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HomeMy WebLinkAboutBuilding Permit #755 - 106 BOSTON STREET 4/23/2012 r. .', BUILDING PERMIT �f {<<E� �b q+ TOWN OF NORTH ANDOVER o �. -• R APPLICATION FOR PLAN EXAMINATION CoPermit NO: Date Received SSACHU5� Date Issued: IMPORTANT:Applicant must complete all items on this page s+ .'� a L°OGA�'Q�N � �� ,:{ 7 S P l ry�z'•:r `3 W,1e "Y:. u .s - e > .. ..-� X�. a -- nT i. - x 4y nrlt t ✓- , 3 ,-r A',. ..e, PROPERT3C�OV!IINER ��,w. ��� r < at I ,yc Pr 't-r ,, '�- •k;r n- R �;'PARCELIN �ONINGb1STR( � - Histor3cTD�sti�tc3 r u yes �no tiL3' u,-w _ �Ulac in TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition 0 Two or more family . ❑ Industrial 0 Alteration No. of units: ❑ Commercial 0 Repair, replacement 0 Assessory Bldg ❑ Others: 0 Demolition ❑ Other ❑K eptic fl Illlell£ ' ,r J LrFloodplaan ;�{yD Wetlands �IVatershed mtric DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: /D &k$-70114 i (L—r t- x, CONTRACTOR Name £ 'J Phone N. AddressItr 't - t K r^t,t H �' {. _` h t t`w r :FS Y 4 z vt 3 '•`-# �' .a. T r F�, --t .Fx 2 �...: ,. �' '-• } Supervisor's Constretion L�cehse r � � Exp mate` ,` ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULD/NG PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ DD�o ` FEE: $ Check No.: _ zD L 1 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access t u anty fU1 Signature of Aen /�wner Signature.of cotractor, _.. - r LocationL� �1f�77'Yi No S Date • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ �— v Foundation Permit Fee $ f4Zp Other Permit Fee $ TOTAL $ Check#/6 25215 Building Inspector Plans Submitted U Plans Waived ❑ Certified Plot Pian ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ .COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRES DEPAfiTMENT Tem �Durnpstet on slte yes no Located at 124FMain Street Y r r Ftre Department signat�lre/date r r " - I INIamuchusetts- Department of Public Safe[\ [dy Board of Building; Re;.lulations and Standards Construction Supervisor License License: CS 47056 MARCOS A DEVERS 16 WOODLAND ST `, LAWRENCE, MA 01841 Expiration: 10/25/2013 l ortvnL<hrncr Trtf: 5685 +m.\ Office of Consumer Affairs&Business Regulation - ".HOME IMPROVEMENT CONTRACTOR . Registration: 106698 Type: 5r\ ,_" Expiration: 724/2012 Private Corporatior MD71NC. Marcos Devers 61 WOOD LAND STREET` LAWRENCE,MA 01841 Undersecretary Cri.�JY.Jv''. IN ENGINEERING REG/PROF CIVIL ENGINEER MARCOS A DEVERS 16 WOODLAND ST LAWRENCE MA 01841-2315 33848 06/30/12 741763 The owner has all warranties on the owner's rights under the provisions of and MGL c. 142A. Total Amount to be paid for the work to be performed under the contract is $5,000.00 The Job will be completed within 30 business days.Beginning within 5 business days after the closing date and completed within 30 business days thereafter The contractor will obtain all necessary construction permits. Owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund Schedule of Payment According to Streamline Guidelines: One third of Documented Renovation Hard Costs for Initial Disbursement of Funds One third of Documented Renovation Hard Costs&Labor after performing 50%or more of the job. One third of Documented Renovation Hard Costs&Labor for Final Disbursement of Funds Upon Completion DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES The contractor and the owner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c. 142A 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 b: 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. Owners: Date: Pierre Ezzi Contractor: ` Date: R&Z Figueroa Home Improvement And MDJ Incorporated R&Z Figueroa Home Improvement And MDJ Incorporated 48 Timber Ln Methuen MA 01844 4/23/2012 Building Repair Proposal Owner:Pierre Ezzi Job Site: 106 Boston St.N.A. Address: 106 Boston St Use: Residential North Andover MA Construction Type: Wood-framed Structure Job Breakdown and Cost: The Contractor agrees to do the following work for the Homeowner: Materials Labor Subtotal &Equipment &other I.Roof a.Repoint chimney bricks b.Repair weak mortar joints at copingflashings $2,000.00 $1,900.00 $3,900.00 XL Clean Out and Debris Disposal a.Removal and disposal of all demolition and construction debris b.Dumpster $600.00 $400.00 $1,000.00 XII.Permits a.Permits $0.00 $100.00 $100.00 Totals $5,000.00 All home improvement contractors and subcontractors shall perform all repairs in workmanlike manner. Any questions or concern relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza,Suite 5170 Boston,MA 012116 Phone: (617)973-8700 The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement. The homeowner is entitled to his/her)three-day cancellation period under MGL c 93 s48,MGL c140D or 255D s14 as may be applicable. The Commonwealth of Massachusetts Print ForF71 Department of Industrial Accidents Office of Investigations is I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): MDJ Incorporated Address: 16 Woodland Street City/State/Zip: Lawrence MA 01841 Phone#: 978-8047588 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 3 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 131-1 Other comp.insurance required.] *Any applicant that checks box#1 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-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Continental Casualty Insurance Co. Policy#or Self-ins.Lic.#: 0417N57512 Expiration Date:4/24/2013 Job Site Address:106 Boston Street City/State/Zip:North Andover MA 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 MGL c. 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 insurance coverage verification. I do hereby certi ams andA&ena t o er'u that the info n provided above is true and correct Signature: Date 4/23/2012 Phone#: $O V -- -7-5--5$ 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#: ' 140 H Town of Andover . o 10 �` dover Mass. (AV ,gay RATED O'V C BOARD OF HEALTH Food/Kitchen PERM TO ILD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....................... ..... tv!!!!/L ............CS .N.71WN........................................................... Foundation Ihas permission to erect........................................buildings on..I.�Alc.........6* .K.......0... ................. Rough i n to be occupied as................ f ...IL0.11..1�r... ............�. ..Blic�ii_o-n_ . . . Chimney rovided that the erson acceptin this ermit shall in eve res ect confdNn to the terms of the on file inP P .P�..�� rY P Final I this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of I Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough k PERMIT EXPIRES IN 6 MONTHS Final 4 ELECTRICAL INSPECTOR UNLESS CONSTRUCTICI Ta IS, Rough ........................ ... .......................................................................... service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SID Smoke Det.