HomeMy WebLinkAboutBuilding Permit # 5/31/2016 Ch
1L.DING PERMIT
N OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINIM"ION
Permit N01a Date Received----__..------- ATOD X
ACH
Date Issued:
IPO RTANT: Applicant must complete all items on this page
RTAN-.
LOCATION 'lL
Print
PROPERTY OWNER
Print
MAP NO- -1 —PARCEL? ZONING DISTRICT:.Historic District yes
-465' Machine Shop Village yes 0
TYPE OF IMPROVEMENT PROPOSED USE Non- Residential
Residential
[I New Building One family F-1 Industrial
r_-J Two or more-family
PE F IMPROVEMENT
wilding
n
TYPE
Bul
w
[I Additio.n No. of units-- Li Commercial
,K- Alteration
i i Assessory Bldg i i others:
I I Repair, replacement
Ei Demolition El Other
epic i �Well i � Flood lain i i Wetlands i Watershed District
i—c
0 Water/Sewer
ryN a S'�e'
d2 tl-
C c'r
Identification Please Type or Print Clearly)
C_LLL : Q, tO
�XOWNER: Name: Phone
C,
Address:
CONTRACTOR Narne: ---.Phone:
N'W 0
hoe'
[AddreMOssm
:
x
i Da
Suporvisor's Cqnstruedon License:C_ 0'7004N Exp7i5a
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H0vIrripro veent Lis enExp. ate
se: 15-1qqq
ARCH ITEC ENC IN Phone:______
Address: Reg.
FEESCHEDULE:BULDING PERMIT.,$12.00 PFR$1000.00 OF THE TOTAL ESTIMATED COro TBASED ON$125.00 PFR S.F.
00 _FEE:
Total Project Cost: $_a�
eceipt No.:--
�7 �
Check No.:— __L c ' to t1ge guaranty fund
�Jrwseredcontraclor donothaveac ess
NOTE: pt?,�,votws conYracting with
Sipature of contractor
'�Signature of AgentJOwn kt e�_z-"-:
t%ORTH
,,
Andover
Tow of
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T ver, SS9
® . LAKE A.
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BOARD OF HEALTH
PERMIT LD Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES WHAT ........ '.:. .......... J�.
""'•"• ��•��• ®n •.' Foundation
buildings .......... ....................................... Rough
has permission to erect ......................... g .. .... .. ...
�� lb . 1.77 / ........................ Chimney
to he occupied as . .........°° ) . .9 ..
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 PLUMBING INSPECTOR
Construction of Buildings in the Town of North Andover.
Rough
VIOLATION of the Zoning or Building (Regulations Voids this Permit. Final
PERMIT IN ELECTRICAL INSPECTOR
CONSTRUCTION
UNLESS Rough
Service
i
.;^.�,,.f................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
CCu2ancV Permit Required to Occupv Buildinor Rough
Final
Display
in
c'Conspicuous
lac the Premises t EIRE DEPARTMENT
No Lathing r Dry Wail To Be Done
Burner
Until ec aApproved the Building Inspector. Street No.
Smoke Det.
t%ORTH
Town of
Andover
— o
ver, Mass,
"�A-rED 01? -7
BOARD OF HEALTH
Food/Kitchen
Septic System
PERMIT TBUILDING INSPECTOR
THIS CERTIFIES THAT ........r M. y'/. .............. .. ................................././..............................................
r ®�Ccj /'.:... ............................... Foundation
has permission to erect .......................... buildings on .. �. .
t � G 7W
�i �fj Rough
/ /
tohe occupied as .................P.... .... .................... .��:.p................................................................ Chimney
provided that the person accepting this permit shall in eve respect conform to the terms of the application Final e
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and PLUMBING INSPECTOR
Construction of Buildings in the Town of North Andover.
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit. Final
PERMIT I IN 6 MONTHS
ELECTRICAL INSPECTOR
CONSTRUCTIONUNLESS STARTS Rough
Service
i
........... ... ....., .... .:::��................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
ccupa cE Permit Required to Occupy Buildin Rough
Display in a Conspicuous Place on the Premises - Do Not Remove Final
Lathingr allBe Done FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
Boston,MA 02-114-2017
�r wwmmass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectriciansIPlumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibl
� y_
Name(Business/Organization/Individual): at S_U" (Ylcnc 1ee"A
Address: -71, prev c/en'-e V1,11 12-]
City/State/Zip: N4 C, '��'( Phone#: 6o_"0'ti°-
Are you an employer?Check the appropriate box: Type of project(required):
lQ'I'am a employer with -,I— employees(full and/or part-time).* 7. 0 New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. 'Remodeling
any capacity.[No workers'comp.insurance required.]
9. 0 Demolition
3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
10 0 Building addition
4.0 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 11.0 Electrical repairs or additions
proprietors with no employees.
12.[]Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other
152,§1(4),and Nye 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. If the sub-contractors have employees,they must provide their workers'comp.policy number. '
I arrr art employer t/iat isproviding ivor/vers'coniperrsation insurance for rrry employees. Below Is thepolicy andjob site
infor'Ination. /� (�
Insurance Company Name: ArtDC 'J` P11 le LLI,
Policy#or Self-ins,Lie.#: Expiration Date: ����6
Job Site Address: __7 �c�cw c`J r vii City/State/Zip: )V Andrverl-
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.
Tdo hereby cerihyj r oder the palms andpenaltiNc ofper;jury that the it formation provided above Is true and correct.
Signature: Date:
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#:
Board o`Budding
LJcc�nse: CS-070043
JONATHAN OSUP",W
185 Atlantic Ave 94
Salisbury MA 01-952
i yl
08126(2016
Office of Constufter Affairs&Business Regulation
p HOME IMPROVEMENT CONTRACTOR
'
Registration: 159444 Type:
Expiration: 4/30/20.18 Private Corporation
JOSCON MANAGEMENT INC.
JONATHAN O'SLIWVAN
72 PROVIDENCE HILL RD,
ATKINSON,NH 03811
Undersecretary
BUILDING & REMODELING
CANT R A C T
MASSACHUSETTS HOME IMPROVEMENTS CONTRACT
This form satisfies all basic requirements of the 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 Nome 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 Company Name
Mr.8 Mrs.Wird
Uaaaon Management,h)c
Street Address(do not use a Post Office Box address) Contractor/Salesperson]Owner Name
71 Foxwood Drive Jona an C'Salhvan
City(Town State Zip Code Business Address(must include a street address)
North Andover,MA 01845 185 Atla*Avenue
Daytime Phone Evening Phone 978821.7267 City/Town State Zip Code
Email:mewirtz@acomcast,net Sal0ur7,MA 01952
Mailing Address(It different from above) Business Phone Federal Employer ID or S.S,Number
503.489d999 51-1494191
Home Improvement Contractor Reg,Number 199444
Expiration date 00-2018
The Contractor agrees to do the following work for the Homeowner,
(Describe in detail the work to complete;specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.)
Master Bathroom&Closet
The following scope of work has been developed based on renovating the existing master bathroom per sketch. Work to include re configuring the bathroom
per sketches provided by Mary,
Scope of Work
0 Building permits per the Town of N Andover.
0 Temporary protection and daily cleanup throughout the remodeled areas.
® Demolition work to include the following: Removal of the flooring tile,shower unit,wallboard at the tile wall tile areas,tub unit,vanity,wail removals
per sketch Disposal of all construction related debris.
® Remove the existing sub flooring at the new plumbing locations to access plumbing for the new layout and cads upgrades.
0 Rough carpentry to include re configuring the existing bathroom per the new layout including the door openings. Minor framing adjustments in the
floor for the new plumbing supply runs.
® Insulate and fire caulking as needed.
U Install new' "blue board on all new walls and disturbed areas. Ceiling to be overlaid with 3/8°blue board. Blue board to be plastered with a
smooth ceiling finish. Depending on the actual disruption to the ceiling,we may be able to patch and skim coat the ceiling. TBD,
o Frame for a new the shower unit per layout including the water closet room. Install a pre-fabricated shower base unit supplied by owner. O
Q Install homeowner purchased bathroom towel bars,robe hooks and toilet paper holder.
0 Plumbing work to include disconnecting the existing shower,toilet,tub and vanity sink. Re configure the existing plumbing for the new fixture
locations, Code upgrades may be needed and further exploratory work needed to determine once the sub flooring has been removed.
0 Plumbing fixtures by others.
a Electrical work has been figured on code upgrades throughout the bathroom,rework the existing electrical at the wall removal area. Install
homeowners supplied vanity lights,recessed lighting and bathroom fan vent. Add a 20 amp circuit receptacles per code. Install 2 shower recessed
lights,6 general recessed lights,four low voltage wall lights and fan/heat light. Walk in closet light.
a Carpentry work to include window trim and install(1)new pocket door ung. Master closet shelving re configuration TBD. Materials TBD.
a Install a new vanity and associated hardware supplied by the owner.
a Install file backer board throughout the bathroom floor area,shower and bathroom walls per sketch. Tile materials and bench seat by others.
a Install Laticrete anti fracture Strata Mat on the bathroom floor.
a Waterproof shower walls vAh Laticrete Hydro ban waterproofing.
a Install new homeowners purchased tile throughout the bathroom area per sketch. Tile baseboard has been figured in the closet area.
a Install a shower glass door system per sketch. Additional specifications needed. Door allowance listed below. Final amount TBD.
a Painting throughout the bathroom area. Painting included on the master bedroom wall side of the bathroom
a Final post construction cleaning throughout the project area.
Allowances: by others
a Plumbing futures by others
6 Vanity including the top by others
a Tile floor(Materials) $3,200.00
• Shower glass enclosure TBD
Total for the above scope of work including the Allowance amounts: $28,490.00
Required Permits— Building permit Proposed Start and Completion Schedule-The following
schedule will be adhered to unless circumstances beyond the contractor's
control arise.
(Owners who secure their own permits will be
excluded from the Guarantee Fund provisions of 5-23-16 Date when contractor will begin contracted work.
MGL chapter 142A,)
6-30.16 Date when contracted work will be substantially completed.
Actual start and completion will be determined once all materials are
on site, Shower door install will add a week from the completion date
above, Glass template can't be done until all the shower file work has
been completed. Template to actual install typically takes 2 weeks,
Total Contract Price and Payment Schedule
The Contractor agrees to perform the work,furnish the material and labor specified above for the totals of:$28,490.00(�)
Payments will be made according to the following schedule:
$2,849.00 10%Deposit Upon signing contract, (not to exceed 113 of the total contract price or the cost of special order items,whichever is greater)
$5,698.00 20%Upon the start of the project
$8,547.00 30%Upon the of the completion of demolition and rough in inspections completed,
$8,547,00 30%Blue board I plastering completed and the start of the work.
$2,849.00 10%upon substantial completion of the contract.Shower door install(Law forbids demanding full payment until contract is completed to both
party's satisfaction)
The following matedallequipment must be special$0 to be paid for NIA
ordered before the contracted work begins in order to meet the completion schedule.(")$0 to be paid for NIA
NOTES:(*)Including all finance charges(")Law requires 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.
s(all terms
the warranty must be
ched to the cOntf 8ct)
Express Warrant•Is an express warranty being provided by the contractor? [N®� described regardless
Bless of/he actions of anythirdpartylsubcontractor
Subcontractors-The contractor agrees to be solely responsible for completion of the worke9
utilized by the contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement
Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within Ns 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.
TDon't be pressured into signing the contract Take time to read and fully understand it Ask questions if something is unclear.
Wake sure the contractor has a valid Home 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 617-973.8187 or 888.283.3757.
Moes the contractor have insurance?Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to
see a copy of a"proof of insurance"document.
TKnow your rights and responsibilities.Read the Important Information on the reverse side of this form and get a copy of the Consumer
Guide to the Home 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 once or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the
third business day following the signing of this agreement,See the attached notice of cancellation form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACESttI
Two identical copie ton must be completed and signed.One copy s Id go to the homeowner.The other copy should be kept by the
'contrac
Ho /jo ne S e Con is Signature G
rh 6_ �—
Date D
Contractor Arbitration
The Home Improvement Contractor Law provides homeownautomaticallrs with the n aht to ffordedt o a contractoate an r,however.on The contractor would have to resolve
they have a dispute with a contractor.The same right is no y
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
that
beenthe
approved by the contractor
Secretary of the Executive Office othis
f Consumerhe
ccontractor may submit the dispute to a private arbitration firm which has
Affairs and Business lation and the consumer
chapter 142A. shall be required to submit to such arbitration as provided In Massachusetts General Laws,
r
4 g
aors Signatureo
mewn at
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 homeowners rights Linder 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 contractor 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 homeowners 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 tee copy of"A Massachusetts Consumer Guide to Home Improvemenv'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 hgoWwww.mass.gov/oclbr/
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
617973-8787,888-283.3757 or visit the HIC website at i'ittp://www,u'nas,,�;.gov/(x(�ibr/
Go online to view the status of a Home Improvement Contractors Registration:http:116.state.ma usfhorr6 mproven�end iU-.,nseehst.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
508.652-4800,508-755.2548 or 413-734-3114