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HomeMy WebLinkAboutBuilding Permit #374-11 - 70 RALEIGH TAVERN LANE 11/2/2010 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant Tust complete all items on this page LOCATIONU PROPERTY OWNER WAL4�-3,ft- rillt. 0 Lq-- Print MAP N010-6--PARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes 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 + 1WYh Y p �x -.--...�._� a.'iw*8. '.. t drtFaty�,zad-_.✓ --sw[ ®,Septicq#�Well ; i ®�Floodplam � �etlAands 1 '®,iWater"shedtDistnct, (]Water/Sewer - - - DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Prin Clearly) OWNER: Name: `-e SP1--1`� Phone: G8 3 - S1 Address: -�o CONTRACTOR Name: ��Ste' tom- �� Phone: 9 Pq ---�4 Address: Supervisor's Construction License: 13 Exp. Date: �a 3 71 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$925.00 PER S.F. �` Total Project Cost: $ FEE: $T �` Check No.: �Z Receipt No.: 3 6 L3 NOTE: Persons contracting with unregistered contractors do not have access to the -y- nd Signature of Agent/Ovvner< Signature of. tractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ [TYPE OF SEWERAGE DISPOSAL Public Sewer F1Tanning/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 DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COTt/IMENTS 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: . I 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, 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.$10041000 fine NOTES and DATA— For department use Notified for pickup - Date Doc:.Building Permit Revised 2008 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 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 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit n all cases if a variance or special permit was required the Town clerks office must stamp the decision from the Board of Appeals hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doc.Building permit Revised 2008mi { Location_ Gli/h No. Date -1d / 40R'rh TOWN OF NORTH ANDOVER 3 �c F w • , ; �o Certificate of Occupancy $ s";AMUS I Building/Frame Permit Fee $ Foundation Permit Fee $ j Other Permit Fee $ TOTAL $ Check # 2 3 6 4 Building Inspector The Commonwealth of Massachusetts UVDepartment of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/FIectricians/JPlumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �E � � Address:pQ,0 aJ City/State/Zip: `� Phone#: Axe an employer?Check the appropriate box: Type of project(required): 1.P3d�employer with 4. ❑ I am a general contractor and I 6. E]Now construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet.? 7• F1 Remodeling . ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its ' officers have exercised their 10.❑Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c.152,§1(4),and we have no 12.E]Roof repairs insurance required.] employees.[No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurancefor my employees Below is the policy and job site information. Insurance Company Name:boy P ' ` t i Policy#or Self-ins.Lic. � Expiration Date:,_0 9--aJ / Job Site Address: � `� 1 � � �1�' City/State/Zip: p. Attach a copy of the workerscompensation 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 u hep ains andpenaldes ofpeijury that the information provided above is true and correct. Signature: �j Date: Pot) A)i-1 Phone# 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other ContactPerson: Phone#• NORTH T0VVn of And L.. ......... No A K E -o dover, 1Vlass., 2 - t O COCMIC EWICK RATED 1�l BOARD OF HEALTH IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... .. ............ .D.v...................... .............. ........... Foundation ..................... .. has permission to erect building on ...�"a... ... Rough to be occupied.as 4. .......!�! .G...�!1r.. . Chimney ...... .. P ... . ........................................ provided that the person accepting this permit shall in every respect onform 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 INa60NTHLS ELECTRICAL INSPECTOR UNLESS CONSTRUC Rough ................... ................ Service BUILDING INS CTOR Final Occupancy Permit. Required to Ocatpy 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. , 0 Boarant ,� 401 ah D sand Rov� Nrcaiu traaon- ACTOR .Regis _ 1z� r„ �A ration. 31fi/?01.1 TYPe. DBqP. ..:. T10 282379'' rvd PaintingOnn Od V H" or S.SL&.. i' GTOh ST.#156 J1676 ' iassachuNctks- Uel�artntcut of Public Safety Board Of Building Rc!ulations and Stan[tartl� Construction Supervisor License License: CS 93403 Restricted.to: 00 SEAN OCONNOR 26 CHESTNUT ST SALEM, MA 09970 ' -----er FxPirat'On: 12/31/2011 Tr#: 10208 203 WASHINGTON ST.#256 PRESERVE SALEM,MA 01970 carpentryl paintingI roofingIgutters PHONE:978.745.8745 SERVICES FAX:978.745.3476 SALES@PRESERVESERVICES.COM a_ J Walter& Silvia Soule Date Bid:10/13/2010 70 Raleigh Tavern Lane Estimator:Sean O'Connor North Andover, MA 01845 (978) 683-7851 EXTERIOR PAINTING ESTIMATE CARPENTRY* Left Wall: Siding: Remove the siding; dispose of the siding; install new flashing above windows; install tyvek;tape the seams of the tyvek; install rubber membrain around the windows; install pre-painted Hardie Plank Siding (or Certainteed)with a 15 year factory warrantee using stainless steel nails. Trim: Replace with Havey Industries paintable pvc the front and rear vertical facia on both sides; the top rake board and molding;the bottom piece on the vent. Right wall above the garage starting at the top of the bottom window: Siding: Remove the siding; dispose of the siding; install new flashing above windows; install tyvek; tape the seams of the tyvek; install rubber membrain around the windows; install pre-primed fingerjointed cedar using stainless steel nails. Prime the siding an additional coat and paint the siding 1 coat white on the entire wall not just where new. Trim: Replace with Havey Industries paintable pvc the rake board&molding and 1 horizontal piece on the vent. Dust pan left: Siding: Remove the siding; dispose of the siding; install tyvek;tape the seams of the tyvek; install pre- primed fingerjointed cedar using stainless steel nails. Prime the siding an additional coat and point the siding&trim 1 coat white. Trim: Replace with Havey Industries paintable pvc the rake board&molding and on both right and left sides of the dust pan. On the right side remove the dish. POWERWASHING: Powerwash the rear wall. ,—MISC. : The ridge vent on the garage check to see if there is an opening for bats to enter. PRICING Basic $ 10980 Sales Tax $ 0 Total Price $ 10980 including Labor&Material* Payment Terms: 33.3% deposit(day of start); 33.3%progress; 33.3% end of job McNisa/Amex Sean O'Connor Customer Signature *The cost of paint is included in the above price except for the following: Benjamin Moore Aura (a new line of Benjamin Moore paint) exterior paint will cost an additional $32 per gallon; other specialty products prices will be given on a per product basis. **Above additional prices includes all discounts. ***The carpentry portion of this estimate is valid for 60 days and the painting portion is valid for 365 days. **** Warranty: Craftsmanship: Kyron Inc. DBA Preserve Services warrantees all exterior painting against blistering and peeling for a period of 2 years. The only exclusions are: wooded gutters; walked on surfaces; and structural problems such as but not limited to"mill glazing." Should peeling or blistering occur we will fix the affected area including labor and materials. For the warranty to be valid the invoice that was presented at the time of completion must have been paid in full. Licenses: Home Improvement Contractor(HIC): 123553 Protection: It is required by law that exterior painting contractors have a home improvement contractor license. If a contractor is properly registered, you are entitled to limited protection by the Residential Contractor Guaranty Fund up to $10,000 (The above is a only a summary of Massachusetts General Law 142A). To check our license or our competitors go to: http://db.state.ma.us/homeimprovement/licenseelist.asp and check license 123553. Construction Supervisor(CS): 93403 The Construction Supervisors license is under an individual's name, not a company name. To A check Sean O'Connor's, owner of the Kyron Inc. DBA Preserve, license go to: http://db.state.ma.us/dps/licenseelist.asp select Construction Supervisor and license 93403. Insurance: Worker's Compensation: Our policy is under Kyron Inc. DBA Preserve Services Protection: Covers the injury of a worker employed by the contractor doing work at your home. To check our policy or our compititions go to http://mass.gov/dia/ on this page go to "check worker's compensation proof of coverage"our license is under Kyron zip code 01970. Liability Insurance Our policy is under Kyron Inc. DBA Preserve Services and has limit of$1,000,000. Protection: Covers your property in the event of accidental damage up to a dollar limit specified on the policy. To check our policy we will provide a certificate from our insurance company. EPA: Renovation, Repair and Painting(RRP) Nat-21650-0 To do work on homes built prior to 1978. All painting&remodeling contractors have to be trained and registered with the EPA. The fines for noncompliance are up to $33,000 per day. Protection: Helps educate the consumer and the contractors on safe practices when handling lead. To check our registration or our competitors go to: http://cfpub.epa.gov/flpp/searchn firm.htm and search for firms located in Salem Ma.