HomeMy WebLinkAboutBuilding Permit # 6/17/2015 "®Rry
96
BUILDING PERMIT
TOWN OF_NORTH ANDOVER ® ,
APPLICATION FOR PLAN EXAMINATION ®y
Permit NO: 104 6 -f, Date Received
� wY@O PP
CH
Date Issued.
RT'ANT: Applicant-must com lete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
11 Addition El Two or more family 11 Industrial
❑ Aeration No. of units: ❑ Commercial .
Y%Zepair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition 11 Other
❑Septic . �WPIC �Flc�odpla�rY ❑ '7f,77 -7777
1Netl�nd� � � Watershed �xs�rrcf
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Identification Please Type or Print Clearly)
OWNER: Name: IJAi iAvv ( ( Phone-_L\ ci '-Y _C1,
Address:
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ARCHITECT/ENGINEER Phone:
Address: Reg. No. �1
FEE SCHEDULE;EULDIPIO PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST EASED ON$125.00 PER S.F.
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Total Project Cost: $ D 19 , 4 FEE: $
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Check No.: 114 Receipt No.: Q ,2,6 �>
cl contractors Flo not have access to the uaran un�l
Wath ante Istere �'f
contracting �
NOTE: Persons n III
%g�afr�� Anf/ �rter ' S�g�ature cif corttractdr ��� :� - ^�
C®®RTH
_t own of
Alladover
® ,, �•. 1 "t
® ® •? - _
nO LAKE y • Vl' MASS'
COC KICNE WICK��•
�d A°RArE0
S U -
BOARD OF HEALTH
Food/Kitchen
PERmmml �T T U Septic System
THIS CERTIFIES THAT ...e�1( fJ C 0.;12.` ............... .................................................. BUILDING INSPECTOR
"�,-7. � / Foundation
has permission to erect .......................... buildings on . < xG�......................................
Rough
to be occupied as `A..1.�:�:.......! (...lery
S ���R
p� ..................... .. ... .. ............ Chimney
provided that the person accepting this permit shall i respect conform toms 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 IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESSTIO S RTS Rough
Service
.............. .... ... .. .. . . ....................................
BUILDING INSPECTOR Fina
GAS INSPECTOR
Occupancy Permit Required t® Occupy BulldinRough
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.
i 5 inn.
I'a istrafiOn 0 139495
Construction Licenseff 80815
Federal 11.13#27O4 1848
Customer;
Bill Cooper
37 Rock ltd
North Andover,MA 01845
f.ONTRAC
Sid rj *preminted Hardle clank-smooth
Replacement of the following:
All siding including all window/sills and door trim
Remove and replace existing siding with*Jaynes Hardie Plank
Removal of existing siding including under lament and nails as required
Installation of James Hardie wrap and tape to complete exterior of home
installation 5.25 or 6.25 with 4 or 51nch exposure*Hardie Plank
All siding will be fastened using 2 Inch galvanized ring nails
All trim boards will be 5/4 x 6 Hardie boards fastened with a hidden fast ning system(pre-painted)
installation of composite window sill nosing(solid vinyl composite)
All municipal permits and fees Included
All Dempster fees and disposal included
Total cost of project including all materials and labor...........................................................................„,...............,,................$27,430.00
4t � tl,dxp EG'm6kt v'�+pr�eYBRak
*Sheathing per 48 sheet$85,00
*NOTE:Electrical permit,including removal and reattachment of the eletrical service meter,is included in total cost.Array and all
subsurface electrical issues or code violations will be presented to the homeowner by a licensed electrician,if any.The homeowner
is responsible for any and all work plus cost related to any and all poten ial code violations.
Roone
t ascia boards sofflts/Rake Boards
Remove and replace all fascia boards with composite boards composite naterials approximately 115ft.....................................$1465.00
Remove and replace soffits with Y Inch hardle panel board solid approxi ately ll5ft....................................................................$146,5.00
Remove and replace rakes with 1x6 hardle trim or composite approximately 11O11........................................................................$1290,00
6iutters
Remove and replace 5as K style white aluminum seamless gutters with le f guard-115ft
Total cost of project including all materials and labor... .....................................................$2,929.00
Siding color__5.25 Artic White
"frim colorArtic White ,_, —
Total cost of project including all materials and labor.................................................................................................................$34,579.00
HardieCredit.................................................................................................................................................................................................1,000.00
Total cost of project including all materials and labor...............................y.,..,,...............,...,.,... ....,...,.....,..,.,.$33,579.00
Payment schedule: !(
Deposit for siding order:$8,000.00
Start date:$S,00D.00
Upon stripping of complete home:$4,000.00
Upon completion of 25%of siding install:$4,000.00
Upon completion of 50%of siding Install:$4,000.00
Upon completion of 75%of siding:$4,000.00
Upon completion of 100%of siding:$4,579.00
ICS Bi f oaper
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4 The Commonwealth of Massachusetts
Department of IndustrialAccidents
Office of Investigations
W I Congress,Street, Suite 100
Foston,MMA 02114-2017
www mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/OrganizationClndividual):
Innovative Contracting Services Inc
Address: 339 Pleasant Street, Second Floor
City/State/Zip: Malden, MA 02148 Phone#: 781-393-4427
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 8 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. E]New construction
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g, ❑Demolition
workingfor me in an capacity. employees and have workers'
y p tY� 9. ® Building addition
[No workers' comp. insurance comp. insurance.t
required.] 5. ® We are a corporation and its 10.E] Electrical repairs or additions
3,❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] t c. 152, §1(4),and we have no Renovation
employees. [No workers'
13.® Other
comp. insurance required.]
*Any applicant that checks box 41 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 state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp,policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: John M. Costello Insurance Agency (Travelers)
Policy#or Self-ins. Lic. #: 7PJUB-471 OP86A Expiration Date: 7/1/2015
Job Site Address: OCL r ..0 11; City/State/Zip; ��y �,, (�h ,(�ay�.-� go (,-)I b'-I
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 WORTS ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
�,
I do hereby certify under,theme%r?s aM, p�ti`&hies of perjury that the information provided above is true and correct
Signature: Date:5�/ °(
Phone#: 731-393-4427
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License #
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
E1: 7- S J�'i•S!�
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1�( Massachusetts - Department of Puoi c Sa?ety
Board of Building Regulations and Standards
Con.truction Supen is,)r
L;cense. CS-080815
EMANUEL F COg-LHC1_ ..i.
51 HAWTHORNS Simi
Malden MA 0214$ .
Con'mis>ioner 03/30/2016
Office of Consumer Affairs& Business Regulation
, QMEIMPROVEMENT CONTRACTOR
registration: 171578 Type:
3, ,expiration: 3/29/2016 Private Corporation
INNOVATIVE CONTRACTING SERVICES INC
EMANUEL COELHO
43 THORNDIKE ST
CAMBRIDGE, MA 02139 Undersecretary
The Comrnarawealh of Massachusetts
Department of Fire Services -
Office' of the State"Fire Marshal.
' • ;r P:O.Box.1025 5t<1taRoad,StoW_RIA 01775
'APPLICATION FOR PERMIT
Date:
` N. A n:d o v e r T ermit:No Dig safe Numb
(Cityor Town) . (HApplicable)
Laaeeordanc -with thcprovisioas-ofMG_L- Chapter - 10 as
provided in Section 527 CMR 34 • application is-hercby made _ StartDate '
9 t •
C OTC(it) �" �--
(Full,name ofperson,Firm or Corporation)
'State clearly ' AddressJ� - ( j/`� l �� ��1� A;1 4r cj__L �
purposefor (Street arP.O.Box City arTowa)
wiuchpemai Forpeamssioato locate dumpster' for constr C i an/ novati nn/(iamnl i t--i•nn
isrcqucstcd
of building.
Comments: dumpster" must be 25from structure or *covered' whPri n•nt fn ,ire
at
(Give location by street and no.,or dcscn e in such manner as to'provied adequate idcatifrcatian oflocalion)
Name of competent'operator CerG'No.
(IfApplic blc)
DateIssucd-rejected r, Z( _S7_
(SignatureofApplicant) -
Date of expiration Au--y5 S; �Q f�` Fee$ -90 .00 Paid $, Due
The -Commonwealth of PlassaGhusetts :.
' Department'of Fire ServicesIVA
Office of the State Fire Marshal
P.O.Box 1025 SLde'Road,..Stow,MA.01775 '
PERMIT '
Date:
North Andover )Permit3Vo
Di Safe V= er
•(City of Town) (If Applicable•)
In accordance.with the provisions of k-GL 14 8 Chapter TO asprovided in section
_52-7—EMR. 3 L}
Start Data
This Permit is granted to:.
Full name ofperson,Firm or Corporation
Permission to locate dumpster • for construction/renovation/demolition of building.
Co=ed:" dumpster. must be. 25" from structure if unable to place with required
Restrictions:clearance dumps-ter must be covered with plywo"od or tarp end of 'work dap
(Give location by street and no.,or describe in such manner as to provied adequate identiEcation of 16catioa)
FcePaidS 50 .00 f' 142- Fire Chief
This Permit will expire (Signature of offical ) g pe (Tide)