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Home My WebLink AboutBuilding Permit #1022-15 - 124 BRIDLE PATH 6/8/2015 NORTII BUILDING PERMIT °F�tLeD 'bq"o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,� - O� �01 Permit No#: � 2 i , Date Received ��ADRATED SSACHtlsfc Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION do w ` _Print PROPERTY OWNER YY1 Q�' Oy-(aR � / rint 100 Year Structure yes no MAP ''PARCEL: ZONING DISTRICT:-Historic District y s no Machine ShopVillage y s no TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential I ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑ Commercial ❑Alteration No. of units: � ❑ Repair, replacement ❑Assessory Bldg_ ❑ Others: ElDemolition ❑ Other - _- - - �"' ®s�Watershed District.` P �[A;JSeptich �W. ell iFlootlplain Wetlands DESCRIPTION N 0 FW - WORK TO BE PERFORMED' Identification- Please Type or Print Clearly OWNER: Name: v- Cc v � Phone: 7 � Address: Contractor Name: n kf Cr wf(tc'p Phone: Email: Address: 'b o� Supervisor's Construction License:CSS/ea)-6 3 Exp. Date: Home Improvement License: 1S6�i Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.. 1�7 }� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have accesslo th ua anty fund --- ---- - n.- a � F _ - . t. Location 1� ��J [ t I I No O r Date . TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $- ' I I Foundation Permit Fee $ I { Other Permit Fee $ TOTAL $ f_ (� Check#T z'r Building Inspector I i _ - it Plans Submitted❑ Plans Waived'❑ Certified Plot Plan ❑ Stamped Plans ❑ -TYPE O'P.-SEWERAGEDISPOSAL- Public Sewer Elg/M g Y Tannin assa eBod Art El... . Swimming Pools El Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc... ❑ - :Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTM,ENTAL SIGN OFF - U FORM . DATE REJECTED: DATEAPPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS .CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature i COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/S—nature�Date Driveway Permit DPW Tovyn Engineer: Signature: � Located 384 Osgood Street FIRE t?EPARTfIF=IST =Temp Dumpster on side yes.. .. : . _ no Located at U4 Mair Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drops requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA—_(F®r department apse) i . I I I I ® Notified for pickup Call Email Date Time Contact Name i Doc.Building Permit Revised 2014 ' I I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets-of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) j ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 NORTH own of , 0 C, h ver, Mass, �1 coc 1c.t.1c. S U BOARD OF HEALTH Ii PERMIT L D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT INASW�........C).b ...................... has permission to erect building n . Foundation ....'.Q%.. - ...... er.kdLot—we........ .. Rough tobe occupied as ......�.. .. ... ..... ......... .... .... �. ..................................................... Chimney provided that the person accep Ing this permit shall in every respe onform 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 IN 6 MON S ELECTRICAL INSPECTOR ' Rough . UNLESS CONSTRU N RTS Service ............D ........................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final A No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. i — W RICIN' Roo ��tG�C�u1I�S - . Massae,h.».se40 dome Tm �oveaom.e�.� Contract This foam,satisfies all basic re , requirements S pts of the states Home Improvemelrt Contractor Law(MGL chapter 142A),but does not include standard language protect homeowners. Seek legal advice if necessary. An y person planning home improvements should first obtain a copy of"A Massachusetts ceOf Consumer Crnide to Home Immala emeerrt"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regalati.on`s Consumer Infoatian Hotline at 617-973-877 or 1-888-283-3757 or on our website. ' 11OnMowner hfOrmation 'Contxactor Infomatzon O�lam K Company Name • StreetAddre (do not aPost Office os address) r t Gu��rS a y COutraactov Salespe(A,n/OwnerName City/Town �( State Zip Code � Bpsiness Address(must incl e.a street address) t4Y►G�OvQ� I't►'1�- • 01ffyS" iso 8Qrr Sf. Daytime Phone Evening Phone Cityrcown State Zip Code Mailing Address(It different from above) Business Phone978-689 ddy 7 red Einpioyer ID or S.S.Number Law tlmtmostlioHomeImprevementContmetorltes:Number Expimdondate • mc improvement contactors Itnve 13856�](} n valid reB stration munBarao/ The Contractor agrees to do the following worlc for the Homeowner: (Describe in detail�ie worlr±o completed,specifyingthe type,brand,and grade of materials to be used,use additional sheets ifnecessa Y'oo �, (��e.asQ See a��P�l ��pog� ') i.2eiluired Permits-The following building permits are required Proposed Start and Completion ScheduIee followin-Th and will be secured by the contractor as-the homeowner's agent; be adhered to unless circumstances beyond the contractor's schedule control arise (Owners who secure their own permits:WiU be excluded frons.the Guaranty Fund provisions of � 9 /-L—Pate when contractor will begin contracted work. MGL chapter 142A.) 6 20 S Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of-. /� a$d D > Payments will be made according to the following schedule: ( ) $31-0000 upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichis greater $ ever ) $ by ! ! or upon completion of 7` -00 upon completion of the contract, (Law forbids demandin fan p a yment until contract is completed to both party's satisfaction) . The following material/equipment must bespecial ordered before the contractedworl�be ' to be paid for to meet the completion schedule.(**) �s in order to be paid f_or — - - OIO2/ZZ/Zi-Z'Znc? 1L •��5-��L••�T•p ao 8tSZ-SSL`805`008'h'ZS9'80S -a-eomQ ssoursng xa fag 2T0/QLD 00'b8-LZL-LT 9 Texaua0 AOU20:4V Q ;o a0r-0 uo.aaS jucsjduxoa xeumsuo0 :lea`ssaucsnq u jsuTeSe s4tTducoo 03 xa�sr.4nx el,xo sa�.ltidsxp 3o uo1.•cxpaut�uuo�`ut arm aoueastsse.10,-I s�,•�stlaasuaoiL/}ualztahoa uziauiotl/sta•�.Lu•a�.�.s'G.P//:c1-�tiL MO.4ca ag s,ao�-3,e: ao0 u§o snluls'3T.mans.ol.aurP CID /tqu;,00/Au,o-Neu.---i nA//; 4�T�s a��sga�a�xaCR;iqAxo LSLE-ESZ-288`L8L8-£L6`LT9 9TTZ0,M`uo4sog`0LTS taoog`ezuXa3laea OT �% . . y1D R Connfraciorc A rbitri lion 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 conliactor. The same right is not:automatically affordedto 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 coal'-.1 actor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. 1 The contx and the h 'contractor hereby mutually agree in advance that in the event the contractor has a dispute concern g b con c;the contractor may submit the dispute to a private arbitration firm,which has been approved by the Sec et ary the E cutve Office of Consumer Affairs and Business Regulation and the consumer shall be required to sub rmit to ' f ch arb' ation as provided In Massachusetts General Laws, ch er 142A.. Ho>znees Signature Contractor's signat e NOTICE:The signatures of the p es above apply only-to the agreement of the parties to alternative dispute resolution initiated by the contr or, The homeowner may initiate alternative dispute resolution eY,en 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(Le.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners may be excluded from certain rights if ttze contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Ftuid provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and work anlilce 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 emlmeration of other matters on which re homeowner and contractor lawMy 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 2iyen•to the owner and the other kept byte contactor. Ary mcdT�car on to tl:e.o+igival con��actmTastbP�� x'!'i��g and agreed to by both parties. Contracted work may not begin until both parties have received a fixity 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 payrro.ent schedule in cases where the homeowner deems him/herself to be financially insecLue. However,in instances where a contractor deems him/herself- to im/b erselfto be financially insecure,the contractor may require that the balance of funds not yet due be placed in a j oint escrow account as a prerequisite to continuing the contracted work. Withdrawal of(ands from said account would require the signatures of both parties. Additional Wormation � 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 Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Pa:rlcPlaza,Room 5170,Boston,MA,02116 617-973-8787, 888-283-3757 or visit the OCABR website at 1�://ww,,v.mass.Xov/ocabr/ if you want to very the registration of a contractor or i f you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law, contact: Director of Home Improvement Contractor Registration n:P rass Re�r_dation — FREE ESTIMATES PROPOSAL Construction Supervisor Lic. # CSI02663 FULLY INSURED H.I.C. Reg,# 138569 1VW01XIE-1111" GITIMRS AAISM H01" IMFROWAMW Specializing in Seandess • All Colors Available 350 BERRY STREET . NORTH ANDOVER, MA 01845 TELEPHONE: 978-687-2247 PROPOSAL SUBMITTED TO PHONE DATE dCAaV.,s kv, 687- )176 6STREET JOB N M€/LOCATION Mq 8rid le- a�A orrnF_ WK STATF ANO ZIP COOe JOBSTART DATE iI l r An.cto VW M /9 p/9'16' W eek o f Twn2 9 '�` d-015" S7f v-cDo 31 03570 per S6. usi*n 64 �j ta'HkQ. vj o o o( OvrchL�cd' S k t 3 a m P O W t J r'a+,e&, (.(S e 6 4 t,f,C-11 Q,t U52 tFCe -e wa;(*e-rS�u'W on su✓1roow. Iry r P_e VVX+MP0 5. Abo`F d0i ruW-r'eA.r 8arlc roof, +W� be-en YonQ-. (,..,ax�_, down. �o 16 'W- pa_pt tr' Ucjoor 6aarr-re.,r � Ik a . cL-,\,f u " + aC( Raua r ro kep, 0 hCe_ pre f i s c6nc laQr dowvn %+&c t9.r- SW i P s on Qowp s `I Q_K ta4 d4wv. i`0 rtZkA*l s per t&&s Cud C-40 Mai V. ]Owe-.r- 4`o„ V--o ods �=�- 1. i1�a s cQs. Vit W A4-, ge�v.�ck� 'VQ-vl+ 4f\e vx CAfl,• C pw, v-p a hd. kcLuk Q vj a- pmoo Ce,,- a V ►q-w 0,4 w.�as ®�' roof - e�� M .� price a(so i riciuoLQ.s of ` c a Skvs of `�wedL 1( ,r- W 0 0 J de-c k v-o re plAce rhevl, X ado, 'OrA rot +t Il Q_ rep lace_ct @ , /DO- per Sho?,f ej plywood'. We PYOpOSC hereby to fumish material and labor-complete in accordance with above specifications,for the sum of:$ Payment to be made as follows: r'/O®�cJ cJ cte? OS(� ./l. _ ANP-i&-� /)n, (u ht Ce All material is guaranteed to be as specified.Ali work to be completed in a substantial workmanlike manner according to specifications submitted,per standard practices.Any alteration or deviation from Authorized above specifications involving extra costsw be executed ordy upon written orders,and will become an Signature extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond out dortirol.Owner to carry fire,tornado and tattiernecessary,insurance.our workers are fully NOTE: This proposal ma be covered by Workmen s Compensation Insurance.Non payment by agreed party may result in litigation withdrawn by us it not pt8d withi �� with penalties including court cost and compensation both real and punitive. / /// days.- i Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and her y making this.a valid contract. Signature Y are authorized to do the ork as pecified. yment wi made as outlined. Date of Acceptance: Signature i The Commonwealth of Massachusetts Print Form ____ _ --- Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 _ ! Boston,MA 02114-2017 t www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly = Name(Business/Organization/Individual): ' f l� �-L tarS Address: 3, C S� City/State/Zip: d.AvP4 Of 916- Phone#: 978-68?-o1JY 7 Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 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' 9. ❑ Building addition [No workers'comp. insurance comp. insurance.# required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.E] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ R of repairs insurance required.]t c. 152, §1(4),and we have no K P employees. [No workers' 13. Other � q( p r re-y'oo¢ 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: L- ov-S M(A fkA Policy#or Self-ins.Lic.#: Ui C S- 3) S- 32 7 4 7- 0/tf Expiration Date: 9/3 0/,JOl S- Job Site Address: 1V 1961- iPa Th City/State/Zip: A1,"VW,M/q B lst(s 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. 1 Ido hereby certi under the pains and penalties of erjury that the information provided above is true and correct. Signature: Date 6 3 /5- Phone#: Q�8-689- a,aY 7 { Official use only. Do not write in this area,to be completed by city or town 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 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their tract oflhirees Pursuant to this statute,an employee is defined as"...every person in the service of another under any c express or implied,oral or written." f An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the F receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair be deemed t be an employelling r." or on the grounds or building appurtenant thereto shall not because of such employ r MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any acceptable evidence of compliance with the insurance coverage required." applicant who has not produced either the commonwealth nor any of its political subdivisions shall Additionally,MGL chapter 152, §25C(7)states"N enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),addresses)and phone number(s)along with their certificate(s)of Limited Liability Partnerships(LLP)with no employees other than the insurance. Limited Liability Companies(LLC)or ers' compensation insurance. If an LLC or LLP does have members or partners,are not required to carry work employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date e ffof the affidDepaavit should be returned to the city or town that the application for the permit or license is begrequested, Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials - Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference submitone affidavit indicaer. In addition,an ting current that must submit multiple permit/ nt applications in any given year,need only policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 = Boston, MA 02114-2017 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 7-2010 www.mass.gov/dia i Massachusetts -Department of Public Safety Board of Building Regulations and Standards Cor%trurtinn Stiller%isnr / S License: CS-102663 SCOTT W WRIGtfT 350 BERRY ST —, NORTH ANTDOVFjt MA Expiration Commissioner 0811212015 , .Office of Coammer Affairs h Business Regnlstiaa A 'ROME IMPROVEMENT CONTRACTOR iR+ tsg'tshatlan: 13M9 Type: Expiration: 4/1412017 DBA WIGHT GUTTERS SCOTT WRIGHT M BERRY ST. NO.ANDOVER,MA 01845Undersecretary i