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HomeMy WebLinkAboutBuilding Permit #878-15 - 1327 SALEM STREET 5/6/2015 4K AU tou� ' BUILDING PERMIT "°oT"�ti TOWN OF NORTH ANDOVER o? APPLICATION FOR PLAN EXAMINATION z ti Permit No#: Date Received �QA`R, 4SS reo Date Issued: �S� ACHUS IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER' Pnnt . . 100 Year Structure yes o MAP -;PARCEL 07 ZONING- DIST- ICT: __ _ Historic District yes o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 'W'One family ❑Addition ❑ Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Se tic ❑Well, ❑ Floodplain ❑Wetlands El Watershed District /10 Wate, Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: LGA, M,rt�,a„�.� Phone: (,ri- q)g0i • 94-75' Address: �32'l Se-U-e- - - Contractor Name:JJA6n-!22. Phone:__ Address: Supervisor's Construction License:--v7-3 0 ' Exp. Date:_ 61zq ,l5_ Home.Improvement=License: . lu `t "1 '� T s Exp. Pate, 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: $ FEE: $ k O 2- , u 0 Check No.: � 2-7- Receipt No.: o;gJ 2Je NOTE: Persons contractingwith r, ' tered contractors do not have ac ess to the guaranty fund Signature of Agent/Qwne — gnature of contracto ~i i 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 I' ❑ Building Permit Application i ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses L3 Copy of Contract L3 Floor Plan Or Proposed Interior Work o 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/Cross Section/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:Building Permit Revised 2014 I 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 III Reviewed On Si PLANNING & DEVELOPMENTnature g COMMENTS CONSERVATION Reviewed on Siqnature 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 Town Engineer: Signature: Located 38 Street .FIRE DEPARTMENT Temp Dumpster on site yes noZLocated at 1NMain Street Fire Department signature/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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Location 1 ��� �`� ►� No. 4F 78 Date / • • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $Idol,� Foundation Permit Fee $ Other Permit Fee $ � . ,.. TOTAL $ Check# Building Inspector %AORTfy Town Of _ � E ndover tit -I6 iy C% h ver, ass s- -C o > Mass, / C OC.*CMr W"a �• ' A-SAO AT 7d RED ''P 7S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System d3i BUILDING INSPECTOR THIS CERTIFIES THAT ..........!.�.�1�..........................................................:............................................. C has permission to erect .......................... buildings on .�....7.r... ..�. ...�.r�-.�...................................... Foundation 3 to be occupied as .................. ...l� all�d/�,5 Rough .............................................................................................................. Chimney provided that the person accepting this permit shall in every respect 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. 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 .. `............................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired 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. Tin. 98 Forest Street K,e Y Murphy • North Andover,MA 01845 • PH:978-688-5335 Building Contractor FAX:978-688-7207 Proposal To: Keith Mullen 1327 Salem Street All Home improvement Contractors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma. 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 Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA02108.(617)-727 8598 CC: Date: 5/6/2015 Job: Replacement windows Date of plates: None Architect: None Location: Same Section 1-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 4/27/15. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 5/20/15.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 fumished hereunder shall be free from defects in materials and workmanship for a period of 1 year 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 III-Scope of Work Page 1 of 4 t f � � Kevin Murphy Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:978688-5335 FAX 97868&7207 General Proposal is to supply and install thirteen replacement windows. Permit will be obtained by contractor. Building Thirteen Harvey replacement windows will be supplied and installed Seven windows on first floor will be clad exterior, and clear pine interior. Six windows on second floor will be clad exterior and interior. New pvc window sills will be supplied and installed. No allowance has been made to replace any interior or exterior casing. First floor windows will have wood removable grilles. Second floor will have grilles between the glass. All windows will have full screens. Painting No allowance has been made for any interior or exterior painting. Waste Removal All construction debris will be disposed of by contractor. 1 s Kevin Murphy Page 4 of 4 Bu lding Contractor 98 Forest Street North Andover,MA 01845 PH:9785885335 FAX 978588.7207 Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ...... ... ... ... ... ....$ 8500 Payment to be made as follows: Percentage/Item Description Amount 1 Permit obtained / deposit $4000 2 Job complete $4500 Total 2 $8,500.00 "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 rP Y 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 OT�'v"T IS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date Signature Date The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 °a www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Eleett'icians/Ptumbers. TO BE FILED WITH THE PERI MING AUTHORM. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: ole S'V SST City/State/Zip: ta, , per. • oLT-Whone#: 'VI T Are you an employer?Check the appropriate box: Type of project(required): LtSV am a employer with _employees(full and/or part-time).* 7. F1 New construction 2 I am a sole proprietor or partnership and have no employees working for me in ❑ 8. ,Remodeling any capacity.[No workers'comp.insurance required.] 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition Q4.❑I am a homeowner and will be hiring contractors to conduct all wort:on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13. Roof re airs These sub-contractors have employees and have workers'comp.insurance.t p 6.FJ we are a corporation and its officers have exercised their right of exemption per MGL c. 14.F1 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *An applicant that checks box#1 must also fill out the section below showing the' y pp g rrworkers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. t ontractors that checkthis 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 ant an employer ilial is providing workers'compensation itisrii attce for ttry employees. Below is the policy and job site information. Insurance Company Name:_,J Policy#or Self-ins.Lic.#: (A� b-1 z/L L'-J Expiration Date: 57 Job Site Address: L 32,71 City/State/Zip: "e,, 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 her\e6Y certify under the pains attd penalties ttty that the information provided above is true and correct. OLS, Date: Phone Official use only. Do not sprite 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 /DDf die9RH CERTIFICATE OF LIABILITY INSURANCE 6/25/2014 YYYY) 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 POLICES 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 endorsements. 11 PRODUCER FA , Sandi Munroe M P ROBERTS INS AGCY INC (978) 683-8073 Fa Na:(978) 683-3147 1060 Osgood Street ADDRESS: i mpro ertsinsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURERB: GUARD INSURANCE 169 BOXFORD STREET INSURER NORTH ANDOVER, MA 01845 INSURER D: N NSURER 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLI Y N MB MMIDDfY EFF PO�CY EXP LIMITS HCOM MERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000,000 CLAIMS-MADE MV OCCUR PREMISES Ea o=rrence $ 500,000 BOPI068945 11/22/1311/22/14 MED one person) $ 15,000 A PE RSONAL$ADV INJURY $ INCLUDED nGENOTHER' 'L AGGREGATE LIMIT AP PLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY 11JE1:1LOC PRODUCTS-COMP/OP AGG $ 2 OOOOOO AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ANYAUTO BODILY INJURY(Per person) $ A ALLaWNED NT SSCCEEDULED MCA7013608 01/23/14 1/23/15OS BODILY INJURY(Peraccdent) $ HIRED AUTOSNON-OWNED PROPERTY AUTOS dentDAMAGE $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMS-MADE AGGREGATE $ 1 r CUP9145304 11/22/13 1/22/14 D RETENTION WORKERS COMPENSATION XPER OTH- AND EMPLOYERS'LIABILITY ST TUIE ER ANY PROPRIErORMARTNERIEXECUTNE YIN E.L.EACH ACCIDENT $ 500,000 B OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) KEWC527844 07/01/14 7/01/15 E.LO,SEA.E-EAEMPLOYEE $ 500,000 If descrbe 0, IONOPERAT500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks SchedLde,rnziy be attached ifmorespace is reqLirad) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF TIE 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. AUTHORIZED REPRESENTATIVE Im ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS-053099 KEVIN W MURP10 98 FOREST ST North Andover MA 0 45i� Expiration Commissioner 06/29/2015 �le Cpazn�zarnzurecr,�o��/�ciaoac�acateL� i. Office of Consumer Affairs&Busi ess Regulation I U196 OME IMPROVEMENT CONTRACTOR egistration: 401874 Type: xpiration: 6/29=16, Individual KEVIN MURPHY j Kevin Murphy 98 FOREST ST. g N.ANDOVER,MA 01845 Undersecretary iII f