Loading...
HomeMy WebLinkAboutBuilding Permit # 4/6/2015 NORrN BUILDING PERMITo� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINAI N " o man � Permit NO� G " Date Received too Date Issued: i koc►+usk�� IMPORTANT: A licant must com Tete all items on this age LOCATION PROPERTY OWNER e .l I ) 'Print b"(0nt AP MAP NO: PARCEL: ZONINGDISTRICT: Historic District yes hn Machine Shop Village yes no I 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 KAssessory Bldg ( ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well Q Floodplain ❑Wctlainds ❑ Watershed District ❑Water/Sewer An 8, '& 9 e"C( n Identification Please Type or Print Clearly) OWNER: Name: oil dt r ° � � %i s ef(lk � l ® ` Phone: Address: CONTRA "7/,/' Phone: , m 13 Add"rens: °" ; , , " . S0pervia0 s Cr�n�tr6' ion License '71 Date: ,.� Home Improvement License: % Exp. Date: d 2 014 ARCHITECT/ENGINEERezetpe,�- c ;... Phone. . .�- Address. ; / / ��.. � .eoz �� �� t /VV Reg. No. 2, 6. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$128.00 PER S.F. I/P °"1 Total Project Cost: $ �5 0 FEE: $ Check No.: "" Receipt No.: s NOTE: Persons ontr ding with unregistered contractors do not have access to the guaranty fund Sianature`ofAaent/Ownerliture contractor ana. �, f µ Plansemitted 1 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans r TYPE OF SEWERAGE DISPOSAL ell Swimming Pools ❑ Public Sewer Tanning/MassageBody Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ i Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS NS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FOR DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMENTS CONSERVATION ❑ ❑ Is- COMMENTS sCOMMENTS N_.? ) DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments w Water& Sewer Connection/signature&Date Driveway Permit Located at 384 Osgood Street i FIRE DEPARTMENT - Temp Qum pster cn,.site ° yes no Lc►cated,at 124 Main Strut Fire ©0pairl�mon s ginature/date r' OOMIVNEIT AM tAORT11 A town ot _71 Andover 0 N Fjg-, 15 I- . I to AA o. LAKR h ver, Mass, COCHICHRWICK 0 ArE 0 U BOARD OF HEALTH Food/Kitchen PER I Septic System THIS CERTIFIES THAT ..... .M. ..... ........ .......... ........ .... ... BUILDING INSPECTOR Foundation has permission to erect.......................... hpialdings on . .... 5........ & 4 - Rough to be occupied as . ...s4*4.. ...... ........*"**......... ....... Chimney provided that the person accepting this permit shall in every respect to th ms 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 AW PERMIT EXPIRES IN 6 MON"I'HS ELECTRICAL INSPECTOR UNLESS CONST RUCTIQM TA4 t Rough � 00 42 0 Service 00 ............ .............. 4 ................... ........................ Final BUILDING INSPECTOR GAS INSPECTOR Occu-nan Permit Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be one FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. ........... ...... Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements ofthe state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information Name CompanyN e 7 Street Address(do not use a Post Office Box address) Contractor/Salesperso OwnerName "p t7t / CZ 1,2 tjj I C C " City/Town State Zip Code Business Address(must include a street address) Daytime Phone Evening Phone City/Town State Zip Code ;7Y 661_11 Mailing Address(It different from above) Business Phone FederalEmployerIDorS.S.Number Homarmprovement ContmctorReg.Number Eaxpvationdote Iaw squire that mast home ' improvement contractors hang aralidregbtratton numtier �Z72 ✓ The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeownefs agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of c°3�Date when contractor will begin contracted work. MGL chapter]42A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule True Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of 3 y ^ e r M Payments will be made according to the following schedule: $1 1 upon signing contract(not to exceed 1/3 ofthe total contract price or the cost of special order items,whichever is greater) $ r t7 b,by / / or upon completion of7 $ ""'/ by / / or upon completion of $ d L upon completion ofthe contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special S to be paid for ordered before the contracted work begins in order -- to meet the completion schedule(0) $ to be paid for NOTES:(1)Including all finance charges('t*)Lawrequires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(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. I, Express Warranty-Is an express warranty being provided by the contractor? ❑No es(all terms of tile warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion ofthe work described regardless ofthe actions of any third 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 asreement 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 lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • 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 a valid Horne Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered 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 infonnation 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 ofthe Consumer Guide to the Horne Improvement Contractor Law. 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 main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight ofthe third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of thus right. DO NOT SIGNYWS CON CT IF THERE ARE ANY BLANK SPACES!!! Two identical copies ofthe eontraot must be mpleted and si ed.Ona copy sltould ge to die homeowner.the other copy should be kept by the contractor. GM Homeown i's° Igpature Contractor's Signatu� e Date JEFF PELLETIER CONSTRUCTION LLC 13 Clark Avenue Salem, New Hampshire 03079 Richard & Kara Kaufman 233 Main Street N. Andover, Massachusetts 01845 March 28, 2015 CONTRACT Garage construction at 233 Main Street, N. Andover, Massachusetts Jeff Pelletier Construction LLC will obtain a building permit (except electrical permit), and act as General Contractor for purposes of erecting a 24' X 48' garage at the property of 233 Main Street, N. Andover, Massachusetts. Duties include scheduling and supervising sub-contractors such as Excavation Company, concrete company, framing company, garage Door Company, and any other subcontractor needed to complete this project. Jeff Pelletier Construction LLC to provide materials to complete framing, roofing, and siding. Jeff Pelletier Construction LLC is to finish exterior of garage with roofing and vinyl siding to match existing house as best as possible. No interior finishes are included in this contract. Jeff Pelletier Construction LLC will provide a dumpster for construction debris and a portable toilet for use of construction personnel. Excavation Company, concrete company, and electrician to be paid directly by Richard Kaufman. ESTIMATED COSTS $50,200.00 Payment schedule for Jeff Pelletier Construction LLC $ 1,000.00 1" Deposit for permits (PAID) $16,000.00 2nd Deposit due upon obtaining Building Permit $17,200.00 Due upon project completion/Final Inspection NOTES: 1. Jeff Pelletier Construction LLC will not be responsible for any extra costs involving site work or concrete work due to any unforeseen circumstances. 2. Jeff Pelletier Construction LLC will not be responsible for any damage to driveway, lawn or any other property by any construction vehicles including but not limited to excavation equipment, dump trucks, concrete trucks, j cranes, lulls, or delivery trucks. 3. There shall be no guarantee in cracks in concrete. All measures of prevention will be taken such as good compaction, rebar, fiber mesh and control joints. 4. Garage doors will be metal clad R-11 insulated and have no glass. 2 doors will have openers with remote operation. One will be manual operation. I' Jeff Pelleti r Date Richard Kaufman ate April 4, 2015 WARRANTY, All materials and workmanship on the garage structure to be Built at 233 N. Main Street, N. Andover, Ma shall be warranted by Jeff Pelletier Construction LLC for a period of one year. Warranty starts on the date of the final inspection by the N. Andover Building Department. Damage resulting from storms, floods or any other act of nature is not covered. There is no warranty on cracks in concrete as mentioned in original contract. Jeff Pelleti r Date Jeff Pelletier Construction LLC G Richard Kauf 'pan Date Owner The Commonwealth of Massachusetts -Department of IndustrialAccidents I Congress Street, Suite 100 Boston,MA 02114-2017 - °` www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legib Name (Business/Organization/Individual): e9 r Address: 1 -2 rb�'Z V City/State/Zip: I-el,-vj p1/ J ')2") I Phone#: aJ 3 `/,S__f -5--2 1'Z Are you an employer?Check the appropriate box: Type of project(required): 1.❑I'am a employer with employees(full and/or part-time).* 7. L• 'New construction 2.0I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.F]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition 10 ❑Building addition 4. 1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions proprietors with no employees. - 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13.❑Roof repairs • These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL G. 14. Other 152,§1(4),and we have no employees.[No workers'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. ffthe sub-contractors have employees,'they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees.'Below is the policy and jab site information. Insurance Company Name: Policy#or Self-ins,Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pairr"ndpenalties ofpejury that the information provided above is true and correct. Signature: ._.__... Date: Phone#: 61 c> 3 cit Official use only. Do notwritein 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#: p,offTlry ?O4 r.ae Ya'.bao , A Town of North Andover n, Machine Shop Village Neighborhood Conservation District Commission WOO Osgood Street North Andover, MA 01845 ss�CHU Certificate to Alter Date: Is I LI Contact Name&Address: 233 Maul 4f- Nowlht 14 k1AOVC*' M44 O t &W Project Address: Project Description(attach additional pages,if needed): Commission Vote: Voted.....q—to 1) to grant/deny Certificate to Alter on Comments(attach additional pages,if needed): Signed: A, Machine Shop tillage Neighborhood Conservation District Commission MSV NCDC Page 1 Scanned canner LEFT ELS EVATION � �FREVATION ".�.Lxuxc..L. °x,.+couuncno ° '� e°rv«cr..n�u1w. "°•"°`T0"r,xccw°xu„xmwrox W ® ® ] Do U K FRONT ELEVATION $I�GVJJ { LEVATION ,wax w.�ff LIFETIME ARCHITECTURAL ¢ a ASPHALT SHINGLES = 15/32"TECHSHIELD RADIANT RIDGE VENT 'g HEAT BARRIER ROOF Q SHEATHING ENGINEERED ROOF 12 / \ TRUSSES @24"O.C: 5� TRUSS BRACING PER TRUSS MANUFACTURERS REQUIREMENTS SIMPSON H2.5A HURRICANE TIES ALUMINUM DRIP EDGE �coN ti WRAPPED ALUMINUM (2)2x4 TOP PLATE O z IQ cxo"noxwmxew� z FASCIA&SOFFIT 2x4 WALL STUDS @ 16"O.C. I �x ------------- - .--- ---------- .- .. y VINYL SIDING w/ Qm s 15132"TECHSHIELD RADIANT HEAT BARRIER SHEATHING APPROVED ANCHOR BOLTS PER °°ro oea le,wu N LOCAL CODE REQUIREMENTS �P moo w"` -—-—-—- ROX.F40_R LINA--- '-------- 6e�evnnous • °N">:;o�r�`"°.o`cocx �,.o'al�°o coox 2x4 PRESSURE TREATED ILN SOLE PLATE NOTE:CONCRETE FLOOR/FOUNDATION BY OTHERS. seCTZN —� FLOORR PLAN 24'-0" NOTE:MINIMUM 6"CLEARANCE FROM BOTTOM OF PLATE SECTION "A-A" TO TOP OF FINISHED GRADE SCALE:1/2"=1'-0" (A-1 PIAT BATF p° 111,.146"ION¢ �-wocvaur .� �n 1 WP I ` WP � ,`iu�`aW�oM.iN®vhf xm�w.YA.am��.LLt LgTE ATInN ) ATION nw"rn4m5°°""o uweuesa�`�nwaiw'sr101srv�u+wnm uewrvanwuaa �""wi.ro`'r"'anm"4i" c""a rHoww+ow.uwuv vnucwr �nwo:w.ow,ucx.um�u.uowcwuw.uogam ,_1L, ninmrw.axu.wusra _ _ �,uriwnrr.w. 4� mwrw�e+i u.mm vantim'aov.m iv�"iai`"' r ® V m 0 K FRONT ELEVATION ua ENATION �i IN LIFETIME ARCHITECTURAL ASPHALT SHINGLES = 15132'TECHSHIELD RADIANT RIDGE VENT N HEAT BARRIER ROOF SHEATHING ENGINEERED ROOF 12 / \ a+n.u.noco+rac mr.J TRUSSES 0 24'O.C: 5� n TRUSS BRACING PER TRUSS MANUFACTURERS REQUIREMENTS 6 , ALUMINUM DRIP EDGE SIMPSON H2.SA HURRICANE TIES i e `man+ruau a WRAPPED ALUMINUM (2)2X4 TOP PLATE p R I awwxanamw� k FASCIA&SOFFIT + 2x4 WALL STUDS Q 1S'O.C, ..................... -.....................•. ......... .._.--......--..,...-..... VINYL SIDING w/ j I $ 1513T'TECHSHIELD RADIANT �4 HEAT BARRIER SHEATvx HING l I au•tt APPROVED ANCHOR BOLTS PER wu OeC.70,iota l i I N LOCAL CODE REQUIREMENTS � �PP34?S�E404$1 INE _—_ euvAnous a - 2x4 PRESSURE TREATED —-—-—_ -—-—-—-—- nv SOLE PLATE NOTE:CONCRETE FLOORIFOUNDATION BY OTHERS. a PL"unou FLOOR PLAN 24'-0' NOTE:MINIMUM S'CLEARANCE T FROM BOTTOM OF PLATE SECTION "A-A" TO TOP OF FINISHED GRADE SCALE:M"-11-0" A-1 mow. nmm+m awme.r N,uu a ZURICH WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6ZZUB-4885P86-7-14) RENEWAL OF (6ZZUB-4885P86-7-13) INSURER: AMERICAN ZURICH INSURANCE COMPANY 1 NCCI CO CODE: 80012 INSURED: PRODUCER: JEFF PELLETIER CONSTRUCTION, DESANCTIS INSURANCE AGCY LLC 100 UNICORN PARK DRIVE 13 CLARK AVE WOBURN MA 01801 SALEM NH 03079 Insured is A LIMITED LIABILITY COMPANY Other work places and identification numbers are shown in the schedule(s)attached. 2. The policy period is from 10-19-14 to 10-19-15 12:01 A.M.at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s)listed here: NH B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE EXCLUDED - REFER TO RESIDUAL MARKET LIMITED OTHER STATES INSURANCE ENDORSEMENT WC 00 03 26 D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 10-17-14 WC ST ASSIGN: NH OFFICE: ZURICH-ORLAN 809 PRODUCER: DESANCTIS INSURANCE AGCY 78535 Massachusetts - Department of Public Safety Hoard of Building Regulations and Standards Construction Super%icor License:: CS-106103 r j JEFFREY P PELLETIER' rr�, 13 CLARK AVENUE Salem NH 03- 979 y� &=t '`• Expiration Commissioner 12/03/2015 ��e �poo�aa�zoazcae�cll�a�� /�aeo«c�udeCtd j Office of Consumer Affairs&Business Regulation License or registration valid for individul use only UV OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 172024 Type: Office of Consumer Affairs and Business Regulation xpiration: 5/14/2016 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 JEFFREY P PELLETIER JEFFERY PELLETIER 13 CLARK AVENUE SALEM,NH 03079 Undersecretary Not j .vGithout signature