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HomeMy WebLinkAboutBuilding Permit #739-11 - 193 GRAY STREET 5/3/2011TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �/ - Date Received Date Issued: 15, �� C Eff ORTANT: Applicant must complete all items on this LOCATION i ok_5 Print PROPERTY OWNER 5,C5'1 4 Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑ Addition ❑ Two or more family ❑ Industrial . Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Demolition❑ ❑ Assessory Bldg Other ❑ Others: P, Septic ❑IWe11 n �+�Water/Sewer�r`+__�'i... fi®aFloodplaiu�®Wetlancls� ©watershed+Distr`ict; ' i DESCRIPTION OF WORK TO BE PERFORMED: I,.�o� � �b�r�.-�� �,,.5 4''t.�� Prov ��� �� trJ �c��r'S , • ; Com-- '_ Fk__U �.A (51 "&-- Identification Please Type or Print CIearIy) OWNER: Name: o-t'� S. 1G "�W � - Phone: 00118 Address: Iiia C104-`'( CONTRACTOR Name: 15;pooz)n� L -LC_ Phone: Z3���� srmv C*__� SA. ep ,_� Address: C(O Supervisor's Construction License: "1to�Co�a Exp. Date: Home Improvement License: IEdGS01�1 Exp. Date: ARCHITECT/ENGINEERPhone:_ (SOS) S'1Z-SA-06 Address: ti5by3e+j j Ml(l Reg. No. Ae7PS\5 FEE SCHEDULE: B ULDING PERMIT: $92.00 PER /$9000,00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $- `I S = yy FEE: $D 2 Location q2 512 n No. 3 1 Date lz� MO0 TOWN OF NORTH ANDOVER 3 O 41 O F w f �.o- Certificate of Occupancy $ s'MUs t� Building/Frame Permit Fee $ 5 �' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 100 51 24 0 Building Inspector Plans Submitted ❑ - Plans Waived ❑ ' Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Well ❑ Private (septic tank, etc. ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMME CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Sicinature COMMENTS d Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Sicinature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood 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 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Soard of Appeals AL the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording ist be submitted with the building application Doc: Doc.Building Permit Revised 2008mi U) m m X m 4 m X m (A m O iW oq cn cn 0 cO cgo CA Ccal nOM; ,Cos I C) cg -S 2 C . � .n M= Z 3- - DW . 0ca o.,. mCO LA. CL. P -o =r —4 CD 0 0 CO) 0 :E CD a 2>4 m 5 U2 0 30 W= 0 z:5. CIS 0 E. C2. CD =y7 0 SO CL co 0 =rE 4c Ce 0 CD CD n-0: 0 CD C3 -g 0 0 03 CA H O. cr CD CO) CO) :E CO) CA CD M CO) =-O . = CD : co O C.) CD I CD 0 0 =r, CD so CL"E: C-) L-3 0 Co col 0. C2 • CD: cn c4 o CD cn z M r. z w0 91 Z (D cp �z 0 odar. Go CD az 'o CD 0 n CL FS O al o CL >Cc CD CD CL cr CD Olt CD 0 CD ca CD L CO CD CA CD CO) 0 "0 CD Z CR O CD O CD O iW oq cn cn 0 cO cgo CA Ccal nOM; ,Cos I C) cg -S 2 C . � .n M= Z 3- - DW . 0ca o.,. mCO LA. CL. P -o =r —4 CD 0 0 CO) 0 :E CD a 2>4 m 5 U2 0 30 W= 0 z:5. CIS 0 E. C2. CD =y7 0 SO CL co 0 =rE 4c Ce 0 CD CD n-0: 0 CD C3 -g 0 0 03 CA H O. cr CD CO) CO) :E CO) CA CD M CO) =-O . = CD : co O C.) CD I CD 0 0 =r, CD so CL"E: C-) L-3 0 Co col 0. C2 • CD: cn c4 o CD cn z M r. z w0 91 Z (D cp �z 0 odar. Go �z 0 z n pd Cc: 11 Cc: C/) 43 a al o CL 0 b M 0 Vu �,." NOTES: - All construction and demolition debris will be removed from the site. Any latent defects encountered will be discussed with the customer and come as an additional charge than provided for in this contract. A labor rate of $50.00 per man hour will be used plus any materials. We have estimated a time frame of 15 business days for the portion of the work scope provided by us and our associates, conditions permitting. This job, for construction services, as stated above, shall be contracted at: $ 28.470.00 Payment will be appreciated according to the following schedule: With the signing of this contract $ 2,850.00 (Deposit) At work commencement $ 6,640.00 Interim at mutually agreed upon times $16,980.00 ► At completion $ 2,000.00 Total 1 $28,470.00 14-6 �7s � SARACENO CONSTRUCTION LLC DO NOT SIGN THIS CONTRACT IF THERE ZAIRE �� i ANY BLANK SPACES By. Ste. -led Saraceno Date By: `Owner–__---�-- 7�--'- 'W'-101ember and �Ulanager Dete If you are in agreement' with this contract, please sign and return one copy, with deposit. Retain one copy for You records. Once deposit is received we will contact you to schedule a start date. ADDITIONAL CONTRACT INFORMATION Massachusetts General Law requires that all home improvement contractors and subcontractors be registered as a Home Improvement Contract, NIC registration". Our registration number i ' 165503 ander SARAC€NO CONSTRUCTION LLC; Steven Saraceno. Address any and all inquiries, questions of validity and disputes to: OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATION, 10 PARK PLAZA, SUITE 5170 BOSTON, MA 02116 (617)973-8700. As owner of the property,under contract, you are entitled to all warranties and owner rights as stated under the provisions of 780 CMR R6 and MGL c. 142A. PERMIT NOTICE: it shall he the contractors.' obligation, as the o: hers, agent, to. ebt�i.n the build.i.ng. permit. A!I ethers term is shall and will be obtained by the individual subcontractor as necessary. Owners whom secure their own construction related permits or deal with unregistered contractors will be excluded from access to the "Guaranty Fund" as provided by the State of Massachusetts. As owner of the property under contract, you are entitled to the owners' three-day cancellation rights as stated under MGL c. 93, S48; MGL c. 140D, S10 or MGL c. 255D, S14, as may be applicable. MA LICENSE NUMBERS: B1128931, CS 271`44, CS 76963, BU 21866 FIN: 20.1278723 w... PLUMBING - Disconnect and remove existing kitchen sink, utility sink and dishwasher. - Rough plumbing as may be necessary for new kitchen sink, bar sink, dishwasher and refrigerator - Install waterline for new refrigerator location and ice maker in bar area. - Reinstall "q* refrigerator - Reinstall dishwasher. - Install new kitchen sink faucet. Faucet suppled by owners. ins,a« ne:YY, ar sinR faucet. Faucet supp.teu by owners. - Relocate existing gas line to new location for new gas rangetop - Install gas I rangetop. Rangetop to be supplied by owners. Viking 36" gas, model #DGSU160-5B ELECTRICAL - Owners responsibility WALLBOARD - Supply and install new blueboard and skimcoaf veneer plaster ceiling, smooth finish and ready for paint by others - Supply and install new blueboard and skimcoat veneer plaster to all disturbed wall areas, smooth finish and ready for paint by others CABINETS and COUNTER TOPS - Install custom cabinets and hardware, per plan. All cabinets and hardware supplied by owners - Counter tops, supplied and installed by others INTERIOR TRIM and COLUMNS - Supply and install base trim as may be necessary to tie new kitchen area into existing areas. Trim to be similar to existing, paint or stain by others - Supply and install two round columns, tops and bases for knee walls per discussions with owners. HEATING AND A/C - Supply labor and materials to drain heating system to shorten baseboard heat along kitchen exterior wall to accommodate new cabinets - Supply labor and materials to remove and relocate as necessary A/C air return, approximately 12"x18" FLOORING - Supply and install bamboo hardwood flooring for useable kitchen floor area and great room, approximately 600 sf, flooring from builders selection. ADDITIONAL APPLIANCES Install one countertop downdraft system and venting. Venting system from Faber, Model: Scirocco and ventin ials to be supplied by owners. ns a one X24" microwave ra a raw from Sharp, to be supplied by owners. Install One ilf n,derco.u,iite.r, Y irie, c0o.le.r rafrigerator, supplied. by ov"..n.e.rs Install one undercounter, ice maker, supplied by owners a ENGINEERING EXCAVATION h CONSTRUCTION 90 High Street — North Andover, MA 01845 ° Telephone: (978) 258-8885 Fax:978 ( ) 258-7722 8 7722 - - email: saracenoft(a)live.com - i Construction LLC 90 High Street — NorthAndover, MA 49845 - CONTRA -CT - DATE: April 19, 2011 SUBMITTED TO;: Scott and Keliee Twadelle 193 Gray Street North Andover, MA 01845 TELEPHONE: ' 978-685-2759 JOB LOCATION: same as above JOB DESCRIPTION: Kitchen remodel per plans as detailed below. New flooring for great room. SARACENO CONSTRUCTION LLC IS PLEASED TO PROVIDE YOU WITH THIS JOB CONTRACT FOE. C.O.... k— .C.TIn"r. S.FR�/ICES. P.T T!-lE A.DrJ.��!= R'rEE:?E"�C.EQ. LO.C:°T!.0. :^:E !!lII.I: I: D 0 inr- THE STATED MATERIALS AND LABOR TO PERFORM THE OUTLINED SERVICES. ALL WORK WILL BE CONSTRUCTED IN STRICT ACCORDANCE WITH THE MASSACHUSETTS BUILDING AND LOCAL CODE. UNLESS NOTED OTHERWISE, THIS CONTRACT DOES NOT INCLUDE COSTS FOR ANY OF THE FOLLOWING: DESIGN PLANS, PAINTING, LANDSCAPING, and ELECTRICAL. THESE SERVICES CAN BE PROVIDED AT AN ADDITIONAL COST. PROPOSED WORK SCOPE DEMOLITION - Remove existing appliances and dispose of with the exception of the double wall oven, dishwasher and refrigerator. These will be stored in basement during remodel for reinstallation. - Remove and dispose of existing counter tops. - Remove all existing cabinetry for site removal by others. Every effort will be made to remove these cabinets with minimal or no damage, however, customer understands that some damages may occur. - Remove all flooring to include, tile and hardwood flooring in kitchen area and pine flooring in great room. Total approximate area of flooring is 600 sf. Dispose of all. - Remove existing kitchen closet adjacent to laundry shoot. - Remove entire kitchen ceiling - Remove portions of kitchen wallin new bar area, as necessary to expose plumbing for relocation for new bar sink- - Remove portions of structural wall between great room and kitchen, as necessary to facilitate new overhead flush beam and half walls FRAMING En.gi.n.e.er, su~ I aL�d install b.^ca4'a to. 4c.^.ert' su o.rt ne_vr. v. o_i.n^ un. structural wall. s aratih^ Np y p' N Y pp p a p g kitchen and great room. Opening width to span from back wail of dwelling to approximately five feet of front dwelling wall. Labor and materials as necessary for knee wall construction, per plans and discussions with owners. i 71. Office of Consumer Affairs*Business'Regula6on HOME IMPROVEMENT'CON7RACTOR Registrati0Pi:s,:,-4 65503. Expiratibrt 2/2512012 Tr# 293690 SARAGENO COMM• ruCCION ILC. xy STEVEN SARAO 90 HIGH N0, ANDOVER, MA 0'1$,?!5 '' Undersecretary Milssachusetts - Department of Public Satct% Boar*(] of Building Re ulations and Standards Construction Supervisor License License: CS 76963 Restricted to: 00 STEVEN SARACENO Y 90 HIGH ST N ANDOVER, MA 01845 Expiration: 2/17/2012 ('vnunissiluu" Tr#: 20799 I 0 ) | !2 o k a N ® w o 2 § §© § E N§■) ` 2 & ' »\ _ ° § § )\\ e§ A 3) 2/ '® w &7 3] �3z/ Z �3S»� j))[ d] -j� . ,® \)§ k ? (j w u) ; « /\\ u 7} � �z . /§ u \ o . D� 2u \/ \ƒ( mm� j Ld g2\�4 goy o\u ��2 m �.k SGu z»< z Oz M) 5, goo ���oc �E E*z9 6, )°° 6 �\(m« ¥3 /8 ww (§w�a�- z(=� <1 —Em])e �#�jz�zgg 333�)ow 9992/§/�% / °c-• °@ PMMKe23& \ �R)))})2) \ \ j cn t—; -- -- --- ------ - rn N 0D m 04 31 n�NO .c Ca n' r S0O �' Z;o o MO cn z�+0 o O 0 r A z Pd M 47) Z r 3 L J� _tF- C r Nwzo r N —! 0 Z O m 00 _ W Z �1 W ^ 'O - _ O_ L4mN �Il �i �_ a. a Kos z'z 0 0 z r *om 00 z 1 how � mn *cam. I �0— 0M;u� NN LA0 A or�'jmom Z=; X D mZ3=irN ' M.mr- i I mzZ r—Orn30X -- --- oaa m >� Li ZAP 0 SIiaSCa m a u 5> Z 7i DA DBSCR1PItON BY 41 �] t. V)�m�11Oo7 dN; The Commonwealth of Massachusetts Department oflndustrialAccidents ` Office of Investigations ' ! E6 iu i 600 Washington Street Boston, MA 02111 www.mass.gov1dia s - Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print'Legibly Name (Business/Organization/Individual): Address: '�ifl 14 k GR City/State/Zip: W-0, 4& D . %ti (�a�l� Phone #: Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors listed on the attached sheet. # 2.0i am a sole proprietor or partner- ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. 5. ❑ We are a corporation and its [No workers' comp. insurance officers have exercised their required.] 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] employees. [No workers' comp. insurance required.] Type of project (required): 6. [} New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roof repairs 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 are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. If; Expiration Date; Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Sedtion 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 DIA for insurance*coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. I % 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 _ 1\ - Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone numbers) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to cavy workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confinnation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pen -nit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sur&that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pen-nit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future pen -nits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-87:7-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.govldia