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Home My WebLink AboutBuilding Permit #304-14 - 94 MAPLE AVENUE 10/2/2013 BUILDING PERMIT TOWN OF NORTH ANDOVER ,. . OPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: _.. ��Ss�c►+u5�4�y RT AOT:_Apphcant must com lete all items on this paEe r Cit LOCATIONSAK�� 1�Qaltti2 y�Print PROPERTY OWNER Print MAP.NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yesno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential j New Building One family Addition Two or more family Industrial Iteratio No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer _ . Ideutifcation Please Tve or Print ClearIv OWNER: Name.- . �- Phone: Address: I6 F cz A h Kr MA OI _ --- CONTRACTOR Name: ►-, "- Phone: Address: Supervisor's Construction License: Exp. Date: Norrie Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone- Address: Reg. No. FEE SCHEDULE:B ULDING PERMIT.512.00 PER 51000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S.F. Total Project Cost: $RC"' FEE: $ Check No.: Receipt No.- NOTE: PersonfeWrowl wit11 tin registered contractors do Iaot!rave cess o lie guarant},fund Signature ofAgent/Owner Signature of contractor i II TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page Print. PROPERTY OWNER_ a Print100 Year Old'Structure yes no MAP NO r_v-_ PARCEL- - ZONING DISTRICT: __ Historic District yes no. Machine.Shop Village yes, no. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ElFloodplain El Wetlands ElWatershed,District'. p Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: I Identification Please Type or Print Clearly) ' OWNER: Name: Phone: Address: CONTRACTOR Name: Address:_ Supervisor's Construction License: r- _Exp: Date Homme Improvement License--- _ - _ Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund gnature of:Agent/Owner, .__ Signature of cont_ractor... .- �� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Building Department The folowing 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 p P 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 Li 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) o 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 cans if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apt),-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must bP subm.tted with the building application Doc: Doc.Building Permit Revised 2012 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE.OF-:SEWERAGEDiSPOSAL 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 DEVE LOPMENT COMMENTS CONSERVATION Reviewed on C� Si nature COMMENTS HEATH Reviewed on Signature COM--MENT 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 Toiv�! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTM,ENT _'Temp Dempster on site yes no Located-at'124 Mair Street - Fire Depart`men -sign atu're/date COMMENTS 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.$10041000.fine NOTES and DATA— (For department use i i U Notified for pickup - Date i i Doc.Building Permit Revised 2010 Location t No. Date . - TOWN OF NORTH ANDOVER 1, Certificate of Occupancy $ • ,,,,,._ Building/Frame Permit Fee- FoundationPermit Fee $ Other Permit Fee $ TEs' TOTAL $ Checl ' � 2694, 0 Building Inspector � �.10RTf-r Town of . � Andover No. 4 C, LANE h ver, Mass, p� l [OC HICHEWICK A4. S U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT ....... ........................................................ BUILDING INSPECTOR ... p .... \ 6 r............................ Foundation �� .... ................. has permission to erect ....... buildings on Rough ' A, �+ c.�p,. to be occupied as .. �...64%.\ ......1"tr. ...rr4w ....4 ..1.7. I. S..... ...:� 1C...�t. . chimney provided that the person accepting this permit shall in every respect conform to the rms 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final 3 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CO NSTRUCTIO A Rough Service .................... .... ...................................................... Final BUILDING INSPECTOR 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. SEE REVERSE SIDE lislssact�useti - Dcliaritilent of Putt{ic S:Ifetr t' Board( Builditi, Re,,i l-Alivtl �n��St�►ntl.irt{� .� P �ar,rN�Icel,se License:�S69 w`4 LEONARD SANTOSUOSSO III , y 5 RED FERN CIRCLE LONDONDERRY, NH 03053, 1 t • is�d .. .. 4 +trt'i r' �� ' �w! ti... Expiration: 9/21/20134 t'sn,zris�iunriTr:'r: ' ell,�poa?vrn�acuea�l�a,,U�GaQoac�uDeL(-. Office of Consumer Affairs&Business Regulatiofi OME IM'E R IE�NtEI��, (3AITftAC OP. 4 A . egi$tration 163015' Expiration;V5/4/2015 LLC LEONARD SANTOSUOSSO&SON'CONSTRUCTION - LEONARD SANiOSUOSSO `BRED FERN CIR � -- j LONDONDERRY,;NH 03053 <et .r.. Undersecrteta_ry i LtceRse or reg�strat�on valid for individul use'only bef:re the expiration date:'If found return toy Office of Consumer-Affairs and Business Regulation 10 Park Plaza-Suite 5170 . Boston,MA 02116 I of valid without signature The Commonwealth of Massachusetts L Print Form Department of Industrial Accidents Office of Investigations ' 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):Apple Wood Construction,Inc Address: 5 Red Fern Circle City/State/Zip:Londonderry, NH 03053 Phone#:603-432-8599 Are you an employer? Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 2 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑✓ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no 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. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:Peerless Insurance Company I Q Policy#or Self-ins.Lic.#: � 1 V C �t 1 Expiration Date: Job Site Address: 92 Maple Street City/State/Zip:N Andover, MA 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. I do herebycertify under the ains andpenalties o er'u that the in ormation provided v ' used abo a is true and correct P Signature: Date Phone#: 603-432-8599 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#: rQ Bank i Amer""WostConvefftmNwts Close Window Check Images Print this nage Account: x2713 -Apple Wood Checking Check Number: 2487 Date Posted: 9/27/2013 Amount: $100.00 Zoom In Q Zoom Out Q . . . ___.- � . -•. . - -. -. _ . .. .• _ . - •248'7 , APPLE WOOD CONSTRUCTION'INC:. 'so3.4Uasss 5 RED FERN CIRCLE LONDONDERRY,NH 03063 sama�z+ts, Date a fo the - order df k,�L�f`�/\.(>��[\la►. e`-1�{,�i —cep U011ars e TD BANK' ror 10002487ne,X 211370.54.51: 8 248 26 271.3m �O p w 0 dr O N g O Z 0 !•' - xx �dr taoro owo=+ O - n, _ WOth - _ O 1 • OMC -7: OWt0�7 M L13O Z t o ru to dtdLd - ��Ld is fV 0D won 0% 4• i' I t 14888-751-9000-Live Customer Service 24/7 I Locations I Terms of Use I Member FDIC I @2DI3 To Bank,N.A.All Rights Reserved. httrx•blv,cirx+xcmlina Mhank rnnJ/:nrmralcFtankimWPtdf:rcalr:,ictnmarCanirnlf:MtMrtannlfia�w(acs,(/inriar_9Rirt-�dR7RtIa1s�7M'LnQ.�7Ramry u+tclMM 1H. , Unfiled Notes Page 2 A71 .` o Construction I/We,the owner(s)of the premises mentioned below,hereby contract with and authorize as contractor,to famish all necessary materials and labor,to install,construct and place the improvements according to the following specifications, terms and conditions,on the premises described below: Owners: David Mushaty Phone: 401-651-9696 Address: 92 Maple Street,North Andover,MA Contractor Information. Apple Wood Construction Inc,5 Red Fern Circle,Londonderry,NH 03053 FED ID#45-2837711 HIC#163015 Contractor ID#CS87691 Part I Description Apple Wood Construction,Inc.,will: See attached estimate dated 9/20/2013 For the above or attached specifications the undersigned agrees to pay the sum of $5222.00 The Customer agrees to make payment in accordance with the schedule of payment as follows: Deposit on signing agreement: $1740.00 Start of work: $1740.00 Substantial completion of project: $1742.00 Part R Proposed start date:Approximately two weeks after issuance of town permits. Proposed end date:Approximately 3-6 months after start of work. Contractor is not responsible for delay,damage or inability to cavy on the work caused by or resulting from strikes, blackouts,fires,accidents,lack of material or any other cause beyond the control of the contractor either before or after the delivery of the material and equipment at the said premises. The contractor is to be permitted to proceed with the specified work without interruption and hereby authorized to do such work as in his opinion is necessary to complete this contract Plans may need to be altered slightly during construction phase at the contractors discretion. Part III \ This agreement shall become binding only upon the contractor's written acceptance here of or upon the contractor's commencing performance You may cancel this agreement if it has been consummated by a party there to at a place other than the address of the seller,which may be his main office or branch office by ordinary mail,by telegram or by delivery,not later than midnight of the third business day following the signing of this agreement in accordance with MGL c 93 s 48;MGL c 140D s 10 or MGL c 255D s. Londonderry,New Hampshire 603-432-8599 www.applewoodconstruetion.net Appl Qo Constrtctii3n Pan IV The contractor will do all such work in a workman-like manner. In the event of discovery of hidden damage,it will be charged in a cost plus manner,labor,plus material,phis twenty percent(20%). This amount is due immediately upon completion. The owner(s)agree that in the event of cancellation of this contract before work is started,the owner(s)shall pay to the contractor,on demand,twenty-five(25%)of the contract price plus any material that may have been ordered as it's stipulated damages. Part V The owner(s)will bear the burden of any penalties or fees associated with delays or litigation necessary to complete this contract and collection of all monies due. Delay in payment of any Portion of this contract shall be subject to interest charges of eighteen percent(18%)per annum. There are no other agreements,understandings,representation or warranties,verbal or otherwise,expressed or implied, which are not contained herein. All additional work and/or materials requested by the owner(s)must beaid immediately. ely. Pan VI All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston,MA 02116 617-973-8700 Part VII All work is warrantied for one year after completion date. The contractor reserves the rights to take before and after pictures of the project for use on contractors own website for informational purposes only. Londonderry,New Hampshire 603432-8599 www.applewoodconstruction.net v k We -�-ow, Construc!d Part VIII PERMIT NOTICE: a. Any and all necessary construction related permits are the contractors obligation to obtain. b. If an owner secures their own construction related permit or deals with unregistered contractors they shall be excluded from access to the Guarantee Fund. Part VIIII This contract is subject to.the approval of the General Manager. In Witness whereoC the parties have here unto placed their hands and seal this 20th day of September 2013. DO NOT SIGN THIS CONTRACT IF TiHERE ARE ANY BLANK SPACES. X .� David Mushaty Date: Londonderry,New Hampshire 603-432-8599 j www.applewoodconstruction.net i I i C C` pple--food Construction September 20,2013 David Mushaty 92 Maple Street N.Andover,MA ESTIMATE 4X7 DECK 1. Removal of existing deck,stairs and solid stairs underneath. NOTE: If this takes more than 1 day additional charges will apply. 2. Dig two footings and fill with concrete. 3. Prep house with ice and water shield and proper flashing. 4. Supply materials and construct pressure treated 4x7 frame. 5. Supply and install Azek decking(standard color)with hidden fasteners. 6. Supply and install white vinyl sleeves on posts. 7. Supply and install white vinyl aprons and caps on posts. 8. Supply and install white vinyl railing with flat rail and square balusters. 9. Supply and install white Tanza(synthetic wood) to risers and sides of stringers. 10. Removal of all trash due to construction. TOTAL: $5222.00 NOTE: Possible patch will be needed where existing railing is tied into house. NOTE: If the inspector makes us dig footings or go up and over what is listed above additional charges will apply. 5 Red fern Circle Londonderry, NH 03053 603-432-8599 www app`ewoodconstructior ��vzt7 r'�y SH-r�rl hWLF 5TQvQos V�t�+�l niRsf�l +c ¢EE� l� yr Ln-p `1 i -Tkm VT-,M 11�011r e aC\lE gi J(J�JT t+nJy,Ea. o ' u IXS TirnZA � � I �'{X� 1'(UrG1t�Fs7 �fxyyx, (a7 axe�.t yirl tnzim�,5 OFF > i A-rivc,� T_ ir�zn � rm�t-z-rvrr� iz `iXG `Foss ntV-iZ 1X8 fh41ZPr