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HomeMy WebLinkAboutBuilding Permit #687 - 1423 SALEM STREET 6/10/2009 t BUILDING PERMIT rpt fl oT e;9tip TOWN OF'NORTH ANDOVER F t'. - . - . ' yp APPLICATION FOR PLAN EXAMINATION # . Permit NO: Date Received 1!" - - ��SSgCHUS�� 5 Date Issued: - 0' v IMPORTANT:Applicant must complete all items on this page LOCATION ""i" � � Aelo�llpvf Cc) W Pant ti PROPERTY OWNER Print MAP NO: PARCEL: ZON,ING DISTRICT: Historic District _.yes r }Y Machine Shop Village yes n 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 ` t' #; Floodplain Wetlands Watershed District Water Sewer DESCRIPTION OF WORK TO BE PREFORMED: Iden 'fication Please T e or Print Clearly) 8 OWNER: Name: of - Phone: �'/D0 i s Address: Sq(em Jt. C416 COIN'TRACTOR Nara .e: VOgA Phone: d � E, Adc ress.. dAve, �4 l!'Ytr` 1 � , Supervisor s Coastru;dtion Licensed . Exp. Date: Hone„Iprovement'License: Exp. Date: t 3 .C. 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: $ `� FEE: $ j DL Check No..: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to a guaranty fund T m,. signature of,.Ag"d caner__. ._ Signature of contracto Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Taming/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales- 1 1, 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 i j I CONSERVATION Reviewed on Signature COMMENTS r FtALTH 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,DEPATRTMENT -Temp DuMDster on site yes 'no LUocated at 1,24Mairi.Street , F i re`3Department 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 I Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No j MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine f NOTES and DATA For department use i I ❑ Notified for pickup Date Doc.Building Permit Revised 2008 ' i I, I Building Department . ' T 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 o 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 E3 Workers Comp Affidavit ❑ Photo. Copy of H.I.C. And C.S.L. Licenses o 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 stampthe decision from the Board d 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 Location W3 No. G Date NORTH TOWN OF NORTH ANDOVER F •.. _ _ AL • ; . Certificate of Occupancy $ MUS Building/Frame Permit Fee $ S Foundation Permit Fee $ y" ,i Other Permit Fee $ TOTAL $ Check J ,i 22-107 -- -_ Building Inspector I F FORTH Town of 2 " Andover No. o - LAKE dover, Mass., C OC HI C MEW1CK ADRATE D PPS\ �5 `S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...........C4-K-I...'%V.. !'A........ ........ � h 1 �................. .. ... ... ..................................... Foundation buildings on ..... ... . ........ &IttA.......... ... ......a................. Rough has permission to erect............................ g �. K .... . t0 be eCCllpled as........ .....�.. ............... ...... ....�. ...... ...................................................................................:.......... 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final ��® • PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR . UNLESS CONSTRU STARTS Rough .... .....:. Service BUILDING INSPECTOR Final Occupancy Permit Required to 'Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry"WallTo -Be Done_ FIRE DEPARTMENT Until. Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. I 2009-05-29 14:38 _ 978 8$0 0023„ l 1044— i 1 _•. 24t�.. 27" 70" _. ,_15rt �% 33'k- 36" 3'!3g .._ 31 7V, ._ ...j 91, 33"'f II ...�, .r �H ' -i..-13.i..c:.•.H �? •- ... .: �i�Rn�!Ip,,�t.n,id;;GTtluP"{uPP.i,r.. "iPa�L•P�7k�aa:'ii Pri.!)6:i"<.,.P,n3a�uluta���dW3't i;(•#-•`!.g•�l,!c;;i _ WW1530R 2730 �t 30 :. 24:DIS.M V.TD91� OCD338424 ................ i 3 -n-- N i yiYxi.?} N 5 �Ire •_ •• �r�A! M (A :;P'"id 04, E�� ;iM- 44 I I Art „Itl ilL�x�; c� 4D$15 5836 B1 5L � •.� ^I�_.._�:�,...,J,i '��_�. � :__ -..,....___... ....BP9648CRSGR--_-._..._._..- N s 0.. w sensa granite giallo latina 50 sgft w14 back Splash $3605.00 i with 4"back splash $4001.50 sink included 56.5sgft newo�. , I rAli dimeju ionssiiC dc�ign36ious given adv Plug is nn�tril;intd drsil n and must not bc. Designed:5/29/2009 ! 9UL?ICCt t0 Verification all job3iG;mid - releaxrrt orc:cdpir.d UnIK,+a Hprlicr•f".ahlhas Printed:5/2912009 adjustment to fit job conditions. been trtidl or,loh order rlac.&I r I 1 2 kimbed kit _ erwin}„11: Y• All D `e\ The Commonwealth of Massachuseft U, j1 Department of Industrial Accidents Office of lnveskgations gto 600 TTrashin n Street .�; Boston, MA 02111 www mmsgovldia . Workers' Compensation Insurance Affidavit- Builders/Contractors/Ei Alicant nformation ectriciaas/pitimbers ppI Please Print LeQibl i NaB � e Business/ , ( Or iza6o � n/Endividu el . G r C3 'Address: 20 5+v0L,4 e City/State/ ' : �o g SO F_ �/�14; ®1'1 c��RS?7 Phone#. . Are you as employer?Cheek thea ro PP Pritate boz: Type of Project(required): I•[] I aro a employer with 4. ❑ I am a general contractor and I ( � : employees (full and/orpart-time).* have hired the sub-contractors 6.. ❑'New construction � 2.� I am.a.9ole proprietor or partner. listed on the attached sheet,2 7. ❑.Remodeling ship and have no employees' These sub-contractors have working forme in any capacity, workers' camp.insurance. g' ❑Demolition [No workers'camp,insu¢ance 5. ❑ We are a corporation 9• �]Building addition rP and its required. officers have exercised their 10.(]Electric a]repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.❑ Plumbin myselt[No•war6ns'comp., . a grepa►rsoradditions insurance-required.]'t §I(d),and we have no 12.❑Roof r-pairs .employees: [No workers' comp• insutartcx required_) 13•❑.Other `�Y applicant that checks boxy#l moat also ffii out the section beiow showing their workers'aompettsetion policy information t homeowners who submit this affidavit indicating they am doing all work and than hire outside contractors must submit a now affidavit indicating�Cmrrrnctors that check this box rnustetlecbrd an adtfitioasl aheetshow such. ing•the name of the sub•cwtractom and their workers'cem^, n. . � dart n ePrployEF drat is protnding workers'co ensatfan r F_••-, &n M d0TL. . . infornxakon. mP insurance for my empboyem Below is the o � p key and job site Insurance Com pony Name: ' 6tcd Policy'#or Self-ins.Lic.9:_. 0100 C- Expiration Date: lILI Job Site Address- iyz3 sa �Ay4>,�r -- city/statert Attach"a copy of the workers'compensation policy declarafioo page(showing the policy number and expiration da Failure to secure coverage as required undea Section 25A of MGL c. 152 can lead to the imposition of criminal fine up to $0.00a0 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER penahies of a of up to 250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office fd a fine investigations of the DIA for insurance coverage verification. I do hereby cert nd r the pairs and penalties of perjury that theinformation m ' P vided above is true and correct. Si tore: Date: p p Phone#: LBoard use nilly. Do not write in this areq to be completed by city or town off n: Permit/License# hority(circle one): Health Z Building Department 3.City/T©wn Clerk 4.Electrical Inspector 5. Plnmhing Ins r p�son- Phone#: Information a and Instructions Massachusetts General Lachapter 152 requires all emp Ioyers 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 wrirten." An e»rployer is defined as"an individual,partnership,association, corporation or other legal entity,or any two ormore of the,foregoing engaged in a joint enterprise,and includirig the legal representatives of a deceased employer,or the recei�%er or tnrstee of an individual,partnership,associatiorn 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 mai-xitenance,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 states that"every state or local Scensing agency shall withhold the issuance or renewal of a license or permit to operate a business or oto construct buildings in the commonwealth for any appli'c'af ant who has not produced acceptable evidence.ocompliance with the insurance'covernge required." Additionally, MGL chapter 152, §25C(7)states'Neither tie 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 requn-emerds of this chapter have been presented to the coritracting authority." �Appiicants Please fill out the workers',compensation•affidavit compi=taly,by checking the boxes that apply to your situation and,if necess sub-contra s name(s),addres es a �y� mpp1Y �'( ) s( ) �nd 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 carry workers cornpensation insurance. If-an LLC or UP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Departme 9 of Industrial Accidents for confirmation of insurance coverage... Also'be sure to sign and-date the affidavit. The affidavit should be returned to the cityor town that the.appIfication for the permit or license is being requested,not'the Departmq;nt of Industrial Accidents. Should you have any.questions regarding the law or if you are required to obtain a workers' compensation policy,pleasecall the Department atthe nurnber listed below. Self-insured companies should enter their self insurance'llemse number on the'appropfiate line. City or,;Town Officiais 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 number which a-ill be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need 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 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 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 bum 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 doinot hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Endustiial Accidents Office of Envestibations 600 Washington Street Boston, MA 02111 TeL #617-7274900 Ext 406 or 1-8.77-MASSAFE Revised 5-2ti=Q5 Fax;9 617-727-7744 www.mass.gov/dia ards efe -Vomvrrl CONTRA ations✓annddS B d of anilding Reg CTOP" I' oarENT OVEM HOME IMP, 149585 1 Tr# ,62168 Re!isti- �3012010 Exp►�at�4�1 log l IANSON CONST." IQN��C� a SONt$ AIG HAN f> I CR. T AVE � `: Administrator.` 20 STRO TON.MA WEI �ILMING ft: Board.of HuiIding-Regulat►orS'sand Standards \` `I Construction Supervisor License 1 " License: CS 70415 \J Birthdate%7/18/1972 J lar; i ,.Expirat( 7 j1j8l2009 Tr# 16720 c ,Restnc�t�o CRAIG A HANSOM 20 STRE)UT AVE ll `4 ,��'� i \ = .5 � WILMINGTON, MA 01884. Commissioner 02/14/2009 16:46 9784092062 CRAIG HANSON PAGE 01106 Hanson Contsuuct on 20 Strout Ave Wilmington MA.01887 .508 509-W4 CONTRACTOR AGREEMENT THIS AGRUMENT made the__26_day of May by and between Hanson Conquuction ,.hereinafter called the Contractor. 20 Strout Ave Wiltr n MA 018$7 and Kimberly Chalcravard , hereinafter called the Owner. Witnessed,that the Contractor and the Owner for the consideration named agree as follows: Article 1. Scope of the Work The Contractor shall furnish all of the u atezaals and perform all of the work shown on the Drawings and/or described in the Specifications entitled E Mbit A,as annexed hereto as it pertains to word,to be performed on property at 1413 Salem St. N. Andover MA Artiele 2.7flme of Completion The work to be done under this contract shall be commenced on or about 6/l/09 Time is of the essence. Article 3.The Contract Price The Owner shall pay the Contractor for the material and labor to be performed under die Contract the sum of 6642.00 ,subject to additions and deductions pursuant to authorized change orders. Article 4. Progress Payments Payments of the Contrast Price shall be paid M- the manner following: 1 st. At Signing of Contract $2242.00 2nd. Afwx-rough inspection $220000 3rd. .A.fter cabinet install $1100.00 r.After finial inspection $1100.00 r 02114/2009 16:46 9784092062 CRAIG HANSON PAGE 02106 Article 5. General Ptovisions 1)Ali work shall be completed in a workmanship like manner and in compliance with all building codes and other applicable laws. 2)To the extent required by law alll work shall be performed by individuals duly licensed and authorized by law to perform said work. 3) Cootxactor may at its disc nedon engage subcontractors to perform work hereunder,provided Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this Contract. Sub Contractors word.for Hanson Construction only,any extra work per#orated mll be billed as Exna Work Orders. 1 4)All Extra Work orders shall be in writing and signed both by Owner and Contractor. 5) Contractor warrants it is adequately insured for injury Lo its employees and others incurring loss or injury as a result of the acts of Contractor or its employees of subcontractors. 6)Contractor shall at its own expense,obtain all permits necessary for the work described herein to be performed.The Contractor will also be responsible for i nplementing OR-site work required of the Order Of Conditions(OOC)issued by the Town/City Conservation Commission.The Owner will be responsible for implementing all adxxttnistrative conditions of the OOC including but not limited to required recoardiw at the Registry of Deeds,bond postings,as-built plants or obtaining the Certificate Of Compliance. 7) Contractnr agrees to remove all debris and leave premises in broomi clean.condition. 8) In the event Owner shall fail to pay any periodic or Wi stalliment payniett.t due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. 9) T >irt tng - -the-z° €riean_Ar�oon. r� ►�t'[B.�C,`� 10) Contractor shall not be liable for any delay due to circumstances beyond its control induuding strikes,casualty or general unavailability of materials, 11) Contractor warrants all work for a period of 121wDihas following completion.See separate warranty for detailed description of coverage and/or exceptions. 12)There is an additiomd charge for paint colors that exceed 2, trim is not considered a color, $150.00 each additional color. 13) Any landscaping,dxi veways and Sprinklers that we disturb dufing construction will be repaired to die best of our ability within a reasonable cost-This excludes any work that is part of the agreed contracted work and cost is included in the price. 02/14/2009 16:46 9784092062 CRAIG HANSON PAGE 03106 14) If Owiirr chwses to have their own sub contractor perForn work they will solely be responsible to schedule work,deliveryof materials and wanranty dic work performed. If any dan aW to work that has been performed by or will affect the job perfonnance of Hanson Construction,thein the Owner will be billed directly for cost,of repairs_ 15) hi any case where unsuitable soils east or ledge is found,an additional charge may be billed to accommodate the additional costs. .Article 6. Other Terms: None 02/14/2009 16:46 9784092062 CRAIG HANSON PAGE 04/06 Notice: 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, tn.ust 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, Room 1301, Boston MA 02108. Designated Registrants Name Hanson Construction Registration dumber 1.4%85 Salespersons Name CM. Hanson Notice: No agreement for home improvement contracting work shall require a down.payment (advance deposit) of more than one-third of the total contract price or the total amount of all deposits or payments which die contractor must make,in advance, to order and/or other%ise obtain delivery of special order inaterials and equipment,whichever amount is Beater. Notice: If the boxneowner obtains his own construction-related permits for the work described under this agree rent,the homcowner is hereby advised&-it in the event of a dispute,ju(Wnent and nonpayment of the contractor,the homeowner will not be entided to make a claim to or collect from the guazanty fund established by Chapter 142A,M-G.L. 02/14/2009 16:46 9784092062 CRAIG HANSON PAGE 05/06 Ealubit A Quote Attached SPEC CATIONS As sl�cified in written quote. GUARANTEE: The contractor shall guarantee that he will make good,at his own expense,any defects arising from poor or unproper workmanship for a period of one year after completion or provide the same guarantees from bis subcoatraetors or from manufacturers of materials and/or appliances installed in this home. Tkus baniding Wali conform to all.mu ucipal, state,and federal regulations affccting this wC>rL See Warranty for details and exceptions. HOMEOWNER:- DO OMEOWNERDO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signed under seal this 26 clay of May ,2009. Signed in the presence of'. ley ntrax-t�ar lay �r 02/14/2009 16:46 9784092062 CRAIG HANSON PAGE 06/06 Hanson Construction 20 Strout Ave Wilmington, MA 01887 Date 3/3012009 Estimate 7 Name / Address Chakravarti 1423 Salem St. N.Andover MA 01845 P.O. # Terms Due Date 3130/2009 Other Description Qty Rate Total. Kitchen Remove cabinets and framing over island Install new cabinets Install 2 pendant lights over island(customer to supply lights) install 3 recessed lights as discussed Schedual appliances Schedual coutertops(counter top installers to fastened sink) Install 3 under cabinet fights Hook up!gas cooktop and vent,sink,faucett, dishwashed,oven/micro and fridge water line (customer to supply appliances, sink and%ucett) All debris to be stored in a dumpster and removed All permits will be paid for by Hanson Const. 6,642_00 6,642.00 Subtotal $6,642.00 Sales Tax (0.09) $0.00 Total $6,642.00 Hanson construction hansonconstruction@llve.com 508-509-9454