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Home My WebLink AboutBuilding Permit #317 - 43 SUMMIT STREET 10/13/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:, Date Received Date Issued: s 3 d IMPORTANT:Applicant must complete all items on this page LOCATION LIM Print eussell. 1-111 1 PROPERTY OWNER �- Ci Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes n Machine Shop Village ye no 100 year-old structure ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Orp4amily ❑Addition wo or more family ❑ Industrial ❑Alteration No. of units: — ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other { `F`Sepfc ❑Well` '` ❑Floodplain Wetland's: ; WatershedDstnct DESCRIPTION OF WORK TO BE PERFORMED: s � (Identification Please Type or Print Clearly) OWNER: Name:_ lb ae/ rnPhone: Address: CONTRACTOR Name: }��j Phone: Address: Supervisor's Construction License: .67(o /, Exp. Date: z-/V- Home V-Home Improvement License: /OG 2 3.3 Exp. Date: -.2 2Q11 Z ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASTED ON$125.00 PER S.F. Total Project Cost: $ 79�Q, FEE: Check No.: 1 5-od Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce o the guaranty fund Si 'nature of A ent/Owne'ra -g - - g �i1��rignature'of contr . _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/BodyArt E] Swimming Pools El 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 It COMMENTS i 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: Signa t. re: - Located 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. 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 U Notified for pickup - Date i. Doc:.Building Permit Revised 2011 June/mi 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: Doc.Building Permit Revised 2008mi Location _°�� I No. Date NORTh TOWN OF NORTH ANDOVER F �a Certificate of Occupancy $ M�S t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # J U r, Building Inspector NORTF� ToVM Of over .4• X. TV% • 1 o o dover, Mass., l COCMICKEWICK %S � SATED 4 BOARD OF HEALTH Food/Kitchen Septic System PErt IT TBUILDING INSPECTOR THIS CERTIFIES THAT........... .....VS....... o r` 'f� ` d ..................................... ......................................... . ......... Foundation has permission to erect...................................I..... buildin s on ....q1...q.41........ !!!A!!!.M ............... !fig.. Rough to be occupied as.............�... ......... .Q.... Chimney .... ................. ..................................................................... provided that the person acceptin his permit shall in every respect confi) to the terms of the application on file in Final 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 S PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC ` S Rough . Service .... ` BUILDING INSPECTOR 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 SIDE Smoke Det. Proposal AB CARNES, INC. Page 1 of 1 30 Arrowhead farm Rd Boxford, Ma. 01921 978-887-1431 or 781-599-9197 Mass,Builders License No.000230 Contractors Registration.No 100733 ProI Submitted To: CLAIR &RUSSELL MERCIER TR Date September 5,2011 41-43SUMMIT ST Project Name 41-43 SUMMIT ST REALTY TR NORT ANDOVER, MA 01845 Address 43 SUMMIT ST NORTH ANDOVER,MA 01845 978-6 6-4983 We pro )ose to fumish material and labor-in accordance with the specifications below: Seven y Nine Hundred Dollars($7,900.00) Paymnt to be made as follows: $300.00 Deposit, Balance Upon Completion Notice:III home improvement contractors and subcontractors engaged in home Authorized improvery ent contracting,unless specifically exempt from registration by provisions Signature of ChaptE r 142A of the General Laws,must be registered with the Commonwealth Note:This posal may be withdrawn by us if not accepted withi 0 of Massa usetts. Inquiries about registration and status should be made to the Mass.go icenses website. days. ROOF PROPOSAL IZI STF IP ROOF OF ALL LAYERS OF ASPHALT SHINGLES,COVER ROOF DECK WITH 15 POUND FELT PAPER. COVER EXTERIOR WALLS AND FOLIAG WITH TARPS TO HELP 0SM GE, INS ALL ICE a;<WATER SHI IDE ATLEADING EDGE ONLY, AND THREE FEET IN ALL VALLEYS AND ALL ROOF PENET TIONS.UNHEATEDARDED. ® COVER ALL PERIMETERS WITH EIGHT INCH ALUMINUM DRIP EDGE. INS ALL RIDGE VENT AND/OR®AS NEEDED ROOF LOUVERS FOR ADDED ATTIC VENTILATION. ! ® COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS. REF LACE WALL FLASHING(S)AS NEEDED WITH ALUMINUM OR LEAD AT THE ADDITIONAL COST OF$25.00PLFT.WE MAY NEED TO REMOVE THE SIE ING TO PERFORM THIS WORK.YOU MAY NEED TO HAVE A CARPENTER REINSTALL THE REMOVED SIDING. ❑ CHI 4NEY FLASHING; CUT ALL EXISTING TAR AND LEAD FROM CHIMNEY(S).CUT NEW REGLET WITH CARBIDE SAW AND SECURE NEW LEAD FI ASHING IN PLACE W/LEAD ANCHORS. PROPERLY SEAL REGLET JOINT. PLEASE ADD TO ABOVE PRICE. ❑ REE UILD CHIMNEY FROM ROOF DECK UP WITH NEW OR USED BRICK. TO ABOVE PRICE. ® CO ER ROOF SURFACE WITH CERTAINTEED LANDMARK WOODSCA LIFETIME ARRANTY SHINGLES. ® RE LACE DEFECTIVE ROOF DECKING WITH 1X8 SPRUCE BOARDS AT NAL COST OF$4.50PLFT. ® COVER ROOF DECK WITH CDX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADDITIONAL COST OF $4.00PS FT. 0 SH114GLES ARE TO BE STORM NAILED.(USE SIX NAILS PER SHINGLE) ❑ INSTALL SKYLIGHTS PROVIDED BY CUSTOMER,FRAME ROOF DECK AS NEEDED,PROPERLY FLASH UNITS WITH FLASHING KIT(S)PROVIDED, CUSTOP IER TO PERFORM ALL INTERIOR WORK. ADD TO ABOVE PRICE. ❑ REN OVE EXISTING GUTTERS ❑INSTALL NEW SEAMLESS.032 ALUMINUM GUTTERS USING THE POSITIVE LOCKING BAR HANGER SYSTEM. ® RE CE DEFECTIVE OR ROTTED TRIM BOARDS AS NEEDED WITH#2 PINE PRIMED,ADD$15.00 PER FOOT TO ABOVE PRICE. ❑ INS ALL NEW ALUMINUM DOWNSPOUTS. MECHANICALLY FASTEN ALL CONNECTIONS. CLEAN A L PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA. OBTAIN ALL PERMITS AND CARRY ALL NECESSARY INSURANCE AS REQUIRED BY LAW. WE CANNOT CCEPT RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS. CUSTOMER SHOULD COVER VALUABLES. GREAT CARE WILL BE USED TO PROTECT THE STRI CTURE AND FOLIAGE.HOWEVER,SOME MARRING AND OR MINOR DAMAGE COULD OCCUR. HAND R IL ONLY,NO NAIL GUNS TO BE USED. SPEC kL INSTRUCTIONS: THE AB VE PROPOSAL INCLUDES THE HOUSE AND SHED WAR TY-ATI work warranted to be free of installation defects for 5 years;This is limited to the installed item(s)and their repair only.Material warranted by mfg.to b free of defects for 50 years,seethe manufacturers warranty for exact warranty performance. Customi r has legal right under federal law to cancel this contract without penalty or obligation within four business days from the date of signing this agreement via Priority Mail Delivery Confirmation. Please see reverse side for cancellation procedures. Once all tems in this contract are completed as agreed,customer has 3 days to fulfill payment schedule.All parties agree that all disputes shall be settled by the disputer olution process on the back of this agreement. Please see reverse side,Dispute Resolution. SigninAce �ean/sou have accepted all the terms as stated on the front and back of this agr ment. Please see reverse side. Date ofSignatSignat r PLEASE SEE REVERSE SIDE The Commonwealth ofMassachusetts De artment o P f Industrial Acciden is Office of Investigations 600 Washington Street Boston,MA 02111 SV _ www,mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �d Address: City/State/Zip: Phone#:_ E.Are you an emplo eck the a ro riate box: r pp' p Type of project(required): • a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 El construction 2.❑ I am a sole proprietor or partner- listed on the attached sheget.t 7• ❑Remodeling ship and have no employees These sub-contractors have working for me in any capacity. workers'comp.insurance. 8' ❑Demolition [No workers'comp.insurance 5. ❑ We ate a corporation and its 9 ❑Building addition required.] officers have exercised their 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. C. 152,§1(4),and we have no insurance required.]t employees. I2.❑Roof repairs [No workers' comp,insurance required.] 13.❑Other *Any applicant that checks box#1 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. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. BB Insurance Company Name: VR Policy#or Self-ins.Lie.#: y.�Q / Expiration Date: Job Site Address:_ `t , City/State/Zip: lz,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 as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Bea ed that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance cover e verification. Ido hereby cert f u r the and a It s o \ P per that the information provided above is true and correct_ Si ature: I Date: 'hone FQfi-lclalonly. Do not writein this area,to be completed by city or town official n: Permit/License# ority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: ' Phone#: at,:wrr t i t ')181t f r 31.11T RLR f-VMrANT VU/UOUb-UU WC 002-50-2480 13102 ----------------------------------------- 013-66-0311-10 C ` - A B CARNES INC C H A R T 15 B011f ORD 0019211-0000 A Chords company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM I.Of THE INFORMATION PAGE- WiC990619 to Water Street I• "AWL. . .— i AgRE I1 I WORKERS COMPENSATION ANS EMPLOYERS PO 1149 LIA81UTV POLICY INFORMATION PAG A. MA 01970-0449 lNSUREq IS ► US POUCYNUMM CORPORATION RENEWAL_ 002 02480 ER WOMEMS f SEE W ION OF I`d°EM 1.OF'THE INMRiVlATiON PAGE- WCM610 ffm 2 POLICY PEtWD 1241 A.N.stani�l thm*t the hWir rci a nallit+uaekfma 03/31/11 To 03/31/12 Ivs►r a A. Workers Compwftffon frisurant* Pat One the,p� "piles ffi the WorkeaS Compensatlon Low of states listed here: KA 8. Employers U*Mffty insuranow'Part TWo of to Voliq t0ifPaR to —edit state listed In item B.A. The limits of our ife eft unto Part Two am Bodily injury by Accident$_ 1,000,000 each accident soft Infury by DissI I n S 1.000.000 Policy limit Badly Injury by Olum S i.400,000 each employee C. Ocher States 111MMnf.:Part Three of the potfcl►sppUM to the SU tt"s, if any. Ifsted f SEE ENDORSEMENT - WC200306A O. This policy includes thmm endom anteMs and schedules: SEE EXTENSION OF ITEM 3.0.Of THE INFORMATION PAGE -WC990612 ITBI4 TM ppm for aft s. policy vAll be determined by our Manual;of Raids, C lasif ogrowM REM "d RmhV Pbtmh. AN irriormstion repuMW below is subject to heertf cs"on and chow by sudit f�»eaiutn'asats RatoPer estimated til fkittiOns Code ftmber Total I emend shots $100OFIW Pmmiu Atesittat 3 Year x Annual 3 Year SEE EXTENSION OF ITEM 4.OF THE INFORMATION PAGE -WC7754 TAXES/ASSESSRENTS/SURCIIAR&ES $232 t»s r rrt�eci r e rz ► aesysr qM8 14A 1111MUM PFISMIUM S38 SL H imficeW below.inlartm aditutr+» m ma of osmiushaft be made: aSana-pimalty 0 ii6ta11i" 0 "Gila, URPOWPIVENKIIA 03/17/11 ASSIGNED RISK 66 Matte elate f wong office Authortod peptasentati- WC 00 00 01A sM/(RWd 04mf►) =. Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Basten,Massachusetts 02116 Home Improvement Contractor Registration: Registration: 100733 Tyw: Private Corporation EXr,!--Z= 5, 412 Tris 293445 A. B. CARNES, INC. Barry Carries 39 Arrowhead Farm Rd. Boxford, MA 01921 Update Addrvn and rttmrn card.Mark reason fur chouge. Addri-w �1 Recewsl Employment LQst Card ♦iaw:tchusctt,-Dcltar(mcrit rfi Public Safe1% Board of Buildint Rc-mlatinm and Stavdard* Construction Supervisor License Urense: CS 58439 Rtshacted to: KENNETH R CARNES �cage 9 DORIS ST GROVELAND.MA�l1834 Expiration: 1114M 12 (.•mmi+t qrr Tm- 144W