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HomeMy WebLinkAboutBuilding Permit #298-11 - 61 WESLEY STREET 10/8/2010 I BUILDING PERMIT ole t%o oT"qti TOWN OF NORTH ANDOVER �� yt''- ._ •.*` �% APPLICATION FOR PLAN EXAMINATIONX-0 '' J i 0 roe Permit NO: 7t Date Received �y 0 AYEo rP��Ry .SSACHUSE Date Issued: ` IMPORTANT: Applicant must complete all items on this page LOCATION ��� .,f :k1i „} b. +.�.w. •+ ..Y _ t Prl(lt »-.i� t: .I• .. ,~�� yr. � ., r e..F '+ S `9'"M.K -9'. ai 's �'� PROP ERTY OWNER�.�r. : f rt la..d''r .ti• ! :Y. qct1 t- t. .;� F of '� !4 - � `�I•p't tv.i-:.b�M. . � iMAP 210'; . PARCEL 7nNING'DISTRICT Histone District �� G �h. mgt yes: ..no r `.. Machine Sfiop,Village yes . ,j. TYPE OF IMPROVEMENT PROPOSED USE -- - Residential - • Non- Residential 0 New Building lebrie family ❑Addition . ElTwo or more family 11Industrial ❑Alteration No. of units: 0 Commercial WRepair, replacement 0 Assessory Bldg ❑ Others: 0 Demolition 0 Other =Septic d Well. El'Floo'dplain 1Netlands q:Watershed District s �a , E10at6/5ewer, DESCRIPTION OF WORK TO BE PERFORMED: I� szoyl.nv poo r `vt' room W/ t1we w Identification Please Type or Print Clearly) OWNER: Name: /9,c>1re1' GLoldee-y Phone: 9M -688-63/ Address: CONTRACTOR Name: Phone: . AcJdress"` � a ' wry ,...,,• s. �,t.r 'r p. r ..a- �r� ,.,t, Supervisor,s Construction License - Exp Date ' Home Improvement License`.. '. Exp. .Date. y ARCHITECT/ENGINEER Phone: I jAddress: Reg. No. FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON - $925.00 PER S.F. i Total Project Cost: $ �_l - FEE: $ G, - �` Check No.: Receipt No.: P3 Y7 2.--- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor 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 Packaginb/Ss a ale '" ❑ ' 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 .1 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments I Conservation Decision: . Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW'gown Engineer: Signature: , Located 384 Osgood Street - FIRE DEPARTMENT := Temp Dumpster on siteyes no; Located at 124 Main Street Fire Department signature/date COMMENTS. . Dimensi®n 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 i ® Notified for pickup - Date Doc.Building Permit Revised 2010/October a i 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 DOTE: 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 0- Copy Of Contract c Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report If j Applicable) ❑ Engineering Affidavits for Engineered product 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 BuildingPlans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculationslicable if Applicable) Pp ) ❑ Copy of Contract ontract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products OTE: 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 rnust be submitted with the building application Doe:Building Permit Revised 2008 R. Locatio4k MeJOL-0:1,2 S7 No. Date s MORTq TOWN OF NORTH ANDOVER }��» • : Certificate of Occupancy $ �ss�►cNustt� Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 23 5 Building Inspector NORTy BUILDING PERMIT 0 t%-ED ,6�tio TOWN OF NORTH ANDOVER 32 yt ,• 4, =6 0 APPLICATION FOR PLAN EXAMINATION �0 Oy Permit NO: Date Received �g40RATEo�QayRS �SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION;: 6.�,.. 14/i I ;5 ,- t`Vp� .1�G�oVZf . ..':..;.:. .. . . 5 Print PROPERTI'.01NNER . r > Ye.l.. r0e•e✓ >, ti x` ;. . Prat MAP.-216,-- 'ir- G. PARCEL . . : ZONING DISTRICT:_ Historic Distract " yes. � no\ Machine Shop Village yes ,no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building VOne family 0 Addition ❑Two or more family 0 Industrial 0 Alteration No. of units: 0 Commercial EVRepair, replacement 0 Assessory Bldg 0 Others: 0 Demolition 0 Other q`Septic ❑Well` p Floodplain ❑Wetlands 0 WatersFed District. 0 Wafer%Sewer DESCRIPTION OF WORK TO BE PERFORMED: S.r✓i` i'r2 moo�' P•,'v> room !�✓i`�do w Identification Please Type or Print Clearly) OWNER: Name: 1,9�1d,-ze-ci Phone: 9 T -688-6 3/ 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:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON w $925.00 PER S.F. Total Project Cost: FEE: $ (� Check No.: d Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor ORTH 0 of ®ver . , No. j/--"' a 1j -W. -M ._ o dover, Mass.,10- O LAKE g' ' 1 o COCMICMEWICK %dSs ATED 7 BOARD OF HEALTH PEnMIT T , D Food/Kitchen Septic System BUILDING INSPECTOR � THIS CERTIFIES THAT.....1'��4........... .r..V... .... ............................... .............. Foundation has permission to erect.........:.............................. buildings on ....W............ .. .......... S.. Rough to be occupied asC�... .....S ........ LS..... .....C.c.s+. .. oQ ........ ............................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 CONSTRU S S Rough .... ....... ......... ............................... .................................... ............. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ORTH TO" of LAKE O dover, Mass.,. O COCHICHEWICK S BOARD OF HEALTH PERMIT T- D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... �Ir {,........... r.. ... .... ............................... .............................................: -Foundation has permission to erect.........:.............................. buildings on ....to�............W.e..�.......... .....4.. Rough to be occupied asc(... .....�Ld*r .............L'.V.0-.A..l d4!! ........�q lr'1.R...N�. ............................ Chimney provided that the personaccepting this permit shall in every ryraspect conform tothe terms of the application on file in Final 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 UNLESS CONSTRU ST S ELECTRICAL INSPECTOR Rough ..........".'�:'................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. ic, cViu II-VLA r rritn NLrivi_tM ► -`.- W 421 Y I CERTIFICATE OF INsST CE t STA FARM FIRE AND CASUALTY COMPANY,Bloomington,Illinois T 5,00 CARR! Q STA FARM GENERAL INSURANCE COMPANY,Bloomington,Illinois Q STA FARM FIRE AND CASUALTY COMPANY,Scarborough,Ontario IZvsU�ANc Q STA FARM FLORIDA INSURANCE COMPANY,Winter Haven,Florida - - Q STAT FARM LLOYDS,Dallas,Texas insures the following policyholder to the coverages Indicated below: Name of policyholder i Dzmit y .Hrytsuk' Address of policyholder [13A Whittier Dr Seabrook, NS 03674 Location of operations same Description of cperetions Construction The policies listed below have bee i issued to the policyholder for ft policy periods shown,The Insurance described In these pol'ic'ies Is subject to all the terms exclusloris,.n conditions of those policies.The limiia of liability shovm may have been reduced by any paid claims= -- POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE `F INSURANCE fictive Data l Eatpiratlon fate: (at inffi7g of I licy perio N/A Compn hensive BODILY INJURY AND 94-BV-3438-4- F Bus+ s Llabili 05/0i/2010 j 05/01/2011 PROPERTY DAMAGE "Phis Insurance Inctutr( C7 Fero ........ cts-Co Completed Operatiii�is._.. . -------- Q Con actual Liability Ond r$round Hazard Coverage Each Occurrence $500,000 Q Pe Orta(injury — Q Adv 'sing Injury General Aggregate S 1,000,000 Q Fate.oslon Hazard Coverage Q Col pse Hazard Coverage Products-�Completed $N/A 0 Operations Aggregate Q -- POLIGY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXC ESS LIABILITY Effective tate ; E Nxadon Date (Combined Single Limit) N/A Q Umbrella Each Occurrence $N1A N/A Q 4th_ r Aggregate $N/A Part 9 STATUTORY Part 2 BODILY INJURY 6Ki7B-0715rn135--09 Worb irs!Compensation 05/01/2010 05/01/2011 and E mployers Liability Each Accident $100,000 Disease Each Employee $100,000 - Disease-(policy Limp $500,000 POLICY NUMBER TYP OF INSURANCE POLICY PERIOD LIMB"$OF LIABILITY Effective Date l Ctrp mdw Date fat be@!nnIng of elicy perigd 29.2009-957 01 r d B350 04/24/2010 10/2112010 100,000/0300,000/,650,000 6 THE CERTIFICATE OF INSU RAN X IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR N9GATIVELY AMENDS,EXTENDS OR ALTE 'THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Till) At-Rom ServLceej Inc„ and the Home Depot are included as If any of the described policies are canceled'before additional insured with r zpects to :general liability its expiration date,'State Farm will try to mail a written insurance notice to the oertificate holder 3D days before cancellation. If however, we fait to mail such notice,. Name land A 1dress of Cedificate Holder no obligation or lieb"tlity Will be imposed on State Farren or As ownts er rept ivies. THD at Roma Servicea zinc 2690 Cumberline Part. Tay &' mature F1tdltort Su312 resertta*o Site 00 ►0 uidi' 3 GA 30359 �n 0511212010__ We C2t_ Agent's Code Stamp Ago txyd P.SChtder 2009 ...,;�klamlyshlr6 F816 5MM 4:8 0440-99 Prlrl W in U." SILVER SCROLL t` lqw 74a7 , tlNjILI U, Ell ..- sem. %�-s: w.. �. -- �,-.... .».n ...�....• .�ow.._.....:...i..!'wS.f��ac.-�7.1 -. �..���s ��R yg �» ► R:..a:.+s=._ _,-. ..m, -.J*— .z 14-A ' x Cvwz .,two`A r. 'DOS POW jai M MA IMR%sW- � , to contiming the contracted work. Withdrawal of funds from said account would require the signatures of both parties. .Addit onial information If you have ever I quesrions or needadditional information about, the .liom� Improvement. Contractor Law or other consumer rights, or if you:wish to obtain a free copy Of ,,A Cansuzner Guide to the Home Improvement Contractor Law, contact: Consumer information hotline 0ffice of Consumer-Affairs and Business Regulation 10 Park Plaza,Room 5,170,Boston.,MA 02116 (617)9734787,or.1-(888),2,833_757 If you want to verify the registration o£a contractor or if you have.questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor l aw,contact: Director of 1lorne Isnprovernent Contractor Registration Bureau of Building Regulations,and Standards One Ashburton Place,Room 1.301,Boston,MA 02109 (617)727=3200 or 1-840-223-4933 :For, assistance with informal mediation,of disputes or to register formal 'complaints against a business,call: Consumer Complaint.Section Office,of the Attorney General (617)727-8400` ANIS/OR Better Business Bureau (548)652-4800 (508)755-2548 X413)734-3134 Contractor Arbitration The Home Improvement Contractor Law provides homeowners with-the right to initiate an ,arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor, however. The contractor would;have to resolve any, dispute :he/she has with a homeowner in court unless both parties agree to the optional clause. provided below. This clause would -91ve the contractor the same right to arbitration as is afforded to the homeowner by.the Homme Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance 'that in 'the event the contractor has a dispute concerning this contract, the contractor may submit the dispute to a private arbitration Kiran which leas been approved by tlme Secretary of the Executive Office, of.: Consumer Affairs and Business Regulation and the consumer shall be required to.submit to such arbitration as;provided1n,Massachusetts General Lawscha' ter 142A. f 'Homeowner's Signature . ignature g p pp y y g p �.. NO'V'ICE: The s natures. of, the urtica above -apply only to the a ree ..ent of the aches to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is.not se aratel si`ned by the parties, nomeowner's Bights A homeow.net's rights under the Horne improvement Contractor Law (MGL chapter.142A) and other consumer protection laws( .e. MGI, chapter 93A)may not be waived in anyway, even by agreement. However,. homeowners may be excluded,froin certain rights if the contractor they. choose is not properly registered as prescribed by law. Homeowners who secure their awn building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The' contractor is responsible for completing .the work as described, in.a timely and workmanlikemanner. Homeownersmay be entitled to other specific regal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, -all. oods sold in im Massachusetts,carry an plied.warranty of merchantability and fitness for a particular purpose. An enumeration of other,:matters on which the homeowner and contractor lawfully agree may added to the terms of the contract as long as they do not restrict a homeo«mer's basic consumer rights. If you have questions about your consumer/homeowner rights, contact.the Consumer Information Hotline(:listed below). Execration of Contract. The contract must be executed in duplicate and should not be:sigped until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One Original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed. copy of the contract, and the three day recission period las expired. Accelerated Payments.. A contractor may not demand payments in advance,of the dates specified on the payment schedule in cases where the homeowner deans himlherself to be financially insecure. However, in instances where a contractor deems.hh-nlherself to be.financially:insecure,the-contractor.may require.that the balance of funds not yet due be placed in a joint escrow account asa. prerequisite attached to the:contract) Subcontractors The contractor Agrees,to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and tabor under this agreement. Contract Acceptance-Upqnl signing,this document becomes a binding contract tinder law. Unless otherwise note: within this document, the contract shall:not imply that any lien or other security.interest has been placed on the residence,:Review the following cautions and notices carefully°before signing this contract. Don't be pressured into signing the contract.Take time to read and fully=understand it. Ask questions if something is.. unclear. Mahe sure the contractor has a valid Home Improvement Contractor Registration. The.law. :requires,most home. improvement contractors ;and subcontractors to:be registered,with the Director of Nome Improvement Contractor Registration. You may inquire about contractor registration by=writing to the Direetor at One Ashburton Place..Room 9301;Boston,MA 02108 or by calling 6177727-3200 or 1-800-223-0933. Does the contractor have insurance?:Chock to.see that your contractor is properly insured. •Know your rights and responsibilities. Read the Important`lnformation on the reverse side of this form and'gct:a copy of the Consumer Guide to the Horne Improvement Contractor Law. You may cancel this agreement if it has been signed ata place other than the contractor's:normal place of business, provided'you notify the contractor in writing at his/her main office or branch office by ordinary maid posted, by telegram sent or by delivery,not.latcr.than miduight of the third business day following,the signing-of this agreement: Seethe attached.notice of cancellation form for an explanationof this right. DO.NOSIGTI3IS-CON RACT IF THERE ARE ANY BLANK SPACES:!. Two identical copies of the contract must be completed and signed. One COPY should go to the homeowner. Tho pthcr oopy:should be kept by,the eantractor. deffcwflces Sign re Contractor's attire �I Date Date Mmachusetts Home Improvement Conte d . This form satisfies all basic requirements of the stab's Home.Inaprovenicat:Contractor Law,(iMGL chapter 142A),but does.not include standard language to.pretect homeorvaers. Seek legal,advice€f necessnry. Any person planning home improvements should first obtain a copy'of"a h-assachusetts consumer guide to home itn vemen(� :before agreeing to any work go-yourlesidertcc;Yttei r ay obta- free copy by calling the Mcc of Consumer Affairs and, Business-Regulation's Clonsumer7nformation h otline at 617-973-8787 hr 1488-183-1151, RompoWner-Inform.stion Contractor Information Name, Audreix 1 rufeex t company lgame Trmted Installm inc' 61 Wedey st zusiiry Tir}tsuk I. 5irce Address fdo rtot use tt.Asstt�ftiec Brrx-adthc�s) i contrsctnr!"�a1cs ,Tsonl CSsti I�amc Nofth Andover VIA 01845 13 A rt7+il ittier di i; 0wrrolin state Zip Code i Buc'utess-Address(must include a street address, (978)885 A963 uealsrook. 03$74 Da}fimoPltorae" 1'.Ntung,l';hcaneJC t} 'orvn,. State. Zi Ii (617)836-11140 208611447. riQailitYg Add,re '(lt diiTenn[froth above) lusins Plionc Tederal employer ID or SS. Number 1 Law requires that mosihoine 3mprwmc t cmtracturs hart a vertu tegish-afinnntmtber (j Po=Imp ovwmcnl Cotnr ctorft'.NumExr �Sj ;. .t=a�irstKxidatc G�..�fi� �� I The Contraetor agrees to do ttte following Work for tho-RomeovtnIer: ✓ ' *� (Desciibe m detail the%*ork to cgmpletedf specifying the-type,brand,and grade f,%materials to be used,use addttio tal.sheets if- necessary) 1'iitchert s3idt+door replacetrtdtt. Living tootn slide door repiacetnent. LMfig jrpooji Wihdqw.M1 —t Required T tits -The folleiving building perniiL&are:'Praposeil dart --and Completion '$Aednle The squired.-and <"I be secured by the contractor as the NION-wing schedule :will' be adlicicd to unless hom^eowtmer's agent, (owners who secure their circumstanecs.beyond the contractor's control arise own. pee*its will be :excluded froth 'thy (!� (t?t)atewiiett catztraclor�11 begin contracted word:. guaranty Fund provisions of MGL chapter 1.42A.) J©d)ate vdien contracted.Work Will Ile substantially cot$ tctird;. Total Contract..Price and Paymeat 5ched6le The Contractor agrees tis perform.the work,furnish the material and tabor specified above for The total s tm.of: 8 455 I (*) 1'a}stn is Will,be made accordir ig to thc,folloNv*g sehedulc- $2270,79 n ` nt � ntttratt; s 2280.46 upon completion_ofthe contract. (Law forbids demanding full pent-until eontract is,eoinpleted to both part}''s sttusfacuon) d he£nllo�aKng rzaateriallequiaxt mink Tie special $ � to be paid for ordered before ltte emAracted a art:begim in order$ ---° to be paid poor -- to nmt;the complcttou schedule.(°') NOTES:(tj Including all finance,charges-(")Law requires that any depositor down-p -.nieni MTu by the contrnetnr Before Work begins may not exceed the greater of (a)one-third of the totat contract price or(b)the acdial cost at'any.special' egwpm"t or oustom made material whieb mu A be special ordered medvance to meet he completion sebedule, Express Wseriinty 4s an eapresS wsrrettt r'btrntg P rGAidrd by thccon+t2uctor? filo Yes (all terms of the,warranty mist be