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Home My WebLink AboutBuilding Permit #107-16 - 94 LYMAN ROAD 7/27/2015 Aa� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: b3— Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page i� Pit. - OWNER PROPERTY � -- int 100 Yew Old Structure yes n, MAP NO: _. PARCELS ZONING DISTRICT iHistoric District yes no Machine Shop Village. yes no _ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family 11 Addition 0 Two or more family [I Industrial - ration No. of units: ❑ Commercial ❑ Repair, replacement 11Assessory Bldg El Others: ❑ Demolition ❑ Other ❑ Septic ❑Well 0 Floodplain 1Netlan-ds ❑ Watershed District ❑Water/$-ewe DESCRIPTION OF WORK TO BE PERFORMED: M P1_671— (3611460M +z �/►1 U D;�� Identifkation Please Type or Print Clearly) G OWNER: Name: K11-4,Y 611*0 R)) Phone: 10 Address: 1-,Yn)✓4 N F¢A Linav __� Phone. ? CONTRACTOR' Name ddress: Supervisor's Construction License. _ .� Exp 'Date: r. O Home Improvement License: ��1�� Xp_ E Date: _ ARCH ITECUENGINEER 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: $ 0, FEE: $ Check No.: �— Receipt No.: NOTE: Persons contracti with unregistered o ac rs do not have access to th guaranty fund SigriatureofAgent/O.wn rt , afore• Plans Submitted L_ Plans Waived ❑ C ified Plot Plan ❑ Stamped Plans Building Department rhe fohowing is�'a-list of the-requited forms to be filled outfor: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 G.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 ❑ 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 tle 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 subm.tted with the building application Doc: Doc.Building Permit Revised 2012 ■ Plans-Submitted❑ 'Plans Waived ❑. '.-Certified Plot Plan ❑ Stamped Plans El _ I ;TYPE--OF-SEWERAGE-DISPOSAL Public Sewer ❑ Tarmmg(Massage/BodyArt ❑. Swimming Pools ❑ Well ❑ Tobacco.Sales g/ 1 e Private,(septic tank,etc._ a . 0o Packagin .S s 11❑ -Permanent D"i�pster.on-Site ❑ :THE-FOLLOWING SECTIONS FOROFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED ., — DATE:APPROVED PLANNING & DEVELOPMENT' ❑ ❑ COMMENTS CONSERVATION Reviewed on - Signafure COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments CQ nservation Decision: Comments Water& Sewer Con nectioniSianature& Date Driveway Permit DPW Tow;2 Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMr NT Temp Dumpser on site . yes no Located at�124iMarStreet r s .,.t ti 1 Fire Departme►it si _ gpature/date COMMENTS y ry•. i :Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area; sq. ft.; -- ELECTRICAL: Movement of.Meter,l.ocat on, mast or service drop requires approval of Electrical Inspector Yes No DANGER.Z®NE LITERATURE: . -Yes No MGL--.Chapter 166.Section 21A-F and G min.$100=$1000:fine _ - I NOTES and DATA— For department use I a ® Notified for pickup - Date l � Doc.Building Permit Revised 2010 r Location No. • = TOWN OF NORTH ANDOVER ' SS106A ` . Certificate of Occupancy $ Building/Frame Permit Feer I Foundation Permit Fee $__� Other Permit Fee $ TOTAL $ ,u Check# f2l uilding Inspector r 1 tkoRTH w: :. . 2 � tEI, : :. .c . : ve. .. O - No. b - 2,o * I t ] - i b � c. ;o # ver, Mass, T O L h NE 1. COC HIC Kl W ICK Q.RATED LPP��S S U BOARD OF HEALTH Food/Kitchen PE Septic System t THIS CERTIFIES THAT .......MjT 4. M"L 1�", BUILDING INSPECTOR .......................... ...... ....... ................................. .. ..... ....................... has permission to erect .......................... buildings on ....94......... r!l.4:� P-4).................... Foundation ..... ............... ............................................. Rough to be occupied as ............. v ...... �/.. :�. 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 --VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT Rough Service ............. .. I ........ ...... ».r::................. 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. P, o Q ROBERT SLANG EVIN ■ Building& Remodeling, LLC 795 Dale Street North Andover,MA 01845 (978)686-3607 HIC#111990 FID#26-0816298 www.LangevinBuilding.com Job Description Colleen Kiley and Mark Barnard 94 Lyman Road North Andover, MA, 01845 Bathroom renovation l.All necessary permits 2.Portajohn on premises 3.Complete demo of bathroom 4.Remove old floorboards and level joists with wedges 5.New 3/4"plywood subfloor 6.Install fiberglass whirlpool tub and replumb drain,relocate rough piping to accommodate new pedestal sink location 7.GFCI outlet and wiring for whirlpool motor on dedicated circuits 8.New light/fan unit wired and vented through roof and install wall fixture above sink 9.New 100 amp service in basement IO.Upgrade wall insulation to R-15 and ceiling insulation to R-30 11.Blueboard and skimcoat plaster on walls and ceiling and Durock on tub walls 12.Prep floor for tile with Durock 13.new window and door casings to be 3/4"X 3 1/i" flat stock clear primed pine 14.Install new medicine cabinet 15.Install tile on floor,tub walls to ceiling and other wall surfaces half way up 16.Install finish plumbing fixtures 17.Paint plaster walls and ceiling 18.All cleanup and trash removal The cost of the whirlpool tub,toilet, sink, sink faucet, shower valve,medicine cabinet, tile, light fixture are not included in our price quote, nor is the cost of the shower door and its installation 13 / ROBERT ANG Building& Remodeling, LLC Homeowner Information Contractor Information Name'eL/.,,j,6 C N C K I ,LE y Company Name 4 Mi4W K iVARr 1.AP6:F—V)M Q1,D e-- l' R6M01E J,) N r, 4 J-C Street Address(do not use a Post Office Box address) Contractor/Salesperson/Owner Name 11YAON Rc orb L --57- &A9 �r4 PJ t_✓I D J City/Town State Zip Code Business Address(must include a street address) X)vk,* AWS MAO Daytime Phone. Evening Phone City/Town Ste Zip Code 3nit} 'Of Syt - Mailing Address(It different from above) Business Phone Federal Employer ID or S.S.Number Home Improvement Contractor Reg.Number Expiration date Law requires that most home improvement contractors have a valid registration number / J `} c7 The Contractor agrees to do the following work for the Homeowner: / (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessacv.) cco yvi 10/}N/'-IW C, 714-1 �° E Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances.beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of l� )7 Date when contractor will begin contracted work. MGL chapter 142A.) /� �P Dae when contracted work will be substantially completed. Total Contract Price and Payment Schedule //�7 o e The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of:$ /� r��,10- (*) Payments will be made according to the following schedule: $/ he total contract price or the cost of special order items,whichever is greater) . $ �— by ,/_/_Y or upon completion of .l— $ by _/ / or upon completion of $ a� upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for ordered before the contracted work begins in order ------ --- to meet the completion schedule.(**) $ to be paid for NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is an express warranty being provided by the contractors Co❑Yes fall terms of the warranty must be attached to the contracts Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. ® Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. ® Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. ® Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. ® Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agwepent. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN T ONTRACT IF THERE ARE ANY BLANK SPACESM Two identical copies of the con trac ust completed and signed. One copy should go to the homeowner. The other copy should be kept by the contractor. eowner Signature Contractor's Signature (42 Date Date ,a �e �cl��rra�ccccnl�o�'C�ll/`cra�ac�cc:;eCT' - Office of Consumer Affairs&Business Regulation (DOME IMPROVEMENT CONTRACTOR registration 111990 Type: "�' Expiration -'Ti 04. LLC ROBERT LANGEVIN BLDG&REMQLDING LLC. ROBERT LANGEVIN, , 795 DALE ST N ANDOVER,MA 01845 — r Undersecretary Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Superiisor License: CS-002685 ROBERT M LAN"VIN 795 DALE ST N ANDOVER Mk 01845!� r.G.� �- • „ "��` Expiration Commissioner 02/24/2016 The Commonwealth of Massachusetts Department of Industrial Accidents Iu - A, LL - Office of Investigations titi#s �i 600 Washington Street. Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please PrintLegib Name (Business/Organization/Individual): /\ \ 00� 1J�- Address: City/State/Zip: NO., A+- T O Phone#: 7�3 i<07 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑Newconstruction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet.t r►odeling hip and have no employees These sub contractors have 8. [J Demolition working for me in any capacity. workers'comp.insurance. 9, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] *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 arid 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby Lify u er the Tai ;nd penalties of perjury that the information provided ab a is tru land correct Si ature: Date: .) Phone#: K 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.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#•