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HomeMy WebLinkAboutBuilding Permit #169-13 - 280 CANDLESTICK ROAD 8/29/2012 NORTJI q BUILDING PERMIT 0* tLEo ti TOWN OF NORTH ANDOVER - APPLICATION FOR PLAN EXAMINATION y r Date Received Permit NO• �9SSgcHus���y Date Issued: c r�-- IMPORTANT:Applicant must complete all items on this page MAPNO: � iARCEL� �� ®N�I ®ISTR ZI;CT �� y #Historic Distract C es achin Vill es, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building '6 One family ❑Addition ❑Two or more family ❑ Industrial -iAlteration No. of units: ❑ Commercial Il Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other ,�,S.eptic� Well� r ���Floodpla,�n t��Wetlands u� �®t Watershed D strict r t; _ _ P DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: J!J Vj 33 5"- 5-2-05- Address: Za5Address: 0 Cd. �" ack �z..� s N'u^.. �+':"Y` - r•�q�ww -�-.v.��.c �a+y- -L -•' r: ++.may y _.g. .g.. rte.=� ,4,.__.'•yY _y-, C'�i N,TF &TOR �Name- L_ L �. lk.:..,:� ..,r� .�; Phone �i't' S33 h/{) � �Adtlress +\'43s a V.4'G Q.�► J ..33•l l�..'t� ^ S ��ai�� _. � �.�/�l'�.. c.V-�+> sat�� �'t �'E'!�'""+'�"�'.'.. ;"'""�""„��.{„S +�. _'.�'-."`� *�-s*� �r �t'''�� P'kF '�;�•"� .�" '.'". it � Supervisors Construction Licensee U3..i?`l` .� Exp� lDate = L'L� L A . : . �� 'a��;'f,a�4-:.+a,IR�"'. , .. .s .. � �-.s.a.=3 ,+4"�.��..�a' :.T�''�'�'-g- �ms^m•..v�-.. _ Home Im rovemen License _ - Ezp �D'ate " ot�Y ARCHITECT/ENGINEER fie. Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ V-k,1013D FEE: $ 2 t Check No.: Receipt No.: �� Z, NOTE: Persons contr 'ng with u egistered contractors do not have access to the guaranty fund ...,. - -'Y 1 _ . .. ....: - - - .. ... . .. - .. - u. ,:.. -. - .:.,.. .. ... - .. .. _ _ .. .. .. is --_ .. .- .. .. - ' .. _ .. - _ ._ - .. 1 ✓ .' S.. p ..... ... J.:. .... -.. .. ..2. ... _ ....: ... x _ .. .. - . 7' _'. _ .. .:_. ..n. ....:.':... .. 1. .. _ h - - ...._ �.: r...tl'Y.'�i`ra'.« 2.y, '.�ti �.rr y.'......�..�..wr l+^ --. - �.�i ." .9r'\v a+ ."v -_+ ...�.-.._. -._�._.__�__.._.�_I ,' ; 741 _%. "i Location hL I . - No. /� Date' 2' r - *f- • �+ TOWN OF NORTH ANDOVER - •? , • z— X16- . LLf ^ . urw Certificate of Occupancy $ r �. �, ' I Building/Frame Permit Fee $9 AL, 'Foundation Permit Fee $ i Other Permit Fee $ t* t _ TOTAL $ '° i - 9 I—.. w. ; -< I Check#44X . ' 7 - . rc :: 's' _...... f Building Inspector .. ' ' 25662 �11 �r r s : f x r ... Ty. .._"�.'. ... A .. .. . _. -... -r;. - a- .. h .-:; I. r ...,-... ... .-: — . .. . a' . :.: ._ e _ �11 —a — 1. . '::,, .ti._ ...Rw.. % s :. - . - - ' - r".. ... .-.. . .:.. ...-.. .. ...1.. 5 h. y ..�. ::: ry �.t , 11, .,,-.: - �. .-. Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody 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 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 Street FIRE DEPARTMEN7� Wemp;Dusteron ` "�Y $` � { inn# r 1� .. ;�. ted at`124 Main Strr,,�e�etR . ' _ � .�� o ,., 71 - �j1 + -m'0. ,+.r. 'y,�c-r r.�`-.:::`._ '.�"x4' s- a z `-�" '+ ♦ -,r. �y, -. '1.� Tll {Fire Department signature/dated _P,.a..,;. ,.4. C,®1111' MENTrS� r :t 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 i 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 MOTE: 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 NORTH own of t ndover o - :... I No. Y , LAM■ h ver, Mass, • 906 COC MICNl WICK A1C, S U BOARD OF HEALTH Food/Kitchen PER IT T Septic System THIS CERTIFIES THAT ............ ..at.. r. ......... BUILDING INSPECTOR has permission to erect g Foundation .......................... buildin son ..� ....... ,�.�lu!!` ,... ...��.�i�. . Rough u h to be occupied as ........ .......:. .... ���.� ........:.��.... Chimney .......... provided that the person accepting this permit shall in every respect conform to the t sof 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR 0 ARTS Rough Service ....... ... ..... ...... 4 ............INSPE................ Final BUIL ING CTOR 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 kvi. www.mass gov/dia Workers, Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: " 10 ,G T— S City/State/Zip: t,� ��,•�vr«� !"L�-. Phone#: q I Are you an employer?Check the appropriate box: Type of project(required): 4. ❑ I am a general contractor and I 6. New construction 1`�(I am a employer with ❑ VV employees(full and/or part-time).* have hired the sub-contractors ? Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet.$ 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 right of exemption r MGL 11.0 Plumbing repairs or additions 3.El am a homeowner doing all work p myself.[No workers'comp. c.152,§1(4),and we have no 12.(]Roof repairs insurance required.]f employees.[No workers' 13.E]Other comp.insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: .► ,f Policy#or Self-ins.Lic.#: �1`yC' C �, U Expiration Date: Job Site Address:, ��a i7 �s—��} 5 %r-LL— L K`eL 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 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. Ido here certify under the pains and penalties ofpe&ry that the information provided above is true and correct Sip-nature: Date: Z 11 L 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 M MM/DDNYYY CERTIFICATE OF LIABILITY INSURANCE 8/7%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 HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(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 lieu of such endorsement(s). PRODUCER WN IAGI NAME: M P Roberts Insurance Agency Inc PHO(AINE ,Ext: 978-683-8073 FAX,No):978-683-3147 1060 Osgood Street ADDRESS: sandi@mprobertsinsurance.com North Andover Ma 01845 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: PROVIDENCE MUTUAL INSURED KEVIN MURPHY BUILDING & REMODELING INSURER B: MERCHANTS INSURANCE 169 BOXFORD 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. 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRNSR TYOF INSURANCE INSR SUBADDL POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,000 ICLAIMS-MADE t "t OCCUR MED EXP(Anyoneperson) $ 5,000 A CPP0060868 1/22/11 1/22/12 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-CAMP/OP AGG $ 2,000,000 riPOLICY E T EI O- LOC $ AUTOMOBILE LIABILITY UumbiNtU ZANULt LIMI I1,000,000 Ea accident $ ANYAUTO BODILY INJURY(Per person) $ B IALLOWNED SCHEDULED MCA7013608 1/23/12 1/23/13 BODILY INJURY(Per accident) $ AUTOS X ALIT PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X WC STATU- DTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/M cunVE Y❑ NIA E.L.IN EACH ACCIDENT $ 500,000 C (Mandatory OFFICERNEin NH)ER EXCLUDED? KEWC3178O0 7/01/12 7/01/13 E.L.DISEASE-EA EMPLOYEE $ 500,000 if yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (AttachACORD 101,Additional Remarks Schedule,if morespaceis required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP VE Jf7 0010 to[ ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD t 98 Forest Set Kevin 1 - 4�# '� hay North Andovveerr,MA 01845 PH:978-688-5335 Building Contractor • FAX:978-688-7207 L Proposal To: Roger Anderson 280 Candlestick Road All Home improvement Contractors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma 01845 sPealicalN exemoftm 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, From: Kevin Murphy Room 1301,tom,,MA 02108.(617)-727 8598 cc: Date: 8/29/2012 Job: Replacement windows 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 9/4/12. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 9/30/12.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 furnished 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 Kevin Murphy Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:9784688-5335 FAX:9784688-7207 General Proposal is to replace twenty doublehung windows, one small casement window, and three large casement units. Building permit will be provided by contractor. Building Twenty Harvey doublehung replacement windows will be supplied and installed.One twin casement replacment window will be supplied /installed over kitchen sink. Two five section, and one four section casement window will be supplied and installed. Exterior trim will be replaced with Azek. Interior trim to remain.All windows will be white vinyl inside and out. All windows will have full screens, and grilles between the glass. Kitchen window will have no grille. Painting No allowance has been made for any painting. Waste Removal All construction debris will be disposed of by contractor. I i Kevin Murphy Page 4 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:97888&5335 FAX 97888&7207 Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ...... ... ...... ...... ... ... ....$ 24,650 Payment to be made as follows: Percentage/item Description Amount 1 Windows dellivered $10,000 2 Job Complete $14,650 Total 2 $24,650.00 *'Notice:No agreement for Home improvement contracting work shall require a dawn payment(advance deposit)of more that one4hird of the total centrad price of the total amount of all deposits or payments which to contractor must make,in advance,to order and/or cthwwise 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 SIG HIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date g I 1 Z— Signature Date