HomeMy WebLinkAboutBuilding Permit #651-12 - 90 PUTNAM ROAD 3/13/2012TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: K(, 1e,7
Date Received
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no -
Machine Shop Village ye , no
100 year-old structure yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Resifibritial
Non- Residential
0 New Building
One family
❑ Addition
0 Two or more family
❑ Industrial
0 Alteration
No. of units:
0 Commercial
0 Repair, replacement
0 Assessory Bldg
0 Others:
❑ Demolition
❑ Other
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DESCRIPTION OF WORK TO BE PERFORMED:
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� � ntifi�tion P1(i �s� Type or
OWNER: Name:
Address: `1() W-�&
CONTRACTOR
Address: 7-J- 0,,n)sS J-6—
Supervisor's Construction License., T(DO F ( Exp.
Home Improvement License: / v ((1 Exp.
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Pao e:
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Date:
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Date: �I `1
ARCHITECT/ENGINEER Phone:
Address: Reg. No
FEE SCHEDULE: BULDING PERMIT. $12.00 PER $900000 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total Project Cost: $ / � FEE:
Check No.: Receipt No.: 3
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑Swimming
Tanning/MassageBody Art ❑
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
10sue &I TU 10
CONSERVATION
COMMENTS
HEALTH
,COMMENTS.
r
DATE REJECTED
DATE APPROVED
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Comments
Conservation Decision: Comm
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
_ • Located 384 Osgood Street
FIRE DEPARTMENT_ Temp Dempster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS r
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
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
Doc:.Building permit Revised 2011 June/mi
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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Comp! iance,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
o 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
MOTE: 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
rnust be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
Location �0 41w� I
No. Date6-12-)2,
Check # 10�e
25093
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $-
TOTAL $
Building Inspector
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Acro CERTIFICATE OF LIABILITY INSURANCE 1...3/7/20%Wmxwf12
THIS CERTIFICATE IS ISSUED AS A MATTER OF INPORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICl rE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTFR THE COVERAGE AFFORDED W THE POLICIES
BELOW. THIS CE"FICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE > S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER
IMPORTANT: If the iif-t uste holder is an ADDITIONAL INSURED. the pollcy(!eg) must be endorsed. R SUBROGATION IS WAIVED, subject bO
the bRrms and Imndltions of the pa1icy, certaln pollGies may mquira an endorsement. A statement on this certfl ete does nut -onfar rights to the
cartiflculo holder in lieu of such endomeme s
PRODUCER TACT colleen Matheove
To>ary Northwest insurance AgtanCy►1 Inc •
PH (781)1361-1$OD I?s�)elsa-7teo4
23$ Bedford Street E .Cmathewootonz-,mv.aam
MA 02420
INSURED
land Line, Inc.
73 C ros a Street
)I=Gtable Ma 01837 1 WSURERF:-- - I -
:OVERAGES CERTIFICATE NUMBER-ma21903821 REVISION NUMBER _
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR ME POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY RI=OUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT YUITH REST ECT TO WHICH THIS
CERTIFICATE MAY EE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIS D HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
-R YPR TE OF R�URANCE POLICY NUrr9ER P OI.IC Y QIP W OTS
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GENERAL UAGUM EACH OCCURRENCE $ 1,000,00
-DAMA13F TO RENTED
COMMERCIAL GENERAL LIABILITY ,C$EMISES IED 006dReKA) S 50100
rA CLAIMS -MADE 1z OCCUR 3D.T606 /s/2012 /5/207.3 MED EW ane2MLM S 1100
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DESCRIPTION or OPERATIONS I LouTtM I VEHICLES CAWwh ACORO 101. AddMorW Rm mAdt Seltedule. Ir mors apace 1%
Allyn Ratcliffe
90 Putnam Road
North Andover, MA
ACORD 25 (2010105)
INS025 (2womoi
S"OULO ANY OF THE ABOVE DESCRIBED POROM E '_ CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, MOTIM ML . BE OELIVERED IN
ACCORDANCE IMTH THE POLICY PROVISIONS.
AUTHORIZED REPT ESMtA?IWI£
@ 1988x2010 ACI
The ACORD name and logo are registered MWI(S of ACORD
All rlghts reserved.
PERSONAL A ADV INJURY $ x.1000 ,
GENERAL AGGREGATE $ 2,000,00
GEN'LAOOREGATELIMIT APPLIES MR;
PRODUCTS.COMF/OPAC 3 S 21000.00
E POLICY PRO- LOC
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$
BINED SINGLE OMIT
AUTOM WR UABILRY
BODILY INJURY (Per Petra) $ 100,00
$
ANY AUTO
SODILYINJURV(per aaad It) $ 300,0
ALL OO ED � SCHEDULED
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/1/2012
/1/2013
NON.OWNED
PROPERTY DAAAAt k S 100 Oa
HIRED AUTOS AUTOS
(Por MX*WM
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UMBROJ A LIAR OCCUR
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AGGREGATE $
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DESCRIPTION or OPERATIONS I LouTtM I VEHICLES CAWwh ACORO 101. AddMorW Rm mAdt Seltedule. Ir mors apace 1%
Allyn Ratcliffe
90 Putnam Road
North Andover, MA
ACORD 25 (2010105)
INS025 (2womoi
S"OULO ANY OF THE ABOVE DESCRIBED POROM E '_ CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, MOTIM ML . BE OELIVERED IN
ACCORDANCE IMTH THE POLICY PROVISIONS.
AUTHORIZED REPT ESMtA?IWI£
@ 1988x2010 ACI
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T.J. Livingstone
(978) 835-5112
LAND LINE
CONSTRUCTION
Land Line Construction Co. will supply customer
With General Liability & Workers Compensation
Insurance Certificate
Dunstable, MA
73 Cross St.
Name: Allyn Ratcliffe Date: 3-2-2012
Address: 90 Putnum Rd. North Andover Phone: 978-688-7828
Roofing Contract & Procedures
➢ Clear the area of any breakable items that would obstruct the job site
➢ Install tarps from the roof fascia to the ground to prevent any damage to the House
Completely remove any existing (1-2) layers of asphalt shingles and dispose of in
container provided by Land Line Construction Construction.
➢ Completely de -nail roof and re -nail roofing boards as needed
➢ Replace any rotted wood at $2.50per board foot/or $50.00 for every 4x8 sheet of
plywood
➢ Apply 6 Feet of Ice & Water Shield around entire perimeter of
House & up all valleys, 3ft. over hips, and 9ft over the great room.
➢ Install 8" white drip edge
➢ Apply Grace Tri -Flex or Gaf Deck Armor composite under -laminate
➢ Install new pipe flanges as needed everywhere
➢ Apply new shingles in the style and color of your choice (Ex. Architect, Three tab)
30yr Archt.
needed, bring to customers attention) $ Additional /Charge ($300-600 per
chimney (I chimneys) Incl. $$Price
)0- Build a small cricket behind chimney for a water run off
➢ All new flange pipes and vents will be replaced
➢ Install a Cobra Ridge Vent System, on the ridge of the house to allow for the proper
ventilation
➢ Install New Ridge Cap over the Cobra Ridge vent.
➢ Your Roof has 30-33sq. of shingle coverage, depending on how much waste for
angles and valley cutoffs there are.
➢ Any variations from project will be drawn up on a separate contract and
signed by both parties, (Change Order)
➢ Completely clear debris and dispose of in waste container provided by Land Line Construe 'on
db ��_� t r wee- c)Y\ fn �L
The materials are a 30 yr -Lifetime warranty & labor warranty is 15 years from Land Line ton.
Payment Pricing: $ 11,625 New 30 yr. - Lifetime Archt. Shingles Shingles
1/3 due at signing of contract V ) 1505 ;'so
1 /3 upon start of jobb
1/3 due upon completion of job
Any changes or add-ons in contract will be drawn up and signed by both parties
Acceptance of Contract
The above process, specigcations and conditions are satisfactory and hereby accepted. You are authorized to do the work specified. Payment will be
Homeowner or Authorized Signature
AS ame
3 20/2
Date Date
THANK YOU FOR CHOOSING LANDLINE COSTRUCnON
The Contractor agrees to do the
(Describe in detail the work to cgmplc
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-zs�b-15
specifying the type, brand, and grade of materials to be used,
'- (CZr1_tf&C+ M_T" C6
lab& -rola 0199'7
Required Permits -The followingliuilding permits are required Proposed Start and Completion Schedule -The following schedule will
and will be secured by the contractor; as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise
(Owners who secure their oivn permits will be
excluded from the Guaranty fund provisions of tJ'
MGL chapter 142A.) ate when contractor will begin contracted work
e when contracted work will be substantially completed.
Total Contract Price and Paymerit!Schedule
The Contractor agrees to perform the work, fiunish the material and labor specified above for the total sumo : 5 C'%
Payments will be made according to ;the following schedule:
�i
14115"Zpon signing contract (not to exceed 1/3 of the total contract price or the cost of special order items, whichever is greater)
�byaalal.
or upon completion of
or upon completion of
$� !J
--�- --- upon completion of the contract. I (Law forbids demanding full payment until contract is completed to both party,s satisfaction)
The following material/equipment must be special $�_ to be paid for
ordered before the contracted wdrk begins in order
to meet the completion schedule (°h to be paid for
NOTES: (*) Including all finance charges (*'k) Law requires that any deposit or down -payment required by the contractor before work begins may
not exceed the greater of I (a) one-third of the total contract price or (b) the actual cost of any special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
Express Warranty- Ts an ress warran beingy provided by the contractor.
Yes (all terms,
Subcontractors -The contractor agrees to be solely resposible for completion of the work d scr bed regardless of the actions of , of th must be any tthird any
Party/Subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for
materials and labor under this a eement
Contract Acceptance - Upon signing, this document becomes a binding contract under law. Unless otherwise noted within this document, the
contract shall not imply that any lienor other security interest has been placed on the residence. Review the following cautions and notices
carefully before signing this contra It.�
Don't be pressured into signing the contract. Take time to read and fully understand it. Ask questions if something is unclear.
• Make sure the contractor has aWalid Home improvement Contractor Re 'stration. The law requires most home improvement contractors and
subcontractors to be registeled[with the Director of Home Improvement Contractor Registration. You may inquire about contractor
registration by writing to the Director at 10 Park Plaza, Room 5170 Boston MA 02116 or by calling 617-973-8787 or 888-283-3757.
Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage, or ask to
see a copy of a "proof of insurance" document.
• Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Cons
Guide to the Home Improvement Contractor Law. umer
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the
contractor in writing at his/her mainjo ce or branch office by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the
third business day following the signing of this agreement. See the attached notice of cancellation form for explanation of this right.
O NOT S16' TH[S CONTRACT IF THE
Two i ntical copies ofthe contract must be completed and signed. One copy should g o the homeown .The oBer� oy shoul'SPu r,CES
1/
0_1
�G � .Date
Contractor Arbitration
The Home Improvement Contractor Law provides homeowners with the right to initiate aniarbitration action (as an
alternative to court action) if they have a dispute with a contractor. The same right is not automatically afforded to a
contractor, however. The contractor would have to resolve any dispute he/she has with a hiomeowner in court unless
both parties agree to the optional clause provided below. This clause would give the contraictor the same right to
arbitration as is afforded to the homeowner by the Home Improvement Contractor Law.
The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute
concerning this contract, the contractor may submit the dispute to a private arbitration fumll which has been approved by
the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required
to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A. !
Homeowner's Signature Contractor's Signature
NOTICE: The signatures of the parties above apply only to the agreement of the parties to! alternative dispute
resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this
section is not separately signed by the parties.
Homeowner's Rights
A homeowner's rights under the Home Improvement Contractor Law (MGL chapter 142A) and other consumer
protection laws (i.e. MGL chapter 93A) may not be waived in any way, even by agreement. i However, homeowners
may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law.
Homeowners who secure their own building permits are automatically excluded from all Gtiaranty Fund provisions of
the Home Improvement Contractor Law. The contractor is responsible for completing the ;work as described, in a
timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor
guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties
provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for
a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be
added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have
questions about your consumer/homeowner rights, contact the Consumer Information Hotline (listed below).
Execution of Contract
The contract must be executed in duplicate and should not be signed until a copy of all exlilbits and referenced
documents have been attached. Parties are also advised not to sign the document until all biank sections have been
filled in or marked as void, deleted, or not applicable. One original signed copy of the coi*act with attachments is to
be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing
and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of
the contract, and the three day rescission period has expired.
Accelerated Payments
A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the
homeowner deems him/herself to be financially insecure. However, in instances where a egntractor deems him/herself
to be financially insecure,'the contractor may require that the balance of kinds not yet due! be placed in a joint escrow
account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the
signatures of both parties.
Additional Information
If you have general questions or need additional information about the Home Improvement, Contractor Law or other
constumer rights, or if you wish to obtain a free copy of "A Massachusetts Consiimer Guide to Home Improvement"
contact:
Consumer information Hotline
Office of Consumer Affairs and Business Regulation ! j
10 Park Plaza, Room 5170, Boston, MA 02116 j
617-973-8787, 888-283-3757 or visit the OCABR website at htip://www.mass.gov/ocabr/
If you want to verify the registration of a contractor or if you have questions or need additi� nal information specifically
about the contractor registration component of the Home Improvement Contractor Law, c�optact:
Director of Home Improvement Contractor Registration
Office of Consumer Affairs and Business Regulation
10 Park Plaza, Room 5170, Boston, MA 02116 i
617-973-8787, 888-283-3757 or visit the IiIC website at http://www.mass.izov/ocabr/
Go online to view the status of a Home Improvement Contractor's Registration: I
hitp://db.state.ma.us/homeimprovement/licenseelist.as.p
I
For assistance with informal mediation of disputes or to register formal complaints againa business, call:
Consumer Complaint Section
Office of the Attorney General
617-727-8400
AND/OR
Better Business Bureau I
508-652-4800, 508-755-2548 or 413-734-3114 i
Version 2.1-11/22/2010