HomeMy WebLinkAboutBuilding Permit #666 - 366 FOREST STREET 4/17/2007Perm
Date
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
. Date Received 2—q
IMPORTANT: Applicant must complete all items on this nage
LOCATION 3U,
F'mRe s t ��-tie �-E-
Print +
PROPERTY OWNER Scl.,,.;eo.
Print
MAP NO: LO bA PARCEL: ZONING DISTRICT: HISTORIC DISTRICT yes
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
'gAddition
❑ Alteration
*One family
❑ Two or more family
No. of units:
❑ Industrial
❑ Commercial
❑ Repair, replacement
❑ Demolition
❑ Assessory Bldg
❑ Other
❑ Others:
Public O Sewer. '`:. Water
b Flood lam E Wetlands'; '
`' � d Watershed District.
DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: 1�. � i,.�l l SQL.,. _ ( ("." D' ' Phone- L(r L -
Location v—
No. 666 Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
Check # FZEL-
20'122
z---7-
Building Inspector
Plans Submitted Plans Waived F1 Certified Plot Pla Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT ❑
COMMENTS
CONSERVATION
COMMENTS'NO
DATE REJECTED
`/DATE REJECTED
i
DATE APPROVED
❑■
DATE REJECTED DATEAPPROVFD
011111 1W
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 ❑
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
Located at 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.3q�
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 —
loa,O
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
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
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
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 2.2007
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169 Boxford street
• North Andover, MA 01845
a •
PH: 978-688-15335
Building Contractor • FAX: 978.688-7207
Proposal
Ta. Mitch Schnier / Lauren Day
366 Forest Street
North Andover, Ma. 01845
From:. Kevin Murphy
CQ
Date: 7/18/2006
Job: Family room addition
Date of plans: 6/01/06
Architect: Tim Ippolito
Location: same
Section 1- Work Schedule
All Home improvement Contractors and Subcontractors
engaged in torn improvement contracting, unless
speaticalty 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, Home
Improvernent Contract Registration, One Ashburton Place,
Room 1301, Boston, MA 02`108.(617)-727 8588
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
Barring Delay caused by circumstances beyond Contactors control, the work will be completed by . 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 fumished 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
me -man rV2MU ,MEny Page 2 of 5
riding Co=tcactoa
189 Boxford steet
Moro, Andover, MA 01845
PH: 978-688.5335
FAX 97888 XIX
General
Building permit will be provided by contractor. No allowances have been made for title v inspection, certified plot
plan, variances, or conservation approval if required by town.
Excavating
Excavation required to install frost wall foundation will be provided. Any additional fill will be removed from site.
Backfilling and rough grading will be provided. No allowances have been made for removal of ledge, lawn
installation / repair, sprinkler repairs, or landscaping.
Foundation
Poured concrete foundation will be provided as shown on plans. Footing will be 10"x20", walls will be 10" thick,
grade to be detemined in field. Concrete cutting will be provided to gain access from existing basement area, to
new crawl space. Rough concrete slab will be poured in crawl space area.
Building
All frame, roof, and siding materials will be provided as shown on plans / match existing / meet building code.
All floor, wall, and roof sheathing will be fir plywood (3/4 on floors, 1/2 on walls, 5/8 on roof ). Floor joists will be
sized to meet code, exterior walls will be 2x4, roof rafters will be 2x10. Roof shingles to match existing. Ice&
water sheild will be installed at all roof edges and valleys. One Anderson Frenchwood six foot gliding patio door
will be provided. Ten Anderson doublehung window units, and one awning unit will be provided as shown on
plan ( five doublehungs for front of existing house, five doublehungs and awning for addition) . Siding to match
existing.
Plumbing
Existing oil fills will be relocated from side of house. New location to be determined.
Heating/Air Conditioning
Forced hot air heating / air conditioning will be extended to properly heat addition. Duct to existing second floor
bedroom will relocated / added as required. No allowance has been made to replace existing furnace.
Electrical
Electrical work required to wire addition to meet code will be provided. Six recessed lights will be provided in
addition , four recessed lights will be added in existing dining room ceiling. Phone, cable, computer lines will be
roughed in by electrician, to be connected by their service provider at owner's expense. Surface mounted
fixtures to be provided by owner ( ceiling fan / exterior light).
Insulation
Addition will be insulated to meet code ( exterior walls will be R-13, cellar ceiling will be R-19, ceiling will be R-
30).
Plaster
All added areas will be blueboarded and skimcoat plastered. Walls will be smooth, closets will be textured,
ceilings to match existing.
II$eviianv�" i mn7Ilay
3ailding Contractoa
169 Boxford street
North k-dow, MA 01845
PH: 978.61�
FAX 97888840M
Interior Trim/Doors
Page 3 of 5
Interior trim will be supplied and installed to match existing. No allowance has been made for any interior doors.
Painting
Interior painting will be provided. All walls and trim will have one coat of primer and two coats of finish. Colors to
be determined. No allowance has been made for any exterior painting.
Flooring
Hardwood flooring will be supplied, installed, finished with three coats of uerathane to match existing.
Tile will be provided at rear entry area. An allowance of $300 has been included for file materials.
Other Allowances
Pressure treated landing and stairs will be provided at rear slider to gain access to yard.
Waste Removal
All construction debris will be disposed of by contractor.
Items Not Included
There have been no allowances made for lawn repairs, exterior painting, alterations to roof lines of existing
house.
McVE n fi' UMTPEDY
MaildingC
169 Bordord Street
North Mdover, MA 01845
PH: 978ZBB-5335
FAX 97&688-)000C
Section N - Price Schedule
Total
Page 5 of 5
We hereby propose to fumish material and labor— complete
in Accordance with above specifications for the sum of .....................................$ 781400
Payment to be made as follows:
Percentage/Item
Description
Amount
1
Permit obtained
$3000
2
Foundation complete
$10,000
3
Roof complete
$25,000
4
Siding / windows installed in addition
$15,000
5
Plastering complete
$10,000
6
Interior painting / flooring complete
$8000
7
Job 100% complete
$7400
7
1$78,400.00J
"No4ce: No agreement for Horne irnprovertrent contracting work shah require a davn PeYfferd ( deposit) of more that are -third of the total contract tm of the total amount of all deposAs or
payrtrents v& h the contracW must make, in advar>ce, to order and/or otherwise obtain delivery of special order materials and equipment, Widever is greater
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
Signature
Signature
ANY BLANK SP CES
Date /
Date 9-13-U-7
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
in accordance with the provision of MGL c 40 S 54, a condition of Building Permit
at: 3 b that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by 141GL
, il,S 150 A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
10A.
The debris will be disposed of in:
G.
Fire Department Sign off:
Dumpster Permit
(Location of Facility)
Signatur o e it Applicant
Date
The Commonwealth of Massachusetts
Department of Industrial Accidents
~4:a Office of Investigations
600 Washington Street
iN•i'
v ; ' Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name tlittsincs 1()rgunixttlianllndiviclual):_�����^ 1�. _ ��,� - __�_r__
Address:_
City/State/Zip: t,4, IA f�. o1 4th Phone #:�-t��
Are you an employer? Check the appropriate box:
lAl am a employer with, _
4. ❑ 1 am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2.0 1 am a sole proprietor or partner-
listed on the attached sheet. i
ship and have no employees
These sub -contractors have
working for me in any capacity,
workers' comp. insurance,
(No workers' comp. insurance
5. ❑ We are a corporation and its
requited.]
officers have exercised their
3.0 1 am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.] r
employees. [No workers'
comp. insurance required.]
Type of project (required):
d. ❑ New construction
7. ❑ Remodeling
S. ❑ Demolition
9-g Building addition
10.0 Electrical repairs or additions
I i .[I Plumbing repairs or additions
12.[] Roof repairs
13.❑ Other_ _
*Any applicant That checks box 0 f must also tilt out the section below showing their wixkers' compensation policy information.
r Homeowners who submit this ti irdavit indicating they arc doing all work and then hire outside contractors Hurst submit a new affidavit indicating such.
(:'ontmciors that check this box mast attached an additional Sheri showing the name of the sub -contractors and Their workers' comp. txilicy information.
I am an employer that is prodding workers' compensadon insurance for my employees. Below is the policy and job site
information.
insurance Company Name:___
Policy # or Self --ins. Lie. #: ii e- _5?2U��_.—_-- Expiration Date:
Job Site Address:, �y-.��- ��� 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 NIGL c. 152 can lead to the imposition of criminal penalties of a
line 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.
J do hereb recti er l es and peva de, o e ury that the information provided above is true and correct
Si e: I Uat
t)1J1cia1 ase only. Do nol write in this area, to be completed by city or lawn nfcial.
City or Town:
Permit/License it
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.
.�uer�a ansurdnCe FAX N0. :19786833147
Jul. 18 2006 11:10AM P1
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310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION
OPP
Barrier Beach - Any land or surface area so defined by the Massachusetts Wetlands
Protection Act, M.G.L. c. 131, § 40 and 310 CMR 10.29(2). Generally, a narrow low-
lying strip of land generally consisting of coastal beaches and coastal dunes extending
roughly parallel to the trend of the coast, separated from the mainland by a narrow body
of fresh, brackish, or saline water or a marsh system.
Bedrock - Solid rock exposed at the surface or overlain by unconsolidated gravel, sand,
silt and/or clay. Bedrock includes weathered or saprolitic components thereof. Bedrock
types are defined and most of their areal extent are described in the "Bedrock Geologic
Map of Massachusetts" published by the Massachusetts Department of Public Works
(1983).
Bedroom - A room providing privacy, intended primarily for sleeping and consisting of all
of the following:
(a) floor space of no less than 70 square feet;
(b) for new construction, a ceiling height of no less than 7'3";
7c) for existing houses and for mobile homes, a ceiling height of no less than
(d) an electrical service and ventilation; and
(e) at least one window.
Living rooms, dining rooms, kitchens, halls, bathrooms, unfinished cellar§ and
unheated storage areas over garages are not considered bedrooms. Single family
dwellings shall be presumed to have at least three bedrooms. Where the total number
of rooms for single family dwelling exceeds eight, not including bathrooms, hallways, -
unfinished cellars and unheated storage areas, the number of bedrooms presumed shall
be calculated by dividing the total number of rooms by two then rounding down to the
next lowest whole number. The applicant may design a system using design flows for a
smaller number of bedrooms than are presumed in this definition by granting to the
Approving Authority a deed restriction limiting the number of bedrooms to the smaller
number.
Biological Mat - A layer composed of microorganisms and organic material located
below a soil absorption system which forms on the infiltrative surface of soil and which
Provides biological treatment of septic tank effluent.
Blackwater - Wastewater from toilets, urinals, and any drains equipped with garbage
grinders.
Bordering Vegetated Wetland - Any land or surface area so defined by the
Massachusetts Wetlands Protection Act, M.G.L. c. 131, § 40 and 310 CMR 10.55(2).
Building - A structure enclosed within exterior walls or firewalls, built, erected, or framed.
of any materials, whether portable or fixed, having a roof, to form a structure for the
shelter of persons, animals or property.
Building Sewer - A pipe which begins outside the inner face of a building wall and
extends to an on-site system or municipal or private sewer.
310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION
Campground - A facility regulated pursuant to 105 CMR 430.00 or 105 CMR 440.0
and
any campground operated by the Department of Conservation and Recreation in a
State Park.
Cell—_ar Wall - That portion of the outside surface of the foundation wall enclosin a fu
basement which is above the cellar floor and below the ground surface. g II
Certificate of Com liance or Certificate - A certificate issued by the ApprovingAuthority
to the owner or operator of a system in accordance with 310 CMR 15.021 indicating that
an on-site system has been constructed or upgraded, and inspected, as necessary in
compliance with 310 CMR 15.000.
CertifiedSvstem - An alternative system which has been approved
for specified uses or site conditions pursuant to 310 CMR 5 288 Systemss which h nt
been certified may be approved for use by approving authorities without further have
Departmental review but subject to any limitations on their use imposed by the
Department pursuant to 310 CMR 15.000.
Certified Vernal Pool - A surface water body that has been certified by the
Massachusetts Division of Fisheries and Wildlife as a vernal pool in accordance with the
"Vernal Pool Certification Guidelines" pursuant to the Massachusetts Natural Heritage
and Endangered Species Program administered by the Massachusetts Department of
Fish and Game at the time a permit application is submitted to the ApprovingAuthority.
Col - A pit with open jointed linings or holes in the bottom and/or • ority.
ess o
Which raw sewage is discharged, the liquid portion of the sewage being disposed of
seeping or leaching into the surrounding soils, and the solids sidewalls into
the pit. Cesspools are nonconforming systems. or sludge being retained
�n
Cluster Develo ment — A cluster development as allowed by local zoningordinances
by-laws in accordance with M. G. L. c. 40 A g.
zoning ordinances or by-laws have been enacted in accordance with mance§ or
§ Where no local cluster development
a cluster development means a residential development design that preserves
minimum of 50 percent open space which may include wet M.G.L.M•c.40 A § 9,
developments, the percentage of open space that can be wetland shall not these latter
percentage of wetland for the entire site under existing conditions as shown on a
but in no case may the wetland portion of the required open space exceed exceed the
50 percent of
the opens ace. plan,
P The open space shall be subject to a deed restriction that provides for
a common area and limits its use to passive recreation.
Coastal Beach - Shall mean any land or surface area so defined b
Wetlands Protection Act, M.G.L. c. 131
unconsolidated sediment subject to wave, tidal and coast y the Massachusetts
§ 40 and 310 CMR 10.27(2). Generally,
gently sloping shore of a bodyal storm action which forms the
of salt water and includes tidal flats,
Commercial Sewa a Waste -Non-toxic, non -hazardous was
facilities, including but not limited to institutional and commercial
foo from commercial
animal holding facilities. ercial food operations, and
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