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HomeMy WebLinkAboutBuilding Permit #106-15 - 11 TYLER ROAD 7/30/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: O Date Received Date Issued: l� MPORTANT:Applicant must complete all items on this page LOCATION Pri t. PROPERTY OWNER I A�� 4�/,.�a Print 100 Year Old Structure yes n MAP NO: �I PARCEL ZONING DISTRICT: Historic District yes o Machine Shop Village yes 0 .TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building P16ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p Septic ❑Well 11 Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) d OWNER: Name: c;��{-� L�G H� `e2 Phone: Address: CONTRACTOR Name: a�v1 �1.�� ✓JL� Phone: Address: Supervisor's Construction License: Exp. Date: / r Home Improvement License: ` S 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: $ /). cam" `� FEE: $ Cl ` Check No.: 1h Receipt No.: 2-1 n/1 0 NOTE: Persons contracting with unregistered contractors do not have access to the uaranty fund :Signaturerof Agent%Owner Signature of contractor - 1 Plans Submitted L] Plans Waived ❑ Certified Plot Plan ❑ tamped Plans ❑ -: Plans-Submitted ❑ Plans Waived ❑ : "-.Certified Plot Plan ❑ Stamped Plans ❑ -TYPE-OF SEWERAGEDISPOSAL Public Sewer ❑ Tanning/Massage/Body Art 0. . Swimming Pools ❑ Well El Tobacco.Sales 0 Food Packaging/Sales ❑ Private-(septic tank etc- Permanent D empster on-Site THE-FOLLOWING SECTIONS FOR-OFFICE USE ONLY INTERDEPARTMENTAL SIGN_OFF - U FORM DATE.REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS ,CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments t _ Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW TowA-2 Engineer: Signature: Located 384 Osgood Street FIRE DEPARTM;- Temp -ump`ster on site yes no Located-at 124 Mair. Street - ..-Fire Depar`tme►it.signature/date'' ' COMMENTS r -Dimensian Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land-area; sq. ft..- ELECTRICAL: .;-ELECTRICAL: -Movement of Meter location mast-or service drop requires approval of Electrical Inspector Yes No DANGER ZONELITERATURE: . =Yes No MGL-.Chapter 166.Section21A=F and G min.$100-$1000 fine NOTES and DATA — (For department use i D Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department --The fora wingi8 a-li'stof the required,forms to be filled ouffor:the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/0'r C.S.L Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work Li 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 o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) a 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 Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract Li Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cans.if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw•al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm-tted with the building application Doc: Doc.Buiiding permit Revised 2012 . Location No. I�yr —�� Date . - TOWN OF NORTH ANDOVER cab' ` . _ Certificate of Occupancy $ Building/Frame Permit Fee $ "�►'� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 0 Check# � Building Inspector r , NORTH ve" '* O - 154 29 a 2014 h ver, Mass coc"Ic"IMCK �1' RATEO LI BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ........ E.% , ,,,, ,,,, ,,, ,,,,, ,,,,,,, , BUILDING INSPECTOR .......... ..... ................ ' �11 , Foundation has permission to erect .......................... buildings on ....I X.........I..flm.. ....................................... Rough tobe occupied as ....... .�......... ..... �OF................................................................... 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 PERMIT EXPIRES IN6,MNTH ELECTRICAL INSPECTOR . UNLESS CONSTRUCT S Rough Service ............. ...................: —. ......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. L Collsunter Business Regulation - Nlass.vav y ulet�Dn t4GABR} _cf C of Affairs&gus3ness Reg ., ../ ITjB Qft9Gat N(eD532e Of the U 111"s Iteg ConSumer Affairs at d Bus !1Urr�e Consume, some rr,�rovement Contractrn6 Lookup IMPrHv�etllt COntcactor Reg �� you can search/filter Me regisUation Ijjt by any of the criteria below. Searc Search'by Reglsfiration Netmt�r 37f15� h Search by Registrant Name {�— r---� __------- ------__" zip Gone t r Search by City Search Registrants) r.- aranty Fund Clack on the registration number to view cQrnpsaint hisiary. you can also stew arti�trat_!�n ar?u- nis September 20, 201.2. The list is Current a of Thursday. Search Results EXPIRATION STATUS REGISTRANT R,ESpONSIBLE REGISTRAM" ADDRESS HATE INDIVIQUAL NUMBER NAME 166 A FIIVAGHAR© 1o/o212014 Curren: ALL uuoc¢or2E Root. LANZAFAME, 137057 BUILDING JOHN Nt MA 01844 ply. ' V 2012 Commonvveaah�r Massamusetts Of tne rh of M�^"a^hvsens fAass.Gov1�1 t f@ till �gTY1C;e rw uaK gat.: Massah S?2t3 fiarr25 �7t72dE��a �. t)n� License.CS-069120 JOHN W LAN 3e TEMPLE OR METHUEN MA 818 cornmrssioner The Commonwealth of Massachasefis , Department offnclus1ria1 Accidents Office of fnvestigations 600 Washington Street .Boston,MA 02111 www.mass gov/a'za Workers'Compensafon bsurance Afradayff:Builders/Cont°actors/Electri.exansfpli mberq A.pplieant Information Please Print Legibly Name(Business/Organrzation/Individual): &I .Address: City/State/Zip: 6A ry,'A iJ Phone#: �'�d ��1� ✓���c7 f Are you an employer?Check the appropriate box: Type of project(required): er with�y .I.EI am a expP to 4. ❑ I am a general contractor and I ' � have hired the sub-contractors 6. New construction employees(full and/or part time). 7. E]Remodeling 2.ElI am a sole proprietor orpartn.ex r listed on the attached sheet.• ship an.d'haveno.employees These sub-contractors have 8. [(Demolition working forme in any capacity. workers'comp,insurance. s. Building addition [N'o workers'comp.insurance 5. ❑We are a corporation and its 10. 1 Electrical repairs or additions required.] officers have exercised.their 3.❑ I am a homeowner doing all work right of exemption per MGL I I. Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roofrepairs insuraucere edemployees.[No workers' �' .� I3.E�Other comp,insurance required.] NAny applicant that checks box#1 must also fill out the section below showing their workers'compensationpolicy information. f'Homeowners who submit this affidavit indicatingthey gdoing allwork and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached as additional sheet showing the name of the sub-contractors and their workers'comp.policy information. ,I am an empfoyer that is providing workers'compensation insurance for my em ployees Below is the policy and job site information. Insurance Company Name% f, ��" '''"s'Tu►'✓� Policy#or Self ins.Lic.# Expiration Date: ft lob Site Address, L I ��L<rl �� /U� City/State/Zip: Attach a copy of the workers'compensation-polley declaration page(showing the policy number and expiration date). Failure to secure coverage.as requiredunder Section 25A ofMGL o.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ofuIo to$ y 250.00 a da against the violator. Be advised that a copy of this statementmay be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. Xdo ltereby certi under t,14palns dpenaldes ofperjury that the inforrnationprovidedabove is true and correct. /2 Si ature: Date: Phone#: offtcial 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 Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract ofhire,- express or implied,oral or written..,, An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or mole of the foregoing engaged in a joint enterprise,and including the legal representatives of a:deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who xesides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or p ermit to op erate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance withthe insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have b eon presented to the contracting authority." Applicants Please fill out the workers'comp ens aiion affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone,number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are notrequired to carry workers'compensation insurance. If an LLC or LLP does have employees,apolicyisrequired. Be advised thatthis affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be suxe to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the afCdavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be-sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant thatmust submitmultiple pemrit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessmy)and under"Job Site Address"the applicant should write"all locations in (city or towix)."A copy of the affidavit that has been officially stamped or marked by th.e city or town may be provided to the applicant as proof that a valid affidavit.is on file for future permits or licenses. .A.new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or p ermit not related to any business or commercial venture (i.e.a dog license orpermit to burn leaves eta.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, Please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commojiw.eajthofMassacl,vsP�s - Depar�mont QfIndwWalAccidents Qfce offlivestiga-0ona F00 Washivon Sweet Boom MA 02111 TOL#61.7-7-27_49-00 ext 406 ox 1-8,777 Revised 5-26-05 FRY,9 617"727'7749 cm-4�TE OF LIANunr INSURANm 11111111111 r Si Eaa�i� i �ln�ii IM -arA i rll�w A=-"WL;=""OLmmL as � � � 01!1#!b oa# Ma+t�wl rEr t oto!A+ itsaft tal4Mit//I�s� tiIMMR M M6't Oi 4##1010� -ow 4"4s 62t I ON 2S lawttwo. Nal�= E _ /1lJi.MWlwt iaaraae� 33754 a VIM 34 1 ' I �--.— ��. a►tatadN�: �i 'Iss� w�rc AM Y _ 7'AR�a00MM00 cowbovR .analE�ullrw i R�OCCWMIDtGt; t _� .rarrpM►ww►t*Y Hl OM,aenri at4.ACKsTI f i Ct AE+s+. ! do``ue ` r — s 1 p xt.aaaRreaztw'�a r s oRa I s v arT ait� _ � � � OppRt u►Mtr 1R'.,we�*+'�TI y .� . •10[L!f�tlIII3 1` 4A 1 ! 3 i 1 i rIMl11@+L/t LAM t "'1 lIR7Mit lM� °f- MKE i VIA EACM occlomwt l4oy0011.49 tttAi aA ttllflAt7 t4J011Q#4 EL.tXaEAiE•f�l<!til DYER;# "GrN Ps 309.400.00 Eto ��"or wsuMi+i�uocR�w+a�tiwEm�oir.�e.Baan m_�►w"'""'w..��r av,.w..�w,.w...r..�s..+t_ _. t i tr..lwed+rs eawip�+�a�w�o""does tW4 p116r40a DOW~M stM L.a"Caft" S � i 4� ��blMtpilfl�4ong1 t a ' R Mir, i !��! aC DRn AS{2410l4`«f 7M A, D mesa and laps atw auttca of^jCO O �Ecacvt nu DI. 1 trfa+4izot�rwav o2 talM j. I - r " Residential & Commercial Rooting chirnn4eysCHIMNEYS POINTED-REBUILT-CAPPED All T es O# Expert Masonry Work Mass Toll Free - Licensed & Insured lw:iCuil};C7:V)1('cI cC!_)-afrrrstr,'tI.S:::c'f' .i ij 7F P.'•. •• 1-800-WAIT-4-US ,� a � � �� License#034200 (924-8487) �tzP ' rp rx a7�190/6-w-0/6-w- We Work Year Round F " 7.1 C{ Proposal To: Janet Eichler Date 4/5/2014 Street: 11 Tyler Rd. 978-683-5275 N.Andover MA 978-289-8200 Roof proposal exntrk4gatos@verizon.net IKO Cambridge 1. Extra caution will be taken to protect house 12. Removal of all work related debris. Planks will be exterior and landscaping as best as possible. placed under dumpster to prevent any damage to (tarps etc.)Magnets run at final clean up. driveway. 2. Remove all shingles from main house only. Not 13. Building permit included. garage- 14. Contractor workmanship warranty: 10 years under 3. Inspect and re-nail any loose or lifted plywood normal wind and rain conditions. or roof boards. Any compromised plywood will be replaced at an additional cost of$55.00 per Total roof cost: $ 7,600.00 sheet of 1/2 CDX fir. Any compromised roof boards will be replaced at an additional coast of IKO Shield Pro Plus Extended Direct MFG. Warranty $2.75 per lineal foot of 1 x8 spruce. A fully transferable 100%coverage for a full non pro 4. Install heavy gauge 8"white aluminum drip rated period of 20 years. Please see details in � edge to all eaves and rakes. 5. Install 6' of IKO Armourguard ice and water pamphlet left in estimate material folder. Offered and shield along all eaves and top to bottom in all included in this proposal at no additional cost. }� valleys. *Note*: Please be advised if applicablevaluables in 6. Install IKO roof guard synthetic underlayment to ' remaining sheathing up to ridge. the attic should be moved or coovv ered.due to minor 7. Install all new pipe boots. debris,dust and asphalt particles that will accumulate 8. Install IKO Leading Edge starter shingles to all during the stripping process. All Under One Roof not responsible for any damage or clean up that may eaves. 9. Install IKO Cambridge Green Limited Lifetime occur in attic. architectural shingles to main house only. Balance due upon completion 15 year non pro-rated warranty by mfg. All shingles will be installed and fastened according References available upon request to mfg. specs. 10. Counter-flash existing chimney lead with ice Highly rated member of the accredited BBS and and water shield,tie into new shingles and seal. Angie's List 11. Install a new GAF Cobra ridge vent capped with color matched IKO hip and ridge shingles. Thank yob! j P