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Home My WebLink AboutBuilding Permit # 1/26/2017 BUILDING PERMIT411, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION '- Permit No#: Date Received ? 3� °RAreo FIX t Ssactius�� Date Issued: IMEPORTANT:Applicant must complete all items on this page LOCATION �. PrintAV PROPERTY OWNER Pnnt 9D.,MOYryes MAP PARCEL. .. ZONING°DISTRICT H�storEc ®istnct yes � - Machne Shop vllage TYes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ SeptEc 1/Ve11 ❑ Floodplain n UVetlands D Watersl eci District . . _q Wafir✓r/Sewer.,. .._ _ _ _ :. _..:: _. " ,. DESCRIPTION OF WORK TO BE PERFORMED: ___Iaenti_ficath n-- Please Type or Print Clearly OWNER: Name: � � ��'��°� Phone: Address: Contractor Na tne q5.114, Phone; 'Add ress.-- L11 Supervisors Construction lacbhse . -, ` �. :. __ Exp. Hom / .. .e.Improvemer3t License:. Exp: Date - - - ARCHITECTIENGINEER Phone: Address: Reg. leo. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.E. E .Total Project Cost: $-. �. FEE: $ Check No.: Receipt No-- 3 7 NOTE: Persons contracting with unregistered contractors do not have.access to the maraniy f d Smmigrafii� e of Agen /Qwner Signature of contracfar IAORTk own of �� ndover. 0 0 No. A14 h ver, Mass, p ne wit K 4 S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .......5 r.. BUILDING INSPECTOR has permission to erect ..........................`buildings on .......,93.7 ........N .....Sro Foundation .......... Rough to be 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 CSTRU...C...TAR ... Rough Service .. .................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to QccupE 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. efimaj i"wm tuldion PROPOSAL Tom Licciardello 374 Main Street North Andover,MA 01845 to ..Coln (C) 978-502-1212 November 16,2016, First Floor 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 now trim. • Install new toilet paper holder,towel bars. • Paint Bathroom. • Removal of all debris, TOTAL LABOR AND MATERIAL $ 13,950.00 Note. This quote does not include any plumbing fixtures, tiles,grout. 'Perms: $4,650.00 upon signing of contract(not to exceed 113 of contract price) S 4,650.00 after plastering $4,650.00 when job complete Submitted By: Chris Rivet MA Lie##CS072173 H1C#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. You are authorized to do the work as specified.Payme will be ma e,s outlined above. Date r E zer G Homeowner Signature Contractor Signature y�� Contractor Arbitration The Nome 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 ad isuie concerning this contract,the contractor may submit the dispute to a private arbitration firm whit has n approved b e Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consume all requi o su it to such arbitration as prvided in!aPahusetts General Laws,Chapter 142A. 3 '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 Elie parties. Homeawner'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 cant'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 tile 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 Elle 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 bath 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 hirrl/l►erself 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 T--C 1-{-C tJ F LC_57J 2 i l�S H``t c—r— l�S- S d c5 7J jcrV � ,c, i—td «J VI1UCr-t Lemic 1r4�� 7"u `'sP� � �1J Zc � a The Commonwealth of Massachusetts Depardnent of IndustrialAccidents lit% Office of Investigations I 600 Washington Street A Boston,MA-021.1.1 • "' � __tt -wwt+.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Le 'b Name(13usiness/OrganizatiorJlndividud): Address:_ -�, s ✓z> ' i i - City/State/Zip. '�r Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I b- ❑ ew construction employees(full and/or part-time).* have hired the sub-contractors 2.Q I am a sale proprietor or partner- listed on the attached sheet. 7.. Remodeling p These sub-contractors have ship arid have no employees $. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance Comp in�e;rance. required.] 5. ❑ We are a corporation and its 101-1Electricalrepairs or additions 3.❑ I am a homeowner doing all work officers have exerbised their 11.❑Plumbing repairs or additions myself.[No workers'comp, rigbtiofexemptianperMGL 12.❑Roofrepairs insurance required.)t c. 152,§1(4),and we have no employees.No workers' 13.❑Other comp.insurance required.] A.ny applicant that checks box#1 mustalso fill ourthe section below showing their workers'compensation policy information. t Homeowners who submit this afl`&vit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. +Contractors that cheek this box must attached an additional sbwt showing the namo of the sub-cont actors and state whether or not those enfaties have employees. If the sub-contractor3 have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'cor*ensahon insurance for my employees Below is the policy and job site informatiou. _. Insurance Company Name: '- , "1% / i;�,f' �,g : � r 1✓ ' - Policy#or Self-ins.Lie.#, 1-f06 V JLw`� ;` ' Expiration Date: L/%/,'/_' /`7 Job Sita Address: City/state/Zip: /U,t'. AN Attach a copy of the workers'com icusatiton policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under section 25A ofMGL c. 152 can lead to the,imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonmcat,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 lavestigations of the IIIA for insurance coverage verification. I do hereby certify u der��he pa ns apd penaMes ofperjury that the infornzW n provided abpve fs t/ue and correct -77- 59 , Date: /°�- 0 Of use only. Do not write in this area,to be completed by city or to wit official. City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health"2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector S.Other Contact Person: Phone#: —� OP ID:GOGL CERTIFICATE OF LIABILITY INSURANCE °ATE` MIDWYYYY' 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 endorsements. PRODUCER CONTACT Macdonald&f angiane insurance Phone:978-688-6921 NAME; Kilts Land 104 Main Street Fax:978-688-5350 PHS No EI:978-688-6921 (FAX c No):978-688-5350 North Andover,MA 01845 E-MAIL KIMQInpins.net Michael Pangione CRSDUCERID�:CHRIS-S INSURERS AFFOADING COVERAGE NAIC# INSURED Christopher Rivet INSURER A:Preferred Mutual Ins Co 15024 207 Winter St. North Andover,MA 01845 ENSURER 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 WTH 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 SEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE DID usR POLICY NUMBER MM/DD OLICY EFF MM/DD YY POLICY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,()00 DAMAGE TO RENTE A X COMMERCIAL GENERAL LIABILITY BOP 0100719749 09/26/2016 09/26/2017 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE OCCUR _ MED EXP(Any One person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PROLOC $ JFCTAUTOMOBILE 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 HCLAWS-MAOF AGGREGATE ,. $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- J OTH- ANDEMPLOYEAS'LIABILITY Y/N TOR LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE❑ N!A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If es,descr be under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ tE$C(IIPTION OF?PErATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) vlFence o1 Insurance CERTIFICATE HOLDEN CANCELLATION F V SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgoodrt St ACCORDANCE WITH THE POLICY PROVISIONS. 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 Hoard of wilding Regulations and Standards License: CS-072173 Construction Supervisor CHRISTOPHER F RIVET 207 WINTER ST N ANDOVER MA 01645; I Expiration: C orv7missioner 06!02!2018 Uffice of Consumer Affairs&Business.Regailatiort OME IMPROVEMENT CONTRACTOR Registration: 139962 Type: Expiration. 9/8/2017 Individual CHRISTOPHER F.RIVET CHRISTOPHER RIVET 207 WINTER ST. P N.ANDOVER,MA 01845 Undersecretary