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HomeMy WebLinkAboutBuilding Permit #810 - 200 HAY MEADOW ROAD 6/1/2011Permit NO: �-/ y TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received 5-/1-7 1' tFffO�NT: A licant must —0 L) V-A, Print VNRR YeLut �cLra>i�: dlG� all items on this MAP NO: lQ q, 8 PARCEL: 76 ZONING DISTRICT: I? [ Historic District yes no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building A One family ❑ Addition ❑ Two or more family ❑ Industrial ft6Iteration No. of units: ❑ Commercial 'Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ep®i loodplan'k d"Weflands} teishe"diD DESCRIPTION OF WORK TO BE PERFORMED: 1lc�w.J �'�►S'��� SGntluto�. oawe� Ae�` I�.��1�1 I.,�w S� Identification Please Type or Print Clearly) (` Iq ) OWNER: Name: 7 p,.,1 , • c Y Phone: 2S-�)' - as') u Address: 2.o j) �,�� - -d�� `^' T"IAA CONTRACTOR Name: Phone: C'1 -:C- 6 - S 3 3 S Address: � t.`Z 1�� S �-r.,.�- " t�.�,,,�ii.� la Y.. v-�..� Mme, o l y-tr Supervisor's Construction License: U'S 3 0 Exp. Date: L v3 Home Improvement License: k -0 Exp. Date: (Z-, �tz - ARCHITECT/ENGINEER �SAA,-Phone: c1'cli 6 f -575-1 Address: S�-t,4- rev . Gam ---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: $ Lt "1 .0 0 U FEE: $ -t S6LI Check No.: w� I 07 / Receipt No.: 4 010 with unregistered contractors do not have acce�s tq the guaranty Pians Submitted C> Plans Waived ❑ Certified Plot Plane Stamped Plan TYPE OF SEWERAGE DISPOSAL Public Sewer ❑Swimming Pools ❑ . Tanning/MassageBody Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. X Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑�i�/ COMMENTS I(%/%� in (,(��E�✓U!�/� � CONSERVATION Reviewed COMMENTS /?z �s HEALTH COMMENTS Reviewed ,l f4aA 'Ire, JS yYir��2 t,.to 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 Os ood 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. -7,10-7 p Total land area, sq. ft.: 54, D-1"2. 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.$10041000 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 o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o 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 o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit .n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording gust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Location �� �?Jt� OL✓ A No. Date V/ TOWN OF NORTH ANDOVER ° Certificate of Occupancy $ Building/Frame Permit Fee $ \�cwusE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # I 24GU7 Building Inspector AL oRo CERTIFICATE OF LIABILITY INSURANCE 1 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(les) 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 CONTACT NAME: DATE(MMIDDNYYY) 1/29/2010 M P ROBERTS INS AGCY INC PA/HC,No 978 683-8073 N,No:(978) 683-3147 1060 Osgood Street ADDRESS:mike@mprobertsinsurance.com North Andover, MA 01845 INSURER(S) AFFORMO COVERAGE NAICS INSURED KEVIN MURPHY BUILDING & REMODELING 169 BOXFORD STREET 169 BOXFORD STREET NORTH ANDOVER, MA 01845 ,IIIF'irt[rM INSURER E : r`rw1Z0nr`tc r`C:0 riCiCATC RII IRARGR• RFVICIr1N NI IMRFR- THIS 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 GERTIRCATE-KAY -BE -ISSUED OR MAY PERT -AIN, -THE- INSURANCE AFFORDED -BY -THE -POLICIES DESCRIBED_ HEREIN -IS -SUBJECT -TO ALL TFIE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADDL INSR Wait VVVD POLICY NUMBER POLICY EFF M/D POLICY EXP MIDD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS•MADE a OCCUR CPP0060868 11/22/10 11/22/11 EACH OCCURRENCE $ QdD_' 000 PREMISES occurrence $ MED EXP (Anyone person) $ PERSONAL &ADV INJURY $ 1 000,000 GENERAL AGGREGATE $ 2 040 000 GEN'L AGGREGATE LIMIT APPLIES PER 1-1 POLICY JET LOC PRODUCTS - COMP/OP AGG $ 2 00.0 000 $ B AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS MCA7013608 01/23/10 01/23/11 accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAM GE $ Per acaiden $ F[EXCESS UMBRELLA LUIB UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN ANY PROPRIETORMARTNERIEXECUm/E OFFICERIMEMBER EXCLUDED? (Mandatory in *9 ll��ll If yes, describe under DESCRIPTION OF OPERATIONS below NIA - ];EWC109881 07/01/1007/01/11 WCSTATU- I X OTH- TORY LIMITS ER EL EACH ACCIDENT $ 500,000 E.LDISEASE- EAEMPLO $ 500,000 E.L. DISEASE - POLICY LIMIT I $ 500,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) r:FRTIFIr_GTF Hr)l /IFR r:flMrFI I ATI11M - TOWN OF NORTH ANDOVER NORTH ANDOVER, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LA ©1988-2010 ACORO'CORPORATION_ All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD P, 9 O u O w v cn O0 p w O w U G W w o 0.i G f3. O w W O f�i cn G W p V� O 0.i q [s. w A CU cn 8 cn C/) I� -' 2 CD O 03 L v/�� Z W CL O � CO) C co cm C y �E O O m m y... G3 Z: �• O C O� 003 0 0 L O O d VD •O.= y ra CL C • : M W � C Cc Cc CJ J -M m C O ZCD C � Z O y. h C O CD C O H CO) ./; Ea c s ca o CL y • c CM CD :cam o 0 cm :c WE E o Q t m 3 rt+ CIO cm m � H 'fl =c � m O C J• N Wca C O E p - 11 N m os ID cm m p C3 Go CDm : C3 o o ..., :oao vs c_ •C CL N H p H~ mCOD m r •N .. oyc F.. �E 'm _'c"=m' �dtev E o`er m•y Z O uj CJ O ® C icsc VD CL vy'o m � O x ..S ��m 5. C/) I� -' 2 CD O 03 L v/�� Z W CL O � CO) C co cm CO2 y �E O O m m co G3 t O� 003 0 0 L O O d y ra O � C Cc Cc CJ J -M .FL O ZCD C � C.) h C O C O CO) The Commonwealth of 1llassachusetts. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Budders/Contractors/ElectriciansiPlumbers Applicant Information Please Print Legibly Name(susirms/orgnization/Individuai): `�p ✓�,.� I �w ,o��-► \�•`~-� �`� �^�6 1'` ^ Address: A. Z City/State/Zip: tv� e, .>�•. E 1� ar. o xq�ui < Phone #: C S-3 Are you an employer? Check the appropriate boa: Type of project (required): 1` I am a employer with �_ 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub -contractors 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 mein any capacity. workers' comp. insurance. _ 9_ Building addition [No workers' comp. insurance_ 5= ❑ We are a corporation and its - 10.❑ Electrical repairs or additions required.] officers have exercised their 3 _ ❑ 1 im a homeowner doing all work right of exemption per MGL 11.Q Phmibing repairs or additions myself [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] t employees. [No workers' 13.11 Other 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 tContractors 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 thepolicy and job site information. Insurance Company Name: �� ;�^ S Co Policy # or Self -ins. Lic. M \L G w L "� V) i'a [ Expiration Date: -1 i 11 Job Site Address: Z.y � ��+ w "r� City/State/Zip: h--;, O I T 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- Ido erification.Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct. = 3 3'57 Qjfw al use only. Do not write in this area, to be completed by city_ or town official City or Town: Permitllacense # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3- Ckyfrown Clerk 4_ Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: A Kevin M.Iurrphyl 0, Building Contractor Proposal To: Paul & Kristen Partridge 200 Haymeadow Road Norh Andover, Ma. 01845 From: Kevin Murphy CC: Date: 5/14/2011 .lob: Screened porch / Deck Date of planes 3/11 Architect: Steve Foster Location: Same Section 1- Work Schedule • 169 Boxford Street • North Andover, MA 01845 • PH: 978-688-6335 • FAX: 978-688-XXXX All Home improvement Contractors and Subcontractors engaged in tame improvement contracting, unless specifically exempt from registration by Provisions of chapter 142A of the general laws, must be registered with the Commonweatlh 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 5/4/11. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 6/30!11. 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 III - Scope of Work Page 1 of 4 Kevin Murphy Building Contractor 169 Bo)dord Street North Andover, MA 01845 PH: 978688.5335 FAX 9786W)00(X General Page 2 of 4 Proposal is to remove and replace existing screened porch with new 14'x20'6" porch and 12'x13'6" deck as shown on owner's plans. Building permit will be provided by contractor. No allowance has been made for any conservation, board of health, or variance approvals if required by town. Plot plan to be provided by owner. Demolition Existing screened porch will be demolished and disposed of by contractor. Excavating There has been no allowance made to provide any excavation. Foundation Poured concrete footings to be provided by others. ( excavator ) Building All frame roof and siding materials will be supplied / installed to match existing / meet code / as shown on plans. Floor framing will be pressure treated 2x12s, exterior walls will be 2x6, roof rafters will be 2x12. Wall and roof sheathing will be fir plywood ( 1/2 on walls, 5/8 on roof ). Entire roof will have ice & water sheild installed. Thirty year roof shingles will be supplied and installed to match existing. Siding will be 1/2 x 6 cedar clapboards ( to match existing ) . All exterior trim will be Azek ( pvc plastic ) . Decking will be Timbertech mountain cedar, interior walls will be moisture resistent plaster, ceiling will be 1x6 v joist pvc. railings will be white composite sample to be given prior to installation) , lattice will be vertical 1x4 Azek. Electrical Electrical work required to wire porch according to plan / meet code will be provided. Plaster Interior walls of porch will have moisture resistent wallboard / plaster finish. Interior Trim/Doom Interior trim will be pvc. There have been no allowances for any interior doors. Painting All interior and exterior painting will be provided. All painted surfaces will have one coat of primer and two coats of finish applied. Waste Removal All demolition / construction debris will be disposed of by contractor. is Kevin Murphy Building Contractor 169 BomAord street North Andover, MA 01845 PH: 978688.5335 FAX 978688•XXXX 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 ..................................... $47,000 Payment to be made as follows: Percents efitem Description Amount 1 Permit obtained $2000 2 Demolition complete $3000 3 Roof complete $20,000 4 Interior of porch complete $15,000 5 Job 100% complete $7000 5 $47,000.00 Notice: No amt far Herne improvement contracting work shall regime a down payment (advance deposit) of more that one4itrd of the total contract price of the total amaaR of all deposits or payments which the contractor nnrst make, in advance, to order araor otherwise obtain delivery of special order rnaterds 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 SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES -Z Date `S I M I [\ Signature Date OWNER INFORMATION: PAUL & KRISTEN PARTRIDGE 200 HAY MEADOW ROAD NORTH READING, MA 01845 ASSESSOR INFORMATION: MAP 1048 LOT 76 DEED REFERENCE, BOOK: 6334 PAGE. 45 ZONING INFORMATION: ZONING DISTRICT. R1 LOCATION OF SEPTIC- TANK EPTIC-TANK TAKEN FROM SEPTIC AS -BUILT PLAN ON RECORD AT BOARD OF HEALTH PROP. PORCH - 14' X 20.5' EX. PORCH TO BE DEMOLISHED 1.5 EX. 2 STORY WOOD FRAME STRUCTURE (� 75.0' e., x,704 09,, HAY MEADO w 289.0' EX. CONC. FOOTINGS TO BE REPLACED W/ NEW FOOTING (TYP PROP. DECK 13.33' X 12' 49.3' 46.5' N38°54'00"E - 45.91' -. REBAR FND F �00 0) Z EX. DECK TO BE DEMOLISHED I CERTIFY THAT THE STRUCTURES SHOWN WERE LOCATED BY AN INSTRUMENT SURVEY AND EXIST ON