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HomeMy WebLinkAboutBuilding Permit #616-12 - 59 CRANBERRY LANE 2/27/2012TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:/ r 6e—d- Date Received Date Issued: r0A -4 i J Q IWORTANT: Applicant must complete all items on this page LOCATION 5 ° Lo Print PROPERTY OWNER Lo ve-� n Unit # P int MAP NO: PARCEL.J,�_ ZONING DISTRICT: Historic District yeno Machine Shop Village ye no 100 year-old structure ye n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other X90,16- dp Wat r hed s strict D�Water/Sewers '� - • - �� � ��,�• _ � _' __�s Lia �,tcLr 1l�iv yr w �tc.tL 1 v tiL rr;KN UKMI;ll: (Identification Please Type or Print Clearly) OWNER: Name: AIAAA 1,611 •e 10 v Addres /_7 -$ 9 9 -.5-g z-8 CONTRACTOR Name: T�(� `t c Yw✓ Phone: ti Address: O30�o I (� 1 „!� I� F►-t�l o� 1`�� Of 99L? Supervisor's Construction License: ( (o 4 8 ct Exp. Date: z 2.n> 13 Home Improvement License: 152 Syg Exp. Date: 10Z 2- A -z- ARCH ITECT/ENGI NEER ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED(OON $925.00 PER S.F. Total Project Cost: $ FEE: $ d Check No.: � a Receipt No.: q NOTE: Persons contracting,w*t% unregistered contractors do not have access to the.Quawanty fund— Location No. J� Date TOWN OF NORTH ANDOVER Certificate of Occupancy $- Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check# 52 e--7� - 25046 "�' Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑Swimming Tanning/MassageBody Art ❑ 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 COMME CONSERVATION COMMEf .TS, HEALTH COMMENTS DATE REJECTED DATE APPROVED C� Reviewed on Siqnature Reviewed on Signature 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 Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COACWENTS 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 Doc:.Building Permit Revised 2011 June/mi 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 MOTE: 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 o 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: Doc.Building Permit Revised 2008mi LU O 4! C O O � L C y O C 'r O C3 C.3 a C cc m m C ;= O O N Ea L O C CL N J o= c .. O O CD C a«. N O mm L N � C cm o_m cc � = C N O m y m m _cg 0 c Q �+ N C t O Ci 42 CO o ".. L C3 o ao P* `-.o c CD o.:5 •N �az O � C Ec.24Dy O O o ..- c K C2O -E ID L CD ti �� aw m E I& N _ N :O 0 N G O m m a c m L a a c c N CD .05_ 0 Z 0 a I r 4 U O O v C21 O L _ O Z O y o C a� cm I O.— EW W CD CL ~ 'C•+ t O� O � O � O d a cma C o4-a cc� v Cc J03 .� •O. O 4" ca C Z 0 �..� Na O C — C_ • C c h OO w O' w W. E' W O o w° p cn o C C w° a°' , U w io w U w W cn iro . w O to a°' w w 114 r� ° �i cn o cn LU O 4! C O O � L C y O C 'r O C3 C.3 a C cc m m C ;= O O N Ea L O C CL N J o= c .. O O CD C a«. N O mm L N � C cm o_m cc � = C N O m y m m _cg 0 c Q �+ N C t O Ci 42 CO o ".. L C3 o ao P* `-.o c CD o.:5 •N �az O � C Ec.24Dy O O o ..- c K C2O -E ID L CD ti �� aw m E I& N _ N :O 0 N G O m m a c m L a a c c N CD .05_ 0 Z 0 a I r 4 U O O v C21 O L _ O Z O y o C a� cm I O.— EW W CD CL ~ 'C•+ t O� O � O � O d a cma C o4-a cc� v Cc J03 .� •O. O 4" ca C Z 0 �..� Na O C — C_ • C c h GALAXY CONTRACTING INC. CONTRACT Contractor Information: Galaxy Contracting Inc. P.O. Box 1654 Wakefield, MA 01880 (781) 944-8489 Home Improvement Contractor Registration No. 152808 Construction Supervisor License No. 86453 Tax ID # 20-2112121 Homeowner Information: Name: Jay Lovejoy Address: 59 Cranberry Lane North Andover, MA Phone No. 617-899-5828 Work to be Performed and Materials to be Used: All labor and materials to be provided as described on estimate #1136. Additional work will be performed on written approval of homeowner. Discovery of asbestos or any other dangerous materials may require specialized services and additional fees. Additional charges will apply for finish work beyond allowances and repair/replacement of substrate materials. The Contractor warrants that he will use only new and fit materials, and that all work will be performed in a good and workmanlike manner, and all products provided by the contractor will function as intended without defect or failure for One Year from the date the work is completed. The contractor will not guarantee products or services provided by the homeowner separate from the contractor's pre -qualified vendors. The following schedule «rill be adhered to unless circumstances beyond the contractor's control arise: Weather conditions are beyond contractor`s control. Ordering of new materials and scheduling of subcontractors pending signing of contract and completion of permit application. Work Scheduled to Begin: 2/20/12 Expected Date of Completion: 2/24/12 Required Permits The following building permits are required. Building. Permit fees will be added to final invoice. All subcontractors will be the responsibility of the contractor. Any subcontractors secured by the homeowner will need to be licensed and insured. Homeowner secured subcontractors will be subject to the contractor's schedule and coordination fees. Certificates of insurance will be required. MOTE: Owners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGL c. 142A. NOTE: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 (617) 727-8598 Total Contract Price and Payment Schedule The Contractor agrees to perform the work, furnish the material and labor as specified in estimate #I 136 for the sum of $6,500. Payment will be made according to the following SCHEDULE: $ 3250. Upon signing the contract. (Not to exceed 1/3 of the total contract price or the cost of special order items, whichever is greater). $ 3250. Upon completion of contract. In order to meet the completion schedule, the following material/equipment must be special ordered before the contract work begins. Window. Homeowner will accommodate containment procedures. Upon signing this contract you, the homeowner acknowledges receipt of the EPA Renovate Right pamphlet. Contractor will be responsible for containment procedures. { JAf /' Ho er's Signature ate �i Con ctor's Sign re and Date You may cancel this agreement provided you notiA- the contractor in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery not later than midnight of the third business day following the signing of the agreement. Unless otherwise noted within this document; the contract shall not imply that any lien or other security interest has been placed on the residence. Acceleration of Payment Homeowner's Financial Insecurity -A Contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. Contractor's Financial Insecurity -In instances where a contractor deems him/herself to be financially insecure, the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal from said account would require the signatures of both parties. Contractor, at its option, may file a Notice of Contract with the appropriate Registry of Deeds and further pursue a mechanic's lien should Homeowner default in payment to Contractor. Should Homeowner default in payment according to the terms of this Contract, Homeowner shall be responsible for Contractor's costs and expenses including reasonable attorney fees in enforcing this Contract. Also a complete description of any other documents which are part of the agreement and a list and description of other matters upon which the contractor and homeowner lawfully agree should be attached to contract. NOTICE OF CANCELLATION You may cancel this transaction without penalty or obligation within 3 business days from the above date. If you cancel any property traded in, any payments made by you under the contract and any negotiable instruments executed by you will be returned within 10 business days following receipt by contractor of your cancellation notice and any security interest arising out of the transaction will be cancelled. If you cancel you must make available to the contractor at your residence in substantially as good condition as when received any goods delivered to you under the contract or you may if you wish comply with the instructions of the contractor regarding the return shipment of the goods at the contractor's expense and risk. If you do make the goods available to the contractor and the contractor does not pick them up within 20 days of the date of cancellation you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the contractor or if you agree to return the goods to the contractor and fail to do so then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice or send a telegram to Galaxy Contracting Inc., P.O.Box 1654, Wakefield, MA 01880. Galaxy Contractting,, Inc. P.Q. Box 1654 Wakefield, MA. 01880 Name 1 Address .lad^ Lovejoy 59 Cranberry Lane North Andover, MA 01845 Estimate Date Estimate # 12/2112011 1136 Project Description Rate Qty Total Set up and remove existing Palladian window above front door. 3,500.00 l 3.500.00 Prepare opening for installation of new matching window. install new window and finish to match existing. Remove all debris to off site location- ocationAdditional Additionalcharges will apply for repair and replacement of 0.00 0.00 substrate materials. To be determined after demolition Materials. My supplier has priced out an Andersen and a Lincoln 3.000.00 1 3._000.00 window, both are approximately the same price. V4 a Keil➢ need to remove the interior trim to determine the exact rough opening then select the appropriate window based on size available. Measuring charges, delivery and sales tax are included with this price. Supp➢y and deliver new window. Total 56.500.00 Phone # Fax # E -mai; Web Site (791) 944-9489 (781) 598-9215 stephenkasPcrta-comcast_rret w�dsu.aalaa��coart�Ttors.eorn HOME IMPROVEMENT CONTRACTOR Registration: 152808 Type: Expiration:I.U2012 Private Corporation CONTRACTING. STEPHEN KASPER�- 65 BASS POINT NAHANT, MA' 01908 '-" $ ` y ° Undersecretary License or registration valid for individul use only before the exPiratiou date- If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 N' lassachusetts - Department of Public Safet} R.Oulations and Standards Board of Buildin;: Construction Supervisor License License: CS 863 .y STEPHEN E KASPER PO BOX 1654 01880 WAKEFIELD, MA Expiration: 6C22013 Tr#: 16489 ( ..nmi,ciuner t, valid with sign re a.ln ut►s lnogllm p►ltA l 911Z0 VjkT `uolsog 009 alms - tztld 3[aud 01 uoltuln2ag ssaulsng put smgjV aawnsuoD jo 33g3O :ol uanlaa puno;31 •altp uol;ualdxa aql aaojaq iquo asn lnPlAlpul ao; pgtn uolltalsl;la.l .lo asu9311 Catla�aasaapu(t _ `; ;,. 80660 dW '1NyHdN 1 �13dSVN N3Hd31S 1 1 N11O-VdiN00 = '� uogeaodlo0 alenud Z60Z%ZYOt :uollendx3 :9dl1 80BZ9L` :uollWlslBO'd U01.O` HIN001N3W3A0adWI 3WOH w /6","I " � u� 3 agl0 NIIIssachusetts - Deportment of public Safet} �r Re��uiat Board of Buiions and Standards ldm, ervisor License Construction Sup License: CS 86453 Restricted to: 00 STEPHEN E KASPER PO BOX 1654 Im WAKEFIELD, MA,01880 Expiration: 61212011 7r#: 17033 ('ommissiuner T TE PMKMftYM %CoORD" CERTIFICATE OF LIABILITY INSURANCE DA L -- I VAGM2 $J, ;��V: �z� I � = 1 12 :a'$' h..„'1 ,-' 4 ', r”. . r$,� lk,02 :�� - : *I e �: -1 IZ;'I§jC 10 11,491,111-1 i ILI W-13 1.4 LA TM IS 70 CEM" THAT UIE POLICMS OF 84SUPAHM LMM BELOW HAVE BEfN ISSUM TOIM RISURM WMM ABOVE FOR DIE POLIM PMO MWATM toominisrANDIM ANY REM11REMBU MM OR CONDffM OF ANY COMRAGIF OR On*R DMINAElff WIM RESPECT TO VMI IM CERT AGATE MAY BE IMIED OR MAY PERYAM. TM DISUPANCE AFFORDED BY IM POLKXS DESCRIBED HEFIEN IS SUBJECT TO ALLIM THOMS,, EXCUIS110M AW GONMIOM OF SUM POLICIES. LOWS SHOWN MY HAVE BEEN REDUCEID BY PM CLAN& sm IMOFNISUPAHM ADDU SUM 2Mww, PQL=ffF PULM OW POMYRUMOR LMYiIS A Geow-AL ups'a R1035469A 01t19M2 OMM jENNOMMMMM X ,cuMMMcMLMM3MLuMMHY X"Mr-MME f, X fccetm SAM GEWAGGM3rA-MUMMV1JFSPRt I MMUMS-COMPMPAM'�$ MILY P110 ( LOC LNUMM B BA261SX011 011MV12 6WA13 25BJM JA t S MAN t,AUTOS -xiHNIEDAUTOS 111MAM31A UPS O=1t EMAOCCUR143ME EMMM LM C 7VIC3309174 GM 12 e2rM3 X S law MrLdraw LWAM= Mr Von r d f, EL-EPMACCMEW CIMEMME310M EMMIJIMEM 1, DISEASE4MUCYLOW Is Evidience- at Courage c-alwKy coubus" Inc 57 wpffi st Rearing MAD11867 Attention, ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents fF „" Office of Investigations 1=r 600 Washington Street - r Boston, MA 02111 wwsv.mass.Jov/dia Al Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers AnPiicant Information Please Print Le ibly tis -Name (13usinessi0rganization/Individual): ����,� �L�rAJi'rLUl,>++ef Address: K C�. 80x,. I �, � Policy # or Self -ins. Liqc. #: 11 Expiration Date: ly� Job Site Address: �/ �/'(/rV �1°//' V ��� City/State/Zip: r /, / 10 (5 1" Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1500.00 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certifyAp to pains_pd pynalties of perjury that the information provided above is true and correct re: - __'Zv-I -_4 1/1 Date: one ii: 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: 0`?%� City/State/Z.ip: A PLhone you in.employer? Check the appropriate box: Type of project (required): 1 am a employer with 4. F1I am a general contractor and I F2. 6. EJ New construction employees (full and/or part-time):* have hired the sub -contractors 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub -contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance., required.] 5. ❑ We are a corporation and its 9 � 10. El Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 1 L ❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof reUst'.- red. insurance re uit c. 152, §1(4), and we have no 9 ,employees. Other [No workers'131-1 comp. insurance required.] "Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. ' Homeowners who submit this affidavit indicating they are doing all %cork and then hire outside contractors must submit a new affidavit indicating such. *Contractor that check this box must attached an additionarsheet showing the name of the sub -contractors 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 au employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. j�( �• / 2 /-�p� Insurance Company Name: � � �%CJT &)04A) Policy # or Self -ins. Liqc. #: 11 Expiration Date: ly� Job Site Address: �/ �/'(/rV �1°//' V ��� City/State/Zip: r /, / 10 (5 1" Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1500.00 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certifyAp to pains_pd pynalties of perjury that the information provided above is true and correct re: - __'Zv-I -_4 1/1 Date: one ii: 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: