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HomeMy WebLinkAboutBuilding Permit # 6/27/2016 BUILDING r��, IIT o� �,oRro-� q wt.gL@D 4 "YO TO OF NORTH DOVER �� 6 APPLICATION FOR PLAN EXAMINATION ® _ Permit NO#: Date Received ✓ e `Z,$Rq� r'e`o rPp,ct`� Ss�Cwus� Date Issued: 7— IMPORTANT: Applicant must complete all items on this page LOCATION D 4 Ct L Print PROPERTY OWNER fir. + rV\ \.r �,r ` C-C Print 100 Year Structure yes MAP 1 PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building k'One family ❑Addition ❑ Two or more family ❑ Industrial A,Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain q Wetlands ❑ Watershed Distract )Nater'Sealer DESCRIPTION OF WORK TO DE PERFORMED: S 1\ 1-e C.Cc. Identification- Please Type or Print Clearly OWNER: Name:-Tc-. Lrr� r;^.J Phone: G j F k j- q t,v 15 Address: `f�t g 1 }�r� LC.V, Contractor Name: �'>�� �-e 's+vgth Phone: ,' - G 9 Email: 3c F J 9- c ,c s-�r < r" e- Address: . $, � � 5:y c r Supervisor's Construction License: C S o -i'l ' Exp. Date: G S r Home Improvement License: (a G Exp. Date: ARCHITECT/ENGINEER >d_cf G (>e— Phone: i- Z- 3— a �b Address: rv,�-'� 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: $ 2—i3 FEE: $ , Check No.: �_/ Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund N®RTH Town offAndover • V2 '26 Y Z o LAKc h t ver, asS9 COC«ICtQ x.95 RATEO I'B�,`°�5 U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT #f.4!"� 6ewmeA/,. BUILDING INSPECTOR Aft has permission to?erect .... ........... buildings on ! I, Foundation ....... .... ... ... ..... ............. ... Rough to be occupied as /. ................................................. Chimney provided that the pn ccepting 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 PERMITI I T • ELECTRICAL INSPECTOR UNLESSI S Rough ervice ""' Final BUILDING TOR �D GAS INSPECTOR ccLdeancy PermitRequired to Occupy Bu ldin 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. TE,S TA Building and Remodeling Start date 5 APPLETON STREE'r Finish date NORTH ANDOVER , MA 01845 lie. °120296 Expires, 11119/117 (978) 682 2023 C Lic. CS 54718 Expires, 6/8118 Piro osal June 23, 2016 Proposal Submitted To: Arthur and Tammy Griffin Home Phone : 978-8214605 249 Carlton Lane North Andover, MA 01845 Job: Install Beam in kitchen Obtain building permit. Complete removal of all demolition and construction materials generated By Testa Building and Remodeling and its subcontractors. CONSTRUCTION: Remove the wall between kitchen and Sun room install the beam according to structural plan that the home owner received from their structural engineer. PLASTER: Hang Y2" blue board on the ceilings and the walls that will be disturbed. Skim coat plaster will be applied to all disturbed areas. COUNTER TOPS: New granite counter tops supplied and installed by others. ($9500) PAINTING: Painting ceiling,walls and cabinets to be done by others. ($5500) A finance charge of 1!/2%per month(18%per year)will apply to all accounts over 30 days past due. In the event collection activity is required the customer shall be responsible for all costs associated with collection,including reasonable attorney's fees. I propose hereby to furnish material and labor complete in accordance with above specifications, for the sum of: $5,275 Five Thousand Two Hundred Seventy Five Dollars One-third to start, one-third after rough inspection, one-third upon completion. Authorized signature I reserve the right to cancel this contract if not accepted in-30–days M, SignatureV1!G Signature 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 fust 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 ConsumerAffairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work. MGL chapter 142A.) Express Warranty-Is an express warranty being provided by the contractor? 1 No 11 Yes(all terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the 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 agreement. 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 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 617-973-8787 or 888-283-3757. •Does 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. •Know 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 office 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 SPACES!!! T o identical copies of the ntract must,be completed and signed.One copy should go to the homeowner.The other copy should be kept by the contractor. o eo a 's ture n ctor's Signature 6i /�` �y 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 >42A. Homeowner's gMiu,re Cont or'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 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 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 5 170,Boston, MA 02116 617-973-8787, 888-283-3757 or visit the OCABR website at littf.)://www�inass.gov/(bcabi��/ 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 litip://www.inass,go ,/ocal)l,/ Go online to view the status of a Home Improvement Contractor's Registration: http://db,statc,n'ia,LisAioiiieii'ii'l)rof(effi(,iitJlicenseelist.as 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 2.1-11/22/201 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 CANCELED. 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 DESPISE 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: C.-tZtr-p 1 H R.5 t ve,\ Ge ZO (-P,Ri-ToA) LAivE N-A, t h 39 6K- ( EcT $cope-; coA.4tsr op A.DDI X Luc, BrAr t Ar Naw ope&diivc, GN WA-u- s el-wEeiv til`I`CM n l A.,%.,D 4. %M(4�,o N Poo(%-, 4 5 eocw .9"in Arric It a t Ott*= Lot- t L�6 t 4�-0 5 \dp t.-Vs N2AT2i2-A-cft5 I To LV L W� PIN$t MP$DpjZ-4x4- w tt4 P419 OF C4PS to _a(. 5tr'",PSoq 'TO LVL Norr-5 f) LUL -50161 CONRlEC r t-Ot- S -r0CCtNr-R wITN Z JkawS S�,Fv►PSc��.+ 31/8 tL o wa 5 O W. Z 2 3 88 5 caEws � iZtioc of 0 o a 12„h tZtt � �:ftN T'tNJ�° 2} 6t.OG1c S T SALst T'4RO Ft-OOR .FVxAmt&)C TO t=t +�dAf�t?w� �t+�t_ TreCottit LAWRENCE H.OGDEN.P.E. 198 EAST MAIN STREET GEORGETOWN,MA:01833 978-352-8318,cell 978-502-5921 ® E(MM/DD/YYYY)A CERTIFICATE LIABILITY INSURANCE A 6/24/16 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 CONTACT NAME: Rich Testa R.W. Testa Insurance Agency, IPHONE FAX (978) 685-1150 AI No: (gig) 681-9002 855 Turnpike Street EMAIL ADDRESS: rich@testainsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# INSURER A:COMMERCE INS CO INSURED INSURER B: Testa Building And Remodeling INSURER C: 5 Appleton Street INSURER D: North Andover, MA 01845 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 CONTRACT OR 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD/Y MM/DD/YYYY LIMITS A GENERAL LIABILITY 516388 6/1/16 6/1/17 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PR E ES Ea occ r n e $ 100,000 CLAIMS MADE Fx—I OCCUR MED EXP(Anyone person) $ 5,000 PERSONALSADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMITAPP LIESPER PRODUCTS-COMP/OPAGG $ 21000,000 POLICY JE LOC $ AUTOMOBILE LIABILITY COMA INED SINGLE E L IM IT a accident $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS eraccident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ I $ WORKERS COMPENSATION WCSTATU-JMITOTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTIO N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) 249 CARLTON LANE, NORTH ANDOVER, MA 01845 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. 1600 OSGOOD STREET NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE RICHARD W TESTA JR ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: The Commonwealth of Massa chusefts .Department of IndustrialMccidents - d I Congress Street,Suite 100 Boston,MM 02114-2 017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectlricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information ry Please Print Ledbly Na7[Tl.e(Business/Organization/Individual): �� v• `C%�r` r'J v ti" @ 'yj Address: 5 ��p C `�-r- City/State/Zip: City/State/Zip: Phone Are you an employer?Check the appiropriaie box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition I❑I am a homeowner doing all work myself[No workers'compAnsurance required.]t 10 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. ❑ 13. Roof repairs These sub-contractors liave employees and have workers'comp.insurance.1 ❑ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.F1 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#his 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 employees. If the sub-c'n6ctors have employees,hiey must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.'Beloiv is thepolicy and job site information. Insurance Company Name: Policy#or S elf-ins.Lie.#- Expiration Date: Job Site Address: City/State/Zip: l 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 ofperjufy that the information provided above is true and correct. Si nature: �'-r Date: Phone#: R:,-, Official use only. Do not ivrite 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#: �-/hC (-,0 7J7(J7L6tL'CCr/f� JC(Ck(JG'l rte—Office of Consumer Affairs&Business Regulation 1- HOME IMPROVEMENT CONTRACTOR Registration: 120296 Type: it Expiration: 11/19/2017 DBA TESTA BUILDING&REMODELING I� JAMES TESTA 5 APPLETON STREET N.ANDOVER,MA 01845 Undersecretary I Massachusetts'Department of Public Safety Board of Building Regulations and Standards License: CS-054718 Construction Supervisor .rJ JAMES M TESTA 5 APPLETON ST N ANDOVER MA 01845 Expiration: Commissioner 06/08/2018 r