator. Be advised that a copy of this statement maybe forwarded io the OfOoe of
Investigations of the DIA. for insurance coverage verification.
X do hereby cert& uri�Z+2/ie pains and penalties ofperjury that file information provided above is true a d correct.
Phone #:
official use only. Do not write in this area, to be completed by city or town official.
City or Town: PermitlLicense #
Issuing Authority (circle rine):
1. Board of Health 2. BuildingDepartment 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
C"n»tact Per.qnn: 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 hi 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 forego&g 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. Howevex 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 employes."
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 fbr the performance ofpublic work until acceptable evidence of compliance with the insurance
requirements of this chapter have beenpresented 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) andphonenumber(s) along withtheir certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are notrequired to carry workers' compensation insurance. If as LLC or LLP does have
employees, a policy is required. B e 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 thepeunit or license is being requested, not the Department of
7n.dustrial 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 he.
City or Town Officials
Please be sure thatthe affidavit is complete audpriated 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 whichwill be used as a reference number. In addition, an applicant
thatmust submit multiple permit/11cense applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant shouldwrite "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 asp -roof that a valid affidavit• is on file for future permits or Ecenses..A, new affidavit must be filled out each
Year .- - . ere a home owner orcitizen is -obtaining alicense.-ox permit riot xelated to -any business :ox eommercia -.venture
-
(i.e. a dog license orliermit to burn leaves eta.) said person is NOT required to complete this affidavit.
The Office of Investigations would Ile 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 CQMMORwealtbtOf Massacl?usPtEs
Depa int oflndustdal.A.ccidents
offilee QUAVeW9440wa •
600 Washiu.gm Street
Boston,MA02111
Tel 4 617-7217-4900 at 406 or 1-87-7-M
Devised 5-26-05 Fax 0 617-727-7749
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AMS
Proposed Kitchen area project:
Ellis family
91 Fuller Dr.
N. Andover MA
1/11/15
1. The Contractor agrees to provide all labor and materials required to perform
the following work:
• Design kitchen
■ Permit fees included
■ Prep home with plastic sheeting, paper as needed
• Air scrubbing equipment also used to reduce dust contamination
• Remove and dispose of all kitchen cabinets
• We can arrange to have the cabinets donated giving you a
possible tax deduction
■ Remove kitchen appliances and store them on the property until new
appliances arrive
• Appliance may also be donated for tax deduction
■ Remove existing flooring in the kitchen area
• Remove wall separating kitchen from dining area
• Some unforeseen wiring and plumbing could be discovered
during this phase of the project
• Beam included in this estimate cost no more than $400.00
■ Remove all wallboard and ceilings in kitchen area
■ Install new %" tile backer over existing subfloor
■ Install new the floor with square or staggered pattern (diagonal can be
done for an extra charge of $250.00
• New insulation added to the walls as needed
• Plaster patching as needed smooth finish
• smooth plastered texture
■ Install exterior venting for oven
Do to joist placement, exterior venting is not always possible. In
this case a recirculating feature of the oven vent will be utilized
11Page
■ Cabinet installations
• Estimated install time for cabinets and trim (3 days)
• Cabinet pulls included
■ Coordinate granite counter template and installation
• Granite not included in this estimate
■ Install new bay or picture window over kitchen counter (window cost not
included)
■ Install new baseboard molding and window casings
• Matching existing house molding
■ Electrician to:
• Install 6 new recessed lights
• Install 2 pendent lights
• Upgrade all electrical receptacles
• Add a receptacle to kitchen island
• Price assumes gas stove not electrical
■ Plumber to:
• Move and install additional heating
0 2 toe kick heaters estimated
• Install new sink, faucet, dishwasher, garbage disposal and stove
(icemaker hookup included if already present)
Estimated costs$18,850.00
Not included in the above estimate:
Paint and paint prep
Pendent lights
Repairs needed for unforeseen damage
Unknown work required to meet current code ( plumbing/electrical upgrades)
Cabinet's hardware and doors
Tile and grout costs
Granite cost
Windows
Appliance costs
Stove
Range
Dishwasher
Refrigerator
Disposal
Sink
Faucet
Etc.
Other estimated costs
2�1)age
Cabinets and door pulls 15,500.00
Picture window/ bay window 1500.00-2500.00
Exterior Door 500.00
Tile with grout (based on $4/sf) 850.00
Tank -less hot water heater Starts at $3000.00 installed
Plumber will need to be consulted prior to finalizing prices
The above is an estimate only and is subject to change based on the customers final choice
of materials and any changes to the work order brought on by homeowner requests or the
need to meet current building code.
2. The Owner hereby agrees to pay the contractor, for the aforesaid estimated materials
and labor, the sum of $18850.00 in the following manner:
• $1000.00 down payment
• $7000.00 start date
• $6000.00 rough inspections
• $3,000.00 after flooring install and painting 1 coat
• $1850.00 upon completion of project
Finish Materials approx. $ (This amount is subject to change based on actual choices
of finished materials made by the homeowner)
100% due at time of order (finished materials will be ordered and purchased at various
times during the duration of the job)
Some finished materials may not be able to be returned or cancelled once the order is
placed and some may be subject to a 20% restocking fee. These charges will be the
responsibility of the homeowner if it is the homeowner requests the exchange or return.
3. This remodel is scheduled to begin (TBD)
4. The Contractor agrees to provide and pay for all materials, tools and equipment
required for the prosecution and timely completion of the work. Unless otherwise
specified
All materials shall be new and of good quality. There is a one year warranty on materials
and craftsmanship, if manufactures warranty does not apply.
5. In the prosecution of the work, the Contractor shall employ a sufficient number
of workers skilled in their trades to suitably perform the work.
6. All changes and deviations in the work ordered by the Owner should be presented to
the Contractor, by the homeowner in writing, the contract sum being increased or
decreased accordingly by the Contractor.
7. The Owner, Owner's representative and public authorities shall at all times have
access to the work.
8. Construction and Jobsite Details:
Existing lawn & driveway may suffer some damage due to construction trucking; every
attempt is made to minimize the damage, however the homeowner shall not hold the
contractors liable for the extra cost if damage situations appear.
Any unforeseen discoveries that may affect the construction costs are they
responsibilities of the homeowner. For example: asbestos, lead paint, mold, ledge, high
water table etc.
9. In the event the Contractor is delayed in the prosecution of the work by acts of
God, fire,'flood or any other unavoidable casualties; or by labor strikes, late delivery of
materials; or by neglect of the Owner; the time for completion of the work shall be
extended'
for the same period as the delay occasioned by any of the aforementioned causes.
3 1 P a g e
10. The Contractor agrees to obtain insurance to protect himself, his workers and
subcontractors against claims for property damage, bodily injury or death due to his
performance of this agreement.
11. This agreement shall be interpreted under laws of the State of Massachusetts.
12. Attorney's fees and court costs shall be paid by the defendant in the event that
judgment must be, and is, obtained to enforce this agreement or any breach thereof.
13. Certifications
Massachusetts Construction Supervisor License # 96462
Massachusetts Home Improvement Contractor Registration # 153859 +r
14. Insurance: Liability Insurance certificate available upon request
IN WITNESS WHEREOF, the parties hereto set their hands and seals the day and
year written above.
N_94",
OWNERS NAMEZOWN S SIGNATURE DATE
OWNER` NAME OWN 'S SIGNATURE A E
OWNER'S ADDRESS
_Aaron Scarpello
CONTRACTOR'S NAME CONTRACTOR'S SIGNATURE DATE
2 Magnolia Ave Salem ,NH 03079
CONTRACTOR'S ADDRESS
41Page