HomeMy WebLinkAboutBuilding Permit #Exception - 42 SUMMER STREET 5/1/2018 L
NORTH
II BUILDING PERMIT 320y Ott eo .6'q�•�L
TOWN OF NORTH ANDOVER 00
APPLICATION FOR PLAN EXAMINATION _
Permit NO: Date Received
gSSACHUs�t
Date Issued:
IMPORTANT:Applicant must complete all items on this page
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LOCATION ` _ - - d �� p. '
PROPERTYWOInntJ
NNER�,
-MA
P-1-NOPARCEL- ZONINGQISTRIGT ,Historic Distract es no
"'Machiie Shop'Village <.yes o
TYPE OF IMPROVEMENT ' PROPOSED USE
Residential Non- Residential
New •din One family
AdditionTwo or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Flootlplain
&Septic z R _ Watershed Districtz t
-
(�DESCRIPTION OF WORK 7_0 BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: a r° Phone:
Address: WL StJv�w\e (Z C;> LX4go-eR-
x a s y
CONTRACT,OR� Name c��� _ _ ^
�:..�.
,Address`• rr� � 2 _ �� t� 0 S
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i `�SupervisorPsi,ConstructionLicen_se ���-C� �l�_`� 1�� �L(,� n,d�
Homeilrnprovement License
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ARCHITECT/ENGINEER
r
Address:
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL
Total Project Cost: $ f
Check No.:
F
NOTE: Persons contracting with unregistered contractors do not have access to a guaranty fund
Signature of contractor'
Signature of,Agent/Owner. _ _ n _
_ _ _
%AORTH
BUILDING PERMIT 0
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
S CHUS
Date Issued: IMPORTANT:Applicant must complete all items on this page
7
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t,PROPE "WNEIN K4I e- 7V Lv; KfPr '-�-
no
MAN §T!R
yes
i 'Machine Pp Village -Yes,, 0
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New din One family
Addition i t i A�on LLICK Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
C�- M41 0
Water/S6Werk
wNi
DESCRIPTION OF WORK T9 BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Cct-[k' e Phone:
Address: �JOTA�
OLIC7
-�p -75
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mp! M Date
ARCHITECT/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: $ f-72 SCJ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access toffieguaranty fund
8-iglqtu-re o--f-A**g-6-_--n---t/,-O,--W---h---O'-t-..--------------------- SighhfUtb of bonthbctor,,,
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Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL L
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
�y s�
COMMENTS
QVj t'l� S"k c t� cZ� �t� � D c_fir' e 0
HEALTH Reviewed on Signature
COMMENTS .�. Z
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 DE ,ARTMEI t r=Temp Dumpster`on site`
`Loc4tediatl1241Main
d
Fire DepartmeritsignatureLdate. _ . � . _.:_ �_ Y
.COMMENTS-•-- f--- ;., ��.:,. ,g� .,,._.
I
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions. i
Total land area, sq. ft.:
i
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No I
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine j
NOTES and DATA— (For department use)
❑ Notified for pickup - Date
Doc.Building Permit Revised 2008 i
I
I
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)
o 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 j
Revised 2.2008 `
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Jt5l�tis REPJCCt
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JOHNI REPLCCi
30 CAMPMEETING RD
O *4A:01?�33 t'p�ticecrctsry- {:
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
�`i4I1.�irtfCiIf3it�illd�I'�f.SUC �_.
License: CS M281
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JOEW REPUCE�
30 CAMPKE-9 Ii!IG�R
TOPSFIELD;MA0983«% f
ExtAration
t.t+rrsmissi4tler 03/04/2014
The Cormnanivealtlr:of Massachusetts
,t r Department of Zndastrial Accidents
?' Office of Investigations
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' 600 Washington Street
f.°:2 Boston, M4,02111
wjvw. iassgov1d&
WiDrkers"Compensation Insurance Affidavit Builders/Contractors/Electric anslPl'umbers
App/cant Information Please:Print:Leta b v
Na:Ine(Busmess�OrLgamizanonlrndi�vidmai).' T'et/V��
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Address':! 30 ����et✓�cl/l(S� 'I��
GitylStatekzp,: �� C ,I 14t o Phony : q ? 3` 6 Z5
Are.you an enipl'over?Check the appropriate:box: Type of project(required),
', I am a general contractor and I
i..[[� I am a employer with 4', �' G. E]New construction
employees.('frill and/or part-time).* have,hired the sub-ccmtractom
f am a sort proprietor,or partner-- listed'on the attached sheet:,t ?• 0 Remodeling;
ship and have no employ. 'Tbese sub-contractors•have 8. Q Demolition
-orlescompinsurance..
9. n Build'iitg additionworkin formein an capacity. w _
[No wor(cers,`comp.insurance 5. �', We are a corporation and.its,
' required..]; officers have:exercised',their
10_Q Electrical repairs or additions
3:_Cj ti am a homeowner doing;all'work right:of exemption per MGL ii I'..Q Plumbing repairs or,additions
myself[o workers'comp. c. 151§I(4)s.and we have no 12.[]Roof repair
insuraance required]!+ employees.[No workemm'
comp..instumce:required.] I�'• tDtfier 1/ �j e
*Anyr applicant.Hlar diecks box R must also filleui the section bcl'ow showing,their wmi--ws-cornpmsatkw pwk.v information:,
TI Homeowners who submit this affi'ftvX indicwft-tbcc,,are dom;gan'wark acrd then.hiie.ourside:comractors nmst submit a,new affihily t indicating;such..
PConmac ars that check-this bar mustamc hedan additional sliest showing;the name of the sab-cvmracra.s and their cams"comp_pofiicy'info=sdom.
I,am.an+emplayier tliat Ls,providing,workers"compensafan irxsurance,formai entploiees., Belot*=is'tli,e°polic}r>and job sii&
in,formadom,
Insurance:Cbin:pany Mame,:
Poi icy, or Self=ins.IIIc.`:; a-piiration Date:
Yob Site.Address: Citytsfatek o:
Attach a copy,of the.workers''compensation policy declaration page(showing the poHO number and'expiration date)':.
Failure to secure coverage,as required:under Section 25A of'M'GL c. 152 can lead to the:imposition of criminal penalties of a.
fine up to$1,500.00 and%or,one=year•im prisonment„as well as civil penalties in,the;f lrrn of a STOP WORD;ORDER.and.a.fine
of'up to$2'50.00 a day against the vi'ol'ator: Be advi'sedl that a copy,of'th:is statement maybe forwarded to the Office of
Investigations of the DM,for insurance:coverage,verification-
f do ftereo c rt under the pains andpenalties of perjuryr thaffI e infarinatinn proutded'abov is true and'correct,
Sr attire t Date:
Phone `D '�7744 6 7-j
Ofciuf use only. Do not tri to in,this area;to be compfeced by cam=artotctr afjrc al.
City or,Town: PermitlL icense
issuing,Authority(circle,one)-
L Board'of Health 2-Building Department 34,CitytTovtm Clerk: 4..Electrical inspector 5.Plumbing,inspector
6.Other
Contact Person: Phone 9:
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PROJECT PROPOSAL
Prepared for: Katie Tylus
42 Summer St
North Andover, MA
Prepared by: John Repucci
Phone: (978) 375-4625
Date: 6/20/2012
WWW.DECK-O-RATE.COM
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Project: Install new Pressure Treated deck with Azek decking,
Pressure Treated railing system with a 2x6 top rail, and stairs with
Azek treads
General Provisions
➢ All work shall be completed in a professional manner and in
compliance with all building codes and other applicable laws.
➢ To the extent required by law all work should be performed by
individuals duly licensed and authorized by law to perform said
work.
➢ Contractor may with owner's permission engage subcontractors
to perform work here under, provided Contractor shall fully pay
said sub contractor and in all instances remain responsible for the
proper completion of this Contract.
➢ Contractor shall furnish Owner appropriate releases or waivers of
lien for all work performed or materials provided at the time the
next periodic payment shall be due.
➢ All Change Orders and/or Additional Work Authorizations shall
be in writing and signed by both Owner and Contractor.
➢ Contractor warrants it is adequately insured for injury to its
employees and others incurring loss or injury as result of the acts
of Contractor or its employees and subcontractors.
➢ Contractor shall, at its own expense, obtain all permits necessary
for the work to be performed.
➢ Contractor agrees to remove all debris and leave the premises in
broom-clean condition.
➢ In the event Owner shall fail to pay any periodic or installment
payment due hereunder, Contractor may cease work without
breach pending payment or resolution of any dispute. Failure to
make payments within three days from due date of payment shall
be deemed a material breach of this contract.
➢ All disputes hereunder shall be resolved by binding arbitration in
accordance with the rules of the American Arbitration
Association.
➢ Contractor shall not be liable for any delay due to circumstances
beyond its control including strikes, casualty, or general
unavailability of materials.
➢ Contractor warrants all work for a period of 365 days following
completion.
I f
Deck- $13,600
➢ 2 X 8 Pressure-Treated frame
➢ 4' wide stairs 11 steps with Pressure treated risers
➢ Azek decking (Brownstone) with the plugged hidden screw
method
➢ Deck size is 16x16 and 6x18
➢ 12"x4' deep footings
➢ Permit $12/$1000 = $132 included
➢ This is a complete job there will be no extras on my part
Payments are as follows with checks made out to John Repucci
➢ 1St upon acceptance $4,534
➢ 2nd when material arrives and start of project $4,534
➢ 3rd upon completion $4,532
Respectfully submitted, John Repucci
Signature KKR�t
Date of Acceptance bla a Z) a
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