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HomeMy WebLinkAboutBuilding Permit # 5/10/2016 BUILDING PERMIT o� �OD � TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 0- Permit Permut Nay#o " �'_ Date Received Date Issued: O][Z.TANTo Applicant must complete all items on this page LOCATION " ( f `` Print PROPERTY OWNER 1c'u d c '1�`ro Mmm Print 100 Year Structure yes no MAP PARCEL: '1 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 01feration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other y„ r re /r J ..G /,i,/�,/ VON rl//f,J�/ kthtii. fii/ ru I r r; / // ; Ni it /cioi/ % , ., ORO/ /i l tr m� r s ,e Elrod lain, Bila ds, Water Iced D fir, Milli, DESCRIPTION OF WORK TO DE PERFORMED: Identifieatio - please Type or Print Clearly OWNER: Name: Phone: Address: ' k ; r tae A°of-k AnJ , e - Contractor Name: 71L)'Kr, ear Phone; Email Address: 21 0r�,z gf, k-1 I VK � , . ' Y� Supervisor's Construction License: °°°f / ' r Exp. Date: , Home Improvement License: ZO 40 / Exp. Date: 36 6 'juluueld ARCHITECT/ENGINEER Phone: RuluoZ Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST EASED ON$925.00 PER S.F. Total Project Cost: $ 14-1 -2gl, C) FEE. $ .,f Check No. Receipt No. ` � NOTE: Persons contiacting with unregistered contractors do not have access to the guarantyfund G�/ i/iii!i�.. t i r i//i/%;,' �ign�t�ire of Aar�nt/O�niner,/ Sinatiare of contrcfic�e i„ U; o _ „ d tAORTH Tawn �- 0 L_a�' No. AIL T % : LAKE �• Andover Ve>C', ass' COC MICKE C. 1 4^7E D 5 U BOARD OF HEALTH Food/Kitchen LU Septic System k. THIS CERTIFIES THAT .....PERMEJ ............0­'kes .......................................... BUILDING INSPECTOR has permission to erect .......................... buildings on .... ........... . ................................. Foundation ................. Rough to be occupied as ............ .. ... . ...................... ..6. . ................................. Chimney provided that the person accepting this permit shall in every respect 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 IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO ARTS Rough Service .................. . .. .tib '.............................. 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. ssachu ctts Home 203 MMEM Sain�lc Contract 1 T his form all basicrequiremtmts ofthe statesHome Improvement ContractarlAw(MGI.chapter 142A),bat does not includestandard ecthomeownem Seek legal advice ifnecessary.Any person planning home improv emeatsshouldfirstobtainacopyof"A nsumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the erA%im and Business Regulation's Consumer Information Hotline Contractor73-8787 or In 1-888 83-757 or on our website. ion Homeowner Information Name Company Name Street Address(do not use a Post Office Box address) Contractor/Salesperson/owner Name 3 ltrds Qr.ve, Ciry/tavm State ZtpCode Business Address(must include a sued address) 11�c, l+'I$MIS %Vet'"r •, Da Phone Evening Phone CitylIown stab ZipCodo y°`ne Mp, LVal 03 F hfailingAddress(Itdifltarntfromabave) Business Phdbc IFederatEmpioyerimorS_SNumber Fsp;,uanfFT=7 61 ,jc) The Contractor agrees to do the following work for the Homeowner.of malcrials to be axed,, additional sheers if tie xssatY.) (Describe in detail the wQ&to completed,specifying thetype,brand,and grad Req -redpermits-The following building permits am required Proposed Start aad Cocumstinceson be and the contr ctoes control arise and will be seared by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be Date cont excluded from the Guaranty Fund provisions of contractor will begin contracted wort MGL chapter 142A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule tkthe material and labor specified above for the total stun o£r �S lr The Contractor agrees to perform thewo ,furnish Payments will be made according to the following schedule•. S�(j�G 4pon signing contract(not to exceed 113 ofthe total contract price ar the cost ofspecial order items,whichever is greater) r�t.. u r T lJQQt i Y1 S�c 11� lard S "e by 1 1 or upon completion of P t i 1C n�r"h� 1 / / or upon completion of Y i 11 S�rt 1�G fy l u�J o�a f'_n•E,616 4,l ez' S G00 6)y___ —__ S (r/upon completion ofthe contract.(Law forbids demanding full payment until contract is completed to both party's satisfaction) mtmustbespeeint s to be paid for The following mataiaVequipm�� � edol ordered before thecontmcied to paid for to meet the completionscbedule(") S p NOTES'M Including all finance charges(s•)IAwrequires that any deposit or down-payment required by the contractor befineworkbegim may not exceed the greater of( 'a)coothin!ofthe total contmet price or(b)the actual cost OFW1Y special equipment or custom mademanerial vfiich must be special ordered in advance to meet the completion schedule E r \Vit n Is an esor�s warranty beinenrovided by the cnntrnetnt� Nn Yes tall tartar of thewarraniv must be attached to the contract) ass ofthe actions of any third Subcontractors-The contractor agrees to be solely responsible far completiono of the be solely 0 rk 9bblcf rreagll P yments to all subcontractors for party/subcontractor utilized by the contractor.The contractor fiuther agrees y P materials and aborunderthis ant ContractAcceptance-Upon signing,ibis document becomes a bindinplaced on ct residence. Unlessotherwise the fo lnotedfollowing iautions and notices the contract shall not imply that any lien or other security interest has been placed on the residence.Review the following cautions and notices tarrefully before signing this contract a Dont be pressured into signing the contract.Take time to read and fully understand it.Ask questionsmost home improvement contractors and e Ivlalce�rcethoa�nhactarhasavalidHomemaprovementConttactorReeislnti!?n. The law requires o�outcontractor subcontr ictom to be registered with theDueetor of Homer Improvement Cotractor Registration.Youcalling 617 97may 3 S 87 or 888-283 3757. registration by writing to the Director at 10 Pa kPlaza,Room 5170,Boston,MA 021��16 or ten so�at you can cenfitm coverage,or ask to o Does the contractor bave insurance? Ask the Contractor forhis iusuraace company see a copy of a-proofof insurance"doament e Know your rights and responaliilities.Read the Importautlnformation on the reverse side of this form and get a copy of the Consumer Guideto the ,Home Improvement Contractorlaw. lace oilier than the contractor's normal place of business,provided you notify the cancelyan may cancel this agreement if ithas berm signcd at a P mail posted,by telegram sent or by delivery,not later tbanu daigbt of the contractor in writing at his/her main office orbranch office by ordinmY I notice of cancellation form far an explanation of this right third business day following the signing ofthis agreement. See the attache DO NOT SIGN THIS CONTRACT IF THERE ARL' ANY BLANK SPACE M uteatiwt copimortbe mnnst[rmube mmpfded and sr� 0-cowtboallptatbaboacowner.Tboorrcapyshwidbckcptbythacon-cwr. Contractor s Signature Hometnvner's Signal= V Date Date 4 Contractor Arbitration ion(as an The Home Improvement Contractor Law provides homeowners with the right to initiate ut mat cally afforded o a alternative to court action)if they have a dispute with a contractor. The same righ contractor,however. The conal clause provided below.e any This dispute ease would give the contra for the same right to both parties agree to the op improvement Contractor Law. arbitration as is afforded to the homeowner by the Home The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute itratin firm which has been approved by concerning this contract,the contracttof may slibmi Consumer Affairs and Business Regulationoand the consumer shall be required the Secretary of the Executive Office to sub 't to such ar 'tration as provided In Massachusetts General Laws,chapter 142-A. ,. Con (��`ttoesll Signature Ho e0wnees Signature onl to the agreement of the parties to alternative dispute NOTICE:The signatures of the parties above apply y r. The homeowner may initiate alternative dispute resolution even where this resolution initiated by the contracto section is not separately signed by the parties. Homeowner's Rightsment Contractor GL chapter 142A)and other consumer A homeowner's rights under the Home Improneott be waived in y way, by agreement. However,homeowners protection laws(i.e.MGL chapter 93A)may registered as prescribed by law- may be excluded from certain rights if the contractor they choose is not properly regi Fund provisions of completingible for the work as described,in a Homeowners who secure their own building permits are automatically excluded from all uaran the Home Improvement Contractor Law. The contraccte entitor is led to other spec pons fie legal rights if the contractor timely and workmanlike manner. Homeowners may or materials. In addition to guarantees or warranties guarantees or provides an express warranty for workmanship sed warrant},to merchantability and fitness for provided by the contractor,all goods sold in Massachusetts cant'he implied a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree maybe consumerlhomeowner rights,contact the Consumer Information Hotline(listed below). 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 Execution of Contract enced The contract must be executed in ete aanlso advised nQbto Sime thdocume t until all blbank its sectiofnsrba a been documents have been attached- of the contract with attachments is to filled in or marked as void,deleted,or not applicable• One original signed copy be given to the owner and the other ed work ma not begin until both parties have rentractor. Any modification to the ceived a fully executed copyoing f and agreed to by both parties. the contract,and the three day rescission period has expired. Accelerated Payments a ent schedule in cases where the A contractor may not demand Payments in advance of the dates specified on the tancesp yin homeowner deems him/herselfto be financially insecure.that the balance of funds IID Y beowever,inins placed deemswhere a contractor a int escroweslf to be financially insecure,the contractor may require account as a prerequisite to continuing the contracted work Withdrawal of funds from said account would require the signatures of both parties. Additional InformationImprovement Contractor Law or If you have general questions or need additional information about the HomeMassachusetts Consumer Guide to Home Imp ovement" consumer rights,or if you wish to obtain a free copy of "Acontact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 ParkPlaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at httn:=''+tip�`• la" "`"?``tb' specifically If you want to verify the registration of a contractor or if you have questions or need additional information 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 617-973-8787r 888-2833-3757 or visit the BIC website at litu?:+s«�� •'`•'`"'i0�'"``ti'r Go online to view the status of a Home Improvement Contractor's Registration: httn;rdtstate.ma.r. /lx;meimnro�°cm�n�'t1C2nSl'tL;t.a;? 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 508-652-4800,508-755-2549 or 413-734-3114 Version 2-1-11/27-1-1010 John ,'hforan. Construction, 1.').LC,. (81,tilding andAetizod'eling 21 Evergreen Drive phone 603-329-6209 14ampstead,N11 03841 fax 603-329-6209 March 2, 2016 Paul Hedstrom 30 Oakes drive. North Andover, Ma. 01845 Dear Mr Hedstrom: This is a proposal to remodel your bathroom as follows: 1. Remove tub, shower, cabinets and toilet. 2. Remove tile on the floor and walls. 3. Replace drywall that was removed with wall tile. 4. Frame area around tub to support tub deck. 5. Cover walls in tub area with poly and cement board. 6. Cover floor area with cement board. 7. Install cabinets and tub surround. 8. Install new baseboard to match existing as close as possible. 9. Install tile and grout on the walls around tub. Tile and grout not included. 10. Install tile and grout on the floor. Tile and grout not included. 11. This includes the plumbing work and the fixtures on the Peabody supply list. Toilet and under mount sink are not on the list. 12. Electrical work includes an exhaust fan and hook up for tub. 13. This estimate does not include the shower door,tub deck, countertop and installations. 14. Disposal of all debris included. 15. No painting included. 16. 1 will apply for permit. Cost: $14,751.00 Respectfully submitted, John Horan Page 1 ISS State of Massachusetts Home Improvement Contractor License#102071 State of Massachusetts Construction Supervisor License#47989 1 0 -- -- --------------- 7 WOODMODE 84 FRAMELESS CABINETS EMBASSY RAISED PANEL DOOR STYLE ca FINISH: BATH.ALCI- 90" .72-R CEILING HT TO SOF HANGING HT:87" MOUDLINGS MBB805 WITH MCR8218 00 SHOW.D.CSHOW.D.OFRM.EXP U-) C4 ro Cl) 0) TOIL. ---I:l D1 8_872, BVBD13-3421 L C\I 0_ CA) All dimensions-size designations !LUCYROSS This is an original design and must Designed: 10/31/2015 given are subject to verification on JACKSON not be released or copied unless Printed: 12/1/2015 job site and adjustment to fit job KITCHEN applicable fee has been paid or job conditions. DESIGNS order placed. HEDS TROM, BOBBY AND PAUL All Drawing#: 1 Scale : 09 " = 11 The Commonwealth of Massachusetts z . F Department oflndustrialAceldents " ;5 I Congress Street,Suite 100 t:M='e tl `Y Boston,MA 02114-2017 www.mass.gov/dia sy Workers'Compensation Insurantce Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY,Applicant Information c I Please Print Legibly Name(Business/Organization/tndividual): .J��r� HorevA Cans lryc.troA I„L C .Address: 1 F;�Cru Caen �t r a e- City/State/Zip: a .s"vk W.A ®3 Phone#: ( b 3 3M -- &d-0q Are you an employer?Checktlic appropriate box: Tyne of project(x'equired): L�T am aemployerwith �loyees(full and/or part-time).* 7. Q New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in 8. [ memo dellhg any capacity.[No workers'comp.insurance required] 9. ❑Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.dr suranca required.] 10 (]Building addition 4.F]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 withno employees. 12.F]Plumbing repairs or additions 5.❑I am a general contractor and I bave hired the sub-contractors listed on the attached sheet. 1. .0 Roof repairs These sub-contractors have emplogees and have workers'comp.insurance.t 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we haye lick Mo Mo workers'comp.insurance required.] `Any applicant that checks box#1 must:also fill out the section below showing their workers'compensation policy information. i Homeowners who sAbniit this affidavit indicating they are 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 state whether or not those entities have em'fiavo ' y'ees,'they must provide their workers'comp.policy numb employees. Ifthe sub-contraer. I am an employer that is pi aiddlizg worhm'compensation insurance formy employees.'Beloiv is the policy and job site information. -`� Insurance Company Name: �nS r 1c:tl-A C-Z>rn P CW.)Ny — Policy#or Self-ins,Lie.#: OTC- 700�,�7 _ ExpirationDate: ��� 1201 Job Site Address: ?() City/State/Zip: 41&& AjG1111 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration elate). 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 WORD 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 herehy cert! under'the pains andpenalties ofperjury that the information provided a_hove is true and correct. Si nature: .-�_ Date: . Phone# ��3� oZ " (aaZ 6 Official use only. Do not write in this area,to he 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#: Client#:490547 JOHNHORA ACORD.R CERTIFICATE F LIABILITY INSURANCEDA 4//06/206/2DD/YYYY) 016 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(les)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 NAME* Lori Hay Ext#12909 USI insurance Services LLC PHONE 855 8 14-0123 AIX No):877-775-0110 A/C No Ext 3 Executive Park Drive,Suite 300 a DRIES&: Loreen.Hay@usi.biz Bedford,NH 03110 INSURER(S)AFFORDING COVERAGE NAICI 855 874-0123 INSURER A:Maine Mutual Group Insurance Co 15997 INSURED INSURER B:EastGuard Insurance Company 14702 John Horan Construction LLC INSURER C: 21 Evergreen. Dr. INSURER D: Hampstead, NH 03841 INSURER E 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 CONDITION OF ANY CONTRACTOR 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. lNSR TYPE OF INSURANCE lNSR WVD POLICY NUMBER SUBR POLICY EFF POLICY EXP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY SC10955638 4/01/2016 04101/2017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE [)d OCCUR PREMISES Eao�ErDenceS25O OOO MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY 51,000,000 GEN'LAGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE 52,000,000 PRO- PRODUCTS-COMP/OPAGG 52,000,000 POLICY❑JECT 0 LOC S OTHER: ED A AUTOMOBILE LIABILITY KA10955638 4/01/2016 04/01/201 a'den SINGLE LIMIT 51,000,000 ANY AUTO BODILY INJURY(Per person) S ALL OWNED X SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOOWNED PROPERTY DAMAGE $ X HIRED AUTOS [.XJ AUTOS Per accident S A U UMBRELLA LIAB X OCCUR KU10955638 4/01/2016 04/01/2017 EACH OCCURRENCE S1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE S1,000,000 DED RETENTIONS $ B WORKERS COMPENSATION JOWC700557 4/01/2016 04/01/201 X PSTATUTE ER DTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $500,000 OFFICERIMEMBEREXCLUDED? a N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE SSOO OOO "yes,describe under E.L.DISEASE-POLICY LIMIT 5500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) This certificate covers all operations usual and customary to the insured's business. This Evidence of Insurance is issued as a matter of information only and confers no rights upon the holder and does not amend,extend or alter the coverage afforded by policies designated on the Evidence. CERTIFICATE HOLDER CANCELLATION John Horan Construction LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 21 Evergreen Drive ACCORDANCE WITH THE POLICY PROVISIONS. Hampstead, NH 03841 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.Ail rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S17622357/M17622353 LMHCX � ���c (f.o��t1N v»tornl��a/C?l�adJ�ic�trJr/tJ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only i'260ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: (W egistration: <102071 Type: Office of Consumer Affairs and Business Regulation p,Expiration: 6/30/2016 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 JOHN V.HORAN CONSTRUCTION John Horan 21 EVERGREEN DRIVE HAMPSTEAD,NH 03841 Undersecretary �Notvalid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-047989 Construction Supervisor JOHN V HORAN 21 EVERGREEN DR. HAMPSTEAD NH 03841 -�-r Expiration: Commissioner 03/02/2018 L