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Home My WebLink AboutBuilding Permit # 10/14/2015 0ORT111 BUILDING PERMIT 0 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION 74 Permit No#:44k7& Date Received ArED t C USE Date Issued: Z--b Inl=Z4 C kMf ORTANT: Applicant must complete all items on this page LOCATION zcl"J LT Print R -VR PROPERTY OWNERW4W o - 24� Print 100 Year Structure yes no 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 El Addition El Two or more family El Industrial C"Iteration No. of units: [I Commercial El Repair, replacement El Assessory Bldg 11 Others: El Demolition El Other e / �/r � f , � Irl Vii, DESCRIPTION OF WORK TO BE PERFORMED: Re 0V 4- .2-1 C A 9 -1, C, Identification- Please Type or Print Clearly OWNER: Name: Rc), T)z',i- ,'S'2-,t)4, Phone: 9A, eS'3 32,30 Address: �-� I u,,v zu,-j S-7 /u, Ao Dooe A Contractor Name:L,12,* Phone: !2,2k - 4 1q c,> Email: Uf)')cLit vc`o' ��) Address: U 4�: ,),?"r D 0 ee 4 Supervisor's Construction License:Cs C)s 2 2 Exp. Dater 1z �117 I Home Improvement License: LO,2 e 7 9 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. Total Project Cost: $ oc FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to ha ntynd n. r."n rn a . ........ t%ORT r Town of ndover 0 No. C, h a " 14 0 COC LAKE "I CHEWICK I.? -4ATEE) P" BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT .................. .......... .......................................I............... BUILDING INSPECTOR A Rough tobe occupied as ............ ......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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR X3 . UNLESS CONSTRUCTION Rough Service ....................n............................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy By Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final FIRE DEPARTMENT No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. CONTRACT 9 Curtis Avenue•Middleton,MA 01949•Phone/Fax:(978)774-1430•Email:iemaycc@gmait.com•www.lemaycc.com -Page 1 of 1 Submitted To: Bob&Deb Gesing Date:07/07/15 61 Union St Location: Kitchen North Andover Ma 01845 Work Phone: We hereby submit specifications and estimates for: Remove existing cabinet doors and drawer fronts. Modify existing cabinets to meet new layout. Build new base and upper cabinet at old Ref.location. Build new doors and drawer fronts and install new hinges reusing drawer slides. Install 4 recessed lights and ceiling fan. Install under cabinet lighting and lights over sink Install blue board over existing ceiling and skim coat plaster Complete trim work as needed and install crown molding in kitchen Prime and paint walls ceiling trim and cabinets with 2 coats finish Repair tile floor(Tile and grout by owners.) Install new sink and faucet provided by owner. Install new Garbage disposal,Install new baseboard heat Clean area and haul away all trash Material $1375.00 Plumbing $2300.00 Electrical $3550.00 Plastering $1800.00 Painting $2900.00 Labor $9000.00 Trash $125.00 Total cost $21,050.00 Not included in quote. Permits,Fan and lights at sink,Hardware,sink& faucet,Floor tiles and granite. Any additional work needed will be based on material cost and labor cost of$50.00 per man hour. Payable as follows..$6,000.00 at start.$6,000.00 after rough inspections with balance upon completion All accounts are due and payable upon receipt. Finance charge of 1.5%per month,which is an annual percentage of 18% on all accounts over 30 days. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviation from above specifications involving extra cost will be executed only upon written orders,and will become an extra charge over and above the Authorized Signatu estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado,and other necessary insurance. Our This Contract may be withdrawn us ifnot accepted within 45 days. workers are fully covered by Workmen's Compensation Insurance. ACCEPTANCE OF CONTRACT-The prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. SignatureA".' ' Date ' LEMACON-01 CONNIEI CERTIFICATEF LIABILITYI lJ N� DATE(MMIDDNM) 711$/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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsemer t. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Connie Parent _ Elliot Whittier Insurance Services,LLC NAME:PHONE (978)977-4$84 F4'f (978)977-0850 75 Sylvan Street Suite 8202 _(A/c No Ext _ _ (n/c No:._ Danvers,MA 01923 EMAIL ADDRESS;iiifo@elliotwhittier.com _ INSURERS)AFFORDING COVERAGE NAIC# INSURER A:4orfolk&Dedham Group 23965 INSURED INSURER B: tica National Insurance Group Lemay Construction Co.,Inc. INSURER c: 9 Curtis Ave. INSURER D: _ Middleton,MA 01949 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN SSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY ONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TH- POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDL CED BY PAID CLAIMS. INSR ADDL SUBR PO ICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER I 1MMJ3DfYYYY`) MMIODIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR R1368489A 0711412015 07/14/2016 A AGR-ENTED pREMISEs Ea occurrence) $ _ 5_0,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY _ $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ 2,000,000 X POLICY u PR 1-1 LOC PRODUCTS $ 2,000,000 L�1 JECT _ --- OTHER: $ -- AUTOMOBILE.LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ___ A _ ANY AUTO R1368489A 07/ 412015 07/14/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS XXNON-OWNED PROPERTY DAMAGE $ '.... HIREDAUTOS AUTOS _tPeraccident __— r � X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE U1405570A 07/14/2015 07/14/2016 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION v TPER AND EMPLOYERS'LIABILITY STATUTE ERH_- B ANY PROPRIETORIPARTNER/EXECUTIVE Y/N 4444382 07/14/2015 07/14/2016 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? ® N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe atta had if more space is required) Carpenter/Remodeling CERTIFICATE HOLDER CANCEL TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E PIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE REPRESENTATIVE xll v O 1988-2014 ACORQ CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts F Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston,MA.02114.2017 www.massgov1d1a Workers'Compensation.insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TSG PERAUTTING AUTHORITY. A licant Information pPlease Print Le 'bl NaMe(Bulln siness/Organizationdividual): ✓/ e+ 1 G1 1C"1F _0 C)v, '' m Address: d2'� (� City/State/Zip: M2I&I(IA) -4 Q&� Phone#: 7A — )y` d/3 C) Are yon an employer?Check&c appropriate box: Type of project()tegnired): 1. I am a employer with ,—employees(full and/or part-time).* 7. F1 New Construction 2,[]I am a sole proprietor or partnership and have no employees working for me in 8. [1 Remodelirig any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.E]lam a homeowner doing all work myself[No workers'comp.insurance required.]t 10E]Building addition 4.❑lam 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 ILE]Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insivance.1 6.❑We are a corporation and its officers have exercised their right of exemption perMGL c. 14.F1 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 41 must also M out the section below showing their workers'compensation policy information. i Homeowners who subiiiif this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. sContractors 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 conirac[ors have employees,YE 'must provide their workeis'comp.policy number. I am an employer that ispNovidingwoslcers'compensation insuranceformy employees.'Below is thepolicy andjob site information. Insurance Company Name: �/'7r`.:etq /UA'7 ZCC �QV41,. :7A6k;RAAJ t CR,0 '1 Policy#or Self-ins.Lie.#: _ NV#3 %2 i Expiration Date:_V, /'4, Job Site Address: A*/t yA ' &A) City/State/Zip:b4m A Ji)C1VL1 t Moo)" Cili `'l - Attach a copy of theworkers'compepsation-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 this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do Xaes-by certify un r the ins andpenalties ofpetj�ury that the information provided a ve is rue and correct. thone, re .m Date: ®� 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#: Massachusetts -Department of Public Safety Board of Building Regulations and Standards iYt-^rtiuCtiii ii si.iiie 'bi ur ...... License: CS-051698 ` ROGER A LEI" 9 CURTIS AVE : 16 O MIDDLETON MA Ol r ✓.+�«w �r1tit�` ` Expiration Commissioner 06/19/2017 'Fr W 110;,„req/i/ Office of Consumer Affairs&Business Regulation ,�� OME , IMPROVEMENT CONTRACTOR registration: 102679 Type:. x � ,Expiration: 7/2/2016 Private Corporatio LEMAY CONSTRUCTION CO.INC. Roger LeMay 9 Curtis Ave Middleton;MA 01949 Undersecretary 3 0....: OSHA U.S.Department of tabor 4' Occupational Safety and Health Administration Roger A. LeMay has successfully completed a 1CWhour Occupational Safety and Health Training Course in Construction Safety&Health James Rodger 9/11 /11 (Trainer) (Date)