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Home My WebLink AboutBuilding Permit #393-14 - 27 DAVIS STREET 10/28/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:,77 Date Received Date Issued: �� I IMPORTANT:Applicant must complete all items on this page LOCATION , 2-2 Print PROPERTY OWNER J ✓l l GV,, Print 100 Year Old Structure yes I MAP NO: A PARCEL ZONING DISTRICT: Historic District yes no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building TP One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial 'y Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District . J Water/Sewer r DESCRIPTION OF WORK TO BE PERFORMED: tL pl.e C-X 'moivR. �t- &P—lmol TA,�.,., ,-ldentification`Please Type or Print Clearly) OWNER: Name: Jkms-,. ��JceL\ Phone: 5'1P, - ct-iS-1(1l � Address: CONTRACTOR Name: Phone: R16 - bo S3 5335 Address: `�� t& 'r- St',,.a-+rS- tit.. fa.��.�v�.... �1�4 f' Supervisor's Construction License: 0`530`I°1 Exp. Date: _bkVkL Home Improvement License: -I L Exp. Date: 6�Lg l 1 ARCHITECT/ENGINEER tw+�r-v . 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: $ \�kSb 0 FEE: $ . Uy i Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ownere,,,,,oQ Signature of contracto Plans Submitted ❑ Plans Waived& Certified Plot Plan ElStamped Plans 2 �6� Location 1 } No. Date to I • • TOWN OF NORTH ANDOVER ' s hr Certificate of Occupancy $ Building/Frame Permit Fee $94.00 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#—t► q4�/ 2 / v Building Inspector Plans Submitted ❑ Plans Waivedg 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`JSE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS 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 T'owo ]Engineer: Signature: Located 384 s -o d Street FIRE DEPARTM`;NT - Temp Dumpster on site yes no Located at'124 Mair Street — Fire Departmerit signature/date COMMENTS i Dimension Number of Stories: Totals square feet of floor area based on Exterior dimensions q _ Total land area, sq. ft.: - i ELECTRICAL: Movement of Dieter 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 f NOTES and DATA— (For department use i El Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department T ine following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofirg, Siding, Interior Rehabilitation Permits ' ❑ Building Permit Application i a Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o 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 Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ 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 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 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 that the; aw))-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must bf- submated with the building application Doc: Doc.Buhjing permit Revised 2012 NORTH own of ndover o3 . :,.. T J h . ver, Mass, C z8226 �A0R^TEO 0, 5 .9s U .�� BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT .� .............. 0 c BUILDING INSPECTOR ................ .... ......................................... has permission to erect .......................... buildings on .. ..... .......�.1....... ....... ................................. Foundation Rough ...t� s d , to be occupied as ....... ......kelp......................................... ::' ......................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 CONSTRUCT ST S Rough Service ............. ... ......................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. 1 KevinNorth A0 98 AnndoeertMA 01845 Murphy • PH:978-M-5335 Building Contractor • FAX:978.688-7207 Proposal To: Jim and Jackie Driscoll 27 Davis Street An Home improvement Contractors and Subcontractors engaged in home crprovement contracting,unless North Andover, Ma 01845 speafically exemp ftm registration by Pro%nsions of Chapter 142A of the general laws,must be registered with the Commornveatth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home From: Kevin Murphy Rte°1"errmt i,�on Mtract 0 108Registration, 7One278598 lace, cc: Date: 10/28/2013 Job: Windows Daae of ptanm None Architect: None Location: Same Section 1-Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 10/15/13. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 10/30/13.The owner hereby acknowledges and agrees that the scheduling dates are approArnate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11—Warranty The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup,the Contractor shall,at his own expense,forthwith remedy,repair correct, replace,or cause to be remedied,repaired,or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section III-Scope of Work Page 1 of 4 Kevin Murphy Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:9786885335 FAX 97858&7207 General Proposal is to replace four exisitng windows, and related trim Demolition Four exisitng wood windows will be removed. Building Four new Anderson doublehung windows will be supplied and installed in exisitng openings. New exterior trim will be Azek. Interior Trim/Doors No allowance has been made for any interior trim Painting No allowance has been made for any interior or exterior painting. Waste Removal Demolition/construction debris will be disposed of by contractor. Kevin Murphy Page 4 of 4 Building Contractor 98 Forest Street Norah Andover,MA 01845 PH:978688,53M FAX:978688-7207 Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of...... ............ ... ...... ..........$ 4500 Payment to be made as follows: Percenta e/ltem Description Amount 1 Job complete $4500 Total 1 $4,500.00 "Not-we:No agreement for Home improvement contracting work shall require a down payment(advance deposit)of more that oneihid of ft total contract price of the total amo inrt of all deposits or Payments which the contractor must mace,in advance,to order anWor otherwise obtain delivery of special order materials ant equipment,whicliever is greater Contractor. Kevin Murphy 98 Forest Street No.Andover, MA 01845 Registration No: 101874 Section V—Acceptance Acceptance of Proposal—I have read this document and accept the prices,specifications,and conditions stated. I understand that upon signing,this proposal becomes a binding contract You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature gQAJ��t �,.o c,d.9-� Date Signature Date i I The.Commonwealth of Massachusetts ag Department of Industrial Accidents f Office oflnva*adons 600 Washington Street Boston,MA 02111 www.mass gov/dr'a Workers' Compensation Insurance Affidavit:Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Les=libly Name(Businesslorganization/Individual)• Address: �� l�v,,o�- S�'►,,..- ' City/State/Zip: 1,�. Phone#: S.-I Ii bB$ -533 Are you an employer?Check the appropriate box: Type of project(required): 1.13 I am a employer with�_ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.t �•`�Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3111 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and wehave no 12.❑Roofrepairs insurance required.]t employees.[No workers' 13.[]Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomiation. f Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit anew affidavit indicating such. 1Contrac bm that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy infomration. I am an employer that Is providing workers'conrpensadon Insurance for my employees Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: kL, L--�(. Expiration Date: 7 Job Site Address: Z:A City/State/Zip: fib, p.,c a•...-� ., G �k 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 Rue 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby ertyy under the pains and penalises of perjury that the information provided above is true and correct. Si store: Date; Phone#: Official use only. Do not write in this area,to he completed by city or town oficsal City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6,Other - - - Contact Person: Phone#: ACORU® CERTIFICATE OF LIABILITY INSURANCE 7 j17M o 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, 80END OR ALTER THE COV&AGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the.cer0mate holder Is;an ADDITIONAL INSURED,the poficy ma)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the poluy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lien of such endomemerd(s)_ PRODUCER GOWTACT _ M P ROBERTS INS AGCY INC PHONE (978)683-8073 1 AIC.N0 (978)683-3147 North Andover, MA 01845 1060 Osgood Street ,DDW�sandi @mprobertsinsurance.com RMIRERM) ARVROING COVERAGE N=2 INSURER A:PROVIDENCE MUTUAL INSUREDKEVIN MURPHY BUILDING REMODELING INSURER B:MERCHANTS INSURANCE 169 BOBFORD STREET INSURER c:GUARD INSURANCE NORTH ANDOVER, MA 01845 INSURER D: RISt1RER E: INSURER F• COVERAGE$ CERTIFICATE NUMBER REVISION NUMBER: TMS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N07VYRHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LLTTRR I ADM Sm TYPE OF INSURANCE am VIVO POLICY NUMBER CYE LRAITS X COMMERCIAL GENERAL LUMUTY EACH OCCURRENCE $ 1,000,000 cta"' '"DE ®° PREMISES Ea ocgD ce $ 500,000 MEDEXP(AM ompersm) $ 15,000 A BOPI068945 1/22/1211/22/13 PERSONAL&AIN INJURY $ 1,000,000 j GEN'L AGGRE{-GATTE LRdfT APPLIES PER: GENERAL AGGREGATE s 2,000,000 POLIcY Q JEEta ❑LOC PmxxxTs-cowroP AGc s 2,000,000 f OTHER: a AUTOMOBILE LIABILnY COMBINED $ 1,000,000 ANYAUTO ALL OWNED SCHEDULED 14CA7013608 01/23/13 01/23/14 BODILYINJURY(RerP—) 3 B AUTOS % AUTOS BODILY INJURY(Per am dart) $ HIRED AUTOS NON-OWNED PROPERTY DANM AUTOS Peracddert $ UMBRELLA LIAR OCCUR B EXCESS LIAR EACH OCCURRENCE $ 1'000f-000 SDE CUP9145304 /22/12 11/22/13 AGGREGATE s 1,000,000 DEC) I;mm ION a $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITYAW PROPR1ErORFARTNIWADmmnPvE YIN % STATUTE ER C OFFICERIM134BER EXCUJOED? NIA EL EACH ACCIDENT $ 500,000 ( In NIQ KEWC422467 07/01/13 07/01/14 Iyer,desrnbeunder EME L DISEASE_Ea PL $ 500,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY Umff $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES -WORD IGI,Add mvd Rmmks SdwAte,may be atm I mono space is reqLftM CERTIFICATE BOLDER CANCELLATION TOWN OF NORTH ANDOVER BUILDING DEPT. - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED a ®1988-2013 ACORD CORPORATION. An rights reserved ACORD25(2013104) The ACORD name and logo are registered marks of ACORD