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HomeMy WebLinkAboutBuilding Permit #676 - 165 SANDRA LANE 4/26/2006TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received: b Date Issued: G IMPORTANT: Applicant must complete all items on this page LOCATION 166-S ,&r/bW0s il-w x&e-we t2 Print PROPERTY OWNER hued 6 G,¢4GOe°Y®✓ Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE 61J, -bo Phone:9�r��6�3-x,53 Residential Non- Residential ❑ New Building ❑ Addition ❑ Alteration ?'One family ❑ Two or more family No. of units: ❑ Industrial Repair, replacement ❑ Demolition ❑ Assessory Bldg ❑ Commercial ❑ Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED��7s�ir2/�N7�49�t'�,�yisse�/6� �lfSTd4L L % cS`U✓1A.0- drzwl� (9 - Qfy/ A,S& ,'u c C-� Identification Please Type or Print Clearly) OWNER: Name: 61J, -bo Phone:9�r��6�3-x,53 Address: XS c S�n/dea/E a(/. Ao/4odE� CONTRACTOR Name: 6A°o(jo6 Phone: 97�-r-G59 r-S31,S�3 Address: ;?k G7,4j1(�Y�'�/ Supervisor's Construction License: Exp. Date: Home Improvement License: /f093a 3 Exp. Date: I- V Zcq�r ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$x10.00=FEE:$'-'—'— Check No.: f/6 Receipt No.: C 7 n Page I of 4 TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art El Swimming Pools 11❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales 11❑ Well ❑ Permanent Dumpster on Site ElPrivate (septic tank, etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyf Signature of Agent/Owner Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH11 COMMENTS DATE REJECTED ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE APPROVED DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer connection signature & date Temp Dumpster on site yes_no-V,,- Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 L. DATE APPROVED Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NorFES and DATA — (For department use Page 3 U4 Doc: INSPECTIONAL SERVICES DEPARTMENT BKORM05 Created 1MC. Jan2006 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 o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit Li 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) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o 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 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: INSPECTIONAL SERVICES DEPARTMENTMFORM05 Page 4 of 4 T M G` Agreement The Methuen Group 28 Gage Street Methuen, MA 01844 978-689-5453 phone 240-359-0507 fax Mass Contractor Reg# 149363 Itwe, the Owner(s) of the premises listed below, hereby contract with and authorize you as contractor, to furnish all necessary materials, labor and workmanship to install, construct and place the improvements according to the following specifications, terms, and conditions, on premises below described with reference to which we warrant I/we are the record holders of title. Owners name: Guido Gallopyn Phone: 978-683-8538 Job Address: 165 Sandra Lane City/State North Andover, MA According to the following specifications: Repair existing deck -replace 514" decking as needed, replace 2 - 4x4 railing posts, build new 6' section of railing to match existing railing, replace 11 ballusters, remove and replace 2 - 2x8 joists, restain entire deck with redwood stain (color to be approved prior to staining) , apply waterseal to entire deck. Decking materials to be used are Pressure Treated Southem Yellow Pine. Remove 70' of existing fence along driveway. Install 70' of new wood fencing - style to be approved by customer prior to installation. Contractor to pull all necessary permits and remove all construction debris. Note: Any changes that you wish to make to the above speciricationa are subject to our approval and must be in writing signed by both parties prior to commencement of work relating to the changes. Such written changes, upon being signed shall become a part of this Agreement. Project Start Date: :Pt2EC �fZU WCE 4J/1 S Project Completion Date: Cash Price $ 3,161.00 Deposit $ 1,050.00 Cash_ Check# //S Additional Due $ 1,050.00 Upon start of work Payable on Completion E 1,061.00 You agree to pay cash according to the terms shown. You also agree to sign a completion certificate upon completion of the work. If you fa® to make payments when they are due, then we may immediately stop worir. We may choose not to start worts again until you are current with the payments. If there is any stoppage of work due to the preceding, such delay shall automatically extend the completion date. Should you cancel this agreement any time after midnight of the third business any following signing of this Agreement, you agree that you will be obligated to pay us the costs Incurred, as of the date of cancellation, for all materials and labor. In the event that we incur costs or expenses in collecting such payments due and unpaid, you shall pay such costs and expenses, including reasonable atomeys' fees. In addition, you understand that by failing to pay according to the above terms, the seller may have a claim against you which may be enforced against your property in accordance with applicable Lein taws. The Methuen Group warrants all labor for a period of one year. You agree that you will assert defective materials claims against the applicable manufacturers warranty. We represent that we carry Workman Compensation and Public Liability Insurance. ALL RESIDENTIAL CONTRACTORS AND SUBCONTRACTORS ARE REQUIRED TO BE REGISTERED WITH THE MASSACHUSETTS BOARD OF BUILDING REGULATIONS AND STANDARDS, UNLESS SPECIFICALLY EXEMPT FROM REGISTRATION. INQUIRIES CONCERNING REGISTRATION SHOULD BE DIRECTED TO: DIRECTOR, HOME IMPROVEMENT CONTRACTOR REGISTRATION, ONE ASHBURTON PLACE ROOM 1301 BOSTON, MA 02108 (617) 727-8588 This agreement may only be modified In writing signed by both parties. This agreement Is governed by Massachusetts Law. YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN SIGNED BY PARTY THERETO AT A PLACE OTHER THAN AN ADDRESS OF THE SELLER WHICH MAY BE HIS MAIN OFFICE OR BRANCH THEREOF, PROVIDED YOU NOTIFY THE SELLER IN WRITING AT HIS MAIN OFFICE BY ORDINARY MAIL POSTED, BY TELEGRAM SENT OR BY DELIVERY, NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING THE SIGNING OF THIS AGREEMENT. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU OWN THE PROPERTY, AND THAT YOU AGREE TO ALL OF THE TERMS OF THIS CONTRACT. YOU ALSO ACKNOWLEDGE THAT YOU HAVE RECEIVED A FULLY COMPLETED COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION, AND THAT YOU HAVE BEEN ORALLY INFORMED OF YOUR RIGHT TO CANCEL. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signed this day of 'F f7WJP'A,7 FM I 1'17411M I O H O p aor. wn°' O w a a w w a a caC w w o cn v o cn mo a OCo cv v CLcc= 00000 4=3 Q L { s�C a Cn 3 0 LU 0 y Z Q o Gad TA C.3 w $ CD = y v E �mo � y Cf) ro _m o Cf)w COL CC32 cm m y = uJ CCD CMOa W W CD tiZ o C •� O ff n C = m L. N ~ 1i o o � m =-_eE uiz F.. •H nt O C Z a .yLLI o o y � m� o� / z = m F. = z cn.=.. A IN m 0 oc 'Sa) Z p„ O y � C I CC v) p 'O O M O O �E m m = O� a� O i cc O C a Ca o c ev CL o c Z CD CL V N! c C eO CLy 0 0 U) LLI U) W W W U) AC080. CERTIFICATE OF LIABILITY INSURANCE OP ID C DATE (MM/DDlYYYY) METHU-1 04/24/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOI\ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Michaud, Rowe And Ruscak Ins. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 198 Massachusetts Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover MA 01845 Phone: 978 688 8829 Fax: 978 557 2130 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Preferred Mutual Insurance Co. 15024 INSURER B: Granite State Ins Co 23809 The Methuen Group Steven L. Smith INSURER C: 28 Gage Street INSURER D: Methuen MA 01844 INSURER E: COVERAGES. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING I 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRPOLICY LTR NSR TYPE OF INSURANCE NUMBER EFFECTIVE POLICY D/YY DATE (MMID POLICY EXPIRATION DATE (MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 300000 A X COMMERCIAL GENERAL LIABILITY CPP0100585290 01/18/06 01/18/07 PREMISES (Eaoccurence) $ 50000 CLAIMS MADE El OCCUR MED EXP (Any one person) $ 5000 PERSONAL BADV INJURY $ 300000 GENERAL AGGREGATE $ 600000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 600000 PRO LOC POLICY 7 JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR El CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND UIH- TORY LIMITS ER B EMPLOYERS' LIABILITY ***SEE BELOW E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $ * OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Carpentry - Residential***Workers compensation certificate to follow directly from Granite State Ins for policy effective 4/8/06-4/8/07. CtR I IFICA f E HOLUtR CAN(;tLLA I ION NORTHA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Town of North Andover IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 27 Charles Street North Andover MA 01845 REPRESENTATIVES. AUT=REPRESZENTA ACORD 25 (2001/08) © ACORD CORPORATION 1 ACORv. CERTIFICATE OF LIABILITY INSURANCE OPID CLI DATE(MMI'DD/YY`YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOK ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Michaud, Rowe And Ruscak Ins. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 198 Massachusetts Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover MA 01845 Phone:978 688 8829 Fax:978 557 2130 INSURED The Methuen Group Steven L. Smith 28 Gage Street Methuen MA 01844 COVERAGES INSURERS AFFORDING COVERAGE I NAIC # INSURER A: Granite State Ins Co 23809 INSURER B: INSURER C: INSURER D: INSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ CLAIMS MADE 0 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 A ANY PROPRIETOR/PARTNER/EXECUTIVE $741106 04/08/06 04/08/07 OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ lOOOOO If yes, describe under E.L. DISEASE -POLICY LIMIT 1 $500000 SPECIAL PROVISIONS below OTHER v -vv I'll — 1 1. — --- I-- I ­vI Ian 11 ... —r.vv OI CIYUVRJCIYICIY I I -—L IMUVIJIUIVJ Carpentry - Residential***Original certificate to follow directly from Granite State Ins CERTIFICATE HOLDER CANCELLATION NORTHA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Town of North Andover NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 27 Charles Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR North Andover MA 01845 REPRESENTATIVES. 1/08) © ACORD CORPORA lz T :11 G ethuen Grow St Methuen, MA OIW L9749-5453 DER REPAIR PLAN 165 Sandra Lane North Andover, MA T The Methuen rot € ti 28 G82e st Methum MA O E 844 4 978-633-5483 DECK REPAIR FLAN 166 Sandra Large North Andover, MA Pao, t No V-165 Date: 04.2241. x IN E The Methuen Grow 28 Ga a St. Methuen MA 41844 978-689-5453 DECK REPAIR PLAN 165 Sandra Lane North Andover, MA Emeq NO 0&-165 Date: 04-22-M FoonNG LAYOUT Type Footing: '12* Iiia concrete pie - W detith wb 112" anchor bolt for Simpson ASA46Z steel post base. Post sizeAype: 4,N 8" PTSYP Sr:m'j ADAq4? $ i e FL PM -1 15" !! Ii (aft r6uIv) C=RAD S GAL4 s 100 ,.S �i3C' .PPQLn� r., r} � w 2 ft 4 in Location L SAN tr' No. Date ",. TOWN OF NORTH ANDOVER 9 1 Certificate of Occupancy $ •,SIACMUSEt4•� Building/Frame Permit Fee $ •� 1 .-- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 19 "14 9 Building Inspector