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HomeMy WebLinkAboutBuilding Permit #988-15 - 419 ANDOVER STREET 5/29/2015Permit NO:. Date Issued LOCATIOI 9 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TANT: Applicant must complete all items on this V C US - I PROPERTYOWNER Dh(�-n"'%Ven Print yes no 0 Machine Sh'60"Villaqe -Ye Fr - Cn Print MAP NO: PARCEL ZONING DISTRICT: Historic District, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building Ll One family 11 Addition -L) Two or more family [I Industrial 11 Alteration No. of units: [I Commercial X Repair, replacement 0 Assessory Bldg [I Others: Ll Demolition u Other 0 Septic [I Well 0 Floodpla,in D Wetlands 0 Watershed District 0 Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: Effian A lVen Phone: Address: lq Aniiacr St mo(tk AMnv-ce- MA FONTRACTOR Name: Phoinie"' C CC S Address: co 0 (N(JI-k 41 Supervisor's Construction License: Exp. Date: —0 Home Improvement, License: Exp. Date: ARCH ITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. MOO PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost:$ FEE: $ bqq -�D Check No.: Receipt No.:- 2-�D&34- NOTE: Persons contracting w4h unregiste d c n ctors do not have access to the guaranty, und Sig_qqturq of Agent/O ner nature of contractor k ttORTHI BUILDING PERMIT Of TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received I Date Issued: IMPORTANT: Applicant must complete all items on this page -I LOCATION Print PROPERTY OWNER Print 100 Year Stru . cture MAP PARCEL: ZONING DISTRICT: -Historic District Machine Shop Village yes . no yes. no yes no TYPE OF IMPROVEMERT- PROPOSED USE Residential Non- Residential 0 New Building 0 One family 11 Addition El Two or more family El Industrial 0 Alteration No. of units: El Commercial El Repair, replacern �nt El kssessory Bldg El Others: 0 Demolition Other - F El Septic El Well -E] El Floodp lain El Wetlands El Watershed District 0 Water/Sewer DESUKIF I 1UN Ul- VVUMM I U Or- rr-r-,r-wn1v1 Identification - Please Type or Print Clearly OWNER: Name: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Home Improvement License: Phone: Exp. Date; Exp. 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: $ FEE: $ Check No.: Receipt No.: 'f' ty und NOTE: Persons contracting with unregistered contractors do not have access to the guaran f LJ14 Location 7 J I / I f 469 "av No.v(1—, Date ff,& C) I % / -/.10 Check # —5� .�; 1;. 2 0 C TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee sL 2— Foundation Permit Fee Other Permit Fee $ TOTAL $ Gti�� Building Inspector -.:v Plans Submitted 0 �r- - n ' Plans Waived El Certified Plot Plan Stamped Plans R TYPE OF SEWERAGE DIS�b-SAL Public Sewer Tanning/Massage/Body Art SwhUming Pools El well Tobacco Sales El Food Packaging/Sales El Private (septic tank, etc. El Pennanent Dwnpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature_ CONSERVATION Reviewed on Siqnature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Zlanning Board Decision: Com %Conservation Decision: Comments Water & Sewer Connection Driveway Permit DPW Town Engineer: Signature: -IM, 9 LWfi R AR&T M E- N LTj' 7m--'�o 91 -7— Located 384 Osqood Street -- I 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 MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine [a Doc.Building Pennit 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4 Building Permit Application 4; 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 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 4. Engineering Affidavits for Engineered products IOTE: 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 Plerm�it NO: J 0 r)ate Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received MPORTANT: Applicant must complete all items on t1his page �oAVN An&ju N 5 LOCATION— P , t PROPERTY OWNER. Print MAP NO: PARCEL 7-ONING DISTRICT: Historic District yes no 0 Machine Shop Villa 0 ge yet rn k N, TYPE OF IMPROVEMENT 'PROPOSED USE Residential Non- Residential El New Building 0 One family 0 Addition '-0 Two or more family 0 Industrial 0 Alteration No. of units: 0 Commercial ,K Repair, replacement 0 Assessory Bldg El Others: 0 Demolition El Other 0 Septic 0 Well DFloodplain El Wetlands 0 Watershed District El Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: D�Arm ANn -Phone: Address: 11 I'll HO(IN OR N�ame. _6T N CO T FAddress- Supervisor's Construction License: Home Improvement License: (I Phone: k4 q -k �13 DACkryLA\_c,�*ti/ JYV1 U_21_UL- ,Exp. Date: q Exp. Date: ARCH ITECT/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: $_ 5(-Q, Lp�( � .5a FEE: ('hprk No-- I Receipt No.: F, -1 1:: -1 The Commonwealth of Massachusetts Department ofIndustrialAccidents I C ongress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers- TO BE FILED WITH THE pERAUTUNG AUTHORITY. NaMe (Business/Organizationqndividual): / V - I Address: 1K, ":7 <—. X4 C, -e—i City/State/Zip:_����/,//,( ag& Phone#: Are you an employer? Check the appropriate box: 1. 1 am a employer with . . employees (Rill and/or part-time)-* 2. 1 am a sole proprietor or partnership and have no employees working for me in any capacity, [No workers' comp. insurance required.] 3.n 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 ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. I am a general contract . or and I have hired the sub -contractors listed on the attached sheet. These sub-contract6s "have einployees and have workers' comp. insuranceJ E;:n We are a corporation and its. office rs ' have exercised their right of 'exemption per MGL c. 152, § 1(4), and we have ri� �in . pl*es. [No workers' comp. insurance required.] information. Insurance Company Type of project (required): 7. Dwemw construction 8.1 ie odelih9/_1/ 9. Demolition 10 F1 Building addition ME] Electrical repairs or additions Ia. n; Plumbing repairs or additions 11 j<66f repairs 14. Other_� their workers' compensation policy information. then hire outside contractors must submit a new affidavit indicating such. e name of the sub -contractors and state whether o.rnot thosepirtities. have orkers'comp. policy number. nsurancefor mY enlplbYees- Below is thepoliey andjob site I Expiration Date" Policy # or Self -ins. Lic. . City/State/Zip:AV�-'e/ Job Site Address: / � A_,04� 56 -- Attach a copy of the workers' compeiisation policy 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 o hereby certify Vde her andpenalties ofperjury that the information provided above is true and correct. Dote: '(I fficial Official use only. Do not write in this area, to be completed by citY or town o 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 Communicat�on Result Report ( Jul -20. 2015 9:52AM 1) Town of North Andover 2) Community Development Date/T�me: Jul.20. 2015 9:50AM F � I e Page N o. Mo d e D e s t � n a t i o n Pg (S) Resu I t N o t S e n t ---------------------------------------------------------------------------------------------------- 5194 Memory TX 819788374455 P, 2 OK ---------------------------------------------------------------------------------------------------- R e a s o n f o r e r r o r 01121) Phone: Address: jlq A(IdM.0 E . E.3 E. 1 5 H a n u p o r I i n e f a i 1 N gn sw o r E x c e , d e d x. E — m a i I s i z e 0 m a E. 2 B u s Y E.4 No.facsimile E. 6 D e t i connection —Fax n a t i o n d o e s n o t s u p p o r t I P Acldrc�, Reg. No. BUILDiNG PERMIT TOWN OF NORTH ANDOVER FEE: $ NG.� Receipt ND.' P1.711 J�. APPLICATION FOR PLAN EXAWNATION Dam Reod. [IN" Building ty n Addition 1. dI L.W. I .M.rcia, 13 N.cAUnitak,===_== ----- =_+ --I al tmr�. M ldentilicatl— OWNER-, Nama: FM� 01121) Phone: Address: jlq A(IdM.0 ARCHITEcT/EKGINEER --------- P110m� Acldrc�, Reg. No. Total Pmject cost $75211��� FEE: $ NG.� Receipt ND.' Check NOTF: M The Commonwealth of Massachusetts Department ofIndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov1dia 'davit: Builders/Contractors/Electricians/Plumbers. workers' Compensation Insurance AM To BE FILED WITH THE pERAUTTiNG AUTHORITY. Name (Business/Organization/Individual):. Address: A0/27 City/State/Zip: z//,/ a 'nhone 4: Are you an employer? Check the appropriate box: J.E] I am a employer with ... �mployees (full and/or part-time).* 2. 1 am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. 1 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 ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5 - I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors li�ve employees and have workers' comp. insuranceJ 6. We are a corporation and its. office rs have exercised their right of 'exemption per MGL c. 152, § 1(4), and we have no epployees. [No workers' comp. insurance required.] /,� 7,9 - �2�s Type of project (required):. 7. V06'V'c6ristrii ction 8. Remodelftiv-1v 9. El Demolition 10 n Building addition 11. Electrical repairs or additions 12. F1 Plumbing repairs or additions 13. i�06f repairs 14. Other--, their workers' compensation policy information. 'Any applicant that checks box #1 must also fill out the section below showing 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 employees. If the sub-con�actors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers'compensation insurancefor my employees. B�Jow is t1lepolicy andjob site information. Insurance Company Expiration Date. - Policy # or Self -ins. Lie. . City/State/Zip: Job Site Address: 6?,5— Attach a copy of the workers' compensation policy 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 veri andpenalties ofperjury that the information provided above is true and correct. I do hereby certify Vde �h e '00� Dste_ 'r, 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): 'I 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone 04/21/2015 09:39 9786884353 ETHAN ALLEN I'm . Ila .- AN% PAGE 02 t'KUJECT APPROVAL AND AUTHORIZATION TO PROCEED WITH WORK TOTAL PROJECT INVESTMENT PAYABLE TO MASTER ROOFERS: PROJECT PAYMENT SCHEDULE: One-third project deposit due upon approval: Total project balance due upon completion: STANDARD PROJECT PAYMENT TERMS- On normal cash, check, or Visa / Master Card credit card orders a deposit in the amount of one-third the approved project cost will be due. The total balance of the project investment will be due upon substantial completion or within twenty (20) days of date of our final invoice. PROJECT WARRANTY: 0 GAF System Plus Materials Warranty El Master Roofers Workmanship Warranty DATE OF PROPOSAL SUBMISSION., Thursday April 15, 2015 PROPOSED START DATE* To be determined. Project commencement is contingent upon date of project approval by the client; Master Roofers producOon schedule; availability of materials; delivery of materials; roof top condifions; and environmental weather conditions. NOTICE: This Proposal is based upon current materials and labor costs. This proposal may be withdrawn If not accepted within thirty (30) days of the submission date noted above. After thirty (30) days, prices may be subject to revision, ACCEPTED AND AGREED: The prices, specifications, terms and conditions contained within this proposal agreement are satisfactory and hereby accepted. Approval of this proposal agreement authorizes all specified work to be performed and completed. CLIENT(S)., Sandy Kinney — C/O Ethan Allen PROJECT ADDRESS: 419 Andover Street North Andover, Massachusetts 01845 Accepted By: Accepted By: Master Roofers Authorization. - Dated: -2' Dated, Dated: Thank you for your considerabon of our professional services. We trust that our comprehensive proposal will meet with your approval. Please contact us at your convenience if you have any questions. We are looking forward to working with you, Respectfully Submitted, Daniel G, Bolduc President John R. Burton Senior Project Manager 04/21/2015 09:39 9786884353 ETHAN ALLEN t aw t�511 Proiect Summary facement Option # 1 The roof replacement summary Outlined below will be completed accomy;ng to the Pmjact specifications within Mis proposal. 8ofore approving &Rd authorl*o any work, please be sure that you have CarefullY reviewed and understand the Mof replacementsPecificadon-9 for this project. SCOPE OF WORK: Master Roofers agrees to remove and dispose of the existing roof System on the specified roof Sections. Master Roofers will furnish and install a new fully warranted, GAF asphalt shingle roof system as per the project specifications outlined in this proposal agreement. INCLUDED ROOF SECTIONS: 1. All attached asphalt shingle roof sections on the main building, GAF ROOF SYSTEM AND ACCESSORY PRODUCTS: 1 , GAF Storm Guard self -adhered, filmed surface ice and water shield leak barrier membrane 2. OAF Deck Armor breathable synthetic shingle underlayment 3, 8' aluminum drip edge 4. GAF Pro Start starter course shingles 5. GAF Lifetime Warranted Timberline High Definition, fiberglass laminated, architectural style shingles 6. GAF Snow Country baffled style, continuous ridge ventilators 7. OAF Seal -A -Ridge matching color hip and ridge cap shingles 8, Lifetime warranted vent pipe flashing collar 9. New custom fabricated aluminum chimney base flashing system below existing lead counter flashings 10, Custom fabricate and install new standing seam bronzed coated aluminum ice belts along the enVre length of eaves on the south facing side of the building, GAF MANUFACTURER'S WARRANTY: All OAF manufactured shingles and GAF accessory products will be fully covered by the OAF System Plus materials warranty, This warranty covers GAF materials from manufacturing related defects for up to forty years. MASTER ROOFERS WORKMANSHIP WARRANTY., The installation of your new roof system as specified In this proposal will be warranted by Master Roofers for a period of five years from the date of project completion, Should any issues arise as a confirmed result of our installation techniques; Master Roofers will perform fair and reasonable repairs at no charge to ensure the roofs integrity. This warranty does not cover materials or workmanship by others or roof sections outside of our specified work areas. ORIGINAL COST ESTIMATE: $59,161.52 JOB COST REDUCTION: $3,000.00 TOTAL PROJECT INVESTMENT PAYABLE TO MASTER ROOFERS: $56,161.52 CLIENT APPROVAL: DATE: —Y /5 CLIENT APPROVAL: r DATE: 0 x 0 1 T� 4mo 0 W, 0 2 ul 0 CL CD W m 4) CD 40-- .2 OU (D CL CD U) (D (D Cl) Cl) Cl) Jj 16. 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