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HomeMy WebLinkAboutBuilding Permit #258-14 - 75 FRENCH FARM ROAD 9/19/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: C>13 Date Received Date Issued: /I�MPORTAANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER L L —I Al ti Print 100 Year Old Structure yjes no MAP NO: - � PARCEL: lC� ZONING DISTRICT: Historic District no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑Wetlands 0 Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: 0�I'L_ s( r�LC;� Phone: g�d • ���- �� � Address: CONTRACTOR Name: L11;4 Phone: !��) •�`���`�� �r Address: 13 ���<- . 571� Supervisor's Construction License: 6(-1,J( Z`' Exp. Date: I Z" Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. a FEE SCHEDULE:BOLDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBA USED ON$125.00 PER S.F. Total Project Cost: $ L ��� © O FEE: $ Check No.: Receipt No.: NOTE: Persons contracting ith unregistered contractors do not have ac ss th)guara ty fund Signature of Agent/Owner - Signature of contractor Plans Submitted ns Waived ❑ Certified Plot Plan tamped Plans ❑ Location No. Dat hy)a cj • • TOWN OF NORTH ANDOVER • tiCkll, a . • Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ ' � Other Permit Fee $ TOTAL $ Check# 41� r Building Inspector 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 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 Siqnature COMMENTS 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 Tovaa Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Mair 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.$100-$1000 fine NOTES and DATA— For department use ® Notified for pickup - Date 6 E Doc.Building Permit Revised 2010 Building Department The foh-awing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofiv,g, Siding, Interior Rehabilitation Permits Li Building Permit Application Ei Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract Li Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks u Building Permit Application Li Certified Surveyed Plot Plan o Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L. Licenses u Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) o 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) Li Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses Li Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract u Mass check Energy Compliance Report o 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 apwaal 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.Buifflng Permit Revised 2012 NORTH Town of 2 t E ndover No. _g 01h LANE •y ver, Mass, 3 COCNICHIMCK ��• �9 A04ATED 1"V' y S V BOARD OF HEALTH Food/Kitchen PERMIT T D N.C.1L Septic System THIS CERTIFIES THAT ........ .......... BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .... ......... 4.. n:✓.......... . .:....... I ..-- JJ Rough to be occupied as .........^$... .. ..��4..C.40V:f !�.ulQ S.L....:�:+...o��....!!�1!..... :5.� Chimney provided that the person accepting this permit shall in every respect conform to the terms of the 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 CONSTRUCT ST RTS Rough Service .......................... ..................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired 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. SEE REVERSE SIDE Residential & Commercial Roofing All Types Of Siidin CHOM r�6EYS POINTED.-n`I=noiLN-CAPPED 9P Expert Masonry 'Work (Mass Tall Free Licensed & Insured 1-800-WAIT-4-vS Owned 4,, C"1 t:'.tt':1 ;' G ........ License#034200 924-8487 = �:' ' C' "rz x 7e, ` cr,�r� m ( / We Work Year Round Proposal To: Neal Shapley Date 7/18/12 Street: 75 French Farm Rd. 978-973-7585 N. Andover, MA Vinyl Siding Proposal neaishapley@comcast.net I. Remove all existing siding and gutters from entire 11. Install all new vinyl accessories: light blocks, split house. Frame in existing gable vents. blocks, meter block etc. (Removing and re-installing 2. Inspect all wood components of entire house. Any electrical meter included in proposal) compromised material will not be left. Any exist- 12. Install composite trim and door bands around ga- ing damage or rot will be discussed, confirmed rage door. with homeowner and replaced. Replacement of up 13. Install composite trim on rear wood shed to(2)sheets of sheathing is included in total cost. 14. Install composite kick plates under all entry doors. Any further compromised material will be re- 15. Install composite mantel system around front entry placed at an additional cost of time and material. door for added detail and curb appeal. 3. Install 3/8" Green Guard insulation board to entire 16. Building permit included house. All seams will be taped. 17. Removal of all work related debris 4. Install 4"standard vinyl corner posts to all house 18. Limited Lifetime vinyl siding warranty from corners. MFG. ,not contractor. 5. Install Mastic Quest or Certainteed Mono- 19. Contractor workmanship w nty: 6 years gram.046 double 4"vinyl siding to entire house. 1 Standard colors only. Total COSI: 6. Soffit area: Drill holes in all rafter bays for added �L'' ventilation. Install vinyl perforated Invisivent Option: Install vinyl shutters. Standard colors a soffit panels. styles.$50.00 per pair additional cos 7. Breezeway soffit: Install vinyl solid beadboard -payment schedule: 1/3 on start date soffit panels. 1/3 at project halfway point 8. Install j-channel to all areas that need to accept -Final balance including any extras due upon vinyl siding. All j-channel will be self-flashed and completion. angle cut for clean professional appearance. 9. Install custom bent white aluminum trim coverage Highly rated member of the Accredited BBB and to all windows, entry doors, fascias, and rakes. On Angie's List rear bay windows, install aluminum trim coverage on as much as possible. Thank you! 10. Install new seamless white aluminum gutters and downspouts. Acceptance of Proposal—The above prices, specificatic ns and conditions are satisfactory and are herby ac- pted. You are authorized to do the work as specified. P iyment will be made as outlined above. r ate of Accentance- T °t 12->� Cinnar, __ Ilanrr Residential & Commercial hooting IM EYS POINTED-.REBUILT-CA3�Ir�EiL? l Types Of Sidi�n� - Expert Masonry Work Mass Toll Free Licensed & Insured 1-800-WA F-4-wig License#034200 (924-80,T) t� > a `fl .rs '`�' We Work Year lRound Proposal To: Neil Shapley Date 8/5/2013 Street: 75 French Farm Rd. 978-973-7585 N.Andover, MA Replacement window proposal nealshap@comcast.net 1. Remove(24) existing double hung windows, (4) double mulled casement units in rear living room. Total cost: $ 21,100.00 2. Carefully remove existing band moldings to accept new window for interior installation. Window specs: Harvey Majesty replacement double Re-install band moldings. hungs and new construction casement 3. Any damaged molding will be replaced at no addi- tional cost to homeowner. Clear stain grade pine interior 4. Install (23) single unit replacement, (1)double White aluminum clad exterior Energy Star Glass package mulled new construction unit, (2)new • • Half screens construction Two light casement units and (2)new • Double locks where applicable, coppertone construction Four light casement units. ( Please see window specs.) hardware 5. All new window rough openings will be insulated 6 over 6 5/8" contoured white GBG's and sealed. (grids between glass)Note 6 over 6 where 6. Any unforeseen rot or damage found during the applicable, grids due to mfg size specifications. installation resulting in extra costs of time and ma- Attic windows will have 4 over 4. Casement terial, will be discussed and confirmed with home- windows will have 8 per light. owner. • Routed bottom sash lif 7. Install all new clear pine extension jambs and 2- 1/2"colonial casing to all new casement windows. payment schedule: 8. Removal of all work related debris. • Half due on window order date 9. No interior or exterior painting or staining in- • Balance plus any extras due upon project cluded in this proposal. completion 10. Building permit included. Highly rated member of the accredited BBB and 11. Contractor workmanship warranty+6 years. 12. Window mfg. warranty: 10 years on parts and Angie,s List mechanisms. 20 years on glass. Thank you! Acceptance of Proposal—The above prices, specificz tions and conditions are satisfactory and are herby ac- cepted. You are authorized todothe work as specified, Payment will be made as outlined above. Date of Acceptance: at,, ! 'Z Signature — IR l'56iy4. - CE C ERTIFIt� ! OF LLASILITS' LNSURAN ?>� caff f?SGAit ItaLDU 2fIIT ctUYZr2CJl'f£ IOk p/S.X film CiMIIP>rRM sl0 H Tl:Ol1 THIS EpTIpIC1tY8. Of _ EX '[MM tpLIC2t9 Mx= iar TNL - --- -- AXD mom, 0)1.1►LT&D�'Mit COKy►M szvTkT ire ns. rxonticcR., si i GisiIPIGai IS Zt SOYn A0 A tpLY OP Lrtt�Y ? I.Tcs6 nSIICflSRt3f. � *� �� :TOILS tl4T 7,YFIPtY►TIVCLY OR }{IAh3I VfLY 111TM IQN III ltaiv[U, soL)oc•. 2wouIWSCi DOX& NOT C004 :h GatTRtNLCI' ! esiWata A If SU6AC}O:4Y �CAtIiIG?L �� .YYXaf ZpSt1821fthe polaofftiesf �++ t k stattt on tYr�• *+LLFx9it` wee not 1 Le Mn 1SZp ire so esdoeserse+s S S TRt7]M'I It cYze Ce Rttttcate holdetoas-y, cescaan Pcatcles slay Mw a}},d cof Ql caeca vi cns P eaia.Ylse/MI►S t.1 t1ftitLT LLC , .. ow wh ••1 __ _— _ parry InQurance Agency -- _. , 522 Chickerin9 Rd. R,-. 125 .000cm North Andover, fy: u?845 Ge.,.T.e+�*. 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POLICY}Xp72TI�Ma , �!i �j f ✓ ' aR�isso>•wac.wtrsv}i � The Commonwealth of Massachusetts 57 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Al 044- A p-l-c Address: T -. ole DA City/State/Zip: -'^^' -5) Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.2'I am a employer with 4. ❑ I am a general contractor and I ` � 6. F1 New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ 1 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.[J Roof repairs insurance required.]t employees. [No workers' 13�2 Other&AtA�-��.S ,J4 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 a're 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 1s providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. la. /rn, VTV)J,4 Policy#or Self-ins.Lie.#: 231 Expiration Date: tk ( q ( Z-A g Job Site Address: t'x_ �'�G� � ' ` ��— City/State/Zip: AIA 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 certo under the pains and penl�al�tiess of perjury that the information provided above is true and correct. Signature: � UJ 1'e` _ Date: Igtq, 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 - - Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or.written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retumed to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permithicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonmalth of Massachusetts Department of Industrial Accidents Offiee of IaVestigatxons. 600 Washington Street Boston.,MA.02111 TeX,#617-727-4900 oxt 406 or 1-877,7MASSABF Revised 5-26-05 Fax#617-727-7749 www.naass.gov�dia klass-(I0\ & r' E�-Orke—Re9UVM ;0CA84 of Gansu Consumer Affairs and Business; Region iswation Lookup Home ImproVement Contractor Reg Istrabor, list by any of the critella t)e'O'�v car search/IF,1te,' tne reg Search! Number 37057 Search by Regis arcm by Registrant NaMe Zip Code i Searcb 0Y C" j."ajr,n Registraws you can alsO Lim-Vie"romptalriA htst" stratinn nurntoe� to he reg Thursday. Sep Search 20, 2012. IfSt I- Search Results EXP RATION STATUS REGISTRANT RESNUMBER REGISTRAT10M ADDRESS I;ATF- m� INDIVit)UAL NUMBER 4 t r NAME i4l.057 166 A FINACHAR0 ,nF.P nPl')O �_ANZAFAME � BUILDING HN k4ETHEL)N N4A 01844 Massachusetts 111h A M35s;3 Uig 3'ec,sjpj,(j service mark of the coftWW"aah nazi C;ov1�a.i lik Si cS.069120 JOHN W tANZAFA 30 TEMPLE OR MF _THUEN MA