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HomeMy WebLinkAboutBuilding Permit #070-13 - 81 MEADOW LANE 7/27/2012 BUILDING PERMIT OF N�oT 6�ti0 TOWN OF NORTH ANDOVER 3� y` ' •_ .6 oL APPLICATION FOR PLAN EXAMINATION * _ Permit NO: �� Date Received �ss44rED0 ACHUS Date Issued:-4 �� �v IM ORTANT:Applicant must complete all items on this page t V Y r x } "LOCATION' 0R0PERTIY,0INNER PrmTt -- MAPN°-O +' § t s HistoncDistnct yes :° no `# `Z PARGEL. ZONING�DISTRIC�T:� „r ' actime'Shop�Village yes not TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building /C One family Addition Two or more family Industrial Alteration No. of units: Commercial epair, replacement Assessory Bldg Others: Demolition Other Flood' lain ,Wetlands t WatershedDistrctY �. Sep�tic� Well, I? i V1later/Sewer; � - L ` DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Ty a or Print Clearly) OWNER: Name: �(��sK Phono/J -3157 Address: 07/ /)1'�i��oLc� G14 A).�1,{J 04- �l CONTRAC1T®R, Name. �Yrw POO Pfi'on 2 ;Address Doub � oz�z Supervisor�s�Corstruction License l _ r Expa �l..Z-- 'Home lm rovement�License . 1� � z Expo Date � . ARCHITECT/ENGINEER Phone: Address: �– Reg. No. FEE SCHEDULE:BOLDING PERM$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ �7� oad FEE: $ Check No.: / Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ovvner Signature of-contracto - 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 Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes d Planning Board Decision: Comments a Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street :FIRE DE _ ,,. .. PARTMENT `Temp:Dumpster on.site Located at 2'4 Main Street "j,` * �. � - r.1 s.i fti3`r t r >- t } }t- ,.� ^�+ i� '+ �+"`.. � ^.. t�� �''^ �.•L'.�c, { 5;�� � �#.dr Fire Department,,signature/clatea : � ., ; f . �a ..ter .. � �. �;x�t, .4 $� >�.�� �, .. 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 F 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 o 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 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) 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) ❑ Building Permit Application ❑ Certified Proposed Plot Plan o 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) o Copy of Contract ❑ 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 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:INSPECTIONAL SERVICES DEPARTMENTMFORM07 Revised 2.2008 Location el All,-u- 4 No. 070 Date Z . • TOWN OF NORTH ANDOVER w • $ .-. Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ ' •"""� Other Permit Fee $ TOTAL $ Check# 25552 Buifdinn�Inspector Residential Property Record Card PARCEL_ID:210/045.F-0023-0000.0 MAP:045.F BLOCK:0023 LOT:0000.0 PARCEL ADDRESS:81 MEADOW LANE FY:2012 PARCEL INFORMATION UseCode y;h1„01 Sale Pnce 1'90,000' ,B'c�ok 03583 Road Type y TR Inspect Date0825/2005 Tax Class: T Sale Date. , 10/30/92 Page 0027 Rd Condition: P Meas Date: ” " 08)25/2005 Owner: Tbf-Pih An 1632 _ _ _ _ _. TREACY,JAMES M,JR Tot Land Area: 0.34 Sale Valid: Y Cerl/Doe �ffio: M"�` Entrance a - X �0 YP t CHERYL A TREACY 9 ;:; Q ., = Collect Id SGC Address: Grantor FlABSBITO,EdIt11AFiD =:'Sewer: '"' InspectReas' 141 ` 81 MEADOW LANE Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style CL Tot,Rooms6'' :Main FnAr.'ea;'<-810'?° ;"Attic: NBHD CODE: 6 NBHD CLASS 6 ZONE R4 . . _ . ._, .. . F Se.. u.".T.,_e `'Code " Mefhod 5 Ft x" Acres':f Influx/Nr°U"aloe' ?:'"Class. Story Height: 2.00 Bedrooms: 3 Up Fn Area 816 Bsmt Area 816 „ , Roof: L Fult Bathsl :-2 _ =Add,Fn Area � ��� �"'' Fn BSH'Area:� 1 �� "P 101 S ��� 14637 0.340 183,687 Ext Wall WS Half Baths Unfin Area. Bsmt Grade: VALUATION INFORMATION A/tasonry Trim Ext Bath Fez 0 blot=Fm Area 11632 `!`�7 1 '. �` x m ''F Foundation: CN Bath Qual: Ta RCNLD: 129253 Current Total: 313,000 Bldg: 129,300 Land: 183,700 MktLnd: 183,700 _ _ _ __ W K, Prior Total: 313,000 Bldg: 129,300 Land: 183,700 MktLnd: 183,700 Ketch G2ual �;T �Eff Yr Butlt,: h 1.9651„, Mkt Adj: s .. .. x" Heat Type: HW Ext Ketch: Year Built:, 1962 Sound Value: =Fuel`TType: G G de A' Gost'81 dgs :129,306 Fireplace: 1 Bsmt Gar tap:% SCondition: A Att Str Val1: Central AC N Bsnit Gar SF',,4 r Att Str Ual2 " Att Gar SF: 480%Good P/F%E/R: //100/73' Porch Type Porch Area Porch Grade Factor E 99 P 44 W 468 SKETCH PHOTO s w s 44 14 14 E G 9 99,Sqk 9 FUIFMIB 480 Sq.Ft 11 816 Sq.Ft 24 4 �4 24 44145 20 j 34 81 MEADOW LANE Parcel ID:210/045.F-0023-0000.0 as of 7/27/12 Page 1 of 1 JUN/05/2012/TUE 07: 59 AM .Financial Insurance FAX No, 6034323852 P, 001/001 AC�® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/5/2012 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(S), 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 endorsement(s). PRODUCER CONTACT P NAME: atricia Blais Financial Insurance Services Inc (PAI CnNo Ext: (603)432-6414 AX No:(603)932-3852 PO BOX 950 EMAIL Ess.pblais@fisins.com INSURER(S)AFFORDING COVERAGE NAIC i Derry NH 03038 INSURER A:National Grange Insurance Co INSURED INSURERB:Guard Insurance Tri-State Window & Siding Co INSURERC: PO BOX 1028 INSURERD: INSURER E: Londonderry NH 03053 INSURERF: COVERAGES CERTIFICATE NUMBER:12-13 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 TYPE OF INSURANCE ADOL SUB POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYY MMIDDI GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AGE TORENTED X COMMERCIAL GENERAL LIABILITY PREM SES ,occurrence $ 500,000 A CLAIMS-MADE D OCCUR APT2995U /16/2012 /16/2013 MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000,000 X POLICY P cT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I X I RETENTION$ 10,000 CUT2995U /16/2012 /16/2013 $ WORKERS COMPENSATION T RY LA ITS OTR AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE❑ NIA E.L EACH ACCIDENT $ 100,000 B OFFICER/MEMBER EXCLUDED? LtWC222290 /11/2012 /11/2013 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) i CERTIFICATE HOLDER R: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR OFFICE USE ONLY AUTHORIZED REPRESENTATIVE Sam Fragala/PAT ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD Z 0-Z F For five(5)�7,26 avinyl windows installed with same specs as above o remove uildexisting front breezeway steps and deck with pressure treated frame and all maintenance free decking and trim boards.When I was leaving from our last appointment1 measured the stairs and they are all different heights,code only allows a maximum height of 7 V a than V difference between steps.The step.from the deck into the breezeway is 8"which nis not coded no more so the best thing to do Is to demo the whole deck and start over. $500.00 To upgrade to Cedar Impressions on the back wall of garage i 19e f rnpo5e hereby to furnish material and labor-complete in accordance with above specifications, for the sum of: See above pricing. I Payment to be made as follows: Upon completion Note:This proposal may be withdra by us if n ccepted within 30 days. Authorized Signature 7 , ` Date [Authorized e tnteofp ratie ab a prices,specifications and conditions are satisfactory and are hereby accepted. ou are authorized t do th w ecified. Payment will be made as outlined above. Signature Date of Acceptance Authorized Signature Date of Acceptance i i i i Page of a r opiont P.O: Box 1028 Londonderry, New Hampshire 03053 -17r.4A1*eA)440 Phone 1-800-432-1461 Fax 603-218-6070 www.tristatewindow.com ^4 Nu 1556681 Proposal Submitted to: Job Information: Jim&Cheryl Treacy Job Name: 81 Meadow Lane Job Address: No.Andover,MA 01845 Job Phone: Home Phone:978-687-3157 or cell:978-457-0572 Architects: E-Mail:jim.treacy1@verizon.net Date of Plans:5129/12 Remove existing wood shakes from house. Remove wood slates only on garage. Dumpsterto be on site throughout the entire project. All debris to be cleaned up daily and loaded into the dumpster. Remove electric meter,cable and telephone wires and reinstall them after vinyl siding is installed. Replace rotted wood as necessary. Cost is material and time at$40.00 per hour,Any rotted wood repair will be done only upon approval of homeowner(note rotted wood repairs on garage included). Install 3/8"insulation board and tyvek air filtration paper on all exterior walls of house and garage. Cover all exterior walls of house with CertainTeed Cedar impressions. Style and color to be determined. j Cover exterior walls of garage with CertainTeed Board&Batten vinyl siding,color to be determined. All window and door casings on house and garage to be covered with custom aluminum,color to be determined. All soffit boards on house and garage to be vented vinyl panels.Color to be determined. Cover all fascia and rake.boards on house and garage with custom aluminum. Color to be determined All lights and dryer vents to be installed on vinyl blocks to match shake and siding color. Install three(3)pairs of in stock vinyl shutters,color to be determined. Install 115'of seamless gutter with all accessories. Trim garage doors with pvc vinyl boards including new weather stripping. Two(2)vinyl double hung windows Installed. Two(2)hopper windows installed including new pressure treated frames. Frames to be covered with custom aluminum. Furnish and install one single light casement window in entry way including new interior and exterior moldings. Furnish.and install one two light casement window in kitchen including new interior and exterior moldings. Furnish and install one 6' Harvey all vinyl patio door with white hardware and new interior and exterior trim. Furnish and install a new fire rated door in breezeway from garage. Install two(2)in stock Harvey lifetime solid core storm doors. Replace the access door on the front of the garage with a new pvc vinyl door Including new hardware. Replace wood trim with pvc boards on the garage back door. Remove all debris from job site. All workmanship has a lifetime warranty which is nontransferable. Total cost to be$27,000.00 i aar of Building Rc xl tins and Standards opervisor License ,-I ers ; CS 102828' � f � I�IC BENNETT 163 wt G 66' E",V&6 UMIE MANCFtES1vR,i�tl 't131 69 . ._ xpirali . 12t1712D12 i'+actnms�aarrtc r:' Tr#: 102828 offrcr oM,,00mfir Affairs&Rus tss Regulation �laME IMPRtt}ttE itENT"CONTRACTOR •tegistatit3tt 18$1 Typo:', l F2l-STATE WINDOW 5RAN ERIC SENNE . X028 �S.�sme .. LONDONDERRY NH .61, Undersecretary ffi 1 �? SPI 1 ! Construction Debris Affidavit In accordance with the provisions of MG.L. c.40 § 54, all debris resulting from any work covered by a Building;Permit shall be disposed of in a properly licensed disposal facility, as defined by M.GL. c. ill § '(50A. Address of Work: The debris will be transported by: ��S, WKI-6 2Z The debris will be received at: 7-1 P it Awb.Mt � 721 1 Date Building Permit Number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street till". i1{ tltll". 11 Boston, MA 02111 {s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual); fb . LcJG. Address: k02_( j 41 SP soat4 RoAp City/State/Zip: LO�Ib4J Ptael-' �A JI, 03053 Phone#: 6o3) 432-iq 61 Are u an employer?Check the appropriate box: Type of project(required): you I.K I am a employer with 3 4, ❑ 1 am a general contractor and 1 6. ❑New construction * have hired the sub-contractors full and/or part-time),* s b contractors ( P e)� 7. Remodeling 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.� ❑ g P P 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 required.] officers have exercised their 10.❑Electrical repairs or additions 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.❑ Roof repairs insurance required.)t employees. [No workers' 13_(Q(Other WZ-Mt*WS ENT comp. insurance required.) /l``�� *Any applicant that checks boz#l 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. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �lr��D.LtVSRicrC�. Policy#or Self-ins. Lie.#: t��C�2?Z9� Expiration Date: t Il Job Site Address:pI1VM4a;o1,,oVE //.I'aYi /e1.4 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 DCA for insurance coverage verification. Ido hereby certify under the pains and ena/ties of perjury t1tat the information provided above is true and correct. Signature: Date: Phone#: Lwle) 2/47 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#: r , 1 . NORTH - . ve' 'o o No. �L^". Oh ver, Mass, L COCKICKEweCK y1' �d A�R�TEO PPp��S S IJ BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT . .. BUILDING INSPECTOR .... W...... . ................................................. Foundation has permission to erect .......................... buildings on �� .I. � ' .��'�'� ...... ........ ..... ............. Rough to be occupied as ... .4.1...!.. 1 ...... Chimney provided that the person accepting this permit shall in every respect conform to the tms 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 STARTS Rough Service ...... ..... .. . ......7.7.,.-................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required 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