HomeMy WebLinkAboutBuilding Permit #475-15 - 453 WAVERLY ROAD 11/17/2014Permit No#--
Date Issued:
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received ! /` y` Zy / T
• IMPORTANT: Applicant must complete all items on this baize
LOCATION `q -3
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2 <•' a •a p
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PROPERTY OWNERel::Z n-
Print 100 Year Structure yesrnoMAP*Z' PARCEL: f J-- ZONING DISTRICT:Historic District yesMachine Shop Village ves
TYPE OF IMPROVEMENT
PROPOSED USE
Resi ential
Non- Residential
❑ New Building
One family
❑ Addition
❑ Two or more family
❑ Industrial
Iteration
No. of units:
❑ Commercial
epair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
0 Watershed District
❑ Water/Sewer
p F 11 DESCRIPTION OF YVORK TO BE PERFORMED:
Identification - Please Type or Print Clearly >,
OWNER: Name: �',Qri Phone:
Address: `71,��3 (��✓ v4� Ald ��v✓��'t/� c�l�``t'�
Contractor Name;:T- Phone:
Address: 93 N k irr,-> t+
o//-(-
Supervisor's
//-6
Supervisor's Construction License: C S Exp, Date: 2 -GQ-- 2,v (�
Home Improvement. License:_ Exp. Date: _ -� �Y..
ARCHITECT/ENGINEER— Phone:
�vf
Address:
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 - FEE: $
Check No.: 'Receipt No.:
NOTE: Persons contracting with unregiMtered contractors do not have a#cess to tl# jtuaranund
re bf Aae,/OwnerSianature of
Plans Submitted L7
Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE"OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/1\4assageBody Art ❑
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc. ❑
permanent Dumpster on Site ❑
PLANNING & DEVEL
COMMENTS
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
Reviewed On
Signature
CONSERVATION Reviewed on 0 111'A Signature'
COMMENTS \ cO S O.r
HEALTH Reviewed on Signature
� ( J
COMMENTS Imo'
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Commen
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster onsite 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
❑ Notified for pickup Call Emai
Date Time Contact Name
Doc.Building Permit 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
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/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
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 2014
�j WU v
Location
No. 4 ! Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ s
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # v�
20'2733
Building Inspector
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MAP 22, PARCEL 114
19 MARGATE ST
BLINK, PAUL F, JR❑&
GRACE H BLINK
BOOK 3494, PAGE 273
MAP 22 PARCEL 113
11 MARGATE ST
KELSEY, JOHN A &
HENRIETTA I KELSEY
BOOK 838 PAGE 159
MAP 22 PARCEL 112
459 WAVERLEY RD
TICE, RENFORD C
BOOK. 3618 PAGE 299
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13' --
MAP 22 PARCELI�'
429 WAVERLEY RD
ALROSE ASSOCIATES
#9 1#3
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#4
EXISTING WETLAND
•4 #5 -
#7 4 EXIST. 24" C.M.P-
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48
PROP. N �;
GAR.
/ 6n _ 15'
MIN.
BIT. CONC. ' -f-,
t .. DRIVE N
DECK
EXIST.
BUILD
HSE.# 453
LOT AREA
45,200 S.F +/-
WAVERLY ROAD
MAP 22, PARCEL 131
427 WAVERLEY ROAD
PICKARD, TIMOTHY H &
HELEN M NEWELL
MAP 22 PARCEL 130
425 WAVERLEY RD
LEVINE, MILTON S.& REGINA
NOTES:
THIS PRO,
PROTECT.
S.V.W. FL.
GBC
CONSTRUCTION
Submitted To: Brian Beckerman
Address: 453 Waverley Road
North Andover, MA 01845
93 Burroughs Road
North Reading, MA 01864
Phone: 978-886-0241
Project: Rear Deck
978-551-8020
We hereby submit specifications and estimates for:
Proposal X
Invoice
Date: 07-26-2014
Location: Back of House
-Demo and dispose of existing back deck rails, decking, framing, stairs, posts and lattice.
-Install new 121x 16' deck with added stair landing and steps out further from existing.
-Deck to be supported on 12" sonatube footings 4'- 0" below grade, with 6"x 6" PT posts.
-Deck framing to be 2"x 10" PT lumber attached to posts and secured to house ledger board.
-Install new 5/4"x 6" PT decking parallel to house and properly flashed at house siding.
o -Install new 4"x 4" PT posts and PT railings around deck and down stairs.
-Install new PT lattice around bottom of deck with access opening.
-All decking to be screwed down and railings to be secured to posts with stainless steel screws.
-All demo and construction debris to be removed from site.
Exclusions: Building permit fees, painting or staining, work to siding, removal of ledge or large
rocks or anything not mentioned above.
We Propose hereby to furnish materials and labor — complete in accordance with the above
specifications, for the sum of:
Twelve Thousand'gh undred and 00/100 ` , / ($12,800.00)
Payment Terms: down, iI/o after all decking and 15% upon completion. q. —,c,- 7j
-�of
All work to be done in a workmanlike manner according to standard practices. Any alteration or deviation from the above- 77 ' -
specifications involving extra costs will become an extra charge over and above the estimate. All agreements are 2�� t 9,
contingent upon strikes, accidents or delaysheyond o4 control. Owner to carry all necessary insurances.
Authorized Signature:
Note: This proposal may be withdrawriby us if not accepted within
days.
Acceptance of Proposal -- The above prices, specifications and conditions are satisfactory and hereby accepted.
You are authorized to do the work as specified. Payment will be made
ee1aas outlined.
Date of Acceptance: to `"Iq -Zb [ � Signature:, 6 aJ4'-'r
i
Of Mgss9�
yG
JOHN S. �+
o LAURETANI
# 34311
C11- S9
Cq�o SUR'j
Motplans.com
LAL.11:11.".RS
101 CONSTITUTION BLVD, SUITE D
FRANKLIN, MA 02038
800)287-8800 FAX.:(508)528-4011
mw
PARCEL 114
PARCEL 113
PARCEL 112
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1
PARCEL 02
`15,200± /S. F,
f
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2 1/2 STORK.
DWELLING' l
'' OE
Kik>a i
ii
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'1
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i GARAGE
100
PARCEL 131
PARCEL 130
LOT CONFIGURATION IS.,BASED
ON DEED. AND/OR
ASSESSOR'S MAP, AND
OCCUPATION. A MORE
ACCURATE REPRESENTATION
WILL REQUIRE AN INSTRUMENT
SURVEY.
WAVERLY ROAD
MOR z GAGE LENDE'
USE 0NLv
Richard S. Gallagher
Attorney at Law ! ``
40 IVN*illard St., Suite 103 617-376-2260 '
Quincv. IIIA 02169 Fax 617-376-2265
Ir-inall: richra;gallagherescrow.com
MORTGAGE INSPECTION PLAN THERE ARE NO DEEDED EASEMENTS IN
THE A60VE REfERENCEO°`i�EED OR
ADDREss: 453._WAVERLY ROAD. NORTH _ANDOVER,_.MAENCROACHMENTS WITH RESPECT TO
? "EXCEPT AS STATED ON THE DEED OF
kz�. , cunco CQ unQrr_er_c rltnlla .r—on cunwu
II
From: Brian Beckerman <brianbeckerman@yahoo.com>c
Subject: Re: Building permit
Date: November 12, 2014 9:31:47 PM EST
To: Jim Intravaia <gbccorpl @verizon.net>
Reply -To: Brian Beckerman <brianbeckerman @yahoo. com>
Jim
Here is the plot plan, hope it is the right one.
On Saturday, November 8, 2014 11:42 AM, Jim Intravaia <gbocorp1 @verizon.net> wrote:
Hi Brian,
I need a copy of your plot plan for the Building permit application.
Can you please scan and email it to me.
I will need it for Monday morning.
Thank you,
Jim
P1 RCEL � 32
,45,200± S.F.
j
N (V
PARCEL 114
2 1/2 STORY,
DWELLING'
i„
PARCEL 113
PARCEL 131
PARCEL 130
1 Attachment 80 KB
PARCEL 112
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LOT CONFIGURATION IS BASED
ON DEED, AND/OR
ZN OF Mq
Ssgn
4
ASSESSOR'S MAP, AND
�F,PV'
yGACCURATE
r;'
1
OCCUPATION. A MORE
REPRESENTATION
O�
IN
WILL REQUIRE AN INSTRUMENT
JOHN S.
o
LAURETANI
SURVEY.
a 34311
WAVERLY ROAD
FESS\NPv
O
YgyO 1 Q
SU
MOP t GAGE LE1 DE.9
�af
USE ONLY
Aotpians.com
Richard S. Gallagher
`
Attorney at Law
��� 1 � '�L.�f\�(..�Z.�
_
.\li.L I \I I ,
101 CONS11711TION BLVD. SUrrE 0
40 Willa,d til., Sui(c 103 617-376-22611
FRANKLIN, MA 02098
800)287-8800 PAX.:(508)528-4011
Quincy, NIA 02169 Fax 617-316-2265
E-mail: rich(ggaliaghercacrow.com
(r�
MORTGAGE INSPECTION PLAN
THERE ARE NO DEEDED EASEMENTS IN
THE ABOVE REFERENCED DEED OR
ADDREss: 453 WAVERLY ROAD. NORTH ANNDOVEii, MA
ENCROACHMENTS WITH RESPECT TO
LENDER: SB MORTGAGE GROUP
EXCEPT AS STATED ON THE DEED OF
RECORD SHOWN.
ATTORNEY: RICHARD GALLAGHER 08-157
oxwER: ROBERT C. ARMSTRONG d MARY M. ARMSTRONG
THE LOCATION OF THE DWELUNG ASSHOWN
APPLICANT: MW BECXERMAN $ PATRICUI MCLAUGHLIN
HEREON EITHER WAS IN
COMPUANCE WITH THE LOCAL ZONING
1
DATE: 11117/=SCALE: 1"=80' COUNTY: ESSEX NORTH
BY-LAWS IN EFFECT WHEN
-
CONSTRUCTED (WITH RESPECT TO
The Commonwealth of Massachusetts -
Department of IndustriglAccidents
Office of Investigations
600 Washington Street
Boston, MA. 02111
www mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
;Applicant Information. Please Print Legibly
Name (Business/Organization4ndividual): 60 /1. 10/_ cl� `�yl% I L—G
Address: '93 /&-�,-ro A k, kid
City/State/Zip-_&o(4
Are yo n employer? Check the appropriate box:
Type of project (required):
1. I am a employer with I
4. ❑ I am a general contractor and I
6. ❑ New construction F
*
employees (full and/ �Zero_
have hired the sub -contractors
7• ❑ Remodeling
2. ❑ I am a sole proprietor
listed on the attached sheet. l'
ship and'have no employees
These sub -contractors have
8. ❑ Demolition
working for me in any capacity.
workers' comp. insurance.g.
Building addition
[No workers' comp. insurance
5. El We are, a corporation and its
10T] Electrical repairs or additions
required.]
3. ❑ 1 am a homeowner doing all work
officers have exercised their
right of exemption per MGL
11. ❑ Plumbing repairs or additions
myself. [No workers' comp.
0.152, § 1(4), and we have no
12.[:] Roof repairs
insurance ] ired. re q u
employees. [No workers'
11d Other
comp. insurance required.]
'Any applicant that checks box41 must also fill outthe section below showingtheir workers' compensation policy information.
t -Homeowners who submit this affidavit indicating they a -re doing all work and then hire outside contractors must submit a new affidavit indicating such.
?Contractors that checkthis box must attached an additional sheet showing the name of the sub -contractors and their workers' comp, policy information.
lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Sol£ -ins. Lie. #: (� - 5�4`i ! ' �� / Expiration Date: —,�(� 2-Q1,5'
Job Site Address: 4 1A City/StatelZi- . A /Ai &hv e, v/ Q l d'.G
Attach a copy of the workers' compensation -policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as requiredunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a
$ne up to $1,500.00 and/or one-year imprisonment, as wellas civil penalties in the form of a STOP -WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of thus statement maybe forwarded to the Office of
Investigations of the DTA for insurance coverage verification.
X do Hereby cert under tlaeAlnq and penalties ofperjury that the information provided above is tate and correct.
D I--' -d); 2 U
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):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other - - -
Contact Person:
Phone
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees,
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,•
express orimplied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a -deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employes "
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced.acceptable evidence of compliance with the insurance coverage required: '
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub -contractors) name(s), address(es) and phone numbers) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line. '
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which -will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license ox permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
Tho Commonwalth of M-assachweats
Depar(meat ofl dustrial Aracidonts
Office o£Inyestigat iou
690 Wada u&,a St ceot
Boston M- A, 02111
W. # 61.7-7.27-49QQ ayt 406 or 1-$77-N MSAFB
Devised 5-26-05 Bay, 617-727-7749
wWWmaagovldza
Office of Consumer Affairs and Business Regulation
S 10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 172037
Type: LLC
Expiration: 5/14/2016
GBC CONSTRUCTION, LLC.
JAMES INTRAVAIA
93 BURROUGHS ROAD
N. READING, MA 01864
SCA 1 0 2OM-05/11 J/
:-J �e �o77t7n OJttr�crr�l� 0���:�"F'�fldrrrC�lr;et"fJ
_ Office of Consumer Affairs & Business Regulation
i0 ME IMPROVEMENT CONTRACTOR
Registration: 172037 Type:
.xpiration: 5/14/2016 LLC
-BC CONSTRUCTION, LLC.
JAMES INTRAVAIA
33 BURROUGHS ROAD
N. READING, MA 01864
Tr# 251514
Update Address and return card. Mark reason for change.
.[:]-.Address 0 Renewal ❑ Employment ❑ Lost Card
License or registration valid for individul use only
before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, MA 02116
Undersecretary Not valid without signature
Massachusetts - Department of Public Safety
Rnnrri of RniHinn Ronulntinnc and CtnnrinMc
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