HomeMy WebLinkAboutBuilding Permit # 9/19/2016 f
BUILDING PERMIT t%0RTk
06
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
Permit Nott:_Xt�_ l-6 7 Date Received ArEa
Date Issued:
L IMPORTANT: Applicant must Complete all items on this page
LOCATION )o Print
PROPERTY OWNER C t,c S
Print 100 Year Structure yes no
MAP �,v PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE .
Residential Non- Residential
Li New Building 'R'One family
El Addition Li Two or more family L) Industrial
W Alteration No. of units: 0 Commercial
0 Repair, replacement 0 Assessory Bldg 0 Others:
Li Demolition El Other
DESCRIPTION OF WORK TO BE PERFORMED:
J
Sc
Identification- Please 'Type or Print Clearly
OWNER: Name: V%O Phone:
Address: J CY OJ
Contractor Name: Phone: 91411 2��,!n
Email:
Address: 5� S J t�� 1
�/ .Supervisor's Construction License: C S – —Exp. Date: lk
Home Improvement License: I I B 4S1 —Exp. Date: 'i 2z
ARCH ITECT/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: 0 FEE: $
Check No.: S59 Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfiInd
_ Plans Submitted'® Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL a
Public Sewer ❑ Taming/Massage/BodyArt ❑ SwiauniingPools ❑
well ElTabacca Sales ❑
ood.Packaging/Sales ❑
Private(septic tanl�, eta ❑ Permanent Dmnpster au Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING cou DEVELOPMENT Reviewed On U)nz'01 o Signatur6i"'
t�
COMMENTS—N" RV FE
PY�G�1 u Cry U n G �- , �'
lit4� N' Ok o- &\ <)am''�w )Jam-- 'rozq
CONSERVATION Reviewed on � � Si nature
COMMENTS
HEALTH Reviewed on &-10 Si net
COMMENTS �UL
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/s"r nature & pafie Drivewa Permit
DPW Town Engineer: Signature:
Located 3 Osgood Street
S4 0 ood et
FIRE DEPAR�TMENfT Terre hum stet on site es
l ocatec} at f24 MainStreet Y,, no_ z
1 777
777777fiy x
Fire ®apartment��gnaureldat , -
CQMMENTS
e10RT11 '�
own of �T, 6 over
O � _ R+
No. )91-doll
na L�K. h ver, Mass, CIO. go 1
�p4 cec",c"tWICK`1'
S 11
BOARD OF HEALTH
Food/Kitchen
PERMIT - T D Septic System
THIS CERTIFIES THAT �V4.......... d ........................................................... BUILDING INSPECTOR
has permission to erect .......... buildings on ...S.(). �7. rr `. � Foundation
Rough
to be occupied as ....���-4 . . ` ...p .... ... ...... .............................. Chimney
provided that the person accepting this permit shall in e4ery 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
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES 16 NINTHS ELECTRICAL INSPECTOR.
UNLESS C® STRUC STAR Rough
Service
..... .,.. . .... ..... ..... ........................................
Final
BUILDING INSPECTOR
GAS INSPECTOR
OccuL!ancr Permit Required to Occupy Buildin 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.
SPECIALTIESF LLC
603e944o8594
Heather Balduino
50 Stanton Way
North Andover Ma
Estimate Drafted: 8/16/16
Job Descripjiota:
1) Excavate& pour approx. 6 concrete footings.
2) Install additional support beam under existing deck approx 4ft off house.
3) Install 16 ft support beam approx 18 ft off house wall to receive extension of existing deck
structure.
4) Remove all deck boards on existing deck.
5) Extend existing deck approx 6ft. (creating a 16x18 foot structure.)
6) Install 2 new footings and support posts under existing deck(mid span) in order to support
roof load of screened in porch.
7) Install approx 300 sq ft of Trex,decking. (decking priced was Trex Enhance Clamshell).
8) All decking to be installed with hidden fasteners
9) Vinyl screening to be installed under deck that supports screened in porch.
10) Build a 16x18 roof structure over existing deck.
11) Roof structure to be constructed out of 2x10 framing.
12) Support roof structure with approx 15 4x4 supports.
13) Roof to have vinyl soffits on all three walls of porch structure.
14) Plywood and shingle roof, shingles to match shingles on existing house. (approx 4.5 sq)
15) Create full cathedral ceiling inside porch area.
16) All support posts in screened in area to be wrapped in white pvc trim board.
17) All upper beams in screened in porch area to be wrapped in pvc trim board.
18) Install approx 850 sq ft of tongue and groove pine on half cathedral ceiling.
19) Polyurethane all tongue and groove pine.
20) Install 1 screen door.
21) Install 60 linear feet of white vinyl railing system.
22) Install approx 12 screen frames on porch.
23) Properly tie all new structures into existing house structure.
24) Install 2 sky light windows in full cathedral ceiling
25) Install 4 recessed lights.
26) Install 1 dimmer switch for recessed lights.
27) Install I outlet.
28) Install one ceiling fan. (Fan unit to be chosen by customer)
Total Job Cost=$19,623.04
* Total job cost includes all materials& labor).
** Estimate includes all disposal fees.
*** Estimate includes all sub-contract labor.
**** Additional charges may apply due to unforeseen construction upon demolition.
*****Payment schedule to be determined upon agreement of contract.
****** This price DOES NOT include permit fees(TBD).
******* R&M Specialties, HIC License It 178487
Sign Upon Agreement;
Ian Fenton and Michael DeBenedetto OL
Chris and Heather Balduino � /�--
Date —MV/—(
Page 12
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y1 e Commonwealth o f`Massachusetts
Department of fnilustrialAccidents
M k 1 Congress Street,Sante 100
`K Roston,MA 02114-2017
www mass.gov1dna
Woxkexs'Compensation Insurance Affidavit:Builders/Contractor's/EYgctxlciansCplumbex s.
TO 13B MED"Wi+'TH`.lam PEttlt�['I"IINC A.U"�,Etd:RT'.l�X''.
Applicant-Information I'leasePrint Iae 'lr1
. � 1NEI=(Business/Organizatioo/fndividual): Iry
Address: K�,)1
City/Mate/Zip: � •� .�' � (� �— Pane GD ` T..Isl
Are you an employer?Check"&&apl r,opriatc box: `! Te of project(.Vequirbd):
P
1.[]1 am a employerWth . . employees(full and/or part-time).* 7,• Now colstx'uct%on
2,0 am a sole proprietor or partnership and have no employees working forme in 8. Remodeling
any capacity.[No workers'comp.insurance required.] Demolition
3.E]1 am ahomeowner doing all work myself:[No workers'camp..irrsurance required.]t 10 n Building addition
4.! t T am a homeowner and will be hiring contractors to conduct all work on my property. 1-will 11.E]Electrical rep airs or additions
ensure that all contractors either have workers'compensation insurance or are sole .I.-1
pr6 rietarswithno oinplol+ces. 12.; plumbing repairs or additions
5,u 1 alga general contractor and Z have Tired the sub-contractors listed on the attached sheet. 1Ro of rep ai]S
xhese sub-contractors lame employees and have workers'comp. $
insurance.
14. Other
6.❑we area corporat�on imd its pf'1-rcers have exercised their right of'exemption per MGL G.
152,§1(4),and we have no.,eniployees.Vpworkers'comp.insurance required.]
Any applicant that checks bdx 41 must also fill out the section below showing their workers'compensation policy information.
T Homeowners vrho suliniif'tivs aT�davlt indicating they are doing all work and then hire outside contractors must sa mit a neve affidavit indicating such
$Contractors that check this box must•atfac ec..I addii anal sheet showing the name of the sub-contractors and state whether or pot those entities have
employees. Mthe sub,Ao iLctors have employees,�iiey must provido their workers"comp.policy number
fa/rz an eiriployert7iat is Providing-worAi rs'coirpensation insuranceformy einproyees." neloiv is thepolicy anidjob site
information.
Insurance Company Name:–
Policy if or I)If-inS,lic*
ame:_Policyi#orSelf-ins.lic.#i: Expiration Date: ,-
Job Site Address: c LPO
�` declaration a e showing thhe�palicy number and expiration to� p date).
ttaclr a copy of the vrax It ers' clxsafio p alicy
Failino to secure coverage as required under MCMI,c. 152, §25A.is a criminal violation punishable by a fixe up to$:1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a:fixe of tip to$250.00 a
day against the Violator.A,copy of this statement may be forwarded to the Office offnvestigations of the DIA fbr insurance
coverage_yerificatioxx.
X rho hereby certify a'er,#lie pains and penalties ofperjury that the information provided above is rue and correct
Sirnatttre: ✓ \ _�_ — ._ Date:
Official nese only. 1Do not-write in this area,to be corrzpleterl by city or town official.
City or Town:
S'ermitfl icerxse#_ --
Issuing Authority(circle ane): i
;t.13oarcl of Health 2.13ulddingDepartment 3.CitylTown Clerk 4.Flectrical Inspector 5.Plumbing Inspector
6.Other
-_ –
Contact Person: _-. __ _... _- ___— ,'.hone=##:_
Massachusetts Department of Public Safety
`f guard of Building Regulations and Standards
License: CS-055336 .
Construction Supervisor
MICHAEL J DEBENEDETTO r
4 HEATHRROOK RQ
MERRIMAC MA 01860
n
Expiration:
LI0812612018
Commissioonernerr
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
s i _ Registration: "1,78487 Type'
4
Expiration.:... 4/22/2018 DBA
i
R&M SPECIALTIES
1.
IAN FENTON
56 NORTH MAIN ST , _ --•rte--
i
j SALEM, NH 03079 Undersecretary
l