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Home My WebLink AboutBuilding Permit #481-11 - 126 LACY STREET 12/14/2010 TOWN OF NORTH ANDOVER �D- APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: l l IMPORTANT:Applicant must complete all items on this page LOCATION \1 Pr PROPERTY OWNER `camV&Ctff ) Print MAP NO:/0 TV PARCEL:ZONING DISTRICT: Historic District yes no Machine Shop Village ye n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 1DUne family K dition ❑Two or more family ❑ Industrial eration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other 91 SepticFloodplam� ®W�etlands� �I ®`�WratershedtDistrict J ES TION OF WORK TO BE PERFORMED: Iden . icatioil Pie CT Pie or Print Clearly) OWNER: Name.—, t V��C `�. , (A Phone: '`f g 6�'D 3� Address: x S T . CONTRACTOR Name: Phone: Address: I J�'C,, v��n�.�,..y ? P U��V44,e 01\ Supervisor's Construction License: 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: $ 7 6) FEE: $ n Check No.: i Y/r— Receipt No.: d NOTE: Persons contracting with unregistered contractors do not have access to g ants fund _i..y Si nature of contrac S gnature_ofzAgent/Owner r F 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 i 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS I 1 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I 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—Fund 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 dOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit n all cases if a variance or special permit was required the Town clerks office must stamp the decision from the Board of Appeals Fiat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doc-Building Permit Revised 2008mi Location l No. —// Date I —w NORT1y TOWN OF NORTH ANDOVER 0 ALO ~ A 9 Certificate of Occupancy $ �''�0��s•.,tea �ssCMUsE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 7 � 6 Building Inspector a The Property subject to these warranties and the- -requirements of this Contract and Rider A may be considered defective by the.Owner without charge to the Owner, where such failure to conform appears prior to the date of completion of the work or during the r warranty,period set forth in this:paragraph 4 of Rider A ! provided,:however, that only reasonable a.djustrnents arising from the expansion or contraction of wood will be made. EXCLUSIONS FROM COVERAGE Contractor specifically clues not assume responsibility for any of the oltowihq .items, each of Which is specifically excluded from this-Warranty- 1. his Warranty:1. Defects in windows or the door to be installed which are covered by the manufacturer's warranties. 2. Damage due-to abusive use; misuse; or lack of proper maintenance of the windows and,door to be installed. 3. Defects in 'items installed, supplied, or work done by the fawner or anyone other than by the Contractor or at its oilier. MANUFACTURERS WARRANTIES The Contractor-hereby°passes through and assigns directly to etre towner any and all manufactur4es warranties on the Andersen windows:and Andersen door supplies!to1he-Owner. 5._ On or be€ore .D:e.'cei.Pber 1, .2010, Contractor shall cause its insurers) to provide one or more Cedificate(s) of Insurance addressed to the Owhi r evidencing one or more: currently effective pol cylpU ivies of insurance (a) providing liability coverage In an amouni - of $1,000,.000 per -incident/S4000;000 inthe* a aggregate; {b? workers' compensation insurance; and. (c) cornmer I veh le lability coverage, f r DLM Remodeli rtners Stephen 'Ventala David.L. McLellan, Owner Its: Partner, duly authorized Dated Noverr ber 22, 2010 Novetrnber 22; 201`0, 2 t ,2 S f RIDER A TO 'CONTRACT For Window Removal and.Replacement Window and.Door l:nstallation at 126, Lacy Street, North Andover, MA 01845 ('Property') Between David L. McLellan, Owner And D.LIVI Remodeling, a Partnership ("Contractor") o, This Rider A is incorporated by reference as a material part of the above- referenced Contract, dated November 22, 2010 between the undersigned parties as OWNER and CONTRACTOR. To the extent that the:provisions of this Rider A conflict with the terms of the preceding two (2) pages of the Contract, the provisions of this TWer A sha i control in every case:: ' 1. The Contractor-shall perform all work in.a good and workmanlike manner. 2. Contractor shall apply fora building permit from the Town of North Andover, which cost is included in the total price.stated:on page two of tate Contract, 3: The Owner shall pay the Contractor the sum of Five Thcusaarud Seven Hundred Thirty Dollars ($5,730.0G) u.Oon the execution of the:Contract and-this Rider A, payable to "DLIM Remodeling." The Owner shall make a final payment in the:amount of Eleven Thousand Four Hundred;Seventy Dollars($11,470.00) up-on the canlipletion of the work; 4. Contractor w errant$ to Owner theft any Arid al construction and otherwork performed by the Contractor ori the Property will be of good quality, free frown T faults-and defects, performed in a good:end workmanlike manner, for a period.of ten (10).years from the,.date of completion of the work,.ani firer-her wear-ants that all work Will be performed in conformance with applicable building,..,sanitary, health„ and environmental codes and zoning ordinances urider'appropriate and. proper.bu:i.lding permits andiauthorizations. Without limiting the generality of the foregoing lanrguag the C ntraetor specifically warrants that for a period of ten (•1% years from the date, of completion of the work, the windows and door installed by the Contractor shall remaln dry, tight, and free from all water and leaks. 1 f Contactors Initials Owner's limit its s �' ..,E `--�-•-.�,.-...-_,..,...e,w....:.._. t i 11:6ctng a,-i fa.11f vs# a h.. re- t Tic7r tiE1 t,sei �iuti 3 C{3 ill: c, CT f��c�'[L '.tca'cc3 . art-i t 1 e.icr z7 r . a �dt & e: ct.te �ante a�trt. Pui c IL a�1) ,ut ::,tr;tt l f } .. ' 43C �a-J i),3'c car lJt"le II,.t''•�o and VIliz Clad .Anderson Wood LaTi klt s:ries rIcnlazcMetnt ti�`€3ldOws,.CI-2ai pin--inTevorani:-while G}1LI so?CBUrlbr.571-ap►bt.,,-Ui?i3 gid5"Ill- 0 {.t'.1 Patio door will}x; lidesc;u NNarr�»3ictt lh cit pine ieir arta' �ititc lad R:esPCc li'uUv Subrriimd:S 14 r4e.r delr ��e _ f E Windows Doons Siding O.Of ing .f��r�FrC@t��;C�:-t39"+y.t t3 gtil�erc tic�Etse r fF=Ft3:5 VS a y t• $rix , v DLM Remodeling Steve Ventola Pave Her-ra fielt 154 Boardman ave„ Mel-rose, lea. 02176 781-223-6,629 761-"1-89-8827 David Mblellari 126 Lacy Street North Andoxer;T+>la. 978-495-073' dltncl e1 t an'u?eartlr l i nlL..t�et. Contract Work-,to be.performccl as IblIo,.Ns: --Remove existing windows and storm windows -Inspectfor and repair any minor rot Prel)opening r6r-new wwr-iiidow imsta lation � -Install wvindows detiiilcd.as follows: :f i l,7-Uou le hang N-�vindow I-P'icurre window 1 —2 lite casernent window 1-6' sliding.patio dear Ai-I windows ter have federal tai; inccntlVe,requir.ed.glazing which is:a 1-ni imt.-m U va ue of,UJi1Anst late.atid caulk all windows -Remove existing patio-door,in,pttct fL�rand re}aaiir any rotted w od_hi l'1 Anderson sNarroulihe- patio door. Flash,ins tlatc-ared caulk as ncccled:Fstall new interior and exterior trim to match existing design- -Ittsulate.and caulk all windows --Iborougldy clean rill witidtiws and work iV �Remove;all debris upon completio t of work F; hict inch all.labor and materi f� 677-2 Office Ansumer HOME IMPROVEMENTit N mess egu a on : on: CONTRACTOR Registration:- .��.61597 Expiration: p/ �2012 Type: I Individual S EN VENT p �. STEPHEN VENTp i ,LA .� 154 BOARDMAN AV1 x t K MELROSE,MA 02176 Undersecretary ses- Department of Public S IViassachuat'et� tt Board li Buildin�o Re!fFulations and Standards . Construction Supervisor License License: CS 92687 Restricted to: 00 STEPHEN M VENTOLA 154 BOARDMAN AVE MELROSE. MA 02176 Expiration: 10/2/2011 Tr#: 4874 ('umYnissiuncr p i 's t ,3 .Y } 1 The Commonwealth ofMassachusetts Department of Xndustrial.Accirlents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Btiidders/Contractors/JElectricia- sIplurnbers Applicant Information I )Please Print Legibly NaMe(Business/Organization/Individual): Z° Address: L I c� ,t/ City/State/Zip: Phone#: -� . Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction ployees(full and/or part-time).* have hired the sub-contractors 2 am a sole proprietor or partner- listed on the attached sheet.? 7. emodeling . ship and have no employees These sub-contractors have 8. Demolition workingfor me in an capacity. workers'comp.insurance. Y9. E]Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its ' required.] officers have exercised their 10.❑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.]t employees.[No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box 41 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. #Contractors 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 isproviding workers'compensation insurancefor my employees Below is the policy and joh site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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,. ell as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator ad s py o this statement may be forwarded to the Office of Investigations of the DIA for iasuranc erification. I do hereby certify under t a' er" ry that the information provided a^boove is true /and correct. Si ature: Date: Phone#: 'L fl-a5 (j Z a/ 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 CIerk 4.EIectricaI Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: