HomeMy WebLinkAboutBuilding Permit #115 - 131 DUNCAN DRIVE 8/10/2009 TOWN OF NORTH ANDOVER
APPLICATI®ONN FOR PLAN EXAMINATION
Permit NO: / Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATIONv�FC
Print
PROPERTY OWNER ' ' IM[a A- 7cJ
Print
MAP NO: /'( /{�PARCEL: 1 b 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 No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BEP FORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address: r
CONTRACTOR Name: `rpt A-t-( LS -e �i� Phone: 76-
Address:_ , 4 t/c�/e-i►rre� teZA- i)Z�L/t;n �qA- C)( gl 0
Supervisor's Construction License: G&O -,?-(.0 Exp. Date: 111 -Lf1 a 9
Home Improvement License: jl! }� Exp. Date: Vl 0
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: $ 75- Gc)(D FEE: $ �BQ
Check No.: 1610 Receipt No.: Z Z.31
NOTE: Persons contracting wit nregistered contractors do not have access tot uaranty fund
Signature of Agent/OWner Signature of contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
Location
No. 5/,�_ Date
NORT„ TOWN OF NORTH ANDOVER
3� i • OL
F 9
. o, ._mss:.. ,• ,
Certificate of Occupancy $
Building/Frame Permit Fee $
s�CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # In/O
225j0
Building Inspector
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
/ "re,INTIERDEPARTMENTAL SIGN OFF - U FORM
1210-rIS ° � DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
� 1
CONSERVATION Reviewed on rd,64K)
Signature
i
COMMENTS
HEALTH Revie ed on 7 D 9' Signature
1 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:
— nA Located 384 Osgood Street
FIRE DEPARTMENT- ?np Dumpster on site yes no
Located at 124 Maio St ZIE
Fire Department"s nature/date
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
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2008
M
N
` Building Department
I The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
I
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
OTE: 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 2008
NORTH
Town of Andover
No.
o - L 0 over, Mass., 9
COC
t4l HEWICK
0RATED F"\
IT BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT......k ...................................................
...... .......................................................................................... Foundation
has permission to erect........................ buildings on ....... ... ................. .......... ...a44A"4a....... Rough
4f
to be occupied as ...... .................................. .... ....... Chimney
provided that the person accepting this permit in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the CodesBy-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 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS Rough
............. .............................. Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not I Remove Rough
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.
J
1'
AN
QO O� 51Gi
tK
P 1
S
lb v
/Y 14 ti%
poi- �
q q�ti LOT#185
AREA=49,581 S.F.
=1.138 AC.
/DO
lb
NOTES:
1) SEE TOWN ASSESSOR'S MAP #104B, LOT 185 p LAN
FOR SITE LOCUS. O ND
F LAND
2) SEE DEED BOOK 5864, PAGE #250, RECORDED AT
E.N.D.R.D. FORDED REFERENCE. IN 1 L1ti1 V 1J
3) PLAN REFERENCE: E.N.D.R.D. PLAN #8525 NORTH ANDOVER, MASSACHUSETTS
4) ZONE DISTRICT: R-1 DRAWN FOR
0
JOSEPH McKEOWN
BUNKERHILL INDUSTRIAL PARK
CHARLESTOWN, MASSACHUSETTS 02129
SCALE: 1"=40' DATE: MARCH 15, 2006
0 20' 40' 80' 120'
i
a
CL
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co
�. MERRIMACK ENGINEERING SER VICES
3/13/06
STEPHEN�'. I, R.L.S. DATE 66 PARK STREET
}
ANDOVER, MASSACHUSETTS 01910
Lot 5
49,581 S.F.
Assessors Mop 1048
Parcel 185
F'UTLIRE RESER�/E
AREA
37'
98-2
----------49 P-2 64/
G �---`T H
IIII
IIIA
P-1 I I OQ'S'IONAL FUTURE
I I 98-1RESERVE AR�q
48-)
Lot 6Leah Bd
I ► I � c�9'x
o
II . l
h I I I I (19'x48')
F j rn
co
E __ _ loot Lc
D-Box
98-3
Septic Tank —,
D
B
'A '
C
Prch D e c k 70
—70
a�
o
Benchmark: / {
Top of Foundation Proposed {
Elev. 132.17' Future
'
Addition
Existing Four (1 Bedrm){
Bedroom Dwelling
IT
� , I
' � w
o
l4- well
we// f
178.30'
WS WS
f
Edge of Pavement -T
D u n c a n Dr V e
The ComMweaft ofMassachusetts
i Delpartnte`"Y of Industrial Accidents
' iceo Inves
f etiQations
600 Nfashineon Street
�e Bosfon, MA 02111
Workers' Com ration fns' www"�sgov/dia .
Pe nuance A f£idavit: Bjut'Ider Contractors/Electricians/Pit�mbers
A R 'cant nformation
I
PIease Print LeQ'bl
N8n1E(Business/Qrgemization/Individual);
Address: del U,&JLfVA
City/sts&zip: till?Ol// M4- p/
Fmn
mployer?Cheek.the appropriate bo=
mployer with 4. ❑ 1 am a Typo of p t1 (required):
ees(full and/or * general contractor and T
part-time). have hired the sub- 6 []Now construction
ole ��
Proprietor or partner- listed on the attached sheet? 7. ❑Remodei'-
ship and have no employees These sul�-Contactors have
mg
working for me.in any capacity, workers' comp.insurance. 8. Q Demoiition
[No workers'comp. insurance 5. We are a corporation and its 9. ❑Building addition
3.❑ required.] Officers have exercised their ID.Q'El=triCal
I am a homeowner doing all work right.a f repairs or additions
myself [No•workers' � t'acemphim per MOL 1!.Q Plumbing repaus or additions
ComP_ 152, §1(4)'and-we have no
msurance•required.]t ern I 12-❑Roof repairs
P ayees.[No workem
' `I3.
ins Oth
�►P• tusrice er .2
t H app[icent tient checks box`#l must also fin oar tha ceation below showier
r fioineownea who sdbmit this d theirworkms'
aft'• omP�satiori oil
_ idavit
indicating they am an wo:yt end then his outside con t s bmft cation
_ ICaatraemrs that aheok this box must atm an e8ditiomsl sheat showing �o�mist sidm,i a sew dMavit iodi
the Rams ofthe mh. ��• oeiiog such.
m worked;' r F•_' irfn 'on
I ars•asf errrpusya teat cs.o1avwdF,rg wo■�.e.^�'con• erzs
wiformat orL iisrrranee for m!'enrplovee, BeLaw
is the lsol�j,.mra job site .
Insurance Company Name:
Policy#or Self-ins.Lic.#:
Expiration Date
Job Site Addr ms:
Adach a copy of the workers' cot .City/state2'rp:
compensation policy decfa.ra�u page(showier;the policy number and expiration date}. .
Failure to secure
coverage as required under Section 25A of MCiL c. 152 cart lead to the imposition of criminal fine up to 21,500a d and/or one-year imprisonment;as well es civil perudtim in the farm of a S7L7P WORK ORDER pies of a
of up m$250.00 a day agairist the violatrn. Be advised first and a fine
Investigations of the DIA for insurance coverage verification.copy of this statement may be forwarded to the Office of
I do hereby certify der e p aloes o e '
f P r!my fibs!the arforn"osr tvvi&d
P above is
( true and
Si •• Corm
Date: �S (o
Phone#-
[Board
use only. Do not write in this•arma,m he co+rspleted or town.o
7
J' Off=W
er;
Permif/License#
hority(circle one):
Fieaith L SniltlingDepartment 3.City/Town Clerk 4. Electrical Inspector 5.plumbingInspector
son:
Phone#:
Information aL nd In'structions-
Massachusetts
General Laws chapter 152 requires all emp Ioyers to provide workers' compensation fur their employees.
J t Pursuant to this statute,an emrpioyee is defined as"..:every person in the service of another under any contract afhim,
f express or implied,ora]or written"
An employer is defined as"an individual partnership,assc:�diation, corporation or other legal entity,or any two or mom
of the'famping engaged in a joint enterprise,and includi"g the legal relmsentatives of a diseased employer,orthe
receiver art ustee'of an individual,partnership,associatiozi or other legal-entity,employing carployees.'lioweva the
I owner-of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwolling house of another who employs persons to do maimtmance,construction or repair wrirlt on such dweliinghouse
i or on the grounds or building appurfEnant themtn shall not b=w=of such eraploymerd be dewed to be atnpioyer."
MGL chapter 152, §25C(6)also states that"every state as-local licensing agency shallwithhold the issaaaeeor
M renewal of a license or permit to operate a business or beta construct buildings in the commonwealth for any
applicant who has not produced acceptable"eace.of aompiiance with the.-insurance'coverage required."
Addidtm lly, MOL chapter 152, §25C(7)states-Neither the commonwealth nor any of its political subdivisions shall
M ent=into arty contract for the performance of public wade umil-=eptsbla evidence of compliance with the insraanee
I requirements.of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation•affidavit compictely,by checking the boxes that apply to your situation and,if
necessary, supply sub-cotrhactor(s)name(s),adclress(es):a nd phone number(s)along with their=elfin*s)of
insurance. Limitrrl'Liability Companies(LLC)or Limited Liability.Partnerships(LLP)with no employees otherthan the
members or partners,aro not required1to carr workers'colTnPrrrsation kmuarice. If an LLC or LLP does have
empioyees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accideri s for confirmatian of insurance coverage. Also Ere sure to sign and date the affidavit. The affidavit should
be.ret umed to the city or town that the.application fur the pe imit or license is being requested,notthe Depar mem of
Industrial Accidents. Should you have any questions regal-cling the law or if you are required to obtain a workers'
oompamtion policy,please-cail the Department at the nurmber.listed below. Self-insured cornpanim should creta their
self insraan=x license number.on tlre'appropiiamlirsa.
City or Town Officials
F ,
Please be sure that the affidavit is complete and printed 1✓glbiy. The Department has provided a space at the botmm
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 number which w►-jlI be used as a rnferznce number. in addition, an applicant
that must submit multiple pemrit/iicensc applications in any given year,need only submit one affidavit indica ting current
t'
policy'information(if necessary)and under".lob Site Address"the applicant should write~"all locations in (city or
town)"A copy of-tile affidavit that has been officially stamped or marked by the city or tawn may be provided to the
applicant as proof that a valid a#6davrt is on file for futwe permits or licenses. A new affidavit must be Mad out each
year. Where a home owner or citizen i obtaining a licause or permit not related to any business or commercial vwtum
(i.e. a flog license or permit to bum leaves etc.)said person is NOT.mquired tA-completethis afiidnk
The Office of investigations would fila 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 iv;;assacbusetts
Department of lmdustriW Aacid=ts
Office oaf Lnv$afi�ions .. .
600 WRC�Qton Stied
Boston, MA 02111
TeL#617-727-4900 ext 406 or 1-9.77-"SAFE
Fax;9 617-727-7749
Revised 5-25-n5 www.raass.DOv/c is N
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Fine Homes & Renovations, Inc.
P.O. Box 3057
w Andover, MA. 01810
(978) 475-5443
(978) 475-6564 fax
Dan & Linda Burns .
131 Duncan Drive
North Andover, Ma. 01845 June 27, 2009
Estimated start date: July 13"
Estimated time to complete project 2-3 weeks
Scope of work: Demo existing deck. Build new deck approximately 14' x 37'w/ 10'wide
stairs to the backyard. Pour 12" sona tubes as required. Framing to be 2"x10" pressure
treated. Built with galvanized fasteners. Install hangers, flashing and lag bolts as required.
Install Timber Tech decking and railing system. Using hidden fasteners for the.decking.
Trim the deck with composite/vinyl trim and privacy lattice w/a
ccess under the deck for
storage. Install trim using stainless steel fasteners. Build a.pergola/trullas type structure
approx. 10' 12' using pine /spruce materials. A dumpster will be on site and all building
materials and debris will disposed of properly.
Estimated costs for thero'ec
p � t $15,600 Includes all necessary 9 buildin materials
and labor to complete this project.
All work and decisions made on this project will be made solely
By: Barry Fine Homes & Renovations, Inc.
* includes drawings and permits as required by the town.
Exclusions: If a certified plot plan is not on file. A fee will need to be added to the contract
for this service.
.l
BARRY
Fine Homes & Renovations, Inc.
Andover, MA. 01810
(978) 475-5443
(978) 475-6564 fax
We propose hereby to furnish material and labor, complete in accordance with specifications, for
the sum of$15,600.00 A deposit of$8,500.00 is required to order all building materials for the
project The balance will be split into two payments. One when the deck is mostly completed.
The balance when the deck is completed.
All work to be completed in a workmanlike manner. According to the standard practices and local
building codes.
Authorized Contractor Signature
All home improvement contractors and subcontractors engaged in home improvement
contracting, unless specifically exempt from registration by provisions of Chapter 142a of the
General Laws,must be registered with the Commonwealth of Massachusetts. Inquires about
registration and status should be made to:
Director : Home Improvement Contractor Registration
One Ashburnton Place,Room 1301
Boston,MA. 02108 (617) 727-8598
Registrant's Name: Bar Fine Homes and Renovations,
. rYInc.
Brian Barry
Registration Number: 136892
ACCEPTANCE OF CONTRACT
The prices, specification and conditions are satisfactory and are hereby accepted. Your are
authorized to do the work as specified. Payment will be made as outlined on attached payment
schedule.
DO NOT IGN T S CONTRACT IF THERE ARE ANY BLANK SPACES
Owner(s) Signature- _
Date of Acceptance
r
Bbao w u g egu a ions an andel§—
HOME IMPROVEMENT CONTRACTOR
Registration: 136892
Exp
_gallon: Tr# 279442
=Tripe: DBA
r BARRY FINE HOMES&'RENOVATIONS
BRIAN BARRY -E t
30 RIVERINA RD.
ANDOVER,MA 01810= J
Administrator
i HT1.ella
Board of Building Regulations and Standards
�^ Construction Supervisor License
License: CS 82026
Expiration: --t-t/24/2009 Tr# 11952
'Restriction: 00
BRIAN R BARRY
30 RIVERINA RD
'ANDOVER,MA 01810 Commissioner
w