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Home My WebLink AboutBuilding Permit #689 - 84 PEMBROOK ROAD 6/11/2009BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: H Date Received Date Issued: LO- I I - TYPE OF IMPROVEMENT PROPOSED USE — �'1 74 ResidentiaL_ Non- Residential New Building One faMdp ,,CONTRACTQR Name: Addition Two or more family Industrial <Tjteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other tri:,. #�.. Se Weil =e, Fio6dpidin ',Wetlands� Vateithbd District - a !tb!,3S ne 7, DESCRIPTION OF WORK TO BE PREFORMED: 14Y\A-A Identification OWNER: Name: Ck Address: Please Type or Print Clearly) _f C_ NW 0 Phone:0,-vc) 61�1 — �'1 74 ,,CONTRACTQR Name: -.,Phone- k M1 ,Adldt-e ss. . .�.. "r,v tri:,. #�.. ... o ,q„i-` 'Supervisor's �.Cojnstrqqtion lLicense: 1571 0. Exb. Date A I A" Horne Improvement I-tice,n-, se- ae- . 6 k ARCHITECT/ENGINEER taw 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: $ 2"-k �S-n FEE: $ z1q__i �zb 2 10 Check No.: ' Receipt No.: o) of I 0� NOTE: Persons contra`ctihglwith unregistered contractors do not have access to the guaranty fund C 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 COMMENTS HEALTH COMMENTS Reviewed on Signature Reviewed on Signature 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: Dimension,�..s Number of Stories: Total square feet of floor area, based on Exterior dimensions. 'Z 7-" Total land area, sq. ft.: L( -Z Ae_r.� 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 s ❑ Notified for pickup - Date Doe.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 r ❑ Photo "'OPy"a '' KC And .L. Licensi� t�, `Ni � # ❑ Copy Of Contact ❑ 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 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 DEPARTMENT:BPFORM07 Revised 2.2008 Location �-°-- �4 No. r Date b O NORTH TOWN OF NORTH ANDOVER O� .ao .1 TOWN 9 � Certificate of Occupancy $ Building/Frame Permit Fee $-�' �cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL11� $ Check # 411 1 I 22" Building Inspector • w M W J�' •_ o ca u oaai w cu T� cn O v z "a r .s cbo p w bp O cx .0 U G x 0 w p co GG � w a w p u y C GG o p C z � w w cn v O V) O z O Y � QV W C N ra lu o:.a c O v CD •R O.� C O O z E d LID s N N C 0 CC cm m C: C! C CC it cm c �C N m t r O Z O cm z O U Cn CD rm I 0 C LA O C �E m m 0 CD CL ~ O O � i MO d CA. rma CO2 C +�+ C O O Li JCL o CD� .co C Z ts CD CD CL V V! O C C C 0 CO3 LLI 0 Y+ LLI Y/ W W ce W ca O :•m C O ` C N o:.a c O v CD •R O.� C O Cc • o m CD O _ yr N E d LID s N N C 0 CC cm m C: C! C CC it cm c �C N m t r O Z O cm z O U Cn CD rm I 0 C LA O C �E m m 0 CD CL ~ O O � i MO d CA. rma CO2 C +�+ C O O Li JCL o CD� .co C Z ts CD CD CL V V! O C C C 0 CO3 LLI 0 Y+ LLI Y/ W W ce W ca 07/09/2008 10:02 RAX 19788833147 M-P.ROBERTS INSMUNCE la001 Wow-CERTIFICATE OF LIABILITY INEURANrCE °"'E"'"°°"'"710120QS' TM COMMATE 18 Nmulm A8 A MAT MI OF WMRMATTON M- P- R08MS US AGCY im ONLY AND COMM No RiCiNTs UP" THE CERTIF"T6 "OLDER. TM 1060 MCAFF DOER NGfT Osgo*d 8ta vet TER THE COWMA= AMNO, OR MWft Xmtb Audovor, MA 01.848 � IM Poucms Me ow. 0 COVERAGE mmim Imm rEst 8�73IA s , k Cg MuA wlUMA Mutt ISO STRSB? G; NCM AIID�t, MR 01848 r a. E THE POUCUOF NlHUMXM UWW MLOW HAVE 3MM 68M) TO THE wSUM NAMW ABME FOR YM POIJCY PBWO Wp1 AM. NOZWfTHSTANDiw ANY fW0J RMEN% iE7iIM OR CQNQMON 9W ANY CONflRVr OA OTMM Df1C111m WM REM3WT TO V*WM 'iH MAY PCE3i7T�'ATE MAY 8E CR BY TD 8�R1'AIMf HE MMURANCB AMPOROED T F1E PQIICEM EECR j HEM6k 18 SIP ECT TO AU THE YM M, p DW AND COWnM OF SUCH POUCMAQR@QATIELMt8MOft MAY MWE9EEM1Ii MWiYHASCLAW, 061M�'OLUCY11NNDs Id. uNnm LdEiB �Al MAMMM OL�MJ�fROCU � � ;-� if�`I a PFOO60860 11/22/07 111/22/09 MEDEfIP ar i LlAOVMiJIgtY � a 2 asin MXY Roc P�OUC18.:i0w',nPAA� 000 �tu►oMne�aeuw�,mr �Nv,�utio �� 'PMELUT + 500,000 ALLOVAMAW04 �. sa+��uR�namos � Y" +' H wMmmx 7'AM277013609 1/29/08 1/23/08 NMC4* BpAUTC9 Y DAMM d QARAOP. LuYY1fY AWMM AIITCCNLY.��Y $ OTHER THAN BAAP,C 6 _ __ 09*MMWDVuA UNUM OCbUR Q EACH OOdPNi ! to-- gMMpg ADS i CEDUCT49L8 4 s io011 e"ATKWAW �Rorea�r L�Allllfh D a ' MWC013513 T7/1/09 7/1/06 r ! 0 r-LONK 61fi-FAamo ■ GAA Ann Tmq cF ANDOVM, Nk 36 ]ARTIAT STRUT Amoovs t, MR 01810 IHMV AW OP rAX A*oVC DeW' W PCLfM ae CM OELM 8ORR TM 0~10N OAT' TW"OF, THE I $WK pl6t W WfU. GNMVCR YO KVL IO OAYB WWrrft NOM YO"CEUMWE HOWM NAMEp TO TM: L&T Wr FA! tlRE TC oO SO OWL •Pose Nb OKMVCW Oft URMUry (W AW 00 UPCW IM we1AFWt M AWJM OR MO. ,The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AM 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print -Legibly Name (Bushms/orgu izatioMndividuai): Address: U C�- -31 S3� City/State/Zip:l-.e, Phone #: .5-35' Are you an employer? Check the, appropriate box- I.t I am a employerwide_ 4. ❑ I am a general contractor and 1 employees (fall and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required -1 officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' coin. c. 152, § 1(4), and we have no insurance required.] t amp loyces. [No workers' comp. insurance required.] Type of project (required): 6. [❑ New construction 7. Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I LCI Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other Any applicant that checks box #1 nW9 also 511 out the section below showing their workers' compensation policy inion mow Homeowners who subnat this afrW&vK indicating they are doing all work and then hire outside contraetors must snbnut a new aftkvit indicating such Contractors that cheek this box must ettsched en additional sheet showing the ammo of the sub -contractors and their workers' comp. policy information. ane an employer that is providing workers' compensation. insurance for my employees. Below is thepolky and job site nsumuce Company Name: �,.,� �.._�l IT ., . 'olicy # or Self -ins. Lic. #: y— 5�,, ti :2 �Expiration Date: ob Site Address: �r •�-� �d-- City/Statdzip: L wi4 3 - Mach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). 'a1ilm to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of critninal penalties of a ine 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 five 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 nvestigations of the DIA for insurance coverage verification. do hereby certify ander Me pains and penalties of Bs#uprinformation provided above is tree and correct Ojrwial use only. Do not write in this area, to be completed by city or town official. City or Town: PermitlUceuse # 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 #• Building Contractor Proposal To: David & Christa Palmisano 84 Pembrook Road North Andover, Ma. 01845 From: Kevin Murphy CC: Date: 5/24/2009 .lob: Finish existing basement area. Date of plans: None to date Architect: None Location: Same Section 1- Work Schedule • 169 Boxford Street • North Andover, MA 01845 • PH: 978-688-6335 • FAX: 978-688-7207 All Home improvement Contractors and Subcontractors engaged in home improvement contracting, unless spealic ally 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, Room 1301, Boston, MA 02108. (617)-727 8598 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 6/15/09. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 8/30/09. 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 111- Scope of Work Nevin Mnnvphy Building Contractor 169 so)dord street North Andover, MA 01845 PH: 978-688-5335 FAX 978-1000( General Page 2 of 4 Proposal is to finish existing basement area. Main section (approximately 20'x26') and office section (approximately 13'x16' ) will be finished. Remaining front comer, will remain unfinished storage. Building permit will be provided by contractor. Building Materials required to frame all exterior and petition walls will be provided. Walls will be 2x4 with a pressure treated plate at floor. Door openings will be framed to provide access to electrical service, furnace etc. Any duct work at ceiling will be framed in. Electrical Electrical work required to wire basement area to meet code will be provided. Twelve recessed lights have been included. Additional lights can be added at a cost of $75 per light Electric baseboard heat will be provided in playroom and office area. Phone, cable, and computer lines will be roughed in by electrician, to be connected by their service provider at owner's expense. Any surface mounted fixtures to be provided by owner ( walls sconces etc. ) . Plumbing No allowance has been made for any plumbing work. Insulation All exterior walls will be insulated to meet code ( R-13) . Plaster All walls will be blueboarded and skimcoat plastered. Walls will be smooth, any closets will be textured. Suspended ceilings will be supplied and installed in finished areas. Ceiling will have a 2'x2' revealed edge tile with white grid ( sample will be provided prior to any installation) . Interior Trim/Doom Pre -primed interior trim and doors will be supplied and installed to match existing. Doors will be six panel, solid core units. Double french door unit will be installed at entrance to office area. Existing lally columns in middle of playroom, will be covered with decorative round columns. Painting All interior painting will be provided. One coat of primer and two coats of finish will be applied to all walls, trim, and doors. Flooring An allowance of $30 per square yard, has been included to supply and install carpets in all finished areas, and on stairway. RevilMMIMVPhy BuUdLing Contractor 169 Boxford street North Andover, MA 01845 PH: 978Z 5335 FAX 978588-)000( Waste Removal All construction related debris will be disposed of by contractor. Page 3 of 4 SuUdL img Contractor 169 Boxford Sheet North Andover, MA 01845 PH:978-6BB-5335 FAX 978-688-)O= Section IV - Price Schedule Total Page 4 of 4 We hereby propose to furnish material and labor — complete in Accordance with above specifications for the sum of ...................................... $24,800 Payment to be made as follows: Percenta alitem Description Amount 1 Permit obtained $2000 2 Walls / petitions framed $8000 3 Plastering complete $6000 4 Trim / ceilings complete $4000 5 Job 100% complete $4800 5 $24, 800.00 "Notice: No agreement for Home mprovernent oaitracting work shall regL- a down payment (advance deposit) of more that orae -third of the total contract price of the total amount of all deposits or payments which the cm*actor must make. in advance, to order and/or otherwise obtain delivery of special order materials and equipment, whichever is greater Contractor: Kevin Murphy 169 Boxford 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. 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 Signature r-'Up"WCLIVIO Date S�3o1 O� Signature ` Date_ S