HomeMy WebLinkAboutBuilding Permit #486 - 226 STEVENS STREET 2/20/2008BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: V�40 Date Received lkrlox
Date Issued: O• b d
IMPORTANT: Applicant st eomple 11 items on this page
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LOC;4TION w
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,PROPERTYY, OWNER
NIAP NO PARCEL : ZONING DIST RICTH tonc Dhstnct Y `
_....x hme.ShioViilaae
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
,p
1.
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
One family
Addition v
Two or more family
Industrial
Alteration
No. of units:
Commercial
Repair, replacement
Assessory Bldg
Others:
Demolition
Other
Septic Well ,"' "x 5Floodpiam
x� 1111�tlands w,"'x
aiUatershed District ;
l7UaterJ_ewer
OWNER: Name:
DESCRIPTION OF WORK TO BE PREFORMED:
/ Z' x 3Z1 0-ee.1, OA/ R2 -/9R o A A/0 u s e
Identification Please Type or Print Clearly)
r t A4 AQ j2, -1-1A Af / 7-rri C 7 -,am %
9 70
Address: ZZ 6a S 7-,Eiie1t/S 57-9 F_ l—
wr
d.J- -ff
C.ONTRACTORx Name°i r. ' 9ra"5'Z sr
�P Phone 6 y
- ryu y g y v
Addresses.
Supervisor's Construction Licer�se� -G S' I Exp Date 5
3
Horne Improvement License -1.' .3-1 ?, ,Exp Date
ARCHITECT/ENGINEER Phone:
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: $ %' (, j-0 FEE: $
Check No.: -77 a53 I Receipt No.:�y9S3
NOTE: P-- sons contracting with unregistered contractor, do not have access to the guaranty fund
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)
o Building Permit Application
❑ Certified Proposed Plot Plan
o 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 2.2007
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 Packagink/Sales
Private (septic tank, etc.
Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
LANNING & DEVELOPMENT
MMENTS
ONSERVATION
DATE REJECTED DATE APPROVED
TE REJECTED DATE APPROVED
),L5 R
' �1•'Tom-
.��f' ��i�iliIiCC�I I �o
DATE REJECTED DATE APPROVED
HEALTH
COMMENTS 0/l S.P,A)
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Comments
Water & Sewer Connection/Signature & Date Driveway Permit
Located at 384 Osgood Street
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
Doc.Building Permit Revised 2007
t i+
Location&iAv s% CNS .5'r
No. !I G'' Date s �y
�aRTh
TOWN OF NORTH ANDOVER
• . ' .. • AL
F3?
Certificate Occupancy
+ ; ,
'a
of $
;�s'"•°'tt�'Building/Frame
s�CHus
Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #�)57..��
20953
b'uilding Inspector
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Engineers
January 25, 2008
Mr. Dan Monmarquet
D & R Builders
12 Virginia Avenue
Lowell, MA 01852
(978) 852.5643
C/O Michael Malynowski —MHF Design Consultants Inc.
Re: 226 Stevens St. Addition — No. Andover, MA.
Review of New LVL Beam Support of Existing Roof Rafters
Dear Dan,
TFM has reviewed the new (2) double 1 3/4" x 117/8" x 25'-0 multi -span 1.9E LVL beam
proposed for support of the existing roof rafters above the existing kitchen partitions. This beam
is adequate for the support of the existing roof rafter framing, once gang nailed together in
accordance with the engineered lumber manufacturer's recommendations and supported by posts
such that any one span shall not exceed a length of 11'-0". This review is based on the attached
drawings (SK -1, SK -2, & SK -3) provided by your office. No additional review has been
completed for the remainder of the existing and new construction proposed at this project
location.
Sincerely,
TF Moran, Inc.
1�1P
46T
f r
Kyle E. Roy, , SECB
Senior Structural Engineer
Cc: Michael Malynowski — MHF Design Consultants, Inc.
48 Constitution Drive
Bedford, NH 03110
Phone (603) 472-4488
Fax (603) 472-9747
www.tfmoran.com
New Hampshire Office Locations: Bedford I Manchester I Salem I Keene
V
LETTER OF TRANSMITTAL
48 Constitution Drive
Bedford, NH 03110
Phone: (603)-472-4488
Fax: (603)-472-9747
❑ Standard Mail E12 nd Day ® Overnight ❑ Hand Carry ❑ To Be Picked Up
TO: MHF Design Consultants, Inc.
44 Stiles Road
Salem, NH 03079
PHONE: 603.893.0720
DATE 1/28/2008JOB
NO.
ATTENTION Michael Malynowski, PE
RE:
226 Stevens St. Addition
No. Andover, MA
WE ARE SENDING YOU:
❑ Shop drawings ❑ Report ❑ Plans ❑ Samples ❑ Specifications ® Letter ❑ Change Order ❑ Other
COPIES
DATE
NO.
DESCRIPTION
1
1-25-08
Review letter and SK -1,2, & 3 (wet sealed and signed)
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Reviewed as submitted ❑ Resubmit _ copies for approval
® For your use ❑ Reviewed as noted ❑ Submit copies for distribution
® As requested ❑ Returned for corrections ❑ Prints returned from loan
❑ Return corrected prints ❑ For review and comment
REMARKS:
COPY: D & R Builders — Dan Monmarquet SIGN:
Kyle . yr'P. E., SECB
/f enclosures are not as noted, kindly notify us at once.
LETTER OF TRANSMITTAL
48 Constitution Drive
Bedford, NH 03110
Phone: (603)-472-4488
Fax: (603)-472-9747
Miners
❑ Standard Mail ❑ 2nd Day ® Overnight ❑ Hand Carry ❑ To Be Picked Up
TO: D & R Builders
12 Virginia Avenue
Lowell, MA 01852
PHONE: (978) 852.5643
DATE 1/28/2008
JOB NO. SO (2A> 1 00
ATTENTION Dan Monmarquet
RE:
226 Stevens St. Addition
No. Andover, MA
WE ARE SENDING YOU:
❑ Shop drawings ❑ Report ❑ Plans ❑ Samples ❑ Specifications ® Letter ❑ Change Order ❑ Other
COPIES
DATE
NO.
DESCRIPTION
1
1-25-08
Review letter and SK -1,2, & 3 (wet sealed and signed)
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Reviewed as submitted
® For your use ❑ Reviewed as noted
® As requested ❑ Returned for corrections
❑ Return corrected prints
REMARKS:
❑ Resubmit _ copies for approval
❑ Submit copies for distribution
❑ Prints returned from loan
❑ For review and comment
COPY: MHF Design — Michael Malynowski, PE SIGN:
A< C'-1 Z--�
Kyle E. 10y, Pk, SECB
If enclosures are not as noted, kindly notify us at once.
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REScheck Software Version 4.1.0
Compliance Certificate
Project Title: Kurt and Martha Middlestat Addition
Report Date: 01/23/08
Data filename: F:\Program Files\Check\REScheck\MiddlestatNorthAndover.rck
Energy Code: Massachusetts Energy Code
Location: North Andover, Massachusetts
Construction Type: 1 or 2 Family, Detached
Heating Type: Other (Nonelectric Resistance)
Glazing Area Percentage: 34%
Heating Degree Days: 6322
Construction Site:
226 Stevens St
North Andover, MAO 1845
Owner/Agent:
Kurt Middlestat
226 Stevens St
North Andover, MA 01845
978-764-9201
Maximum UA: 108 Your Home UA: 56 = 48.1% Better Than Code
Designer/Contractor:
Richard Arseneault
D and R Builders
12 Virginia Ave
Lowell, MA 01852
978454-8706
arseneaultr430@comcastnet
Gelling 1: Cathedral Ceiling (no attic)
120
30.0
0.0
4
Ceiling 2: Cathedral Ceiling (no attic)
240
38.0
0.0
6
Ceiling 3: Cathedral Ceiling (no attic)
120
30.0
0.0
4
Wall 1: Wood Frame, 16" o.c.
150
21.0
0.0
6
Window 1: Vinyl Frame:Double Pane with Low -E
13
0.033 0
Window 2: Vinyl Frame:Double Pane with Low -E
13
0.033 0
Door 1: Solid
19
0.033 1
Wall 2: Wood Frame, 16" o.c.
265
21.0
0.0
8
Window 3: Vinyl Frame:Double Pane with Low -E
27
0.033 1
Window 4: Vinyl Frame:Double Pane with Low -E
6
0.033 0
Window 5: Vinyl Frame:Double Pane with Low -E
6
0.033 0
Window 6: Vinyl Frame:Double Pane with Low -E
6
0.033 0
Window 7: Vinyl Frame:Double Pane with Low -E
6
0.033 0
Door 2: Glass
41
0.033 1
Door 3: Glass
41
0.033 1
Wall 3: Wood Frame, 16" o.c.
150
21.0
0.0
7
Window 8: Vinyl Frame:Double Pane with Low -E
13
0,033 0
Window 9: Vinyl Frame:Double Pane with Low -E
13
0.033 0
Window 10: Vinyl Frame:Double Pane with Low -E
6
0.033 0
Floor 1: All -Wood JoistlTruss:0ver Unconditioned Space
500
30.0
0.0
17
Compliance Statement. The proposed building design described here is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code
requirements in REScheck Version 4. 1.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checidist.
The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design
Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design
load as specified in Sections 780CMR 1310 and J4.4.
Name - Title
Kurt and Martha Middlestat Addition
Signature
Date
Page 1 of 1
1/23/2008 3:36 PM FROM: Gallant Ins Agcy
Gallant Ins Agcy T0: 919786889542 PAGE: 001 OF 001
DATE (MWDDM-M
A_ TM. CERTIFICATE OF LIABILITY INSURANCE 0112312008
PRODUCER Phone: (978) 283-3500 Fax: (978) 263.1838 THIS CERTIFICATE
/CONFERS NO RIGHTS UPON THE CERTIFICATETION
GALLANT INSURANCE AGENCY, INC. HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
199 GREAT ROAD / P O BOX 975
ACTON MA 01720
;INSURER
7AAFFORDING COVERAGE NAIC 10
ADIA INSURANCE COINSURED
D & R BUILDERS INC.
12 VIRGINIA AVE INSURER C:
LOWELL MA 01852 INSURER D:
THE POLICIES
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
OF INSURANCE LISTED BELOW HAVE
TERM OR CONDITION OF ANY
BEEN ISSUED To THt INSUKCV
CONTRACT OR OTHER DOCUMENT
WITH RESPECT TO
WHICH THIS CERTIFICATE
TERNS. EXCLUSIONS
MAY BE ISSUED OR
AND CONDITIONS OF SUCH
ANY
REQUIREMENT,
ANY AUTO
POLICIES
IS SUBJECT TO ALL THE
AUTHORIZED REPRESENTATIVE
OTHER THAN EA ACC $
AUTO ONLY: AGG 1 $
POLICIES
PERT
IN THE
EAIIN LIMITS SHOWN MAY HAVE
REDUCED PAID CLEIN
BEEN AIMS.
POLICY EFFECTIVE
DATE MWDDNY
POLICY EXPIRATNAI
DATE MMOMY
LIMITS
$ 1,000,000
NSR AW
CtY
TYPE OF INSURANCE
POLICY NUMBER
LTR
-
AGGREGATE $
BOA -011720043
04/01/07
04/01/08
EACHOCCURRENCE$
GENERAL LIABILITY
DPA7Pf,E TO RENTED 50,000
PREPASES Ea omurence
COMMERCIAL GENERAL. LIABILITY
MED. EXP (Arty one person) $ 5,000
CLAIMS MADE D OCCUR
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC STATU• OTHER
TORY UKTS
E.L. EACH ACCIDENT $
PERSONAL& ADV INJURY $ 1,090,000
A
ANY PROPWETORIPARTNEWEXECUTIVE
GENERAL AGGREGATE $ 2,000,000
PRODUCTS CCMPJOP AGG. $ 2,000,000
E.L. DISEASE -POLICY LIMIT $
0V";dssafbs unddr
SPECIAL PROVISIONS Wow
R:
GEN1 AGGREGATE LIMIT APPLIES PER
PRO- LOC
POLICY JECT
AUTO MOBILE LIABILITY
COMBINED SINGLE LIMIT $
(Ea accident)
ANY ALTO
BODILY INJURY
ALL OWNED AUTOS
(Per person) $
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY $
$
(Per eccident)
NON•OWNED AUTOS
OF OPERATIONS/LOCA ONS/VEHICLES/EXCLUSIONS ADDED BY NDORSEMENT/SPECIAL PROVISIONS
CAh
' CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
GARAGE LIABILITY
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO
DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS
Town of North Andover
ANY AUTO
1600 Osgood St
AUTHORIZED REPRESENTATIVE
OTHER THAN EA ACC $
AUTO ONLY: AGG 1 $
Ray Gallant
Attention:
rn ernon t^nRPAROTInN 199E
OCCURRENCE $CITY
EXCESS / UMBRELLA LIABILITY
OCCUR CLAIMS MADE
-
AGGREGATE $
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC STATU• OTHER
TORY UKTS
E.L. EACH ACCIDENT $
E.L.DISEASE-EA EMPLOYEE $
ANY PROPWETORIPARTNEWEXECUTIVE
OFFR:ERMIEMSER EXCLUDED?
E.L. DISEASE -POLICY LIMIT $
0V";dssafbs unddr
SPECIAL PROVISIONS Wow
OF OPERATIONS/LOCA ONS/VEHICLES/EXCLUSIONS ADDED BY NDORSEMENT/SPECIAL PROVISIONS
CAh
' CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO
DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS
Town of North Andover
AGENTS OR REPRESENTATIVES.
1600 Osgood St
AUTHORIZED REPRESENTATIVE
N. Andover, MA 01845
Ray Gallant
Attention:
rn ernon t^nRPAROTInN 199E
ACORD 25 (2001108)
The Commonwealth of Massachusetts
J Department of Industrial Accidents
W Office of Investigations
d 600 Washington Street
At Boston, MA 02111 f
M www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): i 2 f3 c, ild o,- i.
Address: Zv yitu,it
City/State/Zip: /tuolcd .✓ NN a)o 5-/ Phone #: 918 85-z S'6 elf
Areyou an employer? Check the appy
1. ❑ I am a employer with
employees (full and/or part-time).*
2. ❑ I am a sole proprietor or partner-
ship and have no employees
working for me in any capacity.
[No workers' comp. insurance
required.]
3. ❑ I am a homeowner doing all work
myself. [No workers' comp.
insurance required.] t
`iate box:
4.0 I am a general contractor and I
have hired the sub -contractors
listed on the attached sheet.
These sub -contractors have
employees and have workers'
comp. insurance.$
5. ❑ We are a corporation and its
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
Type of project (required)':
6. ❑ New construction
7. ❑ Remodeling
8. ❑ Demolition
9. ❑ Building addition
10..❑ Electrical repairs or additions
11.❑ Plumbing repairs or additions
12. ❑ Roof repairs
13.❑ Other
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this af:ida it indicati^.g 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 state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Aj a t/ kler
Policy # or Self -ins. Lic. #: 7 S/ k 354 - (3®R — O /17 2 06— f 3 Expiration Date: V oI o J_
Job Site Address: 27C STPf/ews .5,irP-f- City/State/Zip: /luorrff m4 otfyj
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.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Signature: ln_ Date:
City or Town:
not write in this area, to be completed by city or town official
Permit/License #
Issuing Authority (circle, one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.1 Other
Contact Person:
Phone #:
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 "ever state or 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 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 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 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 maybe 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, not the Department of
Industrial Accidents. Should you have any questions regarding 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 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 license or permit to bum 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 Washington Street
Boston, MA 02111
Tel. # 6.17-7274900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
Revised 11.22-06
www.mass.gov/di-a
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Richard Arseneault
12 Virginia Ave
Lowell, MA 01852
(978) 454-8706
D & R Builders, Inc.
Dan Montmarquet
20 Kienia Rd
Hudson, NH 03051
(603) 883-2514
Proposal Submitted to
Phone 978-764-9201
Date1-18-08 P1 OF3
Kurt & Martha M[ittelstaedt
978-777-1100
Street
Job name
226 Stevens St.
City, State & Zip Code
Job Location
North Andover, Mass. 01845
Architect
Date Of Plans
Job Phone
We hereby submit specifications and estimates for: 20x25 REAR ADDITION; FULL BASEMENT WITH WALKOUT:
DEMOLITION/EXCAVATION; Remove all windows, doors, siding, boards, & wall on wall between existing house &
New addition. Core hole (30) between new & existing basement, head off opening to support carrying wall. Remove fill in area
of addition. 1 triaxle of stone under floor and around perimeter of foundation. Bring back to grade. Landscaping by homeowner.
FOUNDATION; Poured concrete footings (10x24). 10" poured concrete walls to 7'10" high with anchor ties and
waterproofed. 30001b.psi mix. 2 drops, 1 for frost wall , 1 for walk out.
FRAMING; Framing of walls to be 2x6 construction. 2x10 floor joist. 2x10 rafters, ''/z" o.s.b. walls, ''/z" fir plywood roof.
3/4"t&g advantek floor, glued & ring nailed. Install L.V.L. beam in kitchen area to eliminate carring wall.
DECK: Deck frame to be pressure treated, 2x8 floor joist, 2x10 beam, 2x12 stringers, 6x6 posts & hurricane braces. Decking
to be "latitudes" composition 5/4" t&g decking with hidden fasteners. P. V. C- post, caps, & bases. Install wire railing system
provided by homeowner. Concrete footings to 4' deep & as many needed by code. Main deck to be approx. 12x28 with wrap
around to connect with stairs to walkway. Steps on opposite side of deck to access side yard.
WINDOWS/DOORS; 5 Windows to be Andersen double hung tiltsash with low -e insulated glass &
insect screens. No grilles. 1 - 6'x6'8" slider & 1-6' x 6'8"double door on gable wall below deck. One
2'8"x6'8" door. Two 6'x6'8" sliders,I — 6'x4'1'0 sliding window, 4—36"xl8"awning windows. All
Andersen doors & windows.
ROOFING; Roof to be G.A.F.30 yr. Architect asphalt shingles (color to be determined). Ice &
watershield to 3 ft. up from bottom of roof & in valleys. Step flashing where needed. Ridge vent.
Aluminum drip edge.
SIDING; To be # 1 red cedar pre -primed. Exterion corner boards & trim to be Primed pine. Soffit
Vent. Tyvek housewrap.
ELECTRICAL; Wiring to Mass. code. 12 recessed lights. Wiring for paddle fan(fan by
homeowner). 2 exterior spotlights (location by homeowner). 2 rear door lights. 2 deck outlets(g.f.i.) 1
below deck. Outlets & switches to code & where needed. Phone, cable & speaker wires as needed.
PLUMBING/HEATING, Provide radiant heat to new addition off existing boiler. Plumbing for 1/2
bath, sink/vanity, toilet to be white kohler. 1 exterior sillcock.Remove existing heat in kitchen area.
Vent range hood to outside.
INSULATION; Insulation in ceiling to be r-30 on sloped ceiling, r-38 on any flat ceiling. Walls to be
R- 19 polly icocellulate. Prop -r -vent where needed. Basement ceiling to be r-19. Vapor barrier where
needed.
BLUEBOARD/PLASTER; All walls to be 1/2" blueboard with 1/2" skimcoat plaster. Smooth walls,
textured ceilings.
FLOORING, Hardwood flooring in great room, tile in bathroom. Flooring costing more than $3.00 s.q.
f.t. shall be an additional charge. Install hardwood floors in living room to match existing.
Authorized Signature,
Acceptance of Proposal- The above prices, specification, and conditions are satisfactory and are hereby accepted.
You are authorized to do the work as specified. Payment will be made as outlined above.
Signature—;Z--� Date of Acceptance: A 2 -lo
Signatu
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