HomeMy WebLinkAboutBuilding Permit # 3/22/2016 BUILDING PERMIT 0 %AORT#1
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TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: K Date Received
S C F0US
Date Issued:
I�M]P �RTAANT.: Applicant inu�stcom�vlete�all items on this page
LOCATION 1W.-
Print
PROPERTY OWNER kc"L,`2
Print 100 Year Structure yes (69,
MAP PARCEL: ZONING DISTRICT: Historic District yes
Machine Shop Village yes nom)
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building p4 One family
11 Addition 11 Two or more family El Industrial
El Alteration No. of units: [I Commercial
Repair, replacement 11 Assessory Bldg El Others:
El Demolition 0 Other
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DESCRIPTION OF WORK TO BE PERFORMED:
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Identification- Please Type or Print Clearly
OWNER: Name: Phone: 7 7
Address: A4, ('K", th L(
Contractor Name, I-14u,1-10 b r ri Phone:
Email: Dear) 6 r-Y) 0 U I I et 6D
Address: �,4mW'JILL(
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Supervisor's Construction Licenser Exp. Date:
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Home 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 unre is erect contractors do not have access to the guaranty fund
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THIS CERTIFIES THAT BUILDING INSPECTOR
.................. ................. . ......... .......... .....................................................
G1has permission to erect ..... buildings on Foundation
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to be occupied as ... ...... ..........dO ..... ...... .. . . .. .................................................... Chimney
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provided that the person accepting this permit s every rej6ct 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
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES I 6 MONTHSELECTRICAL INSPECTOR
UNLESS
l . .. . T Rough
Service
.............. . .
... ......................... Final
BUILDING INSPECT®R
GAS INSPECTOR
Occupancy Permit Required toOccup-y Building Rough
Display in a Conspicuous Place on the Premises — Do of Remove Final
No Lathing r Be®
Wall o Done FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
LEE DEARBORN
BUILDING&REMODELING
4 Hawthorne St.
Acton, MA 01720
508-328-6441
CONTRACT
Mar. 18, 2016
Cheryl Gikas
24 Gilman Ln.
North Andover,MA 01845
CONTRACT for repairs to kitchen and family room due water damage from water pipe ul
ceiling that froze and split at 24 Gilman Ln.
Site preparation:_Move furniture and furnishings to a location within the house as designated
by owner. Remove curtain rods and brackets. Cover floors in kitchen and family room with
protective drop cloths. Seal off door openings as needed to confine dust to and family room.
Labor: 2 carpenters x 4 hrs=8 x 75. 600.
Materials: plastic,drop cloths, tape,dusk masks 62.
Demoltion:Remove two layers of blueboard from family room ceiling and dispose of in container
in driveway. Remove blueboard behind the cabinets where small sink is located. Use vacuum to
collect dust directly adjacent to blade of cutting tool. Remove and dispose of fiberglass insulation.
Labor: 2 carpenters x fn hrs = 12 x 75. 900.
Electrical:Remove and dispose of all (thirteen) existing recessed lights in the kitchen and family
room. Install nineteen new Halo 4 inch insulation contact recessed lights with white trims and
45 watt equivalent:R20 dimmable LED bulbs. Reinstall curved low voltage ceiling fixture over
island.This may require relocating ceiling electric box. Install new 115 volt outlet behind stove.
Add 115 outlet for microwave shelf in base cabinet to left the stove.Wire new range exhaust
hood. Install new electrical outlets horizontiaffy in granite backsplash. Reuistall undercabinet
lights. Replace all other kitchen outlets aird switches.
Sub-contract: Electrician 1600.
Materials: Recessed light frames, trims and bulbs 857.
Plumbing: Replace and relocate laundry drain and water connection box.
Sub-contract; Plumber 800.
Materials:laundry connection box:piping 86.
Plaster. Install 1/2 inch blueboard on family room ceiling and kitchen walls mud ceiling.Apply
veneer coat of plaster.
Sub-contract: Plasterer 1630.
Materials: Blueboard,screws,web tape,plaster 548.
Cabinets/appliances:Instaall tall utility cabinet,cabinet over the refrigerator and tall panel
to the right of die refrigerator; Install base and wall cabinets where utility sink is located;
Install saved door and drawer front panel on dishwasher;Install new hood fan vented to
outside;Install wall cabinet above new hood fan;Install crown molding at top of cabinets;
\Install cabinet kickboard;Install cabinet hardware;fill nail holes
Labor: 2 carpenters x 12 hrs=24 x 75. 1800.
Casings and crown molding.Re-install casings at kitchen window,sliding door and cased opening;
Install paint grade crown molding on kitchen and fainly room ceiling.
Note: crown molding will not cover stone on fireplace
Labor: 2 carpenters x 6 firs= 12 x 75 900.
Materials:3 r/2 inch primed crown molding 332.
Supervision: On site supervision of all work performed
Labor: 1 supervisor 30 nus x 75 2250.
Total 12,365.
Payment schedule: $4,000. upon signing of contract.
$4,000. upon installation of plaster board
$4,365. upon completion
Owner Contractor
Date Date
Contractor Arbitration
The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration 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 homeowner in court unless
both parties agree to the optional clause provided below. This clause would give the contractor 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 firm 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.
Homeowaier'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. 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 Guaranty Fund provisions of
the Home Improvement Contractor Law. The contactor 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 exhibits and referenced
documents have been attached. Parties are also advised not to sign the document until all blank sections have been
filled in or marked as void,deleted,or not applicable. One original signed copy of the contract 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 contractor deems him/herself
to be financially insecure,the contractor may require that the balance of funds 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
consumer rights,or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement"
contact:
Consumer Information Hotline
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787,888-283-3757 or visit the OCABR website at http://wAvNv.mass.gov/ocabr/
If you want to verify the registration of a contractor or if you have questions or need additional information specifically
about the contractor registration component of the Home Improvement Contractor Law,contact:
Director of Home Improvement Contractor Registration
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787,888-283-3757 or visit the HIC website at httn://www.mass.goN,/ocabr/
Go online to view the status of a Home Improvement Contractor's Registration:
http://db.state.ma.us/homeimprovement/licenseelist.asp
For assistance with informal mediation of disputes or to register formal complaints against a business,call:
Consumer Complaint Section
Office of the Attorney General
617-727-8400
AND/OR
Better Business Bureau
508-6524800,508-755-2548 or 413-734-3114
Version 2.1-11/22/2010
NOTICE OF CANCELLATION
YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR
OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE.
IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE
BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE
INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN
BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU
CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF
THE TRANSACTION WILL BE CANCELLED.
IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE SELLER AT
YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN
RECEIVED,ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR
SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF
THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE
SELLER'S EXPENSE AND RISK.
IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE
SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF
CANCELLATION, YOU MAY RETAIN OR DESPOSE OF THE GOODS WITHOUT
ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE
TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER
AND FAIL TO DO SO,THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL
OBLIGATIONS UNDER THE CONTRACT.
TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND
DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN
NOTICE, OR SEND A TELEGRAM TO [Name of Seller],AT [Address of Seller's Place
of Business]NOT LATER THAN MIDNIGHT OF (date).
I HEREBY CANCEL THIS TRANSACTION.
Date: Buyer's Signature:
Booth Electrical Services
16 Proctor Rd.
Chelmsford, MA
Woodbury Home Solutions (plumber)
45 Ossamequin Rd.
Billerica, MA
Millbrook Plaster
26 Chestnut Ave.
Braintree, MA
The Commonwealth of Massachusetts
Department of IndustrialAccidents
X Congress Street,Suite 100
Boston,MA 02114-2017
www mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Lezibly
Name (Business/Organizationffndividual): Le- -vtfbt�t �1
Address: 4 4a,;-+6 t'n e, 44-
city/state/zip: Ac;+vo /14 A- pi 7 Phone#:
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• New construction
2 1 am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling
any capacity.[No workers'comp.insurance required.]
9. ❑Demolition
3.❑1 am a homeowner doing all work myself.[No workers'compAnsurance required.]t
10E]Building addition
4.❑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 11.❑Electrical repairs or additions
proprietors with no employees.
12.[]Plumbing repairs or additions
5. 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet.
• These sub-contractors have employees and have workers'comp.insurance.t 13.[]Roof repairs
6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 14.�Other 11f CG6f
152,§1(4),and we have no.employees.[No workers'comp,insurance required.] ( Y`e�,
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information
I 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 tfiat is providing workers'compensation insurance for•my employees.'Below is the policy and job 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 pains and penalties ofperjury that the information provided above is true and correct.
Signature %/1�•ti� 7.�+— Date:
Phone#:
`&
441
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): i
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Penson: Phone#:
Massach
setts
Board f BuB M ig Rt �iafio na and Stwidards
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LEE H DEARBORN / y/
4 HAWTHORNE ST
ACTON MA 01720
C`w - siioner 02119/2018
�'��,�° �r "�r-a,��a�+w�a��^rr�+a�m�u� ,�+,C, �a^��aa�r•����°�"n�a
Oftice of Consumer Affairs&Business Regulation
L ME IMPROVEMENT CONTRACTOR
" egiatration: 1431 Type:
cpiration: 71241 016 Individual
LEE DEARBORN ,
LEE DEARBORN
4 HAWTHORNE 5T. %
ACTON,MA 01720 Undersecretary