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Home My WebLink AboutBuilding Permit # 6/4/2015 BU %AORT11 ILDING PERMIT 0 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER S C Print 100 Year Structure yes no MAP PARCEL-:95 ZONING DISTRICT: Historic District yes no Machine Shop Village yes, no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building [I One family [I Addition El Two or more family 11 Industrial IN Alteration No. of units: El Commercial El Repair, replacement [I Assessory Bldg Li Others: El Demolition El Other 1 11A N d f e 'g "® atr 0111 DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: All Al Phone: Address: Name: L -Phone: Contractor Na Le-Phone: Email: Address: Supervisor's Construction License: -Exp. Date: Home Improvement License: -E.-p. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. -70�-- -7 3'--, Total Project Cost: $_ /, zl > FEE: $ Check No.: -11-21 Receipt No.: NOTE: Persons contracting with nregistqed contra ors do not have access to the guaranty fund JXN %A®RTH .1 UA T 'T 'T 112 ¢ ..1,, ndu v cr ® to . 'Y i - ver, Mass, 0 A-- r /, r COCHIC11EWICK X01* AERATED S U BOARD OF HEALTH ERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT ..... r ......... �: ..................................................................... BUILDING INSPECTOR ..... � Foundation has permission to erect .......................... buildings on .................................. /.....1........... ............... Rough to be occupied as ...........��?'l�. .E. . .....�.............. .....:... ............................... Chimney >� � o'er ....................................... 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 IIE MONTHS...�...,...�... IN ELECTRICAL INSPECTOR LESS C + I Rough Service ........ ....... 7 .............................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in s Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Segal Construction LLC Estimate A NH LLC Registered in Massachusetts - Manager Jonathan Segal DATE ESTIMATE# Manager's Address:190 Wallis RD. 5/17/2015 3442 Rye,NH 03870 NAME/ADDRESS Robert Segal 118 Sutton Hill Rd. Andover,Ma. PROJECT DESCRIPTION COST TOTAL Dumpsters 1,600.00 1,600.00 Demo 4,000.00 4,000.00 HVAC move ac units,install fans in kitchen,laundry and bathroom Fans to be 3,450.00 3,450.00 provided by owner Insulation 3,315.00 3,315.00 Electrical fixtures by owner 12,000.00 12,000.00 Plumbing Sinks and fixtures by owner 10,000.00 10,000.00 Kitchen cabinet installation cabinets by owner countertops by owner 7,200.00 7,200.00 Flooring does not include preparing floor 15,000.00 15,000.00 Doors and basic hardware 2,700.00 2,700.00 Interior trim 2,000.00 2,000.00 Interior trim labor and installation of doors 6,560.00 6,560.00 Framing materials 900.00 900.00 Framing Labor 6,480.00 6,480.00 Plaster 9,430.00 9,430.00 Painting 9,000.00 9,000.00 Does not include kitchen appliances TOTAL $93,635.00 Either owner may cancel this agreement without any penalty or obligation within three business days of the above date. Attached hereto find notice of cancellation, which shall be used by owner if owner desires to cancel contract. There are two notices for each owner. "Do Not sign this contract if there are any blank spaces" In Witness Whereof, the parties have hereunto set their hands the day and date first above written.. SEGAL CONSTRU TION,L I \ Owner BY: N SEGAL, AGER Owner We carry adequate insurance to protect our customers against injuries to our workmen or the public during the performance of our contract. Page 2 SEGAL CONSTRUCTION LLC A NEW HAMPSHIRE LLC.REGISTERED IN THE COMMONWEALTH OF MASSACHUSETTS MANAGER JONATHAN SEGAL MANAGER'S ADDRESS : 190 Wallis Road,Rye, NH 03870 Tel: 978 580 0125 H.I.C.#132833 C.S.L.#056994 Soe.See.#024-35-3107 CONTRACT This agreement made and entered into this 17th day of May, 2015, by and between Segal Construction, LLC, hereinafter referred to as the "Contractor," and Maralyn and Robert Segal, 118 Sutton Hill Rd., North Andover,Massachusetts, hereinafter referred to as "Owner,"witnesseth: Whereas, said Owner is desirous of having improvements made on the premises known as: Sutton Hill Rd.,North Andover,Massachusetts A. Contractor agrees to perform said improvements in a workmanlike manner for said Owner, according to the following Specifications: Plan drawn by Kerri Frick,RA 05/15/15 B. Said improvements are to be made for the consideration of$45 per hour per carpenter. All materials purchased by contractor will include a 15%markup. To be paid at the end of each week C. To be paid as follows: The owner shall supply and pay for all kitchen cabinets and bathroom cabinets and all countertops as needed for the renovation as well as all plumbing and electrical fixtures. D. The Contractor agrees to start on or before May 22, 2015. The Contractor agrees to substantially complete the improvements on November 22,2015. E. Any changes to be subject to the order and direction of said Contractor and must be in writing. F. Contractor shall not be liable for any delay or nonperformance caused by war conditions, priorities, restrictions, or other regulations pursuant to public authority affecting performance or credit, strikes, lockouts, accidents, Act of God, reduced supplies or material or labor or any other contingency beyond its control. In the event of Contractor's inability for any reason above stated to perform or to complete performance of this agreement,Contractor may at its option cancel or terminate this agreement; provided that in the event of the termination of this contract by the Contractor by reason of any of the above causes after partial performance by the Contractor the Owner shall and hereby agrees to pay to the Contractor such proportion of the entire consideration as the amount of material and labor furnished and performed shall bear to the total amount of material and labor to be furnished and performed under this contract immediately after the termination of this agreement. This agreement is not subject to cancellation. G. If the contractor is unable to obtain all the necessary permits to begin the improvements covered by this agreement by May 18,2015,then the contractor shall be able to extend the completion date one day for each lost day. H. The owner shall have all warranties and rights under the provisions of Chapter 140A of the General Laws of the Commonwealth of Massachusetts. CONTRACTOR TO VERIFYALL DIMENSIONS IN FIELD IKEA CABINETS,RINGHULT HIGH GLOSS WHITE,DUPONT ZODIAC SNOW WHITE OR 16-0' 16U' 16-0' EQUAL COUNTER 13'3' 10-1" 23'-11 12' NEW SINK IN EXrG LOCA71ON IKEA CABINETS,RINGHULT HIGH GLOSS WHITE,DUPONT ZODIAC SNOW WHITE OR EQUAL COUNTER e§v DW oO� OVEN rnVN m KITCHEN MASTER BEDROOM OFFICE � m 01 NEW REFRIGERATOR, N ® ® COORDINATE WATER SUPPLY S- FOR ICEMAKEA REF. 1, IKEA CABINETS,RINGHULT �O m " HIGH GLOSS WHRE a �j IKEA CABINETS,RINGHULT 3 I'-1012' 10-11' g 6• Y HIGH GLOSS WHITE,DUPONT 4 v ZODIAC SNOW WHITE OR 'a N •o U m EQUAL COUNTER ALIGN � � CARPET PAINT EXISTING COLUMN,WHITE -- PURR OUT COLUMN,TO ACCOMMODATE a TILE ELECTRICAL OUTLETS LIVING ROOM N G m CLOSET CLOSET ❑ MASTER BATH ~ O 0 9 IL 0 --�Q 0. FURR OUT WALL,TO ACCOMMODATE ELECTRICAL OUTLETS TILE SHOWER WITH BUILT IN BENCH 4.8,0„ AND GLASS DOOR DOUBLE VANITY WITH RECESSED MIRRORED MEDICINE CABINETS,ROBERN AIO SERIES,OR SIM 120 VAC 20 AM GFI READ. LINEN CLOSET KERRI FRICK,RA Segal Residence 118 Sutton Hill Rd. scale Reference No. 516 Concord Ave. N.Andover,MA Lexington,MA02421 Tel 713-829.9759 05/15/15 A1.01-FLOOR PLAN Date Drawing CONTRACTOR TO VERIFY ALL DIMENSIONS IN FIELD IKEA CABINETS,RINGHULT HIGH GLOSS WHITE,DUPONT lea, 16-0" 164, ZODIAC SNOW WHITE OR EQUAL COUNTER 2317 tlt NEW SINK IN EXPG LOCATION IKEA CABINETS,RINGHULT HIGH GLOSS WHITE,DUPONT ZODLAC SNOW WHLTEOR EQUAL COUNTER N DW 000 OVEN r` b KITCHEN � m MASTER BEDROOM OFFICE NEW REFRIGERATOR, 4 ® ® !' COORDINATE WATER SUPPLY 3` FOR ICEMAKER REF. H R -- - IKEA CABINETS,RINGHULT HIGH GLOSS WHRE IKEA CABINETS,RINGHULT 3 4'-1012' 10'-71' g-S, Y HIGH GLOSS WHITE,DUPONT b o ZODLAC SNOW WHITEOR m N U m EQUAL COUNTER Y q ALIGNPANTEXISTING COLUMN,WHITE CARPET FURR OUT COWMN,TO ACCOMMODATE TILE ELECTRICAL 0UI1tTS a LINING ROOM .4 CLOSET CLOSET ❑ ® c tz ® ® ASTER BATH e ❑ a FUM OUT WALL,TO ACCOMMODATE ELECTRICALOURETS TLE MOWER WITH BUILT IN BENCH AND GLASS DOOR DOUBLE VANITY WITH RECESSED MIRRORED MEDICINE CABINETS,ROBERN AIO SERIFS,OR SIM 120 VAC 20 AM GFI REOD LINEN CLOSET KERRI FRICK,RA Segal Residence 118 Sutton Hill Rd. Scale Reference No. 516 Concord Ave. N.Andover,MA Lexington,MA02421 Tel 713-829.9759 05/15/15 A1.01-FLOOR PLAN Date Drawing The Commonwealth of Massachusetts F Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plum et s. TO BE FILED WITH THE PERMITTING AUTHORITY. Please Print Le ibl ApplicantInformation �� Name(Business/Organization/Individual): ffAddress: 6 R V 0/-2 S -- City/State/Zip: L Phone k 7 Are on an employer?Check ttre appropriate box: Type of project(required): 1. I am a employer with__,_,_employees(Rill and/or part-time).* 7. ❑New construction 2.F1 I am a sole proprietor or partnership and have no employees working for me in 8. [a Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.[�Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 14.0 Other 6.0 We are a corporation and its officers have exercised their right of'exemption per MGL a 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer tJtat is pr oviding workers'compensation insurance for•my employees. Below is the policy and job site information. — Insurance Company Name: Policy#or Self-ins.Lic.#: C. OO u i q S- , cf LAExpiration Date: / l l g City/State/Zip: r 7 � Job Site Address: -..�.,�_ � Attach a copy of the workers' compensation policy declaration page(showing 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. Ido hereby certify ufr r thepgi s andpenaltiesthe information provided ab ve is te ,p erjury that rse and correct. Date: Signature: / Phone#: 7 =f 2 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#: mas'sachusetts _Department o 9 Re Uiatior;s anf Pd.Standards 5oard of 3isildin 9 L44;ic�-afety COnstruction Supervisor License: CS e -056994 � JONA ILAN D SE 190 WALLIS RD�� Rye NH.03870 Ccrnmissioner Expiration 09/0 7l2015 I c�/Xe �por�aT�aoazcaeczl��a�� fQJae�ccaeGta. Office of Consumer Affairs&Business Regulation (�OME IMPROVEMENT CONTRACTOR egistration: ,;169131 Type: S Expiration: -_5/19/201-7-- LLC SEGAL CONSTRUCTION LLC JONATHAN SEGAL 190 WALLIS RD. RYE, NH 03870 Undersecretary