Loading...
HomeMy WebLinkAboutBuilding Permit #404 - 200 FRENCH FARM ROAD 12/29/2008 BUILDING PERMITo "°DT bgti TOWN OF NORTH ANDOVER 0 - *` APPLICATION FOR PLAN EXAMINATION Permit NO: 6 Date Received (/ (� ,1V �l �°awre°•�`'.ch SSACHUS�� Date Issued: IMPORTANT:Applicant -m��ust complete all items on this page LOCATION___ t .w.- Print PROPERTY OWNER -e ,� ,rA t --</f--"-, . . Ile Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building -::Z2 fame dition Two or more family Industrial a ion No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: C , _ c,• i remit Phone: ga. 9;70 -- ,2 Address; Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER 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: $ / � V� �� -10FEE: $ /, Check No.: (9L �" Receipt No.cQ NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund I Signature of Agent/Owner Signature of contractor ,.� �.. Location to ' No. Q3v Date ' f HpRTq TOWN OF NORTH ANDOVER 3? � . 00 � 9 Certificate of Occupancy $ �'�s•►�Mus�� Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ U Check # 21 % / 3 0 Building 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT I C MMENTS CONSERVATION Reviewed on Signature COMMENTS Lin al:�� a/ Lill" - �A�m "M7 HEALTH Reviewed on Signature COMMENTS 4✓� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments i 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 I i 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 OT- El 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 n r ❑ 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 Workv�✓r ❑ 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' _-PV f rr(-e, , Li Photo Co -of H.I.C. And C.S.L. Licenses ;L ❑ py Of Contract ❑ Floor rossec lon/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable)L'� ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products IVOO-e-, NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) %�� A T, Li Building Permit Application ❑ Certified Proposed Plot Plan 's , ❑ Photo of H.I.C. And C.S.L. Licenses r ❑ 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:Building Permit Application s Revised 2.2008 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 W ashingtonStreet Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leo-ibiy Name (Business/Organization/Individual): r Address: S I/-le �af /oa�3 City/State/Zip: 4111 0107, Phone AAAu an employer?Check the appropriate box: 1 I am a employer with 4. g Type of project(required): ❑ I am a eneral 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. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its 9 ❑ Building addition required.] officers have exercised.their 10:❑ Electrical repairs or additions 3.E] I am a homeowner doing all work right of exemption per MGL I l.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.[] Roof repairs insurance required.] t employees. [No workers' 1.3. Othe comp. insurance required_] r An * applicant-that+ y checks box#I-must also fill out the section below showingtheir workers,compensation Homeowners who submii.xhis affidacii iiidicatiog Uiei�art iuiFin nil :;a � P policy information. thzn hire outside conitac:turs must submit a new a—nava indicating tContrautors that check this box must attached an additional sheet showing the name of' sub contractors and their w . suc . workers'com oli information. P P �' n ormation. 1 am an employer that is providing workerscompensation insurance for information my employees. Below is the policy and job site Insurance Company-Name: - Cn Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address:_pZ0 ool 41? Z. City/State/Zip:, Attach a copy of the workers' compensation- 4,r,Z V�c A—, 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. 1 do hereby certify nd r the pains andpenalties of perjury that the information provided above is true and correct S i sirature: Date: -Q� Phone#: 7 cf Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuinel g 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#: �<O �i70 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 o r local licensing agency shall withhold the issuance or renewal of a license or permitao 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 compi-etely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(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. Theaffidavit 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 lava 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 permitAicense 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 iicense 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 Was1iington Street Boston, MA x2111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26=05 Fax#617-727-7749 w vw.mass.aov/dia .�>._ i�7assachusctts.-,pcpartmEnt of Public Safct�. . ��ulutions and Standards 1 Board of Buil({►►�'; Re supervisor License Construction Sup License: CS 72449 Restricted to: 00 CARL G GRENIER �" 53 STILES RD STE B102 SALEM, NH 03079 Expiration: 4/11/2010 T r#: 3156 ('umn�isi„ner 7k Boardpp Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 136029 xpirat►on ti/x{2010 Tr# 273532 CARL GRENIER lgfv ;. t 7.7 1 ? CARL GRENIER. k J1 53 STILES RD SUITE E3t02 J C; SALEM, NH 03079 Administrator s Arctitect Drawings, Certifications and Permits PAID • Upon completion of the project, a copy of the stamped final drawing will be provided to the homeowner. Entine Project as originally specified: $163,625 (included main rooj) (Paid as of 10121108: S13,625; Remaining: $150,000) - The remaining$150,000 to be paid as follows: 25% ($37,500) upon acceptance of proposal; 25% ($37,500) upon successful flaming inspection; 25% ($37,500) upon completion of kitchen cabinet installation, electrical,plumbing,flooring 15% ($22,500) upon completion of job including the deck(prior to punch list); 10% ($15,000) upon completion of pungh list, homeowner walk-thru and complete site cleanup (not to be unreasonably withheldldelayed by homeowner). • Projected Timeframe: Entire project should be completed within 50 business days of the execution of ground-break. In the event homeowner is given at least seven (7) business days advance notice of a decision that results in the contractor unable to proceed until said decision is made, one day shall be added for each day delay beyond the seven day limit. $7,500 of the Entire Project fee may be withheld by homeowner if the project is not completed within 60 business days of the execution of the contract unless extended in writing by the homeowner. An additional $7,500 of the Entire Project fee may be withheld by the homeowner if the project is not completed within 70 business days of the execution'of the agreement. • General conditions: o Carl Grenier is responsible as project supervisor. o Carl Grenier or his father to be on the site at all times unless approved in advance by owner. o Driveway, retaining wall, grass and sprinkler system to be protected and to be returned to pre-existing conditions. o Dust barriers maintained o Job site will be maintained in a clean and orderly fashion o No smoking on premises o No disposal of any type into woods behind our house. o Consideration of neighbors. • Lien/General Release: o Carl Grenier and GC Contracting, in consideration of the payment amount and schedule. included above agree to complete this project in a quality workmanlike manner for similar projects in similar residences. o Carl Grenier and GC Contracting attests and ensures that he has not and will not assign any claim for payment or right to perfect a lien, or take any action which may allow a sub-contractor or supplier to do so, against the project or the homeowners at any time. All subs and suppliers shall execute waiver of liens, copies of which shall be provided to homeowner within 15 days of execution. o All materials purchased in accordance with the specifications and plans of this project after the execution of this contract are property of the homeowners of this project. o Copies of all original receipts for materials related to those contracted items with an allowance will be signed by an officer of GC Contracting,whose signature will attest that the amount of and cost of are accurate and accurately reflect the cost to GC 3 .a Siding and Trim Demo Existing Siding and removal/proper disposal of all materials • Replace w/Hardy Board w/4"reveal including shed • 5/4" Pine Trims all remaining (verticals, around windows and doors exterior, etc.) Kitchen Demo and Remodel per plan • Cabinets (includes $250 per linear foot @ 38' _ $9,500 allowance) • Granite countertops (includes $60 per sq ft installed) @ 56 sq ft= $3,360 allowance) • Demolition and removal/proper disposal of all materials • Installation of new beam o Demo and replace kitchen.ceiling • Construction of center-island with surface burners and drop in,stove. (Stove and burners to be' , purchased e - purchased and provided by owner). • Electrical (wiring and outlets) • Plumbing (tie in; relocate ice cube line as required) • Tie in to propane/gas line for stove • Convert pantry to pull out shelving. • Convert current refrigerator space to additional pantry storage per plan • Build out of media center with desk on wall abutting bathroom. • Sub floor prep • Sheetrock and insulation(remodeled walls and beam area only); Warranty settlement cracks for one (1)year. • Heat recovery vent(in family room wall) • Vent in Master Bath r. Interior and Exterior Paint • Exterior Addition (and other replaced sections of Hardy Board or trim board) • Interior Kitchen and ceiling • Foyer up to stairs Red Oak Flooring in Addition, kitchen and back hall, and front foyer) • Installation, sanding and three layer polyurethane finish ❖ If foyer is not completed with hardwood floors and interior paint a$3,000 credit will be issued. Replace Shed Roof • 8" White drip edge • Yard will remain neat and clean; extra care will be taken to prevent damage to shrubs and grass, as well as pick up of all nails. Deck Addition 06' x 16' w/stairs) • Trex or equivalent flooring as approved by owner; • Railings, balusters, posts and caps to be high-quality PVC. • Vinyl lattice from foundation around deck with an access door. • Construction to accommodate grill area, seating and 4 person Jacuzzi (to be added later) • Electrical (for Jacuzzi, lighting/spots and two deck outlets) 2 J Date: November 8, 2008 Proposal Contractor: GC Contracting, Carl Grenier, Contractor This proposal represents the current understanding of work to be completed and fees to be charged. GC Contracting will be responsible for pulling all necessary permits and that all work meets or exceeds all pertinent building codes or regulations. Any discrepancy between the contractor's proposal and this addendum, the addendum will prevail. Foundation • Demo existing base and removal/proper disposal of all materials • Excavate as needed(protecting existing landscape and grass). • Footings, foundation, slab installed and three vent windows, beam pocket and a/3.5x 3.5' access door. • Install foundation drainage and tie into existing PVC drains system • Stone work finish(if siding selected deduct$3000) • Backfill and compact soil • Restore grass around foundation area. Grass Care and_sprinkler system-included to existing conditions (coordinate w/ Steve Morrison) 16' x 30' Addition with removal of existing materials (pricing based on $110 per sq ft) • Demo of existing addition and removal/proper disposal of all materials • Framing (480 sq ft; 2"x 6" construction); • Framing for fireplace (zero clearance)with mantle • Insulation R-19 walls and�R-32 floor and ceiling • Electrical—6 cans, 1 fan, outlets, 2—three way half switched plugs • Sealing up of bathroom window (retaining the "window" and roman shade from the bathroom side. Vent to be installed in bathroom. • Lights on either side of the fireplace on the wall. • (2)Exterior GFCI three-prong outlets, one by deck, one on"dog house" side. • Two cable feeds/outlets; wired for speakers (5:1) • Prep for plasma TV above the fireplace. • Heat(Runtal system w separate zone) • Roofing(w/Architectural Roofing 30 year rated; 100%Ice &water shield) • . Sheetrock,prime and painted • Doors (Pella French Door) and Windows (Harvey)w, 6' window by French doors (all Low- E/Argon) • Interior Trim(Colonial) • Relocation of outside sillcock • , Retain existing basement window) ;. - • Coordinate w/Gas Company to install gas tank and feed for grill, fireplace and stove. • .(2) Window Seats ($1,500 extra) • Slop Sink in garage w/shelves above it. • Insulate wall between garage and house behind slop sink • 2 new electrical outlets in garage between windows. • Replace Dog House door and roof • Bookcase not included • *** "Cathedral ceiling estimate n/i Contracting specific to this project and delivered to the homeowner within 15 days of purchase date. o Homeowner to carry homeowners insurance o GC Contracting to fully cover all workers for liability insurance. Accepted as an addendum to the Contractors proposal by: (date) Car Gr, ier, President of GC Contracting i 1 I i �3(date) Michael ouza, Ho er /gml(date) Ellen Caille, Homeowner a 4 --—---------_ PLAN OF LAND IN NORTH ANDOVER, MASS. SCALE., I"=40' 121112008 SCOTT L. GILES R.P.L.S. 50 DEER MEADOW ROAD NORTH ANDOVER, MASS. 147.99' LOT#14 46,750 S.F. rn M cn N N M 30, PR"P ADD. 16116 EXIST HS 43'+1- 33'+1 3'+133'+1 #200 PND. E so 9 , R=8>p 5 148 02, Fi4�cNc OF q Ah'M 804D X972 �ro�OST o��� ` V4QRTK � Town of tAndover . No. o over, Mass., • COCHICHEWICK y1. AORATE D S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING.INSPECTOR ..... .......................r'e'ly......................... THIS CERTIFIES THAT....... ..... �. ...� ...•...••.••.•••. Foundation ftrhas permission to erect........... ............................ buildings on ... ....... .... ... �..... Rough to be occupied as.. S&S til� ..... .... j�'�i�i�-idwtgpsson . �j►............................. Chimney provided that the person accepting this ermit shall in e4re'* pacthe 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 I�D PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU STARTS Rough Service ....... . ..... ............................................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place o'n the Premises — Do Not Remove Final No Lathing or D' 7 Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.