Loading...
HomeMy WebLinkAboutBuilding Permit #43 - 15 WEYLAND CIRCLE 7/15/2009 BUILDING PERMIT Of NORTH ,ORDA 16 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: / �/ SACHU`� IMPORTANT:Applicant must complete all items on this page .LOCATION Print PROPERTY OWNER ;Z Print NIAP;N4: PARCEL , ZONINGgDISTRICT, 7 HistoricDis##vct. eyes no s Machine ShpUillage yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential New Building One family Addition I Two or more family Industrial Alteration No. of units: Commercial Repair, replacement AssessoryBldg Others: Demolition Other Septic Well Floodplain ,,'Wetlands' a Watershed D stric#`s Water/Sewera " ra DESCRIPTION OF WORK TO BE REFORMED: M Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: 15 4 CONTRACTOR- Name. .5� .. 1a,�� �� -Y Phone=. �7a� � Address: „A vt ivof E Supervisor's Construction License: Gc 2-�r Exly. Date:g 1!x Home Improvement License: Exp. .Da#e: 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: $ /���s�f, FEE: $ /o2 Check No.: ' l Ob q Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access t t ranty and ignature.of AgentJOwner awIT Signature of contractor W 4 w i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Swimming Pools ! ` Tanning/MassageBody Art Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site r THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED } PLANNING& DEVELOPMENT COMMENTS I — CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Siqnature 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 onwsite yes _ no. Locatea at 124 Main Street, za Oe 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 - Date Doc.Building Permit Revised 2009 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 ❑ 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 L3 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 2008 Location 15 Al C y�4 h e (,I C,— No. , Date NaRTh TOWN OF NORTH ANDOVER F 9 i s i Certificate of Occupancy $ „ • �'�s'•^e^E<�' Building/Frame Permit Fee $ " AC MUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # vU 222 _ Building Inspector NORTH F 04" 0 : t. 4dover . 0 No. dover, Mass., 72O T LAKE 1, lee COCHICMEWICK V ADRATE D PPa\ `S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT......... ........................................A.010." !.... .............................:.............. ............................:.. Foundation has permission to erect...................................... buildings on....l.!5.......I ..l ,. ........�.�.4'F.-T......... Rough to be occupied as.... �) 1 11!4 �� Chimney . ........ ........ ................................. ...............................................,. provided that the person accepting this permit shat 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 a PERMIT EXPIRES IN NTHS ELECTRICAL INSPECTOR. UNLESS CONS" T S 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 Narl-athing or Dry Wall To BeDone FIRE DEPARTMENT' Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. The Com 'M t ealfh ofMassachusetts 1 Department of lndustrid Accidents •. Office of Investigations t 600 Nl crshington Street BOStom, MA 02111 WWW "UrS&gov/din . Workers' Compensation Insurance Af davit: Builders/ContractorsMieatricians/Plambers A P Brant Information. Please Print Leggbl Neale(Business/Orgeoizafion/[ndividunl): �^ s At c Address: City/State/ZipV OPI 144 Phone#: . y°7,�.�[f1 f 72.E31 employer?Chectt.tHe appropriate box: ti►pioyer with 4. ❑ I am a general contractor and IF 1�t(regnir :es(full and/orpart-time).* have hired tha sub-contraryors conshruc ion ole proprietor or partner- listed on the attached sheet 3 deling f ship and have no employees These sub-eontaactors have working far me in any opacity. orke rs' comp.insurance. lition [No workers'comp. iasuratsce.. 5. a are a corporation and its ing addition 3.❑ required] officers have exercised their . ical repairs or additions I am a homeowner doing all work right of exemption per MOL ing repairs or additions myself, [No workers'comp. c. 152, §1(4),and we have no insurance required.].t .employees. [No workers' 12.❑Roof repairs wrap. insurance required.] 13•[].Other "Any applicant tiutt checks boz'#1 tiomeownmust atso fill out the section below showing their worketa'iiontpensation policy mn nnsho4 t ets who submit this affidavit indicating they are doing an work and then hue outside conuactom must suc ;Coattactots that check this box mustrtteobed=additional shwa;show tTi7bmit a aero afFidavit indicating h trig.t he risme of the sub-conneetm and their worksxs'sem P.I am.an e�loyer fitat&,Prnvidf`mz:workers'compensation tnskrance or p.Etc;u fiimiation. information. my employees: Below is the Policy andyok site . Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: ------------ Job Site Address: Attach a copy of the workers'soar nsation City/State/zip. Failure to secure pe policy declaration page(showing the policy number and expiration date). coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal fine up to $1,550.00.a d and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER ffited a fine of up to$250.00 a day against the violator. Be advised that investigations of the DIA for insuranca copy of this statement may be forwarded to the Office of e coverage verification. I do hereby certify u the pains and penalties ofPer*7 rhar the information provided above is ttrie and coned Si titre: � Date: Phone ✓[ S t5 cl Of 7cial use only. Do not write in this area,to be Convicted mp eted by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of health 2. Building Department 3.City/Tow u Clerk 4. Electrical Inspector 5. Piumbing Inspector 6.Other Contact Person: Phone#: Information a nd Inastructions Massachusetts General Laws chapter 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 written." r An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'fbmping engaged in a joint enterprise,and includiz-eg the legal representatives of a deceased employer,or the receiver ortrustee-of an individual,partnership,associatiorn or other legal entity,employing employees.'However the owner•of a dwelling house having not more than three apas-anents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maiintrxhance,construction or repair,work an such dwelling house or on the grounds or building appurtenant thereto shallnot because of such employment be doomed to be an employer." MGL chapter 152,§25C(6)also states that"every state or-local licensing agency shall withhold the issuance or renewal of licensior permit to operate a business or ite construct buildings in the commonwealth for any applicant who has not produced acceptable eviidenceAr compliance with the insurance coverage required." Additionally, MOL chapter 152,§25C(7)states'Neither the commonwealth nor any of its political subdivisions shall enter into arty contract for the perfbi am cc of public work undl-acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers',compensation affidavit compiem-tely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s),address(es):arhd phone number(s)along with their cerrificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members orpartners,arc not requiredito carry workers'coTnpensatron insurance. Van LLC or--LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and-date the affidavit The affidavit should be returned to the city or town that the.application for the permit or license is being requested.,notthe Department of Industrial Accidents. Should you have any.questions regarding the law or if you are required to obtain a workers' compensation policy,please-call the Department at the narnber listed below. Self-insured companies should enter fmir self insraance licanse number on ihe•appropTinte line. City or Town Officials 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/Iicense.number which will 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 of-the affidavit that has been offic'raily starnped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for f dun permits or licenses. A new affidavit must be filled out each year.Wheys a home owner or citizen is obtaining a license or perrmit 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 do not hesitate to give us a call. The Department's address,telephone and fax number. The CommonwezL1t1i of Massachusetts Department of Fzidustnal Accidents Office(if Investigations 600 Washington Street Basion, 1vIA 02111 II TeL #617-7274900 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax#617-727-7744 www.mass_gov/dia I i �. -- Board of Building Regulations and Standards • Construction Supervisor License > I License CS 82026 Ex�tration�g24/2008 Tr# 11952 �Resio—Q BRIAN R BARRY } �f 30 RIVE RINA RD l +x y a 'AN DOVER,.MA 01810 Commissioner �•S A� wid�dar 1. Bar o ut ing egu a i is an an ar s. i HOME IMPROVEMENT CONTRACTOR y `£ Registiation: 136892 c:4 Expirafio'n,'^9/10/2010 Ti* 279442 —LType DBA j BARRY FINE HOMES&!RENOVATIONS BRIAN BARRY , i � .30 RIVERINA RD - ANDOVER,MA01810'=.Ly% Administrator" i r:- BARRY Fine Homes & Renovations, Inc. P.O. Box 3057 Andover, MA. 01810 (978) 475-5443 (978) 475-6564 fax Peter & Lisa Pizzi 15 Weyland Circle North Andover, Ma. 01845 June 12, 2009 Contract Scope of work: Remove four existing double hung windows and one triple wide casement with circle top and all.associated trim ( interior& exterior). Prep window openings. Install new construction windows. Install composite trim on the exterior of the windows. Install pine trim to match the existing trim on the interior. Paint the windows and the interior trim. ( match existing ) Remove all construction debris and dispose of properly. Pella Architect series windows: w/ Classic white exterior and removable grills. $5,379.03, ( 2 ) 29" x 57 Double Hung -with out screens ( garage ) ( 2 ) 29" x 57: Double Hung With Vivid View screens ( Master Bedroom ) ( 2 ) 25" x 41" Casements -with Vivid View screens ( Master.Bedroom) ( 1 ) 38" x 57" Spring Line Circle Top. Building Materials: Interior/exterior trim, flashing & miscellaneous hardware. $ 925.00 Labor: Includes demo, install and painting windows and interior trim. $3,750.00 Total estimated costs of the project: $ 10,054.03-:: **All work and project decisions to be made by Barry Fine Homes & Renovations, Inc.** r. 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$10,054.03. A deposit of$5,500.00 is required to order the special order windows for the project. . The balance will be due upon job completion. All work to be completed in a workmanlike manner. According to the standard practices and local building codes. Authorized Contractor Signature toe All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from registration by provisions of Chapter 142a of the General Laws,must be registered with the Commonwealth of Massachusetts. Inquires about. registration and status should be made to: Director: Home Improvement Contractor Registration One Ashburnton Place,Room 1301 Boston,MA.02108 (617) 727-8598 Registrant's Name: Barry Fine Homes and Renovations,Inc. Brian Barry Registration Number: 136892 { ACCEPTANCE OF CONTRACT T-he prices, specification and conditions are satisfactory and are hereby�accepted. Your are authorized to do the work as specified. Payment will be made as outlined on attached payment schedule. DO NOT SIGN CONTRACT IF THERE ARE ANY BLANK SPACES Owner(s) Signature _ Date of Acceptance Costo► A rova9 Form: �n Signature: G Date: 6���1�� Frame Radius=1$:875 25 37.7li. r 26... Viewed from the Exterior Quote Number: 559374 Line Number: 40 Scaling: 1/2"= 1' Description: Architect, Casement, Casement, Casement, 87.75 X 57, White, 4-11116" Rough Opening:88.5"X 57.75"