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HomeMy WebLinkAboutBuilding Permit #821 - 5 SKYVIEW TERRACE 6/22/2010BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:—P Date Issued: & Date Received O R_ TYPE OF IMPROVEMENT New Building PROPOSED USE Residential One family Two or more family No. of units: 'replacemen Assessory Bldg tion Other S u 1IVel1Floodpl rV1/atet/Sawa. DESCRIPTION OF OWNER: Name: Address: .Sly ly�v`_w CONTRAC.TR: Non- Residential Industrial Commercial Others: ain Ir+Vetlands Watershed Districf Y WORK TO BE PREFORMED: Please Type or Print Clearly) 7- OT -'1k18 V l 1 1 Supervisor's,Construction.lidense b s') now q4 _ �xp� Date:: Home ImProvemen# -L'#cense.=- � ' '•-� Exp - :Date ARCHITECT/ENGINEER K,/ve4`'k- Phone: ----� Address: -ft-_ 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: $_ 7 FEE: $ D Check No.: 91,-2/ 2- Receipt No.: .23 QZ NOTE: Persons contracting with unregistered contractors do not have access to the guaranty.fund Signature of Agent/Owner Signature of con tracto 4 N3 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL 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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes �V Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/signature & Date Driveway Permit DPW Town Engineer: Signature: 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 - Date Doc.Building Permit Revised 2010 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: Building Permit Revised 2008 Location -r2r4.oc No. P? Date ? n;, ,60 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ zg!�2-- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # o1Z 230,5 � Building Inspector 0 z cd a W x O o w° a cin 0 U z or. b w° w°' U `° w 0 w w2' w p U. w �2 cf) � w a p U � w z - m cn o cn U) Cn zC/) 0 O � U C/) C/) 0 w U C/ P -i INI Lv- 2 O O O co O 'o s Z Q CL O CO) G C co cm O 'a OD C N CO2 O O -P m m CD CD CL ~ _ 0 0 O O � CL CMa c co C CD CL V y R C C R CO) cm o a� c CZ o ` C CO O 'y C cc o V CLC cv cc z o � L CF �, :... is 0 C (: Q$ ©:mac 0; &S E ce CD m ' 0 ` N t c��3 � N A C m v a � : M-0 C A O O S' YJ �N CD` m o O cA�[ G. V L.: V N O t = O Qf ` L. C Q COD p,Ct •� O � m m N O Z O yr C C- O d C � m : y m C C _ ® CL 0 ~ e0+ H O COD t •SNA A dt C Z C* d O � O :0 �U3 O Z CNv =.2a,m:Nm U) Cn zC/) 0 O � U C/) C/) 0 w U C/ P -i INI Lv- 2 O O O co O 'o s Z Q CL O CO) G C co cm O 'a OD C N CO2 O O -P m m CD CD CL ~ _ 0 0 O O � CL CMa c co C CD CL V y R C C R CO) cm CERTIFICATE OF LIABILITY INSURANCE A!, p. facbeste XbSU>kruMM Ame „M CUT�1CA'1R tS RUED ASA 1060 04900d Street I%Xth Audovar, WA 01848 tPHYmzmm==o _ 169 Boma=& fun -V NOM AVIDMR, fA 01848 ML 06FrEmuVaLm cww Mae ac mull MRA. ROONNO 17ILUTAPPLMOWR ANVAUTO ALLOw4omyw H smatglMAlfOA "MCA" Na*O"V A1TW i41FiAee �NJTY ANM'AU10 0cm CLAM#Vw owuo OIA C RX: 979-699-7207 68 04 7AM277013608 MUMS APPORIWn CONERA68 NAtC� 11/22/08 11/22/09 5 �BFi�OLrIlrNr ! 500.000 1/23/09 1/23/10 P.r a+ �Rr DAMaaa a 500,000 7/1/09 7/1/1Q aFaulu Ax�►oFT�a+� ,,�,�e eec vW , FNISNOIWIM R A��LIoI�Pq�'fFlfafOMRAfFIIN TO" OB' Al�D(7fiUxl cA7Q TH9uw, rMi,t lNOBAVOR TD NAR -I(—)OAYl1 Yr�TiiN lalllt'l'N 1�d1►HA, t 01848 1400 corn D T IAMM TQ7 0l ft"W a ""OLOg FFANBIf 70 HFt M",� 9IlT! IMPOaQ No OOL—. AILL" 70 00 60 YHALL rmmoolkaw"71 6 V",ft worm +a Amm ae ao f - - I*' 11�011 lfNd AiCQpC1 ems aad ® IN44ft ACOftb 40R TfON. Alf wlphbor�Id. loga+rn►rogba�ednOft OfAGpft �h. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ''' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AVRficant Information Please Print Le ibl Name(Businesstorpwzationmwividuai).' Address: City/State/Zip: Q, ,. b�.,�,.�,c,� .. a�S�LPhone #: - 11 nI,<` Are you an employer? Check the -appropriate box: 1 am a employer with _L 4. ❑ 1 am a general contractor and I employees (full and/or part time).* have hired the sub-omtractors 2. ❑ I am a sole proprietor or partner- fisted on the attached sheet t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp, insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] ' officers have exercised their 3. ❑ Y Am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, 01(4), and we have no insurance required] t employees. [No workers' ---- comp. insurance required.] Type of project (required): 6. ❑ New construction 7. Remodeling 8. 0 Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I I Q Plumbing repairs or additions 12.❑ Roof repairs 13,n Other Any appitcaatt that checks box # 1 roust also fill out the section below showing their workers' compensation policy information; Homeowners wbo submit this st4fidevi► indicating they we doing all work WA then hire outside contractors rnug subrWt a new affidavit indicating such. contractors that check this box must attached on additional shat showing the name of the sub-eontmetors and their workers' comp. policy information. am an ion. employer that Is provUbg workers' compensation insurance for my employees. Below is Me.policy and job Site �formettiore. asurance Company N 'olicy # or Self -ins. Lic. #: L C 00 1 _ Expiration Date: ]' l t) Db Site Address: 't;-' J\�v,e � `T� t� _ cityistattaip: t,/L\4 �,,� a �a ' ►ttaeh a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). adore to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine 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 f up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of avestigations of the DIA for insurance coverage verification. do herebx certify render the pains and penalties of perjury that the information provided above is tree gad correct: L_1_ -D QJj`rcial use only. Do not write in this area, to be completed by city. or town ojj'ieiat City or Town: Permit/Ucense # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Cityli'own Clerk 4. Electrical inspector S. Plumbing Inspector 6. Other Contact Person: Phone #: J 169 Boxford Street PH: 978-688-5335 North 1845 Building Contractor FAX: 978-688-7207 Proposal To: Jim & Cuma Pettorelli 5 Skyview Terrace North Andover, Ma. 01845 From: Kevin Murphy CC: Date: 5/24/2010 .lob: Replace front door Date of plana;: None Architect: None Location: Same Section 1- Work Schedule All Home improvement Contractors and Subcontractors engaged in home improvement contracting, unless specifically exempt from registration by Provisions of Chapter 142A of the gametal laws, rru st be registered with the Corrurmmuealth of Mme. Inquiries about registration and States should be made to the Director, Home Improvement Contrail Registration, One Ashburton Place, Room 1301, Boston, MA 02108.(617)-727 8598 Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 6/15/10. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 7/15/10. The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11- Warranty The Contractor warrants that the work furnished hereunder shall be free from defek.s in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair correct, replace, or cause to be remedied, repaired, or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section 111- Scope of Work Ij McVAan MMVLMnnV 01 ' SuRding Contractor 169 80)6ord Street North Andover, MA 01645 PH: 9788885335 FAX 978888-)000( Page 2 of 4 General Proposal is to replace existing front door/ sidelights and related rotted trim. Building permit will be provided by contractor. Demolition Existing door unit and trim will be removed. Building New fiberglass unit will be supplied and installed in existing opening. An allowance of $1000 has been included for new door / sidelights. All rotted exterior trim / sheathing will be replaced as required. Interior Trim/Doom Interior trim will be reused / replaced as required. Waste Removal All demolotion / construction debris will be disposed of by contractor. Items Not Included There have been no allowances made for any painting or flooring - MI$Owuan rV2Mn gNV Building Contract= 169 Boxford street North Andover, MA 01945 PH: 979-688-6335 FAX 978888-)000( Section IV — Price Schedule Page 4 of 4 We hereby propose to furnish material and labor — complete in Accordance with above specifications for the sum of ..................................... $ $2500 Payment to be made as follows: "Notice: No agreement for Home improvernent contracting work shall require a dorm payment (advance deposit) of more that one-third of the total contract price of the total amount of all deposits or payments which the contractor must make, in advance, to order and/or otherwise obtain delivery of special order materials and equipment, whichever is greater Contractor: Kevin Murphy 169 Boxford Street No. Andover, MA 01845 Registration No: 101874 Section V - Acceptance Acceptance of Proposal — I have read this document and accept the prices, specifications, and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature r Date 1 Signature Data