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Home My WebLink AboutBuilding Permit #351 - 43 FULLER ROAD 10/1/2006 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Of NOoT a 14' 3? e�:r• ...,. •. �0 Pernnit NO:3S r Date Received i WOO Date Issued:Lo "ATOP n••�q9 SSACHUgE IMPORTANT: Applicant must complete all items on this page I LOCATION 4/3 Zvi/e r R Print PROPERTY OWNE5t-ra-m C./,'p Print MAP NO.: PARCEL: ZONING DISTRICT: ( - 2 TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building 2'0ne family ❑ Addition ❑Two or more family ❑ Industrial R-Alteration No. of units: Repair, replacement ❑ Assessory Bldg ❑Commercial Demolition ❑ Moving(relocation) 1 ❑Other ❑ Others: ❑ Foundation only DnESCRIPTION OF WORK TO BE PREFORMED t/W�r` Identification Please Type or Print Clearly) i \ OWNER: Name: M a r 1L ' 71" rr,` 7-r,h Q j e Phone: 97Y 9 9 y �ro351 Address: Rc,l CONTRACTOR Name: S r o4L Phone' o 3 413!9 95y3o Address: 9 an'Fn Rol L ��rin„ r/Frru! .i r1 - I Supervisor's Construction License: CS 07.33iG Exp. Date: 7 G, - o Y Home Improvement License: 6 V Exp. Date:—?,Z/ /o7 ARCHITEC"17ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$11.00 PER 51000.00 OF THE TOTAL ESTIMATED COST ASED ON 5115.00 PER S.F. Total Project Cost :$ '�,? K5-,9 ao FEE:$ Check No.: Receipt No.: Page I of 4 L13 � Location L 3 t u ��f No. Date TOWN OF NORTH ANDOVER . : , Certificate of Occupancy $ sACHU <�' Building/Frame Permit Fee $ 1 ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 4� 19752 —Building Inspector TYPE OF SEWERAGE DISPOSALSwimming Pools C JI Tanning/Massage/Body Art Public Sewer Tobacco Sales ❑ Food Packaging/Sales Well '_! Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund - Signature of Agent/Owner Signature of contractors / . Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ ,,COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS 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 Building Setback(ft.) Front Yard Side Yard Rear Yard Re uired Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JNIC.Jan.2006 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 Addition Or Decks ❑ Building Permit Application ❑ ,Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) 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 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 DEPAR'rN1EN'CBPF0RN105 Page 4 of 4 �1ee .�anv�na�uaea/,l/ o�./�aaac�rluaeQa � � BOARD OF BUILDING REGULATIONS j License: CONSTRUCTION SUPERVISOR Number`CS 073316 Birthdate x07/06/1965 i_irpires"6'-7-/:06/1068 Tr.no 28279 Res5= 1 SCOTT J LAPOIFYr= 9 GRIFFIN RD LONDONDERRY, NH-63ir 3 � Commissioner t ;/fie Vo �eQ'� �✓vcaaoaT'�ucael�a , Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 129364 lug Expiration- 811.8/2007 Type: DBA K,A.T ConStuCtiOn' Scott Lapointe � � } 9 GRIFFIN RD. Londonderry,NH 03053 Administrator i r1Yy Town of 0RTAndover o No. � f _t7iLAIII o over, Mass.. �• 0 COCHICMEWICK �k • 7,95 RATED PP ,�5 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...mi. ..40............%T'. .4... .. . .... ............. ..................................:................... Foundation has permission to erect .... buildings on �. .... r Rough .. . . . . . . . . ...... . . to be occupied as..... ��....�i .T........�.�r� .. 10.a.�............. ........5:. � ..� Chimney provided that the person accepting this permit shall in every respect conform to the terms of thea licationn ie*'*in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 3W" PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU T S Rough ............. .............. .... ....... Service . . .... .... ... .. .. . ............... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ---- aenaer s rax w:ous-Cau-ti5Z1 Page 1 of 1 SIC®RD. CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(M 1 08/09/06 KATCO- PRo°ucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Santo Insurance - Salem HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 224 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Salem NH 03079 Phone:603-890-6439 Fax:603-890-6521 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Aaa=ican international Group K A T Construction, DBA INSURER B: Nationwide Companies Scott Lapointe INSURER C: 9 Griffin Road INSURERD: Londonderry NH 03053 ASSURER E: _ COVERAGES 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),VITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR WS"RE TYPE OF INSURANCE POLICY NUMBERDATE(MM/DD/YY) DATE(MM/DDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 B X COMMERCIAL GENERAL LIABILITY SIAC1390133002 08/02/06 08/02/07 PR`E-UETO B!L (Eaoccurence) $100000_ CLAIMS MADE �OCCUR MED EYP(Any one person) $5000 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE $2000400 GEN•L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2000000 POLICY JERO, F7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUT $500000 O 51BA1390133001 08/02/06 08/02/07 (Es ALL OWNED AUTOS X SCHEDULED AUTOS BODILY (Per personon)) $ X HIRED ALITOS X NON-OWNED AUTOS BODILY dent)INJURY (Per eccldert) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIAB LITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: A•G $ EXCESSIUMBRELLA LIABILnY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ _ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND X ORY LIMITS A ER EMPLOYERS'LIABIUTV T ANY PROPRIETOR/PARTNER/EXECUTIVE WC8931351 12/20/05 12/20/06 E.L.EACH ACCIDENT $100000 OFFICERiMEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $100000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOMMAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of North Andover IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 1600 Osgood St REPRESENTATIVES. North Andover MA 01845 AUTHORIZED REPRESENTATIVE James A Santo ACURD 25(2001/08) 7 ACORD CORPORATION 1988 The Commonwealth of Massachusetts 1 Department of Industrial Accidents l' Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): K 0T Co n 5 j t^ r f,,0 k Address: 96r,' FK-,,, 4J City/State/Zip: k on d 4 o3 o5, Phone #: 1,4 -,4o -- 06 Are you an employer?Check the appropriate box: Type of project(required): 1.u I am a employer with f- 4. ❑ I atn a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ t am a sole proprietor or partner- listed on the attached sheet. * 7 Remodeling ship and-have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] ? employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. '*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. /am an employer that is providing workers'compensation insurance fir my employees. Below is the policy and job site in formation. Insurance Company Name: A/YI e.�,'c ait Tit�e�n�_ `on�r f �o✓!� Policy#or Self-ins. Lic.#: We- -Se-W S-23/3s% Expiration Date: Job Site Address: q3 -,(',,l/F r P_J City/State/Zip: /ti,15�galo,l- 17,4 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 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 STOP WORK ORDER and a tine 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. /do hereby certify under the pains and penalties of perjury that the h!formation provided above is true and correct. Signature: Gee(- Date: — 6 c7.1- 0 61/ Phone#: 603 S/3�7 WO Official use only. Do not write in this area,to be completed by city or town oJrcial. 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#: CONTRACTOR AGREEMENT Page 1 This agreement made the 31st day of October by and between Scott I LaPointe herein after called the Contractor and Mark&Terry Strangle,herein after called the owner(s). Witness,that the contractor and the owner for the considerations named agree as follows: Article 1. Scope of the work The contractor shall famish all the materials unless noted and perform all the work shown on the Drawings and/or described in the Proposal as annexed hereto as it pertains to work to be performed on property at 43 Fuller Rd N. Andover MA Article 2. Time of completion The work to be performed under this Contract shall be commenced on or before the 1' day of November 2006 and completed on or before the I!I day of December 2006 Time is of the essence.The followingconstitutes substantial completion of work pursuant to this coin his proposal and contract:when all items have been completed.Any change orders P written once the job has started will add time to the completion date and will be stated m the change order. Article 3 the Contract Price The Owner shall pay the Contractor for the material and labor to be performed under the Contract sum of Thirty two thousand eight hundred and fifty-nine dollars($32859.00) subject to additions and deductions pursuant to authorized change e orders. Article 4.Progress payments Payments of the Contract price shall be paid in the following manner Payment # 1 deposit upon signing of contract...................... ................. $5759.50 Payment #2 Start of project...............................................................$12050.00 Payment #3 Completion of windows 1/2 completion of siding...................$12050.00 Payment #4 completion of work........................................................$3000.00 Paget Article 5. General Provisions Any alteration or deviation from the above specifications,including but not limited to any such alterations or deviations involving additional material and/or labor costs,will be executed only upon a written order for same,signed by owner and Contractor,and if there is any charge for such alterations or deviation,the additional charge will be added to the contract price of this contract ff payment is not made when due,contractor may suspend work on the job until such time as all payments due have been made. A failure to make payment for a period in excess of seven days from the due date of the payment shalt be deemed a material breach of this contract. In addition the following general provisions apply: I. All work shall be completed in a workman-like manner and in accordance with all building codes and other applicable laws. 2. The contractor shall furnish specifications for home improvements,a description of the work to be done and description of the material to be used and the equipment to be used or installed,and the agreed consideration for the work. 3. To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 4. Contractor may at his discretion engage subcontractors to perform work hereundre, provided contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this contract. 5 All change orders shall be in writing and signed b owner and contractor, and shall be - c g g � Y incorporated in,and become a part of the contract b. Contractors at his expense obtain all permits necessary for the work to be performed. 1J , Page3 7. Contractor agrees to remove all debris and leave the premises in a broom clean condition. 8. In the event owners shall fail to pay any periodic or instailment payment due hereunder,contractor may cease work without breach pending payment or resolution of any dispute. 9. All disputes hereunder shall be resolved before any contracted work resumes. la. Contractor-shall not be liable for any delay due to circumstances beyond its control including strikes,weather,casualty or general unavailability of materials. 11. Contractor warrants all work for a period 12 months following completion. Any work performed by any subcontractors not hired by K-A-T construction will not be covered by K-A-T construction. 12. The contractor shell furnish a list of all items that are to be supplied by the clients. And the stages when these items are to be on site. Article 6.insurance The contractor represents that it has purchased insurance,and agrees that it will keep in force for the duration of the performance of the work,or for such longer term as may be required by this agreement,in a company or companies lawfully authorized to do business in the state of Massachusetts. Such insurance as will protect KA-T construction and the owners of the site from claims for loss or injury, which might arise out of or result from the contractor's operations under this.project,whether such operations be by the contractor or by a subcontractor or its subcontractors. Article 7. Start date and completion date The actual start date and completion dates may vary due to circumstances beyond our control. Such as permits being issued, inclement weather,back ordered materials, scheduled inspections etc. Upon signing. I agree to pay for the above s ted work that is to be performed under the conditions as s within. Customer si e date J date Customer signature K-A-T Representative , date /a/moi/a G