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HomeMy WebLinkAboutBuilding Permit #149 - 95 SOUTH BRADFORD STREET 8/22/2011 BUILDING PERMITr10 R Tli . o�t ,6- TOWN OF NORTH ANDOVER Fr4'`''`- o� APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ' 30 -TED Date Issued: Zti' IMPO TANT:Applicant must complete all items on this page LOCATION t5'v c�7d9 ' eAJ �ca'ej Print PROPERTY OWNER G1 s s- eb Z I Print MAP NO: / PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes r no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: tete" Identification Please Type or Print Clearly) OWNER: Name: L i say )eo ) Phone: Address:_ c C" 5,= v TY /3 v, -j r rf 5' 7- CONTRACTOR CONTRACTOR Name:Pb• eh ttCp h 57' LLQ Phone: Address: a- Glc 6yr> 14 tl-e t Supervisor's Construction License: q V Zee Exp. Date: q/ e (l"Z.... Home Improvement Licenser '2,; Exp. Date: 61Z4//z°- 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. 14 Da Total Project Cost: $ !J3 �� FEE: $ Check No.: 2-C7 a� Receipt No.: -�--� y NOTE: Persons contracting w hunr g* to d contractors do not have access to the guaranty and Signature of Agent/Own Signature of contractor ', i 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 SETI N 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 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 - 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 NOTES and DATA— For department use ❑ Notified for pickup - Date _........._........._.....-- ...--................_......._..._......._.....-.......__._.....__................._..._....._....----.................--- --....-............ _...........................-----......-----........._...- Doc.Building Permit Revised 2008 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 L3 . 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) ij ❑ 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 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 2.2008 AORTH ® 0 2 And over Oir,M..„,.�., V:'�5'� ��/•'fit Xw 0LAKE o dower, 1Vlass..--_--_-�� COC MIC ME WICK �t %ADRATED P "\C ti BOARD OF HEALTH }f Food/Kitchen PERMIT T ;j, Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......U.&!ome............ .. .......................................................... .......................... Foundation has permission to erect........................................ buildings on ....q.im........... ....�.��1..�... ... 4....... Rough to be occupied as....... /1r1.3. ......... O!V!! /. . ............................... Chimney ................. 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 1(� , PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS LESS CO SiRVC` Rou gh 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 S1 D E Smoke Det. Dominique's Construction, LLC 25 Glennon Avenue Dracut, MA 01826 978-957-6308 Property Owner Lisa Kozol 95 South Bradford Street North Andover, MA 01845 978-686-7520 CONTRACT AGREEMENT Entered into this 17th day of August, 2011 between Dominique's Construction, LLC (hereinafter "Contractor") and Lisa Kozol (hereinafter "Property Owner") of 95 South Bradford Street,North Andover, MA. The Owner and the Contractor, for the consideration hereinafter stated, agree to the following: 1. Scope of work as described in quote of August 2, 2011 to finish basement (attached hereto). 2. The Contractor to supply all labor and material for the work to be done per the estimate. PAYMENT SCHEDULE • Dominique's Construction, LLC providing labor for the installment of windows. • Deposit of$2,500.00 due at the signing of contract; $2,000 due at the completion of the framing; • $2,000 due at the completion of the sheet rock; • $2,000 due at the completion of the finish w rk; • Balance of$880.00 due upon completio f emain' work. Y— II Dominique's Constructio , LLC Ms. Lisa Kozol Roland A. Dominique Property Owner 5//-7Z// Date Dominique's Construction, LLC 25 Glennon Avenue Dracut, MA 01826 978-957-6308 August 2, 2011 Lisa Kozol 95 South Bradford Street North Andover, MA 01845 978-686-7520 Quote Finished Basement • Plan&Permit • Frame wall at bottom of stairs • Install new door in wall • Move duct work • Frame 2 new closets next to electrical panel • Install existing doors into that wall i • Frame around wet bar sink • Frame area for new refrigerator • Frame walls for new bathroom • Install new door for bathroom • Install new door in existing cedar closet • Install new steel insulated door into garage • Ramset 3/4"plywood on areas that do not have any • Re-strap ceiling • Move existing exterior cellar door to kitchen area Note: Quote does not include cost of a new door for basement • Insulate as needed • Sheetrock all areas discussed • Install drop ceiling in other areas as per discussion Note: Quote does not include the cost of the drop ceiling material • Primer paint all sheetrock Note: Quote does not include any finished painting • Install new chair rail in main basement • Install new base molding in main basement • Dispose of all debris Estimated Cost- $9,380.00 Note: Price does not include any finished flooring Massachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 44201 Restricted to: 00 h t ROLAND A DOMINIQUE 25 GLENNON AVE DRACUT, MA 01826 Expiration: 4/20/2012 issiuner Tr#: 20647 Office of Consumer Affairs&Bdsiness Re lat, �z License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR the expiration date. If found return— Registration: .c-151738 ~ Expiration: 6/26/2012 Type'. ,- Office of'Consumer Affairs and Business Regulation € - Ltd Liability Corpil 10 Park Plaza-Suite 5176 DO INIQUE'S CONSTRUCTION-;LLC. r .Boston,MA 02116 ROLAND DOMINIQUE 1 , 25 GLENON AVENUE s_ = _� I DRACUT,MA ---- { Undersecretaryrte 1 t Not valid wit ou signature s �.- A1C RV� ,..�.. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIODNYM 07/11/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODYCER;ANDTHE,CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dick Insurance Agency,Inc PHONE , (978)851-3323 (978 851-3324 FAX 461 M ANC ) 'n Street AI No: Main EMAIL. brian@dickinsuranceagency.com Tewksbury,MA 01876 Phone (978)851-3323 Fax (978)851-3324 NGM INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURERA: INSURER B: NGM Dominique Construction LLC INSURER C: Liberty Mutual 25 Glennon Ave "INSURER li Dracut,MA 01826 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,-TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD UBRI POLICY EFF POLICY p� LIMA S I POLICY NUMBER MM/p GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 RV COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Faocaarence $ 500,000.00 A El Elc1A1MS MADE WoccuR MPK2159X 10/12!2010 10/12/2011 MED EXP(Any one person) $ 10,000.00 ❑ ❑ PERSONAL&ADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PEGENERAL AGGREGATE $ 2,000,000.00 R POLICY [J PRO- [:] LOC PRODUCTS-COMP/OP AGG $ 2,000,000.00 ❑ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ❑ ANY AUTO BODILY.INJURY(per Wrsoh) $ 250,000.00 ALL OWNED SCHEDULED M1 K1097X B ❑ AUTOS AUTOS 10/01/2010 10/01/2011 BODILY INJURY(Per accident $ 500,000.00 El HIRED HIRED AUTOS NON-OWNED AUTOS PRO DAMAGE radetEl ❑ n $ 100,000.00❑ UMBRELLA LIAB ❑OCCUR $ ❑ EACH OCCURRENCE $ EXCESS UAB ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY YIN ❑WC bY`TAMIT ❑ER ANY PROPRIETORIPARTNER/EXECU FVE C OFFICERIMEMBER EXCLUDED? ❑N/A TBI EL EACH ACCIDENT $ 500,000.00 (Mandatory in NH) eGl 07/04/2011 07/04/2012 D" es,describe under ' 2 3 E.L.DISEASE-EA EMPLOYEE$ 500,000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF NOTICE E WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOROED ATIVE ACORD 25(2010/05)OF ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 91 Garage 8' 12' 3' 18" � Stairs 16' 12' 6" 12' 6" f Ge 1 -Tj 20 10" PC 0 S � 9' Garage J 8' 12' Propsed Bathroom Propsed Sink 3 Stairs (� 1 ' 12' 6,� 12' 6' — —20' 10' Location lrp No. ` Dated l TOWN OF NORTH ANDOVER s ' Certificate of Occupancy $ • e �k '��;',k���'• Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ L, ('TOTAL $ Check # /✓ 2445 Building Inspector