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HomeMy WebLinkAboutBuilding Permit #829-13 - 68 RIDGE WAY 6/3/2013f . 1 FORTH of 11,10 �6qh BUILDING PERMIT �? ,�.:r. ._'�'•'6 °� TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION 41 Permit NO: Date Received Date Issued: �9SSacNus��,c`� --Ulh 11� PORTANT: Applicant must complete all items on this page F LOCATION - int PROPER OWNER Print MAP NO. 4 PARCEL..W i ZONING DISTRICT: Historic District yesno Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Exp. Date: �I,741 Residential Non- Residential ❑ New Building One family ❑ Addition 0 Two or more family ❑ Industrial eAlteration No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well 0 Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer Identification Please Type or Print Clearly) OWNER: Name - Address: CONTRACTOR Name: CCr4 r j�_Phone:q2- L18`�`a1 Address: Supervisor's Construction License, �(�r„� 1 Exp. Date: �I,741 Home Improvement License: j `'� �l Exp. Date. 10 � 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: $ Ist Check No.: Receipt No,: NOTE: Persons contracting with unregistered contractors do not have access to the guar fund Signature of Agent/Owner Signature of contractor_„,/, f `1 Plans Submitted ❑ e '. PlansWaived-11 Certified Plot Plan ❑ Stamped Plans ❑ TIYPE 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 PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH c- COMMENTS 10111Mff"o MW ❑ Reviewed on Signature Reviewed on Signature ti Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes-.- Planning es.- Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer connection/Signature � Date Driveway Permit 'DPW 7Pavw! Engineer: Signature: FIRE DEPAR1. '0.cated at'124 M Fire De6arf' hh J� COMMENTS LOcatea ;jb4 usg000 Street HEW - Temp Dumpster on site yes no - `.�sigrii?,�i�re/date 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 Building Department The following is a list of the required forms to be filled out for the appropriate.permit to be obtained. Roofil,g, 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 ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products 10TE: 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 I0TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application Q 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 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 appal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm:-tted with the building application Doc: Doc.Building permit Revised 2012 Location QO No. % 1— J v Date t0 Check # 2 -,7- I 26464 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �.I Building Inspector • • Enter construction cost for fee cal - North Andover Fee -Calculation Construction Cost $ 10,374.00 m $ - $ 124.49 Plumbing Fee $ 15.56 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 15.56 Total fees collected $ 255.61 68 Ridge Way 829-13 on 6/3/2013 Replace Plumbing Fixtures and Floor &2e tpamvnzancueat a�Cac�iva Office of Consumer Affairs & Business Regulation DOME IMPROVEMENT CONTRACTOR egistrafion:`"163015 Type: Expiration;; LLC LEONARD LEONARD SANTOSUOSSQ'`-=.`:` 5 RED FERN CIR LONDONDERRY, NFi 03053 Undersecretary AIJIJLt:-2 UN IU: 11413 AiiCCOR- CERTIFICATE OF LIABILITY INSURANCE D 06103120Y �r 06!031203 13 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, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 endorsemends). PRODUcr=R Phone: 603-890.6439 Planright Insurance -Salem Fax: 603-890-6521 224 Main Street Suite 3C Salem, NH 03079 Jason M Mlocek INSURERA: PeerlesS Insurance Company 24198 INSURED Applewood Construction Inc INSURER B : Leonard Santosuosso INSURERC: 5 Red Fem Circle Londonderry, NH 03053 INSURER D : INSURER 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUHR POLICY NUMBER POLICY EFF /DDlYYYY I POLICY EAP MMIDDrifYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR CBP7025202 07/2412012 07/2412013 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one reon S 15,00 PERSONAL $ ADV INJURY S 1,000,00 GENERALAGGREGATE 8 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO ­ POLICY PRODUCTS - COMP/OP AGG S 2,000,00 6 A AUTOMOBILE X LIABILITY ANY AUTO AUTOsNE X SCHEDULED HIRED AUTOS X NON OWNED AUTOS BA7026198 07!24!2012 07/2412013 COMBINED SINGLE LIMIT 500,00( Ea acciden BODILY INJURY (Per pereon) $ BODILY INJURY (Per amidont) $ Per exldent $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ . DED I I RETENTION $ S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN FCIMEn E EXCLUDED? Y (Mandatory ) D S detccibe under D RIPT ON OF OPERATIONS below N/A WC7026199 3A NH & MA 07/2412012 07124/2013 X WC STATU- O R - E.L. EACH ACCIDENT $ 100,00 100 00 E.L. DISEASE - EA EMPLOYEE $ r E.L.DISEASE - POLICY LIMIT S 500 00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddRleaal Remart:a Schedule, If more apace Is required) Leo>aalyd Santo9uosso is excluded from workers compensation coverage Town of North Andover, MA 120 Main Street North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR=0 REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rignts reserves. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD O E a MA s N v C cm cm m L O cm O N d r O z O a J O �i IN �. s i V v O OO J G W LU a a Zy� N (A V ? ? a d: LLz CL c z Z z a U ? W OC m N 0 LU U m mJ C 4. W AOcu Ln Y Z .0 t U t ) O .Q 7 E � b�.0 .i. � :3 C C ti v O LL In L.LL W U LL OC LL W !n LL W LL m N {) E a MA s N v C cm cm m L O cm O N d r O z O a J O �i IN �. s i V v O AN The Commonwealth of Massachusetts Print Form Department of Industrial Accidents vOffice of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Inc Name (Business/Organization/Individual): Apple Wood Construction, _ Address: 5 Red Fern Circle City/State/Zip:Londonderry, NH 03053 Phone #:603-432-8599 Are you an employer? Check the appropriate box: Type of project (required): ❑✓ I am a employer with 2 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub -contractors �. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑✓ Remodeling ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have employees and have workers' comp. insurance.} 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] 8. ❑ Demolition 9. ❑ Building addition 10. [1 Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other *Any applicant that checks box #I must also fill out the section below showing their workers' compensation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: -1 Policy # or Self -ins. Lic. #: \,)JG �0 D, C;.\°) Expiration Date: Job Site Address: 68 Ridge Way City/State/Zip:North Andover, MA N3 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 under the pains and penalties of perjury that the information provided above is true and correct. #: 603-432-8599 Oficial 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 #: e le .. pp0-ood constructiiin I/We, the owners) of the premises mentioned below, hereby contract with and authorize as contractor, to furnish all necessary materials and labor, to install, construct and place the improvements according to the following specifications, terms and conditions, on die premises described below: Owners: Patrick & Laura Whyte Address: 68 Ridge Way, North Andover, MA Phone: 978-337-4830 Contractor Information: ripple Wood Construction Inc, 5 Red Fem Circle, Londonderry, NH 03053 FED ID# 45-2837711 I-iIC# 163015 Contractor ID# CS87691 Part I Description Apple Wood Construction, Inc., will: See attached estimate dated 5/28/2013 For the above or attached specifications the undersigned agrees to pay the sum of $9599.00 The Customer agrees to make payment in accordance with the schedule of payment as follows: Deposit on signing agreement: $500.00 Start of work: $2500.00 Start of plumbing: $2000.00 Start of electrical: $1499.00 Start of file work: $1400.00 Start of painting: $750.00 Upon substantial completion of project: $950.00 Part H Proposed start date: Approximately two weeks after issuance of town permits. Proposed end date: Approximately 2 months after start of work. Contractor is not responsible for delay, damage or inability to carry on the work caused by or resulting from strikes, blackouts, fires, accidents, lack of material or any other cause beyond the control of the contractor either before or after the delivery of the material and equipment at the said premises. The contractor is to be permitted to proceed with the specified work without interruption and hereby authorized to do such work as in his opinion is necessary to complete this contract Plans may need to be altered slightly during construction phase at the contractors discretion. Part III This agreement shall become binding only upon the contractor's written acceptance here of or upon the contractor's commencing performance. You may cancel this agreement if it has been consummated by a party there to at a place other than the address of the seller, which may be his main office or branch office by ordinary mail, by telegram or by delivery, not later Bran midnight of the third business day following the signing of this agreement in accordance oath MGL c 93 s 48; MGL c 140D s 10 or MGL c 255D s. Londonderry, New Hampshire 603-432-8599 www.applewoodconstruction.net -,W_�'--od I k Construction Part AT The contractor will do all such work in a workman -like manner. In the event of discovery of hidden damage, it will be charged in a cost plus manner, labor, plus material, plus twenty percent (20%). This amount is due immediately upon completion. The owner(s) agree that in the event of cancellation of this contract before work is started, the owner(s) shall pay to the contractor, on demand, twenty-five (25%) of the contract price plus any material that may have been ordered as it's stipulated damages. Part V The owner(s) will bear the burden of an), penalties or fees associated with delays or litigation necessary to complete this contract and collection of all monies due. Delay in payment of any portion of this contract shall be subject to interest charges of eighteen percent (18%) per annum. There are no other agreements, understandings, representation or warranties, verbal or otherwise, expressed or implied, which are not contained herein. All additional work acrd/or materials requested by the owner(s) must be paid immediately. Part VI All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, MA 02116 617-973-8700 Part VII All work is warrantied for one year after completion date. The contractor reserves the rights to take before and after pictures of the project for use on contractors own website for informational purposes only. Pan VIII PERMIT NOTICE: a. Any and all necessary construction related permits are the contractors obligation to obtain. b. If an owner secures their own contruction related permit or deals with unregistered contractors they shall be excluded from access to the Guarantee Fund. Londonderry, New Hampshire 603-432-8599 www.applewoodconstruction.net Apple',W. d Construction part VHU This contract is subject to the approval of the General Nfanagcr. In Witness whereof, the parties have here auto placed their hands and seal this 28 day of May 2013. DO NOi' SIGN THIS CONTRACT IF THEM ARE ANY BLtiNK SpACa. N� will Patrtk Whyte Laura Nhyte X learn Selosuosso General Manager Londonderry, New Hampshire 603432-8599 www.applewoodconstrur,tion.net May 28, 2013 Patrick & Laura Whyte 68 Ridge Way North Andover, MA pp lei -Woo -d Construction ESTIMATE MAIN BATHROOM 1. Draw plans necessary to obtain town permits. 2. An allowance of $150.00 is included to obtain permits. 3. Prep area to contain dust as much as possible.. 4. Removal of existing: a. Vanity and countertop b. Medicine cabinet c. Tub and surround d. Tile baseboard e. Wallboard where needed 5. Supply materials and build up floor under tub to be even with existing tile floor. 6. Add blocking where needed. 7. Plumbing allowance of $2450.00 is given to include: a. Re -work vanity plumbing for one sink b. Re -work plumbing for new shower c. Install tub d. Install mixer valve, shower head and tub spout e. Install sink and faucet. 8. Electrical allowance of $600.00 is given to include: a. Make existing vanity lights into two sconces b. Add outlet or outlets c. Change existing and new outlets to white GFI/tamperproof devices d. Install two customer supplied sconces 9. Supply and install wallboard as follows: a. Durarock in tub area b. Wallboard where needed c. Repair popped screws in ceiling d. Finish to a smooth surface NOTE: Painter will need to do prep work prior to painting. 10. Install vanity and top supplied by customer. 11. Supply and install 5'A" pre -primed speedbase around perimeter of room. 11 Page PPI `Wood Al Construction 12. Shower as follows: a. Supply mud and apply to all seams b. Supply and install rubber membrane brushed and rolled on c. Supply and install one wall insert d. Install tile on walls and in insert e. Supply and install urethane grout for tub area NOTE: Tile supplied by customer. Will need 83 square feet wall tile and 30' bullnose file NOTE: Natural stone, glass tiles, patterns and sealer will be an additional charge. 13. Hang customer supplied mirror. 14. Supply and apply latex paint to two walls and ceiling. Touch up where needed. Color to be selected from Benjamin Moore. 15. Removal of all trash due to construction project. TOTAL: $9599.00 21 Page