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Home My WebLink AboutBuilding Permit #323-13 - 20 FULLER MEADOW ROAD 10/17/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: I� Date Received Date Issued: t ORTANT:A licant must com lete all items on this age LOCATION Q10 ..JJ((1-74 Mg `.'AJ61') t rmt PROPERTY OWNER & S Unit# Print MAP NO] q� . PARCEL:_ZONING DISTRICT: Historic District yeCno Machine Shop Village ye100 year-old structure ye TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building kr6ne family ❑Addition ❑Two or more family ❑Industrial ❑Alteration No. of units: ❑Commercial ❑Repair, replacement ❑Assessory Bldg ❑ Others: ❑Demolition ❑ Other ticl7 Wella`r D ood FEWshed ►is k a•....sP WAR . .z,+rig.::tv�..sff� 'i.,.�nY..;/r. = ��,�..." t•?.:� 7_..'r�atir�.cis.cS .: � }..�x:..e�.��r,:4tt+w:.. t'�.tat � DESCRIPTION OF WORK TO BE PERFORMED: -J UIVI'm (Identification Please Type or Print Clearly) OWNER: Name: I'AI IL -�-CURI`.S 600 6,107 3 Phone: Address: rod( -el! H cz�q �q4,J t'�� F CONTRACTOR Name: �1�kj't Phone: Address: 3 , Supervisor's Construction License: Exp. Date: 2 J ! Home Improvement License: 1,1! S Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$92 .00 PE .F,%-� Total Project Cost: $ 6 4 FEE: $ Check No.: Receipt No.: NOTE: Persons contra ing with unregistered contractors do not have access to the uaranty fund _. ... . natureof=:Agent/.Own` 'tature_ofi°contracto Iff Location No. Date Lto ` If--/.I- TOWN /.I -TOWN OF NORTH ANDOVER Certificate of Occupancy d ; 4 Building/Frame Permit Fee $ �' ��' 'Z, Foundation Permit Fee $ �. Other Permit Fee $ TOTAL $ Check# ) 1 25854 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑- Tanning/Massage/Body Art ❑ Swunming 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS f HEAL=TH 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 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 servicedroprequires approval of Electrical Inspector Yes DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use 0 Notified for pickup - Date Doc:.Building Permit Revised 20117une/mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding,g, Interior Rehabilitation Permits ❑ Building Permit Application o 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 MOTE: 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) o 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: Doc.Building Permit Revised 2008mi 1;,AV Q N , } l Residential ,demi l CC�y yy�y�ppo�Commercial ��asg�fiyr�acgy All Types Of SidingIVINEYS ... Expert Masonry Work Mass Toil Free �' e= Licensed & InSUred 1-300-VtrA§T-4- S �lUned : «,,e, ,,.,,r Sr ..t Iv?s �c�" License#034200 t (924-3487) �� cxee wazow v-_,golkot � we work Year Round a < ^ �.,. ,. e ::'. r:t .�_� B � „sy :•<$ evils 4°�. i'. r:.3a f x� '`�' �y�., Proposal To: Carrie Googins eoy'zi,5, Date 9/6/12 Street: 24 Fuller Meadow Rd. 978-689-8360 N. Andover, MA Vinyl Siding Proposal carriescg@comcast.net 1. Remove all existing Hardi Plank, Ix4 trim, wood 13. Install all new vinyl accessories: light blocks, ga- clapboards and corner boards from entire house. ble vents split blocks, meter block etc. (Removing and 2. Inspect all wood components of entire house. re-installing electrical meter by licensed electrician Any compromised material will not be left. Any included in proposal) existing damage or rot will be discussed, con- 14. Removal and installation of light fixtures and firmed with homeowner and replaced at an addi- doorbells included. New fixtures and doorbells must tional cost of time and material. be provided by homeowner if wanted. 3. Remove all existing gutters and downspouts. 15. Install composite kick plates under all entry doors 4. Install 3/8"Tyvek or Typar housewrap to entire where applicable. house.7�1_1 seams will be taped. 16. Install all new white aluminum .032 seamless gut- 5. Install 4" standard vinyl corner posts to all house ters and downspouts. corners. 17. Proposal does not include ant painting or staining. 6. Install Mastic Quest .046 or Certainteed Mono- 18. Building permit included gram double 4"vinyl siding to entire house. Stan- 19. Removal of all work related debris dard colors only. 20. Limited Lifetime vinyl siding warranty from 7. Soffit area: Drill holes in all rafter bays for added MFG. , not contractor. ventilation where needed. Install vinyl perforated 21. Contractor workmanship warranty: 10 years under Invisivent soffit panels where applicable. normal conditions. 8. Install j-channel to all areas that need to accept Total cost: 24,600.00 vinyl siding. All j-channel will be self-flashed *(full online discount applied and included ( pp *) and angle cut for clean professional appearance. Highly rated on the Accredited BBB and An ie's 9. Install custom bent .032 Alcoa white aluminum • g Y g trim coverage to all fascias and rakes. List 10. Remove (2) existing windows on front of garage payment schedule: and frame in.No interior work included. 1/3 on project start date 11. Install white composite PVC to garage door 1/3 at project halfway point frame, casing and weather bands. Final balance including any extras due upon project 12. Proposal does not include siding on interior of completion e screen porch. / 2?1-f Thank you! 4 Udeptance of Proposal—The above prices, specific tions and conditions are satisfactory and are herby ac- cepted. You are authorized to do the work as specified, Payment will be made as outlined above. Office of Consumer Affairs & Business Regulation - Mass.0ov � The Offloal Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation Home Consumer Home Improvement Contracting Home Improvement Contractor Registration Lookup You can search/filter the registration lift by any of the criteria below. Search by Registration Number 1137057�� Search Search by Registrant Name �- Search by City �� Zip Code Search Registrants! Click on the registration number to view complaint history. You can also vow arbitration and Guaranty Fund history The list is current as of Thursday, September 20, 2012. Search Results REGISTRANT RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS NAME INDIVIDUAL NUMBER DATE ALL UNDER ONE ROOF LANZAFAME, 137057 166 A FINACHARO 10/02/2014 Current JOHN BUILDING METHEUN, MA 01844 0 2012 Commonwealth of Massachusetts Mass Gov®is a registered service mark of the Commonwealth of Massachusetts Kn.�ril ..t fjll{1111H•' fit- 11m ,4$1+1 "I.nul,ir i. .vnstrtwric+n Sur>ar'v 5)i i.'.•n� t I se .:,5 69120 JOHN W LANLAFAME 30 TEMPLE OR METHUEN, MA 01044 tAijoi ion. 43/201$ GATE(ry%w001YYYYI ! Q� LIABILITY INSURANCE 10/1/2012 __ __ CERTIFICATE PON THE CERTIFICATE HOLDER, THIS } Y Ft NEGATIVELY AMEND, EXTEND TRACTTf3ET�NEENOTH�155UING AFFORDED NSURFR(S)?AUTHORIZE0 trt�& CERTIFICATE IS ISSUED AS ACME`ER GF iNF0Rt4IAT1ON Ofd1-Y ANII C INFERS NO RIG f x ;'ERTIFICATE DOES NOT AFFIRMA' BLOW, THIS CERTIFICATE OF iNSQRANCE DOES NOT Nb THE CERTIFICATE 14OLDER UTE A C tERRESENTATIVB OR PRODUCER+A otic Ies)must be endorsed, tf 5U8ROGATiON 1S WAtYEO, Subject to Poll ,certain poltcles may require an endolserhont. A statement on this certificate does not confer rights to the EIPORTANT: it the certificate hot Ls an A017iT10NAL INSURED,the P Yt fl!0 tatms and condNions of the P Y Loeschen ciJ TACT Tsacp =1flcate holder in 1MIJ Of sucttendorsement(s. NA IAC IgYg16A1-n„s DtTUG£R PHONE (9781)682-3397 stltagelig Insurance Eflp,l NAICA 63 Merrick street INSURERS AFFORPINGCOVERAGE CO X23 ,NSURERA,The Travelers Insurance KA o 18 4 4 --�—"� ethuon _� _ INSURERS National Gran p Mutual Ins Co suoer INSURERC. `isnothy Cresta, DBA: TC Construction INSURER D =3 Hollis Street 1NSURERE: ,NsuRER F: REVISION NUMBER: .esf~ell MA 01852 2012 Term ;AVERAGES CERTIFIGATE NUMBER: TviE INSURED NAMED ABOVE FOR THE POLICY P'cF.tO iti1S 15 TO CERTIFY THAT 7 IE pQLIC1E5 OF INSURANCE LISTED BELOW QnEO Ely THE C TR POLICIES DESCRIBED HEREIN 15 SUe1ECT TO /1L1 THE TERM” HAVE BEEN ISSUED ttDICATED. NOrN ITHSTANDtNG ANY REUtREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHE�S DOCUMENT WITH RESPECT TO WhIICH THIS CERTIFICATE MAY eE ISSUED OR MAY pEq CIN, THE INSURANCE POLICY EFF POLICY EXP LIMIT$ EXCLUSION AND CONDITIONS OF SUCH POLICIES LIMITS SHAWN MAY HAVE BEEN REDUCED BY PMIS 1,0 0 0,0 0 Ok pOLICV N1JUSEREACM OCCURRENCE S L TYT'E OF INSURANCE - GENERAL LIABILITYF MISfg_ clirreS ---- -- ME08xPIAnyor:e ervo�l 5 s,000, XCDMMF-RCIAL GENERAL LI4PpJ /1/2012 !1/2013 r'r 6809303P271 g 1,000,0001 A CLAIMS-MADE Ox OCCUR PERSONAL b ADV INJUPY , GENERAL AGGREGATE D00,000 pRooucTs•coMDro� ATE _ S ------•– PA' s 2.000,000 c,G I � GEN'L AGGREGATE LIMIT A"OES PETt• COMBINt SINGLk IM:T XPOLICY� PRO- LO" a occlo -- AVTOMOMLE LIABILITY BODILY INJURY(Par petl0 S e001LY INJURY tPcr xuQrn+) _---• ...._. ANY AUTO �— ; ALL OVdNED $CHEOu:.ED PRUN PTY OAMn,- AUTOS AUTOS PeI x t NON.OWNEO 5 MtRFD AUTOS AUTOS EACM OCCURR_ENGE J_ S UM%QELIA,.AH OCCUq AGGREGATE S EXCESS LIA$ f CLAiIaS-MeDE r S WL STEL RA 14 0TH. OED RETENT, N S B WORKERS COIMPENSATION El EACH ACCIDENT I 100,DOS 41+6£MPLO'rER5UAeil+TV YIN 11/6/3011 12/6/2012 E.L.DISEASE-EAEMPLOYE 100,000 NIA ANY ^?pPRIETOR+P6RTNERIEXfCilil,/t� �P8729C Or rICERrMEMUER ExCLUr3FI E L DISEASE•POU.CY LIMIT F S o o 001 16t,nd3W N In N H) 1f yyes,,ft1ce&e unser I3-SCAIPTION of OPERATIONS bctor DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 701,Addttton;"AW"rka Sch**.Ie.M mere spec+%S»avlr.dl Cert iftcate is isaued in the interest of the named insured and holder listed below. Subject to company conditions and exclusiona. i II t Yy.. CANCELLATION CERTIFICATE-HOLGER sHOULO ANY OP THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE 1(97 8)975-0461 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCOROANCE WITH THE POLICY PROVISIONS, All Under One Roof Att: John AVTHORIZEO R£PRPSENrATIVE 30 Temple Drive Methuen, MA 02844 David Segall/NNM ®1988-2010 ACORD CORPORATION. All rights reserves The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street �t Boston,MA 02111 wM s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name.(Business/Organization/Individual): Al Jot -!A 0#1t 4/_ Address: City/State/Zip: - e_1 J-e_ 1 Phone.#: Are you an employer?Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. am a general contractor and I employees(full and/or part-time)-.* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees 'These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers9. ❑Building addition [No workers'comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10..0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.El Plumbing repairs or additions myself. o workers' co right of exemption per MGL Y � mP• 12.❑Roof repairs ll` s'i.dX� insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other S t+ comp.insurance required.] *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. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 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.#: 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 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 DIA for insurance coverage verification. I do hereby certify under th ains and penalties of perjury that the information provided above is true and correct. Signature: Date: l'''l''1 . L j I L Phone#: 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#: �t 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 1 "every state§25C(6)also states that"evestate 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-contiactor(s)name(s),address(es)and phone number(s)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 carry 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 confirmation 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 permit 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 sure 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 permit/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 permits 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 1-877-MASSAFE Revised 1122-06 Fax#617-727-7749 www.mass.gov/dia r 1, r10 W. . . , _ : :. .c . : ve. 4_ 0 No. C' Y O FRIA h ver, Mass, COC NIc Ml Wlc. x,95 RATED 1'P� ,�5 U BOARD OF HEALTH Food/Kitchen Septic System P .E MIT T LD • ! THIS CERTIFIES THAT ...............eCt.�`•G.1 .... .. .�. BUILDING INSPECTOR ... ........ ......... ..... .. .... ... . .. .......... .. .. . . �1 4 Foundation has permission to erect .......................... buildings on . . . ...... ..... ................ . Rough � - g to be occupied as ......... .. .� ......... ..�......... .��.R.. .. ... ................ ......... Chimney provided that the person accepting this per mitlhall in every respect confor the terms of the application Final on file in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 ONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT Rough Service ................ .... ................................ .............. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE