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HomeMy WebLinkAboutBuilding Permit #524 - 84 CANDLESTICK ROAD 2/7/2006Ot Ma °TH 1N p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SSACHUSEt Permit NO:� Date Received: /-�►b Date Issued: —D IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print MAP NO.: i l) 6 k PAR L: ©1 ZONING DISTRICT:... " TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Exp. Date-:_ �� Y Residential Non- Residential ❑New Building ❑ Addition Alteration -gOne family ❑ Two or more family No. of units: ❑ Industrial ❑ Repair, replacement C Demolition ❑ Assessory Bldg ❑ Commercial 0 Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name Address: CONTRACTOR Name: Phone: (_ y -S 33 Address: Supervisor's Construction License:_ o'31011 Exp. Date-:_ �� Y Home Improvement License: 1 l li� Z 1'1"_ Exp. Date: U IA /0 ARCHITECT/ENGINEER Vim/ Q P,-� Name: Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. � Total Project Cost S 6 t Q Q x10.00=FEE: /7 �a Check No.: Receipt No.: L TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer 0 Well Tobacco Sales ❑ Food Packaging/ Sales ❑ Permanent Dumpster on Site (J Private (septic tank, etc. +moi NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fiend Signature of Agent/Owner Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS 4�� Zoning Board of Afq�eals: Variance, Petition No.' Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer connection signature & date DATE REJECTED ❑ ❑ ❑Water. Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE REJECTED DATE APPROVED DATE APPROVED El DATE REJECTED DATE APPROVED e�220 04� A - 71-7 Comments Comments Temp Dumpster on site yes__no Fire Departmennature/date Building Permit Approved and Issued by: - Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided 1J1M NNION Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. NO .S and T ` — (For department use) r pa� rZ Doc: INSPEC"I'I(JNAL. SI.RVIC'ES DLPARTMEN'I:BPPORM05 Cleated JMC. Jnn._OU6 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 ❑ Debris Removal Form ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Form ❑ 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) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Form U ❑ 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 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 DEPART MENT: BPFORMUz NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building it at: is that the debris resulting from this work shall m disposed of in a properly licensed solid waste disposal facility as defined by MGL 11,S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: Fire Department Sign off: Dumpster Permit (Location of Facility) Signatur o e it Applicant Date The Commonwealth of Massachusetts Departinent of Industrial Accidents office of Investigations • � �. Ahs 600 Washington Street .12 Boston, MA 02111 w# w.mass govId is Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers nt LeAli Name(13iwtii190ranitti0n1Individual): Address: Z' A ,,,�, N•r~ v ��rt5f'hoae #• �C1 ti �a - 3 3 S City/State/ tp._1,,�, Are you an employer? Check the appropriate box: `l' ❑ I am a general contractor and I l . ❑ I am a emplo er with __ have hired the sub-corttractars em la d/or part-time).' p Y listed on the attached sheet 2. El I am a sole proprietor or partner- ,.fie sub -contractors have ship and have no employees workers' comp. insurance. working for me in any capacity - 5. ❑ We are a corporation and its [No workers' comp. insurance ohave exercised their required_] 3. ❑ I am a homeowner doing all work nfficers . t of exemption per MGL myself. [No workerscomp. c 152, § 1(4), and we have no employees. [No workers' ' insurance required.] - comp. insurance required.] Type of project (required): 6. ❑ New construction 7. Q Remodeling 8. ❑ Demolition 9. ❑ wilding addition 14.0 Electrical repairs or additions 1 I .l Plumbing repairs or additions 12.0 Roof repairs ME] Other *.try applicant that checks bon #! l most also fit, out the sectshowing their workers' compensation policy ion below information: { t iomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicatingt o - �Contra cs that edrack this box must attached an additional sheet showing the name of the sub-conttactoess and their woritets' ccsmp. VK Y am an employer that is providing workers' compensation insurance for my employeeL Below is the policy and job site information. Insurance Company Name: 6' �1 CIV� Policy 1# or Self -ins_ Lic. #: �.�/ w L 6t{ 0 X22 Expiration Bate:_ i U Job Site Address:N CitylState/Zip: fv _ �✓ Lf 1l —�s2�c, , � t•w-., t`^' L 1�` i6 Attach a copy of the workers' compensation policy declaration page (showing tits policy number and expiration dale). 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 $250.04 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 here c fy undfs-ilny�ns and penalties ofperjury that the information provided above is true and correct, rt- ( fCial tine Eptly. 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. Electrical Inspector 5. Plumbing Inspector 6. Othex Contact Person:. Ploste #: UP i` • _ L; A = kj =T IFI 611 117;: J- :J .:i� '1- ''i. �ii,i2)•'. - ::) .i !1'' i, i.• !.f' ,i' ii•' is ;# }t �S[i ;)'f� i' i � 3: i:} ;f• '. ?:,'- )t ,. h.. } ;FS: r''i+` L`+:' :;T '1:• � 'rY '}. 'i 'tii J -t� :Yeti ),-�. .•.' t,J �'t: i � t ��'<s•: �. �'a;1 i �:ti ii }f: `,t' •'i� - 1%' ��F r. W:.i;1 ,►i<_ t' •.r 'i' t i i. r:f;f ' V.=.:'. ".!: ~ i all 11 Nit AwitaNN'DaLrAWDIM i OmmmmsmaEubsT 5 'JQ0,000 AMAtti:? AIXQVWMEDAUrIDS OCOLYQWmr �P �► ASi M $ 3 Avtc 7AM277012608 01/23/OS 01/23/06 somymw$ • � s UMM" fir s MYN" S AW S owesswWom"WaUff IMM OCCUFNIMM s R swumom a $ Oull IMMIX � s s ISM is ,r X648422 07/01/05 07/03/05 s 500-000 �r tx asdF•r s 40 • �„ - r r s SM _000 eaotrc�strs��-t�'�t�tsFf �eur�oc►sasx�.� ONOW WD 08LIMM tR 7Y OF AM Ftp c a VAE OMOM aS ASOM OR r. =tv"K,\�Nordo, M 01845Ov PH:978-688-5335 Building Contractor FAX: 978-688-7207 Proposal To: Doug & Pat Yates 84 Candlestick Road North Andover, Ma. 01845 Firm= Kevin Murphy =I Dale: 1/19/2006 Job: Finish existing basement area Date of plana none to date Locatkw same Section 1- Work Schedule All Home d pVmrro t Contradds and SLtwntract= aVaged In home ffPVmrreM.mlen spedfic* exempt from registration by Provisions of Chapter 142A of the gaierai Im, rrW be registered withthe ConTrormeatth of Massalmetts, Inquiries about regmtr&m and Status shod be made to the Diredor. Horne Imprmement Contras RegiMbon one Asrtbr" Place, Room 1301, Basiorr, MA 021013. (617)-727 85998 Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 1/30/06. Ba" Delay caused by circumstances beyond Contactors control, the work will be completed by 4r3o/O6. 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. Theforegoing warranties .shall survive any inspection perfomled in connection with the agreed-upon work. Section 111- Scope of Work Zvi o3un7nhy SUDCUnrg ce=tractor 169 Smdord Saeed Mom, Andover, MA 01845 rte 9785885385 FAX 978t)Wx000( General Page 2 of 5 Proposal is to finish 14)36' area of existing basement, and approximately 8'x16' area for laundry and finished storage area. Building permit will be provided by contractor. No allowance has been made for Title 5 inspection, or septic expantion if required by town. Plans can be provided for basement area, if desired by owner. Building All framing. materials required to build. petitions, .frame platform at. entry area,. install 2x4 sleepers with 3/4 plywood floor, and build.closets for finished areas will be provided. Sleepers in main living area will be built up with one 2x4. One Anderson doubiehung window will be provided in bathroom area. Electrical Electrical work required to wire finished areas to meet code will be provided. Ten recessed lights have been included. Phone, cable, and computer lines will be roughed in by electrician, to be connected by their service provider. General layout to be approved by owner prior to start of rough. Electric heat will be installed to properly heat finished areas.( as back-up to forced hot air) Heating/Air Conditioning Forced hot air heating will be provided off -of existing first floor zone, to heat added areas. Dampers will be installed to control .heat .in basement No allowance has been made for any air conditioning. Plumbing Plumbing required to install laundry connections and 3/4 bath will be provided, to meet code. An allowance of $800 has been included for plumbing fixtures, ( $450 for fiberglass shower, $100 for Simmons shower valve, $100 for faucet, $150 for Kohler wellworthlight toilet). Insulation All exterior petition walls will be insulated to meet code.( R-13 will be provided ) Rigid insulation will be installed in floor between sleepers. Plaster New walls will be blueboarded and skimcoat plastered. Walls will be.smooth, closets will be textured. Interior Trim/Doors Interior trim and doors will be supplied and installed to match existing. Doors will be six -panel, solid core, pre - primed units. An allowance of $1100 has been included to supply railings / balusters for exposed side of stairway and railing at entry area. Painting No allowance has been made for any painting. Finished areas can be painted for an additional cost of $1800. Flooring An allowance of $1800 has been included to supply and install carpets in new area and stairs. Tile floor will be provided at entry, bath and laundry area. An allowance of $1050 has been included for file materials. Uevim Mutrphy SmAd itg ekes 169 Boxford Street Borth Andover, MA 01845 PR 97848B-6335 FAX 978M8 -)O= Other Allowances Page 3 of 5 Suspended ceilings will be. provided in new basement area and laundry.Ceiling file to be selected by owner. Plan to install 2'x2' revealed edge ceiling lite. An allowance of $400 has-been included bathroom vanity and countertop. Stair treads from basement up to living area can be upgraded for an additional cost of $1350. Waste Removal All construction related debris will be disposed of by contractor. Items Not Included No allowance has been made for any painting or radiant heating. : . IMevfbm WmMR V 9MUd1ng c 6Rov 169 Bound SUeet Norlh Andower, nM 01645 Pit, 97685 FAX 976588.)000( Section IV - Price Schedule Total Page 4 of 5 We hereby propose to furnish material and labor — complete in Accordance with above specifications for the sum of ..................................... $ 46j000 Payment to be made as follows: Percentage/ltem Description Amount 1 Permit obtained $3000 2 Framing complete $12,000 3 Rough plumbing / electric complete $10,000 4 Plastering complete $9000 5 Interior trim / doors installed $7000 6 Job 100% complete $5000 6 $46,000.00 -'I�oe: NO +-tome �zO,rar�rim�a��,�v+h stag r a do�x,, tadva� d�dj of more �at«,�N�d of the tom mrd�a� price of the rotal �r�o�rrt aF atl depot or Wflwft**:pare=*sirOWrrwfae.era*2MW«duwWwot� ohianderwyofspeaaiordermefaridlsarid eq*wrQMvfthw"isweater Contractor: Kevin Murphy 169 Boxford Street No. Andover, MA 01845 Registration No: 101874 Section V — AecePtance Acceptance of Proposal — I have read this document and accept the prices, specifications, and conditions stated. I 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 Date