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HomeMy WebLinkAboutBuilding Permit # 4/25/2016 UILDIN PERMIT � °�D �-1 TOWN OF NORTH ANDOVER 1° Q APPLICATION FOR PLAN EXAMINATION =� tr n. Perrrtif NC➢ Date Receivedxre4oW�Ppe$� $SegCp'0 Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION . Print PROPERTY OWNER_ as^�. , t �,� ,(:e � ,�'..,�....� Print 100 Year Structure yes no MAF' PARCEL: 5 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Nan- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other r f YIIYP n dm �:a, (fpf;Wl "'li(Yal' ✓/Y f'/,�/'f'r r/ %/"/ r; "9 'r f✓aa✓ON ✓ ✓r �r.✓✓ ra r,.., i , T�PII(F`''>dY(IIJI� DESCRIPTION OF WORK TO BE PERFORMED: rw "t I N' Identification- Please'Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name:-Le-5, i Phone: c & Email: I s:��ar� ttm �� �� ti Address:_jo (-t,L,d,,A6L1 S-f- ° l N %/C eO L Supervisor's Construction License: cs i032'la- Exp. Date: 10)' � , Horne Improvement License: iq Ll /to 2 Exp. Date I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: , �l k�� 1 $ �; I FEE: $ Check No.: Receipt No.: ° NOTE: Persons contracting with unregistered c ntractors do not have access to uaranty fund ,,,.., ,,�.N,✓.r.;;. ., /rr%.::,�/r///✓.//y.,.,r :✓ ///<J�/r,./r,r D//r n r%r//r/,/o/,,mo///„ri�r////%„,r.r/%�r�/�r,..r./�.,,.r/:l,,,r/r//irf,,,i✓,,,,ri✓,io.,rrrriir a/,/�i, ,..„.l.i7u7i,/�a rr/r�;,7rrte�rf0,�oc�.G,,...s..,�r/,.r/i�ii///�r tr�acf7fF�r/",.�/� , ifr�or� ir /i/ .✓/„r � I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swnnuning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m H FORM n j i PLANNING & DEVELOPMENT Reviewed On Signature_ OMMENTS CONSERVATION Reviewed on /,;z Si nature COMMENTS HEALTH Reviewed ori Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FireDep�artment sign�„ature/date r f r { r 'rVy r a yr`� ✓r fir/ �' �� J iw� !r COMMENTSf` t` NORTH Andover Town Of ONo �1 ® ZT - h ver, ass, a. A- COC MIC I49-�[a`y A04ATED rQp,`'(y BOARD OF HEALTH '9S U Food/Kitchen =T Septic System tjER evA BUILDING INSPECTOR ........................... A •, Foundation THIS CERTIFIES THAT ...........••••••• .. ". . has permission to erect .......................... buildings on .... ... ....... ... � ... .... .................. Rough �j/►� Chimney Y+• . .. Iica$ion be occupied as . .;# ..�.•• ct con orm to the'terms of the app Final to p provided that the person accepting this permit shall in every re Laws relati to the Inspection,Alteration and PLUMBING INSPECTOR on file in this office, and to the provisions Town of North Andover. By- 2aAL Construction of Buildings in the Rough Final VIOLATION of the Zoning or Building Regulations Voids this Permit. P1 on Lift% ELECTRICAL INSPECTOR PERMIT EMPIRES N,6 MONTHS Rough LESS CONSTRUCTIONT RTS Service Final BUILDING INSPECTOR • GAS INSPECTOR Rough CCu ancPermit Re aired �o Occu Buildin Final ° Conspicuous Place on the Premises - Do Not Remove FIRE DEPARTMENT Display in a all To Be Done No Lathing or Burner Until Inspected and Approved by the Building Inspector. Street No. Smoke Det. Wordell's Home Solutions LLC Construction Contract Leslie Wordell HIC#144467 CSL#103272 Crate Contracit=# ::] 190 Haverhill St#173 417/2016 1879 Methuen, MA 01844 Name I Address Richard Lemack 4812 Roosevelt St. Hollywood, FL 33021 4712016 Item Description Qty UM Total Labor Demo existing deck existing stairs 1 400.00 Labor Build a new deck to the design submitted to building department approx. 37"high x 20' 1 3,800.00 x 12'. It will have three support beams to make new live load code of 60#per sq ft. (New deck will be rated for 88#live load.) It will be un-attached have 10 concrete footings to anchor new posts. All decking materials will be PT Lumber with exception of vinyl lattice. Pressure treated decking attached with galvanized ring nails.Two sets of PT stairs and a white vinyl skirt wrapping the structure. New stairs will be built and added to new structure with new cement pad at bottom.The final deck size will be approximately 314 sq ft with additional stairs.The outer edge of deck will be wrapped with PT Trim Boards along with the risers being closed with the same. Skirt will be applied to new structure. Materials As required to construct aforementioned deck.To be detailed on final invoice if I estimate 3,829.00 accepted.All materials quoted are PT lumber for the frame. PT railings, PT stairs, and ontv white vinyl skirt. Disposal Costs Disposal Costs for Project(20 yard dumpster on site) l 475.00 Permit Costs Construction Permit Costs estimate 100.00 only (TBD) Phone E-mail Web Site EIN#26-2880144 Total (978)-397-5248 les@wordellshomesolutions.com Wordellshomesolutions.com J AC X Home Own-TS i Page I Contractors Sig-. Wordell's Home Solutions LLC Construction Contract Leslie Wordell HIC#144467 CSL#103272 Date Contract# 190 Haverhill St#173 Methuen. A 01844 4/7/2016 1879 Name I Address Richard Lemack 4812 Roosevelt St, Hollywood, FL 33021 Dt1e bate 417/2016 Item Description Qty UM Total NOTE: Costs for all materials will be actual costs itemized on final invoice verifiable if required. Please see payment requirements listed under item (#3). Items or changes not listed would be in addition to original quote.A signed copy of this quote will be required at the start of project and can either be mailed or handed over before the start of the project Terms and Conditions 1) Scope of Work-, Contractor agrees to furnish all labor,services, materials, installation, supplies, insurance, equipment,tools and other facilities required for prompt and efficient execution of the work described herein in a professional and workmanlike manner 2) Quote Amount; Owner agrees to pay Contractor for the strict performance of his work,the sum as indicated above subject to additions and deductions for changes in the scope of work as may be subsequently agreed upon. 3) Payment Schedule; Owner agrees to pay Contractor in progress payments as follows: Payment#1 $860.00 upon signing contract Payment#2$3442.00 upon start of project to cover materials Payment#3$3442.00 at end of 3rd day of construction Final Payment#4 Full Balance of Invoice Upon 100%completion of project and final inspection Phone# E-mail Web Site EIN#26-2880144 Total (978)-397-5248 les@wordelishomesolutions.com wDrdellshomesolutions.cam Page 2 Contractorss Sig Home Owne V r ell"s Home Solutions Leslie Wordell Construction Contract 1C#9 67 CSL#103272 date Contract# 190 Haverhill St#973 Methuen, MA 01844 41712016 9879 Name 1 Address Richard Lemack 4812 Roosevelt St. Hollywood, FL 33021 Daae Date 41712016 Iters [description City Um Total 4)Work Schedule,- Contractor shall complete the work as required by agreement with the home owner.Contractor is agreed to be no more than 7 days late to start or finish per agreed schedule.Work schedule may be amended based on additional work inclusions and deductions and by agreement between Owner and Contractor. Not subject to delays caused by other contractors or their agents. The parties hereto have executed this Agreement for themselves, their heirs, executors, successors, administrators, and assignees on the day and year written below. ; Phone# E-mail Web Site EIN f#26-2880944 Total $8,604.00 (978)-397-6248 les@ 9*11shornesolutions.cotr wordel iomesolutians.com llemc O-wner Sid: ' Page 3 Contractors Sig; . Vt, USP Po Deck DesignerDECK DE51GN REPORT Lemack � lOf i • u Sri r� _._._..... Y Deck Designer Specification Kit x www.uspconnectors.com All rights reserved copyright 02016 DIY Technologies Page 1 USPCo Deck Design& DECK DESIGN REPORT Lemack Deck layout diagram 4 %✓i 1i�� f � rid �'p,i/// �/////�yoip r «r 101Yd � �1 kE „y% Y Top view without planks Bottom view with planks „ s 6 Top view with planks www.uspconnectors.com All rights reserved copyright @2016 DIY Technologies Page 2 TV USP 58' Deck DesignerDECD DESIGN REPORT Lemack Permit Page: Level 1 AlLOAD AND SUPPORT: Your deck will support a 88 pounds per square foot(PSF) live load. c Posts have 48"below ground support. DECK AND POST HEIGHT: e You selected a height of 36"from the top of the decking to the ground level. The top of the deck support posts will therefore be 27"above ground level. Joists: d; 1 a al Set joists on top of beams, 16"; center to center. C._Poe,V" Stress Ana is: Level 1 Joist Deflection 2001 Joist Bending 263 Joist Shear 211 Joist Compression 211 Beam Deflection 252 Beam Bending 98 Beam Shear 100 Post Stability 203 Note: It is your responsibilty to verify complience with all Local Building Code requirements. This is not a finished building plan. Load Calculations and construction practices are based on the International Residential Code(2015). Limited States Design construction practice values are not provided. www.uspconnectors.com All rights reserved copyright 02016 DIY Technologies Page 9 r U P �mo Deck DesignerDECK DESIGN REPORT Lmemack Beam Layout Level 1 P BEAM LABEL BEAM LENGTH POST COUNT POST SPACING A 19'9" 3 9'4 3/4" B 1919.1 3 9'4 3/4" C 19' 9" 4 6' 3 1/4" www.uspeonnectors.com All rights reserved copyright 02016 DIY Technologies Page 10 The Commonwealth ofMassgehusetts x Department of IndustrialAceidents 1 Congress Street,Suite 100 Boston,MA 02114.2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE ruf ED WITH Tn>;PERMITTING AUTHORITY. Applicant information Please Print Legibly Name (Business/Organization/Individnal): Address: City/State/Zip: Phone#: Are you an employer?Checkth'e appropriate box: 'Type of project(x ' ired): l.n am a employer with , .�• ! employees(frill and/or part-time).* 7, Q New eonsti action 2.EJ I am a sole proprietor or partnership and have no employees Working for me in $, El Remodeling any capacity.[No workers'comp,insurance required.] 9. [l Demolition 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10E]Building addition 4.❑I am a homeowner and will be luring 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.F]Plumbing repairs or additions 5111 am a general contractor and I have hired the sub-contractors listed on the attached sheet, 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.t ' 14, Other 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c, 152,§1(4),andvre have no,employees.[No workers'comp,insurance required.] (: *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy inform ation. t homeowners who subaf this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, t'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. Ifthe sub-cbntracfors have employees,they must provide their workeis'comp.policy number. -fain an employer Cleat is providing ivorairs'compensation insurance for my employees.'Below is the policy anrl job site information. Insurance Company Name: Policy#or Self-ins,Tac.#: Expiration Date: fob Site Address: ' 415'"" ���� � � City/State/Zip: Al A �j� ��� a tA 'A mrd g V 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 e. 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 WORD.ORDER and a fine of tip 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 certify tender thepains andpenalties ofperyury that the information provided above is true andcorrect. Sign e:._._..... _ Date• e 'p Phone# 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 Ifealth 2.Building Department 3.City/'Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: rn-Joseoh T.O'Neil( FaxID:Durso&Jankowski Date:4/25/2016 9:03:30 AM Paae:2 of 2 WORDHOM-02 JONEILL FCERT'IFICAT'E OF LIABILITY INSURANCE DATE(MM/DDMlYY) 4/25/2016 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 endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Durso&Jankowski Insurance Agency PHONE 978 688-7000 FAX (978) 688-7001 11 Saunders Street AIC No Ext:( ) A/C,No North Andover,MA 01845 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC INSURER A:MSA Group 14788 '... INSURED INSURER 6:Guard Insurance Group Wordells Home Solutions LLC INSURER C: 190 Haverhill St.,Suite 173 INSURER D: Methuen, MA 01844 INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/D.iYVYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE LK OCCUR MPT9992P 10/18/2015 10/18/2016 PREM SES Ea occurrence $ 500,000 '......, MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY S 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY� PRO ❑ LOC PRODUCTS-COMP/OP AGG S 200,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO I BODILY INJURY(Per person) $ ALL OWNED SCHEDULED ) BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION$ - I S WORKERS COMPENSATION I PER 0TH- AND EMPLOYERS'LIABILITY i STATUTE ER B AN PROPRIETOR/PARTNER/EXECUTIVE YIN WOWC700060 03/04/2016 03/04/2017 E.L.EACHACCIDENT $ 100,000 OFFICERfi4EMBER EXCLUDED? N/A El (Mandatory in NH) ? E.L.DISEASE-EA EMPLOYEE S 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below ; E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Building Regulations)and Standards ` License: O __ S-103272 Construction Supervisor LESLIE G WORDELL 190 HAVERHILLST, METHUEN MA 01844'' � � Expiration: Commissioner 10/13/2017 1. 6;0l/I37,ONwea'1144, d'me W 'Office of Consumer Affairs&B-siuess Regulation HOME IMPROVE{;.?ENT CONTRACTOR b; — Y Registration: 44467 Type: r Expiration: 1(:%G/-2016 DBA ro-' ROELL'S HOME SO'_UTIONS LESLIE WORDELL 130 HAVER'iILL ST#173 g METHUEN,MA 01844 Uudersecretary&