HomeMy WebLinkAboutBuilding Permit #799-14 - 330 MARBLERIDGE ROAD 5/7/2014t .,
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BUILDING PERMIT
TOWN OF NORTH ANDOVER ° t
f APPLICATION FOR PLAN EXAMINAT ;
Permit NO: '" I Date Received
Date Issued: �9S4ACHUS
IMPORTANT: Applicant must complete all items on this
LOCA
Print�
PROPERTY OWNER �� N$O��t .
�7 Print
MAP NO: 0 ! PARCEL ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New BuildingOne
family
El Addition
❑ Two or more family
❑ Industrial
Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
❑ Water/Sewer
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Identification Please Type or Print Clearly)
OWNER: Name: —�� t4lw6r) Phone: tp1�} as -'103
Address: ,
CONTRACTOR Name: ..1 � Phone: �li"b • `dap" U�;
PjllGl,Vl�,� +yU,SYtws+C
Address:
i3 (ZtvQ,rraoW �ir.. L'%w�S c IUA o1�2�(
Supervisor's Construction License: Exp. Date:
tola�l
Home Improvement License: Exp. Date: t
ltal 25% 0121
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.
Total Project Cost: $ 3D 1 201Q FEE: $ 3�Z•
Check No.: Receipt No.: 2'I c; -4q
NOTE: Persons contracting with registered contractors do not have access to the guaranty fund
Signature of Agent%Owner Signature of contract r
0
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued: .
IMPORTANT: Applicant must complete all items on this page
LOCATION _ -
---
PROPERTY OWNER'
Print, 1:00 Year Old Structure yes no;
MAP NO: PARCEL:.._ ZONING.DISTRICT ,, _Historic District yes no.
— Machine Shop Vilaage yes
.TYPE OF IMPROVEMENT.
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Assessory Bldg
❑ Commercial
❑ Repair, replacement
❑ Others:
❑ Demolition
❑ Other
❑Septic ❑ Well
❑ Floodplain [dWetlands
0 Watershed District'
11 Water/.Sewer
DESCRIPTION OF WORK TO BE PEK1-OKMtu:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Arirlracc-
ARCHITECT/ENGINEE
Address:
Phone:
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: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
Sign ur of Agent/Owner''_ _ SgturP cf ontracto .�_
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
Building Department
The fol!''. W" g is'a list of he required.forms to befilled out -for: the appropriate. permit to.be obtained.
Roofil,g, Siding, Interior Rehabilitation Permits
Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/O'r" 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
L3 Workers Comp Affidavit
o 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)
o 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)
o Building Permit Application
o Certified Proposed Plot Plan
o 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 cas<s if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the apwr al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be subm.tted with the building application
Doc: Doc.Bui?ding Permit Revised 2012
Plans Submitted ❑ ".PlansWaived ❑ -..:'__.Certified Plot Plan ❑ . Stamped Plans ❑
. -TYPE-OF-.SEWERAGEDISP.OEAL"
Public Sewer ❑
Tanning/MassageBodyArt ❑ ..
Swimming Pools ❑
Well ❑
Tobacco.Sales 0
-Food Packaging/Sales ❑
-Private:(septic tank, etc__
permanent D'iimpster on-site
THE_.FOL'LOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT'
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
DATE REJECTED
❑
DATE ,APPROVED
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
- Planning Board Decision:
Conservation Decision:
Comme
:Comments.
Water & Sewer Connection/Signature & Date Driveway Permit
DPW 'I owe Enganeer: Signature:
Located 384 Osgood Street
FIRE DEPARTM AT Tetiip Dumps er on site .yes no
Fire ®e'partme►�t signatare/date ' ; . ,-
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
_Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location-, 'niast-or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONELITERATURE: 'Yes No
MGL-Chapter, 166.Section21A-F and G min.$100-$1000.fiine
F
r y i t5 and UA I A — (1 -or department use
D Notified for pickup - Date
Doc.Building Permit Revised 2010
Location��
No. [— I j Date
Check #
27549
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $�
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Qv
Building Inspector
A.
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ 30,206.00
m
$ -
$
362.47
Plumbing Fee
$
45.31
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
45.31
Total fees collected
$
553.09
330 Marbleridge Road
799-14 on 5/7/2014
Bath Remodel
Enter construction cost for fee cal -
North Andover Fee Cakulation
Construction Cost
30,206.00
m
$ -
$
362.47
Plumbing Fee
$
45.31
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
45.31
Total fees collected
$
553.09
330 Marbleridge Road
799-14 on 5/7/2014
Bath Remodel
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Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
y Construction Supervisor
License: CS -101971
BRANDON D NEW -HOUSE'
4106 ARCHSTONE AVENUE
TEWKSBURY Na' 01876
�i X44 Expiration
Commissioner 07/26/2014
��.e �pomvn�,00u�seal� o��uoaac�utaeC�a
Office of Consumer Affairs & Business Regulation
VME IMPROVEMENT CONTRACTOR
,relgistration: ;.fi67257 Type:
piration: _:8/2412{1-14,k DBA
SUPERIOR KITCHENS&=BATHS � ,`,-�
BRANDON
13 RIVERMEADOW DRIVES=-.
CHELMSFORD, MA 01824" Undersecretary.
TY-� Rt r �r-r � �r.�•�•r rti �r ti r_-�. L��' tai r rs� •�v--L � fl►�.S i�f 1�i�-�
superiorkIiteme,02 7r7s, com,
CONTRACTOR AGREEMENT
THIS AGREEMENT made this 3rd day of April, 2014 by and between Brandon and Jane Newhouse,
hereinafter called the Contractor, and Gina and Jason Newton hereinafter called the Owner.
WITNESSETH, that the Contractor and the Owner for the consideration named herein agree as follows:
ARTICLE 1. SCOPE OF THE WORK
The Contractor shall furnish all the materials and perform all of the work shown on the drawings and/or described
in the specifications entitled Master Bathroom Work Order, as annexed hereto as it pertains to work to be
performed on property located at: 330 Marbleridge Road North Andover, MA
ARTICLE 2. TIME OF COMPLETION
The work to be performed under this Contract shall be commenced on or before May 5a` 2014 and shall
be substantially completed on or before June 6th, 2014. Time is of the essence.
ARTICLE 3. THE CONTRACT PRICE
The owner shall pay the Contractor for the material and labor to be performed under the Contract the sum of
Thirty thousand two hundred six dollars ($30,2o6) subject to additions and deductions pursuant to
authorized change orders.
ARTICLE 4. PROGRESS PAYMENTS
Payments of the Contract price shall be paid in the manner following:
1sT Payment - $3,000 Nonrefundable deposit to hold date due at contract signing
2"d Payment - $7,735 Due on start date
3rd Payment - $7,735 Due after passing rough inspections
4th Payment - $7,735 Due after file installation
Final Payment - $4,000 Due at project completion
ARTICLE 5. GENERAL PROVISIONS
1. All work shall be completed in a workmanship like manner and in compliance with all building codes
and other applicable laws.
2. To the extent required by law all work shall be performed by individuals duly licensed and authorized
by law to perform said work.
3. Contractor may at its discretion engage subcontractors to perform work hereunder, provided
Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper
completion of this Contract.
4. Contractor shall furnish Owner (upon request) all appropriate releases or waivers of lien for all work
performed or materials provided at the time the next periodic payment shall be due.
5. All change orders shall be in writing and signed by both Owner and Contractor.
6. Contractor warrants it is adequately insured for injury to its employees and others incurring loss or
injury as a result of the acts of Contractor or its employees and subcontractors.
7. Contractor shall at its own expense obtain all permits necessary for the work to be performed.
8. Contractor agrees to remove all debris and leave the premises in broom clean condition.
9. In the event Owner shall fail to pay any periodic or installment payment due hereunder, Contractor
may cease work without breach pending payment or resolution of any dispute.
io. All disputes hereunder shall be resolved by binding arbitration in accordance with the rules of the
American Arbitration Association.
ii. Contractor shall not be liable for any delay due to circumstances beyond its control including strikes,
casualty or general unavailability of materials.
12. Contractor warrants all work for a period of 12 months following completion.
ARTICLE 6. JOBSITE EXPECTATIONS
1. Homeowners are responsible for any pets(s) on premises. All pets should be contained in a separate
part of the house during all phases of project. Contractor, employees, & subcontractors may not be held
responsible for pet(s) left unattended for duration of remodeling project.
2. Contractor does not assume liability for pre-existing problems found during demolition phase.
Existing conditions of structure are assumed to be adequate unless otherwise noted by homeowner.
Leveling of pre-existing walls, ceilings, and floors is not assumed to be included within unless otherwise
specified.
3. Area where work is to be performed is to be cleared by homeowner of all belongings prior to project
start. A fee of $50 per 1/2 hour will be charged if responsibility of clearing the area is left to Superior
Kitchens & Baths employees. Damage from dust & demolition to objects left in work area by homeowner
is not Superior Kitchen & Baths responsibility.
4. Homeowners are not permitted to observe within immediate or adjacent rooms while remodeling is in
progress. Superior Kitchens & Baths and its employees and sub -contractors are to be allowed to work
uninterrupted within the immediate project boundaries. Inspection of job site by homeowners is
permitted after jobsite has been cleaned and remodeling has ceased each day.
5. Homeowners are not permitted to help with remodeling process unless otherwise noted.Superior
Kitchen & Baths does not assume liability for injury to homeowners performing work on the job site.
6. By entering into this contract, the homeowner(s) acknowledge that adequate time must be
allocated with respect to selection of finish materials in preparation for project start date.
These materials include, but are not limited to, appliances, electrical fixtures, plumbing fixtures, cabinets,
etc. Superior Kitchens & Baths, at its own discretion, will aid in locating & choosing any of the items
listed. The ordering & delivery of items in time for the project start date is the homeowner's
responsibility. Homeowner(s) understand that selection of finish materials directly impacts the project
schedule and all related contractor & sub -contractor obligations to the project. Any delay of project start
date and any subsequent delay of project schedule due to failure to have necessary materials available to
Superior Kitchens & Baths will result in a non-negotiable $40o re -scheduling fee (per separate project
delay).
7. Project scheduling is sole responsibility of Superior Kitchens & Baths. Though homeowner suggestions
are taken into consideration with respect to the schedule, Superior Kitchens & Baths reserves the primary
role in the schedule decision making process. If owner delays projects due to personal preferences on
scheduling or by refusing entry to Superior, its employees or subcontractors, the owner will be charged at
$400 per rescheduling fee until reentry is allowed.
8. If, during our team meeting, our plumber or electrician's estimates come in higher than what we
initially estimated their portions to cost, this contract is void and home owner's deposit will be refunded.
ARTICLE 7. ADDITIONAL NOTES
Signed this day of April 3rd, 2014
Gina Newto ,Homeowner Date
Jason N on, o er Dat
" Ir`
IrrarldoAlNewhouse, Contractor Date
r
Al
i
Marciano Plumbin
Saugus, MA
617-775-7335
TD Electric
Tom Donahue
42 Fulton Street
Medford, MA 02155
617-718-7344
The Commonwealth of Massachusetts r Print Form
Department of Industrial Accidents
Office of Investigations
- I Congress Street, Suite 100
Boston, MA 02114-2017
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Brandon Newhouse dba Superior Kitchens & Baths
Address: 13 Rivermeadow Drive
Citv/State/Zip: Chelmsford, MA 01824
Phone #:978-806-6857
Are you an employer? Check the appropriate box:
1. I am a employer with
4. Q✓ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2. I am a sole proprietor or partner-
listed on the attached sheet.
ship and have no employees
These sub -contractors have
working for me in any capacity.
employees and have workers'
[No workers' comp. insurance
comp. insurance.:
required.]
5. We are a corporation and its
3. 1 am a homeowner doing all work
officers have exercised their
myself. [No workers' comp.
right of exemption per MGL
insurance required.] t
c. 152, § 1(4), and we have no
employees. [No workers'
msurance
Type of project (required):
6.
New construction
7. 0✓
Remodeling
8. _
Demolition
9.
Building addition
10.
Electrical repairs or additions
11. _
Plumbing repairs or additions
12._
Roof repairs
13.
Other
*Any applicant that checks box #I 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 state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: AIM Mutual Insurance
Policy # or Self -ins. Lic. #: WCC -500-5012548-2013A
Expiration Date: 10-1-2014
Job Site Address: 330 Marbleridge City/State/Zip: North Andover, MA
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 hereby cedj&,uudq the paigd-andVenalties ofperjury that the information provided above is true and correct.
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 #: