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HomeMy WebLinkAboutBuilding Permit #011 - 171 WEYLAND CIRCLE 7/12/2006 TOWN OF NORTH ANDOVER 0ORT11 APPLICATION FOR PLAN EXAMINATION of�,,�o •.1tio 0 r Permit NO: Date Received " �(ii +` Date Issued: SACHus�t�� IMPORTANT: Applicant must complete all items on this page LOCATION '-M 901k kcwC� C ��C--\e PROPERTY OWNER 'C Print ! IAP NO.: (9 5 PARCFI.: ZONING DlS•fRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES 0 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition -- Two or more family - Industrial C Alteration No. of units: Repair, replacement Assessory Bldg Commercial Demolition Moving(relocation) Other Others: Foundation only DF,,SCRIPTION OF WORK TO B PREFORMED, { Lo I Ak 0WS i a`M rb-v Yj "Xi LU f Act ������S , ( �� cion Please Type or riot Cle;aaly) OWNER: Name: 'C'��ti 1 �.0�� C Phone: � US` NZ v Address: V Ck (Jo�,Ykc� C-\r C- �- CONTRACTOR Name: I dla V&"e �Iy �e is Phone 83 Z— Address: lri /1J PA014 AA Supervisor's Construction License: "t 7(7 l Exp. Date: -I �O7 q1j(j I-Ionie Inipro�cnicnt License: 3 Exp. Date: /07 AIZ01I11-LCT, ENGINEER Na111c: Phone: ,ladress: Reg. No. FEE SCHEDULE:BLZDLVG PERMIT: 51200 PER S1200.00 OF THE TOTAL ESTIMATED COST BASED Ott $125.00 PERS.F. Total Project Cost S `� o x12.00--FEE:S Check No.: / _Receipt No.: ` T Page Iot.1 TYPE OF SE�VERAGE DISPOSAL Tanning;Massage,Body Art Swimming Pools Public Sewer Tobacco Sales Well Food Packaging"Sales _ Permanent Dumpster on Site Private(septic tank,etc. _ Electric ti{cter location to project NOTE: Persons contracting pith unret,►iste d cunt ours do not have access to they gu anh,frac Signature of Agent/Owner Signature of contractor 1 Plans Submitted J Plans Waived Certified Plot Plan ❑ Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ 17—Vater Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMNIENTS DATE REJECTED DATE APPROVED CONSERVATION 7 CONIMENTS DATE REJECTED DATE APPROVED HEALTH J J CONINIENTS Zoning, Board of Appeals: Variance, Petition No: I_onim_ Dec is ion,receipt submitted }es Planning Board Decision: Comments Conservation Decision: Continents � ater& Sewer connection,Signature& Date Driveway Permit Temp Dumpster on site yes_no& Fire Department signature date 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.: NO'+ES and DA rA—(For department use) I';e�c 3 of 1 ICLi DI-PAR FMLN fiit'I(tic`.11i> 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 Pen-nit 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 Addition Or Decks ❑ Building Permit Application :3 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) New Construction (Single and Two Family) a 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 ❑ %lass 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 Dur.I\SI'B("i'OVAL NER\R 1"S DEVAR'1111,1 VTA111I:ORN105 I -.- Lot I Location 171 !:j IQ nd Cl1,7 G No. Date -!-Z2-66 MORTIy TOWN OF NORTH ANDOVER 3? •. a OL Certificate of Occupancy $ sA�HU <� Building/Frame Permit Fee $ "r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ,� ti uilding Inspector NORTH own of And o -: No. 70 h t= A E o dover, Mass., Z a C:.r ICMEWICK V % 7 ADRATED '9S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT....... A h....,, � «t�f' - BUILDING INSPECTOR Foundation has permission to erect.......+............................... buildings on ......... �l ..� r'C.�,c.,... Rough to be occupied as..5....totymd 1N1�... .... .1. ....�! ...*./t ... kl.....%.�l.... ...... Chimney provided that the person accepting this permit shall in every re pact conform to the terms of the apolicaTon 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI TS ELECTRICAL INSPECTOR Rough ................. ........... Service .. .... .. .... .... ...................... DING ECTOR Final Occupancy Permit Required to Occupy Building - GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ardd �"'C�9'g"f� Boar o w HOME IMPROVEMENT CONTRACTOR '' R, nvmnno o �ucaelta I. B1-44 I+)G>Fl�6Ut�i4T�ON� I I Registtibit: T28934 ,Li�CeBe 1wOf01V SLPIS01 x Kaon- /9/2007 2t V.vp- r Duval construction F>275 0 I CIE Tr nOC Thomas Duval 4 -' 107 Main ST. "rte �v �- - +k gg ;. Boxford,MA 01921Administrator TROAiIA'S 1 l F ISD, M7# ©19 w,. Caifiti siildnoa I 00 7 35,000 cf enclosed space fi (MGL C 112 S.50L) License or registration valid for individul use"only to-Masonry only before the expiration date. If found return'to-;, 1G-1&.2 Family,Hbmes Board of Bdilding Regulations and Standaids Failure to possess a current edition of the �I One Ashburton Place Rm 1301 " i Massachusetts State Building-,Code Boston,Ma.02108 -is cause for revQcapon of this license: i Not valid without signature °DIGSAFE CALL CENTER: (888)344-7233 a l Phone:978-887-1951 107 Main Street Fax:978-213-9977 Boxford,MA. 01921 s �-,+.x.-, ,-.,-r —•r•=rS»,.p..;v... ,„�, :'.ax •.-�..".,w ,<•w...v=a. r� x 'x -? Duval Construction Co. v 1 ris t � x 5 J ACCEPTANCE OF PROPOSAL We propose hereby to furnish material and labor — complete in accordance with the afore mentioned specifications,for the sum of Fourteen Thousand Eight Hundred Dollars($14,800.00) Payment schedule to be as follows: To be determined at start of job Authorized Signature Thomas E.Duval (Owner) *Note:This proposal may be withdrawn by us if not accepted within 30 days All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from afore mentioned specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents,or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Owner to pay Duval Construction Company and we will thereby make payments to all subcontractors used on this job as outlined in the accepted proposal. The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work specified. Payment will be made as outlined above. In compliance with M.G.L.Chapter 142A.Regulation of Home Improvement Contractors A. The owner may have 3-day cancellation rights under section under M.G.L. c.93,s48;M.G.L.c. 140D,s10 or M.G.L.c.255D.,s 14,as may be applicable. B. Homeowners who secure their own permits will be excluded from the guaranty fund provisions. C. The Owner should direct any inquiries about the GC regarding his registration as a Home Improvement Contractor to: Director/Home Improvement Contractor Registration One Ashburton Place,Room 1301 Boston,MA. 02108 (617)727-8598 Phone:978-887-1951 107 Main Street Fax:978-213-9977 Boxford,MA. 01921 Duval Con structio n Co. P ...�.-...,...a.M>,a..:.�,...,a�.E�:...v......_..,.....,,.�..s..�,::•y'i:..,N.W,.............>h_.w._.,.. ,..a.-..,.,.s...._,.Fc.:,a.. .. , ACCEPTANCE OF PROPOSAL—CONTINUED D. Alternative Dispute Resolution: THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT THE CONTRACTOR HAS A DISPUTE CONCERNING THIS CONTRACT,THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L.c.142A. Date of Acceptance: -zh/ (2 6 a .. r Signature: 4 Commonwealth of Massachusetts Construction Supervisor License—047671 Home Improvement Contractor- 128934 Phone:978-887-1951 107 Main Street Fax:978-213-9977 Boxford,MA. 01921 - - �- — — Duval Construction CoI. PROPOSAL Brian and Daniela Daccord July 11, 2006 171 Weyland Circle North Andover, MA. 01845 (978) 725-4963 To follow is the estimate/proposal for work to be completed at the above listed address: GARAGE Remove damaged siding and sheathing around 2 garage windows and front left corner of garage Repair damaged area of corner post and sill of garage Remove mold damaged blueboard and plaster in garage (approximately 2—4'x8' sheets) and replace Install new t/2" fir plywood sheeting in damaged areas of garage (approximately 7— 4'x8'sheets) Install 2 (two) new Andersen windows in garage Install new cedar clapboard on garage(approximately 200 square feet) Install new pine trim around windows and siding to match existing DINING ROOM Remove 3 (three) existing windows in dining room Remove water damaged siding, exterior sheathing, insulation, interior blueboard,plaster, and interior trim in dining room Replace with 3 (three)new Andersen windows on new 1/2" fir sheathing(approximately 3 sheets) Install new pine trim and cedar clapboards to match existing (approximately 75 square feet) Install new insulation Install new 1/2"blueboard and plaster in dining room(approximately 2 sheets) Install new interior pine trim to match existing Any hidden water/mold damage beyond what is discussed/covered in this contract, will result in increased repair cost and change orders to this contract TOTAL FOR ALL WORK AS DETAILED IN THIS CONTRACT $149800.00 The Commonwealth of Massachusetts Department of Industrial. ccidents Office of Investigations 600 Washington Street Boston, ,VA 02111 wwwmiass.gov/dia Workers' Compensation Insurance ,affidavit: Builders/Contractors/Electricians/Plumbers ADDlicant Information Please Print Le ibl Name AM y vq l �- G ;address: City;Stateizip: Phon Q) 1e you an employer?Check the appropriate box: Type of project(required): I.Kaln a employer with 7�-._ 4. ❑ 1 am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.' E] Remodeling ship and have no employees Thcse sub-contractors have 3. ❑ Demolition working for me in any capacity. workers' comp, insurance. y. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL ME].❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp. insurance required.] — 'Any applicant that checks bar d I must also lill out the section below showing their workers'compensation policy information. +I lomeowners who submit this affidavit indicating they are doing all work and then hire otits ide contractors must submit anew affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-conlractors and their workers'comp.policy information. I am nn employer that is providing workers'compensation insurance for my emplgvees. Below is the policy and job site information. Insurance Company Name:__Y ' _ _ ------._-- -- — --- Policy 'i or Self ins. Lic. !I: 2-__�_ Expiration Date: Job Site Address: t 6 � y" 'CL CC A� C Yc f C_ City;Statc/Zip:_�r V f i�i`-�l'l4�� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of biGL c. 153 can lead to the imposition of criminal penalties of 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. Be adv ised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert'y under lite pains a �nnllies��l' rjurt that the information provided above is true and correct. tii n;tturef/�9✓�M�'J� nate: /Yjicial hese only. ho nut write in this urea, to be completed b►,(:1:0-or town ifltc•ial. City or T,)%n- Permit/License 4 Issuing Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 3. Plumbing Inspector 6.Other C^ntaet Person: Phone