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HomeMy WebLinkAboutBuilding Permit # 9/16/2016 �OidYW BUILDING PERMIT oF���eo TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received .y Ssac yuSE Date Issued: ! IMPORTANT: Applicant must complete all items on this page LOCATION f Print PROPERTY OWNER �MZ Print 100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District yes 09, Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑Two or more family ❑ Industrial C,Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition [I Other ,&"" WK a ' ct:%y � � � c l�.V,llell �� � `;�`��` �• p Floodplaln�,' ❑�`IVetlands ,�.���;.�. . �.�1l:�laters.hed<Dstr� ����.���� ,` ❑ See ti DESCRIPTION O� 1IVORK TO BE PERFORMED. Identification- Please Type or Print Clearly .-7 OWNER: Name: ,�'��' .� > Phone: Address: �� r�r'�c f /�.I�; �i� v�'•� Contractor Name:el'Y r Phone: Email: ✓� Address: 9eZ Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL EsTIMA TED COST}BASED ON$925.00 PER S.r Total Protect Cost: $ ��! , " FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to he arae f NORTH Town z _ 6ndover -,JJ h ver, Mass,Z, 4 COCNIC"t WWW 40 ATE C) S U BOARD OF WEALTH Food/Kitchen PERMIT _T LD Septic System THIS CERTIFIES THAT J.,. V`"4 -A BUILDING INSPECTOR ............. ....... ............ ..... .......... ................ has permission to erect ..." " ,,, Foundation p .,... ,...... buildings on ............. .,........ ...........,.... ,� .. Rough ... to be occupied as 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES 16 MONTHS ELECTRICAL INSPECTOR UNLESS CS IO S Rough Service .. ... . ........... ...... .,.. Final BUILDING EC OR GAS INSPECTOR Occupancy Permit. eguired to OccupL BuRough 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. Riream vet tri,��s PROPOSAL Cathy Dawson 44 Russell Street North Andover, MA 01845 -m (H) 978-685-4927 (C) 978-273-4475 September 14, 2016 Bathroom Remodel Work to be included includes: • Acquire Building Permit • Complete gut of bathroom. • Complete all required plumbing. • Complete all electrical. • Install vanity. • Install medicine cabinet. ® Install acrylic Shower Base. • Install DenseShield Tile board on shower walls. • Install tile on shower walls. • Install new blueboard and plaster. • Install DenseShield tile board on floor. • Install new tile floor. • Install new trim. • Install new toilet paper holder, towel bars. • Paint Bathroom. • Removal of all debris. TOTAL LABOR AND MATERIAL $ 10,500.00 Note: This quote does not include any plumbing fixtures, tiles, grout. Terms: $3,500.00 upon signing of contract(not to exceed 113 of contract price) $7,000.00 when job complete Submitted By: Chris Rivet MA Lie IICS072173 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 1.301 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. You are authorized to do the work as specified.Paym I be made as outlined above. Dated Homeowner Signatur Date Contractor 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 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 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 consumerlhomeowner 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 bath 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/berself 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 Horne 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 Massachusetts Department of IndustrialAccidents Office of Investigations 11 1�1 4 600 Washington Street .4 Boston,MA 0211.1 S' t www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Cont-acters/Electricians/Plumbers Applicant Information __ Please Print Legilbly Name(BusinesslOrga6za2ion/Individual): Address:_ rte _ �-',zK1'72;'RS n / - , City/State/Zip:,Xk_ it/�3 c ��:J ./ � Vii' '�'l Phone#: : Are you an employer?Check the appropriate boa: Type'of project(required: 1.❑ I am a employer-with 4. E] I am a general contractor and I have hired the sub-contractors ❑New construction ,employees(full and/or part-time). 2.11 I am a sole proprietor or partner- meted on the attached sheet 7.. EfRemodeling ship and have no employees These sub-contractors have S. F1Demolition working for me in any capacity,ea act employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp. insivance.l required.] S. [] We are a corporation and its 10.0 Electrical repairs or additions 3.ElI aim a homeowner doing all work off cers have exercised their 11.[]Plumbing repairs or additions myself.[No workers'comp_ right of exemption per MGL 12.❑Roofrepairs c. 152, 1(4),and we have no insurance required.]i employees.[No workers' 13.[ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing theirwotken'compensation policy information. t Homeowners who submit this affidovit indicating fty are doing aliwork and then hire outside contractors must submit a now affidavit indicating such. #Contractors that check this box mast attacbed an additional sheet showing the rimm of the sub-contractors and statewhether or not those entities have employees. If the sub-contractors bane employees,they must provide their workers'comp.policy number. I am an employer that 1s providing workers'compensation insurance for my employees. Below is thepolicy and job site infortnniiau. . Insurance Company Name: ` i_1: 7 I` Z_ Policy#or Selfins.Lie. Expiration Date: I � Job Site Address: T .SQL. City/State/zip:_A/V, Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGI,e. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for instuance coverage verification. Ido hereby certify tt der^r p 'ns a penaMes ofperjury that the informad on provided ahyve is True and correct S" e: .-�'� Date: Phone# Official use only. Do not write in this area,to be completed by city or town o,ficial. 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#: OP ID: OUJA CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDIYYYY) 09/21/2015 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(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 CONTACT Macdonald&Pangione Insurance Phone:978-888 6921 PHorEIE Jane Ouellette Fax P.O.Box 428 Fax:978-688-5350 (Arc.No.1 xt�:978-688-6921 __ T�{arc.Noy: 978-888-5350 104 Main Street E MAIL s:lane@mpins.net Ins.net — North Andover, MA 01845 PRODUCER � Michael Panglone CUSTOMER IDf1:GHRIS-S INSURERf6)AFFORDING COVERAGE NAIC N INSURED Christopher Rivet INSURERA:Preferred Mutual Ins Go 15024 207 Winter St. - - North Andover, MA 01845 KTU2ER B; �— INSURER C: 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 REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP Wye POLICY NUMBER MM1DDfYYYY MMIDDIYYYY - _ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I DAMAGE TO RENTED A X COMMERCIAL GENERA LIABILETY BOP 0100719749 D912612015 09126!2016 PREMISES IEa occurrence 5 100,00 J CLAIMS-MADE L..X� OCCUR MED EXP(Any oneperson) ,$ 5,000 �'-- PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE__ $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 X 1 POLICY j "O_ILCI I I LOC s 5 AUTOMOBILE LIABILITY I I I I COMBINED SINGLE LIMIT $ .,.. .I ANY AUTO I !I {Ea accident} } BODILY INJURY(Per person) $ _I ALL OWNED AUTOS `I I BODILY INJURY IPer accident) S III` SCHEDULED AUTOS I I Ef PROPERTY DAMAGE j 5 HIREDAUTOS I k E 1 (Per � '.._.1 _ NON-OWNED AUTOS ! g I UMBRELLA LIAB ` OCCUR � I EACH OCCURRENCE $ _ I EXCESS LIAB f I CLAIMS_MADE I I AGGREGATE .....�DEDUCT113LE RETENTION $ E I $ I WORKERS COMPENSATION E E I WC STATU- OTH- IAND EMPLOYERS'LIABILITY YIN �I ORY LIMITSL ER ANY PROPRIETORIPARTNERIEXECUTIVE i E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N I A k I 777 — -- Mandatory in i E. Iand L.DISEASE-EA EMPLOYEE{$ If yes.describe under i — --- I DESCRIPTION OF OPERATIONS below j E.L.DISEASE-POLICY LIMIT I $ I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If mare 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 St No Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-072173 Construction Supervisor � CHRISTOPHER F RIVET 207 WINTER ST N ANDOVER MA 01845 Expiration: ' Commissioner 06/02/2018 <• �J�c �%rarr»rnnrnen�/�r�r. �OffieeOfCnnsunierAffairs&BusinessRegul,tion � . ^fir 3 fr -.Y HOME IMPROVEMENT CONTRACTOR �+ I Registration: 939962 Type.- Expiration, ype:Expiration: 918/2017 Individual CHRISTOPHER F. RIVET- CHRISTOPHER RIVET 207 WINTER ST. N.ANDOVER,MA 09845 Undersecretary _