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Home My WebLink AboutBuilding Permit #386-11 - 393 MAIN STREET 11/5/2010 BUILDING PERMIT 00RT11 q t.StL6D /6t �O TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION = 1~ e� (� 4L Permit NO: ,I (P Date Received ') �SSACHUS�� Date Issued: ^fU IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER- - �e.z c, .r.,,. Print t MAP Z10 PARCEL: 4 ZONING DISTRICT::Historic District yes- n Machine Shop Village yes : TYPE OF IMPROVEMENT PROPOSED USE R Non- Residential New BuildingOne fami A on Two or more family Industrial Alteratio No. of units: Commercial ep ir. replacement Assessory Bldg Others: Demolition Other S 1Nell FIdodplair Wetlands _WaWatershed District ter./Sewe _ DESCRIPTION OF WORK TO BE PREFOR ED: _ Identification Please Type or Print Clearly) OWNER: Name: '��.� fie;ems... ... Phone: Address: ��r►�--t` CONTRACTOR Name: �t F ,� Phone. " " 3 Address: �i.A, •-. .. tip .,"4 Supervisor's Construction License: C ' . 0` a Exp. date: Home Improvement License: \�Qrk Exp. Pate: 2< l Z ARCHITECT/ENGINEER P Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ V L) FEE: $ Check No.: Receipt No.:_ ,2— �l NOTE: Persons c tractin wi h unregistered c ' g g contractors do not have access to the uaYan d g h'f $ignatur" Agent/Owner Signature of contracto Plans Submitted Plans Waived Certified Plot Plan Stamped Plans 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 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 CQMMENTS 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 Osgood Street FIRE DEPARTMENT -Temp-Dumpster on site yes -no Locatedet 124 Main Street; Fire Department-signature/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, 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 Doc.Building Permit Revised 2010 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 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:Building Permit Revised 2008 Location No. Date °RTh TOWN OF NORTH ANDOVER ` O L � M D i Certificate of Occupancy Building/Frame/Frame Permit Fee $ d JncMusE 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ` / 1 23660 Building Inspector HORTIy , F . 04" .0 _ ower ��7ZW _-� LAKE O dower, IVlass.,� COCMICMEWICK /d A0 ATED 7SS BOARD OF HEALTH Food/Kitchen .PERM IT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......�.....T..!toJ...6.... ...Mk•�!�!bv+ .........�.............. ..... Foundation has permission to e9m.6f6. r! ....................................... buildings on ...%". 3.......4i �..... .... 1....................... Rough to be occupied as.... � Chimney ... ... ..... ...... ..... provided that the person accepting this ermit shall in every respeciconfo�m to the terms of the application on file in Final P P P 9 P 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 3d� - PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRU N TARTS ELECTRICAL INSPECTOR Rough ......................... .................................. Service BUILD ECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE S 1 D E Smoke Det. Massachusetts- Department of Public Safety Board of Building Re(yulations and Standards Construction Supervisor License License: Cs 53099 Restricted to: 00 KEVIN W MURPHY k 169 BOXFORD ST N ANDOVER, MA 01845 Expiration: 6/29/2011 ('onunissioncr Tr#: 16540 Office 6tlo �� j13Gs�"n�s` �ff81 HOME IMPROVEMENT CONTRACTOR Registration: 1101874 Type: Expiration: '6/29/2012 Individual a.r IFEW MURPHY = ` Kevin Murphy 169 Boxford St N.Andover, MA 01845.` - Undersecretary 169 Boxford Street North Andover, A 01845 PH:978-688-53 5 ! 1 • FAX:978-688-7207 Building Contractor Proposal To: Tom&Pat Teichman 393 Main Street Ali Home improvement Contractors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma. 01845 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,Home Improvement Contract Registratm,One Ashburton Place, Frorm Kevin Murphy Room 1301,Bona,,MA 02108.(617}727 8598 CC: Data 9/27/2010 Job: Rear Porch Replacement 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 10/1/10. i Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 11/1/10.The owner hereby acknowledges and agrees that the scheduling dates are appro3dmate 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 III-Scope of Work � II Hieviiun Mu Iln Bnnaing ic—t- ON Page 2 of 169 Boxford Street North Andover,MA 01845 PH:97&6886335 FAX 97868&)000( General Proposal is to replace existing 6'x12' covered rear porch. Proposal is for labor on . BuildinDpermit ndall materials to be provided by owner. Demolition I Existing floor framing will be removed and reused. Excavating Three new footings will be dug by hand. Foundation Three new 12"x48"poured concrete footings will be installed to support new porch structure. Building New porch floor will be framed at same height as existing first floor. New decking, posts, railings, and steps will be installed. Siding will be repaired/replaced as required. Waste Removal No allowance has been made for the disposal of any construction debris. neviln IWUV pEny Page of 3 Building Contractor 169 Bohdord street North Andover,MA 01845 FH:978ZBB-5335 FAX 978688-X)= Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ...... ... ... ... ... ... ... ... ....$ 1800 Payment to be made as follows: Percents e/ltem Description Amount 1 Payment due at completion of job $1800 Total 1 $1,800.00 Notice:No agreement for Home improvement contracting work shall require a down payment(advance deposit)of more that one-third of the total contract price of the total amamt of all deposits or payments which the contactor must make,in advance,to order and/or otherwise obtain delivery of special order materials and equiprner f whichever is greater Contractor: Kevin Murphy 169 Boxford Street No.Andover, MA 01845 Registration No: 101874 Section V-Acceptance II 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 Date �1 D Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street BostoF4 MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APRAC201 Information Please Print Le 'bI Name(Buskesstorgpnization/Isndividua!}:_ nn � Address: 1d--h 5�.�.�►�fi City/State/Zip:tih._ Are you an employer? Cheek the appropriate box: Type of project(required): 1�I am a employer with____ � 4. ❑ I am a general contractor and 1 6 ❑New construction t ti employees(full and/or parme).'" have hired the sub-contractors 2.❑ I am a sokropr pietor or partner- listed on the attached sheet. t 7 � Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an aci workers'comp. insurance. Y capacity. 9. ❑ Building addition [No workers'comp. insurance S. ❑ We are a corporation and its 100 Electrical requ�] officers have exercised their repairs or additions 3.❑ 1 irn a homeowner doing all work right of exemption per MGL 11.❑ Phrmbing repairs or additions c. 152, 1 4 ,and we have no myself. [No workers' comp. § 12.0 Roof repairs insurance required.)t employers. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box 01 meat also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they we doing all watt and then bas outside coottactors must submit a new affidavit indicating Snob. C anaacto:a that dock this box must attached an additional shoat showing the name of the sub-contractors and their woritaas'comp.policy infonrraation. Cam an employer that is providing workers'compensation.insurance for my employees. Below is the polity and job site rAfor oration. Insurance Company Name: Policy#or Self-ins. Lic. #: kL.t� kA-/-C- � l)q 0 Expiration Date: Tab Site Address: City/Statdzip: �.J� _,.�,,•,.�., �, p 1 {S 4ttaeb a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failwe 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 3f up to$250.00 a day against the violator. Be advised that a copy of this stateromt may be forwarded to the Office of investigations of the DIA for insurance coverage verification. C do hereby,certify under the pains and penalties of penury that the information provided above is true and correct 3' azure: Da l all a- ftne#: --b O,rlcial use only. Do not write in this area,to be completed by city or town gfficiaL 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#: WDDIY 4C Rte CERTIFICATE OF LIABILITY INSURANCE 7 DATE(M/112010010YYY) THIS CERTIFICATE IS ISSUED AS A MUTTER 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 cerdlfcate holder is an ADDITIONAL INSURED,the poliryQes)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certtrycate does not confer rights to the certificate holder In Ilsu of such endomemo s). RODUCER CONTACT M P ROBERTS INS AGCY INC " E (978) 683-8073 (978)683-3147 1060 Osgood Street NaADDREss:sandi@ robertsinsurance.com North Andover, MA 01845 I WkMMS) AFFOMWM COVERAOE t1=0 JSURED KEVIN MURPHY BUILDING & REMODELING INSURER A:PROVIDENCE MUTUAL 169 BOXFORD STREET INSURERB:MERCHANTS INSURANCE 169 BOXFORD STREET INSURER C:GUARD INSURANCE NORTH ANDOVER, MA 01845 INSURER D INSURER E: INSURER F :OVERAGES 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. TYPE OF INSURANCEPOLICY NUMBER MMIDD/YYYY LIMITSGENERAL LIABILITYEACH OCCURRENCE $ R COMMERCIAL GENERAL LIABILITY PREMlSE3(Ea �� S 100,000 CLMMS-MADE OCCUR MED EXP(My one Person) S 5,000 CPP0060868 11/22/0911/22/10 -PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE S 20`00,00F GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO S r 0 POLICY PRO- 7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB ANYAUTo (Ea aocdaM) S 11000,000 ALL OWNED AUTOS BODILY INJURY(Per person) $ 3 X SCHEDULED AUTOS MCA7013608 01/23/10 01/23/11 BODILY INJURY(Perhxxom) g HIRED AUTOS PROPERTY DAMAGE S (Per tet) NON-OWNED AUTOS S S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS L1AB CLAIM84ADE AGGREGATE $ DEDUCTIBLE g RETENflON S $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN RY I X ER • ANY PROPMETOMPAR7HERAEfECUT1W �'"''� 0MCCBMAEMBER EXCLUDE09 U NIA E.L.EACH ACCIDENT g 500,000 (Iwyyoo�ss.lo.y PZ=109881 07/01/10 07/01/11 E.L.OISEASE-EA EMPLOYEES 500,000 DESGtescribe RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S 500,000 :SCRIPTION OF OPERATIONS t LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks SrJMduIs,it more space is requimd) RTIFICATE HOLDER CANCELLATION TOM OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NORTH ANDOVER, MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. r AUTHORIZED REPRESE 01988-2009 ACORD CORPORATION. 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