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HomeMy WebLinkAboutBuilding Permit #128 - 234 HAY MEADOW ROAD 8/13/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONS PermitNO: Date Received Date Issued: /$ O IMPORTANT:Applicant must complete all items on this page LOCATION .. q a V rh1,-1- W 4 Print PROPERTY OWNER Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: RkP-My)e- 7 x;s4/n� slid,nc / m s7'1V 1/ h vl S-lalh! IdentT61ko-V tion Please Type or Print Clearly) OWNER: Name: �nK1e.► Phone: X9-57 Address: CONTRACTOR Name: NJCKc _ lq4( tom Phone: Address:,341 /Yf80�tIan 5 1.7z�e Akr, olg -T' Supervisor's Construction License: ' c1 Exp. Date: r Horne Improvement License: l q I S `�` Exp. Date. 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. J Total Project Cost: $ lob _ FEE: $ 1/6 � Check No.: �� Receipt No.: ,tet 2 3 a 3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner� _ Signature of contractor 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 Packaging/Sales 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 t I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board Decision: Comments �T 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 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 ........._......... 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: Doc.Building Permit Revised 2008 Location No. .� Date MORTq TOWN OF NORTH ANDOVER 3?O: t. o . ,h•C O Certificate of Occupancy $ CNUSE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22623 / Building Inspector NORTH TOMM of o 0 -_ - - O LAKE dover, Mass., COC MIC KE WICK � RATED PP�\ �C v E BOARD OF HEALTH PERMIT T D, Food/Kitchen Septic System ,1 BUILDING INSPECTOR THIS CERTIFIES THAT............. l�f�. c:...( .�: ./F... ...................................................................... ....................... Foundation has permission to erect........................................ bui dings on .. r,� .... .: ��.. . ,1 Q r.l.... ............................. Rough /� z .' vl' �y<e� �r� Lf!`f fes. e' „ Chimney to be occupied as............................. 1 .I '. .�P..................f�'. .�..e........1 1 ................. . .. . . . .. . . . . . provided that the person accepting this permit shall in every respect conform to the term o the applicatioon file in Final this office, and to the provisions of the Codes and By-Laws relating to.the Inspection, Alteration and Construction of Buildings in the Town of North Andover. . PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough . Service BUILDING INSPECTOR Final Occupancy Permit. Required to Occupy 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. Burner Street No. SEE REVERSE SIDE Smoke Det. JV1anon Constru&710�1n% 1 ' ' ' ' Date: May 3,2009 Homeowner Information: Janice Quigley 234 Haymeadow Rd. North Andover Ma.01845 978-794-8495 Contractor Information: Marion Construction Nicholas Marion 309 Mt. Vernon St. Lawrence Ma. 01843 978-725-3625 Salesperson:Nick Marion Construction Supervisor#085497 Exp 8/19/2010 Home Improvement Contractor Registration#141257 Exp 1/27/2010 WORK TO BE PERFORMED AND MATERIALS USED Contractor agrees to do the following work for homeowners: See attached proposal# 1331 , 1335 Anything else is excluded Materials expected to be used:vinyl siding,aluminum,vinyl soffit The following schedule will be adhered to unless circumstances beyond the contractor's control arise: �a Work schedule to begin: 164- p; Expected date of completion: TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE: The contractor agrees to perform the work, furnish the material and labor specified above for the Sum of$9,625.00 Payments*will be made according to the following schedule: *Please make checks Payable to Marion Construction $500.00 Deposit td be paid upon signing $2,325.00 upon start of project $4,000.00 upon completion of existing siding removal $2,800.00 upon completion of project DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Please make sure to sign all three documents *****Homeowner's signature Date Contractor's signature -Z Date You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office or branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mail posted,telegram sent or by delivery,not later than midnight of the third business day following the signing of the agreement. See attached notice of cancellation for an explanation of this right. REQUIRED PERMITS The following building permits are required.It is the obligation of the contractor to secure such permits as the homeowner's agent. 1. PERMIT TO BUILD - YES 2. ELECTRICIAL PERMIT- NO 3. PLUMBING PERMIT- NO NOTE: Owners who secure their own permits or deal with unregistered contractors are excluded from Guaranty Fund provisions of MGL c. 142A NOTE: All home improvement contractors and subcontractors shall be registered and any inquires about a contractor or subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration One Ashburton Place,Room 1301 Boston,Ma. 02108 617-727-8598 Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. ARBITRATION The homeowner hereby mutually agree in advance that the event the contractor has a dispute concerning this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitrations as provided in MGL c. 142A ***** c Contractor 1-z —Z—,— Homeowner Date Date , -L- NOTICE: THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT INITIATED BY THE CONTRACTOR.THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS IS NOT SEPERATLY SIGNED BY THE PARTIES. ACCELERATION OF PAYMENT Homeowner's Financial Insecurity:A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. Contractor's Financial Insecurity: In instances where a contractor deems him/herself to be financially insecure,the contractor may require the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal from said account would require the signature of both parties. I i Awd.am(DinConstrucion NOTICE OF CANCELLATION May 3,2009 YOU MAY CANCEL THIS TRANSACTION,WITHOUT PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE,IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED,ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY,IF YOU WISH,COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER,S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER,AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION,YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION.IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER,OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAILTO DO SO,THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM TO MARION CONSTRUCTION AT 309 MT. VERNON ST.LAWRENCE MA.01843 NOT LATER THAN MIDNIGHT OF May 6,2009 Cancellation of the contract can and will be subiect to a fee of$250.00 Any& all hours rendered due to individual city/town complications(permits) are billable hours. *****Customer Signature Date j :1I�IRl Z978-725-3625 CO"SO—"% 4 MWW978-361-6668 Marion Construction 309 Mt Vernon St Lawrence Ma. 01843 Estimate Estimate # 1331 Marionconstruction@comcast.net Date: 4/26/2009 Salesperson: Bill To: Janice Quigley 234 Haymeadow Rd. North Andover Ma. 01845 misc. This estimate is to be added to the prior vinyl siding estimate #1 emove all existing wood siding from the entire house #2 Install new 3/8"foam insulation to the entire exposed area of the house #3 Remove and repair any minor rott or water damage under existing siding misc. All debris will be removed upon completion misc. does not include any landscaping or property maintainance misc. Any/all rott/water damage is an additional cost to this invoice 1.00$2,825.00 $2,825.00 Please contact us if you need any assistance. 978-725-3625 Total $2,825.00 Page 1 of 1 l _. MRf'`l�fZ�� 978-725-3625 COfZSt1'Z�Ctj,'Ofn% C 978-361-6668 Marion Construction 309 Mt Vernon St Lawrence Ma. 01843 ESt1I171te Estimate # 1335 Marionconstruction@comcast.net [Date: 5/3/2009 Salesperson: Bill To: Janice Quigley 234 Haymeadow Rd. No.Andover Ma. 01845 I i i I ' I #1 Install new vinyl siding to match addition on back that was done prior #2 Install new vinyl soffit to the entire house,garage and addition #3 nstall aluminium coverage to the entire house,garage and addition misc. All debris will be removed upon completion misc. Any/all rott/water damage is an additional cost to this invoice misc. does not include any landscaping or property maintainance 1.00$6,800.00 $6,800.00 i Please contact us 1f you need any assistance. 978-725-3625 'I'oj $6,800.00 Page 1 of 1 07k Board of Building Regulations and Standards HOME IMPfZOVEMENT CONTRACTOR Registrd{ion', 141257 . Expuatton 1/27/2010 Tr# 264695 Type DDA MARION CONSTRUCTION _ NICHOLAS MARION-- r" 309 MT.VERNON STI-" LAWRENCE,MA 01843` Administrator Massachusetts- Department of Public Safetl Board of Building Rc��ulati()ns and Standards Construction Supervisor License License: CS 85497 Restricted to: 00 - - i NICHOLAS T MARION 309 MT VERNON ST LAWRENCE, MA 01843 Expiration: 8/19/2010 (imuniss7„ner Tr#: 1788 !t i !i tbmpnonwea&k of Massachusetts DpPartnrent Of-Industrial Accideais• Qtce O 'Q Eil�r, f I�estz,atiores . .s� 600 W'ashirr.,an Street MA 62111 c� Workers' CamPencation Fusiu-aaee nzas�;ov/daa A cant rmfor. tiara Affid;gvi • liiBu,ders/Contmdors/Ei ectricians/Pinm6ers / Please Print Leeibi Nie (AurineWorpaimfion4ndivldmd); /10 f� Address'. �3 � VeralOrrt S 7 C't3'G /Zig: lyyL d lir 1��3 phone k . 9 -Y— a Are you as empioyerS C Ieek.the appmpriate•box: I Q I,am a emplayer with 4, ct(required): E] I am a general cotitr:actor and I Type of ProjeeR •red): 2 ,PP+a eees(full and/or parr time).* have )fid the sub-contractors 6• ❑New construction . I am e proprietor.cr pwlnm- Iisted on the attached sheet 3 7. Q Remodeling ship and have no employees _ Them` working for mem sul�.eontractots have "rke:rs' comp.insurance. 8. Q I?rmofition [No workers'camP. ince.. 5. (] We are a co ose#ion and its 9. Q Bading addition required.] offices have exercised thea I O.E3 Ej ^tHCal 3.❑ I Din a homeowner doing all work right rep, or additions myseI£[No•warlc' ,comp, c of exetnptton per MCL l I.Q Plurnbi 2, §I(4),'.and•we have no ng�mm or additions ulsru'attce•rrgtxired.];t .•='PZoYe--s.[No workem, 12.[3 Roof repairs Any eppiic=that 6=ks bez't�l fnart atao Sri Dill the CDMA. insu=Cr required..] 13.Q.other t Homeowae. who section below showing theirsvoti; 'eorr�nasation oi' _ edbmit this e�idevit inrfiacing they are doing an wwk.end fh�hoz owaitle conueetkm mfO�tion. �Coaoactors that check this box feastatt chad as ad&-tional mnbmtt a new sheoeshowh*.ttre nemz of the xu&" toaeEon $ davit iadicm*eiech.' 1 .eot ePfoyer tka�isds»viautg:frork:.�'err. °1d worms'`x =i inion atfornurfior �risr�ra�rre for n:y enFlw= Win, :� &Lc pollcj Insurance Company Name: Policy#or Self-ins.Lic.#:_ Expiration bete: do iD Sob Site Addrass: k pyre Attach a copy of the workers'come /[/•�d! /`7�i.. ©/�{/�" PeasatioII poLcy dearatioII oe showiaa Failure to secm�e cavertfp as required under Section 25A of Pab ( e the poi;cy number and e 1�lCL c. ISZ can lead to the xpir�fion time}, fine up to S1,SDO.DO and/or one-year imprisonmeri;as well Imposition of=,hninal perm of a Of up to$250.00 a $s civil perutlfies in the farm of a STOP WORK ORDER and a fine Investi against the violator. Ile advised that a copy of this matrment may be forwarded to the Offtm of gallons of the DIA for inmmmm coverage verification. I do herebry C07%rp un a pains and penalties o tPerl�y t �the infnrmatioa prnni4ded above tragi and cor»L 97 Date: 3 Phone#: S'36 a 4,f"Acial ase onfy, do not write in this area,gib he mnrpletPd bj'd'or town.o,�tria( City or Town: Issuing Aafhority(circle one): Permit/Licanse# 1. Board of Health 2. %Mi) CL Otber Department 3.City/Town Clerk 4. Electrical Inspector S. Pinmbiug laspector Contact Persom Phone#: Information a- lid lntructions Massaehusetrs General Laws.chaptnr 152 requires all emp 3oyers 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 Ain,- expr--ss or implied,oral or writtm" An emplayer is defined n"an individual partnership,amcxiation,corporation or other legal entify,or any two or more of the'famping engaged in a joint enterprise,and inoludi"g the legal representatives of a deceasesd employer,orle receiver orttsrst=-of an individual,partnership,associatiain or other legal entity,employing employee&'Howemthe owner-of a dwelling house having not more than three apartments and who resides therein, or the ocxupant of the dwelling house of another who employs persons to do zn&imtenance,construction or repair wcirk on such dweilinghouse or on the grounds or building appurteneat thereto shall not be:cmme of sorb employment be d--med to be an employer." MGL chapter 152,§25C(6)also states that"every state wr-iocal licensing agency shall wkbhold the issmaneeor renewal of a}ieense or permit to operate a business or ergo construct bnild'm p in the commonwealth for any applicant who has not produced acceptable evidenwair eoarpfsance with tine.insurance coverag=e required." Additionally, MOL chapter 152, §25C(7)stains"Neither thio cormmr nweakh nor any of iia polificgl subdivisions shall enter into any==id for the pwRff mance of public work wid1•arcep{abla evidence of compliance with the insmsoce 1upir cmerrls.of this chapter have been presented to the ac3itttractasg authority." APpficeuts Please fill out the workers'compensation,a£sdavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contrador(s)n me(s),1dd=s(e5):acrid phone number(s)along with their cratificate(s)of insurance. Limited Liability Companies(LLC)or Lirnite ff L'umbility Partnerships(LLP)with no employees othetthan the members or partners,arc notrequired1to carry workam'=ni-Tripexuation irswanrs. Van LLC orUP ebbs have employees,a policy is required. Be advised&at this of d.- vit may be submittd to the Department of Mustrial Acaidants for confirmation of insurance coverage.. Ain Ewe sure to sign and date tate affidavit The afcidavh should i>c re tta ted to the city or town that the application for the pe:rrai#.or ficense is being re4u..sted,not1h Department of Industrial Accidents Should you have any questions reps-din the law or if you are required to obtain a walkers' ooeslpensation polipy,1p cm-=R the Dgmrtrtremt at tine-nuUtber.listed below, Self-insured companies should enter their self-ina^=ncclicansc mincer on %appropriate,iL . City or Town Officials Please be sure that the afndsvit is complete and printed rgsbly. The Depwttnezt hesprovided a space at tine batmen of the affidavit for you to fill out in.tits event the Office of Investigations has to contact you szprding$te appricant Please be sraz to fill in the permit/license numbcr which,w-fll be used as a reference number. In addition,an applicatrt that must submit multiple permwlicense applications in any given year,Herd only submit one affidavit indicating-current policy infornssfion(if necessary)and under"Job Site Ad$s-ass"the appiieant should write"all locations in city or tm+m)."A Dopy oh6e;affidavit that has been of6cia:4 starnped or marimd by the city or town may be provided to the applicant as proof the a valid affidavit is on file for nrhae I permits or liccrrsm A new affidavit must be filed out each year. Where a home owner or citizen is obtainin a license: or p=it not related to any busincm or commercial ventum (Le. a dog license or permit to burn leaves etc.)said person is NOT.r=Mired ta-completr this efstdavit. The Office;of Investigations would lilm to thank you in advance for your cooperation and:should you have any gumstions, please do not hesitste to give us a call. Tiw Depart move's address,t-.I.-phone and fax number.. The Commonwealth of 1,/lassachuse= Departin-nt of Indssstrial Accidents Office-Of Invesfipp ions 600 Washinggton St net Baste MA 02111 TeL #617-7274900 i=406 or 1-8.77-MASSAFE Fax;9 617-727-7749 1L viand 5-2G-D5 www.mass.govidia