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Home My WebLink AboutBuilding Permit #395 - 178 STONECLEAVE ROAD 11/18/2009 BUILDING PERMITo "°oT " qti TOWN OF NORTH ANDOVER 3� 4`<t'- oL 0 APPLICATION FOR PLAN EXAMINATION w Permit NO: � Date Received - � pOgATEO I.P� �h �SSACHUSE� Date Issued: • IMPORTANT:Applicant must complete all items on this page I LOCATION l '"') S ,n,t c Q�,rv- VaK Print PROPERTY OWNER CZ . ,, Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village _yes qn5 J TYPE OF IMPROVEMENT PROPOSED USE Resi Non- Residential New BuildingOne famil Addition Two or more family Industrial teration No. of units: Commercial Repair, eplaceme Assessory Bldg Others: Demolition Other e Well Floodplain Wetlands Watershed District Wate Sewer DESCRIPTION OF WORK TO BE PREFORMED: C � r Identification Please Type or Print Clearly) OWNER: Name: _iZ�,��.�_ a�.�� Phone: 6T -- Address: CONTRACTOR Name:, , J ,.1._,, Phone f 1 `5 -5"3.3 - Address: 1 bv — .' Supervisor's Construction License: Exp. Date: l l Home Improvement License: A Exp. Date; ARCH ITECT/ENGINEERPhone: ` Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ \ , vy "D FEE: $ k12— Check 1ZCheck No.: `h spy Receipt No.: 2 2 74— NOTE: 4 -NOTE: .Persons contracting with unregistered contractors do not have access to the guaranty fund signature of Agent/Owner Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Swimming Pools 1 ; Tanning/MassageBody Art Well Tobacco SalesA.' Food Packaging%Sles' ~14 ' r� 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes r Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Siqnature &Date Driveway Permit DPW Town Engineer: Signature: Located 384 Oso Street FIRE DEPARTMENT Temp Dumpster on site yes no Located at 124 Main Street Fire Department signatureldate 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 re wires approval of Electrical Inspector Yes No 75 DANGER ZONE LITERATURE: _ Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use) i ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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) j ❑ Mass check.Energy Compliance Report (If Applicable) j ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit j New Construction (Single and Two Family) I ❑ 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 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 I Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location �-✓�-- No. -3`�� Date NORTH TOWN OF NORTH ANDOVER 41 JF a • � ; , Certificate of Occupancy $ vs cMust S 9 tom Buildin /Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22667 Building Inspector NORTH Town Of4 over No. 3 - �, _ dower, Mass., LA K6 A-O COCHIC EWICK 7�A0RATEO ,.,%, S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System n BUILDING INSPECTOR THIS CERTIFIES THAT � Yq Foundation has permission to erect........................................ buildings on ........1..0..&..........�.T�?l.'.a.�...(r�',!. ,R... Rough L to be occupied as.....Q .-1�1�v�T' D O �.. Chimney arson acce tin is permit shall in every respect conform to the terms of the application on file in Final provided that the p p g 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 Z _ PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUSTARTS Rough .......................................... ................... ................................... ............ Service BUILDING INSPECTOR Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. '= Massachusetts- Department of Public Safetj Board of Buildinl- Regulations and Standards: Construction Supervisor License License: CS 53099 Restricted to: 00 KEVIN W MURPHY 169 BOXFORD ST N ANDOVER, MA 01845 Expiration: 6/29/2011 ("ummissiuncr Tr#: 16540 p� ✓fie >�anvnwouaea�fi o�� aactu�delt6 -\ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registratic r: 101874 Expiration: 6/29/2010 Tr# 267315 Type.: Individual KEVIN MURPHY— Kevin URPHY Kevin Murphy 169 Boxford St ti:>•` '_ r. � ,` N.Andover,MA 01845 r Administrator j t► t 169 Boxford er tttl 1��1VVV%It51 • North Andover,,MA 01845 • PH:97&8"35 Building Contractor FAX:978-688-7207 Proposal TO: Randy&Trisha Burba 178 Stonecleave Road All Home improvement Contract=and sub=tadm engaged in home Improvement contracting,unless North Andover, Ma. 01845 specifically ftm regMtrallon by P-4si«s of Chapter 142A of the genual laws,must be registered with the Co wro wmatth of Massachaw s.lnquirtes about re isbation and Status should be made to the Director,Home Improvemerd Conbad Registration,One Ashburton Place, From Kevin Murphy Room 1301,Boston,,MA 02108.(617}727&%8 CQ Date: 11%17/2009 .lob: Replacement windows/Door Date of place None Arehitecb None Location: Same Section I-Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 11/9009. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 12115/09.The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11-Warranty The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials,or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup,the Contractor shall,at his own expense,forthwith remedy,repair correct,replace,or cause to be remedied,repaired,or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section III-Scope of Work 1 Kevin Mnauphy Page 2 of 4 Building Contractor 169 8odord SVW Nath Andover,MA 01845 PH:978688-5335 FAX 978.688-)000( General Proposal is to replace fifteen existing doublehung windows, one garden style window in kitchen, and existing front door unit and sidelights. Building permit will be provided by contractor. Building Fifteen doublehung windows will be Harvey replacement type. Both interior and exterior will be white vinyl. Grilles will be in between the glass. Grille pattern to match existing. Half screens will be provided. Kitchen window will be replaced with a Harvey garden window(style and size to match existing ) . New front door unit and sidelights will be supplied and installed. An allowance of$1000 has been included for door unit Existing window sashes, tracks, and storm windows will be removed and disposed of. No allowance has been made to replace any interior or exterior trim. Painting No allowance has been made for any interior or exterior painting. Waste Removal All construction related debris will be disposed of by contractor. Kee vim REWM}ny Page 4 of 4 Building Contractor 169 Brndad street North Andovw,MA 01845 PH:978£6&5335 FAX 978-6WXXXX Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of...... ... ... ...I ............ ...... ....$ 11,000 Payment to be made as follows: Percenta e/ltem Description Amount 1 Permit obtained $2000 2 Job complete $9000 Total 2 $11 t 000:00 "Notice:No a7ewrott for Home mVroverrterd cor&aWM work shall reWft a*mn payment(advance deposit)of more Bert one-third d the total cx&W price tithe total amoutt of a➢deposits or paymeNs which the corttracor mut make,in adva m to order andlor otfhervv'se obW delivery of specal order materials and equ pmer>f,wt=hever is gwter Contractor. Kevin Murphy 169 Boxford Street No.Andover,MA 01845 Registration No: 101874 Section V—Acceptance Acceptance of Proposal—I have read this document and accept the prices,specifications,and conditions stated. I understand that upon signing,this proposal becomes a binding contract You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing OT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date Signature Date The Commonwealth of.Massachusetts Department of Industrial Accidents LA Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aupficant Information Please Print Legibly Name (Businesslorpnizatiomwividual): City/State/Zip: e��ibw� . _ u`t`"'Phone#:__ Are you an employer? Check the-appropriate box: Type of project(required): 31 am a employer with _ 4. ❑ I am a general contractor and I 6. []New construction employees(full and/or part-time).* have hired the sub-contractors 7. {MRemodeling !.C1 am a sole proprietor or partner- listed on the attached sbeet ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. instuanee. 9. ❑ Building addition 5. ❑ We are a corporation and its co . insurance 10. Electrical repairs o�r additions [No workers mp ❑ eP ed 1 officers have exercised their req Il. right of exemption per MGL ❑ Plumbing repairs or additions 3.El I am a homeowner doing all work myself. [No workers' comp. C. 152,§1(4),and we have no 12.0 Roof repairs t employees. [No workers' insurance required.] 13.❑ Other comp.insurance required.) Any applk=t that checks box#I must also fill out the section below showing their workers'compensation policy information Homeowners wbo submit tads af3''►davit indicating they are doing all wwt and digin hire outside contractors must submit anew affidavitindicating such Contractors that check tM1 s box must attached an additional sheet showing the name of the Bub-contractors and their workm,comp.policy infotirmtion. Is am an employer that is providing workers'compmsation.insurance for my employees. Belowthe.polky andjob site aformathm nsamce Company Name: 'olicy#or Self-ins.Lic. #: �. Fk D b b S 3 l Expiration Date: 1 1 1 \ lob Site Address: 'l'b S�°"� �"` LO& t. •' city/Stawzip: t,&, P N,-, 0 wl kttacb a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). aikue to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a be 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of [nvestigatious of the DIA fot insurance coverage verification. r do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Ynrnn #: �Fc - Fl use only. Do not write in this area,to be completed by cityor town offwial. r Town• Permit/Ucense# g Authority(circle one): uildin D artment 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rdof Itealth 2.B S giper Person: Phone M caRR CERTIFICATE -- OF LIABILITY IA SSUR,AIVCE �,TCcMH�,00�Y,►i rRaawew Agency oTWO A� MUfo As A MATMR OR WORMATMN M.P, xtabweHa SnMlti 1060 oagftd street HOWER. THS aet�IOoNpM CATE oosa p�Nq�T�H�E CERTTI; ATE porgy Ani, MA 01848 Tit TH8 aoVERAt A0 eir THE POI ��OIA Ulm �,.. IKatntRs o covE�►oE 1�VIlP SPAY R8't�7D ,SRO IN8UFtRk y j `—.'_".'.— . ..- KWC O too ammi ►NeunH:Re 1 = �... R, .MA 01848 ++eul�R a ►NeuRem a "6 PIM tow►w► ftM ITagil CA aF Nh t7CM FACT OR CTH� baB"pMTN6P0LWP�INDIC�tT$D.NCtWiT18TANDif43 1 AF C7 a1f THE POL ICt89 Q+ W�tH TO WHICH C@RT�lCATE WY 8E ISSUB�OFt PQ.IC M AQMATe LOM SHOM MAV MVE BB.4fV ��!�8lJBJbO1 TOA,L T Tp Ell t18lON9ANq OONOlT101Y6 OF SACH 8YP9At[}CUIIAIS. 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