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HomeMy WebLinkAboutBuilding Permit #388-2017 - 825 JOHNSON STREET 10/12/2016 1 \ q✓- AAA ��' 4-P / BUILDING PERMIT NOED RTy TOWN OF NORTH ANDOVER 32 ti rl• _'h 6 O APPLICATION FOR PLAN EXAMINATION Permit No#: - aO I Date Received 10 f 'd-0/b gSSacHusE�� Date Issued: 1 0 i)'' 9-0 16 IMPORTANT: Applicant must complete all items on this page L`OCATI ON - Print` PROPERTY OWNER Print 100 Year structure yes o MAP- Idl- PARCEL: ZONING pISTRICl: Historic ®s_fnct . yes ' Machine'Shop Vilfage yes. o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- [I New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ® . . ell ® Floodplain4 I]WetlantlsWft6ffitricl � � � � .e 'm� ' � _ � ,_ .. �u DESCRIPTION OF WORK TO BE PERFORMED: (_ a\A U- C eL-�S �.. �0�� %J—�-J Or a Identification- Please Type or Print Clearly OWNER: Name: Phone: ex-)b b°l1 . �tv�tb Address: Contractor Name: Phone: ' C,-YT It, •51 Jr Email - �.C.�;.-�-.,- .,. .- n,.a-� - • Add.'• . ress: G�,.... f Supervisor's-Construction License. - 0� 30`tom -' Exp':. Date:. Home..,lmprovement License: �.o �"I''L Exp. Date:._ d6 ARCHITECT/ENGINEER L,i 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: $ —10 . vi) Check No.: 1 :9-5-7 ► Receipt No.: 3 f 6 ,9--7 NOTE: Persons contractin with unreged contractors do not have access to the guaranty fund n. -- — r Plans Submitted.❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ i Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS a HEALTH Reviewed on_ Signature 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 Drivewav Permit DPW Town Engineer: Signature: FIRE DEPARTS tMENT TernDurnpste�own te�y s nod - Located 3 sgood Street Lo�'"c=at at 1►24 Main. Streets q-- _-- - Fire Dep rtmen s gnatu e%d to C'OMMTS Dimension Number of Stories: Total square feet of floor area, bas'&,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) I i I ti ❑ Notified for pickup Call Email Date Time Contact Name I Doc.Buildiu;Pen-nit Revised 2014 i Plans Submitted-0 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 Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on_ Signature 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPAR�T�LMENTO Temp ®urn„ pster,n site ►eyes (Lo�""cat d at 124 ain — 1EStr e«, Fire pert end si,g ature/date 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 4 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 OTE: 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 4. Workers Comp Affidavit 4 Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) 4. Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 46 Building Permit Application 4 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 2012 IECC Energy code 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 must be submitted with the building application Doc:Building Permit Revised 2014 Location K a-5 S U e•(n+S 0 N No. -7 Date /0 /a • ;101 (o • - TOWN OF NORTH ANDOVER 4 Certificate of Occupancy $ Building/Frame Permit Fee $ 7� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# is 3'7 1 f� ` Building Inspector OR 01 q - - { - c . . ver W. .. ;', o No .16 � z n ,� oh ver, Mass, I O ��► • a 0��. COCNIC Nl WtCR 1� V AERATED S U BOARD OF HEALTH Food/Kitchen PERMIT - T LD Septic System i THIS CERTIFIES THAT kitivI.C4..............r!►!!.urop .......................................... BUILDING INSPECTOR has permission to erect buildings on .......$�.s....ftr*440s.o� S'f •,,, Foundation .......................... .... ............. , Rough to be occupied as ..�.jE..j( �t.C......... ... .� ....... ....I ..Q.PChimney 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 CONSTRUCJAON START Rough ............................ Service .... ..... ..... 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. . 98 Forest Street Ke �"jTl _ Murp hy 0North Andover,MA 01845 • PH:978-688-5335 Building Contractor FAX:978-688-7207 Proposal To: Ed Cain 825 Johnson Street All Home improvement Contractors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma. 01845 specifically exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA 02108.(617}727 8598 CC: Date: 10/12/2016 .lob: Bay Window Date of plans: None Architect: None Location: Same Section 1-Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specked here in writing contractor will begin work on or about 8/15/16. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 9/15/16.The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11-Warranty The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup,the Contractor shall, at his own expense,forthwith remedy, repair correct, replace,or cause to be remedied,repaired,or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section III-Scope of Work Page 1 of 4 2 Devin Murphy Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:9786885335 FAX 978688-7207 General Proposal is to replace existing bay window. Permit will be obtained by contractor. Building Exisitng window will be removed and replaced with a new Harvey, Majesty series angle bay unit. Window will have a clad exterior, and a natural pine interior. Window will be simulated divided light ( permanently applied grilles ) . Center sash will be a fixed picture, side windows will be doublehung. Any exterior vinyl /trim will be supplied and installed to match existing. Interior Trim/Doors Interior trim will be supplied and installed to match existing. Painting No allowance has been made to provide any painting. Waste Removal Existing window will be disposed of by contractor. Cost of window is $2800. The remainer of the cost is for the permit, miscellaneous materials, disposal, and labor Kevin Murphy Page 4 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:978588.5335 FAX 97858&7207 Section IV—Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ... ... ... ... ... ... ....$ 5800 Payment to be made as follows: Percentage/Item Description Amount 1 Deposit to order window $3000 2 Job complete $2800 Total 2 $57800.00 —Notice:No agreement for Home improvement contracting work shall require a down payment(advance deposit)of more that one-third of the total contract price of the total amount of all deposits or payments which the contractor must make,in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever is greater Contractor: Kevin Murphy 98 Forest Street No.Andover, MA 01845 Registration No: 101874 Section V—Acceptance Acceptance of Proposal—I have read this document and accept the prices, specifications, and conditions stated. understand that upon signing, this proposal becomes a binding contract.You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date 1 Vl �.L l% Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02-714-2017 r www mass.gov/dia 1Vorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITy. Applicant Information Please Print Lee'ibly Name (Business/Organization/Individual): Address: 1\ IF , City/State/Zip: T,1 v , �,�.e vim. ! •, c�? i ® Phone#: Are you an employer!Check the appropriate box: Type Of project(required): I.M I am a employer with —employees(full and/or part-time).* 7. 0 New construction 2f]I am a sole proprietor or partnership and have no employar working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.) 301 am a homeownc,doing all work myself[No workers'comp.insurance required.)t 9. El Demolition 4.[:]]am a homeowner and will be hiring contractors to conduct all work onmY property.. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sok 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5�I am a general contractor and 1 have hired the subcontractors listed on the attached shoe!. These sub-contractors have employers and have workers'comp.insurance-t 13_0 Roof repairs 6.❑We are a corporation and its officers have exercised their right of cxcmption per MGL c. 14.E]Other 152.§1(41 and we have no employees.[No workers'comp.insurance required) •Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information- Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tCoatractors 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 u providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: lL\: k__c ,ZJ0 Spm Expiration Date: `1 l i k-" Job Site Address: 5�Z $— J City/State/Zip: N,• Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. I do hereb,certify ffnder,the pains and penalties of peryury that the information provided(above isI true and correct Si azure: Date: 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#- DATE(MkvDDM'Y1� �� CERTIFICATE OF LIABILITY INSURANCE 7/11/2016 THIS CERTIFICATEIS ISSUED ASA MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELYOR 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 REPRESENTATIVEDR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificateholder is an ADDITIONALINSURED,the policy(les)must have ADDITIONALINSURED provislons or be endorsed. If SUBROGATIOMS WAIVED,subject to the terms and conditionsof the policy,certain policiesmayrequiman endorsement.A statement on this certi0catedoes not confer rights to the certiNcateholder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Sandi Munroe M P ROBERTS INS AGCY INC PHONE 1AX (978)663-3147 ArC,Ne,E.,: (978)683-8073 A/C,No 1060 Osgood Street nDRE sandi@mprobertsinsurance.com North Andover, MA 01845 INSURER(S)AFFORDING COVERAGE NAICe INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURER : GUARD INSURANCE 98 FOREST STREET INSURERC: NORTH ANDOVER, MA 01845 INSURERD: INSURER E INSURER F: OVERAGES 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. u. POLICY EFF POLICY EXP TYPE OFINSURANCE POLICY NUMBER MWDDYYYY) (MMA)DLIMITS X COMMERCIALGENERAL LIABILITY EAC OCCURRENCE $ 1 000 000 CLAIMS 1 DX OCCUR PREMISES Ea occurrence) S 500,000 BOP1068945 1/22/15 11/22/16 MED EXP(Anyoneperson) $ 15,000 A PERSONAL&ADV INJURY $ INCLUDED GEMLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 0 J_Ed 0 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED MCA01/23/16 01/23/17 A AUTOS ONLY X AUTOS BODILY INJURY(Peraccident) $ HIRED U NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 H A ]+EXCESS LIAB CLAMS-MADE AGGREGATE $ 1,000,000 DED X RETENTION $ 10,000 CUP9145304 1/22/15 1/22/16 $ WORKERS COMPENSATION X PER 0TH• AND EMPLOYERS'LIABILITV STATUTE ER YIN B ancsannsaeea a.cwoo+Ecurne N NIA E.L.EACH ACCIDENT $ 500,000 (Mandatortin NH) KEWC726509 7/01/16 07/01/17 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yea,describe under 500,000 DESCRIPTION OFOPERATIONS Mi.. E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OFOPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER 1600 OSGOOD STREET SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD25(2016/03) The ACORD name and logo are registered marks of ACORD