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Home My WebLink AboutBuilding Permit #327 - 27 WEYLAND CIRCLE 10/23/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: -07 o IMPORTANT: Applicant must complete all items on this page LOCATION `? � L/ i C.i „ Awe Pnnt PROPERTYubWNER U . ` -L14 C I� Print MAP NO: PARCEL: . ' ZONING DISTRICT : - Iistoric DiSfiic# y Machine Slag Vi11a` s yes nb p. g Y o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: . Commercial epair, replacement Assessory Bldg Others: Demolition Other Septic W611. �_` Flood P a lain Wetlands ��_` 1IVa#ershecl. p Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name:_&?,(, LA GGA f e- U Phone: Address: CONTRACTOR j :-Phone: Address: 3 � Supervisor'.s.Constrdction License: ' ` Exp. Date:`,, Horne Improvement-License: /gym exp, .late: /a ARCHITECT/ENGINEER �i°�/� 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 C st: $ ,� 1 �7 FEE: $ Check No.: Receipt No.: 2 2 SS�j NOTE: rs s contracting with unregistered contractors do not have access to the guaranty fund gra re of.AgentlOwner' - Signature ofcontractoT ` ; Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL - Public Sewer Tanning/Massage/Body Art Swimming Pools `b 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS M t: 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 Town Engineer: Signature: Located 384 Osgood Street FIRE:DEPARTMENT -TernplDmpstei'on site; fires `trio Located.at'!24'Main Street. 'y " .:Fire Department sIghature/date 1 _ COMMENTS a i Dimension Number of Stories: , Totals square feet of floor area based on Exterior dimensions. q i 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 ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 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 Addition Or Decks ❑ 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 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) Li Building Permit Application o 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) o Copy of Contract o 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 Location No. Z�" Date �oRT� TOWN OF NORTH ANDOVER f - R Certificate of Occupancy $ cMusEt�' Building/Frame Permit Fee $ j Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # S 22559 Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, IWA-02111 www.mass.gov/din Workers' Compensation Insurance MH davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 1A /,L Re Address: / Com/ s h0 RI? City/State/Zip: ksi¢L/,;,m, Phone#: Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.4 I am a sole proprietor or partner- listed on the attached sheet. 1 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working forme 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.❑ Electrical repairs or additions 3.❑ I 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 we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other /fid G comp. insurance required.]. *.:..v applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 penalti8s of a fine 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. I do hereM y u er the pains and penalties of perjury that the information provided above is true and correct Si ature- Date: -G 0 Phone : Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers 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 of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,.or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of.4 deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house 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 or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of 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 performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability.Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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 the event the Office of Investigations has to contact 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 d'iust submit multiple permit/license 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 officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not 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. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us'a call. The Department's address,'telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents. Office of Investigations 600 Washington Street III Boston, MA 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-OS www.mass.gov/dia NORTH 0 0 t over No. a 7 z= LAKE dover, Massj_0 'Doll* Ap COCHICH..CK y1. 7d A014'ATEO `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... ....... ...b ... ............... �.................. ...... "" Foundation has permission to erect........................................ buildings on .. ...0. ......W.. . .......... �.e.... Rough to be occupied as.... ..1........ ........ T..........�&A40-t o.....�.... �.�....... ...� � Chimney Ch' e provided that the pe son accepting this permit shall in every respect conform to the termswf 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 CONSTR S ARTS Rough Service ' BUILDING INSPEC R Final Occupancy Permit Required to Ow cpy 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. iiulyd of Buddrdg�.gglaions and i t-u;.Wb ravj;RENT CONTRACTOR: .1 Regio- tron 103014 ¢;I EXrration:7/67-2010 Tr# .270280 .' Type F r ate Corporati" .1 I n, PHIL LACROtX ` Philip �'r Lacroix�' � 151xSHQ H; AAdn rmsirawr Al S�LEM 0 .X79 ............ _ Massachusms, - Dgmrrttment of Public Safetc Board ofBuildin; Regulations and Standards "Construction Supervisor ,License License: CS 9708 Restricted-to: 00 . PHILIP R ' C JR 151 SI-AF4t6 't w SALEM,NW03 r9 Expiration: 7/5/2011 ('uuuiiissiuner Tr#: 17323 URS S 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 Esq. Date: 1019109 Home Phone:978-557-5435 Cell Phone:978-852-3952 Street: 27 Weyland Circle City, State,Zip: N Andover, MA 01845 Job Name: Repair wall damage Estimate of work to be performed: To repair the south west wall of the above home. Damage caused by.leaking water behind the wood siding,consequently,saturating the aspenite sheating,siding,several studs and window trim. Upon"opening up„the affected areas we noted that two(2)of the step flashing had slid up the roof,opening(1)one,2 W+or-gap and the other, because of this,slid down 4+inches. My feeling is that this was caused by ice damage or ice build up. As to when this occurred is anyone's guess. The scope of the damage leads me to think several or more years ago. We have enclosed a detailed accounting of what we believe will be required to repair ALL the affected areas. r. Materials: $62.26 1).2 bundles IKO asphalt architect shingles @$31.13 per bundle. $69.68 2) 1 roll IKO ice water shield $72.95 3) 1 roll tyvek house wrap $7.00 4)40 pieces 5 x 7 step flashing $18.56 5)Two(2)white aluminum drip edge $47.53 6)Seven(7)4 x 8 x 7/16'aspenite $9.90 7) 1 bundle 1 x 3 x 8'strapping $21.87 8)Nine(9)2 x 4 x 10 $14.88 9) 1 roll R+15 insulation $27.25 10) 1 roll poly film $46.38 11)Sixteen (16)foot 5/4 x 4 x 16 ft x 8 primed pine $68.94 12)Two(2)gallons exterior primer tinted $76.80 13)Two(2)gallons exterior siding paint $37.75 14)One gallon exterior trim paint $125.00 15)Disposal fee 60.00 16) Nails,adhesives,caulking,etc $766.75 36.35 Sales tax on all materials only $803.10 Total materials • Labor $1,050.00 1)Day one-21 man hours $1,200.00 2)Day two-24 man hours $1,200.00 3)Day three-24 man hours $1,200.00 4)Day four-24 man hours $1,200.00 5) Day five-24 man hours $1,200.00 6) Day six-24 man hours $ 600.00 7) Day seven- 12 man hours $ 800.00 8)Day eight-painters 16 man hours $ 800.00 9)Day nine-painters 16 man hours $ 800.00 10) Day ten-painters 16 man hours 400.00 11)Day eleven -painter 8 man hours $10,450.00 Total for above work$11,253.10 plus 10% profit and overhead $1,125.31= $12$ 78.41 i N� l TERMS AND CONDITIONS We Propose hereby to fumish material and labor-complete in accordance with above specifications, for the sum of: 12 378.41 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 / 35%after insulation plywood/35%after siding_/balance after painting All material is guaranteed to be as spedW. All work to be oompleted in a workman Eke 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 cany fire,tomado and other necessary insurance. our workers are fully covered by Workmen's compensation Insurance. Authorized Signature Date ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. /'W/ ", mz; gnature -- Date