HomeMy WebLinkAboutBuilding Permit #994-2016 - 338 BLUE RIDGE ROAD 3/23/2014i� A41�� tP
Permit NO: A
Date Issued: 3 /4.
LOCATION
PROPERT
I
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
I IMIPORTANT: Applicant must complete all items on this va2e
- Pnnt
MAP NO: 065 PARCEL:6/7J ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
El New Building
0 One family
El Addition
El Two or more family
0 Industrial
'lAlteration
No. of units:
11 Commercial
El Repair, replacement
El Assessory Bldg
El Others:
[I Demolition
El Other
Ll Septic 11 Well
Ll Floodplain 11 Wetlands
El Watershed District
0 Water/Sewer
OWNER: Name:'�'Oi,-)\ --v
Address:
CONTRACTOR Name:
Address:
Identification Please Type or Print Clearly)
Phone:
� �w o-6')'3 -4
Supervisors Construction License:,Q��C.-) Exp. Date:
Home Improvement License: Exp. Date:
ARCH ITECT/ENIG IN EER Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT.- $1100 PER $10W -W OF THE TOTAL ES77MATED COST BASED ON $125.W PER S.F.
Total Project Co : $ aCQ, Cc FEE: $ ld�l
t4y _'
Check No.: Receipt No.: -7.J
NOTE: Persons contracting with unregistered contractors do not have access to the rantyfund
8ignature of Agent/Owner Signature of cont-rac:
9 %-t
16 "d
a t
BUILDING PERMIT
TOWN OF NORTH ANDOVER
0
APPLICATION FOR PLAN EXAMINATION
Permit No#: Date Received ATED
Date Issued: PORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
Print 100 Year Structure
PARCEL: ZONING DISTRICT: -Historic District
Machine Shop Village
MAP
yes no
yes no
yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
0 New Building
0 One family
0 Addition
El Two or more family
El Industrial
El Alteration
No. of units:
El Commercial
11 Repair, replacement
0 Assessory Bldg
El Others:
El Demolition
[I Other
o plain' "0"' Wetlainds '01, M
i6d
nr:QrPiPT1nM OF WORK TO BE PERFORMED:
Identification - Please Type or Print Clearly
OWNER: Name: Phone:
AAA
I %M -
Contractor Name: Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License:
. Date:
ARCH ITECT/ENGI NEER — 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: $
E: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
32 �� - ?A V --C- ---, , C(
Location
No. 2(AY Date 2 -f,11
I
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $A.? Ll
Foundation Permit Fee $-
Other Permit Fee $
TOTAL $
Check #
13611ding Inspector
. Plans SuBmitted 11 Plans Waived 11
Certified Plot Plan F1 Si
TYPE OF SEWERAGE DIS�b--SAL
Public Sewer El
Tanning/Massage/Body Art F1
Swimming Pools
Well 11
Tobacco Sales
Food Packaging/S
Private (septic tank, etc.
Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed On Signature_
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: 7oning Decision/receipt submitted yes
Planning Board Decision:
Comments
Cbnservation Decision: Comments
Water & Sewer Connection/Si
-qnature & Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
R
17=57AI
f I F1k@R7-E: � �E 0 A.?
R34TMEL-140
'I ��Z' �' , 11 EM! PA I �Q- ff,1
I L
a
p
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.$100-$l 000 fine
NOTES and DATA — (For department use
13 Notified for pickup Call E
Date Time Contact Name
Doc.Building Permit Revised 2014
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
10TE: 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/Cross Section/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
IOTE: 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
2012 IECC Energy code
Engineering Affidavits for Engineered products
OTE: 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
Doe: Building Permit Revised 2014
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ 10,300.00
m
$ -
$
123.60
Plumbing Fee
$
15.45
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
15.45
Total fees collected
$
254.50
338 Blue Ridge Road
994-2016 on 3/23/2016
Cabinets and counter for wet bar
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LUP Cons�tructidn
I/We, the owner(s) of the premises mentioned below, hereby contract with and authorize as contractor, to furnish all
necessary materials and labor, to install, construct and place die improvementsaccording to the following specifications,
terms and conditions, on the premises described below:
Owners: Paul & Karen just Phone: 978-258-9529
Address: 338 Blue Ridge Road, North Andover, MA
Contractor Information: Apple Wood Construction Inc, 64 Noyes Rd, Londonderry, NH 03053
FED ID# 45-2837711
FHC# 181805
Contractor ID# CS87691
Part I
Description
Apple Wood Construction, Inc., wilk See attached estimate dated: 2/29/2016
For the above or attached specifications the undersigned agrees to pay the sum of $10, 300.00
The Customer agrees to nuke payment in accordance with the schedule of payment as follows:
Deposit on signing agreement
$500.00
Start of work
$2500.00
Start of plumbing
$2300.00
Start of electrical
$1100.00
Start of cabinet installation
$2600.00
Upon substantial completion of project
$1300.00
Part H
Proposed start date: Approximately two weeks after issuance of town permits.
Proposed end date: Approximately 3-6 months after start of work.
Contractor is not responsible for delay, damage or inability to carry on the work caused by or resulting from strikes,
blackouts, fires, accidents, lack of material or any other cause beyond the control of the contractor either before or after
the delivery of the material and equipment at the said premises.
The contractor is to be permitted to proceed with the specified workwithout interruption and hereby authorized to do
such work as in his opinion is necessary to complete this contract. Plans may need to be altered slightly during
construction phase at the contractors discretion.
The contractor and/or subcontractors will not enter the house if there are minors presentwithout someone over 18
present with them. V
Londonderry, New Hampshire
603-432-8599
www.applewoodconstruction.net
PP1
Conitruction
part M
Tins agreement shall become binding only upon the contractor's written acceptance here of or upon the contractor's
commencing performance. You may cancel this agreement if it has been consummated by a party there to at a place
other than the address of the seller, which may be his main office or branch office by ordinary maiL by telegram or by
delivery, not later than midnight of the third business day following the signing o f this agreement in accordance with
MGL c 93 s 48; MGL c 140D s 10 or MGL c 255D s.
Pad IV
The contractor will do all such work in a workman -Eke manner. In the event of discovery of hidden damaM it will be
charged in a cost plus manner, labor, plus materiaL plus twenty percent (201/6). This amount is due immediately upon
completion.
The owner(s) agree that in the event of cancellation of this contract before work is started, the owner(s) shall pay to the
contractor, on demand, twenty-five (25%) of the contract price plus any material that may have been ordered as it's
stipulated damages.
Part V
The owner(s) will bear the burden of any penalties or fees associatedwith delays or litigation necessary to complete this
contract and collection of all monies due. Delay in payment of any portion of this contract shall be subject to interest
charges of eighteen percent (18%) per annum.
There am no other agreements, understandings, representation or warranties, verbal or otherwise, expressed or implied,
which are not contained herein.
All additional work and/or mateiials requested by the owner(s) must be paid immediately.
. Part VI
All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or
subcontractor relating to a registration should be directed tm
Office of Consumer Affairs and Business Regulation
10 Park Plaza Suite 5170
Boston, MA 02116
617-973-8700
Part VII
All work is warrantied for one year after completion date.
The contractor reserves the tights to take before and after pictures of the project for use on contractors own website for
informational purposes only.
Londonderry, New Hampshire
603-432-8599
www.appiewoodconstruction.net
uz
P PI
I e-,NVb
P,
Construction
part VIII
PERMIT NOTICE:
a. Any and all necessary construction related permits are the contractors obligation to obtain.
b. if an owner secures their own construction related permit or deals with unregistered contractors they shall be
excluded from access to the Guarantee Fund.
c. Owner must wait for all inspections. If contractor waits for inspections additional charges of $55.00 per hour
will apply.
Part VIM
This contract is subject to the approval of the General Manager.
lit Witness whereof, the parties have here unto placed their hands and seal this day of
-�� )'-� k��2e 2016.
DO NOT SIGN TMS CONTRACT IF TIIERE ARE ANY BLANK SPACES.
I)ate:
X
Leonard Santosuosso In, General Manager
Date:
X
Karen Just
Date:
Londondeffy, New Hampshire
603-432-8599
www.applewoodconstruction-net
.A7ipple Wood
Construction
February 29, 2016
Paul & Karen Just
338 Blue Ridge Road
North Andover, MA
ESTIMATE
ENTERTAINMENT CENTER
1. An allowance of $100.00 is given to include town permit if needed
2. Prep area as follows:
a. Cut back rug as needed
b. Build small comer wall
c. Build up floor %" under cabinets
d. Remove baseboard as needed
3. Plumbing allowance of $2600.00 is given to include the following work to be completed by a
licensed plumber:
a. Run water and drain for new sink
b. Run vent line
c. Hook-up sink and faucet
d. Hook-up dishwasher
4. Electrical allowance of $1925.00 is given to include the following work to be completed by a
licensed electrician:
a. Run 2-3 more circuits
b. Run outlets to code
c. Run outlets for under cabinet components and microwave in cabinet
d. Try to repair electrical that also shares outside outlet
e. Run line and supply light for LED strip in component cabinet and also in two glass
cabinets.
5. Supply and install wallboard to new corner wall and patches made by plumber and plaster to
smooth finish.
NOTE: Painter will need to do prep work prior to painting.
6. Install base cabinets, baseboard and toe kick per plan.
7. Return after countertop installation and install wall cabinets and crown molding per plan
8. Removal of trash due to construction project.
TOTAL: $10,300.00
NOTES: Some painting and touch-ups will need to be done and are not included in pricing.
INITIALS-./O�
11 P a g e
-53to
v -241 23-I'T-24"I
I
INE-GLS.24 BFD24-lR
--------------------------------------------------------
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f�—\ The Commonwealth ofHassachusetis
Department ofIndustrialAceidents
I Congress Street, Suite 100
Boston, MA 02114-2017
www.mass.govIdia
Workers' Compensation Insurance Affidavit: Buflders/Contractors/Flectricians/Plumbers.
TO BE FMED WrM THE PEPMUTTING AUTHORffy.
Name (Busineworganizationandividw);
Address:
City/State/Zip:
Phone #:
A e u an employer? Check the appropriate box: Type of project (required):
1.71 am a employer with _k__.mplo5— (full and/or part-time) 7. El New construction
2.E] I am a sole proprietor or partnership and have no employees working for me in 8. NfRemodeling
any capacity. [No workers' comp. insurance required.] 9. El Demolition
3.FJ I am a homeowner doing all work myself [No workers' comp. insurance required.] t
4.FJ I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10F1 Building addition
ensure that all contractors either have workers' compensation insurance or are sole ILE] Electrical repairs or additions
proprietors with no employees. 12.E] Plumbing repairs or additions
S.E] I am a general contractor and I have hired the sub -contractors listed on the attached sheet 13.E] Roof repairs
Those sub -contractors have employees and have workers'comp. iiisurance.t
6.n We are a corporation and its officers have exercised their right of exemption per MGL c. 14.E] Other
IS2, §1(4), and we have no employees. [No workers'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 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 state whether or not those entities have
__�ployees. If the sub -contractors have employees, they must provide theirworkers'comp. policy number.
lam an employer that isprovifflng workers'compensadon insurancefor nV employees. BeImp is thepolicy andjob site
Information. A
Insurance Company Name:
Policy It or Self -ins. Lic. M
101,
Job Site Address:-�,— V�\&-no,. RA City/State&ip:�),��aL--.\� Mq
Attach a copy of the -workers' compensation poliV declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under thepains andpenalfies ofperjury that the information provided above is true and correct
Signature: Date:
Phone #: ((20--�)LA-tO, 8555
Official use only. Do not write in this area, to be completed by city or tmvn official
City or Town:
Permit/License
Issuing Authority (circle one): i
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone
- - ------ ---
Office of Consumer Affairs & Business Regulation
OME IMPROVEMENT CONTRACTOR Type:
egistration: 481805
wratiow, Corporation
APPLE WOOD CON�TRLJCTIQN'lNt-
EONARD SANTOSLJ§SO'
64 NOYES RD
LONDONDERRY, NH 0305iK U�dersecretary
Massachusetts Department of Public Safety
Board of Building Rcgulatiors and Standards
License: CS -087691
Construction Supervisor
LEONARD SANTOS`6oSS0
64 NOYES ROAW'
LONDO
NDERRi,:�H"
Commissioner Expiration:
09/21/2017