HomeMy WebLinkAboutBuilding Permit #475-16 - 55 PRESCOTT STREET 10/14/2015I
NORTH
66? !1 BUILDING PERMIT°•`•t`��°` ao
TOWN OF NORTH ANDOVER
PLICATION FOR PLAN EXAMINATION
Permit NO: !� Date Received
4re°
E
Date Issued: ®'� SACNUS
IMPORTANT: Anolicant must comvlete all items on this Dap -e
LOCATION -- f 1'PSCv44- S -f sic, X17 �9ncfs`t'�
Print
PROPERTY OWNER Ken n 0 -�ti e i'
Print
MAP N4 K , PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes fo
TYPE OF IMPROVEMENT
PROPOSED USE
Reside tial
Non- Residential
❑ New Building
ne family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
epair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
❑ Water/Sewer
", e PemcLz Remove e;'11
Gnr� f�✓J.5 /f /JPry Gtf�i7r�u S .. �P/.'�OUP c h ✓yrJ��f /!,
"713 J"19
Lfve ei/ d ®tel /,V// /PC -0- //e-1weve Td2'-i
41761 AS ,// /1eal ,-fmP fee ax crxrUV:'-i
IdentYmcation Please Type or Print Clearly)
OWNER: Name: kefI n efh ; o k, /� z- Phone: (c17 6) (.8e-
Address.
8Z-Address: g.5N Re Scc,+�- S -F- toot4-k Ph Jo v r-,- MA Q l e Vsz
CONTRACTOR Name:Phone: 976- 669-,<%1r. V
Address: "/0 (sr_,) d ep Au e- Nor Aojoy e,- PA 01
Supervisor's Construction License: OG 5 „? 6! ( Exp. Date: _ 2, �3 Z o1 b
Home Improvement License:t2o.Z' Exp. Date:
ARCHITECT/ENGINE
Address: /
Phone:
Reg.
FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $
�[4 . 0 FEE: $ `d
Check No.: Receipt No.:
NOTE: Perr-%,;s con ac ng with unregist red contractors do not have a esso ce guaranty fu d
Signature of_lgent/Ownel� . Signature of contractor
y
��
'r
f
1 � � ,
P
a
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#:
Date Issued:
IMPORTANT: Applicant must
LOCATION Print
Date Received
all items on this
PROPERTY OWNER Print 100 Year Structure yes no
MAP PARCEL:_ ZONING DISTRICT: -Historic istrict yes no
achine Shop Village yes no
DESCRIPTION OF WORK TO BE PERFORMED:
Identification - Please Type or Print Clearly
OWNER: Name:
Address:
Contractor Name: Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License:
ARCHITECT/ENGINEER
p. Date:
Phone:
ne: -
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT: $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. ,
Total Project Cost: $
FEE: $
Check No. -=04 Receipt No.:
NOTE: .Persons contracting with unregistered contractors do not have access to the guaranty farad
k .a, • �.� � �-��.-.. �.�,. ;1.� .;�r • . :: ..., , �S [C ir-r n ate P`inf,�rn ntra r('t(�----�-----F-�-- =ate - _
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
TOTE: 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
TOTE: 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
2012 IECC Energy code
Engineering Affidavits for Engineered products
TOTE: All dumpster permits require sign off from Fire Department prior to is 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
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ SwizrmingPools ❑
well ❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH,
COMMEN!"S
Reviewed On Signature.
Reviewed on Signature
Reviewed on Siqnature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/s
Driveway Permit
]DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE ®E!?,I�i�i�(101,Y�;Ternp DLimpsfer an site v.�
ovate ;yes
Loc�))ar((tedsyat 12,4♦Main Streegt
�lI_���y��j�"5"{1��
FirepeparrnenfSignature%vista
tr. + 6'�t F► t�} ? t by ;� �`�i��° f3.{.
_7L
'+t i�
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Motor location, mast or service drop requires approval of
Electrical Inspector Yes No
®ANGER ZONE LITERATURE- lies No
MGL. Chapter 966 Section 21A—F and G min.$1oo-$1000 fine
Doc.Building Permit Revised 2014
Location,��
No. Date 1 `
Check #
29121'
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee
Other Permit Fee
TOTAL
Building Inspector
T
v.
N
C � e
� � O
y C7 n
� O �
CD Izz
0 zN � C
rmlpLQr— F)• f� rm
23 IW = m �
.L�� N�
D c� N 0
-o �, m
O �" i<
0b z
O �CD
CDD O �m
CL
�- �• Cl)
CD OCD
O
W CD �. eZ' z
CO CD
C z• r
U) O W
CD
O� v
O X �
CD Z
Ln
< n
CD
0
O
D
O
Z
O
h
5
CD
N
O
co
O
W
CD
to
2
0
0
0.
CD
o="o 0) z
cCD
cD, CD � 00 � O m
o a: =r -aa y
y
O t/1 .fir CD' o
•77
-Ow S
rt
W cn
0 y o
CL 0
Q►
=rCDCD •� ••
CD =
O < ca
z CD
O O d a.
i.
v 0
a =r
C 1 :to
0 CL y
< CDCD U)
�.
CD
CD
CL
CD
U)
CD
23 CD
r .a
y 'n
� O
00
oo:
3��
`D CD w
y CD :C ?!
CDC
C) y
o �.
D a
CD -
n
M O
CL
(n
Un
co
T
Z7
T
N
Z7
T
7j
T
(7
T
N
T
O
3'
O
j
O
O
O
O'
3
O
O
(D
O
O
(D
C
D)
C
D)
C
C
-6
O
;�
N
O
Dq
m
OU
3
Dq
7
fD
—
rDDS
S
O"
7
O'
Q
n
\
Z
(D
-<
O
mV
rD
(D
T
m
C
W
C
3
W
7o
G)
O
o
'°
o
a
n
z
v0
M
>
G)
m
y
O
m
m
n
m
rD-
z
O
s
0
0
0
\J
1
y
SILVA LIGHTNING BUILDERS
48 LINDEN AVENUE
NORTH ANDOVER, MA 01845
(978) 688-5464 OAF
(617) 7994585 C
CONTRACT AGREEMENT
I, Emanuel A. Silva of Silva Lightning Builders will perform work on 55 Prescott St, North
Andover, Massachusetts 01845 for the sum of Thirty- One Thousand Four Hundred Eighty Dollars and
00/100 ($ 31,480.00).
WORK TO BE COMPLETED:
Exterior and Interior Work
Side Porch (closed top)
• Remove existing overhang trim.
(upper section = front and two sides) (lower section= front and one side)
• Remove existing storm units.(10)
• Remove existing exterior and interior window trims.
• Remove existing siding.
• Remove existing window units. (10)
• Remove existing interior wall board on exterior walls.
• Reframe for new window openings. (5)
(one on each side and three on the front) (size to be determined)
• Cut and install new sheathing.
(missing sections from older windows)
• Cut and install new trim boards to overhangs.
(match existing as close as possible) (-Veer products /pvc stock)
• Apply house wrap to walls.
(Typar)
• Apply flashing membrane to window openings.
(Grace products)
• Install new windows into opemngs.(5)
(Paradigm windows) (double hung)
• Apply flashing membranes to window units.
• Cut and install new exterior window trims.
(match existing as close as possible)(Meer products /pvc stock)
• Cut and install new siding.
(James Hardie siding Products)
• Install insulation to interior walls.
(fiberglass insulation)
• Install vapor barrier.
(6mil)
Page 1 of 3
• Install wall board to studs.
(half inch board)
• Apply joint compound to wall board.
• Cut and install new interior window trims.
(wood / Ix stock)(picture frame style with stools and aprons)
• Caulk interior and exterior weather tight.
Side Porch (open bottom)
• Install temporary supports under upper porch corner.
(in order to remove bottom porch)
• Remove existing post and guardrail.
• Remove existing entire porch deck and staircase.
• Remove existing siding along porch deck.
(two or three rows high)
• Dig hole for footing.
(12 "dia x 48 "deep)
• Dig square trench and install form for staircase landing.
(4 "deep x width of staircase)
• Install sono tube into hole.
• Mix and pour concrete into tube and form.
• Cut and apply self -adhering flashing to house for water protection.
(where deck meets house).
• Frame out deck
(2x8 pt joists with ledger / nailed together /16 "oc bolted to house)
• Attach metal bracket to footing.
• Cut and install post to footing and secure to deck.
(6x6 pt post)
• Frame out staircase.
(2x12 pt stringers 112 "oc / secure to deck and concrete pad)
• Wrap bottom section of deck and staircase.
(Kleer products / Ix pvc stock with lattice panels)
• Reinstall existing post.
(if possible -depending on condition of post)
• Apply one coat of finish to deck boards.
(seals all sides and ends of boardsfor moisture protection)
• Cut and install new decking to platform and staircase.
(Mahogany) (1x4 square edge)(nail and glue)
• Cut and assemble new guard rail.
(match existing as close as possible)(cedar stock)
Contractor will supply permit.(price to be determined and paid on start of job)
Contractor will supply all materials.
Contractor will dispose of debris made.
Contractor will not paint or stain project.
Contractor will only paint or stain new deck boards, one coat.
Page 2 of 3
r
Construction Supervisor License No. 065791
Home Improvement Contractor No. 120334
FULLY INSURED
Merchants Mutual Insurance Co
(Liability Insurance) Policy# BOPI070557
Associated Employers Insurance Company
(Workers Comp) WCC- 500-5010510-2014A
Occupant Confirmation
Pamphlet Receipt
I have received a copy of the lead hazard information pamphlet informing me of the potential
risk of the lead exposure from renovation activity to be performed in my dwelling unit. I
received this pamphlet before the work began.
�taN�r
Printed Name of Owner — occupan
ignature of 0!64er — oc&Vdnt Signature Date
Any other work that needs to be done that is not explained on this Contract Agreement will be
executed only upon written order from the Contractor and signed by both parties becoming an
extra charge over the agreed amount. Additional work will be paid m advance.
COSTS
Carpentry
Work
Labor:
$
21,670.00
Stock:
$
9,360.00
Debris:
$
450.00
Total:
$
31,480.00
TOTAL PRICE: $ 31,480.00
PAYMENTS
Deposit on signing (09/21/15) $ 1,000.00
October 19, 2015 $ 10,160.00 (plus permit fee)
November 2, 2015 $ 10,160.00
November 16, 2015 or when completed. $ 10,160.00
(Job will take about 4 to 6 weeks, subject to change depending on weather or additional work)
(Approximate start date of October 19, 2015, subject to change)
I, Kenneth Tokarz, have had the opportunity to read the above and understand the terms
contained therein and by signing this Contract Agreement, I agree on paying Emanuel A. Silva
of Silva Lightning Builders for the work itemized above on this Contract Agreement.
SIL A LIG BUILDERS
By:
Emanuel A. Silva, Contractor
Page 3 of 3 DATED: SEPTEMBER 21, 2015
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
❑ FBuilding Permit Application
❑ Workers Comp Affidavit r - _
❑ Photo Copy Of H.I.C. And/Or C.S.Licenses
❑ L�LUpY ?i LrynLUMA
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
DTE: 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
DTE: 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
DTE: 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
°
r i ,
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street, Suite 100
Boston, MA 02114-2017
' www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Name (Business/Organization/Individual): 5 tl cion
Address: 1/13 & i,) Jen Ale-
City/State/Zip:
le-
City/State/Zip: k0,111 A4 Phone #: Ile' G 96-St/G 9
Are you a employer? Check the appropriate box:
1.
I am a employer with employeesf, ull a�id/or part time).*
2.❑ I am a sole proprietor or partnership and have no employees working for me in
any capacity. [No workers' comp. insurance required]
3.❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t
4. ❑ 1 am a homeowner and will be hiring contactors to conduct all work on my property. I will
ensure that all contactors either have workers' compensation insurance or are sole
proprietors with no employees.
5.FJ I am a general contractor and I have hired the sub -contactors listed on the attached sheet.
These sub -contractors have employees and have workers' comp. insurance t
6.Q We are a corporation and its officers have exercised their right of exemption per MGL c.
152, § 1(4), and we have no employees. [No workers' comp. insurance required]
Type of project (required):
7. ❑ New construction
8. emodeling
9. ❑ Demolition
10 0 Building addition
ME] EIectrical repairs or additions
12. ❑ Plumbing repairs or additions
13. [] Roof repairs
14.0 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 contractor: must submit a new affidavit indicating such
tContractors that check this box must attached an additional sheet showing the name of the sub -contactors and state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below Is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #: We C— SU U - So i o:5 10 " 201 VA Expiration Date:
Job Site Address: 55- Pf PSCd ti s-1— City/StatetZip: f,14 Aodo Vo/ 114A QI e ys
Attach a copy of the workers' compensation 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 under thepaj^Wfdpena1des ofperjury that the information provided above is true and correct.
/v -/Y 1S
Phone #: Cl 7 6. 6 8 8 S9/ 6Y
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 #:
artrnent of Public Sa#e#y
etts - pep ti StaraY us
massachus ca ulati�ns ar. _ .. .
f gs,iidir9 ey �'�
oar c Surf*txr f
lid
�L41tilli 791
License: CS 06?
EM�EL ASTL� '.
48 Lt1� 01 .5. .
N A1� Expiration
"''� 111202016
\ Oftce."CousumerAffairs & a on
ME IMPROVEMBusiness uENT CONTRACTOR
egistration: 120334
xpiration i'I/26/2015Type:
DBA
SILVA LIGHTNING BUILDERS
EMANUEL SILVA
48 LINDEN AVE.
N. ANDOVER, MA 01845 •.: "_:,`;-:' undersecretary