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HomeMy WebLinkAboutBuilding Permit #564-16 - 12 Lincoln Street 11/5/2015 ORT6O� q • BUILDING PERMIT "` 3� g6 �`a.D�'•�6 TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 74A°R�ieo •� / Date Issued: 9SSACHus�t I ORTANT: Applicant must complete all items on this page ��Locarl0 Phnt J PROPERTY OWNER Y .°l I'1�? �=: GCG w Pnnt 4 K MAP N© 1?ARCEL:y ZONINGiDISTRIC f_° << Historic District yes o rs f Ys oaga ShMahineo Vil TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building rbne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial WfF epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic" ❑.Well UFloedplaii 0 Wetlands . ❑ Watershed D s#roc#5' o--l'�NaterlSewer Tr`a me- 'rol'!� deCb tW i�Jacivre -- Q97me &ze as ex,chn 4 • Cm tyle rearl�f �oo� on burn u� roorus Identification Please Type or Print Clearly) OWNER: Name: Jim Mc c-e .n nell Phone: 4795 /o ir'b--6 10 Address: CONTRACTC2R Narne: ' Phone` 97 nC ` Address � Gr l 1 /I/�e` Ex Date Superv�scir s ions#ructionx Addhse p . Home Improvement License Exp..`Date ' til . f ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: 2 Al A Qa. oy FEE: $ 4,714( Check No.: Receipt No.: NOTE: Persons contras g t unregis red co actors do not have a c to the a fund Signature ofAgent/ wn�r:` x nature of contrast' ' y s .. 07, J_ .. ° '••� - - - - ... ^A n .. is . ...u_� , ° a BUILDING PERMIT ° s,LEo bgti0 TOWN OF NORTH ANDOVER 3� 5 o - 0 APPLICATION FOR PLAN EXAMINATION * - c 'M Permit No#: Date ReceivedrED �gSSgCHus���y Date Issued: _ IMPORTANT: Applicant must complete all items on this page " LOCM LO`Nh f I EROT V; 1ZI P m# X10©°Year S7#ruc use: ye wng) !MAP _(PA�.RCEL �Z®N`I`NG iDISTtR1,:CT�H stor>ic f®istrict1 yesa mo, ac�hn'e=Shop Village �fyes +no; TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑,1Nellu Floo plains ❑Wetlands; �0UV.Ita ersh.edllD% trict, � _ 'I t"er/SeWR 5 DESCRIPTION OF WORK TO BE PERFORMED: a Identification- Please Type or Print Clearly OWNER: Name: Phone: _ Address: Con;#ractorName: fPh®ane - -- - - _ +�E ailu A d-te s�_ Super�uis-or"s•:Conru:cti;®niLicenses a Exp Date. _ IlHorne Imppov m}ent��License_--__ _---------- lb(y iDate- 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund EFw ' :Signature of Ag tom/®wner�� - 1Signat'u ©fr contract®rte__,_-� 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 o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products VOTE: 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 o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/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 products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application ❑ Certified Proposed Plot Plan Li Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products COTE: 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:Building Permit Revised 2014 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. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature v COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes a Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street AFIRE D`=PAR�TME�NT� :hemp ®d'"M tero e yes L►©ca et d at124Mai,nStreet �F�re D`epa�t ent"�signafiure%,_daat"e; CO`MMEN `D 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 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) j ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Location ,(. No. Date/ / J • TOWN OF NORTH ANDOVER i • , Certificate of Occupancy �= Building/Frame Permit Fee r Foundation Permit Fee ' Other Permit Fee $ TOTAL � dq3. Check# i 1 6 Building Inspector NORTH Town oA0le� � EAndover 0 No. ver, Mass COC MICMEWICK BOARD OF HEALTH Food/Kitchen PERMIT L D Septic System �, ' BUILDING INSPECTOR THISCERTIFIES THAT .......... ....................... ......... .....�.0r..1..................................... Foundation has permission to erect .......................... buildings on ... ......... �.�-.�. ....... ..... Rough to be occupied as ....... ...... j �.�. . ...... .... ................................. Chimney provided that the person accepting this permit shall in every re t con or 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. �• � 6A-L PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 4 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TAR Rough Service s ................... .... ... ...... ....... ................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina' No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and `Approved by the Building Inspector. Burner Street No. Smoke Det. CONTRACT ROBERT BOHONDONEY CONSTRUCTION CO. 12 HALL STREET METHUEN, MA 01844 978-685-0970 (office) /978-685-8262 (fax) Fully Insured Construction Supervisor License#979 Exp 4/21/2016 Home Improvement Contractor#114238 Exp 8/16/2017 bohondoneyconstruction@yahoo.com Customer Name: Jim Maccannell Property Address: 12 Lincoln St, North Andover, MA 01845 Contract Type: Front Porch Rear Roof and Interior Repairs Date: November 3, 2015 r Scope of Services: Front Porch, Rear Roof and Interior Repairs 1. Supply local building permit. 2. Supply workers compensation and liability insurance certificate. 3. Supply job site clean-up and removal of construction debris from site. FRONT PORCH 1. Support roof and demo existing deck, stairs and columns. 2. Dig and install concrete footings for new deck. 3. Supply and install new floor framing using pressure treated materials, composite decking and pvc columns. 4. Supply and install new stairs with composite treads and and pvc risers. 5. Frame and install square pvc privacy lattice around bottom sides of deck. 6. Supply and install self storing wall enclosure system with self storing door panel. Harvey Building Supply. i 7. Repair wall siding as necessary at front of house. Page 1'of 2 INTERIOR REPAIRS 1. Supply materials and labor to sheetrock and paint 2 bedroom ceilings and paint bathroom ceiling. REAR ROOF 1. Supply framing materials and labor for new roof pitch on rear roof bump out. 2. Provide materials and labor for rubber roof and all accessories necessary for rear roof bump out. TOTAL CONTRACT AMOUNT: $22,200.00 Payment Terms: Deposit amount of$7,400.00 to start project, Progress payment of $7,400.00 and remaining contract balance of$7,400.00 at completion. ,a � Customer Signature: t`t'�'"� `"`�-- �"�'�'� Date: Contractor Signature: cebi'tf ". Date: rC/- Page /Page 2 of 2 21' u 0 iO CU) 0 10IN SONO TUBE ~ o_ 6x6 Fos 3-2X10Lr1 Beanx cu d, .. Plan View Jackson Lumber&Millwork bob boh. 215 Market Street 11/05/15 Ref: Deck15309 Lawrence,MA Scale: 1/4"= F (800)555 1212 I i I i� VIII Rail Layout Post SKU Description CUT FROM Radiance Post Sleeve.12'. White DT-251055RADWH Radiance Post Sleeve,42". White Rails Section X-ref Cut From B DT-25106RADWH (Radiance Rail Pack 6'. White) A DT-25106RADWH (Radiance Rail Pack 6'. White) Design: Deck15309 STRESS ANALYSIS CUSTOMER: BOB BOH. DATE: 11/05/15 DESIGN: DECK15309 REF: SALESMAN # - ------------------------------------------------------ MEMBER STRESS FACTOR COMPOSITE TYPE SIZE FACTOR LOAD LOAD ------------------------------------------------------- JOISTS 2X10 DEFLECTION 1487 PSF 1G" BENDING G90 PSF SHEAR 382 PSF COMPRESSION 594 PSF 382 PSF BEAMS 3-2X10LM DEFLECTION 203 PSF BENDING 140 PSF SHEAR 145 PSF COMPRESSION G83 PSF 140 PSF POSTS GXG STABILITY 1202 PSF BEARING 821 PSF 821 PSF ----------------------------------- TOTAL LOAD 140 PSF DEAD LOAD 10 PSF LIVE LOAD 130 PSF ------------------------------------------------------- STRINGERS 2X12 DEFLECTION 177 PSF BENDING 19G PSF SHEAR 181 PSF COMPRESSION 741 PSF ----------------------------------- TOTAL LOAD 177 PSF DEAD LOAD 10 PSF LIVE LOAD 1G7 PSF ACQRH CERTIFICATE OF LIABILITY INSURANCE MM/DD1rY'Y) ..�~. 11/3/15 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: N the certificate holder Is an ADDITIONAL INSURED,the policy(es) 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 CONTACT NAME: Bates Insurance Agency Inc. PHONE (781) 396-4985 F°X Ne; (781) 395-9454 92 High Street, Suite BlE-MAIL Medford, MA 02155 ADDREss: Andrea@BatesIns.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A:RCA—Essex Ins Co INSURED INSURERB:A.I.M. Mutual Ins. Co. Robert Bohondoney INSURER C: Bohondoney Construction INSURER D: 12 Hall St INSURER E: Methuen, MA 01844 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INR ADDU SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WV13 POLICY NUMBER M/DD/Y MMMDIYYYY UMTS A GENERAL LIABILITY 2CM7759-15 2/3/15 2/3/16 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GE NE RAL UAB DAMAGE TO RENTED $ 100,000 CLAIMS-MADE Fx—]OCCUR MED EXP(Anyone person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OPAGG $ 1,000,000 POLICY PRO LOC $ AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS eraccident UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AWC40070243322015 8/9/15 8/9/16wRMET,uT OTH- AND EMPLOYERS'UABIUTY ANY PROPRIETOR/PARTNER/EXECUTNE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Ifns desaibe under DESCRIPTIONOFOPERATIONS below E.L.DISEASE-POLICY LIMIT,$ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space B requi red) 12 Lincol Street N. Andover, MA 01845 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1988-20 10 ACMD CORPORATION. All rights reserved. ACORD 25(2010/05) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: .,. t 't: ... � f r........ - .• L .. _. .. � - .. ... 1 • J . A r 1 1 �.1 ' {^. I .. ! - � i r C' r .. , .� 'Y a The Commonwealth of Massachusetts Department of IndustrialAecidents ` 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMUTING AUTHORITY. Avolicant Information Please Print Legibly Name (Business/Organization/Individual): Address: _Vq O City/State/Zip: A,k*UCH IVA 67 Phone#: I7 e 69509?49 Are you an employer?Check the appropriate box: Type of project(required): l.fam a employer with 3 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑1 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Q Building addition 4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I I.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[ oof repairs These sub-contractors have employees and have workers'comp.insurance.t r(.i�l 6.0 We are a corporation and its officers have exercised their right of'exemption per MGL c. 14.�ther 152,§1(4),and we have no employees.[No workers'comp.insurance required.] JL •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 are 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for nay employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: G ��7 c.7�p�AV w Expiration Date: Job Site Address: lo? U ncoli? &4 City/State/Zip: /N -& d� lw e wl - Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerd nd r the p ins7447, n ties of per ty that the information provided aboveis/true and correct. Signature: Date: Phone#: &7 5_0 q—7 0 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 S.Plumbing Inspector 6.Other Contact Person: Phone#: Massachusetts -Department of Public Safety Board of Building Regulations and Standards Cimstructi„n SuperNisor License: CS-000979 ROBERT A BOHONDONEY X- 12 HALL ST ' g METHUEN MA 81844 93 c' ,J�,.,.,11�St�.. '� "•'' `• Expiratior, Commissioner 04/21/2016 pff ce Of .//,. Consumer N1E 1N►pROVFMAfrNTCairs&Busin�s Re ` egistratioR; 114 ONT�CTp gelation < xpiration: ROB23 8 R 8116120 Type: ERT BOHONDONEy CON's r CO DBA ROBERT BOHONDONEy HALL ST METHUEN,MA 01844 Undersecretary .., ,"delvei�traln k - ''trW"fih.AUnYII'•Sgr���' .,.L...0 ` 1 - a� �.t.,"1 ..k - F w �� v! `IXV k V v „ - : win. �, q, �,-•.�e—:i , a r I L ►.�' uis p ' 1, r. E , 4 M N s s. 15 auu5c- �v N O:k:b k 6 va4eaj [0-4(g �Gco",t- PVC