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HomeMy WebLinkAboutBuilding Permit #608-15 - 28 CABOT ROAD 1/16/2015BUILDING PERMIT O� t�eo ,6'9\ TOWN OF NORTH ANDOVER c APPLICATION FOR PLAN EXAMINATION ~ Permit No#: Date Received A 74A�R.tros 11PP`y.t5 Date Issued: IMPORTANT: Applicant must complete all items on this page I:. LOCATION " ., P.ThO !PROPERTY 01/1/NER_- �� ��I '�_ Y- r 00 �.r— i ��` -� Pnnt� - Year`Structur. e yes' o MAP,. _ �� . PARGEL d23 ZONING DISTRICT, Histonc Distncf yes tMachiM �Shop,V llage Ves` ' TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 150ne family ❑ Addition ❑ Two or more family ❑ Industrial 1$Alteration No. of units: ❑ Commercial CtfRepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other t❑ 1,i,e elle gi0 F o dpl ����Wetlands EWatershed District if f 1Natel /S_ DESCRIPTION OF WORK TO BE PERFORMED: ddX1 ilAS' 121 S O Identi fica, ion - Please Type or Print Clearly OWNER: Name: (c_�A_, fy Phone: -7 l Address: rl?�r� ContcactorName it ;Address ����J� �l ��.��''I•- �Sa }' foie C.'L�._ �3 3 G S3y `7 Exp kDate _ U IR n tf7 't -,-1 s ARCHITECT/ENGINEER I�4 f-'-�_ 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: $ y V FEE: $ 014 Check No.: � Receipt No.: nLO_�o NOTE: Persons contracting w'th unre ' ered contractors do not have access to the guaranty fund- _ _ ._ .---- - --- -- -- -- ;Sighatureof Agent/Ow_n r gnature:of contract Location No. lfN Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ -' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Building Inspector Plans Submitted ❑ Plans Waive Certified Plot Plan ❑ Stamped Plans ❑ TYPE"OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimmning 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 & DEVELOPMENT Reviewed On Signature_ 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 Town Engineer: Signature: Located 384 Os 'Street FIRE6DEP4RTIVIENT=iTernp#Dtampster onsite' ,yes - _Tno n sLocated at 124(Main'tStreet F�tre'Department signature`/date} r F _ ` u� ;COIVIMENTS_ 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 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 ❑ 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 Doc: Doc.Building Permit Revised 2008 O :3O � 2 0 y = < C CO) _v =O' CD n m p 0 � Q- 0 y� Z o =� vi C @ rt Oh O C. Fri CD CD W N O NCD CD CD 2 a p U) C7 to CO). 0 as cy CD 00 cD Z y C = CDS CD O 'a ;z Z '� E c ,c mccs - O r' Q M o� D CCD N C. n c0 OZ < C. O v cpp cn O 0 � • o T� ry y C N N M CDC A•V O l�V. rt < Cl)C_E �� � n , COL6 Q f N oo CD —1 Z FL CD '< N CD O '� vii W :CD 0 � =L. Cl) 0`D 0 = CD ;z —1 Z CL CD � --i� a _ p y bCl)o o CQ. CD ti. Cl)CD CD v O U rt Z C CD r n N :ww o ;0 G) D CD z: �� fes: O m. m CD as o 0' � . C. • O N N W T wT V1 ;aT A T n p T N T 3 p rrDD o r rD CD z c r(D �+ m am D m v o c 3 N O �' m < o c m r- m A m 0 a o c �- r- C W MV A 0 �' ci s o c T c c- O Qp C p Z O D 0 v r, n Ln m 3 o �+ rD W °v O 2 4-6s "M Massachusetts - Department of Public.Safety Board of Building Regulations and Standards Construction Supervisor License: CS -053099 KEVIN W NINWIft 98 FOREST ST North Andover NfA 01 45 f, Expiration Commissioner 06/29/2015 c — .–�--- 7- /. tPom.a°°zurea a�C�/%�a�aaclivaeGta'I Office of Consumer Affairs & Busihess Regulation OME IMPROVEMENT CONTRACTOR Type. egistration: :101874 xpiration: , ---6/29)20-16: Individual 1 KEVIN MURPHY << r Kevin Murphy;. 98 FOREST ST. ga N. ANDOVER, MA 01845 Undersecretary The Commonwealth of Massachusetts Department of IndustrialAccidiias Office of Investigations IF 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leafty Name (Business/Organization/Individual): Address: City/State/Zip: & LVuCPhone #: (,'1 V • 537s Are you an employer? Check the appropriate box: Type of project (required): 1. am a with employer � 4. El am a general contractor and I 6. El New construction ` employees (fall and/or part-time).* have }tired the sub -contractors 2.01 am a sole proprietor or partner- listed on the attached sheet. remodeling ship and'have no employees These sub -contractors have 8. Demolition working for me in any capacity. workers' comp. insurance. 9. E] Building addition [No workers' comp. insurance 5. El We are a corporation and its 10. ❑ Electrical repairs or additions required.] officers have exercised their 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. [i Other comp. insurance required.] -Any applicant that checks box#1 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they hie 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 V+ ,-.o /+ Insurance Company Name:. C__� S �-� -t co 11 1 Policy # or Self -ins. Lic. #: U-1er 'I— C S --t Expiration Date: ,-A Job Site Address: Z, -t— CZ�-,, City/State/Zip: t,1 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL o. 152 can lead to the imposition of criminal penalties 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 hi�eby certify under the pains and -S-)7 ofperjury that the information provided above is true and correct. Date: l LL k Official use only. Do not write in flits 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 M A� CERTIFICATE OF LIABILITY ,INSURANCE DATE(AMIIDDdYYYY) 6I25�2014 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, EXTEND OR ALTER THE COVERAGE 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to the term and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER M P ROBERTS INS AGCY INC 1060 Osgood Street North Andover, MA 01845 CONAMTACT Sandi Munroe N PHONEr No (978) 683-8073 ac ND.(978) 683-3147 L—MAIL: san i mpro ertsinsurance . com INSURERS AFFORDING COVERAGE NAIL& wsURER w MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING 169 BOXFORD STREET NORTH ANDOVER, MA 01845 INSURERB: GUARD INSURANCE jNSURER C: INSURER D: E: INSURERINSURER F COVERAGES CFRTIFICATF NIIMRFR- RF)/ISI()N NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 13ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 TERNS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSD ED L YNUMBER POLICY FF EXP PODQ1Y YY1 LIMITS X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 rX1 PREMISES Ea occurrence $ 50010,00 CLAIMS -MADE OCCUR nEOExP one ersm $ 15 000 [P:�PERSONAL&ADV BOPI068945 11/22/1311/22/14 A INJURY $ INCLUDED GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY [] jE�a 1:1 LOC PRODUCTS - COALY/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ (Ea accident) INJURY (Per person) $ ANYAUTOBODILY MCA7013608 01/23/14 1/23/15 A ALLOAUTONED SCHEDULED X BODILY INJURY (Per accident) $ NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMS -MADE CUP9145304 11/22/13 1/22/14 AGGREGATE $ 1,000,0 DIED RETENTION WORKERS COMPENSATIONX PEAK �H- AND EMPLOYERS' LIABILITY /1 EL EACHACCIDENi $ 500,000 B ANY PROPRIErOR(PARTNER/EXECUTIVE N/A OFFICERIMEMBER E)CLUDED? (Mandatory In NH) KEWC527844 07/01/14 7/01/15 E.L. DISEASE - EA EMPLOYEE $ 500,007 Ifyes, descrbeunder 500,000 O OF IC DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, rrey be attached if more spaces required) CFRTIFICATF Hfll r)FR rANrFI I ATIYIN TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. I AUTHORED REPRESENTATIVE M N PIQ*.- ©1988-2014 ACORD CORPORATION. Ail rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD I � - - - �—F- - - - I � 98 Forest Street Kevin 1 i u P ; U North Andover, MA 01845 1 .J • PH: 978-688-5335 Building Contractor • FAX: 978-688-7207 I Proposal To: Sally Bryan 28 Cabot road North Andover, Ma 01845 From: Kevin Murphy CC: Date: 1/16/2015 Job: Window / siding Date of plans: None Architect: None Location: Same Section 1- Work Schedule All Home improvement Contractors and Subcontractors engaged in home improvement contracting, unless specifically exempt from registration by provisions of Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and Status should be made to the Director, Home Improvement 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 contractorwill begin work on or about 1/1/15. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 2/15/15. 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 98 Forest Street North Ardover, MA 01845 PH: 978688-5335 FAX 97888&7207 Page 2 of 4 General Proposal is to replace existing picture window, and replace siding on rear wall of house. Building permit will be obtained by contractor. Demolition Window and siding will be removed. Building New Anderson picture window will be supplied and installed. Siding will be preprimed red cedar shingles to match existing. Interior Trim/Doors Interior trim will be supplied and installed to match existing. Waste Removal All demolition / construction debris will be disposed of by contractor. Kevin Murphy Building Contractor 98 Forest Street North Andover, MA 01845 PH: 978688-5335 FAX 978-688-7207 Section N - Price Schedule Page 4 of 4 We hereby propose to furnish material and labor — complete in Accordance with above specifications for the sum of ..................................... $ 7000 Payment to be made as follows: ""Notice: No agreement for Home improvement contracting work shall require a down payment (advance deposit) of more that onetwd of the total contract price of the total amount of all deposits or payments which the contractor must make, in advance, to order and/or otherwise obtain delivery of special order materials and equipment, whichever 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 Date dtbb Signature Date,