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Home My WebLink AboutBuilding Permit #64-11 - 115 LANCASTER ROAD 7/26/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 1113111 Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION v l t Print PROPERTY OWNER Unit# Print MAP NO:—bA1-i-PARCEL:61W ZONING DISTRICT: Historic District yes Machine Shop Village yes 100 year-old structure yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building XOne family ❑Addition ❑Two or more family ❑ Industrial -IgAlteration No. of units: ❑ Commercial JKRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑Floodplain ❑ Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Me (Identification Please Type or Print Clearly) OWNER: Name: IZ-b�asv�t— .�.,��L� Phone: 6C "0 &Ll Address: 1 lti„ c� �--�-� ,v;� Vy» . 1� .► 1 .. CONTRACTOR Name: Phone: Address: Supervisor's Construction License: 0 5 3 V Exp. Date: Home Improvement License: 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: $ e 1)0 -0 FEE: $ Q,_-6 f Check No.: 6 Uy Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fu Signature ofAgent/Ownar; Signature of contractor i 0 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 Itle /"/ DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on I's ( S i-q re-'-JJ-\,PU J i COMMENTS �oa� SS 6v � 10C3\ 00 HLALTH Reviewed on Signa ure COMMENTS Aviv- 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 I COMMENTS I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop r luires 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 E 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 ❑ 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 ❑ 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 NORT#i TONM of �0 _ o , dower, Mass., 'd.(' LAKE COCHICKEWICK 0RATED P ,�C-1 'PER IT T D BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT................ ........ ........................................................ ................................................................... Foundation has permission to erect........................................ buildings on .....141 ......�..�j/!�C. S .R....... ........ • Rough to be occupied as Is.0 P. ........CU. .� Chimney 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 Final PERMIT EXPIRES IN 6 MQZjHS UNLESS C®NSTRUC"I'I. ��'S ELECTRICAL INSPECTOR- Rough d � ..................... .......................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. Bumer Street No. SEE REVERSE SIDE Smoke Det. 169 Boxford Street Ke'Vilft rth• NoAndover,MA01845h--yr • PH:978-688-5335 Building Contractor • FAX:978-688-XM i ' Proposal To: Bob Mon9 ell 115 Lancaster Road All Home improvement Contractors and Suboortactors engaged in home improvement conbactm,unless North Andover, Ma. 01845 specifically exempt frau regisaation by Provisions of Chapter 142A of the general laws,must be registered with the Common wealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA 02108.(617)-727 8598 CC: Date: 6/15/2011 Job: Shed Date of plans: None Architect None Location: Same Section 1-Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 7/11/11. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 9/30/11.The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11-Warranty The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup,the Contractor shall,at his own expense,forthwith remedy,repair correct,replace,or cause to be remedied,repaired,or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shall survive any inspection perforated in connection with the agreed-upon work. Section III-Scope of Work Page 1 of 4 Kevin Murphy Page 2 of 4 Building Contractor 169 Boxford street North Andover,MA 01845 PH:978&885335 FAX 978888-XXXX General Proposal is to build 8'x8'shed in pool area. No building permit should be required. Demolition Existing shed will be removed and disposed of. Foundation Six inch thick concrete slab will be poured for new shed to sit on. Building All frame roof and siding materials will be supplied and installed to match existing house. Exterior walls will be 2x4, roof rafters will be M. Wall and roof sheathing will be fir plywood ( 1/2 on walls, 5/8 on roof) . Gable ( peaked ) roof will be built to match existing house. Roof shingles to match existing. Siding will be pre-primed cedar clapboards.One steel exterior door unit and one doublehung window will be supplied and installed. Painting Exterior painting will be provided. Waste Removal All demolition/construction debris will be disposed of by contractor. Items Not Included There has been no allowance made for any electrical work or interior finishing. Kevin Murphy Page 4 of 4 Building Contractor 169 BoDdord Street North Andover,MA 01845 PH:978688-5335 FAX 978-6WX)= Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of..................... ...... ... .......$ 8000 Payment to be made as follows: Percenta entero Description Amount 1 Concrete pad poured $2000 2 Job complete $6000 Total 2 $8,000.00 "'Notice:No agreement for Home improvement contracting work shall require a down payment(advance deposit)of more tot one-third of the total contract price of the total amount of all deposits or payments which the contractor must make,in advance,to order andlor otherwise obtain delivery of special order materials and eguipmeM,whichever is greater Contractor: Kevin Murphy 169 Boxford Street No.Andover,MA 01845 Registration No: 101874 Section V—Acceptance Acceptance of Proposal—I have read this document and accept the prices,specifications,and conditions stated. I understand that upon signing,this proposal becomes a binding contract.You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date , �/� Z01 Signature Date I T7ze Commonivealtit of Massachusetts Department of Industrid Accidents -:OVice of Investigations_ 600Vashingto r-Street Boston,MA 02111 - "".mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electric ansfPlumbeit Applicant Information Please PrintLeIdbly Name(susiness/orgwizationJii Address: �� i S� -- .� S'�,�...,✓°� City/State0p: Phone.m. 3 Are you an employer?Chetk the7 appropriate lox: Type of project(required): 1"g,I am a employer with; 4.:❑ I`am a general contradorand I :6. E].New construction employees(fiill and/or part time).* have hired the sub-contractors - - -:�,.listed on-the attachedaheet.1: 7. Q'Remodeling 2.❑ I am a sole propnetoror partner= ship and have no employees These sub-contractors have 8. (] Demolition working for me in any capacity. workers'comp.insurance. . 9. E] Building addition (No workers'comp.insurance 5 ❑ Weare a'corporation and its 10.❑ Electrical repairs or additions III - req l teers have exermsed thetr> ri t of ex tion Cr MGL' I1-0 Phunbing repairs or additions 3.❑ I am a homeowner-doing all-Mit p III c. §!-(4),l(4),and we have no myself_[No workers camp. § 12 Roof repans m% rance.rN#e&l t . employees:'(Noworkers' 13V COUP-'insiiranoe required 'Any applicant that checks box ixI must also fill out the sedroit below showing their workers'compensat►on policy information 1!Homeowners who submit this;affidavit mdiea&g they-an doing all work and then hire outside cont=tin mast submit:a new affidavit indicating.suck tContracam that check fins box most attached--an additional shwt'showing the name of the sub-contractors and thea workers'camp policy information. Yam an employer that is provedaig"svorkees'compensateon Insurance for.my employees.:BdOW is the poltc�'and job site information. Insurance Company Name: r 4.%-A ��•� ERp� - nation Date: Policy#or Self-ins.Lie:#_�,�� twC ? ,�'� � � Job Site Address: .t l�S' ��- - �"`�•� i 11� Gity/stazaip: Attach a copy of the,workers compensation policy,declaratjon page(showing the policy number and expiration date). ' Fat7ure to sectue coverage as required under Section 25A of MGL c.152 can:lead-to the imposition of crin mai penahies of a fine up to$1,500.00 and/or one-year imprisonment as>wellas civil-penalties-in the.form.of-a STOP WORK ORDER and a`fine of up to$250.00 a day against the violator. Be advised..that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby citify 'ns and pe �eju�y that the information provided above is twee and correct.: Si tore: j Date:":_ l i Phone#: Of vial use only. Do not write in this area,to be completed by city or town-offU*L City or Town: Permii/Ucense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityrrown:Clerk 4_Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person; Phoney: _ 07/11/2011 07:45 9786833147 PAGE 01/01 DAT'E(MMfOQ�Yy) 4c'o CERTIFICATE OF UA191UTY INSURANCE 17/11/2011 THIS CER°IIFIGATE IS ISSUED AS A MATTER OF INFOMATION ONLY AND Ct"FIERS NO Rt6MTS UPON THE CERTIFICATE"OUN R. TFgS CERTIFICATE DOES NOT AFFMMATNELY OR 0GATii MY AMISMIX EXTEND OR ALTER TME COVIMM AFFORDED BY TME POLICIES &EtpVU, IMM CERTIFICATE Cr RISURAmm DOES NOT CONSTff M A CONTRACT 9E IMIN THE ISS VOURIERM AUITW .9D I11EPRESENTATM OR PRWUOEttr AND THE CER'TMATE MOLDER. IlI1PfNtTANT. if the a hokWisl;sn ADDMCM RMRED.Vo paUay(l*must Tse QndWead. IfSUBROGATION fS WANED.%Utd to the twma and gond W41 of the pWq,=WMn p ueft may Iqpre an ontlosrsmeenL A 1t on*ft MMO*d0M trot eDnfer rights to the Certlftcat0 holder M Rev of 200 MK16MW110140� 2RODUCER P ROSERTS INS ArCY INCE ) tames(97$)683-$d73 (978)683-3147 1060 Osgood Street ,� sandi®�lbertsinsurance.cm� North Andowr, mn 01845 tames IK3UMR A:PPJMFn EIQGE I4mv" "Mmm ASN MURP8Y SUILDIiI G & RJDDBLIIING INSURM e: CE 169 BOXFORD STREET Nsmlt : INSURANCE MORTB ANDOVER, MA 01845 E MUF&P: COVERAG CERnSCATE MUMSEW t REVISION NUMBER TMT$13 TD CERTIFY—HAT THE POUCIES OF INSURANCE LISTED BELOW NAVEBEE EO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIN TtISTANDI NG ANY REQUIREMENT.TERM OR CONDITION OF ANY CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSION$AND C0140MONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. TYPE OF•NSURANCE POU NUMBER uml7s IUT GONEPAL UABY ( EACH 000U 10E S 1,000,000 7C COMMERCIAL GUNERAL 114911M pRQdItSE$ a oatimen ! 9.00 .000 GLAM*VM ®OCMM WO Esq(Any ane person) 4 rJ 000 A CPP0060969 11/22/1011/22/11 P@Rs30NN.aAmRNA1RY s 1,0000 GENERAL AGGREGATE a 2,000,000 GEWL AGGREGATE LNT APPI Xs FIR PRDOUCTS-Comptap Aw a 2,0 00,0 0 POLICY LOG : AUTDMONS ASHM �to 1,000 000 AAqN�YAUM MCA7013s08 1/23/1101/23/12 OWLYKIURY(s�ar00MM) a AIJT08� w �� BODILY 94AIRY(Par 80MM) 4 a All. P AMUMT006MMa - a UMBRELLA LAO =IM EACH OCCMAENCE s s.lcm UAB HCLAAr4*V=, I: As %'M a am I I S $ MINORS COMNS A=14 AND EMPLOYERS LV LAITY TO T TLl. ANY � rrp E.L EACH ACOWNT 4 500,000 C OFFICIPWARUM Baa F-1 10PA KEWC213375 07/01/11 07/01/12 a L DISEASE-FA EWLO a 500,000 Omda arr$a tnq Q�11d� nom „ E.L OUASE-POLICY umrr I s 500 000 OESCRIPTMN OF OPERATIONS I LOCAYIONS 1 VENICI.ES(Atlash ACORD 1m.AdMmal Remarks Say dit st mere w*c;b b f9*M d) CER'nFICATE HO DER TION TOM OF NORTH ANDOVMSHOULD ANY OF THE ABOVE OMMIBED POLICES BE CANCELLED BEFORE NOME AMOVER, 2SA. 01$45 THE ExPIRAnON DATE THEREOF. NOTICE WILL BE OMMRED IN ACCORDANCE WITH THE POLICY PROVISIONS. Q -� AL'nR20 ®19W2010 ACOtRD CORPORATION. All sights res aved. ACOR025(2010MB) The ACORO name and WO are haled marks of ACORD Location � /9/IGr> �- No. — Date NORTH TOWN OF NORTH ANDOVER. F p + Certificate of Occupancy $ CMUsE<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 244 Building Inspector