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HomeMy WebLinkAboutBuilding Permit #624 - 130 PLEASANT STREET 3/21/2011 I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO. Date Received Date Issued: r �1VIP 6AN�T:A licant must complete all items on this page LOCATION j�O r 4- 5� • • Pr' PROPERTY OWNER 'Zor" �L Print MAP NO:ZPARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential i ❑ New Building 110ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial j epair, replacement ❑Assessory Bldg ❑ Others: ElDemolition El Other P i �oFloodplaui ®Wetlands ®` WatersliedtDistrict �® Se tic ®Well �$ rY{� � i � SSl ✓$.{t-A.A� .Cjr � F'�� � i k K s `®iWater -60r " " "_: �� • � _ _ t ` °.# €fir `3 { z�4 ` DESCRIPTION OF WORK TO BE PERFORMED: Oryk.,a b-n 42-11/1!1 �2 Igentification Please Type or Print Clearly) ,l OWNER: Name: 104• psi S Phone: Jq AJo ddress: �v:-� —^4- CONTRACTOR Name: Phone: � �-7� Address: r o 0 1J /b1 L Supervisor's Construction License: ,/bZ 4119� Exp. Date: I Home Improvement License: /®�i 5�`l Exp. Date: �— ARCHITECT/ENGINEER Phone: 4 ii Address: Reg. No. FEE SCHEDULE.BULDING PER IT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Project Cost: $ �® FEE: $ - Total Pr oj Check No.: N I Receipt No.:. GJ NOTE: Persons contracting with unregistered contractors Flo not have cess to the guarantyff indl Si` afiare o co - i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ j � TYPE OF SEWERAGE DISPOSAL ' - Pubh Sewer ❑ Swimming Pools ❑ `4 Tm_ing/MassageBodyArt ❑ ; kk C� Well - - ❑ Tobacco Sales ❑ Food Packaging/Sales 0 y Private se tic tank etc � , Permanent Dum ster on Site� ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING DEVELOPMENT ❑ ❑ l 3 r COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature A e �.1 COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planng Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature&Date Driveway Permit F i DPW Town Engineer: Signature: ' Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street r Fire Department signature/date CONIlVMNTS ! y Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. ly Total land area, sq. ft.: x ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine r I� NOTES and DATA— For department use 1. t I - ® Notified for pickup - Date Doc:.Building Permit Revised 2008 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 r ❑ Workers Comp Affidavit t ❑ 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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations Y t ns (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 i 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 DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit r►all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. one copy and proof of recording rust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Location No. Date �oRTh TOWN OF NORTH ANDOVER c Certificate of Occupancy $ �ssACHUSEt� Building/Frame Permit Fee Foundation Permit Fee $ ��- Other Permit Fee $ TOTAL $ Check #_� 5 23973 Building Inspector -. ✓/ie:Po�.vrea.uuea/Cl:o�✓�l aoac�uaelta Offiee'of Consuiiier Affairs&Business$egul.- ;. HOME IMPROVEMENT CONTRACTOR r =Registra**(r*x108511 i ExpirationW/19/2012 bB ? 1 SMITH CONSrTRUCTIQN CO Kevin Smith. .. ._= 63 INGLEWOOD N Andover, MA 01845 Und�erscetai y i I - - Massachusetts- Department of Public S:ifetN � .Board of Building Regulations and Standards .I Construction Supervisor License. License: CS 102589 _ Restricted to; 00. •KEVIN SMITH 63 INGLEWOOD STREET NORTH ANDOVER, MA 01845 Expiration: 3/5/?_013 ` ('ununissiuner Tr#: 102589 i Massachusetts Borrie IrrrA!°oyement:Sample ®ntr`a.ct This Form satisfies all basic requirements of the state's]Rome improvemeuit'Contractor Law ' langdage to protect homeowners. Seek legal advice If necessary. An (MGL chapter lA2A),but dors not'include standard 1vTassachusetts consumer guide to home improvement"before agr agreeing tq a ty work on your re iae�nce�You mayvements sohta!m firstobtain a copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Informutioa Hotline at 617-973-879.7 or 1-888-283-3757. PY of"a Ifomeo'wner Information - 1�011tractoi'Information core °ml?�y core 5treel Address(da oat �✓ use 13—so-:e Box address) Contractor/Salep `'Owner NameO 1 5 City/Town State Zi Code t rhe A P usiness Address(must inclu e a street address) AAA- Evenin • g Phone t trrnw 7 State Zip Code ' M 'ing Ad cis(lt different from above) 5t/ usinessPhone ederalEmployw oll r S.S.Ntunher lawregourca tha lays ha oav®_ roma luov®eoaConaactor • pmvrmcateontcactorsluveI 'I aea•Nu<ob� Hxp'aaliondrte The Contractor agrees io do the'following works for the Homeo per bistaanoa numb= _ crt e m e w r o comp e e specs g e e, ran , e o m n s o e� e f , on ace s U�✓t t/` iGt.S I. /� 2`P. yLK_ nel yds Regtiired,]aermlts-The followin ,building pe7WIlUbe ProQrosed Start and Completion'Schad and vyip be securod b the contractor a P Schedule-The Y s the homagent f4IIowin schedule g cork be adhered to 1 (OWners who secure their own permunless circumstances beyond the contractor's control arise exelpded from the Guarant3i Fund pDate when contactor will begin contracted work MGL chapter 142A.)' Date when contracted work will be substantially completed. Total Contract Pi•Ice'and Payment Schedule The Contractor agrees to perform the work,fUrnish the material and labor specified above for the total sum of Payments will be trade according to the following schedule: (*, Upon signing contract(not to exceed 213 of tbe'tctal contract* rice or ' P the cost:of'special order items,whichever is greater) S by or upon campletionrof 5 by -_� -or upon completion of upon completion of the contract. (Law forbids demanding full pay mentuntil contract is completed to botha ,a Tho followingP rtY satisfaction) utateriallequipment must be special to be paid for$ ordered before the contracted wort begins in order S to meet the completion schedule,(**) - to be paid for NOTES:M Including all finance charges(**)Law requires that any deposit or down-payment not oxceed the greater of(a)One-third of the total contract price or P ,mart required by the contractor before wort;begins may which must be special otderedin advance to meet the competion srheciUleactuai cost of auy special equipment or custom made material )Jxpress Warranh-is all eznresswarra'. Nein n: to ar a Subeentractors ';rte contractor a ` actoa'! NO �� all terms of Ebe warran must bo attac ed o the contrnet agrees to no solely responsible for completion of the work described regardless of the actions of any third paitylpubcontractor utilized by the contractor. Tho contractor further a€Tees to be solei 're aterials and ichor„nA this aereement Y spbnsible far all payments to all subcontractors for ContractAcceptance-Upon signing,this documentbecomes=binding ce�ntract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interesthas been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract,Take time to read and fully understand it Ask questions if somethin • ke sur ther h i oma m rave ant Co contractorsems R.c ' g is unclear. rule c thac .•, r to be registered with the Director of Horne Im rover agiWtion Tho law requires mast home improvement regisnation by writing to the Director at One Ashburton Place,Raom 1301,Boston,Contractorat MA 02]0013 o bo calling inquire about contractor close and 1-800-223-0933. n+ Y g 727-3200 or • Does the contractor have insurance? Checic to see that your contractor is properly insured. • Know yourrights and responsibilities. Read the Important Infornlatiola on the reverse side of this form and get a copy of the Consumer Guide to the Home•Improvement Contractor Law. ,; MYou may cancel this agreement if it has been signed at a place a}lii r•than the contractor's normal lace o contractor in writing at his/her main office or branch office by ordinary mail posted,by tele business day following,the signing of this agreement• See the attached notice of cancellation form for an explanationeof this u notify the DO NOT SIGN TATS CONTRACT�,'T telegram sent orb,delivery,not later than midnight of the RE tis nght Two identical copies ofthe•contractmust be completed and si ed Cne co a R F ANY BLANK S}� wry►t 1 Py should ototheho• EA... a meownczT a thercapys uldbc tbythacontractor. Homeowner's Signature Con tor's onto Date /Date �/" COntrktor Arbitration The Home Improvement Contractor Law provides homeowners witlf 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 afforde�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 Off'ice.of Consumer Affairs and nusiness Regulation and the consumer shall.be required to submit to such arbitration-as provided In Massachusetts General Laws, chapter I42A. Homeowner`s Signature Contractor's Signature , NOTICE:The signatures of the parties above apply only to the agreement of the parties.to`aiternative dispute resolution initiated by,the contractor. The homeowner may initiatealternative 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(MC!L chaptez 142A)and other consumer ` protection laws*(i.e.MGL chapter 93A).may not be waived in any way,.even by agreement: Howevez;homeowners ymay,be excluded from 6ertaiwrighis if the contractor they choose is no.t properly registered as prescribed bylaw' .. Homeowners who secure their own building permits are automatically excluded from all GuarantyIyund 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 eniitled'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 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)ab6ut your c6nsum6r/homeowner rights,contact the Consumeii Iinfozimatian Hotline(listed below). Execution of Contract u The contract must be executed in du licate and should not.be signed untiba 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 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 witil both parties have received a fully executed cppy of the contract,.and the three day recission period has expired. Accelerated Payiments A contractor may not demand'payments in advance of the dates specified on the payment schedule in cases whew the homeowner deems him/herselfto be fuiancially insecure. However;in instances where a contractor deems lum/ljerself -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'tff you wish to obtain a free copy..of A Consumer Guide the Home Improvement Contractor Law,",contact: . Consumer Information Hotlihe Office of Consumer Affairs and Business ' _ ss$egulation .10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787or 1(8.88)2833757 `s If you want to verify the registration of a contractor or if you S M. about the contractor re is have que tions or need additional information spec ifaca tratton co11 g compo of the Hoy P me Inuprovem.ent Contractor Law, contact: Director`of Home Improvement Contractor Registration ' Bureau ofBuilding Regulations and Staridards One•Ashburtoia Place,Room-1301,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: " f Consumer Complaint Section Office of the,� ' E.ttorney General (617)727'-8400 ANIS/OR -Better Business Bu ea r u (508)652-4800 .(508)7�5-2548 (413)734-3114 ORTH I TO" of No. 3a� � 1 C' a dover mass. • i > o C �. COC MIC ME WICK � 7,p ADRATED � `s BOARD OF HEALTH Food/Kitchen Septic System .PERMIT T D 1 BUILDING INSPECTOR THIS CERTIFIES THAT .... �. 6.0.1p1r.a.0.......... �. ,t........................................................... ............ Foundation 4 , has permission to erect"a�cceping­this buildings on ......1a.0 si. .. Rough .i............... , ...... .. . .. .... ............. to be occupied as......... I.r.......CA.4........ if.....44.......11r1�.� .�........ . .......... Chimney ' e provided that the persopermit shall in e ry respect conform to the terms of thea ication on file in Final 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 UNLESS CONSTR N S ARTS ELECTRICAL INSPECTOR Rough 00 ........................................................................................... 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 SIDE smoke Det. The Commonwealth of Massachusetts Department of Industrial•Accidents Office of Investigations 600 Washington Street Boston,HA 02111 �'� �• www.massgov1dia Workers' Compensation Insurance Affidavit: Biiidders/Contractors/Electriciains/Plumbers Applicant Information ]Please Print Legib Name(Business/Organization/Individual): b ! ✓ ��Address: w / 97 City/State/Zip: A yy e/diol e,13 Phone#: 9 26 66 Z`7 b(:2�` Are you an employer?Check the appropriate box: Type ofproject(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction �employees(fall and/or part-time).* have hired the sub-contractors 2.R I am a sole proprietor or partner- listed on the attached sheet.? 7• ❑Remodeling . ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. Building addition [No workers'comp,insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.F1 Plumbing repairs or additions myself. [No workers'comp. c.152,§1(4),and we have no 12.0 Roof repairs insurance required.] employees.[No workers' 1311 other comp.insurance required.] ?Any applicant that checks box 41 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 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. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job 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 of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer ' un r the ins nd enalties ofperjury that the information provided a ove is true and correct. Si ature: Date: �7_� /f Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): Y.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: y K 1. l ' M 4 now Oita a t ' 4 ' ¢.�+'a�u � ;� __ ,may-•�+.. M ,.w«, 4 , "' 1T:-r! S,� 1f.1>14"4 j1K(f X�i�"�l'✓l1�$i 1{#Bu 4'�t 4 d 6,.e' ,q.ray.aF 'Z C'. .; 4T S „ q j a� Z »,r 0. r , YpW W + V r NN" r poi nN r 1' TIM • ,, *.-.u" .. a,."�o.. �'r.^.•.'"„'*T"t'� � . � � . 'I �. "AA,��hdkh �`+Vp+F.v�u Ut+'t., F i _ `� v 1",. P .r `^a ..� '+°��,-_?� "i� • �e � p ira ir't''A r€C r 4 a: a ,.w.�r.. '"•''.".`1S"C�'7 T�� 'Rt i, � +� : ���- '� � � :r v t d� p i 6 x Rs +' ''i^n �-A .�f",, • at{1 t,Aa ,Pi1Fln p ♦4+ a UAl SSfjj . J�f T,- kA VN TV r t 5 I