HomeMy WebLinkAboutBuilding Permit #678-11 - 125 Main Street 4/8/2011-L/-,
Permit NO: 6/
Date Issued:
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
IMPORTANT: Applicant must cc
1d.-%1.4;ILI Sf2P,�7,4
Date Received
all items on this
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PROPERTY OWNER 114161 l �� ��' �' &,2 a
Print
MAP NO: 0-2%y PARCEL:00 VG' ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
Alteration
No. of units:
ommercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Weil
❑ Floodplain, Eli Wetlands
❑, WatersbediDistrict
I] Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
, � a -c- ie e�ti 0 l kl,4LZ-
(Ide tification i,Ylease Type or Print Clearly)
OWNER: Name: S!4 /1/ -_a ✓( 64 fz2-- 7-�(IS /--
Address: l? 5— mlgiit/
CONTRACTOR Name: ✓d �4// /)14IrS0 t,C Phone: ` — 1��1
Address: ',?W
Supervisor's Construction License: �Exp.Date: -L,21- Jo .—Jo ff
Home Improvement License: I q `� Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PE7000
T: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total Project Cost: $ i FEE: $ �
Check No.: Ly 2—L Receipt No.: J YO d
NOTE: Persons contracting with unregistered contractor do o h ac s the guaranty fund
Signature of Agent/Owner- Sig ture of -contractor.
-_
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Plans Submitted ❑ Plans Waived ❑
Certified Plot Plan ❑ 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
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED DATE APPROVED
❑ ❑
CONSERVATION Reviewed on Siqnature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Com
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town EnLyi
FIRE DEPARTMENT - Temp Dumpster on site
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Located 384 Osgood Street
yes no
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ 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
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED DATE APPROVED
L
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
P Conservation Decision: Comments
[� Water & Sewer Connection/Signature & Date Driveway Permit
tl DPW Town En ineer)i nature:
m
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main 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 eodrop requires approval of
Electrical Inspector Yes
DANGER ZONE LITERATURE: Yes No,
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
Doc:.Building Permit Revised 2008mi
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
Li 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/Crossection/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)
❑ 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: Doc.Building Permit Revised 2008mi
Location
No. / — / Date 44
Mme,. TOWN OF NORTH ANDOVER
� s
9
Certificate of Occupancy $
s„CNUs <�• Building/Frame Permit Fee $?'
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # V
2 b b
Building Inspector
f�L o Al
Location
No. (!' 7P - ,�a///
Date
Check #
24�-►5
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ lG¢
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
�G
Building Inspector
CERTIFICATE OF USE & OCCUPANCY
Building Permit Number 678-2011 Date: June 3, 2011
THIS CERTIFIES THAT
THE BUILDING LOCATED ON Maya Salon, Unit #1, 125 Main Street,
North Andover, MA 01845
Hadi Fares,
MAY BE OCCUPIED AS beauty salon IN ACCORDANCE WITH THE PROVISIONS OF
THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS
MAY APPLY.
Certificate Issued to:
Fee: 100.00
Receipt: 24215
San Lou Realty Trust
125 Main Street
North Andover, MA 01845
Building Inspector
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1Y1� assachusetts l3oWe Inipt°ovement• Sample Contract
satisfies all basic requirements of the state's ]Rome impnovemeuit'Contractor Law
to protect homeowners. Seek legal advice if neeessar . An Planning (MGL chapter lA?A), but docs not 'include standard
setts consumer guide to home improvement" before a Y 'rmg } person tannin trema improvements should first obtain a copy of "a
:onsumer Affairs and Busineessss Reyoguutlatinn's Consumer Information Hotline t 617-9 73-8797 or "? ally work on Your reshlence. 1= 88_283may -3757 in a free Copy by calling tlTe
r T�ol`i� pop Contractor Information
The Contractor aorrerc +„ >an #i_
- � SLC✓lam: ��� � • .
Required,Isermlts -The followin Kbuilcling permits are required
and Nyill be see'ure by the contractor as the homeowner's agent,
(OVOnei rs who secure their own permits will be
exclpded from the Guarant3i Fund provisions- of
MGL chapter 142..) '
ederal Employer ar 5.5. tunber ' .
requites Lbatmost home'n- nomepmvemen6Canhaclat
�cn[eantracmts haver Eag.Number fixpualian date
reaictea6ao oumhe
J m n O e a OD c i nP•esory••
Proposed Start and Compl�tlon Schedule -The fgIlowing schedule will
be adhered to unless circumstances beyond the contractor's control arise
-----:.._Date when contractor will begin contracted work.
Date when contracted work will be substantially completed.
Total Contract Price and Payment Schedule
The Contractor agrees to peltorm the work, furnish the material and labor specified above for the total sum of
Payitent� will be trade according to the following schedule:
Upon signing 'contract (not to exceed 113 of the'totai contract rice or � '
• p the cost of'specia] order items, whichever is greater)
S--•-•---.---.— by or uponcompletionrof
S by -or upon completion of
�—_ • upon completion of the contiack• ' •: '•
(Law forbids demanding full paymentuntil contract is completed to both party's satisfaction)
Tho following material/equipment must be special $
ordered before the contracted warl'begins in order S to be paid for
t to meet the completion schedule.(**) to be paid for
NOTES: (*) Including all finance charges (**) Law requires that any deposit or down- a
not exceed the greater o f (a) one-third of the to t$1 contract ca or p yIDent required by the contractor before work begins may
which must be special orderedin a`dvanco to meet the complegon scheduleacl cast of any special equipment or custom made material
----- -• a�.��� - z ne connactor agrees to be solely responsible for completion of the work described eunrarmsofthewagardlesii sof thbon t ed e actions of he conduct
pAt—eh is andbcontractor utilized is the contractor, The contractor further hgree$ to be solely'respbnsible for all a
materials and labornnA +r ,eement payments to all subcontractors for
Contract Acceptance -Upon signing, this CiOcumrntbecotnes a binding contract under law. Unless otherwise noted within this document, the
co carefully
shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices
carefully before signing this contract
• Don't be r
p assured roto signing ilia coatracL Take limp to read and fully understand it Ask questions if something is unclear.
Make sure the .•.....,..._.__ „_ lid Ho e T
subcontractors movement Contractor lt_ o�on Tho law requires most home improvement contractors and
w be registered with the Director ofHome Improvement Contractor Registration, you may inquire about contractor
I
by,writing to the Director at One Ashburton Place, Room 1301, Boston, MA 0230s or by calling fi inquire
about'
c or
1800-223-0933.
Does the contractor have insurance? Check to see thatyour contractor is properly. insured,
Guide to the HomrrImprovement Contractor Law.
Know your rights and responsibilities. Read the Important Infomlaliola the reyerse side of this form and get a copy of the Consumer
,; on
You may cancel this agreement if it has been signed at a place aliier• than ilre contractor's normal lace o
contiactor in writing at his/her main office or branch o$ice by ordinary mail'p°sted, b uslurss, Provided you
third business day following, the signing of this agreement Seethe attac]tcrl notice of cancellation form for de explanationoftat f t h notify the
DO NOT SIGN THIS CONTRACT IF T]EIERE ARF telegram sent or by an not later than midnight of the
Air T �TTr s right
Two identical copjes of the•contma-.tmust be camplcted and si ANY B'� LANK [L SP i l l
SA0`l X10 caPYsttauld ao ro thb tmittcowa¢ The atha copy should he SPACES
1¢p[ by the con ctor.
3
Homeo nee Signatu
Conbractbes Signator
Date
ter
Date
Contrhetar Arbitration
The Dome Improvement Contractor Law provides homeowners withthe right to initiate an arbitration action (as an .
alternative to -court action)'if they have a disputa'with at contractor. The same right is not automatically affordei 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 apprpved.by
the Secretary, of the - Executive Office. of Consumer Affairs and mousiness Regulation and the consumer shall. be required
to submit to such arbitration -as provided In Massachusetts General Laws',, chapter I42A.
PTomeowner'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 bomeown6r may initiate alternative dispute resolution even where this spetion is not
separately signed by the parties.
Homeowners Rights
'A homeowner's rights under the Home Improvement Contractor Law (NMGL 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•lyund provisions of
'thd 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 partic ''lar
purpose; An enumeration of other matters -on which the homeowner and contractor lawfully agree may be added to the
term's of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions' about
your consum&r/homeowner rights, contact the Consumer Information Hotline (listed below).
Execution of Contract t
The contract must be executed in duplicgte and should nut. be signed until• a copy of all exhibits and referenced
documents have been. attach6d.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' arties. Contracted work may not begin until both parties have received a fully executed copy of
the contract,. and the three day recission period has expired.
Acce'lernted 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/lierself
-to be financially insecure, the contractor may require that the balance of funds not yet due be placed iri 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 .�, Cons
Law," contact; umer Guide,to the ]lame Improvement Contractor
.
• Cdnsumer Information Hotline !
Office of Consumer Affairs and Business'$egulation
.10 Park PIaza, Room 5170, Boston x MA 02116
(617) 973-8787'or 1(8.88) 2833757 "a
Ifyou want to verify the registration bf a contractor or if you have questiolls or need additional iIl orma'h
about the coritraetor registration component of the Home' Improvement Contractor Law, contact: on 5peelftcally
Director of Home Improvement Contractor Registration '
Bureau otBuilding Regulations and Standards
One•Ashburtoh Place, Room.1.301, Boston, MA 02108 `
(617) 727-3200 or. 1-800-223-0933.
For assistance with informal mediation of disputes or to register formal complaints against a business, call: '
Consumer Complaint Section
Office of the Attarney General '
(617) 727-8400 "
ANF/OR
-Better Business But•eau
(508) 652-4800
.(508) 755-2548
(413) 734-3114
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k Massachusetts - Department of Public Safe" �
.Board of Buildin!a Reulatioris and Stanilardc ' i o iv
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Construction Supervisor Licenser
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License: CS 93545
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Restricted to: 00
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JOHN M MAKSOU
24 WEISNER PRKY o
METHUEN, MA 01844`' --
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Expiration: 6/20/2011 W NL
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The Commonwealth of Massachusetts
Department of Industrial Accidents
t�JOffice of Investigations
600 Washington Street
Boston, MA 02111
�'� s�. www.mass.gov1dia
Workers' Compensation Insurance Affidavit: Biiilders/Contractors/JElectricians/Plumbers
DD11canf Information Please Print Legibly
NaMe(B.usiness/organization/lndividual):
Address: t/✓�G�'
City/State/Zip:.
CIL
Phone #: �j� o2.5j 8 } 1 0 _( C
Are you an employer? Check the appropriate box:
' L ❑ I am a employer with
4. ❑ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2. I am a sole proprietor or partner-
listed on the attached sheet. i
ship and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. ❑ We are a corporation and its
required.]
officers have exercised their
3. ❑ I am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.] T
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling .
8. ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
11. E] Plumbing repairs or additions
12.❑ Roof repairs
13. EI Other
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
7 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp, policy information.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information. A4 , „ ,I
Insurance Company
Policy # or Self -ins. Lic. #: M Expiration Date: Z.-.2.,2- J o V _
Yob Site Address: City/State/Zip:
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
ofup 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 certify up der tJ o pgns andpenaldes ofperjury that the information provided above is true and correct.
Phone
Offzcial 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
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Contact Person: Phone #:
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