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HomeMy WebLinkAboutBuilding Permit #599-13 - 280 CANDLESTICK ROAD 3/7/2013 -7--13 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIO �` 1 Permit N0: 5� �� Date Received Date Issued: ' IMPORTANT:Applicant must complete all items on this page UOCATION -= .Punt. l �RROPERTY OWNER _IZoGcr _A +J _ v_� �Pnnt� .� a100 Year}Old St�ucfure eyes MO O` PARCEL oZ,!�. ZONING DISTRIwCT _ HistorrclDistrct _ _ �Mach(rje�Sliop Village ,yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building '�)One family . ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other :"Septic ❑,1Nell x�4Floodpla n Weflanos 4_ 1❑ Watershed District Awrto`/Sewer t w 22 57 DESCRIPTION OF WORK TO BE PERFORMED: � Identification Please Type or Print Clearly) OWNER: Name: t�51crr �,.-�e-,-56,-J Phone: 132-o-'5- Address: 2_J' 17 -x tCONTRACTORa�Narrie �.��..... rl�.-r tPhone. - _ _ �Adtlress t a�r-.e;rTi Sri-� tip. lR�. S,uperyisor's"C onstructionLicense _bS3 U� Ex date- �_- f Home ImprovementtLicee _ T`4.l`Pi" -`'l _ exp �Datew ARCHITECT/ENGINEER tw vie 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: $ 33, 020 FEE: $ 31�\Z' Check No.: I© Receipt No.: Z �o NOTE: Persons contracts 'th unregistered contractors do not have access to the guaranty fund r--rii!'S'� - ."Signature of Ag .>+ : �. _ - z.r�. i:gt'nfaggy,i wrie ­12�f - fef6 Plans Plans Submitted ❑ Plans Waived Certified Plot Plan 11 Stamped Plans x h- , . . u .. .. - .._.. .. .. . Y 4'--'" - -.ti-. - ... .r - .N �{y .� �T ..., ., y , .. .. ... Y r-. - .St :v+.....- ,., _ i Y r .. .... .. .. -.' a . t. r :.;:. ..: _ - �. cr .... .. _ '�_' . m .,,�, .r...+ {'r ++R+!'.+Jiew�4'•"r '+i'TSF'.r''�/'�".'�irw�^.,�"'T."`r�—'.-. ..r._.. •1.'+'a•..�—�.r'.-'r. r7 4 .. - .. - c.. Location No. �' Date I _ TOWN OF NORTH ANDOVER 5� � �% ,�.� • _; Certificate of Occupancy $ k...�.' T k �, - t,a. C , $�� vv .'S br ..'�I. `r r3� Building/Frame Permit Fee +ate as ; K y, Foundation Permit Fee $ ""� Other Permit Fee $ . TOTAL $ s t Check#� � *, `--�, . 26 96 Building Inspector . T.... _ +fc!.x+. k-.ate .„..•x '» �. ..:. "-nom••- .+rt---` - _ _ _ .'': # - _ - i y r. - .. .:-:.... t - - ......_. -: ... ... .. .. .. Y r r-.,i�- ___._._ iti .._. -..-._.: L - - s:.__..—. _._ _.�:.:_ ... �. .. ._.. r :- .. _: _. .�..... -._ _ _ _ _ +5.a' ':k !: .....- �. .n. :..... - -.....c..;. . ._ .:. ... .. - ." -.. _ .. :-:_ .. .. ..,. - . ...sz. y ::3. :. - .. :r_: , .. _w . _ _ x .. .,:. .,.. _ -.:. ._. :;; r. e t. x. 4�F'.: t - T.'.. .y:,1: :., .. .::3 r :.�...- :....: .. .: .. �t. .A' '1 -.- - ',. M..,. .-i 'k •. Plans Submitted ❑ Plans Waived 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Siqnature 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 i Water & Sewer Connection/Signature& Date Driveway Permit DPW Thud, Engineer: Signature: Located 384 Os o d Street FIRE DEPARTMENT- Temp Dumpster ons ite yes no Located at 124 Mam'Street:• Fire Depai-t'ment signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Motor 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 2010 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 a Building Permit Application a Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract —_ a 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 subm:ated with the building application Doc: Doc.Building Permit Revised 2012 NORT1i oven of � � E :_ 1, ndover o :, - "t No. r) co� .. h ver, Mass, C0C"1C"2_.CNP�1_AERATED 1'P ,�GJ S U . BOARD OF HEALTH Food/Kitchen _PERMI� T T LD Septic System 0. Q��a.4. THIS CERTIFIES THAT ...................... .... ... ...rJ' .140.................................................. BUILDING INSPECTOR r n - ,/r " Foundation has permission to erect ........................... buildings on ... .... .:G�! L.4L..S. �C•� ••••••••.••.••••• 2�— � �?`�®o� N................. •• Rough to be occupied as C<— � . `'— . ...."". 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final 3�� • PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT T RTS 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. Smoke Det. SEE REVERSE SIDE The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Blectricians/Plumbers Applicant Information Please Print Leibly Name(Business/organizationadividual): Address: '�2 hw'e_S S-,— / City/State/Zip: r Phone#: L!a• 15 Are you an employer?Check the appropriate box: Type of project(required): 1.-6 I am a employer with t 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet 1 ?•`�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 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.E]Plumbing repairs or additions myself.[No workers'comp. c.em l52,§1(4),and[No workers'have no 12.[]Roof repairs insurance required.]t empoyees. 13❑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 are doing all work and then hue 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: l ' Z - lr�.C. l r?g 3 Policy#or Self-ins.Lic.#: �L L U U Expiration Date: Job Site Address: 'Z, tG 1) ��- ����`��` Q-�'t~K City/State/Zip: tlu 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 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 hereb cerfify under the pains and penalties of perjury that the information provided above is true and correct Signafore: Date: Phone#: 3 3 E 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#: DATE(MMIDD/YYY`/) .' CERTIFICATE OF LIABILITY INSURANCE 12/4/2012 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 HOUR. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the porny(ies) must be endorsed If SUBROGATION IS WAIVED, subject to' the terms and conditions of the policy, certain Policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder in fiieu of such endorsernent(s). PRODUCER NAME M P ROBERTS INS AGCY INC PHONE 978 683-8073 1(a"xc,No}:(978)683-3147 1060 Osgood Streetsandi@mprobertsinsurance.com . North Andover, MA 01845 911SUREMS) AFFORDING SAGE NAICs INSURER A: PROVIDENCE MUTUAL INSURED KEVIN MURPHY BUILDING & REMODELING INSURER a: MERCHANTS INSURANCE 98 FOREST STREET INSURER c: GUARD INSURANCE INSURER D: NORTH ANDOVER, MA 01845 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWfTHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VNTH 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. INSR SUBR TYPEOFINSURANCE (MMUDD(YYY) (MMIDD/WYY) L7R yyyp PDllCYNUMBER LIMITS GENERAL LIABItm EACH OCCURRENCE_ $ 1,000,000 X COMMERCIAL GENERAL LIMLITY PREMISES(Ea om,renoo) $ 500,000 CLAIMS MADE l"+OCCUR MED EXP(Any onepersan) $ 15,000 A BOPI068945 1/22/12 1/22/13 PERSONAL&ADvINJURY $ 1 000 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE UMIT APPLIES PER, PRODUCTS-COMP/OP AGG s 2,000,000 POLICYESC LOC $ AUTOMOBILE LIABILITY accident) $ 1,000,000 ANYAUTO BODILY INJURY(Perpersar) $ ALLOWNED SCHEDULED MCA7013608 1/23/12 1/23/13 B AUTOS AUTOSaccident) aODILYIMIURY(Per $ R NON-OVN9ED PROPERTY DAMA $ HIRED AUTOS AUTOS (Peracadent) UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAR I ICLA""-AADE CUP9145304 1/22/12 1/22/13 AGGREGATE $ 1,000,000 DED RETENTION $ $ WORKERS COMPENSATION $ I v-STA AND EMPLOYERS'LIABILITY YIN ER ANY PROPPoETDWPARnmmIFxEcvIIVE ❑ NIA E.L.EACH ACCIDENT $ 500,000 C (�excw�z KEWC317800 7/01/12 7/01/13 ELasEASE-EAEMPLOYEE $ 500,000 DE SCRIFTIONOFOPERATIONS below ELDISEASE-P iicyLMiT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS IVEHICLES(A�dI ACORD 101,Addif mW RemeftSd�dute.0 mom;p is required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WTH THE POLICY PROVISIONS. AUTHORIZED REW ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD Kevin�,�j���,�,� 98 Forest Street• i 1 Mr hr-yr North Andover,MA 01845 • PH:97&688-5335 Building Contractor 0FAX:978.688-7207 � Proposal To: Roger Anderson 280 Candlestick Road All Horne improvement Contractors and Subcontractors engaged in home rtnprvement contracting,unless North Andover, Ma 01845 specifically exempt from registration by Provisions of chapter 142A of tlx:general laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Imprrnerned Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA 02108.(61 7}727 8598 CC. Date: 3/7/2013 .lob: Reside house Date of plans: 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 3/11/13. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 4/25/13.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 famished 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 111-Scope of Work Page 1 of 4 r Kevin Murphy Page 2 of 4 Building Contrad" 98 Forest Street North Andover,MA 01845 PH:978688-5335 FAX:978 SW7207 General Proposal is to strip and reside existin house. Building permit will be provided b contractor. 9 9P P Y Demolition All Masonite siding will be removed and disposed of. Building House will be wrapped with Tyvek or equivalent. Cedar Impressions ( vinyl shingles ) will be supplied and installed on the front of the house. Standard vinyl siding will be supplied and installed on the sides and rear of the house. Color to match. Waste Removal All demolition/construction debris will be disposed of by contractor. Kevin Murphy Pa e 4 of 4 Building Contractor 9 98 Forest Street North Andover,MA 01845 PH:9786885335 FAX 9785887207 Section IV—Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ...... ... ... ... .......$ 33,000 Payment to be made as follows: Percentage/Item Description Amount 1 Permit obtained $3000 2 Two sides complete $15,000 3 Job 100% complete $15,000 Total 3 $33,000.00 "Notice:No acpeernent far Home improvement contracting work shall require a loon payment(advance deposit)of more tot one thud 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 Signatu Date l Signature Date