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Home My WebLink AboutBuilding Permit #313 - 124 COVENTRY LANE 11/5/2008 pORTH BUILDING PERMIT O0 TOWN OF NORTH ANDOVER ?`b� � APPLICATION FOR PLAN EXAMINATION 'A Q �Ow be 4t Permit NO: Date Received ��S °°°, r gsSACHUs�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 124 Coventry Lane No. Andover, MA Print PROPERTY OWNER George Vozeolas ' Print MAP NO GI's --PARCELO�ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration x No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands WatershedDistrict Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Strip woad siding- Tnstal l nr%x Vinvz 1 nir1inq and trim work Install replacement windows. - Identification Please Type or Print Clearly) OWNER: Name: George Vozeolas Phone: 978 688-5499 Address: 124 Coventry Lane Andover, No. Andover, MA 01845 CONTRACTOR Name: Aluminum Age, Inc. Phone: 978 664-547s Address:. ` i 7n Main gt raQt_NsLReadinT.—MA0186u1 - Supervisor's Construction License:cs 18685 Exp. Date: 12.06.09 Home Improvement License: 101024 Exp. Date: o6.24.10 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: $ 40.698_oo FEE: $ I Check No.: �// Receipt No.: Vc 6 -z- NOTE: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund mature of A ent/Owner Signature of contracto Location 1 19 /-"L.,y7�-,s lGlf / No. _111 ,,�/ � Date Gf NpRT� TOWN OF NORTH ANDOVER C:� .•a .•,tip F 9 }�o Certificate of Occupancy $ CNUs Building/Frame Permit Fee $ /Y Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �! 2t66 ? Building Inspector 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 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 Ii I 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 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 i ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 �� 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 r1O RT W TO" O Andov, e r No. 31 'kA 3 =-� - -- - LAKE or. dover, Mass., & /-&-'' COCHICHEWICK, y AORATE D `S BOARD OF HEALTH PER .MIT T D Food/Kitchen Septic System l BUILDING.INSPECTOR THIS CERTIFIES THAT � v Q Foundation has permission to erect.............:.......................... buildings1........................ ........ ...................... .................... Rough - to be occupied as................ -s.7rl.'? / ..` !... .!n! .....l .F� C."s '�:.'p ....�'�ye�-... (/fC, /Cxr;: � 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. P/c`�cPot.�,, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ' ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough .... ............................. . .... ... ..... Service . .. ...... .... . BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy 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. Burner Street No. SEE REVERSE SIDE Smoke Det. s-_\ J/Wl3f7rofful�ingegulaot�on_s/a�n tandar s One Ashburton Place - Room 1301 •' Boston, Massachusetts 02108 Construction ivisor License License CS: 18685 Restriction: 00 zl Expiration: 12/6/2009 Tr# 11251 DANIEL A VALENTE . �� ----- ----------------------._.__._...---_._..--.. 659 CHANDLER TEWKSBURY, MA 01876 = ` - -- ------- ---------- Update -Update Address and return card.Mark reason for change Address Renewal Lost Card DPS-CA1 Co 50M-07/07-PC8490 Xe BoaYr6VMrui1li`ng't#egulao/onLs/an tan ar s One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvemen Q bntractor Registration Registration: 101024 Type: Private Corporation If i ;x Expiration: 6/24/2010 Tr# 268468 ALUMINUM AGE, INC. ` DANIEL VALENTE t = 170 Main St � _ w= N. Reading, MA 01864 a Update Address and return card.Mark reason for change. Address Renewal ❑ Employment F] Lost Card DPS-CAI 0 5OM-07/07-PC8490 i I i � ✓die �o9ninw�uueall! o�./fil�waac`i.,�e�a _ Board of Wilding Regulations_and:Standards Construction Supervisor License: License: CS 18685 Expiration 216/2009 Tr# 11251 'Restncfion =0®�t DANIEL A VALENT'r ( :659 CHANDLER �� z�—.—� TEWKSBURY, MA 01876 C'omrnissioner r 101024 ALUMINUM AGE, INC. MA REGISTRATION NUMBER Complete Home Remodeling ° 170 Main Street,North Reading,MA 01864 (978)664-5475•(978)658-8462 DATE: t7ntnhPr 30, 2008 Fax(978)664-6287 Daniel Valente SALES REPRESENTATIVE MAIL ADDRESS: JOB ADDRESS: George Vozeolas 124 Coventr)z Lane LIN U yo^e 92F-F TELEPHONE: JOB TELEPHONE: —RESIDENTIAL CONTRACTING AGREEMENT— - Read this agreement and make sure you understand it before signing it.This agreement has legal force and effect and binds those who sign it. I. DETAILED DESCRIPTION OF WORK TO BE PERFORMED AND MATERIALS TO BE USED Strip Pxi sting wond sidinq from hause and haul away rjc-hri Furnish and install 3/8" fanfold insulation. Cover rake boards, facia boards, d 2 garage door casings, window casings and sills with white aluminum trim material- rover soffit overhangs with white v= roove soffit material. Cover body of house with Certainteed MONOGRAM 46 Vinyl siding basic colors. Furnish and install white seamless aluminum utters .032 uage) complete with premium elbows and down- spouts. Furnish and install seven traditional white corner posts to house and regular white corner posts to chimney. Furnish and install Azek trim board to bottom of threshold, top of door, and between arched window. Replace 25 ft. of wood facia. 24 248.00 If additional wood facia needs to be replaced, we will do so at $6.00 per ft. Remove existing wood sash from 23 windows and haul away. Cut wood stops inside or outside which ever is necessary to install new windows. If inside stops are removed install new stops at an additional 23 Majesty replacement windows with LOW E, Argon, and grids in las 8/8. of house, Install ed panpl.-, from hatt-am of peak to top 'lu II. PRICE Contractor agrees to do all work described in Section I for the total price of $ T®,t 7-0 III. PAYMENT Payment will be made as follows: Deposit upon signing $ 'FA 06)C-) LABOR GUARANTEED FOR 12 MONTHS Start of job AGAINST FAULTY WORKMANSHIP. Halfway thru job $ GUARANTEE IS VOID IF CONTRACT IS NOT PAID IN FULL. Due upon completion $ Payments made after 5 days of completion are subject to finance charge of 1 1/2%per month. HOMEOWNER:DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. BEFORE SIGNING PLEASE READ BACK,SiDE OF TH Ow er's Signal a ate Signed Contractor's Signature Date ignetl Owner's Signature Date Signed s The Commonwealth of Massachusetts Department of Industrial Accidents tall Office of Investigations 600 Washington Street ; ', ;;iii ; . - Boston , MA 02111 w►nw.mass.gov/dia Workers' Compensation Insurance.Affidavit: guilders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibl Name (Business/Organization/Individual): nc. Address: 170 Main Street City/State/Zip: No. Reading,MA 01864 Phone#: 978 664-5475 Are you an employer?Check the appropriate box: 1.® I Type of project(required); an a employer with 2 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 sheet. 7• ❑X Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. 11 We area corporation and its 9 ❑ Building addition required.] officers have exercised.their 10:7 Electrical repairs or additions 3.❑ I am a homeowner doingall work right of g exemption per MGL 11. Plum P ❑ umbin repairs or myself. [No workers' comp. c. 152,§10), and we have no g p additions insurance required.] t employees. [No workers' 12.❑ Roof repairs comp, insurance require 1 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. +Homeowners who submil4bis affidavit indicating Gres are ueieg ail:qff atact tion hire outside contras iuis niu3i submii a new amdavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractor;and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employ information ees. Below is the policy and job site Insurance Company Name: A I G 6592680 Policy#or Self4s. Lic.#:-6443800 11.20.08 Expiration Date: Sob Site Address:- IL24 (`oven t r3Z rano City/State/ZipNo. Andover MA 01845 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 thisstatement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: 978 664-5475 Official use only. Do not write in this area,to be conWieted 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. PlumbiElnspect]or 6.Other Contact Person: Phone k 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 of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and includi-ing 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 resides 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 " p , § ( ) states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit-to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the 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 of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation 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 not required to cant'workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may.be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure 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 lase,or if you are required to obtain a workers' compensation policy,please call the Department at the nurnber.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 affidavit 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 se number which will be P used as a reference number. In addition,an applicant that must submit multiple ermit/ficense applications in any given year,n.e ed only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the 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 permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA.02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26=05 Fax 4 617-727-7749 www.mass.gov/dia