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HomeMy WebLinkAboutBuilding Permit #400-15 - 91 CROSSBOW LANE 10/28/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ' Permit 1V0: Date Received Date Issued: (b 7-b IMPORTANT: Applicant must complete all items on this page LOCA l0 . Print PRO - OWNER .� � su Print 100 Year Old Structure yes n MAP NO: PARCEL:P2.01. ZONING DISTRICT: Historic District yes Machine Shop Village yes z TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building 160ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 'Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 168eptic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Wa /Sewer DESCRIPTION OF WORK TO BE PERFORMED: Do�iR -1- ari PN.►S+S�s yeye IdentificatiRn Please Type or Print Clearly) OWNER: Name: kr�dLt� 1��g,ve-'C�2 Phone: 6S�-i 0 Address: 0l C4_0 f �D CONTRACTOR Name: Phone: C- I_ bA• 'S33 Address: S `t3 vr, sT` 5 ._?" "a_. b\,,d r�v�n . (`M�. ,► Supervisor's Construction License DS'_3 p Exp. Date:� 2 Home Improvement License: 1_t'9t 't`-t Exp. Date: (mik_ZA , ARCHITECT/ENGINEER Vu» 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. t Total Project Cost: $ q,-4,y 0 FEE: $ Check No.: Receipt No.: � NOTE: Persons contractin wi nregiste ed contractors do not have access to the guaranty fund Sign' attire ofAgent/Own � Signature of contractor Plans Submitted ❑ Plans Wail d Certified Plot Plan ❑ Stamped Plans ❑ Locatio (� , C V�b�') L 0 No. f Date r . •, TOWN OF NORTH ANDOVER y Certificate of Occupancy $ Building/Frame Permit Fee $ W5 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#JNY U u Building Inspector Plans SUbmitted ❑ Plans Waived6.-: . .-,".-Certified.Plot Plan ❑ Stamped Plans ❑ 'TIzPEOFSEWERAGE DISPDSAL ` Public Sewer ❑ Tanning/Massage/Dody Art ❑. . ,Swimming Pools Eli Well El -Tobacco-Sales E -FoodPackaging/Sales El Private(septic tank,etc. _ =Pdrmaddnt Dirnpster on-Site ❑ - THE-FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN_OFF - U FORM DATE REJECTED. - DATE:APPROVED PLANNING & DEVELOPMENT` ❑ ❑ COMMENTS i .,CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes . I Planning Board Decision: Comments Conservation Decision: :Comments Water& Sewer Connection/Signature Date Driveway Permit DPW To`vz Engineer: Signature: Located 384 Os- d Street FIRE DEPARTMr'NT Temp D' ' ' 'ter ori site yes no Located at;,12M.4. Mair`Street ,•�..:.. •.' `4' a - •}' "--'• �lf�w Y'Irv4sv�lr FM• r�}JeS A - Fire De`partme►iti*signatur_e/dater rt+� '' -s• tt ..� •h r.,•. , ,• w F r - COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions.^ -Total landarea; sq. ft., ELECTRICAL: Movement of Meter location, mast-or service drop re ires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL.Chapter-166.Section 21A-F and G min.$100-$l000:fine NOTES and DATA— For department use ® Notified for pickup - Date s � Doe.Building Permit Revised 2010 Building Department lrstofahs required:forms to be filled ouf.for.:theappropriate.permit to-be obtained. The fd winq]9 Roofil-,g, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And[GriC.S.L Licenses ❑ Copy of Contract ❑ Floor PlamOr 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) o_ _Engneering_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 apw�al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm:+.ted with the building application Doc: Doc.Building Permit Revised 2012 j NORTH own of E : Andover O •y- to *� h ver, Mass, Dd%PA Al COC NIC MI WIC.f �1. q°RAreo S U BOARD OF HEALTH Food/Kitchen PER LD Septic System THIS CERTIFIES THAT .. .. ................. BUILDING INSPECTOR ...... .... .... ...... .. . . .. ................................ ' ., ... has permission to ere sba" Foundation ........................ buildings on ....... . ....... .......... - - Rough 6011111 � to be occupied as ... ... .. ... ►..... .�. ..... .... ... ... .. . .. Chimney provided that the person ac epting this permit shall in every respect conforll the terms of a application t 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONT S ELECTRICAL INSPECTOR 5I '� • UNLESS CONSTRUC TS Rough Service ............. ................................................................. Final BUILDING INSPECTOR GASINSPECTOR Occupancy Permit Required to Occupy Buildinz 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. 1� i i i 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor ylicense: CS-053099 { KEVINW MURPIf v 98 FOREST ST l ' North Andover WA 0 Expiration l 1 06/29/2015 Commissioner ce or Consumer Arra � • OMEIMpROVEMENr usi6eSgRe gistration: gniation 101,874 CONrRgcrOR ovp, piration:--, 612- 0-76, Type: KEVIN MURpHy : . Individual Kevin Murphy 98 FOREST Sr. N.ANDOVER, MA 01845 4� Undersecretary • 98 Forest Street Kevin,,. Murp,hy,,- North Andover,MA 01845 • PH:978-688-5335 Building Contractor FAX:978-688-7207 Proposal To: Andre&Jennifer Paquette 91 Crossbow Lane All Hare improvement Contractors and Subcontractors engaged in home improvement contrading,unless North Andover, Ma 01845 specifically 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, From: Kevin Murphy Roan 1301,Boston,MA 02108.(617)-727 8598 CC: Date: 10/28/2014 Job: Deck repairs Date of plans: None Architect: None Location: Same Section 1-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 10/1/14. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 11/15/14.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 fumished 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 Worts Page 1 of 4 Kevin Murphy Building Contractor Page 2 Of 4 98 Forest Street Nath Andover,MA 01845 PH:978688-5335 FAX 978686-7207 General Proposal is to renovate existing deck. Building permit will be obtained by contractor. Demolition Existing rotted beam will be removed. Rotted trim around exterior of deck, and on all three sets of stairs will be removed. Building All rotted trim around outside perimeter of deck will be replaced with Azek. Three sets of stairs will have all kick boards replaced with Azek. One section of composite railing will be removed and replaced. One section of rotted sill in screened porch will be removed and replaced. Existing rotted support beam will be removed and replaced with pressure treated 2x10. No allowance has been made to replace any decking. Painting Existing deck, stairs and floor of screened porch will be sanded and sealed with approved product for IPE decking. Information to be provided to owner prior to application. Manufacturer recommends deck is to be sealed annually. Waste Removal All demolition/construction debris to be disposed of by contractor. Kevin Murphy Page 4 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:97888853.3.5 FAX 9786887207 Section N-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ... ... ...... ... ... ....$ 9400 Payment to be made as follows: Percentage/ltem Description Amount 1 Permit obtained / decking sealed $3000 2 Repairs complete $6400 Total 2 $91400.00 Notice:No agreement for Home improvement contracli g work stroll require a dam payment(advance deposit)of more that one-third of the total contract pnoe of the total amount of all deposits or payments which the contractor must make,in advance,to order andlor otherwise obtain delivery of special order materials and equipment,whichever 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 NO THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature d Date tbU Signature Date I` I CERTIFICATE OF LIABILITY INSURANCE 6/25/20DATE14 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. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sandi Munroe M P ROBERTS INS AGCY INC PHONE g']8 683-8073 FAXtNC. (978) 683-3147 N. 1060 Osgood Street E""ANn F IADDRE�.san i mpro ertsinsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# IN URER . MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURERS: GUARD INSURANCE 169 BOXFORD STREETI EC: NORTH ANDOVER, MA 01845 INSURER D: I ER 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 CONDn10N 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. LTR TYPE OF INSURANCE ISD D IC U POLICY EFF L CY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES E r $ 500,000 BOPI068945 11/22/13 1/22/14 MED EXP one person) $ 15,000 A PERSONAL&ADV INJURY $ INCLUDED n'OTHER: LAGGREGATE LIMITAPPLIESPER GENERAL AGGREGATE $ 2,000,000 POLICY JET❑ LOC PRODUCTS-COMP/OP AGG $ 2000 000 $ AUTOMOBILE LIABILITY COMBINED SINGLE UMIT accident) $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED MCA7013608 01/23/14 1/23/15 A AUTOS X AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS d t $ UMBRELLA UABOCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB HCLAIMS-MADE 1,000,000 CUP9145304 11/22/1311/22/14 AGGREGATE $ D I I RETENTION WORKERSCOMPENSATION X I PER 0TH - AND LIUTE AND EMPLOYERABILITY T TER ANY PROPRIErORIPARTNERIIXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBER E)CLubED? NIA (Mandatory In NH) KEWC527844 07/01/1437/01/15 E.L.DISEASE-EA EMPLOYEE $ 00,000 If yes,describe under 500 000 DESCRIPTION FOPERATIONS EL DI -POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts .f Department o De artIndustrial Accidents P Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation]insurance Affidavit: Builders/Contractors/Electricians/Piumbers Applicant Information Please Print Le:=ibly Name(Business/Organizationgndividual): Address: � ►T 5 �� I City/State/Zip: 1 J,,. N-a— 0 0(ti Phone#: eln 3 3 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with_1 4. ElI am a general contractor and 1 6. ElNew construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.+ T`5Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.El Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] !Any applicant that checks box#1 must also fat out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they Aire doing all work and then hire outside contractors must submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. i I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. / Insurance Company Name:. C.,✓��o� �,..,51.�,_�� C. . Policy#or Self-ins.Lie.#: lC.,G(,/C_ 'S'2.'1 V K\-t Expiration Date: Job Site Address: R Ua SS �dw U4+ e- City/State/Zip: M O KLIL5� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert under the pains and penalties ofperjury that the information provided above is true and correct. &Ynature: Date: �Z Phone#• Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# 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#: