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Home My WebLink AboutBuilding Permit #135 - 201 DALE STREET 8/13/2009 BUILDING PERMITo` "°oTH A TOWN OF NORTH ANDOVER 02.°`�t - 6'° APPLICATION FOR PLAN EXAMINATION Permit NO: 6� Date Received SSACHU`+� Date Issued: 140 IMPORTANT:Applicant must complete all items on this page LOCATION 0 ( IP ' reet Aktl A,,.k-.,e,- Print PROPERTY OWNER M�r _ A�•C�e Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no �I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alterati No. of units: Commercial e air, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Q ltce d uu Sen es rew"e"'t Re s A. -f 3 0J5,4e lls u-F lit 1../ Identification Please Type or Print Clearly) OWNER: Name: Mo,V, A-4e Phone: Address: cP0 t e ,et.•f- lvoet-L ct.", V&111rr CONTRACTOR Name: C- _ �W��i Phone: 97&- 344 r,)S9y Address: /0,;' LA//ey 126 rl Ix7x�,-� r rti`t� 0I S2 / Supervisor's Construction License: "7I3 Exp. Date: /o i9v9 1, Home Improvement License: /6013L/ Exp. Date: (;Z511,0 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: $ 51f 0 — FEE: $ Check No.: 'a�7-a Receipt No.: .aZ. 3� NOTE: Persons contracting with un a istered contractors do not have access to aranty find Signature of Agent/Owner Signature of contracto . Location 2 d/ �G/�` No. Date MORTH TOWN OF NORTH ANDOVER f 1 3? •• OL F T Certificate of Occupancy $ bis'^•• E<� Mus Building/Frame Permit Fee $ s�c Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #222 226 ,:) b � f Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools n Well Tobacco Sales Food Packaging/5a1e5 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 HEALTH Reviewed on Signature COMMENTS `j 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 IVIa"r�et 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-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 tAORTH Town o Andover . No. 0 LAKE over, Mass.,_e_P11-F16!F 15$ COCHICHEWICK A 0RATED 0"? C7 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT............... BUILDING INSPECTOR Foundation h I as permission to erect........................................ buildings ..Ify.................................................... Rough to be Occupied as..................3... ....................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ......opr.........I............................................................................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. StE REVERSE SIDE Smoke Det. Order Jackson LUMBER & MILLWORKTransaction # 215 Market Street 234 Primrose Street 10 Industrial Drive 145 Temple Street 459887 Lawrence,MA 01843 Haverhill,MA 01830 Raymond,NH 03077 Nashua,NH 03060 Ship Date Pcd Phone: (978)686-4141 Phone: (978)372-7727 Phone: (603)895-5151 Phone: (603)883-7777 8/11/09 A/0 Fax (978)687-5841 Fax (978)373-7443 Fax (603)895-5152 Fax (603)883-7778 Location RAYM ND MAIL TO: Jackson Lumber&Millwork Co.Inc. Representative PO Box 449, Lawrence, MA 01842 KEN MONACO Ship . GREG BEARDSLEY 210D 201 DALE ST *CASH ACCOUNT* NORTH ANDOVER, MA 01845 105 VALLEY RD (978)352-2809 BOXFORD, MA 01921 Customer# Order# Order Date Oper Purchase Order Terms Ship Via 35455 459887 07/15/2009 003 CASH DELIVERY LN# Item Number Ordered Description 1 SOANDVAN 2 (C245LR[20174)) C245LR,Unit, EA 561.45 1122.90 White/Clear Pine,LR Handing, (All Sash)High Performance Sm artSun Low-E4 Glass(Includes 4 9116'Factory Applied Clear Pine Complete Unit Extension J ambs) 2 SOANDVAN Recd on PO#225184 on 8/06/2009 2 SOANDVAN at Bldg: EXT Sed:B Bin: B09 C rt:030 SOANDVAN 1 (CN245LR[201751) CN245LR,Unit EA 511.76 511.76 White/Clear Pine,LR Handing (All Sash)High Performance SmartSun Low-E4 Glass(Include s 4 9/16'Factory Applied Clea r Pine Complete Unit Extension Jambs) 1 SOANDVAN Recd on PO#225184 on 8/06/201119 1 SOANDVAN at Bldg:EXT Sect:B Bin:B09 C rt:030 SOANDVAN 2 (1344043) CN45,lnsect Screen, EA 19.91 39.82 Stone 2 SOANDVAN Recd on PO#225184 on 8/06/2009 2 SOANDVAN at Bldg:EXT Sed:B Bin:B09 C rt:030 SOANDVAN 4 (1344048) C45,lnsed Screen, EA 21.01 84.04 Stone 4 SOANDVAN Recd on PO#225184 on 11/06/2009 4 SOANDVAN at Bldg:EXT Sect:B Bin:B09 C rt:030 SOANDVAN 6 (1361537),Hardware Pack,PSC, EA 4.74 28.44 Andersen Classic Series-Ston e 21C� * (a[q .C� • 1,786.96 Special order and manufactured merchandise is non-returnable. e Customer agrees that any amount not paid within 30 days ofTotal: invoice date will carry interest at the rate of 1.5% per month U P. • 1,898.65 and further agrees to pay all costsincurred in collection, Due:; 0.00 including reasonable attorney's fees. * Actual Sales Tart 111 be calculated at=the rate Page 1 of 2 8/10/2009 11:31:OOAM e tiine:of delivery , Order Jackson LUMBER & MILLWORK Transaction # 215 Market Street 234 Primrose Street 10 Industrial Drive 145 Temple Street 459887 Lawrence,MA 01843 Haverhill,MA 01830 Raymond,NH 03077 Nashua,NH 03060 Ship Date Pcd Phone: (978)686-4141 Phone: (978)372-7727 Phone: (603)895-5151 Phone- (603)883-7777 1 8/11/09 A/0 Fax (978)687-5841 Fax: (978)373-7443 Fax. (603)895-5152 Fax: (603)883-7778 1 Location RAYMOND MAIL TO: Jackson Lumber&Millwork Co.Inc. Sales Representative PO Box 449, Lawrence, MA 01842 KEN MONACO Ship . GREG BEARDSLEY 210D 201 DALE ST *CASH ACCOUNT* NORTH ANDOVER, MA 01845 105 VALLEY RD (978)352-2809 BOXFORD, MA 01921 Customer Order# Order Date Oper Purchase Order Terms Ship Via 35455 1 459887 07/15/2009 003 CASH DELIVERY LN# Item Number Ordered Description 6 SOANDVAN Recd on PO#225184 on i V0612009 6 SOANDVAN at Bldg:EXT Sect:B Bin: B09 C rt:030 i 1,786.96 Special order and manufactured merchandise is non-returnable. a Customer agrees that any amount not paid within 30 days of t • invoice date will carry interest at the rate of 1.5% per month U . • 1,898.65 and further agrees to pay all costs incurred in collection, Due: 0.00 including reasonable attorney's fees. * AcEual Sales?ax Will be calculated at the rate, Page 2 of 2 8/10/2009 11:31:OOAM thatis rd of lieaatthe time of delivery Valley Road Woodworking Company MA LIC.71369 105 Valley Road,Boxford,MA 01921 MC. 160134 Contract Owner Info: Contractor Info: - Mark and Stephanie Aude 201 Dale Street Valley Road Woodworking Company North Andover,MA 01845 Greg Beardsley-owner 105 Valley Road (978)258-6957 Boxford,MA 01921 (978)360-2590 Mass HIC. 160134 expires 06/25/2010 Job Description: **A11 tasks refer to the three exterior walls'of the"green"bedroom.** Replace(3)bedroom windows with Andersen 400 series casement windows. Replace damaged siding on the 3 bedroom walls and install new 1x8 pine v-groove to match existing siding, Work will begin on the south facing side and proceed clockwise Owner's are responsible for: • Removing all siding and exterior trim on the three bedroom walls. • Remove any damaged sheathing • Prime and paint new siding and exterior trim. • Prime and paint new interior trim. Contractor is responsible for: • Obtaining a building permit from the Town of North Andover for siding and window replacement. (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of MGL Chapter 142A). • Ordering all construction materials for this project. • Remove all construction related debris and dispose of it at Mello's Transfer Station in Georgetown. • Installing Tyvek building paper over sheathing. • Replacing existing � (3)windows and installing(2)C245 and(1)CN245 Andersen 400 Series casement windows. • Install new 1x8 v-groove pine siding and exterior trim (All fasteners will be stainless steel). • Install new interior window trim. ,5 + Total contract price is$5405.00 Payments will be made according to the following schedule: $2831 is due upon signing the contract. $944 is due when materials arrive on site. $326 is due when work begins. $434 is due when the"south"wall is complete. $434 is due when the"east"wall is complete. Balance is due when the"north"wall is complete and total project is finished. Work is scheduled to begin on July 20,2009 and should be substantially completed by August 14,2009. You may cancel this agreement if it has been signed at aplace other than the contractor's normal place of business, provided you notify the contractor, in writing at his of f ce by ordinary mail posted by telegram sent or delivered, not later than midnight of the third business day following the signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES! 5 �r O er's si T� Con 7pa,� , 7J (fit;' 7 7 Date Date The contractor and homeowner hereby mutually agree in advance that in event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to sub 't to arbitration as provided in MGL Chapter 142A. Owner's signature Conzractorr s s' NOTICE: The sl es of the parties above apply only to the agreement of the p alternative dispute resolution initiate by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. home improvement contractors and subcontractors shall be registered and that any inquires about a contractor or subcontractor relating to registration should be directed to: Registration Division,Program Coordinator One Ashburton Place,Room 1301 Boston,Ma 02108 Tel: (617)727-3200 ext.25239 The Commonwealth of Massachusetts kj ( Department of Industrial Accidents Office of Investigations a 600 Nlashington Street Boston, AL4 02111 www_nzassgov/dia . Workers' Compensation Insurance Affidavit. Bailders/Contractors/Eiectricians/Pfambers Applicant Information Please Print Legibly Ntame (Business/Organizafion/individual): I t o4 0o� y sem. <o , r t t Address: City/State/Zip:_ AK4,, . vmA- ooy Phone#: . Are you an employer?Checktthe appropriate box: 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I Type of prep(required): _ tployees(full and/or part-time).* have hired the subcontractors b ❑New construction 2. I am.a:sole proprietor or partner- listed on the attached sheet.t 7. D Remodeling ship and have no employees These sub-contractors have 8. D Demolition working for me in any capacity, workers, comp.insurance. [No workers'comp.. insurance 5. 9. ❑Building addition ❑ We are a corporation and its required.) officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.Q Plumbing repairs or additions myself. [No-workers'comp. c. L52, §1(4),and we have no 12. insurance uired. .t ❑ Roof repairs r u1 ] .employees. [No workers' camp. insurance required.] I3• Dther 'Any applicant that checks boi#I must also fall out the section below showingtheir workers'Icon pensation T homeowners who submit this affidavit indicating they are doing all work anthen hire outside contactors motist submit alicy new affidavit indicating such. ;Contactors that check this box m1wattached an additions:sheat showing tthe name of the sub-contractors and their workers'cors.^.pli..•'- r rte•i t.,tnmtstion. ant an employer that is protndutg: informatiom workers'compensation insurancefor m1'employees; Below is the policy am job site Insurance Company Name: rvl e re C,t,.}S M v+ve Tn eg o, Policy#or Self-ins.Lic.#: CC P 10Lt 0069 Expiration Date: S,Zg Co Job Site Address:__10 City/state/z' N 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 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 hereby cert• and h ai a •penalties of perjury that the information provided ab ve is gree and correct Si Lure: Date.- Phone ate.Phone#: 97 a— 360 t)f,}`iciat use only. Do not write in this area,to be conVhmed by city or town of rcia[ City or Town: Permit/License# Issuing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all emp foyers 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,br 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 apart rents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,cbnstruction 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 er 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 t3he 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-contractors)name(s),address(es).and phone number(s)along with their certificates)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,notthe Department of Industrial Accidents. Should you have any questions r egar-ding 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%A ill 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 fiDed out each year. When 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of lnvestigations 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 1-8.77-MASSAFE Fax 4 617-727-7749 Revised 5-26-05 www.mass.gov/dia C7,2ie P xrynonusera Jl�aW-W--u Board of Building Regntatlonsand Standards Ucense or registration valid for hi ividnl nse duly HOME IMPROVEMENT OONTRAC FOR before the-expiration date..ff found-return to: Rgstoean:- 160134 Board of Building Re galations and Standards ExpIr#fion=..6125120't0 Tr# 270009 - One Ashburton Place Rm 1301 Type:.flBA Boston,Ma.02108 VALLEY ROAD WOODWORWNGCOMPAIVY GREG BEARDSLEY.:.-:.. 105 VALLEY RD_ BOXFORD,MA 01921 Administrator. Not valid _signature Borrel o *.gym xis 006 WWI esftkmo& 00 f > f191?QQS 7 r fi673: GREG C BERRDStI - 105 VALLEY EiOA13 =_ cam_�fj � BR RIP.- t9192t' -,Own mzs loser` a L - E y