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HomeMy WebLinkAboutBuilding Permit #129 - 27 WEYLAND CIRCLE 8/13/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: A plicant must complete all items on this page LOCATION 4 L Iry 6`JL +- Print" PROPERTY OWNER_ . . Pring. MAP NO: PARCEL J ? -Z0NINd DISTRICT: �=Historic District yes r' m Machine Zhou Village fires no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building , ne famil 1 -- Addition or family Industrial Alteration No. of units: Commercial e air, replaceme Assessory Bldg Others: Demolition Other :Septic. Well a Floodplain `c" Wetlands Watershed District Water/Sewer� . ° DESCRIPTION OF WORK TO BE PERFORMED: �) IR /z-one I/6�' /8- /V-V � /Z 1--�/L e � �—moi tyooO -to 41I eliyG, L-0 tv13 0)4� 4-A 2e -tG Identification Please Type or Print Clearly) OWNER: Name- -,t= rt / Phone: G! -, f Address: F " n CONTRACTOR" Marne:P �� ���,,�} PBI J� Phone: r Address:�Cil f11 " % i , !rh-1 / i V.� .4/23 Supervisor's Construction:License.t , Exp. Date: / Home Improvement License.: ` 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. r Total Project Cost: $_ f lTr 'Q. �f FEE: $ Check No.: �7 Receipt No.: a_ NOTE: Persons contracting with un re istered contractors do not have access to the guaranty fund ignature ofi Agent/Owner' Signature of£contract©r , Plans Submitted Plans Waived Certified Plot Plan Stamped Plans i 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 i i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS I, II HEALTH Reviewed on Signature COMMENTS i I� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street .FIRE DEPARTMENT - TempDurnpster on site yes,,_' ' no y Located at 124 Main,Street' -� d � b Fire Department signatureldate ' '§ a, U COMMENTS i Dimension i' Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: i 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) I I - e t ❑ Notified for pickup - Date ..._........................_...._._..._........................................__..............................................._.._...........................................................-----....__.._..............................................._....----._...................:.................._............__._........_.._ ...._.................... Doc:.Building Permit Revised 2008 I 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) b, ❑ 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 t Location a 7 No. Date i ,.oR•� TOWN OF NORTH ANDOVER O • OR M � Certificate of Occupancy $ �cHus E Building/Frame Permit Fee $ s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 7�6 22314 /I Building Inspector a r r- T=7 Proposal Phil Lacroix & Sons, Inc. BUILDER / CONTRACTOR For Over 50 Years 151 Shore Drive Salem, NH 03079 (603) 890-3998 Proposal Submitted to: Ms. Jeanne Colachico Date: 7/27/09 Home Phone: 1-978-55V-5435 Street: 27 Weyland Circle City, State, Zip: North Andover, Ma. 01845 Job Name: Windows + Door work WE herby submit contract for the following work: 1a) To replace (1) one three " lite " door unit with a Harvey (3) Three lite Slider center lite (operates only) with brass hardware and divided grids between the glass/ low-e argon filled insulated glass. 1 b) Above the door we will set (3) three fixed cites to match the lower door units. These windows will be low-e argon filled without grids. 2a) We will replace the present double hung window with a picture window look casement window. The (2) side lites will vent and the center sash will be fixed. These units will have low-e argon filled glass with grids between the glass. 2b) Above this picture unit window, we will set a transom window( as above the door) °i with lites sized to match the picture window in width but height will be + or- 36 inch's. We added grids at our last meeting this will add $ 178.00 per door and $ 87.00 per sidelight. Also add $ 107.00 for the center lite totaling $ 635.00. A credit of$ 101.70 for the slider over the hinged doorwwand addition of$ 684.0 above our quote of$ 15,466.35 + 434.00 for a total of: $ 16,480.65 '30 � $ I 167 00 0 0 �'� lea �l TERMS AND CONDITIONS We Propose hereby to furnish material and labor- complete in accordance with above specifications, for the sum of: $ 16,480.65 Note: This proposal may be withdrawn if not accepted within 10 days. ALL PERMITS AND ENGINEERING COST ARE THE RESPONSIBILITY OF THE PROPERTY OWNER. PERMITS ARE AN ADDITIONAL COST TO THE TOTAL JOB PRICE. Payment to be made as follows: 25% at start/25% During install/25 % at painting stage/20 %when complete, /Balance when done All material is guaranteed to be as specified. All work to be completed in a workman like manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. t nzed Sin re Date ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are a zed to do the work as specified. Payment will be made as outlined above. S' Lure Date Signature Date i 1 ice (:nmrnonweaft of Mnssachusettc Departme"Y of industrial Accidentr Eli'�, Q97ce of Investi;shoos 600 ffarkirrgfan Street MA 62.111 c � w>'srw_�nas.�gov/die . markers' Campe oration 1n9i1rSnee A$daviL, Sanders/Coatractors/Eie . . A cant Information. ctnciaas/plamb-rs 'bt Name (Business orpjzafiom4ndividusl)• l Please Print Le O Address: Citylstafe/ ziF Phone#: . Are you at emPIOYer?Cheek.the a ro PP Priste�boz: ' I ata a employer with 4. Type of project(regi employees(foil and/or— ,� ✓—� a general cotrizactot and I °' part time). have: hired the sub-=Mtactors 6• n New cons�ction . 2.Q I am.a sole proprietor: pier- listed on the attached Remodelia ship and have no empluYeerfi Th_se 3 7. g working for mein sub-contractors have [No worlters' �'capacity. workers' comp.insurance. 8' Q Demolition mp. atria We: are I corporafaon and its 9. Building addition 3•❑ required.] afI•icers have exercised tl►eir I ain a homeowner dcsirrg all work ri ' 1Q•❑"Electrical repairs oradditions myself[No•w.arkers'comp. of cxemPtton P�MSL 11.�]Plumbing insurance.nquired. .t �, 91(4),and-we have no 12. oraddifions .•�Pjoy�s:[No worms' ❑Roof repairs `Any"licamthet eUP• insfineeraquired.] 13.Q.06= aEtecks bo>'t�l mntt also fi[!out the section beitra•showing their worked'o ;Any who stibmtt this efiidavit wicatiteg they eat �j otupensetion poi*information _ 1Caauacmts that dteok this box r uusrattoie:d as edcL-tioas]Rg RD 1" k O-d them hire outside connctara must submit a neiv I �'�•�nmete of die aub.00ntrya And afrtdnvit indicating such•' tae ewloyer butt is Prantiiartrg:reQr&#W„rr ersa � ir work= `x '';mf�ou. irtforrr�ior_ i+istiraRce for azJ'. plmre� o, Insnrartce Corn PoaJ`�:Oad site . parry Name: ' /?/r� rC/ /z Policy#or Se+t`-ins.Lie. Expiration Bete; Job Site Address: Attach a copy of the workers' t:om Pem4atiou Policy declaration page(showing the policy number seed e inn up to secure coverage as required under Section 25A of xpirafion date} . fine up to$1,500.00 and/or one-year im I�14L C. 152 can lead to the imposition of criminal Of up to$250.00 a l�onme�as well a`s civil penalties in the form of a Pmmhim of a. �3 against the vioiairn. Be advised that MP WORK ORDER and a fine lnvestagations of the DIA for ins ersge etin"roti a copy of this matement may be forwarded to the - . of rtrence cov v on. I do hereby certify an the,Peuna and penerlfi�n e Y fP rlrvy tSfi�the information Provided above is toric and o0 Si M4 Date: Phone#: ~i Gell Of reial ase nnty. do not in this asp,riv be conrptattled. ' J or town rte( City or Town:: Issuing Authority(circle one): Permit/License 1. Board of'Health 2 SuMi o De 6.Otbe'r patent 3.City/Tvwa Clerk 4. Electrics!Inspector S. Plum hiv-Iasptxtar Contact Person: Phone#: Information a. tid Instructions Mamsachusetts General Laws chapter I S2 requires all emp Ioyem to provide workers' compensation for their employees. Pursuant to this statute,an w ployec is defined as"..:every person in the service of another under any contract Aire:, express or implied,oral or writienl' An empfayer is defined as"an individual partnership,ami=i6afian,corporation or other legal entity,or any two or mom of the fare in en in a joint enterprise,and includis� the la go g gaged � terpn g c gal ttpresentanves of a deceased employer,ar are mxiver ort mstx•of an individual,partnership,,*,z ciatiazn or other legal-entity,employing etnployees. 'Rowemthe owner of a dwelling house having not more than three apartments and who resides therein, or fire occupant of tfie dwaliing house of another who employs persons m do ma Lmt= ace,cons�vctim or repair w&k an such dwelfthouse or on thegro�iards or building appurtenant thereto shall not b==of such employment be deemed to be an ampioyer." MGL chapter 152,§25C(6)also states that"every state o•z-local accusing agency shat withhold the issuanceor `i renewal of a license or permit to operate a business or to construct buildings in the commonwealth for an applicant who has not produced acceptable evirfeuce.of comprsauee whir the..iusurance coverage repaired." Addit ianal;iy, WQL chapter 152,§25C(7)states`Nmitber t ie commonwealth nor any of its polificel subdivisions shag enter imp any cormmd for the pafomreaice of publiic wane until.acceptabIr.evidence of compliance with the insurmcx requirements.of this chapter have bean presented tn.the carrtracting audhority." Apprumnfs Please.fill out the workers'compensation,affidavit completely,by checking the boxes that apply in.your situation and,if naccamy, supply sub-aontisctor(s)rffime:(A addr ss(et):Slid phone number(s)along with thea carrificate(s)of insurance. Limited,Liability Companies(LLC)or Limited Liability.Pw narsiiips(LLP)with no employees other6am the mcmbars ar.partnem,are nat rcquired,to carry workers'cc>Tnp=Lmdion hwarej e: Van LLC orLLP does have empioyees,a policy is required. Be advised that this afCrd2.vit maybe submitted to the Department of industrial Aecidants for confirmation Ofinsurance coverage. Aim live sure to sign and date the affidavit The affidavit should be retained to the city or town that the application for the permit or license is being requested,not'th Deparfmant of Industrial Aceidants. Should you have any questions.rep -dig the law or if you are required to obtain a warlcers! compensation policy,please call the Department at the nurreber.fisted bolcrw. Self insured c arrparries should entertheir 1` self ixrsraz+ncc license number ansC appropiiaie iir�. City or Town Offeinis Please be sure that the affidavit is complete and printed bgibiy. The Deparnnent hasprovided a space at the bottmn of the affidavit for you to fill out in the even't tlse.Office o f•Investigations has to contact you regarding lb-applicant Please be sura to fill in the iit/licensm number which w-M be used as a reference number. pC1Tn hr addition,an iicarrt . � aPP that must submit,multiple permit/3icensc applications in any given year,need only submit onaaffidavit indiratin -=nznt '.. oft inforrnatian if n and under"Job Site Adria-�" i p c (. ecessw- applicant should write `alt locations in_(city or t"m)"A am of'the affidavit that has bei.offrciaily starrrped or mariced by the city or town may be provided to the applicant as proof that a valid a#�idavit is an rite for fuiwz permits or licenses. A new affidavit must be Med out each year. Where a home owner or citizen is obtairning a license: Or permit not related to any business or commercial vwtrie (i.e. a dog license or permit to bum leaves etc.)said parson is NOT.=Iuir ad to-compidz this affidavit The Of-=of investigations would nice tD thank you in ad�rance for your cooperation grid should you have uestions, Y �Y4 please do not.hesitate to give us a call. Tho Dapamncr t''s address;'teiephone mud fax number. The Commonwea dth of Departinant of Industrial Accidcmts office of Envestig.2fians 600 Washington Sheet Boston, MA 02111 TeL #617-727-4900 i=4.06 or 1-8.77-MASSAFE Fax#61 7-727-774 P_-visa 5-2b-Q5 w-VW.M Is.gavidia From'Natasha NMOLIm Fax!D:Santo Insurance Page 1 of 1 Date:8/12!2009 02:03 PPA Page:1 of i c� CERTIFICATE OF LIABILITY INSURANCE OPID NN PRODUCER THIS CrEIRTIFICATE 15 15SUED AS A DATE(MMfDDMW) PH, 08/11j09 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Santo insurance - Salem HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 224 Main street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Salem NH 03079 Phone: 603-890-6439 Fax:603-890-0315 INSURERS AFFORDING COVERAGE MAIC# INSURED IN;URER.A: Zurich-American 16535 INSURE',B: Nationwide Companies 23787 Phil Lacroix & Sons Inc INSURER c 151 Shore Drive INSURER.D: Salem NH 03079 INSUREF:E: COVERAGES THE POLICIES OF INSURANCE LISTED SELO'VV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REOU!REMENT,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 SUB.IECTTO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR7WE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYIY) DATE(MMIC) AIM LIMITS GENERAL LIABILITY EACH OCCI_RF.=NCE s2,000,000 -1'..h.0`: B k COMMERCIA-GEHERALUAeI-IT1 ACP5303625407 11/29/08 11/29/09 IFtilA:„EMISES(_a"cjrerce) s100,OD0 CLAIMS MADE LX I OCCUR I,MED EXP(Ay,ne Fe-son) S 5,000 FERSJNAL xAD✓!N,URY s2,000,000 GENERAL ACGREGATE 2,000,000 �CE1,'11-LA0GREGATE LIMIT APPLIES PER. FRODUC'TS-COMPi0P A.GG s211000,000 'OLI'DY PRO- LOC JEGT AUTOMOBILE LIABILITY "OMEINED SINGLE LIMIT B ANYAU-o ACP5303625407 11/29/08 I 11/29/09 '(Ea accident) 6500,000 ALL GINNED AJTOS EOGILY INJURY S X SCHEDULED Al-70S (Per pers)n) X -4IRED AUTOS ECCIL`.'INJURY X (Pera;c�dent) $ VOID-OWNED AUTOS I FROPERTY DAMAGE S I(mer ar-cider[) GARAGE LIABILITY I ALSO CNLY-EAACCIDENT S ANY AU-0 OTHER THAN EA ACC S ! ALTO CNL"e. AGG S EXCESS/UMBRELLA LIABILITY EACri OCC�_RPENCE s" IrrOCCUR F7 C-AIMS MADE I I AGGRE3.4TE S S DEDUCTIBLE !S i RE ENT ON $ S WORKERS C MP NSATION YLIN ITc Y!Pd CR_ I E� AND EMPLOYERS'LIABILITY X T _�1 - _ C ANV PROPFIETORIPARTIVERiE(ECUTIVE 6ZZUBS793C09308 10/24/08 10/24/09 EL E Z-ACCIDENT S 1000000 A OFFICERAAEMSEP,EXCLUDED? (Mandatory in NH) I E.L.CISEA.SE-EA ENIFL_)i EE I s 10 00 0 DO 4-yes,describe under SPECIAL PROb'ISIDNSbelow I_L.CIS EASE-POLICY LIMIT I S 1000000 OTHER i DESCRIPTION OF CPERATIONS/LOCATIONS/'VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Jeannne COlachico REPRESENTATIVES. AUTH RIZED REPRESENTATIVE Jason M Mlocek ACORD 25(2009101) ©1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NORTH TOANM O `` 4 Ove r 0 4 , &L nn No. Id- 9 -_Tpia Wkr yy 4�, *. dover, Mass.,TO COCMICKE WICK V A004TEO `S BOARD OF HEALTH PERMIT . T D Food/Kitchen Septic System THIS CERTIFIES THAT i�r '�'�''� COZ46C� 110 BUILDING INSPECTOR Foundation w has permission to erect........................................ buildings on ...a?e14-" ...... /. N :..................................... Rough tpoor— o be occu ied aS /�C0e.� l- /c:�� ��= Chimney ............................... ....1....................................................................................... y provided that the person accepting this permit shall in every respect conform to the terms of the application on 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. - •- Massachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 9708 _ Restricted to: 00 PHILIP LAR V(JR 151 SWO D SALEM,NH'03 '9 --�- �` Expiration: 7/5/2011 ('unnnissiuncr Tr#: 17323 ✓tie "+ovrvrreoortuP¢C�%z_oy✓�//aaecu�uaeC�d - Board of Ruildinj;Rgu.la{ions an Standards t .,,-IIVP :i'"E iAENT CONTRACTOR. q - Re ls.tratio► , } 9 a 1C3014 (= -- Expiration ,:7/GL2010 Tr# 270280 Type -'Nifvbte Corporation i PHIL LACROIX&SONS INC Philip,dr. .Lacroix, 151 SHORE DR SF:LEM G'C79 Administrator