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Home My WebLink AboutBuilding Permit #451-11 - 584 OSGOOD STREET 11/29/2010 BUILDING PERMITO* NORTH q TOWN OF NORTH ANDOVER 024": '`- o� APPLICATION FOR PLAN EXAMINATION Permit NO: A Date Received ��Rwrao�rp``(y �Ssgc►+us�� Date Issued: o IMPORTANT:Applicant must complete all items on this page LOCATION 1:�?%-L Vs ..» Print PROPERTY OWNER__ CVA0e tC. Print MAP 210 10/0 PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Resi Non- Residential New Building COne family Addition ore family Industrial Iteration No. of units: Commercial eplacement Assessory Bldg Others: Demolition Other S Well Floodplain Wetlands Watershed District ' ter/Sewer �.D+ESCRIIPTION OF WORK TO BE PREFORMED: 1 ;,\c `i�c Q.Q 7L-'T.—_ Ln.,Nlpl��J V N l S Identification Please Type or Print Clearly) OWNER: Name: 3 -*_C,,C__ Ca`2Z�� Phone:(C'.7, )rj Address: Js-Q,, CONTRACTOR Name: Phone: ` , 53 Address.. ... Sc�. N-J- A. t,� U ,,c iLt T— Supervisor's Construction License: L "1 Exp. Date: t Home Improvement License: b k 4t-_1 1 Exp. Date: t 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: $ 6130 c) FEE: $ 16 D v Check No.: I 0 I S 2-- Receipt No.: 3�Y NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund _.._ - ___._..-., -- _ _ _ . _ _ _ Signature of Agent/Owner gnature of con tracto __ 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS. HEALTH Reviewed on Signature COMMENTS 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: Located 384 Osgood treet 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 ❑ 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 c / Location -5tr r ^► Q No. AvDate 66// k •o moTOWN OF NORTH ANDOVER o�<<. :•Sao AL 3? •. '• p { ° •; ; Certificate of Occupancy $ _ Building/Frame/Frame Permit Fee $ ---''" Must 9 Foundation Permit Fee $ "'-- Other Permit Fee $ TOTAL $ Check # 23745 Building Inspector Massachusetts- Department of Public Safet} NEWL Board of Building Regulations and Standards Construction Supervisor License License: CS 53099 Restricted to: 00 KEVIN W MURPHY 'z 169 BOXFORD ST N ANDOVER, MA 01845 Expiration: 6/29/2011 Co nun iss ion C I. Tr#: 16540 Office* koK1`Yriff �1"ff�P Btf5��5Pf�1 VHOME IMPROVEMENT CONTRACTOR Registration: ,101874 Type: Expiration: `6/29/2012 Individual kw ,°MURPHY: Kevin Murphy Q`� �e , 169 Boxford St 1- N.Andover,MA 01845 Undersecretary The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 kijp www.mass.gov/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Apyticant Information Please Print-Legibly Name(Businessmrpnizatiot>lindlvidual): U Address:_ City/State/Zip: U A_ _ I�^G. to 1 4.1 Phone#:�c7��, Are you an employer?Check the-appropriate box: Type of project(required): 1-P I am a employer with 1 4. ❑ I am a general contractor and 1 6. ❑ New construction employees(fall and/or part-tune).* have hired the sub-contractors - ?..El am a solt,proprietor or partner- listed on the attached sheet. t 7 4caRemodeling ship and have no employees These sub-contractors have 8. ❑ Demolition aci workers' comp. insurance. 9. Building addition working for hnc in any capacity. ❑ g [No workers'comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.ElI am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. C. 152,§1(4),and we have no 12. Roof repairs [No workers comp. insurance required.]t tyrnploytxs. [Alo workers' 13.❑ Other camp. insurance required.) Any applicant that check$box f#1 must also fill out the section below showing their workers'corrgxmsetion policy infomntion: Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must anbmit a new affidavit indicating suck ;onescion that check this box must attached an additional aheet showing the mane of the sub-co ntiactors and their workers'camp.policy inform-ation. ani an employer that is providing workers'compensation.insurance for my employees. Below is the.pollcy and job site Kformation. r-- nsurance Company Name: 'olicy#or Self-ins.Lia #: lG�w� l V�� l Expiration Date: `1 ob Site Address: City/Stat&Zip:_I,,(„ L('LnMaA c- 0 t i kttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). �aihue 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 S 1,500.00 and/or ane-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine _if up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. 'do her by certify under the pains and penalties of perjury that the information provided above is true and correct. ii lair Dane: Lho c#: C 1:;_3 3 Oftu hal 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#-. 4C0 DATE(MWDDMYYY) CERTIFICATE OF LIABILITY INSURANCE 7/1/2010 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the cartllicate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION 13 WAIVED,subject to thetwo. and condlBons of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the cortillesta holder In lieu of such endonem n%e). RODUCER CONTACT NAME: M P ROBERTS INS AGCY INCANNE (9'78) 683-8073 1060 Osgood Street Arc ra:(978)683-3]47 North Andover, MA 01845 ADDRESS:Sandi.@ roberts insurance.com CUSTOMERID0. INSURERS) AFFOROINO COVERAGE NAZCA ISURED KEVIN MURPHY BUILDING & REMODELING I INSURER A:PROVIDENCE MUTUAL 169 BOXFORD STREET INSURER B.MERCHANTS INSURANCE 169 BOXFORD STREET INSURER C:GUARD INSURANCE NORTH ANDOVER, MA 01845 INSURER D: INSURER E: INSURER F :OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE OR POLICY NUMBER MMlDDlYYYY D/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES E o=xrence s 100,000 CLAW-MADE ®OCCUR MED EXP(Any erre person) ; 5,000 4 CPP0060868 11/22/0911/22/10 PERSONAL a ADV INJURY j I i 0 GENERAL AGGREGATE S 2,000,600 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s 2 i 0 r 0 POLICY JECTPRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea acclderd) ; 1,000,000 BODILY INJURY(Per person) s ALL OWNED AUTOS 9 X SCHEDULED AUTOS MCA7013608 01/23/10 03/23/11 BODILY INJURY(Per acd PROPERTY DAMAGE HIRED AUTOS (Per acddeM) s NONOWNED AUTOS ; $ UMBRELLA LIAB OCCUR EACH OCCURRENCE j EXCESS LIAB CLAIMSAME AGGREGATE j DEDUCTIBLE RETENTION $ j WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN T S ANY FROPRIETORIPARTNER0MC ITIVE E.L.EACH ACCIDENT ; 500,000 OPPICERINEMEER EXCLUDED? NIA (Mands"MNIp KEWC109881 07/01/10 07/01/11 EL DISEASE-EA EMPLOYEE S 500,00 tt yes deserts under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT ; 500,000 :SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,d more space is raWWed) RTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NORTH ANDOVER, MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. r AUTHORIZEO REPRESS NE Y ®1988-2009 ACORD CORPORATION. All rights reserved. MRD25(2009/09) The ACORD name and logo are registered marks of ACORD o 169 Boxford Street �tj [Zi North Andover,MA 01845 �� 'i t f • PH:978-688-6335 Building Contractor FAX:978-688-7207 Proposal To: Jack&Nancy Correia 584 Osgood Street All Home irnWvwwd Conhactors and subcontractors engaged in home improwwwd=*ac"'unless North Andover, Ma. 01845 spmffically e=W rrom registration by Pravislons ofcnelter 142A of the general laws,must be registered Whh the comrwrWea th of Massadnaelts.Inquiries about regisbation and Status should be made to the Director,Home r From: Kevin Murphy R�Boston,n+A021 si�i27Me Ashburton P I Date: 6/15/2010 Job: Replace existing window Date of plans: None I Architect: None L catiion: Same I Section 1-Work Schedule 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 8/1/10. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 10/30/10.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 j The Contractor warrants that the work fumished hereunder shall be free from defects 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 conect,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 .ID�Y1 Page 2 of MaUding Cowbnctoa 169 Boxford Street North Andover,MA 01845 PH:976-68&5335 FAX 978668-)000( General Proposal is to replace four section window unit and wood storm door, in rear wall of existing house. Building permit will be provided by contractor. Demolition Existing window unit, and all related rotten trim and siding,will be removed. Wood door and related trim will be removed. Building New Anderson TW400 series window unit will be supplied and installed to match existing. Window unit will be a four wide, doublehung unit, with transoms above. Screens and grilles will be provided.Any rotted sheathing will be replaced with fir plywood. Cedar clapboards will be replaced as required. Related exterior trim will be replaced with Azek. New wood storm door will be supplied/installed to match existing. Interior Trim/Doom Pre-primed interior trim will be supplied/installed to match existing. Waste Removal All demolition/construction debris will be disposed of by contractor. Items Not Included There have been no allowances made for any interior or exterior painting. III I r �g1 Pages of 3 t'St UMng Contvaa:toa 169 Bo)ftd steel Nath Andover,MA 01845 PH:9788885335 FAX 978888-X)00( Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ... ... ... ... ... ... ....$ 6500 Payment to be made as follows: Percentage/Item Description Amount 1 Job complete $6500 Total 1 $6,500.00 "Nofioa No agreement for Flom inhprovemeM contracting work shall require a down payment(advance deposit)of rnor s that one-third of the WW toted price of the total arrount of all deposits or payments which the contactor mut make,in advance,to order andfor otherwise obtain delivery of special order materials and equipineM 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 Qk' Date -'7 Signature Date f C)