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Home My WebLink AboutBuilding Permit #397 - 191 HAY MEADOW ROAD 11/18/2009 E NORTH BUILDING PERMIT O?° t'`r' F°;�~oo� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �9"� �Tto,••`�, �SSACHUS�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Ql\. Print PROPERTY OWNER Sc,;-7 1c�lQ,e„i-s•� Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential. New Building One family Addition Two or more family Industrial Itera i No. of units: Commercial epai ti replace Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: J Identification Please Type or Print Clearly) OWNER: Name: �c.,a� z,,,—► Phone:Address: CONTRACTOR \`� l 1 �, ,,,..,.,.off �� Rr�� the►•ate G,. -, 1�• CONTRACTOR Name: ��,-w Phone:LJ Address: d` Vv "k_ Supervisor's Construction License: U'S-3 U °�`� Exp. Date: 7_0, t t 1 Home Improvement License: O \, ?/,-I Exp. Date: ARCHITECT/ENGINEER Phone: 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: $ 3"1 q U FEE: $ �\ I,, Check No.: Receipt No.: 2 Zee 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 Tanning/Massage/Body Art , Well Tobacco Sales Food Packaging/Salest 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 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 Osgood S reet FIRE DEPARTMENTz.,Temp Dumpster on site yes no Located at 124 Iain At eta t 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 equires 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 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) ❑ 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 ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location 4 No. Date MORTIy TOWN OF NORTH ANDOVER 3: - •' O0 � Dt' i Certificate of Occupancy $ 00 CMUtt�' Building/Frame Permit Fee $ SAS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 9,/v 2 2 F z)L8 Building Inspector ToVM NpRTH of , t .. 4Andover _ p �,cw..wan �4•,' •I, etc No. 3 7 o dover, Mass., D A- COC HIC HE WICK V 7�ADRATED S E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT b... .....211.......OWN.......................................................... .... .. .... .................... ................ .......... Foundation has permission to erect........................................ buildings on..........C.. .l.......l.- .... .. / !- .. � ••••••••.•• Rough to be occupied as.... Chimney Ife..,p. � U� n 1ifw� ,�- . • . . 6a�c�c� ............................. ................................. .............. .......... ...................................................... provided that the persopting this permit shall 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR O STARTS 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 SafoN Board of Buildin!- Re.-ulations 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 ('unnnissiunrr Tr#: 16540 ,per ✓�ze L/6�9YI)7.04t1IJ o��/l�LdQd¢f./1.tldeL�d l �\ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:., 101874 Expiration: 6/29/2010 Tr# 267315 type ..Individual KEVIN MURPHY" Kevin Murphy 169 Boxford St ,,Q N.Andover,MA 01845 Administrator ---•---- -_ - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 IV www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElePlease ease Print mbers bl Applicant Information Le Name (Business/Orpaization4Ddividual): Address: City/State/Zip: N. , b nn.�y r' Phone# Are you an employer? Check the-appropriate bots: Type of project(required): I am a employer with '�-- _ 4. ❑ I am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 7. DRemodeling attached sheet th d isteon e a !.❑ I and a sole proprietor or partner- l slop and have no employees 'ti,ese sub-contractors have 8. ❑ Demolition working for me in any capacity• workers' comp. insurance. 9. (❑ Building addition (No workers'comp. insurance 5• ❑ We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their 1 L Plumbing repairs or additions ❑ I a a homeowner doing all work right of exemption per MGL ❑ myself. [No workers' comp• C. 152,§1(4),and we have no 12.[:] Roof repairs insurance required.)tP1+aY [No workers' 13.0 Oilier comp.insurance required.) Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infannation Homeowners wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such Contractors that check this box must attache)an additional sheet showing the came of the sub cmunetors and their workers'corp.policy infot nwtion. am an employer that is providing workers'eompemation.insurenee for my employees. Below is the.policy aced fob sate "formation. nsurance Company Name,• -� .� •- s iolicy#or Self-ins. Lic. #: 1� �^-'C— y CJ 6�3 Expiration Date:---D �` lob Site Address: \ IL �`-ti - -'��"^'' City/Staoa/Zip: K/*,. kttach 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 MGL C. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year ii prisoument,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violaror. Be advised that a copy of this statement tray be forwarded to the Office of Investigations of the DIA for insurance coverage verification. r Zu "ZurW7 b certify under the pains and penalties of perjury that the information provided above is true and correct. Date- [ ate: Q,79'eial use only. Do not write in this area,to be completed by city.or town offciat City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 3.Plumbing Inspector 6.Other Contact Person: Phone#: coR CERTIFICATE OF LIABILITY INSURANCE ��►, a'RCMDO, THIS CBtTlgCAT'E l3 =MUED A8 A MATMR OF MFORMATIOM M.?, RaibastOt ssa>ju�a� A�lADlY OMLX AMD CONPlR$ NO RIOlt'1�8 UPOM THE CEFt'tIFlCA7E 1060 Oag0prl 8tsggt H011yER. IF11lt CERTIFICATE DOES MOT EMD BXTgNl3 OR 11o�r AaC1q�. MA 0184B A T><R TN�i CnUWMAC AF'K ev TH P >1C O R INGURERS AFFOKtWo COVERAW 1RVIIP >!RIRP1tY INWRERA 1 �UDLZ IrAfCD1 __.. lab ammaw 62mat ►NeuD�D:n 1 = ._. . XMM AMXNXR, MA 0184a MUNN ONeuRrtDe c TMfc PMpM�Mp-IBQF Iti81JRANCJL b W OF AMY W 1186UE�CM W�M i 1'DTFM:M "ME0ABWEI�pOI�7H9 PDWY P&VW INDICATED.N07WlThBTAM�ll�3 IAYIAYPEf1'T Tl4ir I LO SSYTMMF(Xl 1E9 CBS=WD U�T ALL TMS�04 CEftWICItT4 AMY BEM OR PQI ICIBE Lmm 9FVM A—ww eM vyPAJ MAMN6. CJI UMONSAVD OONDITM OF AXH POIJOSr Nu ,. . UAWAM '� XALtlfiltEIMLLDAIDD{.DDY ' CwMeWoe [Z OCCUR CM0060868 04 11/22/09 12/22/09 mmogp onr A �`� 0 N 5 I OQQ _ PWAQR4L#ADViMAlRY 1 aeDAAE1BRlat11LMTAMl9A9MR WAL D46 2. p P LOC PRODUCTS-cou ATP Afl0 • 000 M►DODIDfMMLDAD OW MYAUID C ALLMOMAUrN � BNtOIEL�fR s 500.000 B 90"MM WAMOs 7AM277013400 1/23/09 1/23/10 M"y"J $ I MQAt110A NO"W14D AUTODI a0D s Pw► P$�bAAN1q $ 800,000 OAI1AAe�OTY ANYAUIO OOKY-DLA OIDENT _ OCCIR _ _CLAM1MWM t�0-00MMRWM AOOAlOA7! DD Q�UDYeLiE ...—..• MD.LM tRD� UMKM ltDA ^ i TIE Y im c ' D>�° ►DnmD x,34111c006031 7/1/09 7/1/10 00 s00 0 • ao 0 mor arenDaDttOtM►hOC111D01M►vlllraDu,Ot�wODDe AD:!>q'1 DDy ewaassr«T,s.Sa,u.*RDVppQ1Ol< Ac: 978-680-7207 cAMCEt.LA_ N SWULOANYORTMDAPpLMMM6CANCILLED A7Q THS QNB ftWX*ODgtDD M M DWM" 2XPPATDON 20MOV NO A�{/qA w4L eNORgvOOt 70 MAA,-1-0— OAVS WWTM 1600 OSGOW T Q� OMtJOA 1KMa! AM Nm TO Tote uPT,MH'rTmujm TO M 40 0MLL MM"" ATSOMPNo, m► 01848 R DTs*MM ca µD��l11t1iQ wMn ARD>!M MlN) TfDDD 0 D�d m l90-MO ACORD POItA . All r 1090 9D+M Died D11DD,Itd 0?ACORO 1'dl�1 tARd. 169 Boxford Street Hevan Murphy PNorth H over,5A 01845 Building Contractor FAX:978-688-7207 Proposal To: Scott Robertson 191 Haymeadow Road All Home improvement Contractors and Subcontractors engaged in home imProvernerd cm*ac",unless North Andover, Ma 01845 gpecfficalty exen"ftm regmArat1on by Provisions of Chapter 142A of the general laws,twig be registered wfth the Comnwrweallh of Massadwsens.inquiries about registration and Statrns should be made to the Director,Home Improvernerd Contract Registration,One Ashburton Place, Front Kevin Murphy Room 1301,Boston,MA 02108.(61 7>-727 8598 CC: Date: 11/1 V2009 Job: Replace two casement windows Date of plans: None Arch bwb None Location: Same Section 1-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 11/16/09. Barring Delay caused by cirarmstanoes beyond Contactors control,the work will be completed by 12/15/09.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 fumished 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 Muse 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 E'Rewrim&C'2anrrpa? Page 2 of 4 �saBL�gj��a4aacC� 169 Boxford street Moro,Andover,MA 01845 PH:978688-633.5 FAX 978.688-x)000 General Proposal-is to replace two existing casement windows. Building permit will be provided by contractor. Demolition Two existing window units will be removed and disposed of.Any rot around windows will be removed. Building Two Anderson, five section, casement windows will be,supplied and installed to match existing units( as close as available from Anderson ) . New windows will be approximately five inches shorter than existing. Any rot damage found around window openings will be replaced. Siding,and interior trim will be supplied and installed to match existing. Interior wall will be patched/plastered as required. Painting No allowance has been made for any interior or exterior painting. Waste Removal All construction debris will be disposed of by contractor. L� • � Rewiim f unipllny Page 4 of 4 BuBdiug contractor 169 Boxdord Street North Andover,MA 01845 PH:978688-5335 FAX 978-688-)O= Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of............... ... ... ... ...... ... ....$ 9700 I Payment to be made as follows: Percentage/item Description Amount 1 Job complete $9700 Total 1 $9f700:00 -Notice:No agreerneM for Home improvement contracting work d iall req"a clown PeYffient(ate )of more that aethad of the WWI contract price of the total arrim t of all deposb or payments which the contractor moist make,in advance,to order and/or otherwise obtain delivery of Wwal order materials and equipment,whichever is greater 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 DO SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date 1, Signature Date