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HomeMy WebLinkAboutBuilding Permit #241-15 - 115 LANCASTER ROAD 9/8/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 'I. Permit NO: Date Received Date Issued: I PORTANT: App licant must complete all items on this page rVIC LOCATION P'`int PROPERTY OWNER �,..rt- Ial F Print y 100 Year Old Structure yes no MAP NO: _ PARCEL: ZONING DISTRICT Historic District yes o Machine Shop Village yes no TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building 160ne family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 1 �.�,s,.,.�3-e �t•..;s'�-��..a c�.c.�c. Nu ��n�-p(t�..13' c�.�� Identification Please Type or Print Clearly) OWNER: Name: an6ert Phone: S-iYi - 636 • o6�i Address: „,mss r n CONTRACTOR Name: �<Q, :, ,,_ M..• 4. __ _____.--Phone: 3 _.L Address: �a ��r�JT tr'.�-►--fi- 11 t 1� . ., � a.:��.� Supervisors Construction License: 05-3 91`k Exp. Date: «- Home Improvement License: ' Av 0,li4 -_ _ Exp. Date: 7-OL� t1� ARCHITECT/ENGINEER Ny 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: $ 2C1 `�b D FEE: U U Check No.: L 1 S Receipt No.: �� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund �Signattare of Agent/Owne Signature,of'contracto -.._ _ Plans Submitted Plans Waived Certified Plot Plan ❑ Stamped Plan 7 Plans-Submitted ❑ Plans=Waived .-.' Certified Plot Plan ❑ Stamped Plans ❑ a._ TYPEOF:;S>JWERAGEDISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑. . Swimming Pools ❑ Well ❑ -Tobacco-Sales •FoodPackaging/Sales ❑ Private{septic tank,etc_: permanent Dempster on-Site ❑ a - I =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 Conservation Decision: :Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Tow;! Engineer: Signature: Located 384 Osqqqd Street FIRE DEPARTMENT.-Temp DurnOter on site yes no Located at-124tMain Street FireDepartme�ifsignature/date � ,���-. , ��. ; xti :-� �, ,;,;� g •�« x, _fi r.` y., s. , COMMENTS . , r T-•. .DimenstGn.- 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 requires approval of Electrical Inspector Yes No DANGERZONE LITERATURE: Yes No MGL.Gh'apter 166.Section 21A.--F and G min.$10041000:fine NOTES and DATA— (For department use ® Notified for pickup - Date I Doc.Building Permit Revised 2010 Building Department The fol,-owing"is"a=list of.the required forms to befilled outfor.:the appropriate-permit to be obtained. Roofifg, Siding, Interior Rehabilitation Permits ❑ B;iailding Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And1Or 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) o- Engineering Affidavits for Engineered pro _ucts_f__ 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 apn•,al 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.Buifding permit Revised 2012 1 Kevin p�\V/� �� 98 Forest Street North Andover,MA 01845 PH:978-688-5335 • Building Contractor FAX:978-688-7207 Proposal To: ob Mongelt 1 5 t anCaSter Road All Home improvement Contractors and Subcontractors _. engaged in home improvement contracting,unless Orth Andover, W 01845 specifically exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Improvement Contract Registration,One From: Kevin Murphy Ashburton Place,Room 1301,Boston,MA 02108.(617) -7278598 CC: 0 Date: 8/28/2014 Job: eck Date of plans: o'e, Architect: one Location: ame, Section I -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, /8/14'. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by y10/15/14. 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 Kyear 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 performed in connection with the agreed-upon work. Section 111 - Scope of Work Page 1 of 9 Page 4 of Kevin Murphy Building Contactor 98 Forest Street North Andover,MA 01845 PH:9*1 25 FAX:9,—.—,207 'General Proposal is to upgrade existing deck on rear of house. Building_permit will be obtained bycontractor. No Ilowance has been made for any footprint v emolition All existing decking and railings will be removed. Frame of deck to remain. wilding All new Timber Tech XLM decking will be supplied and installed on deck and stairs. Harvest Bronze / Walnut Grove decking will be installed as is shown in Tiber Tech brochure. Kickboards on stairs and rim boards of deck will also be trimmed in matching color. New white radiance railings will be supplied and nstalled to match front of house. Under side of stairs will be trimmed with Azek bead board. New " dry, system"will be installed under existing deck frame. lectrical Two Timber Tech lights will be installed in posts/rails. Location to be determined. Waste Removal Ali demolition/construction debris will be disposed of by contractor. 0 . 0 0 0 0 NORTFI Town of s_E over No. - ,� oh ver, Mass, pr 'P coc.ucM.ww 1. x,95°R�reo �PR���S U BOARD OF HEALTH PERMIT LD Food/Kitchen Septic System THIS CERTIFIES THAT . 0..., BUILDING INSPECTOR ... .............. ...... .. ...... ............................................ A Foundation has permission to erect .......................... buildings on ..I.�.�......... ....................""" Rough to be occupied as ....... .. ..N ....... �,�...... P +. ..�....................... Chimney provided that the person accepting this permit shall in every respe 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. 6/b CA#.& fir ,f/"j .e PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIOS 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. Page 4 of Kevin Murphy Building Contractor 98 Forest Street North Andover,MA 01845 Se ff- Price Schedule We hereby propose to furnish material and labor complete in Accordance with above specifications for the sum of ... ... ... ... ... ... ... ... ... ... ... ... .$ 29,50 Payment to be made as follows: Percentage/ Description Amount Item j1l Permit obtained / demolition complete; $3500' 2 OeCking installed' ;$15,000; P IRailin s installed,/ $8000, 4 UOb complete', $3000 I I I I I I I I I I ] I 1 Total 41 $29,500.0 —Notice:No agreement for Home improvement contracting work shall require a down payment (advance deposit)of more that 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 and/or otherwise obtain delivery of special order materials and equipment,whichever is greater Contractor: Kevin Murphy 98 Forest 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 JDate Signature Date The Commonwealth of Massachusetts - Department of Industrial Accidents Office of Investigations IV 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): ,1�✓� „rte _ Address: City/State/Zip: �,�, b w.�., M;,. ���`� Phone#: b U -5-3 31 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a �with employer 4. El am a general contractor and I - 6. F1 New construction F employees(full and/or part-time).` have hired the sub-contractors 2.❑ I am a sole proprietor or partner- 7. Remodeling listed on the attached sheet.� 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 10.El 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.]r employees.[No workers' l3.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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. U--C. 1-116114 Expiration Date: Z Job Site Address: \,C- 1.�...��a�e ti `(l�. City/State/Zip:_ c X%%T� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 herebcert under the pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: �_< 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 health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: DATE -0 �hf CERTIFICATE OF LIABILITY INSURANCE 6/25/2014� 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(ies)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 F TACT Sandi Munroe : M P ROBERTS INS AGCY INC NEg78 683-8073 F''X 0.(978) 683-3147 1060 Osgood Street IE .san 1 mpro ertslnsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE MAIC# INSURERA- MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURERB: GUARD INSURANCE 169 BOXFORD STREET jNSURER C: NORTH ANDOVER, MA 01845 INSURER D: NSURER 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 B SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NS D L N MBER POLICY EFF I V LILY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE El OCCUR SESEa occur r� $ 500,000 BOPI068945 11/22/13 1/22/14 MED EXP one erson $ 15,000 A PERSONAL&ADV INJURY $ INCLUDED GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY 1:1PECT ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea amident) ANYAUTo MCA7013608 01/23/14 1/23/15 BODILY INJURY(Per person) $ A AUTOSALLOWX SAUTE�DULED BODILY INJURY(Per accident) $ NON-OWNED PROPERTY D AGE $ HIRED AUTOS AUTOSaccident) UMBRELLA UABOCCUR EACH OCCURRENCE $ 1,000,000 AH EXCESS LIAB HCLAIMS-MADE AGGREGATE $ i CUP9145304 11/22/1311/22/14 DED I I RETENTION WORKERSCOMPENSATION X SE T TE �R- AND EMPLOYERS'LIABILITY ANY PROPRIEfORIPARTNERIEXBCUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICERIMEMBER EXCLUDED? NIA (MandatoryinNH) KEWC527844 07/01/14 7/01/15 E.L.DISEASE-EA EMPLOYEE $ 500,060 If es,dlscrbeunderDESCROPERATIONSPTION OF 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. itAUTHORRED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Location �--+"mea S�t ,z-- Vd' No. 1 Date o - TOWN OF NORTHANDOVER Certificate of Occupancy $ • '— Building/Frame Permit Fee t Foundation Permit Fee $ r�F p ni Other Permit Fee $ jc a »Ef��`., Cir ED h. TOTAL $ Check#-� 7 1 J Building Inspector