HomeMy WebLinkAboutBuilding Permit #11-15 - 135 JOHNNY CAKE STREET 7/7/2014 BUILDING PERMIT O�No Dr b�ti
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION10 ,
Permit No#: �j / Date Received �s oArED
SACHU
Date Issued: a ,
IMPORTANT: Applicant must complete all items on this page
LOCATION: _ _
PROPERTY OWNER,�
Pnntr 100 Year Structr Ye ! no:.
MAP�� PARCEL .uZONING DISTRLCT Historic ®isfncty ye` ono ;
Machine Shop Village ye no
-� - - -- - _
0
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:
0 Demolition ❑ Other
Septics 1Nell ❑'Floodplain, ❑Wetlands.; ElINatershed�Distnet
I]:Water%Sewer
DESCRIPTIOP OF WORK TO BE PERF MED:
..Rt I t -fi'le.,
P
e
dentification- Plea e Type or Print Clearly
YP
OWNER: Name: D d re Ccry�,fr,PC AA Phone: /
Address: /,3,5- T�Alle V G Sl /U Axl-ovepc q (ol&4 �
Contra
-.t -N _ u — Pf one:_
�. � c�
IAddre-ss:_ f°Y1tytJr1
' CS
5 - 2 1�- r6
} Super icor s Construction License ___ - - LExp �Date: . ..r._ -_
Homexl`rnprovementxLicense= Exp
n
ARCHITECT/ENGINEER Phone:
Address: /56.41P .0 Reg. No.
FEE SCHEDULE.BULDING PERMIT.!!�)2.00 PER$1000.00 OF THE TO AL ESTIMATED COAST^ SED ON$125.00 PER S.F.
Total Project Cost: $ �� L`' FEE: $ ® '�
Check No.: < Rece�pt No.: )
II, NOTE: Persons contracliiregisterey contractors do not have access nd !'
i
N
Li'gnature ofAgent/Qwne Srgnature of contractor �.
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL +
Public Sewer ❑ Swimmin Pools ❑ I
Tanning/Massage/Body Art ❑ _ ,g , I
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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
i
r
CONSERVATION Reviewed on Signature
A {
COMMENTS
HEALTH Reviewed on Signature
II
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Con nection/sici nature& Date Driveway Permit
DPW Town Engineer:Signature:
Located '384 Osgood Street
IF E D EPARTMENT c7 Temp F_ umpster ons situ
Locatedlat 124.Mai Street t �
Fire!Departmentsignature/date
x
C;j MMENTS
y
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
Movement of Meter location mast or service drop requires
ELECTRICAL. Movem p q 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 i
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
o Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
j ❑ 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
f
o 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)
L3 Mass check Energy Compliance Report (If Applicable)
1 ❑ 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
L3 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
Location C l �- —
1
No. 1 Date �-
I
i
e •, TOWN.OF NORTH ANDOVER
Certificate of Occupancy $ t
Building/Frame Permit Fee $
. s ? Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check#
27739
Building Inspector
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
115;j64 8,30 OA) im
$ - $ 187.78
Plumbing Fee $ 23.47
Gas Fee 100 comm. 1$3 1t00}00)
Electrical Fee $ 23.47
Total fees collected $ 334.72
135 Johnny Cake
011-15 on 7/7/14
Bath remodel, laundry room
r -i r V NORTF� - r
2 c . . ve' 'o
0
- �
No. -
® T Z ti
oh over, Mass,
C0CNICN2 WIC"
�S,9S RATEo PPP,`'�5
U BOARD OF HEALTH
Food/Kitchen
PERMIT T L D Septic System
11111111101
THIS CERTIFIES THAT ........... .�i�.�l!016'. .. .......... BUILDING INSPECTOR
Foundation '
has permission to ere ......................... ildings on ......ar... ... : ..: . ...... .... r.
Rough
to be occupied as ...Fol.... . .. . ... .....� .. :- . . . .. .... .... ....�...� imney
provided that the person accepting this permit s all in every respect conform to the t s of the a plication 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
I .
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIOSS4 S Rough
Service
.. ...... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required 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.
i
A. F. Watson General Contracting Estimate
3 Edgemont Street
Derry,NH 03038 DATE ESTIMATE#
Tel. 603-437-6134
Cell#603-661-5360 6/28/2014 1498
NAME/ADDRESS
Tom&Brenda Comerford
135 Johny Cake St.
N.Andover,MA 01845
TERMS PROJECT
Due on receipt 2nd Flr Laundry Closet
ITEM DESCRIPTION QTY COST TOTAL
Cont.fee Contractors 10%Fee profit+overhead 10.00% 642.82
CHANGE ORDER
May 29,2014
>Removed l Miscellaneous.(-$0.00)
>Increased price of labor from$2,520.00 to$2,700.00.
(+$180.00)
>Added 1 Subtotal.(+$6,428.23)
>Added 1 Cont.fee.(+$642.82)
Total change to estimate+$822.82
I
THANK-YOU A.F.WATSON
TOT L $75071_05
SIGNATURE
OWNERS SIGNATURE
T<YVV\-
Page 2
Y
A. F. Watson General Contracting Estimate
3 Edgemont Street
Derry,NH 03038 DATE ESTIMATE#
Tel. 603-437-6134
5/29/2014 1529
Cell#603-661-5360
NAME/ADDRESS
Tom&Brenda Comerford
135 Johny Cake St.
N.Andover,MA 01845
i
TERMS PROJECT
Due on receipt Mud Room
ITEM DESCRIPTION QTY COST TOTAL
labor Carpenter's labor estimated Hrs. 52 45.00 2,340.00
1. Demo closet walls,strip tile floor 12hrs
2. Patch walls and ceiling as needed 12hrs
3.Install new tile floor.12hrs
4.Build and install bench and cubbies per drawing two
walls.12hrs
5.Install Door?4hrs
3/4"Birch 4'x 8'x 3/4"Birch Plywood 4 73.05 292.20
poplar 1"X 8"X 1'-0"Poplar 30 2.43 72.90
Plumbing Cap Plumbing 50.00 50.00
Electrical Electrical work 300.00 300.00
Disposal Disposal fees 100.00 100.00
B1ueBd. Tx 8'x 1/2"Blue Board 2 10.99 21.98
Miscellaneous Miscellaneous 75.00 75.00
Subtotal labor&Materials 3,252.08
Cont.fee Contractors 10%Fee profit+overhead 10.00% 325.21
Painting Painting by Others 0.00
THANK-YOU A.F.WATSON p
TO ~ $3,577.29
SIGNATURE
OWNERS SIGNATURE
A. F. Watson General Contracting Estimate
3 Edgemont Street
Derry,NH 03038 DATE ESTIMATE#
Tel. 603-437-6134
Cell#603-661-5360 6/28/2014 1498
NAME/ADDRESS
Tom&Brenda Comerford
135 Johny Cake St.
N.Andover,MA 01845
TERMS
PROJECT
Due on receipt 2nd Flr Laundry Closet
ITEM DESCRIPTION QTY COST TOTAL
Permit Town of N.Andover building permit fee Allowance 0.00 0.00
labor Carpenter's labor 60 45.00 2,700.00
1.Cut seam in carpet @ master bed rm doorway.fold
carpet back as needed to route plumbing pipes in floor.
2.Remove shelving from hall closet and bath rm closet.
3.Remove the back wall of the bath rm.closet,and strip
the back wall of the hall closet as needed for laundry
hookup and electrical.
4.Relocate central vac and electrical as needed to frame
new doorway for laundry.
5.Open wall in kitchen pantry closet as needed for pipe
route also in basement pipe box would need to be opened
to access plumbing.
6.Repair and close pipe box and pantry close,install new
blue board laundry closet wall as needed.
7.Install a 3/4"birch plywood partition to create a
shallow closet for bathroom.
8.Close Hall floor from pipe routing and reinstall carpet.
9.Install Bifold Closet doors for laundry closet access.
10.
j BlueBd. 4'x 8'x 1/2"Blue Board 3 10.99 32.97
3/4"Birch Tx 8'x 3/4"Birch Plywood 2 61.05 122.10
IXIOClear Pine 1 X 10 Clear Pine 16 4.26 68.16
Doors Bifold Door unit 1 425.00 425.00
Plumbing Allowance Plumbing:Supply and install necessary 2,000.00 2,000.00
drainage+water piping
Miscellaneous Miscellaneous 80.00 80.00
Electrical Electrical work Allowance 1,000.00 1,000.00
Subtotal labor&Materials 61428.23
THANK-YOU A.F.WATSON
TOTAL
SIGNATURE
OWNERS SIGNATURE
.
Pagel
Massachusetts Home Improvement Sample Contract
This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard
language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A
Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the
Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website.
Homeowner Information Contractor Information
Name- Coni Name
�'1 r soul ae
Street Address(do not use a Post Office Box addr s) Contractor/Sal arson/Own Nam
e
L�A_ T6�n e 0 � ST 1^ �+�� ` 50N
Ci own S Zip Code Business Add (must include a s t address
VeI� c� 0 L PilI10N
Dayti.a Phone Evening Phone City own State Zip Code
7 Q7- 62 Zo r O
Mailing Address(It different from above) Business Phone Federal Employer ID or S.S.Number
Home hupruvement Contractor Reg,Number L•xpbmion date
taw requires that must home /
impmvument mntmctors have
valid registration number
The Contractor agrees to do the following work for the Homeowner.
(Describe in detail the work to completed,specs Vung the type,brand,and grade of materials to be used,use additional sheets if necess J
Pe-Ao `M41 LGvy\k M r /Y10i�/au r( 7'� z z 24G ll GIISe(
Re2 'c
AO ^ (�r �
Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will
and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise
(Owners who secure their own permits will be
excluded from the Guaranty Fund provisions of 7 Z—/Date when contractor will begin contracted work.
MGL chapter 142A.)
Date when contracted work will be substantially completed.
Total Contract Price and Payment Schedule
The Contractor agrees to perform the work,furnish the material and labor specified above for the total stun of: (*)
Payments will be made according to the following schedule:
$ 2� upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater)
, L r
$ b / / or upon completion of 9DVq'/L r N5�OCr16A)
$ / /_or upon completion of
$� upon completion of the contract. (Law forbids demandin full payment until contract is completed to both
p patty's satisfaction)
The following material/equipment must be special $ A be paid for
ordered before the contracted work begins in order
to meet the completion schedule.(**) $ paid for
NOTES:(*)including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may
not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
Express Warranty-Is an express warranty being provided by the contractorsNo❑Yes fall terms of the warranty must be attached to the contract)
Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third
party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for
materials and labor under this agreement
Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the
contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices
carefully before signing this contract.
• Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear.
• Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and
subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor
registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757.
• Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to
see a copy of a"proof of insurance"document.
• Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer
Guide to the Home Improvement Contractor Law.
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the
contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the
third business day following the signing ofthis agreement. Seethe attached notice ofcancell4ion form for an expla4on of thi right.
DO NOT SIGN THIS CONTRACT IF THERE E Y BL CES!
Tura identical copies of the contract must be completed and signed.Ore copy should go to h spy should be re c 'r�l10
-Lo��
Homeown 's Signa re WContractor's!
Date Date
SINQf�ice.of Consumer Affairs&Business Re u'atioa
OME IMPROVEMENT C i'4.°r�IL A
eglstration; 118848 TYPe
XPIration AM212015 DBA
A.F.WATSON GEN CQNTRACTING.
i
ARTHUR WATSON
, F
3 EDGEMONT ST
DERRY, NH 03038 Undersecretary.
Massachuse. . -Oep
artment of Public Safety
9
Of gtiil14n0�er3idati�r�s and
Boar
dSta en'isor i &2 Family F .
Construrt=on CSFA-063168 a
License; , c
wATSON rI
DEFY� 03038 '�
r� Ex Pi ration
0211212016
Commissioner
The Commonwealth of 1V1assach.usetts
Deparbuentoflndustyr(tlAccidie is
Office oflnvestigations .
600 Washington Street
Boston, NIA 02111
www.ivnassgov/clra
Workers'Compensation Insurance Affidadt:Buflders/Cony°actor sAlectxxclauslPXer.
Applicant Wormation Please PrintLealblY
Name(Businesslorganizafion&dtvidual): A&U
.A.d&ess: 3E
��""��honeik
City/State/Ztp: Ee 0 J G ,` o
Are yo employer?Check the appropriate box: Tyne of project(required):
1, lam a employer wither 4• I am a general contractor and I 6. []Now construction
employees Gull and/or part tim.e)•* have]tired the sub-contractors
2.[l I am a sola proprietor or partner listed on the attached sheet; �• fRIe—°deling
ship and•haveno•employees These sub-contractors have 8. ❑Demolition
working forme in any capacity. workers'comp.insurance, g, Building addition.
[No workers'comp.insurance 5, ❑We area corporation audits 10.0 Electricalrepairs or additions
required.] officers have exerelsedtheir
3.[j I am a homeowner doing all work right of exemption per MGL 11.[]Plumbing,repairs or additions
e EEO corn . c.152,§1(4),andwehaveno 12,[] °ofxepairs
myself [N p
insuraucerecluired.] emptoY
ees.[No workers'
coap•insurance required.]
13[]Other,
�A•ay applicant that checks boxflf must also 0 outthe section below showingtheir workers'.compensationpolicy information.
'Homeownerswho submitibisaffidavit indicatingfhey9" doing all work and thenhire outside contractors must submit a new affidavit indloaft such.
xContracfors that checktlus bob mustattached an addifioud sheet slhowingthe name of the sub-contractors and their workers'comp.policy information.
Yam an employer thatisprovidingwor1kerrs'compensationinsurancefog•fnyeinpI e� Be1'o isthepalicyanrij0 Site
in,formation.
Insurance CompanyName;. t✓ I b er4y MIC11
Policy#or SON-ins.Dic.#: C, 3 f on Date: / f
lob Site Address-- Ca e-- ST- Pity/State/Zip:, IQ Ah�0\/e-2. /elf 6►$�{�
Attach a copy oMe workers'comPensation•polley declaration page(showing-the polley numbor and expiration!date). }
failure to secure coverage.as requiredunder Section 25A ofMGL o.152 can lead to the imposition of criminalpenalties of a
flue up to$1,500.00 and/ox one-year imprisonment,as well.as civil penalties in the form of a STOP WORK ORDER.and a fzn.e
ofup to$250.00 a day against the violator. Be advised that a copy of this statementmay be forwarded to the Office of
InvestigationAtha for insurancecoverage verification.X do 11ereby enaltles eytury that Me information provided ab ve is true and eor'r"ect. -
Si afore• Date: �/ /
Phone 4: 0�
official use only. Do not write in dais 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/Tovm Clerk 4.Electrical Inspector 5.Plumbiung Inspector
6.Other - - -
Information and Instructions -
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for that employees.
Pursuant to this statute,an ernTloyee is defined as"...every person hi the service of another under any contract ofbire,-
express orimplied,oral orwxitten."
An employWis defined as"an individual,partnership,association,corporation or other legal entity,or any two or
xaoxe
of the f6regoing engaged in a joint enterprise,and Including the legal representatives of a'deceased employer,.or the
Ted
eiver ox trustee ofan individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having notmore than three apartments and who xeAdes therein,or the occupant ofthe
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
ox on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an anaployer."
MGL chapter 152,§25C(6)also 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
anter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance
requirements of this chapterhave beenpresented 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)andphone numbers)along with their certifieafe(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members orpartn.ers,arenotrequiradto carryworkers'compensationinsurance. If an LLC orLLP doeshave
employees,a olic
. � yisxegwxed. teadvised thattlusaffidavit maybe.submitted tothe Department of 7ndusfrial
Accidents fox confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returnedto the city or town that the application for the.permit or license is being xegaaAed,not the Department of
II� Industrial Accidents. Should you have any questions regarding the law or if you are xeq*e'd to obtain a*orkers'
compensation policy,please call the Department at tho number listed below. Self insured companies should enter their
self-insurance license number on the appropriate line. '
City or Town Officials
I
Please be sure thatthe affidavit is complete andpriated 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 pennit/license number whichwill be used as a reference number. In addition,an applicant
that roust submitmultiple permit/license applications in any givenyear,need only submit one affidavit indicating current j
policy information(ifnecessary)and under"Jab Site Address"the applicant shouldwrite"all locations in . .(city or
tov&)",A copy ofthe 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 frle dor future p ermits or licenses. .A new of ldavit must be.fillad out each
year.'Whcre a home owner or citizen is obtaining a license ox permit not related to any business or commercial venture
(i.e.a dog license or liernaft to burn leaves eta.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to,thank you in advance fox your cooperation and should you have any guestions,
please do not hesitate to give us a call.
Thebepartmenes address,telephone and fax number:
�h�CQjnmoawean of Massa c vs-tt,
Qffic�oTu �di� aon
6.04 Wasbia&a ftQt
Boston,M 021 It
TQ1,4 617-72Z-4900 e�406 ox 1-87.7 WA.SS.AFF,
Revised 5-26-05
WWWmag¢-v1dxa.