HomeMy WebLinkAboutBuilding Permit #746-13 - 61 FOREST STREET 5/10/20131J�4 2- r 'z -
TOWN
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print ---
PROPERTY OWNER Sic L T( �2 6 0
Print 100 Year Old Structure yes no
/
MAP NO: / Qb PARCEL: 16J ZONING DISTRICT: Historic District yes no
Machine Shop Villaqe yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
�6ne family
0 Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
0 Demolition
❑ Other
❑ Septic 0 Well
❑ Floodplain 0 Wetlands
❑ Watershed District
0 Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
'�7P%)� Sal Jyoy%I' S �L s f
Identification Please Type or Print Clearly) AGYp
OWNER: Name: Li✓ Phone:
Address: ST ,JA
CONTRACTOR Name: r��'�L� GI Phone:
Address: �I-Q> 0/�
Supervisor's Construction License: d �'� Z Exp. Date: `� 2
Home Improvement License:
Date: I o ( z 20�
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: $ off! 51�6' 6 C FEE: $ v�.�t`i 00
Check No.: Ll y 5" ? Receipt No.: ;2w 573
NOTE: P rsons contracting wjtb un r ' ter d contractors do not have access to the g arantyand
Signature of Agent/Owne . Signature of contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ gamped Plans
Location 61/ 115 -611 -'Ir 5-1- 1__
No. — / Date
Check # 4/ y S
26373
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
It
r
BuiOna Inspector
0
Plans Submitted ❑ Plans Waived ❑
Certified Plot Plan ❑
Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/MassageBody 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 Siqnature
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comm
Comm
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 signatureldate _
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
El Notified for pickup - Date
t
Doc.Building Permit Revised 2010
Building Department
The fohowing 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
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
o Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
MOTE: 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
❑ 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
MOTE: 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 2012
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Residentiaf & Commercial Roofing Ml
Sisllg�c� ,. Types Of
CHAMN Y,S P0.1-RE811.tllty-cAPPE
Expert Masonry Work
Mass Toll Free j c Licensed & Insured
!.<3cd!/u Owned :$ Operated .Sir. rte= /')?v y
1-800-WAIT-4-US,�, _��= License #034200
(924-8487) ff lZazm tae �Zahv We Work Year Round
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Proposal To: Scott Cooke
Date 3/21/13
Street: 61 Forest St.
N. Andover, MA
781-710-6880
Vinyl Siding Proposal
scookesk8@aol.com
1. Remove all existing siding and corner boards
from entire house.
2. Inspect all wood components of entire house.
Any compromised material will not be left. Any
existing damage or rot will be discussed,
confirmed with homeowner and replaced at an
additional cost of time and material. 1 st 32sq/ft of
plywood at no additional cost.
3. Carefully remove all existing shutters, gutters and
downspouts.
4. Install Tyvek house wrap to entire house- All
seams will be taped. Not generic.
5. Install 4" standard vinyl comer posts to all house
comers. (white or colored)
6. Install Mastic Quest or Monogram .046 double 4"
vinyl siding to entire house. Standard colors only.
7. Soffit area: Drill holes in all rafter bays for added
ventilation where needed. Install white vinyl
perforated Invisivent soffit panels.
8. Install j -channel to all areas that need to accept
vinyl siding. All j -channel will be self -flashed
and angle cut for clean professional appearance.
9. Install custom bent Alcoa white aluminum trim
coverage to all fascias, rakes, entry door casing,
window casings and sills.
10. Install white composite PVC to garage door
frame, casing and weather bands. 1x5 PVC with
1-5'8" decorative molding.
11. Carefully remove existing awning. Install 1x8
PVC ledger board flashed and tied into new
siding. Re -install awning.
12. Install all new vinyl accessories: light blocks,
gable vents, split blocks, meter block etc. (Removing
and re -installing electrical meter by licensed
electrician and permit included in proposal) Install (3)
new flush white electrical covers.
13. Removal and installation of light fixtures and
doorbells included- New fixtures and doorbells must
be provided by homeowner if wanted.
14_ Install composite kick plates under all entry doors
where applicable.
15. Re -install shutters, gutters and downspouts if
wanted.
16. Proposal does not include any painting or staining.
17. Building permits included
18. Removal of all work related debris
19. Limited Lifetime vinyl siding warranty from
MFG. , not contractor.
20. Contractor workmanship warranty: 10 years under
normal weather conditions.
Total cost: $21,300.00
Options:
• Install louvered or raised panel vinyl shutters.
S 60.00 per pair additional cost.
* Note* Proposal does not include any material or
labor to be done on new front entry.
Payment schedule:
1/3 on project start date
1/3 at project halfway point
Final balance includin any xtras e u n project
comnletinn
ACC3R D
VRODUCER
Perry Insurance Agency
522 Chickering Road
Norlth Andover. MA 01845
INSURED
CERTIFICATE OF LIABILITY INSURANCE:DATEI
_ 101o4rza12
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
AI Tro Tut: r_rVWRAC.FAFFORDED 6Y THE POLICIES_laELOW-
JOHN LANZAFAME
DBA ALL UNDER ONE ROOF
30 TEMPLE DR
METH UEN, MA 01844
tNSURERSAFFORDING COVERAGE NAIC f
INSURERA ATLANTIC CASUALTY INSURAr`, :E _ I
INSURER B AIM � --
INSURER C —
INSURER O ---
I vvicee�cvca —
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD "401CATED NOTWITHSTANDING
ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIF; -ATE MAY BE ISSUED OR MAY
PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANI) CO'JDITIOHS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAW$.
TR Ip51ffi TYPE OF INSURANCE
A GENERALLJABIUTY
J� COMMERCIAL GENERAL LIABILITY
fi1.AIMS MADE J OCCUR
F]MEO
k ^'i
POLICY aNlN"w"NORwr]04[
L118000227
9/11/2012
9/11/2013
LIMITS
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EXP � ^fry ar- person! --�---.,..
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CERTIFICATE HOLDER CANCELLATION
SHOULO ANY OF THE. ABOVE DESCRIBED POUCtES I* CAN6£LLEU BEF'O"E THE EXPMW
DATE THEREOF. THE ISSUING INSURER WALL ENDE'GVOR TO MAR. TO DAYS WRIT"
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DD SO $ILII
IMPOSE NO OBLIGATION OR LAABILITY OF ANY KIND UPON THE WSUkR. ITS AGENTS OR
y`
}AUTHORMEOREPRESENTATIVE
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C12�. 1 ♦r, •
t T{dice uk t'onsurrter r�Itairs Business Regulation - Mass.UUv /
Q.
The Otfiaai yyebsae of t" Cmc a of Gonsumar AfEa� f3usir+ess
Regulation tOCASR) (''
Consumer Affairs and BusinessRegu�tion
Home Consumer rtorne Improvernent Gontracnng watwn La*up
'Home Improvement Contractor Reg-
strati4n {f by any of the criteria below.
You can search/fitter the regi
Search by Registration Nui,RW
37fl57 - Search
Registrant ��-rJ_� r----_..-----------•—'—' '
Search by R eg Name Zip code t
Search by City
Search Registrants
registration number to view complaint history_ You can also �"4"' °n and uarantY_Fun
Click on the
WIMcnber 20, 2012.
The list is current as Se to€ Thursday, Pe
REGISTRANT RESPONSIBLE
NAME INOIViDUAL
ALL UNI)FR ONE ROOF LANZAFAME.
JOHN
Search Results
REGISTRATION ADDRESS
NUMBER
EXPIRATION STATUS
DATE
13_ 057 166 A FINACHARO 10/0212014
BUILDING
METHEUN, MA 01844
0 ZO1 Z G9(T MqnYM0lth ul Massachusetts_
sAass.GoA is a rePisterrsd service mark of the COMMAVAalth 0f MaSSACIIU!►t N '
t Massachusetts Department oP Public Safety
d Standards
Board of Building Regulations an
Con%tructsnn Supeniwr
License: C.S-OB9120
30 TEMPLE DR =
METK"N MA 0184 ll
1ti " Expiration
9.2.w naro312015
Current
www. mass.gov/dia
Workers' COMPensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leaibly
Name (Business/Organization/In dividual):_
Address:_
City/State/Zip: 1A -c-"v
AC (- t./y1 3 T/l d i t /?, 0/--
6'4"' A -S S Phone #
?--7 J. �-) 7s"9 l
Are you an employer? Check the appropriate box:
1.21"1 am a employer with
'
The Commonwealth of (Massachusetts
have hired the sub -contractors
Department of Industrial Accidents
-,
®ffice ofli2vestigations
-_
600 Washington Street
employees and have workers'
Boston, IMSA 02111
comp. insurance.!
required.]
www. mass.gov/dia
Workers' COMPensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leaibly
Name (Business/Organization/In dividual):_
Address:_
City/State/Zip: 1A -c-"v
AC (- t./y1 3 T/l d i t /?, 0/--
6'4"' A -S S Phone #
?--7 J. �-) 7s"9 l
Are you an employer? Check the appropriate box:
1.21"1 am a employer with
4. ❑ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2. ❑ I am a sole proprietor or partner-
listed on the attached sheet.
ship and have no employees
These sub -contractors have
working for me in any capacity.
employees and have workers'
[No workers' comp. insurance
comp. insurance.!
required.]
5. ❑ We are a corporation and its
3. ❑ I am a homeowner doing all work
officers have exercised their
myself. [Na— oV kers'. comp.
right of exemption per MGL
insurance required.] t
C. 152, §1(4), and we have no
employees. [No workers'
comp. insurance required.]
*Any applicant that checks box #I t 1 fll
Type of project (required):
6. ❑ New construction
7. F-1Remodeling
8. ❑ Demolition
9. E] Building addition
10-ElElectricalrepairs or additions
11.❑ Plumbing repairs or additions
11P Roof repairs
13 ;�tJYn 4
"OtherL
mus a so , out the section below showing their workers' compensation policy information.
I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet 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.
lam an employer that isproviding workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:I!q I_h--1 /W J %V)I'
Policy # or Self -ins. Lic. #:
Expiration Date: I � I � � 2 Jl 3
Job Site Address:_ llq
City/State/Zip:
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 $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. 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 certify Vder the ps az�d per alties.of perjury that the information provided
Official use only. Do not write in this area, to be completed by city or town official.
City or Town:
Permit/License
,is true and correct.
q ( Z sk 3
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