HomeMy WebLinkAboutBuilding Permit #88 - 257 BRIDLE PATH 7/29/2009 BUILDING PERMIT NORTH
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TOWN OF NORTH ANDOVER o i p
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received �SSACNus����
Date Issued: "0
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IMPORTANT:Applicant must complete all items on this page
LOCATION '. 7 �S ZlfXt✓ 047-7/-
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PROPERTY OWNER In "P-6- 0
^ AL�� .
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MAP NO: PARCEL: ZONING DISTRICT: .:Historic District yes no
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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:
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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)
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® 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
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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
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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.
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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
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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.