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Home My WebLink AboutBuilding Permit # 7/17/2015 FORTH BUILDING PERMIT OF�zL�D �6 1N TOWN OF NORTH ANDOVER Aa APPLICATION FOR PLAN EXAMINATION _ Permit No#:� Date Received '� AD`�greDWPea'�y gSSACHlJS�R Date Issued: 'IMPORTANT: Applicant must complete all items on this page LOCATION { %5` 15 ,zz1 V Print PROPERTY OWNER C-,:, rr , �a Print 100 Year Structure yes n`o MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: I/z ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other j� f,r r xa /f r t ® Se tics U1%ell x % ❑ Flood Iain ,r Wetlands r k� Watershed eDistncf �t. �i'f� r� ' r'Y�, ^� ,., sa; ✓ � DESCRIPTION OF WORK TO Bf PE FORMED- j, Identification- Please Type or Print Clearly AOWNER: Name: Gam: O-) wo",e. I Phone: I S LIS L�3 Address: lay ;— �udjt'zf) -5-1 r Contractor Name: 1')2 1-L -T"- L:, /,Lc-i-o Phone: - Email: Address: S6 C c�tS-f�.' Supervisor's Construction License: 6 �s �/ Exp. Date: Home Improvement License: ill Exp. Date: :2&?--? ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ , L/® C) FEE: $ Check No.: Receipt No.: C�q NOTE: Persons contractin with unregiste contractors do not have esess to the guaranty fund -- -- i NoRTH Town of _ E : 1, ndover O -� - �' 0 Z n h ver, Mass, I COCKICHt WICK X11,9 Teo �" '(2 S tI BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT �.T...... . . BUILDING INSPECTOR .................. v ...... ..........^................................................................ cc Foundation has permission to erect .......................... buildings on . .�.d .........�?�?.I..�. l.`ti`� ......................... L Rough to be occupied as ......� Ob I ..�`�`! `��• ......�'......... ........ ........... ............ ........................................ 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 CONSTRUCTI ST..... TS Rough Service ........... ........ ................................................. 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. Daniel Construction Company 56 Cordis St.Wakefield,Ma.01880 Proposal Corey and Jessica Manuel 105 Sullivan St. No.Andover, Ma. Scope of work: remodel existing 3 d floor Contractor will: • Pull permit • Frame existing 16'x34'3rd floor • Frame for bathroom, laundry room,office and storage room • Install plumbing to code for bathroom and laundry • Homeowner to provide all plumbing fixtures • Install electrical to code; recessed cans on flat area of ceiling • Outlets to code throughout area • Install electric heat • Supply and install (2) 5'x4'window units • Insulate to code • Blue board and plaster all walls and ceilings • Tile and grout bathroom floor; homeowner to supply tile and grout • Install doors and door trim as needed • Install window trim and baseboard as needed • Install prefinished oak floor to match existing • Trim outside of windows to match existing • Install oak treads with pine risers • Build access panels for storage • Dispose of all job related debris Totalcost of Labor and Supplies..................................................................................$46,400.00 Payment schedule..........$12,400 to start............$5,000 after rough plumbing...........$5,000 after rough electric..........$5,000 after rough bldg.. inspection........$5,000 after plaster.............$5,000 after finish trim..........$4,000 after floor installation.........$5,000 upon completion < r t i P� / _• , 4 x > 4 The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Let=ibly Name(Business/Orgarrization/Individual): r 7— In Address: J �t City/State/Zip: 1�`ck e� 1�1��r MA ( Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am.a.employer with employees(full and/or part-time).* 7. E]New construction 2, am a sole proprietor or partnership and have no employees working for me in 8. �emodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 0 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.F1 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E]Roof repairs These sub-contractors have employees and have workers'comp.insurance.# 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[]Other 152,§1(4),and we have nemplo o. yees.[No workers'comp.insurance required.] *Any applicant that checks box#i 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. lam an employer tfiat is providing workers'compensation insurance for•my employees.'Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: 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 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. I do hereby certifyun, r dethe pains and pe r ofperjury that the it formation provided above is true and correct. Signature��A-"—, Date: ® � 1 Phone#• ( �/ `l`L/ 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.PIumbing Inspector 6.Other Contact Person: Phone#: Massachusetts -Department of Public Safety Board of Building Regulations and Standards - flrJ Construction Supervisor License: CS-067334 V:i MARK T EMERO- 56 CORDIS ST WAI-CEFIELD MA 01$80r 1 M", c ✓ ��/� �r„�+�`� Expiration j 11108/2015 Commissioner Office of Consumer Affairs&Business Regulation OME IMPRGV€MENT CONTRACTOR egistration: 122114 Type: Expiration. 712312016, Individual f . MARK EMERO f MARK EMERO 56CORDIS STREET WAKEFIELD, MA 01880 � — Undersecretary x