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HomeMy WebLinkAboutBuilding Permit #297-2017 - 50 STANTON WAY 5/1/2018 BUILDING PERMIT NORTH q �T LED 16 TOWN OF NORTH ANDOVER a APPLICATION FOR PLAN EXAMINATION _ + 1 * Z e Permit No#: X 9I -a-V Date ReceivedgDR^7ED 4Py�5 �Ss�aC US Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION1c3 Print PROPERTY OWNER C c '5 Print 100 Year Structure yes no MAP PARCEL: ( ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 9One family ❑Addition ❑Two or more family ❑ Industrial 51 Alteration No. of units: ❑ Commercial ❑ Repair, replacement - ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p Sep#i.c ❑,W,e119 4 i� Floo'plain, ®`Wetlantls ❑ Watershed Di is f, L OWN ater Sew_ DESCRI 1PTIiOI N OF WORK TO BE PERFORMED: Ir\, VQ0 O-V r nein CkA, Identification- Please Type or Print Clearly OWNER: Name: C4,c 1s 5 C3 i ro Phone: Address: �")o S L,40YN U3 A w�ojer PI)C\ c31$ Contractor Name: Phone: G03 1911 m9`t rn Email: Address: SL 004, 5* Swl� ISN d�o�9 Supervisor's Construction License: CS - 0S5 331° Exp. Date: Home Improvement License: Exp. Date: Z� 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: $ (°1 ��Z3 . 0 O FEE: $ 1�S Check No.: 559 Receipt No.: �Wfl NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ., 1 1 Plans Submitted Plans.Waived Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL = Public Sewer ❑ Tanning/MassageBody Art ❑ Swin Mi'g Pools ❑ t well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dwnpster on Site ❑ � I I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY i INTERDEPARTMENTAL SIGN OFF - U FORM i� natur PLANNING & DEVELOPMENT Reviewed On U i� ' Si e V l 9 I COMMENTS >U1 tol� por eyl(f('G& u )G 0&no LKA 1e�� any CONSERVATION Reviewed on / S• I nature 'D COMMENTS _ HEALTH Reviewed on Signa (4 COMMENTS �C `, 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: _ a � rLocated 4 Osgood ,. , � ,,..... r 38 od .; e frAR±TMEN Temp D�umpster=ori Lted of 124 MatriiStreet - r ` S � ' -F�re INP.0 „� partment�Fsignatur�e/dated ` €N ,w.r,,0 _ n4 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 actor Ye p s No DANGER ZONE LITERATURE, Yes N® MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For•r deNartment use) LJ Notified for pickup Call Email E Date Time Contact Name Doc.Bnilding Permit Revised 2014 r' 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 4 Building Permit Application 4 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks , 4. Building Permit Application 4, 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 4. Building Permit Application 46 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 Location T 0n1 ' lilt p 4 No. _ U! ! Date 9- 1-7- ; 016 • . TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 7�'r— f Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 4/1, A Building Inspector 17t Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 193623.00 m $ - $ 235.48 Plumbing Fee $ 29.43 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 29.43 Total fees collected $ 394.35 50 Stanton Way 297-2017 on 9/19/2016 screened porch, roof over new deck r , NORT1y - � � t s � c . : ve: - No. � a 1 h ver, Mass, cln I q us 9017 coc.41 ".WICK �',• S U BOARD OF HEALTH Food/Kitchen PERMIT - T LD Septic System F.C.4+004 BUILDING INSPECTOR .. . .. ...THIS CERTIFIES THAT ......, w ::......... .......................................... . z .... .... Foundation has permission to erect .......................... buildings on ...,��/L �. �� � �. .... . ... . . . .. ........ ....... .. Rough to be occupied as �.� RChimney provided that the person accepting this permit shall in e4ery respect conform to the terms of the application Final on file in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUC N STA41ILM Rough Service ..... .... . .... ... III,.. ............................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. Plans Submitted°® Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DIS7EITa-uningWas Public Sewer sage/Body Art ❑ Swizmming foolsWell Tobacco Sales El Food Packaging/Sales El (septic tank, etc. E] El Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On SignaturejwlJ f r COMMENTS )Cn N- wa'(`` CONSERVATION Reviewed on :� Si nature COMMENTS HEALTH Reviewed on Si nat� COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments , Water& Sewer-Connection/s►- nature& Date Driveway Permit _ DPW Town Engineer: Signature: FIRE�DEP Tiocated 384 Osgood Street ARTMEIVT°` z mpster o ,"' s Loc ed at 124 Tulp TOMS Ype ua �:a � ono e - �`. r k Main Street �� i -- - t:Fire ®e ..-.. , .. r`• tYi i* f wx �' ..� '` .k ,�,,�,,=�t: partment signaturee/date . a, ,' ,, .a.' ,. , ' ''�..►e it �'�, � '� 't:.�?�"t�'f:.A"a,.�s* 't�. .fir•F•:7"��.5` E��`.'�"';�"mac,,:� ~^4 , r \:,� � s�.. c w •,• �t�.esra s t SPECIALTIES, LLC 603e9 e8594 Heather Balduino 50 Stanton Way North Andover Ma Estimate Drafted: 8/16/16 Job Descrip ion: 1) Excavate&pour approx. 6 concrete footings. 2) Install additional support beam under existing deck approx 4ft off house. 3) Install 16 ft support beam approx 18 ft off house wall to receive extension of existing deck structure. 4) Remove all deck boards on existing deck. 5) Extend existing deck approx 6ft. (creating a 16x18 foot structure.) 6) Install 2 new footings and support posts under existing deck(mid span) in order to support roof load of screened in porch. 7) Install approx 300 sq ft of Trex decking. (decking priced was Trex Enhance Clamshell). 8) All decking to be installed with hidden fasteners 9) Vinyl screening to be installed under deck that supports screened in porch. 10) Build a 16x18 roof structure over existing deck. 11) Roof structure to be constructed out of 2x 10 framing. 12) Support roof structure with approx 15 4x4 supports. 13) Roof to have vinyl soffits on all three walls of porch structure. 14) Plywood and shingle roof, shingles to match shingles on existing house. (approx 4.5 sq) 15) Create full cathedral ceiling inside porch area. 16) All support posts in screened in area to be wrapped in white pvc trim board. 17) All upper beams in screened in porch area to be wrapped in pvc trim board. 18) Install approx 850 sq ft of tongue and groove pine on half cathedral ceiling. 19) Polyurethane all tongue and groove pine. 20) Install 1 screen door. 21) Install 60 linear feet of white vinyl railing system. 22) Install approx 12 screen frames on porch. 23) Properly tie all new structures into existing house structure. 24) Install 2 sky light windows in full cathedral ceiling 25) Install 4 recessed lights. 26) Install 1 dimmer switch for recessed lights. 27) Install 1 outlet. 28) Install one ceiling fan. (Fan unit to be chosen by customer) Total Job Cost=$11623.00 * Total job cost includes all materials&labor). ** Estimate includes all disposal fees. *** Estimate includes all sub-contract labor. **** Additional charges may apply due to unforeseen construction upon demolition. *****Payment schedule to be determined upon agreement of contract. ****** This price DOES NOT include permit fees (TBD). *******R&M Specialties, HIC License# 178487 Sign Upon Agreement: Ian Fenton and Michael DeBenedetto Chris and Heather Balduino r Date Page 2 F oQ ` t rC/ i 7 i a V r 1 a e i f 10 IV —71 nonose, 4 �CiP t1 �JCYrG�L E 311& S'CQ��- _ x,71 co VIIJ S u)oo tit '_gaff1 s � u i , vp SGrn1 sC rr,$ Scccs £f-'D Ne i __ o 318 SC4l�— i it Ud 13' b CG'vne>� P,8 nG�r dol Sue- IL � t O -R k(a 3ecrr'i 3-7 6 D1r / x WWW' lis I � f I � I 7,-i ple 2XS .�—� o 7 lt. ix6 L I 0011 i fid'✓ �/,fiS 84 )ono t,J��� The Commonwealth of Massachusetts z . Department ofIndustrialAccidents _ 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia ,Y. Workers'Compensation Insurance Affidavit:BuUders/Contractors/Elpetricians/Plurnbers. TO BE TEE WITH� PERMITTIl�TG AUTHORITY-A Applicant Information • ]?lease Print Legibly Name(Business/Organization/Individual): - Address: 5 C MA A k V\ 5A City/State/Zip: le^y. ® 0 Phone#: G03 1 N y 8 9 9 Are you an employer?Check&e appropriate box: 'Type of project()required)- LQ I am a employerwith employees(full and/or part-time).* 7.• []New construction 2.VI am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition In I am a homeowner doing all work myself[No workers'comp..insurance required.]t 10 []Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors withno employees. 12:0 plumbing repairs Or additions 5.❑I am ageneral contractor and I have hired the sub-contractors listed on the attached sheet. IF-1 Roof repairs Theso sub-contractors have employees and have workers'comp.mince.; or MGL c. 14.❑Other e a co oration and its officers have exercised their right of'exemptionp 6.Q Wear rp _ 152,§i(4),andwehavenc..emplo ' .Wpworkers'comp.insurance required.] *Any applicant that checks box4lmust alsofill out the section below showfii theirworkers'compensationpolicy infomnation T Homeowners who submit tivs affidavit indicatingthey are doing all work and then hire outside contractors must submit a new affidam indicating such and state whether or not those entities have t -ached an additional sheet showing the name of the sub-contractors _ Contractors that checkthis box must•at[ employees.If the sub-c6n6d6rs have employees,ley must provide their workers'comp.policy number. I am an empZoyer tft,a is pr,ovidingworkerscompensation insurance for my employees.'Belot/is'the policy acid jab site information. Insurance Company Name' Policy#or Self-ins.Lic.#: Expiration Date: l //Job Site Address: 505 City/State/Zip: A N1. A.0&��'° ^�� Attach a copy of the workers' compepsatioi policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine 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 of up to$250.00 a day against the violator.A,copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der lie pains and penalties ofpeiyury that the information provided above is due and correct signafore: Date: v/8A, Phone# 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 ' ei Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for them• loyees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, expxess or implied,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 anotherwho 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 employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a Iicense or permit to operate a business or to construct buildings in the commonN�ealth for any applicant who lias 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 number(s)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 may be submitted to the Department of•Industrial Accidents foi•confumation 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-insure_d 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 hag 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 areference 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"rob 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. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or 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 Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,AIA 02114-2017 Tel. # 617•-727-4900 ext.7406 or 1-877-AIA.SSAFE Fax#617-727-7749 Revised 02-23-15 wwwmass.gov/dia I $' Massachusetts Department of Public Safety Board of Building Regulations and Standards 1. License: CS-055336 Construction Supervisor 5 MICHAEL J DEBENEDETTTO 4 HEATHBROOK RDy© J�4 MERRIMAC MA 01860 i Expiration: Commissioner 08/2512018 ��e tOao�zir�znauaeal��d�C��/�rd6cuci�u�1e(��I Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Re istration:t'1,78487 Type: - � Expiration 4/22/2018 DBA I ' T, '54- I' R&M SPECIALTIES � IAN PENTON 56 NORTH MAIN ST ' F SALEM, NH 03079 Undersecretary l r j