HomeMy WebLinkAboutBuilding Permit #604-2017 - 88 DUNCAN DRIVE 12/6/2016BUILDING PERMIT
AAW 4 Ur TOWN OF NORTH ANDOVER
APPLICATION FOR. LAN EXAMINATION
Permit No#: (06 q ao J/ Date Received
Date Issued: I All V I ly
' LWORTANT: Applicant must complete all items on this page
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PROPERTY -- ��'G�-- _ .--
OWNER,__ "�_,4NLA_A)
16 q` fit -1-00W6 a--r"8-tFLfdtU' Pe_ Y_e* S ^ 0
PARCEL: n Ee)
MA K§tbrib-Distriet y�es
0
Machihe- Shop Villa - -- - n
no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
0 New Building
0 One family
El Addition
0 Two or more family
El Industrial
El Alteration
No. of units:
[I Commercial
,< Repair, replacement
D Assessory Bldg
El Others:
0 Demolition
El Other
El Se'ptie "Q1 Weii
0 Flb6dp!aini D Wetlah- 8
Wafers) District -
Water/Sewer
DESRIPTIRN OF WO
�r4-
BE PERFORMED:
- Please Type or Print Clearly"
OWNER: Nam
Pho
Address: 0 (f)
Contreibtbr Naffie: Rhone-__
A . ddress: yEll
V
rvisor's Construction License.
E-jd bate: b-0
,Supe ps
Home Improvement -License- 17. Exp
o
ARCHITECTIEN G I NEER 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: $ 00, FEE: $
Check No.: A rDZ� Receipt No.AZO
-
NOTE: Persons contracting witIz unregistered contractors do not have: access tt the guaranty fund
e idnaturq*f contractor''
6
- — T. IV LWA 44_.,,Y_'S . . I.... .. .. ....
f '% - -,I,o I -)! "
Location F, 2� -, - IV ,
No. t L ( 1 1) G f
Check #
- , . j
Date I ') - � - (-� / �--
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
Building Inspector
Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑
•TypF bF SEWERAGE DISPOSAL
Public Sewer ElTanning/Massage/Body
Art ❑
Swnirming pools El
well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc.
permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF e U FORM
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
NSERVATION Reviewed on
COMMENTS
HEALTH
COMMENTS
Reviewed on '
_ n
, ll k
Signature
nature
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:
Locatea M4 usgooa Street
FIRE DEPARTMENT = Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signatureldate
COMMENTS
limension
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 lies No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
Doe.Building Permit Revised 2014
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
❑ 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
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
40TE: 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
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CONSERVATION DEPARTMENT
Community Development Division
December 6, 2016 j 0 L( -7 7
Mr. & Mrs. Weimann
88 Duncan Drive
North Andover, MA 01845
88 Duncan Drive, North Andover
Stairs and Walkway
Conservation Conditions of Approval, NACC #180
Pursuant to section 4.4.2 (L) of the North Andover Wetlands Protection Regulations, applicants
Gary & Sue Weimann, filed for a small project for work proposed at 88 Duncan Drive, North
Andover. The proposed work includes the replacement of existing stairs and walkway within the
same footprint. All work is outside of the 50' No -Build Zone and 25' No -Disturb Zone.
During the November 30, 2016 public meeting, the NACC voted unanimously to approve this
project. All work shall conform to the following:
RECORD DOCUMENTS: Small Project Filing Including:
Application Checklist, Trepanier Remodeling LLC proposal,
Graphic of stairs and walkway, Existing Conditions As -Built
Plan to Accompany Certificate of Compliance dated March 25,
2016
Filing received: November 23, 2016.
The following conditions are hereby mandated:
CONDITIONS:
1. Prior to the start of construction the applicant shall ensure that the site contractor has reviewed
the small project permit and is aware of the wetland resource area and the limits of the proposed
work.
2. Excess construction material shall be properly disposed of offsite and accepted engineering and
construction standards and procedures shall be followed in the completion of the project. There
shall be no stockpiling of material within 100' of wetland resource areas.
3. Upon completion of the approved project and site stabilization, please contact the Conservation
Department for a final inspection.
4. This permit shall expire six months from the date of issuance.
1600 Osgood Street, Building 20, Suite 2-36, North Andover, Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542 Web xvww. http://xvww.toxvnofnorthandover.com/conservel.htrn
Should you have any question or comments regarding the contents of this letter, please do not
hesitate to contact the undersigned at 978.688.9530 at your earliest convenience. Thanking you in
advance for your anticipated cooperation with this matter.
Respectfully,
ORTH ANDD ER CONS RVATION DEPARTMENT
J rifer Hughes
onservation Administrator
1600 Osgood Street, Building 20, Suite 2-36, North Andover, Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542 Web www. http://www.townofnorthandover.com/conservel.htm
$i'�Yk� " 1,
Trepanier Remodeling LLC
14 East Capitol Street
Methuen, MA 01844
Bill To
Gary/Sue Weimann
88 Duncan Dr
No. Andover, Ma
CS# 069815 HIC#122347
Item Description
Front walkway and stairs:
Materials/Labor Remove existing retaining wall and replace with new Cambridge wall: 160s/f
Materials/Labor -Remove concrete steps and replace with granite steps T' rise T wide: 6 steps
-Remove uneven brick walkway and replace with Cambridge ledgestone: 260s/f
02.10 Demo Removal of all debris off property:
Payment schedule:
Down payment: 10,996.50
Balance on completion: 10,996.50
We look forward to working with you!
Date
Invoice #
11/23/2016
61
Terms I Project
Rate I Qua... I Amount
7,340.00
14,153.00
500.00
7,340.00
14,153.00
500.00
Total $21,993.00
Payments/Credits $0.00
Balance Due $21,993.00
The Commonwealth of Massachusetts
Department of XndushialAceldents
1 Congress Street, Suite .700
Boston, MA 02114--2017
WWW mass govIdia
Compensationbsuraned Affidavit: Brdlders/Contractors/Electricians]Plumbers.
TO BE FILED WITH THE PTRMIT ZING AUTgOItTTY.
777.... r.n'Prinf
Name(Businessi(5rgai&ationftdividual):
;,\
Address:
..� mss^
City/State/Zip: Phone #:.
Axe You m employer? Check the appropriate box:
1. ❑ I am a employer with employees (full and/or pari time).-
am a sole proprietor or partnership and have no employees Working forme in
any capacity. [No workers' comp. insurance required.]
3.E] I am a homeowner doing all work myself [No workers' comp. insurance required.] t
4.[]I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensurethat all contractots either have workers' compensation insurance or are sole
proprietors with no employees.
5!�]j I am a general contractor and I have hired the sub -contractors listed on the attached sheet
hese sub -contractors have employees and have workers' comp. insurance
❑ We are a corporation. and its, officershave exercised their right of'exemption per MGL c.
6.
152 i(4) and We have no employees. [No worker' comp. insurance required.]
Type of project Orequired);
7. ❑ N6Vd6nstraciion
8. [] Remodeling
9. F1 Demolition
10 ❑ Building addition
11.[] Electrical repairs or. additions
12_[f :Plumbing repairs or additions
13% 0 Roof repairs
14.er
applicant fibatchgclosbbX#lrriustals0filloutthesectionbelowshowingtheirworkers,compensationpoficyioformation:"
�Y
I Homeowners who submit thig affidavit indicating they are doing all work andthen hire outside contractor must submit a new affidavit indicating sue
*Contractors that checkthis box must attached an additional sheet showing the name of the sub -contractor and state whether or not (hose entities have
rffl�a„h-c ontractors have employees, they must provide their workers' comp. policy number.
X am an employer that is providing workers'
information.
Insurance Company
Policy ## or Self -ins. Lic. 9-;
compensation insurancefor my employees. 8elo7v is tliepolicy andirob site
ExpirationDate_
City/State/Zip:
Job Site Address:
Attach a copy of the workers' coanpeusationpolzcy declaration Page (shovviaagthe poiicynumtber and ex�piraizoaa. date)-
by a ffib up to
0.00
Failure to secure coverage as required under MGL
o.1in, §25A is
the form of criminal OP WORK ORDER and a fine o p to $200.00 a
and/or one-year imprisonment, as well as penalties
be forwarded to the Office of Invesiigaiions of the DIA for insurance
day against the violator. A copy of this statement may
coverage verification.
X do liereliy certify�tlae enalties ofperjury that the information provided a ove is ue ani correct
one #: i 1
official use only. Do not -Write in this area, to he completed by city or town offzciax
permit/License #
City or Toyvn-.
Issuing Authority (circle one): i
1. Board of Health ?,. Building Department 3. Citymown Clerk 4. Electrical inspector 5. Plumbing inspector
6. Other
Phone
Contact Person
ane n �
s_
The Commonwealth of Massachusetts
Department of XndushialAceldents
1 Congress Street, Suite .700
Boston, MA 02114--2017
WWW mass govIdia
Compensationbsuraned Affidavit: Brdlders/Contractors/Electricians]Plumbers.
TO BE FILED WITH THE PTRMIT ZING AUTgOItTTY.
777.... r.n'Prinf
Name(Businessi(5rgai&ationftdividual):
;,\
Address:
..� mss^
City/State/Zip: Phone #:.
Axe You m employer? Check the appropriate box:
1. ❑ I am a employer with employees (full and/or pari time).-
am a sole proprietor or partnership and have no employees Working forme in
any capacity. [No workers' comp. insurance required.]
3.E] I am a homeowner doing all work myself [No workers' comp. insurance required.] t
4.[]I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensurethat all contractots either have workers' compensation insurance or are sole
proprietors with no employees.
5!�]j I am a general contractor and I have hired the sub -contractors listed on the attached sheet
hese sub -contractors have employees and have workers' comp. insurance
❑ We are a corporation. and its, officershave exercised their right of'exemption per MGL c.
6.
152 i(4) and We have no employees. [No worker' comp. insurance required.]
Type of project Orequired);
7. ❑ N6Vd6nstraciion
8. [] Remodeling
9. F1 Demolition
10 ❑ Building addition
11.[] Electrical repairs or. additions
12_[f :Plumbing repairs or additions
13% 0 Roof repairs
14.er
applicant fibatchgclosbbX#lrriustals0filloutthesectionbelowshowingtheirworkers,compensationpoficyioformation:"
�Y
I Homeowners who submit thig affidavit indicating they are doing all work andthen hire outside contractor must submit a new affidavit indicating sue
*Contractors that checkthis box must attached an additional sheet showing the name of the sub -contractor and state whether or not (hose entities have
rffl�a„h-c ontractors have employees, they must provide their workers' comp. policy number.
X am an employer that is providing workers'
information.
Insurance Company
Policy ## or Self -ins. Lic. 9-;
compensation insurancefor my employees. 8elo7v is tliepolicy andirob site
ExpirationDate_
City/State/Zip:
Job Site Address:
Attach a copy of the workers' coanpeusationpolzcy declaration Page (shovviaagthe poiicynumtber and ex�piraizoaa. date)-
by a ffib up to
0.00
Failure to secure coverage as required under MGL
o.1in, §25A is
the form of criminal OP WORK ORDER and a fine o p to $200.00 a
and/or one-year imprisonment, as well as penalties
be forwarded to the Office of Invesiigaiions of the DIA for insurance
day against the violator. A copy of this statement may
coverage verification.
X do liereliy certify�tlae enalties ofperjury that the information provided a ove is ue ani correct
one #: i 1
official use only. Do not -Write in this area, to he completed by city or town offzciax
permit/License #
City or Toyvn-.
Issuing Authority (circle one): i
1. Board of Health ?,. Building Department 3. Citymown Clerk 4. Electrical inspector 5. Plumbing inspector
6. Other
Phone
Contact Person
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is' d'ef`ined as "an individual; partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enferpri'se, and including the legal representatives of a deceased employer, or the
receivbt'or trustee ofan individual, partnership, association or other legal entity, employing employees. , However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicaztt whd has not produced -acceptable evidence of compliance with the insurance coverage xequited."
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill. out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub=contractors) name(s), address(es) and phone number(s) along with their certificates) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or Partners, are not required to carry workers' compensation insurance. If an LLC or LLP docs have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
IndustrialAccidents. Should you have any questions regarding the law or if you are required to obtain a w' orkers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate ling.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
thai must submit multiple pennit/license applications in any given year, need only submit one affidavit indicating current
policy information (ifnecessary) and under "Job Site Address" the applicant should write •"all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for fixture permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i. e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of IndustrialAccidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax # 617•-727•-7749
Revised 02-23-15 www.mass.gov/dia