Loading...
HomeMy WebLinkAboutBuilding Permit # 7/27/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION h Permit NO: =''9iT� -Date Received Datelssued: t S IMPORTANT A plicant must complete all items on this page qrl"u, 4 _ RORE`Y&'O NE ::= dtue �CTv AA\`.fJO C _- �d NG© ` Isa€lam is Ys- e. TYPE OF IMPROVEMENT. PROPOSED USE Residential Non-Residential New Building ❑One family ❑Addition ❑Two or more family C Industrial ration No.of units: ❑Commercial ❑Repair,replacement ❑Assessory Bldg ❑ Others: Demolition ❑Other �ESe 5cy �ell�\`�\����F�`adPlaid�p,N/`etlantls�� b Wate7shed-DrstCct�\�\- DESCRIPTION OF WORK TO BE PERFORMED: M P��i RR ZdRQyn1 tZ�moD�� Idenfification Please Type or Print Clearly) G OWNER: Name:Cc,446� -it7'- !MA-RK 'es�`rr-6,n Phone-b �'G��t'37y Address % �yM AN R6,+1D \\ \ � CONTRAC�OR f�a e� PbOn A�ress S,i] eet�sors Cans�t�ctiolL�ee ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT;$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F. Total Project Cos{; , FEE:$ ' Check No.: z-`�� - Receipt No.: NOTE: Persons contract" with unregistered o ac rs do not have access//o�to th guarantyfund Signature ofAgent/Own r" ature of contractor 4t ` Plans Submitted'u Plans Waived❑ C ified Plot Plan❑ Stamped Plans❑ Town of Mass, J"I BOARD 01 HEALTH PE"T TO ILD 'Z11sy— provided thatthe person accepting this permit shall in every respect conform to the terms ofthe application Fi-I 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. R..gh PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTr,STARTS R.ugh � � BUILDING INSPECTOR GAS INSPECTOR QecupancV Permit Required to Occupy Buildin R-gh DisplayinaConopcuouuPbuoondmPmmiso»—DoNntRommm NoLathing mDry Wall§BeDone FIRE DEPARTMENT Until Inspected and Approved bythe Building Inspector.' M ROBERT LANGEVIN Building&Remodeling,LLC 795 Dale Street North Andover,MA 01845(978)686-3607 HIC#111990 FID#26-0816298 _Lang-inBuilding.com Job Description Colleen Kiley and Mark Barnard 94 Lyman Road North Andover,MA,01845 Bathroom renovation 1.All necessary permits 2.Portajobn 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 10.Upgrade wall insulation to R-15 and ceiling insulation to R-30 I I-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%"X 3%"flat stock clear primed pine 14-Install new medicine cabinet 15.Install tile on floor,tub walls to ceiling and other wall surfaces halfway up 16.Install finish plumbing fixtures 17.1'aint plaster walls and ceiling 18.A11 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 ROBERT LANN NEVI Building&Remodeling,I_I_C Domneowuer Idafformation CouBractor lot-—atiou Name ep/1�J<E N£ KI L€y Company Name � Mf�RK Bf} f}RD OBtEP�T LAnIG��iN 6ln�z�(ZEmo)�<)n/G 2,t_c StreetAddress(do not use aPost Office Box address) Contractor/Saleep—ado—losses, Cara— state Zip Code Business Address noun include a street address) P7f) AND tette 618y5 7%� D+4'dE Sr 9�0 Daytime Phone Evening Phone Chy/rown S e Zip Code 6»66937 f6 auo2T Q D�✓ MFl orgy. Mating Address(It different from above) Business Phone Federal Employer m or s.s.Number nuwprc�m�commm .g .M, spaaeoc nu mp— ad aeovemev //�`�9 O a /! /7 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to wmple[ed,specifying dre type,brand,and Bade of ma[eriads to be usetl, dd" I I '£ .) /�ccoY ✓'i41"/Nr- T�13 �5�21 �1� Required Permits-Thefollowingbuildingpersutsarerequired Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered m unless circumstances beyond the contractor's control arise (Owmcrs who secure their own permits will be it excluded from the Guaranty Fund provisions of � )7 ;whet,contractor will begin entmeted work MGL chapter 142A.) fS �P �! Dewhen cook'acted wodc will be snbstantialty completed. Tohrl Contrast Price and Payment Schedule f The Commetm'agrees to perform the work i mish the material and labor specified above for the total sum of 0} Payments will be made accordingto the following schedule: 5r9RT �� contract price or the cost of special order items,whichever is greater) by_/_/_or p..completion of $ by / /_or upon completion of S a upon completion of the contract.(Law,forbids demanding fall payment until contract is completedto both party's satisf tion) The following mamial/equipment most be special $ robepadfia ordered before the contracted-dc begins in order to meet he completion schedule.("=) $ robe paid rot NOTES:(e)including all finance charges(c')law requnes that arty depositor down-payoent inquired by the contactor before work begins may aptexceed tlo gasteref(a)one-thad,file,last contract priceor(b)the,and cost ofanyspecial equipment or custom made material which must be special ordered in advance be meet the completion schedudd g W lv-Ywh' "ddb H M t n V ❑Y (Il to tM w th dandC th a t) Subcontractors-The c.ntmeter agrees to be solely responsible for completion of the work described regmdless of the actions of any third patty/subcontrnaor utilieed by the contractor.The contractor further names to be solely responsible for all payments to all subcontractors for materials and labor vader this au Bement Contract Acceptance-Upon signing,this document becomes a binding contract under law. wi Unless odierse noted within this document,dee ct contrashall not imply that my lien or other seomity interest has been placed on the residence.Review the following cautions and nodeas carefully before signing this contract e Don't be pres ned into signing the card.t.Talc,time to read and fully understand it Ask questions if something is rtes,. Make sure the C..-..,has a valid Home Improvement Contractor Reen trea o t The law requires most home improvement conom,Core and subconv-.to be registered with the Director of Home Impowhenent Cmhodemr Registration.You may inquire shout contractor regisnpr ion by writing to theDirector at 10 Park Plana,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. e Does the convector have insurance?Ask the Contractor for his ireardace company information so that you can confikm coverage,or ask to see a copy of a"proof ofinsumnce"doatment Know your right;and responsibilities.Reed the Impenitent Information on the ravers,side fthis form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this ageem,nt if it has been signed ata place other than the contractor's normal place.fbusiness,provided you notify the oodn"r in writing at his/her main office or branch o1Tee by ordinary mail ponied,by teleg'am sent or by delivery,not later than midnight ofthe third business day following the signing ofthis agenntent.See the attached notice of esocallatione form for an explmtation ofthis,ight. DO NOT SIGN T ONTRACT IT THERE ARE ANY BLANK SPACESM Swo,rn m ern sofarc o pekd stud sg�ed.Ore ceM shoWd goroNe homeewne.Theether wpy should be kept by the mntubr. I- ,owner Signature/ Contractor's Signature Date Ince - �. Office of Consumer Aflzirs&Business Regulation E —ROME IMPROVEMENT CONTRACTOR a ,Jiegist2tion: .111990 Type: rc �;'E piration 2/11/2017 LLC ROBERT LANGEVIN BLDG&REMOLDING LLC, ROBERT LANGEVIN 795 DALE ST N ANDOVER,MA 01845 —` Ilutlersecrehry Int se D p -'�e e u oartl.,r B�1q.ny R�y„I zt:on=�,.d�ca..aad:, �s CS-002685 I` ROBERT M LANGEVIN 795 DALE ST HANDOVER MA 01845. 02/24/2016 The Commonwealth of Massachusetts (u - Department oflndustriatAccidems Ma. Office ofluvestigations � IVY 600 Washington Street; t Boston,MA 02117 (,. _ www.mossgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plambers A licant Information Please PrinfLeeibly Name(Business/Organintionlmdividuap:RO E-R- /—A 1-Y-F-V1 P -49/X—ff R yh�I ANG HG Address: city/State/Zip: s ty_ A N7�€� n1R Phone#: 9-77 6 F631So7 Are you an employer?Check the appropriate box: Type ofproject(required): 1.❑I am a employer with 4.❑i mn a general cormac,.r and I 6.❑New construction employees(full and/or part-time).• have hired the sub-contractors 2. [am a sale proprietor orpartner- listed on the attached sheet t Z yodeling hip and have no employees These sub-contractors have 8.❑Demolition ;.king for me in an workers'comp.insurance. 9. Buildm addition g y capacity. 5.❑We me a corporation and its g [No workers'comp.insurance °w 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑I am a homeowner doing all work right of exemption per MGL 1 l.❑Plumbing repairs or additions myself[No workers'comp. c.152,§1(4),and we have no 12.❑Roofrepairs insurance required.]t employees.[No workers' 13.❑Other omp.insurance required.] *Any applicant thaz cM1ecks boz#1 must also 61t out the section below sM1owing Heir workers'compensazion polity information. t Homeowners who submit this atYidavit indicating thry are doin6 all work and then M1ire outside conhactom must submit a new affidavit indimting such. $Contracrom drat check Ns box must attached an additional sheet showing the name of the sub-covtractors and ihev workers'comp.policy information. l am m employer that is providing workers'compensation ins meefor my employees 8e1om is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/zip.- Attach a copy ofthe 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 oferlminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form ofa STOP WORK ORDER and a fine of up to$250.00 a day against the violator.Be advised that a cepy ofthis statement maybe forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. I do hereby c fy u the pa" dl penaaies ofpeq,uy that the information provided ab a it tru and correci . t��G-�/ �-Gtr^-'F-P�v� Date- ���-7�I Official use only.Do not write in this area,to be completed by city ortowo I ficial City or Town: PermittLicense# Issuing Authority(circle one): I'Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: