HomeMy WebLinkAboutBuilding Permit #331-15 - 59 CRANBERRY LANE 10/1/2014 BUILDING PERMIT NORTH
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TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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Permit No#: Date Received 9 o Argo IPa��y
SSACHUSS
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
...Print
PROPERTY OWNER
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 ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units- ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
Contractor Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
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: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contrac ?r
_ T
Location
No. 3 1 �� Date
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. - TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $3424(54)
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
4
Check#
Bui ding Inspector/
F �
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE'bF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ permanent Dumpster on Site ❑
T E FOLLOWING SECTIONS OR OF ICE USE ONLY
I TERDEPARTMENTAL SIGN OFF - U FORM
PLANNIN & DEVELOPMENT Reviewed O Signature_
COMME TS
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CONSERVATION Reviewed Si nature
COMMENTS
7L
HEALTH Reviewed on —Signature
COMMENTS
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Zoning Board of Appeals: Variance, P ition No: Zoning Decision/recei�t submittedY es
Planning Board Decision: Commen s
Conservation Decision: Comm nts
Water & Sewer ConneCtion/Signature& Date Driveway Permit
DPW Town En neer: Signature:
Located 384 Osgood Street
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, ased on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter locatio ma t or e i e drop requires approval of
Electrical Inspector Yes o
DANGER ZONE LITERATURE: Yes / o
MGL Chapter 166 Section 21A—F and G min.$100-$1000 ine
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NOTES and DATA — (For department use)
❑ Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014
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/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
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 2014
Enter construction cost for fee cal - North Andover Fee Cakulation
Construction Cost
301000.00 m
$ - $ 360.00
Plumbing Fee $ 45.00
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 45.00
Total fees collected $ 550.00
Foundation 100
59 Cranberry Lane
331-15 on 10/1/14
Bathroom remodel
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COC LAKI
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�•9 A°RAreo �PP��S
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BOARD OF HEALTH
Food/Kitchen
PERP
Septic System
-,, T T LD
THIS CERTIFIES THAT M,.. ........,CO3 ar,.��.. ... BUILDING INSPECTOR
Foundation
has permission to erect ...................... buildings on ....>�. .d.J...... .... . .... .... . . ......... .. �
�R ►�4........�. Rough
to be occupied as .... ... f/.....Ponform
.� ... ... .r..................... Chimney
provided that the person accepting this permit shall in every respect to the erms o he 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
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
• UNLESS CONST N Rough
Service
... .......... ... ...... ........... Final
BUILD SPECTO
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.
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GALAXY CONTRACTING INC.
CONTRACT
Contractor Information:
Galaxy Contracting Inc.
59 High Street
Reading, MA 01867
(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 N. Andover MA 01845
Phone No.
Work to be Performed and Materials to be used:
All labor and materials to be provided as described on estimate#1798. 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 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 will 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.
Work Scheduled to Begin after: 9/ 1 /14
Expected Date of Completion before: to/ i o/14
Required Permits
Building permits are required. 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.
NOTE: Owners who secure their own permits or deal with unregistered contractors
are excluded from the Guaranty Fund provisions of MGL c. 142A.
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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:
Office of Consumer Affairs and Business Regulations
10 Park Plaza Suites 5170
Boston, MA 02116
(617) 973-8700
Total Contract Price and Payment Schedule
The Contractor agrees to provide labor&materials as specified in estimate#1798 for the
sum of$30,975. Additional charges will apply for labor and materials not specifically
described and included on estimate#1798 attached. Additional work will be performed
on written approval of homeowner. Upon signing this contract the homeowner is
agreeing to pay for services rendered. Any deposits or payments collected will be
returned if services are not provided.
Payment will be made according to the following SCHEDULE:
$ 6,195. 20%Upon signing the contract. (Not to exceed 1/3 of the total contract
price or the cost of special order items, whichever is greater)
$ 6,195. 40% Completion of demolition.
$ 6,195. 60% Completion rough inspection.
$-6,195. 80% Completion of finish wall.
$ 6195. 100% Upon completion of contract.
In order to meet the completion schedule, the following material/equipment must be
special ordered before the contract work begins. All finish materials.
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.
l
Homeowner' Si ature and Date Contr tor's Signature d Date
You may cancel this agreement provided you notify 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.
Depm'tment of l»d sMd Accident
qfflaqflTw�. , ns
.600 Wiskhw0 n Stress .
Mf 02111
Workers' Campmsation Insurancx Affidavit:$uflderslCantia�dvnMeclaida laumbas
MWbS nt Iuform� Prig Legfbly
Name a
Crty/StatetZip: �. o� 13�7 - Phone#:� 1 yH $N$q
Aie a as mploce. Che kogApprapriateb=, TM ofpr4ed(req ted):
1.I .1 am I avloya with r_ '. ❑I=a gaaarA dart Mi ant 1. 6. 0N ..tee n
cm�*m(M and/or PuWm )' Imre ad 1 the sad-aonaa+ei t 7r ❑��g
2.❑ I a sutapmgsiexot o;�axmar- Ihtedori a sh+xc
• ship ad have wwMIGYM T� 8. ❑nemogrion
.woftg for me in any capaft. '. 9. B additiaa
[No workers'c amp.iwaxaace- s- ❑ Weare a empoxAon and its 10.0 Electrical ragaics or additions
-ms's have ea�erasat thea_
.❑ lzina a doing allwork � > 11.0 xpa�rs aitia�s
myself:(No w tut +M- c.15Z, 1�4 sad we Have no �,❑goof repass
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iGantre6eneEtat mk*A baa:=vwIaUwdw&ft 1Asa t�satesaf0is reoatisa�easawltlna�anodoees' po{isy�--^,��
I am an employer did&pvWdbq ms's' orlon buarr mjbr my m g6yus Jkfow*the poJtay w d fpb sits
ASMUM cotapanyNatM_ -
�'PQACY.#or.SaLLing.Lie.# NN 3 000 00 Eapi"In Dbm2L
Job.Sita Amass: City/S :
Attach a copy of thewortwe fiompwftaa PQUq destUM"PGP Oha�rtngthe Pd19 n and eapirasian lode).
Failure to sec�iie coverage as tegnixod tinder Sasia4�5A ofi�IGL c.1sZ cwt ked tD flu impOaitiga of cri�rgGnaitus of a
c SI;St�i?.DO�d/or ono-vear�4 as well as cK ptaaitics 1A the formof a STOP WORK ORDER and a fin
,.f"n in-n-91sn rin 9.fav easiest the vialataL Be advised first a MY ofthis zw=imtmzy be f warded.to the Office of
Tn.s.�ria+ety►»cif r1�P TSTA fnrinsufmce cdvi;rm vejj i4afti""
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OffMr-I�eftfir. Do tit W bt d*QTRQ1 to be"""d by dV or amn of efnt.
Issning Authority(drdie one):
1.Board of Health•L 13wkAnDepwament 3.On./Tom Cork 4.Me uical Inspector 3.Ptumb inspector
4.Other
Conrad Person:
GM ACON-02 LHOLLAND
CERTIFICATE OF LIABILITY INSURANCE F
21271201
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, MMO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terns and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder In lieu of such endomeme s.
PRODUCER SACT
Salem
45 MainSStrreeet Street Services,LLC PHONE81 9333100 FAx No (781)933-9048
Woburn,MA 01801 ADDRESS:-
INSURERM
AFFORDING COVERAGE NAIL o
INSURER A:Dorchester Nut Fire Ins Co 13706
INSURED wswwRB:Travelers Cas$Surety Co of AM 31194
Galaxy Contracting,lnc wwRER c Mesco Insurance Company
57 High St INSURER D:
Reading,MA 01867 DMURER E:
INSURER F
COVERAGES 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 SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR Sim
TYPE OF INSURANCE POLICY Nurem POLICY EFF POLICY EXP LDMT3
GENERAL LIABILITYEACH OCCURRENCE t 1,000,00
A X COMMERCIAL GENERAL LABILITY R1036469A 01119/2014 01119/2015 PREMISEStrEacccurrencei) S 100,00
cxArt,Rs MAGE Q OCCUR
MED ENP Wry one Pinson) $ 5,00
PERSONAL&ADV KIURY S 1,000,00
GENERPLAGGREGATE $ 2,000,00
GEW AGGREGATE LWIT APPLIES PER: PRODUCTS-COMpIOPAGG S 2,000,00
POLICY PRO• LOC $
AUTOMOBILE LIABILITYCORIBIN®SINGLE LWr
aodiant $
B ANY AUTO BA2616Xo11 01/07/2014 01/07/2015 BODILY KIURY(Per Person) s 250,00
�OWNED
X AUT BODILY KR RY(Per accident) $ 500,00
NON4NMM ;UEX HIRED AUTOS X RTY oaMAGE s 100,00
XM
S
U + LIAg OCCUR EACH OCCURRENCE $
EXCESSLWB AGGREGATE $
DED RETENTION $
WORKERS COMPENSATION WC STATU-UMITSOTH-
AND EMPLOYERS'LIABILITYRN
C ANY PROPERIETORIP�YIN C3080080 0212112014 02121/2015 aL EACH ACCIDENT $ 1,000,00
RIM
OFFICEEMBER EXCLUDED? EJ N 1 A
In NH)
ELDISEASE-EAt7G+lo $ 1,000,0
Kym describe under
DESCRIPTION OF OPERATIONS below El DISEASE-PCxICY LWT I s 1,000,00
DESCRrTION OF OPERATIONS I LOCATIONS I VEKCLES(ANaeh AC GRO 1TN,AddiBaml Ranalo<Scheduh K more space is requhed)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE E)WRATIO N DATE THEREOF, I NOTICE WILL BE DELIVERED IN
^ - — ACCORDANCE WITH THE POLICY PROVI7
AUTHOR®REPRESENTATIVE
m 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
Massactiusetts-Department of Public Safety
Board of Building Regulations and Standards
Construction Supen-isor
license:CS-105118
MAX5 KASPER
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?A Sea Vies Ave
r4wwmt MA 819
Expiration
Commissioner
Pam" date. nadret MW
Rep1�'
5208 P Cosmo" p,MA02116
4
J�k c97,e,
d Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston,.Massachusetts 02116
Home Improvement Ca� rator Registration
r a Registration: 152808
Type: Private Corporation
Expiration: 10/2/2016 Tr# 257718
GALAXY CONTRACTING INC
STEPHEN KASPER
"";
65 BASS POINT RD r h
NAHANT, MA 01908 � �
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Address and return card.Mark reason for change.
`—'
SCA 1 ip 20M-05/11 Address f-] Renewal ❑ Employment ❑ Lost Card
V f2P�QOiI79//79.NI2C(�PdG�2 O��%/�GpQdQ�2L/Q��Q
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
before the expiration date. If found return to:
ME IMPROVEMENT CONTRACTOR P
klylegistration: .152808 Type: Office of Consumer Affairs and Business Regulation
piration:• ,14/21 016; Private Corporation 10 Park Plaza-Suite 5170
` Boston,MA 02116
GALAXY CONTRAC7lh c' ;;
STEPHEN KASPER
65 BASS POINT RD �� Qc_
NAHANT, MA 01908 Undersecretary ,JA&
Not valid without nature
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