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Home My WebLink AboutBuilding Permit #453 - 200 HAY MEADOW ROAD 11/29/2010 BUILDING PERMITO*NO oT 6'97 TOWN OF NORTH ANDOVER F? b`'` .`_�. ° p APPLICATION FOR PLAN EXAMINATION Permit NO: � Date Received 9 ' ') ��SSACHUS Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 2 uyR-Oaa Print PROPERTY OWNER Print MAP 210 /0 '� PARCEL: ZONING DISTRICT: Historic District yes nGK Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One Tamity Ad ' ' Two or more family Industrial Iterati No. of units: Commercial -Re-pair, replacement Assessory Bldg Others: D olition Other e ti Well Floodplain Wetlands Watershed District Water/Sewer � DESCRIPTION OF WORK TO BE PREFORMED: (L20\C-cJ- l6 lig'--�s Identification Please Type or Print Clearly) OWNER: Name: Phone: llmq� 2_ fq d;10 Address: -LOti CONTRACTOR Name: �e..,� !\...., _ Phone: 51 Address: �� r- �1• 3l ....�T" r��. �.,,1.�� ( ��5" Supervisor's Construction License: D15-3 V'1, 1, Exp. Date: \za 1 [Home Improvement License: k D -1\4 Exp. Date:- �k 1.a l Z ARCHITECT/ENGINEERPhone: I 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: $ �6,U )1p FEE: $ Z,0 ,6 Check No.: d�,� Receipt No.: 02� �� NOTE: Persons cont cting with unregistered contractors do not have access to the guaranty fund 01-9nature of Agent/Own Signature 6666—n Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer r:°��^> � `t' Swimming Pools (I— Well Tanning/MassageBody Art i Well Tobacco Sales Food Packaging/Sales �nvate�(septictank,a 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 i Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os o d Street FIRE DEPARTMENT: -Temp-Dumpster on site yes no— Located at oLocated.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 NOTES and DATA— For department use ❑ Notified for pickup - Date l Doc.Building Permit Revised 2010 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 L3 Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o 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 Li 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) L3 Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses, o 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 Revised 2008 Location No. '�" •✓ "� Date - %ooTN,� TOWN OF/NORTH ANDOVER c 41 - - P Certificate of Occupancy $ Nus Building/Frame Permit Fee $ "� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check # ! 2 3 7 7 Building Inspector Massachusetts- Department of Public Safety Board 0 Building Regulations 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 Commissioner Tr#: 16540 � ---- — —Office•-6fl�o�'��ff�P�`�`B`tvsi�s�� HOME IMPROVEMENT CONTRACTOR Registration: _101874 Type: Expiration: ,6/29/2012 Individual 1 K -•I'�fMURPHY;\. E=:�"--�°�-_��.-. 1 Kevin Murphy 169 Boxford St N.Andover,MA 01845 Undersecretary The Commonwealth o Massachusetts � h f . Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print-Legibly Name(Businessiorpnizationnndividual): Address:_ City/State/Zip: 1.), ICom. �?��Phone#: �'��— b1 3 5� Are you an employer?Cbeek the,appropriate box: Type of project(required): 1 am a employer with_ k 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors t.❑ I am a sole proprietor or partner- listed on the attached shcct. t 7. { Rernodeliag ship and have no employees Thi sub-contractors have 8. ❑ Demolition workers'comp. insurance. 9. Building addition workiag for mein any capacity. ❑ g [No workers'comp.insurance 5• ❑ we are a corporation and its 10.❑ Electrical repairs or additions required] officers have exercised their 3,❑ I im a homeowner doing all work right of exemption per MGL IL❑ Plumbing repairs or additions myself.[No workers' comp. e. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. (No workers' 13.❑ Other . comp. bmwduce required.] Any applicant that checks box V must also fill out the section below showing their workers'cmnpensation policy information Honmownen who submit ibis affidavit indicating they are doing all work and then hire outside eontnmetora must subrttit a new affidavit indicating such contractors that check this box nest attached on additional street showhig the name of the sub-contractors and dwir workers'comp.policy infortriation. am an employer that is providing workers'compensation.insurance for my employees. Below is the.policy and job site Kfornation. /� nsurance Company Name: 'olicy#or Self-ins.Lic, I I t.?l V Expiration Date: '1 l ob Site Address: City/State/Lip: A i riach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). -aihue to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine if up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. do*here cerci under the parrs and penalties of per fury that the information provided above is true and correct .i Date: ?ho a#: - oi'ieial use only. Do not write in thb area,to be completed by city or town ofpciaf City or Town: Permit/License# Issuing Authority(circle ore): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector 6.Other Contact Persost• Phone#- 4C6R& pATE(MNWDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 7/1/2010 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 cef ficste holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the poky,certain policies may require an elndorsemerlt. A statement on this certificate does not confer rights to the carliftsts holder in lieu of such endorseme"O. RODUCER CONTAUT M P ROBERTS INS AGCY INC PHONE 1060 Osgood Street (978) 683-8073 ,,,c,,o:(978)683-3147 North Andover, MA 01845 AODRE S:sancU@ robertsinsnrance.com CUSTWFRID,#. INBURER(e) AFFORDING COVERAGE NNCI ISURED xmN MURPHY BUILDING & REMODELING I INSURER A:PROVIDENCE MUTUAL 169 BOXFORD STREET INSURERB:MERCHANTS INSURANCE 169 BOXFORD STREET INSURER C:GUARD INSURANCE NORTH ANDOVER, MA 01845 INSURER D: INSURER E INSURER F :OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADM ISUBR I CY EFF POLICY EXP ISR TYPE OF INSURANCE POLICY NUMBER D1YYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY PREMISES FIs occurrence S 100,000 CLAIMSaMADE ®OCCUR MED EXP(Any ons person) s 5,000 4 CPP0060868 11/22/09 11/22/10 PERSONAL&ADV INJURY s 0'000 GENERAL AGGREGATE S 2,000,660 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.CoMP/OP AGG E 2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILrrY COMBINED SINGLE LIMIT ANYAUTO (En accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY(Per person) S BODILY INJURY(Per accident) $ 3 X SCHEDULED AUTOS MCA7013608 01/23/10 01/23/11 PROPERTY OHMAGE 5 HIRED AUTOS (Per ecddeM) NON-OWNED AUTOS S a UMBRELLA LIAR �j OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS4VDE AGGREGATE $ DEDUCTIBLE S _ RETENTION $ S WORKERS COMPENSATION fA AND EMPLOYERS'LUIBIUTY YIN X ER ANY PROPFI1ETORNARTNEfteXECUTNEE.L.EACH ACCIDENT S X00 000 OFFICEMEMR EXCLUDED? NIA (Mende"InNlq Q KENC109881 07/01/10 07/01/11 EL.DISEASE-EAEMPLOYEE $ 500,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 506,0 0 °SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atmdl ACORD 101,AddiD"I Remedrs Sdredrle,if more space is required) =_RTIFICATE HOLDER CANCELLATION TOM OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NORTH ANDOVER, MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESE151 hml f V. i. 01988-2009ACORD CORPORATION. All rights reserved. :ORD25(2009/09) The ACORD name and logo are registered marks of ACORD • 169 Boxford Street Kevin Murphy • PH:North Andover, A01845 i • Building Contractor FAX:978-688-7207 PropoS81 To: Paul&Kristen Partridge 200 Haymeadow Road All Horn impnnemeM Contractors end subcontractors engaged In home improvement contracting,unless North Andover, Ma 01845 specifically exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the CanmanNealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Horne Improvement Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MAo2108.(s17)-7278598 CC: Date: 10/19/2010 Job: Replacement Windows Date of plans: None Architect: 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 11/10/10. Barring relay caused by circumstances beyond Contactors control,the work will be completed by 12/15/10.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 111-Scope of Work i Kevin Murphy Page 2 of 3 Building Contractor 169 Bo)dord Skeet North Andover,MA 01845 PH:978688.5335 FAX 978688-XXXX General Proposal is to replace sixteen existing window units. Building permit will be provided by contractor. Building New replacement windows will be Pella brand ( to match existing ) . Window openings and trim to remain. Sashes and balances (the tracks on the side, the windows slide up and down in )will be removed. Any storm windows will be removed. New Pella windows will be pre-finished interior, clad exterior. Wood removable grilles to match existing and full screens will be provided. Glass will be rated for the federal energy tax credit. Two new screens will be provided for existing Pella windows. Painting Any touch up painting around windows will be provided. Waste Removal All existing windows and any construction related debris will be disposed of by contractor. V J ' Kevin Mnnvphy Page S of 3 RuUcUng Contractor 169 Bordord Street North Andover,MA 01845 PH:9785663335 FAX 978586-)000( Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of...... ... ... ... ... ... ... ... ... ... ....$ 16,000 Payment to be made as follows: Percentage/Item Description Amount 1 Deposit required by pella to order windows $4000 2 Payment due when all windows installed $10,000 3 Job / painting complete $2000 I I i Total 3 $16,000.00 —Notice:No agreement for Home improvement contracting work shall require a dawn payment(advance deposit)of more that one4hird of the total contract trice of the total amaeht of all deposits or payments which the contractor must make,in advance,to order andfor otherwise obtain delivery of special order materials and equipment,whichever is greater Contractor: Kevin Murphy 169 Boxford Street No.Andover, MA 01845 Registration No: 101874 Section V—Acceptance I• 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 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date 7 Signature Date