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HomeMy WebLinkAboutBuilding Permit # 8/5/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: " ) I IMPORTANT:Applicant must complete all items on this page LOCATION Print Y OWNER ' . PR OPERT � , Print 100 Year old Structure yes no MAP NO: 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 Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: 9 ) Address: Ex ' Supervisor's Construction''License: ,, p. .bate: Home Improvement License': Exp., Date 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. .w Total Project Cost: $ // 6 ' 6 ° FEE: $ Check No.: Receipt No.: . NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of A ent/Owner ignature of contractor44 �,� f 1 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ t%ORTH town of '� - � _ 1, Andover No. 166- �® __ "� h ver Mass �' �� O LAKE ' ' COCHICNEWICK y1. AoRATED P��,c'�� Y`� U BOARD OF HEALTH M AN T LUFood/Kitchen Septic System THIS CERTIFIES THAT 1p rQ ew 6Q0S... BUILDING INSPECTOR .... ... .......... ....... .......................... .... .... .. ,. Foundation has permission to erect ...:......4bufldings on . C.. .1�,�. ................ . ..... � ..... . .....: Rough lefto be occupied as ........... . �.... ................ ... . ........................................................ 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 IT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR LESS T S�RTS Rough FinalService BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Bulldlna 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. "ERu CUSTOM B (JI LDI NG REMODELI NG This agreement made this 24'day of April, year I Two thousand and Fifteen by and between Cote and Foster Contracting,Inc. hereinafter called the Contractor and Ralph& I Maureen Enos,hereinafter called the Owners, wl 'I-Iaymeadow liesses that the Owners intend to remodel the existing kitchen at the address of 51 Rd.,North Andover,MA. i Now,therefore,the Contractor and the Owner, for consideration hereinafter named,agree as follows: ARTICLE i The Contractor agrees to provide all the labor and materials to do all things necessary for the proper construction and completion of the work shown and described on drawings. The drawings and specifications are the basis of the contract. ARTICLI 2 In consideration of the performance of the contract,the Owner agrees to pay the Contractor, in current funds as compensation for his services hereunder$45,610.00 to be paid as follows: t-)�----Payment 1 -$2,500.00 at signing of contract Payment 2 -$8,000.00 at start of demo cabinets and counters Payment 3 -$8,000.00 at start of mechanicals Payment 4 -$8,000.00 at start of cabinet install Payment 5-$8,000.00 at start of tile I Payment 6-$8,000.00 at start of finish mechanicals Payment 7-$3,110.00 at completion of project ARTICLFJ3 Final payment on contract amount as agreed above to be paid within ten(10) days of project completion or occupancy. If final pay, ent has not been made within this time a 10% charge per month on the balance due will be charged. All minor punchlist items will be complete as part of the one year warranty on the finish product. Failure to pay balance within ninety(90)days may result in legal action. Initials: 7X7 20 Aegean Drive - Unit 15 - Methuen,MAO 1844 Tel: 978-682-6518 - Fax: 978-682-1221 www.coteandfost,er.com i TICLE 4 Additional work above and beyond the contract agreement: All additional work done to be quoted at the time the client requests the work. The work will be done and billable at its completion. The client has ten(10) days to pay the additional cost after he or she has been billed for it. Initials• �/ `���1� ? In witness whereof they have executed this agreement the day and year first above written. I Ralph Enos, Owner Maureen Enos, Owner William T. Foster DBA Cote & Foster i - —148''-- - --69.'— —33"— 51„ -233" -24`--- 24" 51 " -24" 24' 85}" 36": -21 —33" ---24" _.33" _. —85i. . i A N tli - - SCHROCKTRADEMARK BWB21 CNTYSS33 29 DISHW 833RT , ON DOOR MAPLE WITH WHITE PAINT 3-BASE FARM SINK CABINET cx*� "' F33tS PLYWOOD CONSTRUCTION SINK MODEL WHITEHAVEN c: to CEILING HEIGHT 83" 29 11116 X 21 9116 X 9 518 TO BE TRIMMED Cq cu N '- HANGING HEIGHT°7" ON SITE TD9R OPEN SOFFIT SHAKER CROWN FOR CROWN MOLDING SMLR FOR LIGHT VALANCE 8-BASE CABINET WITH 0 � �', TOP DRAWER AND DOUBLE ROLLOUT O � TRAYS 1-SUPER LASY SUSAN 5-PANEL FOR BACK OF ISLAND - . OUTSIDE CORNER MOLDING FOR `--- `--�' - 3DB15 B36RT 3DB15 EDGE SPLEGS(SPOOL LEG)TO BE APPLIED TO THE BACK OF 2-BASE DOUBLE TRASH CABINET THE ISLAND DOORS APPLIED TO BACK OF ISLAND ONLY T II - N SPL --_BP963�3.SCRSGR L G 6-WALL CABINET ABOVE REFRIGERATOR 21`DEEP M C) a �f. 7-WALL GLASS DOOR WITH MATCHING INTERIOR cr _ i N W" 1S 4 165A" 23a -- —31" All � a All dimensions_size designations 4_ This is an original design and must Designed: 5/8/20151 given are subject to verification on TECHNOLOGIES` not be released or copied unless Printed: 511212015 j 1job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. EN®S KITCHEN FINAL All Drawing a- 1 No Scale. The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization4ndividual): rv I:b /" ... Address: 4 1-2.. City/State/Zip;,Al �` " Phone#: a / Are you an employer?Check the appropriate bpx: Type of project(required): 1.❑ I am a employer with 4.eK✓J I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.# 7• Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp,insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.E]Roof repairs insurance required.]1 employees. [No workers' 1311 Other comp.insurance required.] kny 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. :ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site formation. tsurance Company Name: eb er)/a 1 Ae-c,- V_ A" t)V 5 7- a../ :)licy#or Self-ins.Lie.#: C` '414/4 ° Expiration Date: el wb Site Address: / r t �a o City/State/Zip: lVe .7-6t 14A,,,I)e rt k ltoq- ttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). tilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ie up to$1,500.00 and/or one-year imprisomnent,as well as civil penalties in the form of a STOP WORK ORDER and a fine .up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of vestigations of the DIA for insurance coverage verification. lo Hereby certify under the pains and penalties of perjury that the information provided above is trite and correct. mature [ r z Date: Lone#: !� 414 te''tf C� 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#: AC®R ® CERTIFICATE LIABILITY IU DATE(MM/DDNYYY) 5/6/2015 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 PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, 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 CNTACT NAME: V]Ctoria Lowes, CISR MTM Insurance Associates PHONE (978)681-5700 AA/C o:(978)681-5777 1320 Osgood Street ADDARIESS:vickiel@mtminsure.com INSURER(S)AFFORDING COVERAGE NAIC# North Andover MA 01845 INSURERA:State Auto Insurance INSURED INSURER B�,IG Casualty Company Cote & Foster Contracting, Inc INSURER C: 20 Aegean Drive INSURER D: Unit 15 INSURER E: Methuen MA 01844 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 master List 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 CONTRACT OR 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 TYPE OF INSURANCE ADD B POLICY EFF POLICY EXP LTR D POLICY NUMBER MWDD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $ 300,000 A CLAIMS-MADE Fx_1 OCCUR BOP2722545 12/31/2014 2/31/2015 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY JECT PRO LOC $ AUTOMOBILE LIABILITY COMB INED(SINGLE LIMIT d1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDX SCHEDULED BAP2370166 02 2/31/2014 12/31/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per acc dent Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATIONX WC STATU- OTH- AND EMPLOYERS'LIABILITY y/NLIM ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) 0004962937 6/20/2014 6/20/2015 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Property Coverage OP2722545 12/31/2014 2/31/2015 Business Personal Property $40,491 Scheduled Equipment 2/31/2014 2/31/2015 Contrctors Equipment $169,928 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder as listed below This certificate of insurance represents coverage currently in effect and may or may not be in compliance with any written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 384 Osgood Street AUTHORIZED REPRESENTATIVE North Andover, MA 01845 //��// P MacDonald CPCU, CIC �dlr'!/"'>;44 ACORD 26(2010106) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9rrinnsN ni Tho A('rl!P l namo unrl Innn mro ronia4ororl mnrlre of Arnon