HomeMy WebLinkAboutBuilding Permit #801 - 35 PENNI LANE 6/5/2007Permit NO: b
Date Issued:_
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
y �t Lav 16\
9 1.
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
One family
❑ Addition
Two or more family
❑ Industrial
-CAlteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
DESCRIPTION OF WORK TO BE PREFORMED:
?
Identification Please Type or Print Clearly)
OWNER: Name: Phone: Z
ARCHITECT/ENGINEER Wd t-414 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: $'�', d a n FEE: $
Check No.: �r 3 Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
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
Li 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: INSPECTIONAL SERVICES DEPARTMENTMITORM07
Revised 2.2007
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer5
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
PLANNING & DEVELOPMENT ❑
COMMENTS
CONSERVATION ❑
COMMENTS
HEALTH ❑
COMMENTS
DATE REJECTED
DATE APPROVED
a
DATE REJECTED DATE APPROVED
■
DATE REJECTED DATE APPROVED
zoning Board of Appeals: Variance, Petition No: --___.Zoning Decision/receipt submitted
yes
Planning Board Decision:
Conservation Decision:
Comments
Comments,
Water & Sewer Connection/Signature & Date Driveway Permit
Located at 384 Osgood Street
Dimension
Number of Stories:/'
Total square feet of floor area, based on Exterior dimensions. 17-,
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop equires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 2 1 A —F and G min.$100-$1000 fine
Doc.Building Permit Revised 2007
r
Location
No. �-U` Date
TOWN OF NORTH ANDOVER
F 9
Certificate of Occupancy $
moo, _ •.
Building/Frame Permit Fee $
�Ss+cMust
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 6
20260
Building Inspector
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Workers' Calnpewaation 111suranee Affidavit: Builders/Contraetors/EkdricieWplembers
IW kept InfWau i®u
Name.�-
Address:_Jc _ S ��....�:t _._..��.�Ak—"
City/Stale/Zip: hit- -oA't 57 Phonc N:..._.3.'1Y.�
Are you on employer? Check the appropriate box: _
I V 1 am a employer with. a ._
4. ❑ I an a general comractor and I
employees (fb# andlor part-time).+
2. I atm a We proprietor or partner.
have hired the sub-contractom
listed on the attached sheat,
ship and have no employees
These euh•CeMlractors have
wonting for me in airy capacity.
workers' camp. insurance.
(No workers' comp, insurance
5- ❑ We are a c rporatinn and its
netptired,)
3, ❑ 1 am a homeowner doing all work
officer's have exercised their
right of exemption per MGI_
myself. [No workers" comp,
C. 152. Si(4). and we have no
insttrmlee "bed,) t
employees. No workers'
comp. insurenot required.I
( TYW of project (remred):
!j 6. ❑ New coristruction
1• [ Remodeling
R, ❑ 1kmclition
4 RBaikling additia)n
t0•❑ IEIeetrical repairs or additions
t t .❑ plumbing repairs or additirxts
12.[J Roof repairs
130 Other
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CO~ Persson -- �_ Pbo" M:
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-68$-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
at: 2 ?,.Cl ".VVV.A- 1U is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by NIGL
. I I , S 150 A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
I OA.
The debris will be disposed of in:
(1v
on of Faci
Signa o Permit Applicant
Fire Department Sign off: _ ti1).
Dumpster Permit `
Date
_''0 ^i
Building Contractor
Proposal
To: Debbie Murphy
12 Pembrooke Road
North Andover, Ma. 01845
Frone Kevin Murphy
ce.
Date: 5/22/2007
Job: Shed Dormer
Date of plains: None
Architect: None
Location: Same
Section 1- Work Schedule
• 169 Boxford Street
• North Andover, MA 01845
• PH: 978-688-5335
• FAX: 978-688-7207
All Home improvement Contractus 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, Hume
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 thins day following the signing of this agreement, unless specified here in
writing contractor will begin work on or about 6/4/07.
Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 8/15/07. 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 II -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
Kewi an IiRi annphy
Building Contractor
169 Boxford Street
Nash Andover, MA 01645
PH: 978468846335
FAX 9784686-)000(
General
Page 2 of 4
Proposal is to completely gut existing second floor, build three quarter shed dormer on rear of existing house,
finish two bedrooms, and frame future bathroom. Building permit will be provided by contractor. No allowance
has been made for any variances if required by town.
Demolition
Existing second floor will be completely gutted.
Building
All frame, roof, and siding materials will be supplied and installed to match existing house / meet building code.
Existing floor frame to remain, exterior walls will be 2x4, roof rafters will be 2x10, ceiling joists will be 2x8. All
sheathing will be fir plywood ( 3/4 on floor, 1/2 on walls, 5/8 on roof ) . Ice & water sheild will be installed on
entire dormer roof. Roof shingles to match existing. Vinyl siding will be supplied and installed to match existing
(as close as available by manufacturer ) . Some color variation may occur due to age and availability. Three
vinyl doublehung windows will be supplied and installed in new rear wall. No allowance has been made to
replace existing second floor windows.
Plumbing
No allowance has been made to provide any plumbing for future bath on second floor.
Heating/Air Conditioning
Existing forced hot water baseboard heat will be replaced / relocated as required to properly heat second floor
area. No allowance has been made to replace / upgrade existing boiler.
Electrical
Electrical work required to wire second floor area to meet code will be provided. Phone, cable, and computer
lines will be roughed in by electrician, to be connected by their service provider at owner's expense. Any surface
mounted fixtures to be proivded by owner ( ceiling fans etc.) . No allowance has been made to upgrade
existing electrical service.
Insulation
Added / renovated area will be insulated to meet code. ( R-13 in exterior walls, R-30 in ceilings) .
Plaster
Second floor area will be blueboarded and skimcoat plastered. Walls will be smooth, closets will be textured,
ceilings to match existing.
Interior Trim/Doors
Preprimed interior trim and doors will be supplied and installed to match existing. No allowance has been made
for any built-ins.
Waste Removal
All demolition / construction debris will be disposed of by contractor.
Heviisn fid, mvphy
Building Contractor
169 Boxiord Street
North Andover, MA 01845
PH. 97888&5335
FAX 978,688-)000(
Items Not Included
Page 3 of 4
There have been no allowances made for any plumbing, painting, flooring, renovations to first floor area of
existing house.
Uevriim Munpliay
Building Contttra r l or
169 Boxford street
Morro Andover, MA 01845
PH:97BZ88-5335
FAX 978£88-)O=
Section IV - Price Schedule
Total
Page 4 of 4
We hereby propose to fumish material and labor — complete
in Accordance with above specifications for the sum of ..................................... $ 35,000
Payment to be made as follows:
Percentage/item
Description
Amount
1
Permit obtained
$3000
2
Roof frame complete
$15,000
3
Siding / windows installed
$8000
4
Plastering complete
$5000
5
Job 100% complete
$4000
5
$35,000.00
Notice: No a7awnent for Horne aprovernent contracting work stall require a down payment (advance deposit) of more that one4wd of the tohal corral price of the total aff"" of all deposits or
payments which the contractor nxat make, tri advance, to order and/or Www w obtain delivery of speael order ffBW & and equ pawt, whilrever is Beater
Contractor: Kevin Murphy
169 Boxford 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 Dated
Signature Date