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HomeMy WebLinkAboutBuilding Permit # 9/6/2016 ,AORTH BUILDING PERMIT 't,r-D TOWN OF NORT111 ,41130VER APPLICATION FOR PLAN EXAMINATION 7x) Date Received_— "'ATE D Permit No#: PP CHU Date Issued:_-.__ ,___ I �� IM ORTANT: Applicant must coni Iet�all items on this_page —---------------7-­ LOCATION r)nt PROPERTY OWNER Print 100 Year Structure yes (11)? MAP PARCEL: ZONING DISTRICT: Historic District yes tl�? Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE _Residential Non- Residential [I New Building 0 One family 11 Industrial 0 Addition 11 Two or more family ,ri,Alferation No..of units: Commercial 11 Repair, replacement 0 Assessory Bldg 0 Others: 0 Demolition [I Other DESCRIPTION OF WORK TO BE PERFORMED: ,identification- PI se Type or Print Clearly < Phone: OWNER: Name;'__� Address:-,,, Contractor Name: Phone: Email: O Address: ,2, 7� L,/ZIA Supervisor's Construction License:_j=e1_511/ _Exp. Date: Home Improvement License: �ro?" —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.: 6�S NOTE: J?ersons contracting with unregistered contractors do not have access Wth 'guars t nd ati 00 NORTH Town of 2 _ 6 hover No. � � a � a _ h � s h ver, Mass, T1111111'KA" !r, 400-TS / gyp_ COCH�CMlwICR V 7,q 0RATEa U BOARD OF HEALTH Food/Kitchen `_ Septic System PER IT T LD THIS CERTIFIES THAT ........N ....... ! 4-� il.. .. .......... .. . . BUILDING INSPECTOR .. Foundation has permission to erect.......................... buildings on .....IC1.1 .... ........ .,. .�.......... Rough tobe occupied as ....,....... .... *. .d . ........................................................... 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 CONS TIO Rough Service _40Final BUILD G 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. efmi6 qvm e4mij &aidion.. PROPOSAL Chris Spychalski 191 Barker Road North Andover,MA 01.845 781-276-6000 781-454-0454 cbrisspy@gmail.com Kitchen Remodel April 8,2016 Work to be completed includes: • Building Permit $ 200.00 • Install new Andersen Slider $3,250.00 • Install new Andersen Awning Window 41x41. $ 972.00 • Install undercabinet lighting. $ 700.00 • Install new 220V circuit to electric heat. $ 400.00 • Install all Base&Wall Cabinets. $4,000.00 • Hang new blueboard&Plaster $ 700.00 • Install new faucet,Garbage disposal,and dishwasher. $ 450.00 • Install now baseboard. $ 350.00 • Removal of all debris. $ 100.00 TOTAL LABOR AND MATERIAL $ 11,122.00 Terms: $3,700.00 to start $3,700.00 after plastering $3,722.00 when complete Note:This quote does not include the cost of plumbing fixtures,pendants,or appliances. Painting is also not included. Group I Granite would be$3,600.00 Submitted By: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C)508-265-3115 (H)978-794-1165 North Andover,MA 01845 All Home Improvement Contractors shall be registered. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor. Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. utline ab You are authorized to do the work as specified.Payments will be made so 7m"' Date Signature m Date-, Signature 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 cretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to su fnit to su h itration as provided in Massachusetts General Laws,Chapter 142A. Homeowner'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 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 Consumer Guide to the Home Improvement Contractor Law",contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787 or(888)283-3757 The Commonwealth of Massaehuse Us r� Department of IndustrialAccidents E i Office of Investigations 13 �l 600 Washington Street Boston MA 021.1.1 s Wn .massgov/dia Workers' Compensation Insurance Affidavit: Bunders/Contractors/Eleetricians/Plumbers Aj2plicant Information Please Print Le 'b Name(Business/organization/individual): +� , Address: Z 14 Z� / R City/State/Zip:,/Jr, , w1,K Phone �-7 Are you an employer?Check the appropriate box: Type'ofproject(required)- 1.El required):1.0 I am a employer-with 4. ❑ I am a general contractor-and S 5. ❑New construction mployees(full and/or part-time). have hued the sub-contractors 2.Z am a sole proprietor or partner- listed.on the attached sheet 7.. jf`Rernodeling ship and have no employees 'These sub-contractors have S. []Demolition working for me in anycapacity. employees and have worker's' 9. F1 Budding addition [No workers'comp.insurance comp. insurance.; . required.] 5• C] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.[No workers'camp. right of exemption per MGL 12.[J Roof repairs insurance required.]t c- 152, §I(4),and we have no employees.[No workers' 13. ]lather comp.insurance required.) 'Any applicant that cheeks box 01 must also fill vuttbe section below showing theirworkers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. TContramrs that check this box must attached an additional sheet showing the runne of the sub-contructors and state whether or notthose entitles have employees, If the sub-contraotors have employees,they must provide their workers'comp,policy number. lam an employer that isproviding workers'compensation insurance for my employees. Below 6 thepolley andjob site information. _ Insurance Company Name: �f r '�J_ - 1 Al-7W, Policy#or Self-ins.Lie. 6 0 0,1)`' � � �, Expiration Date: Job Site Address: /rCity/State/Zip: 4V �a'�(JJo+�/�, AV Attach a copy of the workers' comm ensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead io the imposition of criminal penalties of a fine up to$1,50D.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. Be advised that 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 pains a penalties of perjury that the information provided abpve/' 4r and correct S e ``•, . 'r �E ' '� Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# IssuingAuthority(circle one): 1.Board of Health'2.Building Department 3.Cityl'Fown Clerk 4.Electrical Inspector 5.Plumbing Inspector . 3 6.other Coutact Person: Phone#: 0 OP ID: OUJA A�ORn CERTIFICATE OF LIABILITY INSURANCE D 09121/20/TE YYi o9�z1,<2o15 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 pollcy(ies) 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 Phone: 978-688-6921 CONTACT Macdonald&Pangione Insurance pNorEi Jane Ouellette FAX P.O.Box 428 Fax:978-688-'5350_(Alc,No ._W.978-688-6921_ (AfC,Not: 978-688-5350 104 Main Street EJMAIL ADDRESS:jane_a mpins.net North Andover,MA 01845 ADDREPRODUcER ORIS-5 Michael Pangione CUSTOMER_ED ate INSURER(S)AFFORDING COVERAGE NAIC# INSURED Christopher Rivet INSURER A:Preferred Mutual Ins Co 15024 207 Winter St. INSURER B North Andover, MA 01845 INSURERC: INSURER D: 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 POLICY BY PAID CLAIMS, VN_S TYPE OF INSURANCE INSRDDL SUER I MNOflDD YYYY MM DD YYYY _ LIMITS WVD LT POLICY NUMBER GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,00 A X COMME=RCIAL GENERAyP LLIABILITY 1 'BOP 0100719749 09/26/2015 09/26/2016 DAMAGE TO RENTED $ 100,00 _ I _k i I.PREMISES fEa occurrence I MED FXP(An one er $ 5,000 _.son) ._.---__._.._�.-..-._....-- I-- GLAIMS MADE X OCCUR ! s PERSONAL&ADV INJURY $ 1,000,00 - I I GENERAL AGGREGATE $ -- 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; k PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY - k PRO- k -}LOC JECT k I $ AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT 5 (Ea accident) ANY AUTO BODILY INJURY(Per person) ._ ALL OWNED AUTOS - BODILY INJURY(Per accident) $ I.._.__I SCHEDULED AUTOS PROPERTY DAMAGE -_3 HSREO AUTOS ii(Per accident) S J, NON-OWNED AUTOS EXCESS LIAR I CLAIMS-MADE FAGH OCCURRENCE , s UMBRELLA LIAB I OCCUR I I I I AGGREGATE I S - I DEDUCTIBLE I -- ' $ I RETENTION $ WORKERS COMPENSATION TWO STATU- OTH- AND EMPLOYERS'LIABILITY Y!N i j ___STORY LIMITS ER ANY PROPRIETORIPARTNER/EXECUTIVE ❑3 N r A i E.L.EACH ACCIDENT s OFFICER/MEMBER EXCLUDE U7 ! ---- (Mandatory in NH) f i El DISEASE-FA EMPLOYEE 5 Ryes,describe under OESCRIPTtON OF OPERATIONS below ! I C.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (Attach ACORD 161,Addittonal Remarks Schadule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood $t No Andover, MA 01845 AUTHORIZED REPRESENTATIVE 4 �� ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License, CS-072973 Construction Supervisor CHRISTOPHER F RIVET 207 WINTER ST ,; N ANDOVER iVIA 01845 (� l Expiration: ' Commissioner 0610212018 �J�r• (rrr�uirairrner��/�r/r''-l(�t.ifnr�rrlr'/L� �. Offiee Of Consumer Affairs&Business.Regulation f 'HOME IMPROVEMENT CONTRACTOR t Registration: 139962 Type: Expiration.- . 9/8/2017 Individual' =mss- CHRISTOPHER F.RIVET CHRISTOPHER RIVET 207 WINTER ST. N.ANDOVER,MA 01845 — Undersecretary i