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HomeMy WebLinkAboutBuilding Permit #Exception - 85 CARLTON LANE 5/1/2018 ` OE tkORTN q �t� 4,4 -� BUILDING PERMIT 't"10 i, �o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * z~ a Received ��4�� P` y Permit No#: Dat ATH Date Issued:4,� l IM ORTANT:Applicant must complete all items on this page �,L04C,4TION' Pnnt rPF"bP"ERTYxOWNER� JPnnt f 100+Year Structure ayes ,x j MAP r a fJ PARCEL ZONING'DISTRICT ` �` HistonDstricfii yes` d? . _ ,,:� . . Macli[ne;Shop,Vlllage. yes, � TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family D Industrial n No. of units: ❑ Commercial -61Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ 'Q %od'lal � 610 C41 Wat rsiietlk�stt4 _ _�n ❑ pti p"�IVe } p o DESCRIPTION OF WORK TO BE PERFORMED: _( eDc.�r' �d-{S'���•.e oly�ck- No �vL�Pr .�+� c1�a c,P Identification- Please Type or Print Clearly OWNER: Name: 1 Phone: bV3- 14'1't -L695 Address F�;- Cs-r k+v�• t,,� .,,y am.ri.• 1�..- Contractor.Name k<* Phone a.%_ to. ,Address� `TM �� es �. yt, ,L Ex Date�l.�•'1,1z S� �� Supervisors ConstructioniLicerise t�S� �R fa p T -► ``"'° _ 2" R`r '' y ExpY"DatA��:$. IHomelmprovemeit License` ��� ARCHITECT/ENGINEER 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: $ °N 1z0D FEE: $ �VZ t,, Check No.: �Wq Receipt No.: b` 6 NOTE: Persons contracting with unre istered contractors do not have access to the ivaranty f 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 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 Workers Comp Affidavit 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) 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) • 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 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 Plans Submitted.❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑ 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH, Reviewed on_ Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decisionlreceiptsubmitted yes Planning Board Decision: Comments Conservation Decision: Comments C Water& Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPNN'RTMENT .Ternp Dwrnpster on sife yes - s no '° Loeatetl at 1 air S reet He Department sign ture/date v 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Location No. / Date 1 r . - TOWN OF NORTH ANDOVER , • , , „ri Certificate of Occupancy $ t Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check ire Building Inspector IAORTH BUILDING PERMIT oF�tteo 'bq�o TOWN OF NORTH ANDOVER ° . APPLICATION FOR PLAN EXAMINATION * ,� H Co[ [K .cw V1` Permit No#: �"� Date Received �'�s „T90�Q . gACHUsfc Date Issued: WI/ ky IMPORTANT:Applicant must complete all items on this page LOCATION - P Print PROPERTY OWNER` .• rte'' � ,��,.�, :`. u ,: }.r.. .: 100YeaR's tructure yes PARCEL ZONING, DfSTRICT Historic District yes'` d3e Machine:Shop:Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building g One family ❑Addition ❑Two or more family ❑ Industrial n No. of units: ❑ Commercial %Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: i rr Phone: by-3- ` "1 7-6$5 Address: tr in a.,•.•. MQ Contractor Name: t4u�� (�,.,< � Phone: Email' r AddressFv r c r pity e_,A. uCicese xp DateS ' o 'Lpervisors= onstructiE Hom,e.lmprovement License: `6� n Exp Date :.'�.�tz :��.Y._; ARCHITECT/ENGINEER ti,,,P'_9, 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: $ q�U,a FEE: $ ��2_ Check No.: "1 Receipt No.: 6�� NOTE: Persons contracting with unre istered contractors do not have access to the uaranty f x.1-: E ; : i •-:<,:r !,' ;p s•=�f ,, r� •'p€. r -I NORTIy 490, . 1c . - ve. . O ` No. "h , ver, Mass, 4�6� OrA COCNIC tWICK\y1• �.95 4^Te0 nPP��y U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ..............\..e �.•r.G� ++'� BUILDING INSPECTOR �( Foundation has permission to erect .......................... buildings on ... 4ss ....................... % • Rough Am * ...dqll:!k g to be occupied as .....� . . �...�j�i�. ................... Chimney provided that the person actin this ermit shall i eve respect conform to the terms of the application P p p g p �every p pp 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TIO Rough Service .. ..... .. ..... .N..... S ... ....... ' Fina BUILDTO 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 North Andover,MA 01845 • PH:97"88.5335 Building Contractor FAX:978.688-7207 Proposal To: Jerry Lemmon 85 Carleton Lane All Home improvement Contractors arra subcontractors engaged in home Improvement contractng,unless North Andover, Ma. 01845 specifically exempt from registration by Provisions of Chapter 142A of thageneral 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)-7278598 CC: Date: 5/30/2016 Job: =rearRot on front porch Date of plans: None Architect None Location: Same Section I-Work Schedule 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 6/15116. Barring belay caused by circumstances beyond Contactors control,the work will be completed by 7/30116.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 II-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 ilk Kevin Murphy Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01 845 PH:9788885335 FAX 97888&7207 General Proposal is to repair existing rear deck, and repair/replace rot on roof/ceiling of front porch. Permit will be obtained by contractor. Building Decking will be removed, and re-installed as required on rear deck. Damaged framing members will be replaced with pressure treated 2x8s to match exisitng. New post caps will be supplied / installed to match existing. Azek trim boards will be supplied/installed around nm of deck, and kick boards on stairs. Damaged piece of window trim will be replaced with Azek. Damaged ceiling on front porch, flashing, and trim around opening will be removed and replaced. Exterior grade plywood (to match existing )will be installed on ceiling. Azek trim/new flashing/ice and water sheild will be supplied and installed at opening in roof. If this portion of the job is deleted, a credit of$1800 will be given. Painting No allowance has been made for any painting. Waste Removal All construction debris will be disposed of by contractor. Revimm WWRPliby Page 4 of 4 Buuding Contractor 98 Forest Street Nash Andover,MA 01845 PH:9786885335 FAX:97868&7207 Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of.....................................$ 9300 Payment to be made as follows: Percentage/item Description Amount 1 Permit obtained /deposit $1800 2 Deck repair complete $5000 3 Job 100% complete $2500 Total 3 11$9,300.00 —Notices No agreement For Home improvement mntradrig work shall require a dwm payment(advance deposit)of more that onettfud of the total mrrlrad price of total amount of all deposits or payments which the contractor must make,in advance,to order anchr otherwise obtain delivery cf special oder materials and equipment,whichever is greater �Ss G rdZh�i. Contractor: Kevin Murphy s��y,a k ilio-11 ret- 98 Forest Street No.Andover,MA 01845 Registration No: 101874 9 $p U 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 S"/1 1140 Signature Date IF I Tf it -4-L The Commonwealth of Massachusetts Department oflndustrialAccidents t I Congress Stree4 Suite 100 Boston,MA 02114-2017 www massgov/dia XWorkers'Compensation Insurance Affidavit:Bugders/ContractorsXlectricians/Plumbers. TO BE FILED WITH THE PERMITTING AITPHORTTy. Applicant Information Please Print Legibly Narne(Business/Organization/Individual): v - - Address: t-IeACity/State/Zip: Nv ,, �,�pvt,.< Ma,, 012�t� Phone k It-IS- Are re you an employer!Check the appropriate box: Type of project(required): I.�1 Rma rmployer with `` employers(full and/or part-time)• T 201 am a sole proprietor orpartnership and have to employees working for me in 7. ❑New construction 8. U Remodeling any capacity_fNo workers comp.insurance required.) meownoa 9- ❑Demolition301 m a hoer diall work mYIL(Nowoders'pomp.insurance 4.[:]]am a homeowner and will be hiringcontractors to conduct all work on 10 Q Building addition my property. I will ensure that all contractors either have workers'compensation insurance or are sok I I-[:]Electrical repairs or additions Proprietors with no employees. 12.a Plumbing repairs or additions S Q I am a general contractor and I have hired the sub-contractors listed on the attached shoe- These subcontractors have employees and have workers'comp.inarrance,t 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c 14.❑Other 151§1(41 and we have no employers.[No workers'comp-insurance required.] •Any applicant that checks box n must also fill out the section below showing their workers'compensation policy iaformation- t Homeowners who submit this affidavit indicating they are doing all work and then hive outside cotrtractors must submit a new affidavit indicating such. [Contractors that check this box must attached an additional sheet showing the name of the sub-contractorsand state whether or not those entities have employers. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an eneployer that iss providing workers'compensadon insurance for my employees Below is the policy and job site information. Insurance Company Name: GI.A,1-1, Lo Policy#or Self-ins.Lic.#- t%W C. -1 Expiration Date: -L l t—I Job Site Address: reT- `.a..ie City/statelZip: t.Jr. A�uV,^ 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 age the violator.A copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. I do hereby,cert if 1( the pains and penalties of perjury that the information provided above is true and correct Si attire: �--� Date: Phone#: 5'� V t. >i 'S3 Official use only. Do not write in this area,to be completed by city or town ofuial 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(MMiODNYYY) CERTIFICATE OF LIABILITY INSURANCE 7/11/2016 THIS CERTIFICATEIS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER.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 REPRESENTATNEOR PRODUCER,AND THE CERTIFTCATEHOLDER. IMPORTANT:N the cerfificateholder is an ADDITIONAUNSURED,the policy(im)must have ADDITIONALINSURED provisionsor be endorsed. If SUBROGATIONS WAIVED,subject to the termsand eonditionsof the policy,certain policiesmayrequlrean endorsement A statementon this cef ilicatedoesnot corder rights to the certHlcateholder in haunt such endorsement(s). PRODUCER CDNF"`T Sandi Munroe NAME M P ROBERTS INS AGCY INC PHONE FA% A o;N,,EM: (978)683-8073 „�,,�, (978)683-3147 1060 Osgood Street A11. sandi@mprobertsinsurance.com North Andover, MA 01845 INSURER(S)AFFORDING COVERAGE NAICa INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING REMODELING INSURERS: GUARD INSURANCE 98 FOREST STREET INSURERC: NORTH ANDOVER, MA 01845 INSURERD: INSURER E NSURERF: :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 TEE 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 NY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSANDCONDTRONS OF SUCHPOLICIES.LIMITS SHOWNMAY HAVEBEEN REDUCED BYPAID CAMS. POUCY EFF POLICY EXP TYPEOFINSURANCE POLICY NUMBER M UNITS X COMMERCIALGENERAL DA UTY EAC I OCCURRENCE $ 1 000000 CLA.—E �OCCUR PREMISES Ea a¢__ $ 500,000 MEDEXP(Anyonep—) $ 15,000 BOPI068945 1/22/15 11/22/16 A PERSONALdADV INJURY $ INCLUDED .ENL AGGREGATE LIMN APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY [3 JJEC LOC PRODUCTS-COMPA)PAGG $ 2 000,000 OTHER: $ AUTOMOBILE LABILITY CAMBNED SINGLE LIMIT $ 1000,000 Ea acGdenl I ANYAUTO BODILYINJURY(Perpewn) $ OWNED SCHEDULED MCA7013608 1/23/16 1/23/17 BODILY INJURY(Paaccident) $ A AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Px atcideni $ 8 R EACH OCCURRENCE $ 1,000,000 A JERETENTION CWMS1rA0E AGGREGATE $ 1,000,000 HS 10 000 CUP9145304 1/22/15 1/22/16 $ WORKERS COMPENSATIONX PER 0711 D EMPLOYERVLIABIUTY S YIN TATUTE ER B —='— NIA rxc tcwerxwouan D NIA EL EACH ACCIDENT S 500,000 (NaMatoryn NH)ra KEWC726509 7/01/16 7/01/17 E.L.DISEASE-EA EMPLOYEE S 500,000 N Tec,desaiba under 500,000 DESCRIPTION OFOPERATIONS bd— E.L DISEASE-POUCY UNIT $ DESCRIPTION OFOPERATIONS I LOCATIONS/VEHICLES(ACORD 701,Addit.,W R—d.Schedde,aey tre atlad,,d V—spa-R required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER 1600 OSGOOD STREET SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE]I BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD25(2016/03) The ACORD name and logo are registered marks of ACORD �.e Vaant�acaaz,taeu��,�z o��a�oac�uiJeL(. f.. Office of Consumer Affairs&Business Regulation (�-Vjw5 HOME IMPROVEMENT CONTRACTOR ype. Registration `2101874 Expiration 6191201.8 Individual KEVIN MURPHY Kevin Murphy , 4' 98 FOREST ST. N.ANDOVER,MA 01845 Undersecretary Massachusetts Department of Public Safety Board of Building Regulations and Standards I License: CS-053099 Construction Supervisor i KEVIN W MURPHY 98 FOREST ST —ry z ` NORTH ANDOVER M0184 Y, t .11'111\A _/1►"'� Expiration: Commissioner 06/29/2017