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HomeMy WebLinkAboutBuilding Permit #88 - 257 BRIDLE PATH 7/29/2009 BUILDING PERMIT NORTH ytr a sp'•_ .'_� "° 0 TOWN OF NORTH ANDOVER o i p APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �SSACNus���� Date Issued: "0 a IMPORTANT:Applicant must complete all items on this page LOCATION '. 7 �S ZlfXt✓ 047-7/- Print PROPERTY OWNER In "P-6- 0 ^ AL�� . Print MAP NO: PARCEL: ZONING DISTRICT: .:Historic District yes no _ o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential -Non- Residential New Building One family Addition Two or more family Industrial Iteration S I D IrV(vr No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands`. Watershed District .— Flood _,Water/Sewer ro DESCRIPTION OF WORK TO BE PREFORMED: ���t Identification Please Type or Print Clearly) OWNER: Name: RTZ 6-0 CSI tl,� Phone: g��-� H b C Address: 7 U CONTRACTOR Name Phone:. Address:. - _ Supervisor's Construction'License: ,-Exp. Date:. : =�50// - Home Improvement"License 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: $ /y9'S� FEE: $ 1 Check No.: Receipt No.: e� o-lo�-10 NOTE: Persons cont acting with unregistered contractors do not have access to the guaranty fund Si 9.na_tu_r _ 7 i natureof contract r _e e__tOwner t Location o'? �—7 dIZ z S�& ✓'�� t No. Date t MORTIy TOWN OF NORTH ANDOVER 4 9 Certificate of Occupancy $ Building/Frame Permit Fee $ '"-'" sAC14USE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 35-f1 22 �Z '/ U ` Building Inspector Dimension Number of Stories:_______._Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I ELECTRICAL: Movement of Meter Iocation, wast or service drop requires apprrovall of Electrical Inspector fifes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) i ® Notified for pickup Call Email Date Time Contact Name = Doc.Building Permit Revised 2014 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 o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit t Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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 o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets.of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) _ o Copy of Contract o Mass check Energy Compliance Report o 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 is recorded at the Registry of Deeds. One copy and proof of recording that the appeal period is over. The applicant must then get th must be submitted with the building application Doc:Building Permit Revised 2014 i w D&I Construction Building with the QUALITY and Character of yesteryear. 44 Addison Ave Ext. C a. 3191 -7-23-09 Methuen, MA 01844 �d s (978) 685-3037 Estimate Submitted To: Margo Kealler 257 Bridle Path Andover,MA We hereby purpose to furnish the materials indicated and perform the labor necessary for the Completion of- Siding, fSiding,exterior repairs,and painting—Option#1 (See specifications sheet) All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completion in a substantial workmanlike manner in the sum of. Fourteen thousand nine hundred fifty dollars-$14,950.00 Payments to be made as follows: $2500.00 when work begins. Remaining payments as work progress ! Respectfully submitted: Darren Martino PA Mq Any alteration or deviation from the above specifications involving extra costs will be executed only upon written order, and mill become an extra charge over and above the estimate. All agreements contingent upon accidents, or deiays beyond our control. Note-This proposal may be withdrawn if not accepted within 10 days. Proposal Date 06/29/09 ACCEPTANCE OF PROPOSAL The above prices, specifications,and conditions are satisfactory a�:d are hereby accepted. You are authorized to do the work as specified. Paymen i&-.11 be m e. o' 'fined above. /+ ✓F/ 0 1 l Date: Signature: OFFIUE COPY I KEALLER RESIDENCE Specifications Sheet OPTION#1 Scope of work: Installation of new siding, exterior trim, and shutters as described. Painting as described DEMOLITION Front-Strip off existing clap board siding. Remove existing corner boards(3 locations). Remove existing trim boards around both garage doors. Remove all existing shutters. Remove the trim board under the front door. Take down lights as necessary. Left Side-Strip off existing clap board siding from the front corner up to the chimney. Right Side-Strip off existl.g clip board siding from the font corner up to the chi lnp�'. o' Note: This estimate does not include removing any window trim or fascia and soft boards. This estimate does not include any rot to plywood or framing that might be exposed after siding has been removed. Any repairs other than those described will incur extra cost. EXTERIOR TRIM Install new standard 10"corner boards at three locations on front of house. Install new trim boards around both garage doors. Install new trim board under front door. Install new i light blocks for coach lights and spot lights on front of house. All newly installed trim boards to be pvc material. All exterior trim boards to be fastened with stainless steel ring nails. Note: This estimate does not include any other trim to be installed other than that described above. SHUTTERS Provide and install new black vinyl shutters to all the windows on the front of the house. :SIDING J'nstallation of tie harttiptank clap board siuiiig(sirtooth side out) where removedPori the front and sides as described above. All siding to be fastened with stainless steel ring nails. PAINTING Caulk and fill all gaps and seams on newly installed siding and trim.. Apply two coats of white paint to the newly installed siding and trim boards on the front of house and both sides up until the chimneys. Note: Thi,estimate does riot include an;painting of trig or siding on the remainder of the house. This estimate does not include painting any window sashes. i MISCELLANEOUS Apply a deck wash and scrub rear deck The existing storm windows will remain in place. The Commonwealth ofMassachusetts k� I Departnwnt of Industrial Accidents r= ii Offcce of Investigations 600 97ashhTMn Street »d ; Boston, MA O2111 WWW M=S gov/dia . '6�orkers' Campensation Iashmce.Afidavit: Builders/Contractors/Eiectricians/Pinwbers A R licant Information • . Please Print Leeibi Name (Business/organization/Individual): �fiW/J /�1�RI-llva Address: A'71)i f(t-v AV e a77 City/ IZig: M7/Tvi N ,M Oj �y4 Phone#: Q7 97,f 7jAyoumployer?C lmkifie appropriate boz: mployer with 4. ❑ 1 am a FD ject(required):general contractor and I ees(fufl and/orpart-time).* haus d rho strb-cotttractarsconstruction ..�, Iam.a.sole proprietor or partner- listed on the attached sheet S deiirrgship and have no employees These stdb-contractors haveworking for me in any opacity. work=" comp.insurance. lition[No workers'comp, iasut=' 5. Q We are a corporation and its ng additionrequired] officers have exercised their cal repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11. myself [No•worki s'co Q Plumbing repairs or additions camp, L52, §1(4),'and-we have no 12.[]Roof rtspairs insurance requiretL].t employees. [No workers' comp. irmurance roquired.] 13.�Other S l D/4 6 f `Arty applicant that checks bud#1 must also fill out the section below showing theiraorkarc'ii t Homeowners who submit this afiidsvit indi=m theyare$ ' an ompmsetiori policy information. ICoabactors that theck this box must ° wok and then hue outside connectors must submit a new Affidavit India such' an additional shay showing• metre of dice sub-coanactors and their woriaxs•ccs,poli J irfarmation. !r.r.an er+?oyer fiat is praoviaartg:►oorir.„�s'cor:.edzsatus� irisurairce or infornrafion, J M enrloye= BPlow.is thePO&7 a d job site . Insm-ancc Company Name: Policy#or Self-ins.Lie.# Expiration Date: Job Site Address: City/Stato/Zip. Attach a copy of the workers' compeusatiou policy declar-ation sbowina Faihrre to secure covers a as Pali( b the policy number and expiration[lat?e). . g required under Section 25A of MGL e. 152 can lead to the imposition of criminal penitis of a fine up to$'1,500.00 and/or one-year imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a fine of up to 5250.00 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 certify under the pains and penalties of perjU7 I*ar the p ennrmaA01z in J` m ' ded above is trice and corrPcL r0fber official use onfy,al do not write in this este,pQ be eo mp�ed by city or town of`czd n: Permit/License# hori=ty(circle one): health Z Building Department 3.City/Tewu Clerk 4. ElectricalInspector 5. Plumbing Inspector on- Phone#: Information a. lad Instructions z Massachusetts General Laws chapter 152 requires all emp 3 oyers 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 Aim, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two ormore of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the ret eiver ort ustee-of an individual,partnership,asociat:ioiu or other legal antity,employing employees.'Howeverthe owner-of a dwelling house having not more than thrze apartments and who resides then* or the occupant of the dwelling house of another who employs persons to do maintenance,construction or relms wcirk an such dwellinghouse 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 oar-local licensing agency sW withhold the issuance or renewal of a license or permit to operate a busmi en or *o construct buildings in the commonwealth for any applicant who bas not produced acceptable evidence o'E 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 performemm ofpublic wort-, until-acceptable evidence of compliance with the ins== requirement$of this chapter have been presented to the,contracting authority." ApPlicantta .. Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contcactor(s)name(A address(es):and phone nu mber(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)ar Limited Liability Partnerships(LLP)with no=play=other gum the members or partners,are not required°to carry worku' t ccsrnpensafion ins✓rm= Van LLC orUP does have employees,a policy is required. Be advised that this a f lid- vit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also'Ese sure to sign and'date the affidavit The affidavit should be returned to the city or town that the appticafion for the:p�nit or license is being requested,nottthe Department of Industrial Accidents. Should you have airy questions regarding the law or if you are required to obtain a workers' oouupmmtic n policy,please-call the Department at the nurmbar listed below. Self-insured companies shouid enter their self iZSUTSri ilwusC u=uw on the a}+ppi op irm nim. City or Town Oftncials 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 tine event the Office of Investigations has to mntarx 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/iiCOnse 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 officiaily stamped or marked by the city or town may be provided to the applicant as proof that a baud affidavit is on frit for futre permits or licenses. A new affidavit must be fined out each year.Where a home owner or citizen is obtaining a license: or permitnot 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 Thr Office of investimitions would like to thank you in advance for your cooperation and should you have any questions, pleas✓do not.hesitate to give us a call The Department's address,telephone and fax number. The CoMMMWeaith of Massachusetts Dcpartttaent of IndustrW Accidents Office of Envn iiptdons 600 Wa&ington Siieet Boston, MA 0:2111 TeL 9 617-7274900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax#617-727-774 www.mem.gov{din Z. Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration; 124961 Expiration 9/17/2009 Tr# 1325.44 1 ' Type Individual DARKEN MARTI. Darren NIARTINO',+ 44 ADDISON AVE``EXT. METHUEN, MA 01 844 't Administrator i I N111 sachusetts- Department of Public Safety hoard of Buildin Re-ulations and Standiwds law Construction Supervisor License License: CS 66342 Restricted to: 00 r DARREN MARTINO 44 ADDISON AVE EXT II METHUEN, MA 01844 Expiration: 8/15/2011 ('unuuisiuncr Tr#: 1170 NpRT#q ® of : _ Andover VA No. _ 070 dover, Mass., I� COCMICKEWICK ��. 7� ADRATED P'Pa\ -`y S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ...........IC.......5.. ( 0 .' .0040.%...... ..............................�.............................. Foundation has permission to ere t........................................ buildings on ...p�.S ........1.?.tnl. ... ..5, .....-.... Rough to be occupied as.... .........�........ .... .....�1 I ..� . . Chimney rovided that the arson acce ti this ermit shall in eve act confdrm to the terms of thea lication on file inP P P P ry PP 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 OONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU 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.