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HomeMy WebLinkAboutBuilding Permit #910-11 - 100 STEVENS STREET 6/29/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �� Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 100 .E S Print PROPERTY OWNER Lr,,, IU LAakosa6 Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family 0 Industrial 0 Alteration No. of units: 0 Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑Floodplain 0.Wetlands ❑ Watershed District ❑ Water/Sewer © DESCRIPTION OF WORK TO BE PERFORMED: 1 RGA �4C,r 'Ro� 4-Y-um t`�ct5 ertol� �5 Std(kD - OLA t.���►rle,..�(' �rs 'I-1,.0 �XrS�-�hc' 3— Sc4Soyl 1�a4-�.� (Identification Please Type or Print Clearly) OWNER: Name: ( cam CnST-c.o�0 Phone: X27- Address: eo Sc�ev1S S o CONTRACTOR Name: g y-jr c Juu it Phone: 5-C)8-?6?-812Z Address: PC) Re> K S F 61 Supervisor's Construction License: 035 714 Exp. Date: S Z Home Improvement.License: (Z 0 b 2 3 Exp. Date: r6�1� f II 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: $ r., oo© FEE: $ RIVI 00 Check No.: /0 �Zfb -Receipt No.: C;?,// 3?3 NOTE: Persons contracting w'th unre ister, con actors do not have access to g arae nd ,Signature ofiAgent/Qvvner _ignature of= contractor r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming 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 - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ I COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature 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 FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date • ti COMMENTS _, I I I Dimension I' Number of Stories: Total square feet of floor area, based on Exterior dimensions. I Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract f ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses Ej Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Location /o 6 No. Date NOR�h TOWN OF NORTH ANDOVER t Certificate of Occupancy $ sACMU t� Building/Frame Permit Fee $ 04 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 'IF 90 245 ; 3 Building Inspector ORTH T0,91111i;M of o Andover }( --= o dower IViass. Y �= LAKE 1 COCHICHEWICK 7�AERATED pPCC;) `SS BOARD'OF HEALTH Food/Kitchen -PERMIT T D Septic System y-- BUILDING INSPECTOR Ct �Ci f / 6�.' THIS CERTIFIES THAT.............e�.....��............... G..--............�............................................................................................. Foundation has permission to erect..................:...................... buildings on , d 5���'c��S SVI— ........................................................................................... Rough .�- g to be occupied as............ae./914...............................C- ................:... .. '1w Chimne y.. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 PERMIT EXPIRES IN 6 MONTHS Final s ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO STARTS Rough ............................ .1;. .... ....61-1-1......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Ntassachusetts- Depal-tmcnt of Public Saf(t Board of Buildim, Re-ulations and Standard Construction Supervisor License License:.CS 59169 CHARLES J MULIK Y 23 REDMOND AVE N READING, MA 018640".'o Expiration: 9/5/2012 (bnunissiunrr TO: 259 ( �ffiec oi:Cons�criei A1'faif,� BusSAcss�Tr�_? HOME,I PRQVEMENfiiwOtQ;�uiCT(R � u Regnstratiom;4126093 ' Expiration 10r16l011 3; � : Ty0 ',; IrdiVidiaal ,•t a i-' GNAR(lr ilVULIK _Xj >-HARLSS :MULIK 2 Kedmi b.Mil AW16u\_. _ = �� �•' - .i�r reading,MA64q*,"4q*,: I ndcr�aCrct N A 1. CJM BUILDERS, INC. ESTIMATE P.O. Box 545 Wilmington, MA 01887 DATE Tel. 978-649-7300 4/13/2011 Fax 978-851-4090 Website: www.cjmbuildersinc.com CUSTOMER Layla Eastwood 100 Stevens St N.Andover,Ma 01845 Project/Job DESCRIPTION Total Cjm Builders Inc.proposes to furnish the stock and labor for the repair work at 100 Stevens St.in N.Andover,Ma.All work will be done in a timely manner and with quality workmanship.Repair work will include; SCOPE OF WORK FRONT OF THE HOUSE *Remove and replace the bottom base and trim cap on all five outside corner boards *Window over the front door will have the top and side trim be replaced,including the radius trim *All four lower windows will have the top and side trim replaced *Upper window on the family room side will have the top and side trim replaced *Family room window will have the top and side trim replaced,including the radius trim *Front entrance will have all the corner boards and panel work replaced *Replaced the water table on both sides of the front door RIGHT SIDE OF THE HOUSE *Four windows will have the top and side trim replaced.The windows in the bay area are ok and wont be replaced BACK SIDE OF THE HOUSE *Kitchen window will have the top and side trim replaced *The outside corner board next to the 3 season porch will be replaced LEFT SIDE *The two windows will have the top and side trim replaced ALL TRIM WILL BE REPLACED WITH AZEK OR EQUAL MATERIAL ALL PUTTY AND PAINT WORK WILL BE DONE BY OTHERS ALL THE DEBRIS WILL BE REMOVED OFF SITE TOTAL COST OF THE TRIM REPLACEMENT 4,895.00 I HEREBY ACCEPT YOUR ESTIMATE AND AUTHORIZE CJM BUILDERS,INC.TO START THE WORK. SIGNATURE Tota Pagel e 1 CJM BUILDERS, INC. ESTIMATE P.O. Box 545 Wilmington, MA 01887 DATE Tel. 978-649-7300 4/13/2011 Fax 978-851-4090 Website: www.cjmbuildersinc.com CUSTOMER Layla Eastwood 100 Stevens St N.Andover,Ma 01845 it Project/Job DESCRIPTION Total THREE SEASON PORCH *Remove the ten existing wood door panels and replace them with white vinyl Emco traditional deluxe doors that have both storm windows and full screen *Remove nine vertical fluted trim boards between the door panels and replace them with Azek or equal trim *Remove two outside corners boards and replace them with Azek or equal trim *Remove two inside corners and replace them with Azek or equal trim *Cut back the decking around the perimeter of the porch and install a drip cap so water does not collect *Remove the trim under the doors and replace them with Azek or equal trim *Replace the two doors to the exterior with vinyl Emco doors will be an additional $1200.00 TOTAL COST OF REPAIR WORK TO THE PORCH 10,975.00 RAILINGS ON THREE STAIRWAYS *Remove the existing wood railings and post on three set of stairs * Install new white vinyl railing system back in place of the wood railing *Re-level the stairway on the back side of the three season porch TOTAL COST OF THE RAILING WORK 3,200.00 WARRANTY One year on stock and labor after the one year the manufacture's warranty will remain. PAYMENTS * 1 st.payment due at signing $6000.00 *2nd.payment due after the house trim is complete$7500.00 *Final payment on completion$5570.00 I HEREBY ACCEPT YOUR ESTIMATE AND AUTHORIZE CJM BUILDERS,INC.TO START THE WORK. SIGNATURE Total $19,070.00 Page 2 The Commonwealth of Massachusetts Department of Industrial Accidents 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/Organization/Individual): Rwl ln-V � Address: City/State/Zip: hone#: -'D g - 9(Q, — $ ( 2-1a Are you employer?Check the appropriate box: Type of project(required): 1.E311 am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sb%et. 1 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 ME]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,❑Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:_ 106 S�cvetn 34 City/State/Zip: Attach a copy of the 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 of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert u der the plins d enalt* of erju that the information provided above is true and correct. Si nature: Date: LZ Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Per # 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#: