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Home My WebLink AboutBuilding Permit #472-15 - 188 BEAR HILL ROAD 11/17/2014Permit No#: ii, Date Issued: 1( -,1 � BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applicant must complete all items on this page V-�•tIEO /6s•NO\ °i +� e« LOCATION_'C6 PROPOSED USE PROPERTY OWNER s�A,-� Print ?rd 5 C �_ e,,.. - �.= - -&One family MAPPARCEL: Print ZONING, DISTRICT: 100 Year Structure yes Historic District a 156Alteration No. of units: yes -YRepair, replacement ❑ Assessory Bldg ❑ Others: Machine Shop Villaqe ves ❑ Other TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building -&One family ❑ Addition ❑ Two or more family ❑ Industrial 156Alteration No. of units: ❑ Commercial -YRepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands: ❑ Watershed District TZ�yVater/Sewer DESCRIPTION OF WORK TO BE PERFORMED: + "et K- �u "Oeol Identification - Please Type or Print Clearly OWNER: Name: pc/d— Phone: �Yis - lel Address: Contractor NameVCa,,,- N�.,.,►lPhone: C -z 6b$ -533 �5' _ Address: q �6 k,:vre-sT- 5�- i- KA, 5 - Supervisor's Supervisor's Construction License: US 3 0 Q.S . __ Exp. Date: L LIAU T Home Improvement License: _ ly t Y/-1 Date:...__b` ARCHITECT/ENGINEER 11av yl -z, 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: $ 22,E by FEE: $ 2-110 S Check No.: � 2-S-2-7- Receipt No.: 2SZ7 0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner, ,�-p�Signature of contractor_ j Location ' ✓L �� No. P? "' Date �` I TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $_olo"! Foundation Permit Fee $ Other Permit Fee $ TOTAL $->I 0 Check# I2`�Zz G.UG%V uilding Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signatu COMMENTS CONSERVATION Reviewed COMMENTS nature HEALTH 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 Osg000 Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 o Building Permit Application ❑ Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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 o 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 Doe: Building Permit Revised 2014 0 0 ENO .wam N d r n • jo 0 CU 0LU y� z CD cn CL c m o.� U) � as � r Cl)t V i Jz E V O Y O Q' tlJ: m U) C J L CO y� m a Z ~ ''AA V jCU = ' v 0 = C 0C CL r N _ N Q X Z 0 W p o 0 � U T 0 0 °' rc un c N 3 c J C;) W CL Z mss m CL CL U) 0) V 0 = 0) _ ~ 0 cc :5 _ L - o Cl) cc F+ t W O � OO 0 0 • W i 0 N �o'~c O FE cv o L c o OL 0 0 > 0 w L: O C O' m m 00 O CL CL CF) Q a a _ J � O Z CLN C ° ° H0 J W oC z W W d N N 0 = L6 H ? Z Z Wa R Z z U W o i m N uj O CG C E _ M J V W C7 LL t+O-+ m C d W a+ u Y N O O z 4J a �_ �o_ a � � v U aj o g LL L/) LLL C U LL K LL K N LL = LL m tn h n • jo 0 CU 0LU y� z CD cn CL c m o.� U) � as � r Cl)t V i Jz E V O Y O Q' tlJ: m U) C J L CO y� m a Z ~ ''AA V jCU = ' v 0 = C 0C CL r N _ N Q X Z 0 W p o 0 � U T 0 0 °' rc un c N 3 c J C;) W CL Z mss m CL CL U) 0) V 0 = 0) _ ~ 0 cc :5 _ L - o Cl) cc F+ t W O � OO 0 0 • W i 0 N �o'~c O FE cv o L c o OL 0 0 > 0 w L: O C O' m m 00 O CL CL CF) Q a a _ J � O Z CLN C Mau, Boa "sett, rdofe I . Idi - department e e t 0 e 141a Of P 1. 1jStrjjC 01) Wations Ub 1C.Safjet IcUPC 480'r and Standards y 10Q V -ft 1 . rds 98 Folos 1yorth T ST dove, ArA 0 tj ease. 14 UOTI-, comm'ssi, '1 1t+ ner ' 6/29/?tion z iptsigi ess Regulation office bfConsumer A1,A--- OME IMPROVEMENT CONTRACTOR Type: AbI8 egitrabon: '.A. ".74 Individual - xpirabon: 6/291201,6- KEVIN MURPHY Kevin Murphy 98 FOREST ST- Undersecretary N. ANDOVER, MA 01845 Kevin Murphy Building Contractor I Proposal To: John & Priscilla Fox 188 Bear Hill Road North Andover, Ma. 01845 From: Kevin Murphy CC: Date: 11/17/2014 Job: Renovate existing deck Date of plains: None Architect: None Location: Same Section 1- Work Schedule • 98 Forest street • North Andover, MA 01845 • PH: 978-688-5335 • FAX: 978-688-7207 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. Inquiries about registration and Status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108. (617}727 8598 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 11/17/14. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 11/26/14. 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 111- Scope of Work Page 1 of 4 Kevin Murphy Building Contractor 98 Forest Street North Andover, MA 01845 PH: 978888 5335 FAX 978888-7207 Page 2 of 4 General Proposal is renovate existing deck. No allowance has been made for any footprint change. Building permit will be obtained by contractor. Demolition Existing decking, trim, and railings will be removed. Frame of deck to remain Building New Azek XLM Harvest Bronze decking, will be supplied and installed on entire deck and steps. New railings will be TimberTech Radiance Rail Express. Outside rim board will have new Azek trim supplied and installed. Waste Removal All demolition / construction debris will be disposed of by contractor. Building Contractor 98 Forest Street North Andover, MA 01845 PH: 9786B8,9335 FAX: 978888.7207 Section IV - Price Schedule Total Page 4 of 4 We hereby propose to furnish material and labor — complete in Accordance with above specifications for the sum of .....................................$ 22,500 Payment to be made as follows: Percentage/Rem Description Amount 1 Permit obtained / deposit $2500 2 Demolition complete $5000 3 Decking / rails installed $12,000 4 Job 100% complete $3000 4$22,500.00 "Notice: No agreement for Home improvement contracting work shall require a down payment (advance deposit) of more that oneahird of the total contract price of the Mel amount of all deposits or payments which the contractor must make, in advance, to order andror otherwise obtain delivery of special order materials and equipment, whichever is greater Contractor: Kevin Murphy 98 Forest 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 DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature eol�' �AJARS Date Signature Date 0,,, 'J t - ' 0,,, �'►� CERTIFICATE OF LIABILITY INSURANCE 6/25/2014 � THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER M P ROBERTS INS AGCY INC 1060 Osgood Street North Andover, MA 01845 CONT CT Sandi Munroe ONE g78 683-8073 FAX N :(978) 683-3147 San i mpro ertsinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING 169 BOXFORD STREET NORTH ANDOVER, MA 01845 INSURER B: GUARD INSURANCE INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER - THS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IM TR TYPE OF INSURANCE IN WVD I N BE POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000,000 CLAIMSMADE a OCCUR I E $ 500V 111-N 11-7 OOO MED EXP An one person)$ 15,000 BOPI068945 11/22/1311/22/14 A PERSONAL&ADV INJURY $ INCLUDED 'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 n POLICY ❑ JET PO- LOC PRODUCTS - COMP/OP AGG $ 2,0 0 000 $ OTHER: AUTOMOBILE LIABILITY COMBINdEDiSNGLE MT $ 1,000,0 BODILY INJURY (Per person) $ ALO MCA7013608 01/23/14 1/23/15 A ALSCHEDULED AUTOS TOS X AUTOS BODILY INJUF2Y(Per accident) $ PROPERLY DAMAGE $ NON -OWNED HIRED AUTOS AUTOS P ent UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ r r 000 * EXCESS LIAB CLAIMS -MADE CUP9145304 11/22/1311/22/14 D I I RETENTION WORKERS COMPENSATION X I PEROTH- T U R AND EMPLOYERS LIABILITY ANY PROPRIEfOR/PARTNERIEXECUTIVE 500,000 B OFFlCERIMEMBE2 EXCLUDED? NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 500,000 (Mandatory in NH) KEWC527844 07/01/14D7/01/15 Ifyes, descrbeunder 500 000 IPTI N OOPERATIONS I E.L. DISEASE- POLICY LIMITr DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached ifmorespace'srequired) CFRTIFICATF HOI nFR CANRFI I ATInN TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. I AUTHORIZED REPRESENTATIVE M N kdwt ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street .Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: S `L t ct7 S tl�t City/State/Zip: �,,,,.`1.� p,�.c,.,,,,, N., o`1>6 -Phone #: �'-K't` S-3 3 Are you an employer? Check the appropriate box: 1. M I am a employer with t_ 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and'have no employees working for me in any capacity. [No workers' comp. insurance required.] 3111 am a homeowner doing all work myself. [No workers' comp. insurance required.] r have hired the sub -contractors listed on the attached sheet. These sub -contractors have workers' comp. insurance. 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. -3 Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. E] Roofrepairs 13. ❑ Other 'Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. lam an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:. GV,% ,-.Ok �,►-�1 C. I Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: \ 0tlJ 1�.� r �` n--& A-t City/State/Zip: Iv, . A--ka..,., Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 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 advised that a copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. I do hereby cert under the pains and penalties of perjury that the information provided above is true and correct. Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health'2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone #: