HomeMy WebLinkAboutBuilding Permit #477-12 - 27 DAVIS STREET 12/14/2011TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: % — lZ Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION �Ln
Print
PROPERTY OWNERI t �:,� r_,a t l Unit #
Print
MAP NO: �6 PARCEL: ZONING DISTRICT: Historic District yes
Machine Shop Village yes
100 year-old structure yes
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
f 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
Nater/Sewer
DESCRIPTION
OF WORK TO RR PRRFOurr-Pr)•
�Ji,�u viu
1 Yt_ w
(Identification Please Type or Print Clearly)
OWNER: Name: _1 �,�. t \ Phone:
Address: 271 1) S'r;,.,..,�.fi� davv
CONTRACTOR Name: \Ze,.,�a..".�L...... Phone: 9.11�_
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date: b l 2i l k-7
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.
Total Project Cost: $ p E FEE: $ 13 0
Check No.: 10 7Receipt No.:_-�
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fjmfid
Signature of Agent/Owne r,_(Jrv:�r .Signature of contractor
Location
a7
No. 7 7 — �2 Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 16 7 7 5
24664 Building Inspector
r
Plans Submitted ❑ Plans Waive 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
PLANNING & DEVELOPMENT11
COMMENTS
CONSERVATION
COMMENTS
DATE REJECTED
DATE APPROVED
11
Reviewed on Signature
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Planning Board Decision:
Conservation Decision:
Comments
Comments
ing Decision/receipt submitted yes
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site yes
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Located 384 Osgood Street
no
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 2011 June/mi
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
Doe: Doc.Building Permit Revised 2008mi
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Address: Wov
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Are you an employer? Cheekthe-appropriate bo= -Tgpe-of
project (required):
1 *1 am a etit er with 4. :I°atn a general contactorand I
_:6._ -Q Neer consoactian .
eatployees (fan and/or part -UM)." have hired the sub-contrac�nrs:
2. ❑._ Y am a sole pniprieloraz partnpa- - _ =- listed an the attached.dp . # ..
713Remodeling
ship and have no employees These sob-contrwims have
8. ❑ Demoiii6n
woddag. for me in any capapitY wo&=' �o�• msmnnce`
9. ❑ BWIdmg additma
(No workers' oomtp. insurance. 5., -El We Area- and -its
10:� epaus or additions
��-} ' -6 have exercised their <
3. ❑ 1 ram a Avner doing all work sight°ofiexemgtion pear m(I
-= 2 i:Cj P.bu bing_repairs or additions
.: , c. 152, §-I(4), and m►yseli [No wo�cers comp.
12:�'Roof iepaas. �:
msmamce reduu'ed-j # eP�OYoes- hd°'wodC'ers'
'c'-�: insurance requirodj
►Aup applicemt that chedt� bax #i.ma�stalsa fit!"the,sw ion blow dwwkg thea waft= eon Po�Y
# Homaowneis Wbo saba$tthis of xUvitk&catmg $epiate doing all wa& =dftn bine QUW& 6M9MCt=Mao sdurdt anew affidavit..: sWIh
=C �e#i3ieelc 8nsbo�tstenad�tia�i shee�s>a�eneroe ofSie s and�enr woo�as' cv�mg.pofiry unfo�crmoian
I am an rrnPloy'ey` isp>aotadurgworkera carapon ursunwrcefor.my.. Below.is poti�y erE�%o_ B srts
informatfoa. �' r1 .•
insurance Compaly
Policy # or Self -ins. Lie.
Job Site Address: 2 '2 ►a E.":s �'f�+.�.�.:,� CifylStatalZip: &lr 4 f�
Attach a copy of the workers' compeasatou poliep declu^ation Page(shote the Policy nnieber and eapiratiton ate):
Failure m secure coverage as required unft Section 25A of MGL c.152 caa.Iead m theme of rrhminal.penalties-`of a
fine w 51,500:04 andlor one- as wen;ass.civil m-the-form.of a STi3P WORK ORDER and a Jne-
up year' mtpz>so�mment penalties: .
of up to $250.00 a day against ibeviolator: Be.advised fltat a =
arPy of this statement be faiwatded � ffio Office of
may - _ .
imvestigations of the DIA for irmuzow coverage verification -
1 do kereby certify u h _ pins and penalties ofpopay thatthe infwmadon prapided ab+r m isDireand correct;
Of wjd use onl}c Do not write in this area, to be cemplettd hy. orfe m:qf dkL
City or Town: Permiaeease-#
issuing Authority (eirde one):
1. Board of Health 2 Building Degartmea 3- Ckyt-r-mm;.7 ietit 4z Electrical u1ARm w S. Plumbing Inspector
6. Other
contactPeru; = Pttn+e}
07/1112011 07:45 9786833147 PAGE 01/01
CERTIFICATE OF LIABILITY INSURANCE 11/11/2011
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Kevin MuEphy,
Building Contractor
Proposal
To: Jim & Jackie Driscoll
27 Davis Street
North Andover, Ma 01845
From: Kevin Murphy
CC:
Date: 12/13/2011
Job: Pantry / Laundry
Date of plans: None
Architect None
Location: Same
Section I - Work Schedule
• 169 Boxford Street
• North Andover, MA 01845
• PH: 978-688-6335
• FAX: 978-688-XXXX
All Home improvement Contractors and Suboartractors
ergaged in home Innpravement contracting, unless
specifically exempt from registration by Provisions of chapter
142A of the general lags, must be registered with the
Conmiornveafth of Massachusetts. Inquiries about
registration and Status should be made to the Director, Home
Improvernent Contract Registration, One Ashburton Place,
Room 1301, Boston, MA 02108.(617)-727 8598
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 1024/11.
Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 12131/11. The owner hereby acknowledges
and agrees that the scheduling dates are approximate 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 fumished 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
Building Contractor
169 Bodord street
North Andover, MA 01645
PH: 9786865335
FAX 978688)000(
General
Page 2 of 4
Proposal is to renovate/ finish existing 8'x12' pantry area. Building permit will be provided by contractor.
Demolition
Demolition will be performed by owner.
Building
All framing and siding materials required to fill in old stair opening, frame down ceiling, build any pettions and
install new window will be provided. One new Anderson TW400 series doublehung window will be supplied and
installed.
Plumbing
Plumbing required to add laundry connections and run line for ice / water maker in kitchen will be provided. No
allowance has been made to add a utility sink, or any other plumbing.
Electrical
Electrical work required to wire room to code will be provided. Any surface mounted fixtures ( ceiling light / wall
sconces) will be supplied by owner/ installed by contractor.
Heating/Air Conditioning
Forced hot water baseboard heat will be added as required to properly heat room.
Insulation
Renovated areas will be insulated to meet code.
Plaster
Renovated areas will be blueboarded and skimcoat plastered. Walls and ceilings will be smooth.
Interior Trim/Doors
No allowance has been made to supply or install any interior trim or doors.
Waste Removal
Any construction debris will be disposed of by contractor.
Items Not Included
There have been no allowances made for any interior trim, doors, interior or exterior painting, or flooring
Interior trim and door can be supplied and installed for an additional cost of $1200.
Kevin Murphy
Building Contractor
169 Boxford street
North Andover, MA 01845
PH: 9766886335
FAX 9786WXXXX
Section IV — Price Schedule
Total
9�
Page 4 of 4
We hereby propose to furnish material and labor — complete
in Accordance with above specifications for the sum of .....................................$ 101800
Payment to be made as follows:
Percentage/item
Description
Amount
1
Permit obtained
$1800
2
Window installed / framing complete
$4000
3
Plastering /job complete
$5000
3
$10,800.00
Notice: No agreement for Home irtprovement contracting work shall regime a down paymerd (advance deposit) of more Drat one4wd of the toW oorWad prim of the bW amoiul of an deposits or
payments whidr the M*adm must make, m a Nar>ce, to order andlor otherwise obtain delivery of spedat order materials and egrdpmerd, whidrever is greater
Contractor: Kevin Murphy
169 Boxford 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
Signature,
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
'�'-D' "-� C-*-kk
Date k 2:::j 13
Data