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Home My WebLink AboutBuilding Permit #381 - 200 RALEIGH TAVERN LANE 11/8/2006 I� I i TOWN OF NORTH ANDOVER OORrH APPLICATION FOR PLAN EXAMINATION Of++�•o •�'�'o �? e• r. " '• OL i F p li Permit NO: Date Received �o Date Issued: SSACNUS IMPORTANT: Applicant must complete all items on this page r LOCATION ao0 (-NQ��N �� I Print PROPERTY OWNER \ h O Print MAP NOV PARCEL: ZONING DISTRICT: I T-Y-PE—AND--USUOF-BUILDING STORIC DISTRICT SES—❑------.-----—- --------------- TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑One family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: [Repair, replacement ❑ Assessory Bldg ❑Commercial A Demolition f ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORM D i Tc`l y L-e L-J cl,-U S Identification Please Type or Print Clearly) OWNER: Name: Phone: GS 1 Address: 20 0 —rev\-)e r�j 26 CONTRACTOR Name: oto\,-,A-r P,\ l'�,.� �5 �k Els Phone: X03 (o j' Address: (a07 Supervisor's Construction License: Exp. Date: Q " Home Improvement License: `, Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED ST BASED ON$125.00 PER S.F. Total Project Cost :$ 1 � , 1-0 o v� FEE:$ 3 � Check No.: S Receipt No.: Page I of 4 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to theg u n Signature of Agent/Owner Signature of contract V Plans Submitted El Plans Waived El Certified Plot Plan ❑ �/Stdtn Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM - - — DATEREJEC-T-ED DATE-APPROVED----------i-- PLANNING & DEVELOPMENT ❑ ❑ - COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS -- FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 Building Setback( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 I I 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 ,i Workers Comp it ❑ Photo Copy O H.I.C. d/Or C S.L icenses ❑< Copy of Contrac o Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) 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 o Mass check Energy Compliance Report In all ca ' p � 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 No. 2� " Date f/ a NORTh TOWN OF NORTH ANDOVER O ` x Certificate of Occupancy $ -TS ACMUs<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ " TOTAL $ Check 19785 4 rs Building Inspector ti, NORTiy own of : t _ over 0 N.......... No. a a/ A dover, Mass., drove COCMICMEWICK V Ids RATED P'P�\ 7 BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THAT ��.)....... r !!r�!!►......................................... .. ........................... ...THIS CERTIF ES ....... Foundation has permission to erect........................................ buildings on �............ �..... .. . ... .... Rough 00O to be occupied as........1..A �!!N......'.�...... � • Chimney thprovided that the person accepting this permit shall dery respect Conform to the terms of the application on file in is office, and to he provisions of the odes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMEXPIRES IN 6 MONTHS Final IT T T T ELECTRICAL INSPECTOR V 1 V LESS COl V ST®U ON ATRough ......... .................................................. Service ................. . .. ... . BUILDING INSPECTOR Final Occupancy Permit Required to Ocatpy Building GAS INSPECTOR 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. Bumer Street No. SEE REVERSE SIDE Smoke Det. JOHNSON CONTMCTING 6 PARTRIDGE LANE PELHAM, NH 03076 (603) 635-7481 Debra A. &Raymond A. O'Brien August 9, 2006 200 Raleigh Tavern Lane North Andover, MA 978-681-1893 978-314-0032 (Cell) RE: Ventilation Modifications, Door, Trim& Siding Replacement. CONTRACT Scope Of Work: A outlines the scope of work to be performed on the garage gable wall only. All trim boards, siding and vapor barrier are to be replaced with Tyvek house wrap, solid vinyl trim boards and pre-primed cedar siding. Upon completion, the new clapboards and trim will receive two coats of a latex paint. Scope Of Work: B outlines the scope of work to be performed on the RHS gable wall of the main body of the home. All trim boards, siding and vapor barrier are to be replaced with Tyvek house wrap, solid vinyl trim boards and pre-primed cedar siding. Upon completion,the new clapboards and trim will receive two coats of a latex paint Scope Of Work:A -Scaffold entire gable wall of garage; -Remove all trim boards, siding, drip cap and house wrap;* -Install Tyvek house wrap to the entire sidewall. The wrap will abut the flanges of the Andersen self-flashing windows; -Install vinyl trim pieces to garage door surround, door surround, window trim, corner boards and rake boards utilizing stainless steel nails; -Install vinyl garage doorstops; The vinyl trim installed to abut the Andersen windows will be sealed with vinyl adhesive caulk -Install new drip cap to all horizontal trim pieces; -Map and install pre-primed cedar siding sealing all joints utilizing stainless steel siding nails. Seams will be minimal; -Apply two (2)coats of latex paint to all trim and all clapboards to this side only; -Install one(1)piece of cap to the ridge to further shield against water infiltration; -Drop scaffolding; -Dispose of all debris daily. Please Note: -All vinyl trim pieces are white in color. -Customer is responsible for purchasing paint. -The corner board replacement encompasses four (4) vinyl pieces, two (2) on the garage side face and one (1)piece each on the front and rear faces of the home. -The garage cannot be used to house vehicles during construction. Scope Of Work: B -Scaffold entire RHS gable wall of main body of home; -Remove all trim boards, siding, drip cap and house wrap;* -Ice & Water barrier will be installed three (3) feet above the roofline and step flashing of the family room gable for additional protection from water infiltration; -Install Tyvek house wrap to the entire sidewall. The wrap will abut the casing of one wooden window and one gable wall vent; -Install vinyl trim pieces to replace rake boards, window casing, corner boards and valley trim board (at the intersection of the family roof line and gable sidewall) utilizing stainless steel nails; -Install new drip cap to all horizontal trim pieces; -Map and install pre-primed cedar siding sealing all joints utilizing stainless steel siding nails. All seams will be staggered and sealed; -Apply two(2)coats of latex paint to all trim and all clapboards to this side only; -Drop scaffolding; -Dispose of all debris daily. Please Note: -All vinyl trim pieces are white in color. -Customer is responsible for purchasing paint. -The corner board replacement encompasses four (4) vinyl pieces, two (2) on the main gable face wall and one (1)piece each on the front and rear faces of the home. -The front secondary entry will be inoperable during construction. *Although there is no visual evidence of any underlying problems, the customer should be aware that problems can be revealed during construction. Typically this would involve insect or water damage affecting the integrity of the structure. Should the contractor determine deficiencies not presently visible, the area(s) shall be documented with photographs and the customer appraised of the problem(s), the option(s) available for correction and the cost(s) of the repair(s). Corrective action would commence upon written instruction. This work would be billed separately under "Time & Materials/ Supplemental Work". Total Cost Of All Labor, Materials, Tax & Disposal: $11,200.00 TERMS: 33%Down Payment. 33%On Start Of Work 34%Upon Completion. CONTRACTOR WARRANTS HAVING ADEQUATE LIABILITY INSURANCE. This document shall serve as our agreement. You have by law, three business days to cancel this agreement. ACCEPTANCE AND AGREEMENT: f4D.(17r�- Date: l Z k(� Mr. Raymond A. O'Brien Date: C� Mrs. Debra A. O'Brien, This document was prepared,agreed to and accepted by; James A. Johnson JOHNSON CONTRACTING pp 5 - � � v��ie Lrovrui�zn�zrueaf(�i. n�/l�aasa.•�uutelGi f BOARD OF BUILDING REGULATIONS. f License: CONSTRUCTION SUPERVISOR Is �A Number-.CS 065225 Birthdate _*10/09/1961 1 Expires _10/09/2007 Tr.no: 17331 Restricted''00 BRUCE D STEWART i 49 SWALLOW LN DUNSTABLE,,MA 01827 a Commissioner tie� uirea Board of Building Re$alations and Stan HOME IMPROVEMENT CONTRACTOR 1 Registration`\133257 Expira4ion 513012007 l STEWART HOME IMPROVEMENT' STEW BRUCE 13g HILLSIDE TERRA. DRACUT, MA 01826 Administror at z' The Commonwealth o Massachuselts Department of Industrial:lceidents - y' Office of Investigations 600 Washington Street Boston, ,V14 02111 www.mass.agov/din t Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please PrintLegibly Namt: (littsincss;()rganiinlion/In(liviJuui): a(nrYleS 4-\ •�b�n�S W� / —SE) C', �CrV1 Address: G!) _ V�\ cz l--rte.,C- _ C lty,State;Zip 1 lr� r s Phone #• 3 6 s Are you an employer?Check the appropriate box: Type of project(required): 4. ❑ 1 am a general contractor and with g construction I.❑ I am a employer 6. ❑ New construct em to employees Full and or art-tune). * have hired the sub-contractors P y ( p Remodeling 2.[�I am a sole proprietor or partner- listed on the attached sheet. _ 7. ❑ R g ship and have no employees 'These sub-contractors have 3. ❑ Demolition working for me in any capacity. workers' comp, insurance. y, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.E] Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ 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' 13.E] Other comp. insurance required.] ".\ny applicant that checks box r?1 must also fill out the section below slowing their workers'compensation policy information. y Ilomeowners 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 I am tin employer that is providing workers'compensation insurance for my employees. Below is the policy and job site inf nrmalion. Insurance Company Name:__._—_ - ------ —__--- --- __-- Policy "or Self-ins. Lic. .'E:---_—__ — Expiration lob 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 N lGL c. 152 can lead to the imposition of criminal penalties of a k K ORDER and a tine •-v imprisonment,as well its civil penalties in the form of STOP NOR 1500.00 and/or one-year im tine a to� p P 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. lift)Hereby c'ertyJ under die sins aid penalties(/'perjury that the information provided above is true and correct. tii nahue: nate: Phone �� 5-- ------------------- ----- t)JJiciul use only. l?(ctut write in this arra, to hcrccup/rted by :1 f car mwn,,�Jicial. City or Town: PAmmit/License,* Issuing Authority(circle one): I. Hoard of Health 2. Building Department 3. City/Town Clerk d. E?eetrical Inspector :i. J luinhing inspector 6.Other Contiet Pt r'=.oft: _ Phone!#: _J