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HomeMy WebLinkAboutBuilding Permit # 12/20/2016 ........ .. . .. ...... Norrry BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION '` tN. Y n R n�1- Permit No#•. �Y Date Received �r 4R�rp „Q¢ Cl RSSACyIls Date Issued: t. I ORT.ANT: Applicaxzt mu—st7�co�mplete all items on this page LOCATION C,�'� 7 ,:S ^ 7 Print PROPERTY OWNER dPrint '100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District es Machine Shop Village yes n` ` TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family Cl Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other D Sepftc ❑WeII ❑ Floodpla►n ❑�IVetlands ❑ V�latershed Distrrct ❑ aterJSewer� �. � � ,�M� �R DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: �.� Phone: Address: t ' Contractor Name: � r �� Ul- Phone: Email: i ' Address: 2 Supervisor's Construction License: / Exp. Date: Home improvement License: /J Exp. Date: ARCH ITECTIENGINEER 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: $ 01 Check No.: Receipt NOTE: Persons contracting with unregistered contractors do not have access to th guarani and - -- - - %A©RTH r Town �2 _ : _ Andover O M t++ No. 53 " 1 - . h , ver, Mass • C;ta , ft?Al� LAKI4 COCNICMRWICtt 11' �RTE U Pp4�,i'�5 11 BOARD OF HEALTH Food/Kitchen PERM _ L D Septic System THIS CERTIFIES THAT ...,. 111W '� BUILDING INSPECTOR .... . . .. ........ ............. .......... . has permission to erect ........................... �SV buildin s on „ �„ ,1!�, .�"' Foundation V Ick!-. . aQs Rough to be occupied as ......r.. . ,. ..... .... ..... ...................... 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 CONSTRUC SPTA Rough Service . ....... ... .. . .. ..........,...... .. . .................... ........ BUILDING. . . INSPECTOR.. Final GAS INSPECTOR Occupancy Permit Required to Occupy Puildin 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 Bet. PROPOSAL Rev 1 Don Foss 492 Salem Street North Andover,MA 01845 (C)978-683-7300 (H)978-682-3088 j dbfraf@gmail.com October,16,2016 Install new custom shower in master bath. Acquire building permit. Remove existing shower. Cut out floor tile and build curb for shower. Frame for shower seat. Install granite for seat. Install new rough plumbing and copper pan. Fixtures from Peabody Supply on Quote#SO 18371178 included. Instill tile board on walls. Install granite curb. All tile,motar,grout included. Tile floor and two shower walls. Install two niches. Grout walls and floor. Finish for plumbing. Disposal of debris. TOTAL LABOR AND MATERIALS $7,980.00 Dote: This quote does not include glass enclosure. Terms: $2,660.00 upon signing of contract(not to exceed 113 of contract price) S $5,320.00 when job complete Submitted By: Chris Rivet MA Lic##CS072173 HIC#1.39962 207 Winter Street (C)508-265-3115 (H)978794-1165 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 fiom 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 astspreuified, Payments will be made as o ined above. Date2-O.//Q,//6 Homeowner Signature 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 ZU1111,Ch n the consumer all be required to such arbitration as provided i sachusetts Genl A. IXHomeowner's Signature nature 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 o may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or u 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 a (listed below). u u 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 u: 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. a 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 Pat-ties. 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 Cominonwealth of Massachusetts L1ep4rhnent of 1'ndustriatAcc&ents I'•; ? Office of Investigations tJ 600 Washington Street - ;Y Boston,MA 02.1.11 ...� ti www.mass govldiac Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �^ J Please Print Le 'b NaMe(Business/Organization#ndividual): Address. t_.s207 mei I City/State/Zip:,/Jo. .• :�1�' � �' A{tC Phone#: � Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a Y em to er-with 4. E] I am a general contractor"and 1 P 6. ❑ ew construction employees(full and/or part-time).* have hired the sub-contractors 2.®`1 am a sole proprietor or partner- listed.on the attached sheet. 7. 0 Remodeling ship acid have no employees These sub-contractors have S. ❑Demolition W for me in an capacity. employees and Dave workers' � Y P ty� 9. E]Building addition [No workers'comp.insurance comp. iasuzanceJ required.] 5. E] We are a corporation and its 10,E]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'camp. right of exemption per MOL 12.[]Roofrepairs insurance required.]t c. 152,§1(4),and we have no 13.❑Other employees.[No workers' comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing theirwotkess'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, lConhactors that check this box must attached an additional sheet showing the mane of tho sub contractors and state whether or not those entities have employees. If the sub-contractors have employees,they trust provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job site information. Insurance Company Name: ..- ,�'�"'�i�'�.:,_/9 •�� r ti � . Policy#or Self-ins.Lic.#: / Expiration Date: Job Site Address: �� 11'/�c' r—itylState/Zip: �/wT� 1/1,4 Attach a copy of the workers' eom `MBOon policy declaration page(showing the policy number and expiration.date). Failure to secure coverage as required under Section 25A of MOL c. 152 can lead io the impasition of criminal penalties of a fine up to$1,540-00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$254.40 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 ceYV wrier pains pdpenaNes ofperjury that the infornza on provided abyve ' true and correct. Signature: Date: Phone Offrcial 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 lnspector . 6.Other Contact Person: Phone#: 0 s OP ID:GOGL CERTIFICATE OF LIABILITY INSURANCE DATE DD016 09/15/2016 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 Phone:978-688-6921 CONTACT Kim Landry Macdonald&Pangione Insurance PHorEie Fax 104 Main Street Fax:978-688-5350 (AIC,No .978-688-6921 fAIC,No):978-688-5350 North Andover,MA 01845E-MAIL KIM@mpins.net Michael Panglone ADDRESS: CU OMERRR to :CHRIS-5 INSURER(S)AFFORDING COVERAGE NAIC# INSURED Christopher Rivet INSURER A:Preferred Mutual Ins Co 15024 207 Winter St. North Andover,MA 01845 INSURER 0. .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 ADDL SUBR POLIGY EFF POLICY EXP LTR TYPE OF INSURANCEmm ML POLICY NUMBER MMIOD MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE S 11000,000 A X COMMERCIA€.GENERAL LIABILITY BOP 0100719749 09/26/2016 09/26/2017 PREMISES 'e occurrence $ 100,000 CLAIMS MIAOE a OCCUR MED EXP(Anyone person) $ 5,000 PERSONAL&AOV INJURY $ 1,000,000 GENERAL AGGREGAT 5 $ 2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,00 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE= $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY,LIM}TS ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ _OFFICERIMEMBEREXCLUDED' ❑ NIA (Mandatory in NH) E.L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ IpvESC{{IIIPTION OF PEpATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more space is required) igence 0 Ifisurance 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(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-072173 Construction S�.q)e�,viso� iu Ire ?a CHRISTOPHER F RIVET 207 WINTER ST i N ANDOVER MA 01045 Expiration: Commissioner 08/02/2018 Office of Consumer Affairs&Business.Regulation � f+ .o''�HOME IMPROVEMENT CONTRACTOR Registration: 139962 Type: Expiration: 9/8/2017 Individual CHRISTOPHER F.RIVET CHRISTOPHER RIVET 207 WINTER ST. N.ANDOVER,MA 01845 Undersecretary r I 1