Loading...
HomeMy WebLinkAboutBuilding Permit #422-13 - 889 JOHNSON STREET 11/27/2012 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received I 1) 1 Date Issued1 IMPORTANT: Applicant must complete all items on this page PROPERThY OWNER _ �;o Y. _ Pri 100,Year,0ld,Structure Lyes .: MAP}NO =PARCEL 1 ZONINGgQIS+TiRICT HistoricfDistri;ct yes` J CL . y fio V e achine S p 4_illag r yeses_ , TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other . r- _ _ t ;S tic: ❑Well ❑�Floodplaih' Wetland's;. 0 }V1/atershed�Drstrict . UV61, r/Sewer _ -1- " DESCRIPTION OF WORK TO BE PERFORADI- 00 '.1 Identification Please Type or Print Clearly) OWNER: Name: J,o c,,._ Phone: ( fi �b� Address: k CONTRACTOR ,Name C,e ,.�� �" " JPhone 3 Supervis'or's�Constriaction. 'Home,Flmprovement�License ARCHITECT/ENGINEER No Phone: r Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �Lt71 2 uU FEE: $ Check No.: ( ��?i Receipt No.: 2— NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature ofAgent/Owne�� v _ Signature;of�confractow Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped ns ❑ Plans Submitted ❑ Plans Wa4�7 Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL l�// 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 w CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS I Zoning Board of Appeals: Variance, Petition.No: Zoning Decision/receipt submitted yes 'y Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Tow Engineer: Signature: Located 384 Os o d Street FIRE Located - Temp Dumpster on site yes no at 124 Main Street: Fire Departmentsignature/elate -a COMMENTS Dimension �I 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 I DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use I i ® Notified for pickup - Date ill Doc.Building Permit Revised 2010 Building Department The fohowing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o 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/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: Doc.Building Permit Revised 2012 Locatio eYO a� No. ate 1 • • TOWN OF NORTH ANDOVER Certificate of Occupancy $ °mow71,. Building/Frame Permit Fee y3 Foundation Permit Fee $ it e Other Permit Fee $ J` � '' ._•. TOTAL $ -;5 o Check jq� ` 25982 Building Inspector Y ORTy Town o Andover O to No. 4zz _ - h ver, Mass • o - > > COC NIC Nl WICK V OATIE S l! BOARD OF HEALTH Food/Kitchen . PERMIT T L D Septic System A. THIS CERTIFIES THAT • ,�,,,� BUILDING INSPECTOR ..................73�. ......... ...awi .................... .... Foundation has permission to erect .......................... buildings on .......... .... ............ .. . . •.. •• •••• Rough to be occupied a ... ...:...... � ....... . ........................:................ Chimney provided that the person accepting this permit shall in every espect 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 Rough VIOLATION of the Zoning Or Building Regulations Voids this Permit. Final ' PERMIT EXPIRES I MONTH ELECTRICAL INSPECTOR. • UNLESS CONSTR r N�STAK S Rough Service ........ ... ............ ..:................................... Final BUILDING INSPECTOR I GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Fina' No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner j Street No. { Smoke Det. SEE REVERSE SIDE {I I • 98 Forest Street e' '1 urr p-k-hyFv9i' North Andover,MA 01845 - ii • PH:978-688-5335 Building Contractor • FAX:978-688-7207 Proposal To: Jack and Nicki McNaught 889 Johnson Street All Home improvement Contractors and Subcontractors pe home contracting;unless North Andover, Ma 01845 spea�'tiglly exempt isa tion 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.(s1-1)rn 8598 CC: Date: 11/27/2012 Job: Replace Windows 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 9/15/12. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 10/30/12.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 Kevin Murphy Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:97868&,5335 FAX 9788&7207 General Proposal is to replace twenty five windows in existing house. Building permit will be obtained by contractor. Demolition All exisitng windows,trim,and frames will be completely removed and disposed of. Building Twenty one Harvey, all vinyl doublehung windows will be supplied and installed in first and second floor of existing house. Four harvey basement windows will be supplied and installed to replace exisitng units. All windows will have grilles between the glass,white vinyl interior and exterior,full screens, and a U-factor of 030. New exterior trim will be supplied/installed,and wrapped with aluminum to match existing trim detail. Interior Trim/Doors New pre-primed interior trim will be supplied and installed to match exisitng. Painting No allowance has been made for any interior or exterior painting. Waste Removal All demolition/construction debris will be disposed of by contractor. Kevin Murphy Pa e 4 of 4 Building contractor 9 98 Forest Street North Andover,MA 01845 PH:97848&5335 FAX:978688-7207 Section IV—Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ...... .................. .......$ 20,300 Payment to be made as follows: Percentagelitem Description Amount 1 Permit obtained $2300 2 Windows installed $13,000 3 Job 100% complete $5000 Total 3 $20,300.00 Notice:No agreemend for Horne improvement ombacting yuck shaft regime a down payment(advance deposit)of more VIM one-thud of the total oor tr price of tha total amoLr t of all deposits or payments which the contractor must make,in advarme,to order andfor otherwise obtain delivery of special order materials and equiprnerd,whictmver 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. 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 CCA Date Lel Z`� Z Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/Individual): Address: CU5 City/State/Zip: Qv, k d,J�.yew,. U(Y,4—Whone#: 'S 3 !r Are you an employer?Check the appropriate box: Type of project(required): 1.15 I am a employer with_ .J 4. ❑ I am a general contractor and I 6. (]New construction employees(full and/or part-time).` have hired the sub-contractors 7. JARemodeling 2.ElI am a sole proprietor or partner- listed on the attached sheet.t ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers' comp.insurance 5• ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.El am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 1211 Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box mustattached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ✓mak�.�l a�.t :.►.� ...�e:t- � ) t Policy#or Self-ins.Lic.# It q.&/C. 31'X Expiration Data: Job Site Address: I?)a Ck ,,���.cvi � �� City/State/Zip t&ZZ� 0 VP1 q Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). 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$250.00 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. t cio hereb certify under the pains and penalties o ' ry that the information provided above is trice and correct Si afore: Date: 'L �777- Phone#• Official use only. Do not write in this area,to be completed by city or town ofciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3'.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#' I DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 18/7/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: M P Roberts Insurance Agency Inc H N,Ext: 978-683-8073 (AC,,No): 78-683-3147 1060 Osgood Street ADDRESS: sandi@n►probertsinsurance.com North Andover Ma 01845 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: PROVIDENCE MUTUAL INSURED KEVIN MURPHY BUILDING & REMODELING INSURER B: MERCHANTS INSURANCE 169 BOXFORD STREET INSURER C: GUARD INSURANCE INSURER D: NORTH ANDOVER, MA 01845 INSURER E: INSURER F: COVERAGES 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILN R TYPE OF INSURANCE "NSR I) POLICY NUMBER (MMIDDlYYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,000 ICLAIMS-MADE OCCUR MED EXP(Anyoneperson) $ 5,000 A CPP0060868 1/22/11 1/22/12 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 21000,000 POLICY JE 6 LOC $ AUTOMOBILE LIABILITY Ea accident) $ 1,000,000 IANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED MCA7013608 01/23/12 01/23/13 B AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH AND EMPLOYERS'LIABILITY YIN X TORY LIMITS ER ANY PROPRIETORMARTNERIEXECUT1VE E.L.EACH ACCIDENT $ 500,000 C OFF IC atony in N EXCLUDED? ❑ NIA KEWC317 8 0 0 (Mandatory in NH) 7/01/12 7/01/13 E.LDISEASE-EAEMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) III CERTIFICATE HOLDER CANCELLATION TOWN OF ANDOVER BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ANDOVER MA 01810 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI E SENTATI ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD