HomeMy WebLinkAboutBuilding Permit # 6/22/2016 �AORTH
,BUILDING PERM11T
TOWN OF NORTH ANDOVER 00
APPLICATION FOR PLAN EXAMINATION
V,
Permit No#,: " Date Received ppRArcD C,7
U5
Date Issued: TJ
AL 11
IMPORTANT: Applicant must complete all items on this page
x
„� � at , r�7 w li%�y„/, r�, ✓r U//��i/�, a ,,,,,,,/�„/°� ilrf ,,,,.../ .r,/, rr„vr//</�//r//,Gu„r,�i///a i� / ,i,//r/
1'wyl
ono'
,
Mae.
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
0 New Building El One family
El Addition Li Two or more family El Industrial
iii-Alteration No. Of units: 0 Commercial
El Repair, replacement Ei Assessory Bldg 11 Others:
11 Demolition 0 Other-
W anDistrictK,
p
t
I d h,
"A g,
p
?
t6
101,1111/1,/#91/1"',
DESCRIPTION OF WORK TO BE PERFORMED:
L T
Identification - Please Type or Print Clearly
OWNER: Name: e- 0 rL r-* L^/ Iq (-/-,e AJ Phone:
Address: I ;L 01 We V L P11v r,> C- 1 dz-c- n1v-Dav”
Contractor Name CiPhone
..........
"31
X
P
00
"NA/P
Home;ImP, 114/ P ,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 Coat: $ a 0 FEE:
Check No.: IS L11
" 'C2 Z 4--e Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the gua wntyfund
4r,e of Agent/Ownrlgnat4tare of r
contras
rJAORTH
Town of oAndover
® t
-rool
® —
gj(A.Jf
o ,,Ka h ver, M SSy
coc"Ic"IWICK
®� 0 RATED /`P�`,`'��
U BOARD OF HEALTH
Food/Kitchen
E rtm 11F TU LD Septic System
26(
0
THIS CERTIFIES THAT ,,,,,,,,, ,,, ,, .. ... .. BUILDING INSPECTOR
................................... .....................................�................,.....
... .., Foundation
has permission to erect .................... .. buildings on ..........:.. ................ A, J.. .......... ...... . ..
Rough
tobe occupied as ........... .. ..................... .....................• .................. ............:.................................... Chimney
provided that the person ac epting 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 CONST TION S Rough
Service
.. ... ...... . ..... ....... ..... ......... ..... ............ Final
BUILDI INSPECTOR
GAS INSPECTOR
Occupancy Permit Required t® 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 Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
This forni satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard
min
Seek
k if necessary. Any person planning home improvements should first obtain a copy of"A
cc homeowners.0 Ho
g tray
tilling the
language to protect homeowners- Seek legal advice
'I ' -t at.h arty work oil your residence.You 11 y obtain a free copy by c�
Massachusetts Consumer Guide to Home improvement"before agreeing to at
usi -973-8787 or 1-888-283-3757 or oil our website.
is
Office of Consumer Affairs and Business Regulati on's consumer Information Hotline at 617
Contractor Information
Homeowner Information
Name Company Name
0 K 14 _j C qe�o A_e—LI
Street
Contracti.1 Salesperson/owner Name
A�dd,.s(dua._Fu_w a-F-WCtilike Be-address)
2 q W 9:1 L Wj 4)
City/Town StateZipCode Business Address(must include a street address)
41vilov,cm- WA 01Vqs-
VL —Slale —ZipC—cde'
Cit/Town
Daytime Phone Evening Phone
--I79 —q,784 Business Phone Federal roployer ID or S.S.Number
MailingAid—dress(It different from above) 1,W,unera Contmror Reg.Nt'IM E,Tii.twn&Ic
-7//7 la ol/6
The Contractor agrees to do the following writI for the homeowner:
,and grade of materials to be used,use additional sheets ifnecessary.)
(Describe in detail the work to completed,specifying the typ
3ij,L 1> eo&N C It Cbrandr -4
F, L V/
Required Permits-The followijigbuilding permits arere7qtiired Proposed Start and Completion Schedule-The following schedule will
1.
er's agent: be adhered to unless circumstances beyond the contractor control arise
,old will be secured by the contractor as the limilcow"
(owners who secure their own permits will be
AoAte when contractor will begin contracted wo&
excluded from the Guaranty Fund provisions o
MGL chapter 142A.) �t,%�r/,7RkDate when contracted work will be substantially completed.
Total Contract Price and payment Schedule A 0
The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of:
Payments will be made according to the following schedule:
$ 1040 0 1 00 upon signing contract(,lot to exceed 1/3 of the total contract Price or the cost of special order items,whichever is greater)
ROU'l
$_L �* *V by or upon completion Of
$ P700 by or upon completion of
___L — e4 o both party's satisfaction)
upon completion ofthe contract. (Law forbids dein ling full payniei�'uitil contract is completed t
to
be special to be paid for
ordered before the contracted work begins in order $
4 to meet the completion schedule.(") to be paid for
t NOTE'S:(4)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 litany special equipment or cus(ona made material
which must be special ordered in advance to meet the completion schedule,
ontractor? 0 No Q Yes(all terms of the warranty most he antiched to tire contra
cll
Ex ressWarran Is it express warrant responsiblby the e for completion of tile work described regardless of the actions of any third
-actors-The contractor agrees to be solely
Subcontractors to be solely responsible for all payments to all subcontractors to'"
party/subcontractor utilized by the contractor. The contractor further agrees
materials and labor under this a rree reat
Contract Acceptance-Upon signing,this document becomes a binding contract trader law. Unless otherwise noted within this document,the
contract shall not imply that any bell or other security interest has been placed on the residence. Review the following cautious and notices
carefully before signing this contract.
• Don't be pressured into signing die contract.Take time to read and fully understand it. Ask questions ifsomething isullelm. rs and
• Makesure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors
subcontractors to be registered with the Director of Nome Improvement Contractor Registration, You may inquire about contractor
o the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757.
registration by writing t
• Does the contractor have insurance? Ask the Contractor for his insurance company informationso 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 widget a copy of the Consumer
Guide to the Home Improvement Contractor Law.
d at a place other than the contractor's normal place oftiusiness,provided you notify the
,I this agreement if it has been signe In 11 Igi 11
Full aycrmce it posted,by telegram sent or by delivery,not later than i idi i it of e
contractor
tractor in writing at his/her main office or branch office by ordinary it right.
third d t.",s..'essda,,follo)miiii,tliesigiiinfloftilisa6reenient. See the attached notice of cancellation form for an explanation of this 9
DONOT SIGN THIS CONTRACT11' IjI___ARE ANY BLANK SPACES!!!
contractor.
Tevo identical copies of the contract must be completed and signed.one copy should go to die hoincowner.Tire other copy should be kept by the
"
ol,
Signature ractor's Signature
��51Q�f
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 AtTairs and Business Regulation and the consumer shall be required
to submit to such arbitration as provided In Massachusetts General Laws,cha r 142A
Alome., i4ere'sSignature C4dractorrs 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
maybe 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 consurner/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.Conti-acted 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/lierself
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 patties.
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 hUp,
..._A
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
Go online to view the status of a Home Improvement Contractor's Registration:
flrctrtzwtsrr wovement/license dJst.� p
---—----------
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
NOTE:When finishing the area;.round the hood,5/8"clearance above hood is required for hood installation.
E
F� J Hood I K
I I C
f j A D B Junction
K I box access
Blower
—f access panel access
I
0.. (both ®M
H sides)
Top View Front View left Side View Right Side View
Model A B C D(door) E F G H I J K
Model 3218(816) 28314(730) 221/4(565) 323/8(8 35114(895) 2 (635)- 1212(317) 32 7/S(835) 67/8(175) 17(432) 101/6(
G� 40"Madel 371/8(943) 331/4(845) 271/4(692) 373!8(949) 401/4(1022) 30(762) 15(381) 377/8(962) 67/8(175) 17(432) 101/6(256)
45"Madel 371/8(943) 331/4(845) 271/4(692) 423/8(1076) 451/4(1149) 35(889) 1712(445) 42 7/8(1089) 67/8075) 17(432) 101/6(256)
Minimum clearances* Wall Finishes/Surrounds/Mantels
Back 1"(26mm)towrapper for 45"models,all others 112",13mm) NOTE: Combustible wall finish materials and/or surround materials
to wrapper-0"(0mm)toSpacers must not be allowed to encroach the area defined by the fireplace
Sides 12" 13 mm)to wrapper front face(black sheet metal).Never allow combustible materials
o"f03
mm)to Spacers to be positioned in front of or overlapping the fireplace face.
Top Standoffs 0"(0 mm)to top standoffs Non-combustible materials,such as surrounds and other fireplace
Floor 0"(0 mm) trim,may be installed on the fireplace face,but they must not cover
From Bottom of Unit
any portion of the removable glass panel or control compartment.
" 1626 mm
to Ceiling 64 ( ) Vertical installation clearances to combustible mantels vary
according to the depth of the mantel.Mantels constructed of non-
Vent3"(76 mm)—Top••. combustible materials may be installed at any height above the
1"(25.4 mm)—Sides and Bottom fireplace opening.However,do not allow anything to hang below
Front Service Clearance— the fireplace hood.
clearance immediately in 36"(914 mm)
front of viewing area(s) Minimum clearance requirements include an
shelves,window sills,mantels,etc.above the fiireplacle.ns such as
`3"(76 mm)above any horizantalfinclined vent component.
••Top vent clearance can be reduced to 2"on horizontal runs when first elbowNOTE:?o avoid heat-related finish damage,use finish materials rated
is located at least 6 If above the fireplace. 175 OF,or higher,on the underside of the mantel.
Combustible side clearances Mantel height
At 6"minimum
side wall
clearance,a
combustible Top View of r--Mantel depth
wall can project Fireplace 18(457)
to any length.
16(406)_
450' Combustible materials 14 356 .
31/2" allowed in shaded area ( )• f a:°
(89 mm) "Safe Zone". 12 305 g f�
( ) :
Combustible walls 10(254) ,
_ shown in dark gray
— -- - Combustible mantel 8(203)
= legs may project
beyond either side of 12 8 4 EA
the fireplace opening (305)t0(203)6(102)2
as long as they are keptwithin the shaded area in.(mm) (254) (152) (51)
6"- - illustrated here. Fireplace
(152 mm)
ScorpioTm and ScorpioCD Series Direct-Vent Gas Fireplace
. e
Fireplace framing specifications Roof framing dimensions Pitch c D
NOTE:Dimension"D"is the Framing
y construction to be 0/12 101/2" 101/2"
required framing depth when 101/2 2 x 4,or larger. c (267 mm) (267 mm
the finish material(drywall) (267) g )
thickness is 1/2"(13mm). 6/12 10112" 12"
(267 mm) (305 mm)
Vent Framing—Top Vent i ° 12/12 101/2" 173/4"
with One 901 Elbow
31/8 7(178) (267 mm) (451 mm)
TT 121/8
Termination heights for vents above flat or sloped roofs
Roof Pitch Termination
Height
6 C Flat to 6/12 1.0 it(0.3 m)
ZR Vertical 6112 to 7/12 1.25 It(0.38 m)
I`minimum wan 7/12 to 8/12 1.5 It(0.46 m)
E Vent i 8/12 to 9/12 2.0 ft(0.61 m)
D termination _ 9/12 to 10/12 2.5 ft(0.76 nl)
'1/2 A A Flaihingstorm collar, * 10/12 to 11/12 3.25 It(0.99 m)
�
\✓ \ 11112 to 12112 4.0 ft(1.22 m)
Inches(millimeters) -' i 12/12 to 14/12 5.0 It(1.52 m)
Model A* B C D E Vent pipe 14/12 to 16/12 6.0 ft(1.83 m)
35"Model 35 3,43-899 361/4-895 38314-984 18-457 233/8-594 16/12 to 18/12 7.0 it(2.13 m)
40"Model 40 3/8-1026 41 114-1048 43 314-1111 18-457 281/4-717 18/12 to 20/12 7.5 It(2.29 m)
45"Model 1 453/8-1153 411/4-1048 43 314-1111 18-457 281/4-717 *Indicates lowest point of ventilation 20/12 to 21/12 8.0 ft(2.44 m)
C=Minimum height of top vent installations
E=Minimum height of rear vent installations Framing the ceiling opening Routing the gas line _
*Minimum opening size;additional 1/8"per side is recommended. 101/2"(267 mm) Left side front
'— minimum corner
1y �
fireplace
framing
Fireplace framing specifications—
corner installation with horizontal termination Roo 10 1/2° Pipe coupling
(recommended)
Framing (267 mm) ;
E yi minimum i
1 inch from corner to framing
/ x(178) Cen Plumb /57 8"
Framing .�� Bob 3"
(76 mm) %' (195mm)
fC i'/ Di
V
r� Installing the horizontal termination
A
Inches In rear- To help s meorm walu
ande
InBltnibn n is recommeadetl Bat
B --- (mm) Vent with the FnIVIDPApaaer(SYe.5HF)
Baric YmIl of chaselenclosure(including finishing materials 45°elbow be installed on the eakder
sidealthewall. Termlaation*
Model A 8 C D E F (")
(3081 m 10) m
lif 35" � 5.951 421r1s1068 30114 14114 6518 (151181) \
768 362 168
4038 6313/16 4511132 323!16 15718 8112 p6 mm)
40" 1025 1621 1152 818 403 216
49314 35114 1712 10114 gVda5H68 i \ [25.4 mm)
45" 4538 1153 70318 1788 264 895 445 260 x
1 �
This document is intended as a planning guide to highlight trade-related installation and finish Mate.,CenlerltneWYentP�is
Ne1Ne Sameas Mee.1ty. ne al
information.It does not replace the included installation manual.Information is subject to change we framredpeniep.
without notice.See the manual for more detailed information. Min.Distance to Base
Bra 4a'Yent Sedpn, or Appliance.
Mascopfc rent secdon,
Elhaw or Appliance Collar** Base of Appliance
.Recommended IHP termination kit:H1968.
"With termination kit only,6-9114=
P/N 400298-05 Rev.A 1012014
}
s
= Y
u r
The Commonwealth of Massachusetts
W Department oflndustrialAccidents
i
X Congr-ess Street, Suite 100
Boston, HA 02.114-2017
www.rnass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/l lectricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information 11Pl//eas/e Print Legibly
Name (Business/Organization/Individual): �g v( !�v�C G, 11 ; is�� N-4c 4/'l.� e'Ick t-t 17
Address: S 1 iq c- y J) ,
0/ YA
City/State/Zip: P09-T-61 4 oyl p,AN hone C17 t'O P —933
Are you an employer?Check the appropriate box: Type 4f project(required):
l.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction
2. 65'a sole proprietor or partnership and have no employees working for me in 8. []Remodeling
any capacity.[No workers'comp.insurance required.]
In I am a homeowner doing all work myself.[No workers'comp.insurance required.]f
9. ❑Demolition
4.F1I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 [J Building addition
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. I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
❑ 13.F1 Roof repairs
• These sub-contractors have employees and have workers'comp,insurance.$
6.F1We 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 41 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-contraciors Have employees,they must provide their workers'comp.policy number.
I am an employer that is providing ivorl>ers'compensation insurance for^nay employees'Below is the policy andjob site
information.
Insurance Company Name;
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address; City/State/Zip:
Attach a copy of the workers'campeii ation 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 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 Hereby certify u oder thepain ndpenalties ofperjury that the information provided above is true and correet,
Signature: Date;
Phone#: q? Co X-4- — 3-
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#:
--mo�ii m ��o oachimeff,
vlie zP6zz�uaozioecz Regulation
Office of PROVEMENTer rCONTRACTOR
WME IMPROVEMENT Type:
gistration 179313pgA
piration 7/17!2016;,
HUTCHINS HOME IMPROVEMENT
PAUL HUTCHINS
121 FARNUM STREET
NORTH ANDOVER,MA 01845 Undersecretary
i Massachusetts Department Regulations fand Standards
3' Board of Building Reg
License: CS-059105
Construction Supervisor
PAUL G.HUTCHINS
15 STACY DRIVE
NORTH ANDOVER MA 01845
t'ls.n CA Expiration:
Commissioner 0510512018