HomeMy WebLinkAboutBuilding Permit #595-12 - 142 BERKELEY ROAD 2/8/2012 TOWN OF NORTH ANDOVER
//�� APPLICATION FOR PLAN EXAMINATION
Permit NO. 7 Date Received
' � 1.
Date Issued: n
IMPORTANT:Applicant must complete all items on this page
LOCATION `�Z
Print
PROPERTY OWNER l-v-- SSo// e`G Unit#
Print
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes (&
100 year-old structure yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑New Building )(One family
❑Addition ❑Two or more family ❑Industrial
Alteration No. of units: ❑Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑Demolition ❑Other
❑S p c -® well" 4, F1oodPlainWetlands ';r 0 Warshed istricts7
❑Water/Sewer ` �5 � 3*z � r�
y� a��::ha..�...._v...,.ej. � t ; �rsb ' �'
DESCRIPTIO OF WORK TO BE PERFORMED:
(Identification Please Type or Print Clearly)
OWNER: Name: n� --e n 1 ,4� eSS�� �^� Phone: 97 - (,6g - -7 ct �(
Address: 1-12-
CONTRACTOR
-12CONTRACTOR Name-,4+L,,4-c- Phone: L3 7 9 -L(Z-� -�-o
Address: /414C�Ct> 9
Supervisor's Construction License: l Exp. Date: �'f Z�
Home Improvement License:_ I' �7 Exp. Date: G 2-3 Z
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: 9, O Cl FEE: $_ Ll l �-
Cheek No.: l'd(d�� Receipt No.: �c�
NOTE: Persons contracting with %'s—eyed contractors do not have access to the guaranty fund
-- - --,i — — —i� ---- ..F fi— — —
i
Si nafure�fA�ent/Owner� _ , � '�iSianatureaof�contractorf
NORTH
T011" ' of
0
4.
oo , dover, Mass.,
•
C OC L.CA
NE WICK �1•
SRATED P?E`�,�5
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
: ..... ....�.�.s .. .. .
THIS CERTIFIES THAT—,.... Foundation
has
has permission to erect........................................ buildings on...�. ..._..
«�/�I/..� ......�A.11....... Rough
to be occupied as.......... Chimney
1*w'1+... ...... ..........�.wwry.� ...................................................................................... v
provided that the person accepting this permit shall in every respect conform to the terms of the application 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
1 T T ELECTRICAL INSPECTOR
UNLESS LESS CONSTR V C TS 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 SODE Smoke Det.
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer TanningWassage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑
I 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
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Siqnature
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
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
rnr ern a�rr•rc+
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 drop requires approval of
Electrical Inspector Yes
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— For department use
Ll
i
I
i
Notified for pickup - Date i
Doc:.Building Permit Revised 2011 June/mi
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
o Building Permit Application
❑ Workers Comp Affidavit
Li Photo Copy of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
o Floor Plan Or Proposed Interior Work
a Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition or Decks
o Building Permit Application
❑ Certified Surveyed,Plot Plan
❑ Workers Comp Affidavit
a Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
a Mass check Energy Compliance Report (If Applicable)
❑ Engineering Affidavits for Engineered products
MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
o Building Permit Application
o Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
o Mass check Energy Compliance Report
a 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
Massachuscfts- Departioent of Public Safch
' Board of Building Rrt elutions.rnd Stantlar(Is
Construction Supervisor License
Failure to possess a current edition of the License: CS 69513
c„-
Massachusetts State Building Code
is cause for revocation of this license. JASON A WILCOX
Refer to: WWWMass.Gov/DPS 24 NEWBURY RD
IPSWICH, MA 01938 y
a—
J'"�"—�'-� I Expiration: 8/24/2012
('onunissiuO1'i Tr#: 428
�j ....- .........tea
—C�N Office of Consumer Affairs&Business Regulation
License or re I HOME IMPROVEMENT CONTRACTOR
gistrafion valid for individul use only j
before the ex i Registration: �,43213 Type: �.
Office of piration date. If found return to: Expiration: ��/ 31f012
Consumer Affairs r DBA
10 Park plaza and Business RegulationA f NTIC DESIGNUST �HbES
Boston Suite 5170
MA 02116 :r ! - t .
it JASON WILCOX' a<
24 NEWBURY RD 7"�`Y� r -
IPSWICH,MA 01938'`
Undersecretary r'
Not valid without signature —
S c) r`"� —L (vi r a A,
ear AS CAIl t
`/LI�`� /► r'r'i��.��7 Cot l 1�� q't �/
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Contractor Arbitration
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 IIQI automatically afforded to e
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 toa private arbitration firm which has been approved by
the Secretary of the Executive Office of Consumer Allain;and Business Regulation and the consumer shall.be required
"Ucitrafiprovided In MassachusettsGeneral Laws,chapter 142A.
g
ntractot'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 stiction is not
saratel signed by the eriies.
Homeowner's Rights
A homeownees 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 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,
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 catty 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 consumerlhomeowner rights,contact the Consumer Information Hotline(listed below).
Execution of Contract
The contract must be executed in AWJicgte and should not be signed until-a copy of all exhibits and referenced
documents have been attached. Parties am 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 patties.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.
Accelerated 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 hhn/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
IFyou have general questions or need additional information about the Home Improvement Contractor Law or other
consumer rights,or1f you wish to obtain a free copy of "A Consumer Guide to
Law,"contact: the Home Improvement Contractor
Consumer Information Hotline
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
(617)973-8787 or 1-(888)2833757
If you want to verify the registration ora contractor or if you have questions or need additional infomt
about the contractor registration component of the Home Improvement Contractor Law,contact: ation specifically
Director of Home Improvement-Contractor Registration
Bureau of Building Regulations and Standards
One Ashburton 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:
Consumer Complaint Section
Office of the Attorney General '
(617)727-8400
AND/OR
Better Business Bureau
(508)652-4800
(508)755-2548
(413)734-3114
ATLANTIC DESIGN
Phone: 978-423-9920 Fax: 978-312-1446
Homeowner nformatiow on 10i;
storkInformation
Name nn pony ame
1W-L- `fies_lule � .. �Cyb,•l t CCs
Strew Address(do not use a Post Office fiox address) Contrattairl Salesperson/Owner Name
City/Town State Zip Code luainess Address(must include a street dress)
[X (6`I —-7 C1 1 a�, ,G t k 31 4.
Daytime Phone Evening Phone I.ity/ro State Zap Coda
�r7k:wlQ� 9V-4123--qvo 2-7'2, — 7 6 Ck — y 3 0
Mailing Addreis(It different from above) IBusiness Phone 4aderal Employer ID or S.S.Numbs
L"rageiret hbsh ahoa tree b.I Roma CMMOernq.N.abw ru p.um ser
p..eom oamworr bva s 2 /
Mail eera.dan w..bQ
eHomeowner:
The Contractor agrees to do the following worts for the
sem
Required Permlb-The following_buiWill permits aro required Proposed Start and Comp4lion Schedule-The following schedule will
and will be secured by the contactor as the homeowner's agent, be adhered to unless circumstances beyo6d the contractor's Control arise
(Owners who secure their own permits will be -
excluded from the Guaranty Fund provisions of 3 , L ZDate when contractor will begin contacted work
MGL chapter 142A.)
Date when contracted work will be substantially completed.
Total Contract Price and Payment Schedule
The Contractor agrees to perform the work,fiunish the materiel and labor specified above todie total sum oE-
(•)
Payments will be made according to die following schedule:
f It, 6 3,6upon signing contract(not to exceed 1/3 of the tool con price g f the cost of special order ionts,whichever is grater)
s14 by /A/ I Z-or upon completionof j ✓t rjo Gcs�,6-rt
S by /_I or upon completion of
S 1 3 upon completion of the contract (Geo forbids demanding full payment until Contact is com letal to both
/ p parry's satisfaction)
7U following material/equipment must be special f to be paid for
ordered before the contracted ares begins in order S to be paid for
to meet the wmplatio s schethde.(oo)
NOTES:(4)Including all finance charges(•*)Law requires that any deposit or down-payment required by the contractor before work begins may
not exceed the greater or(a)one-third'of the total contract price or(b)the actual cost of any special equipment or custom made material
which must he,pedal otderadin ILdvaoce to mat the completion schedule,
)3xarers Wamnty-Lan tanress watnsty belga orowMad by the eantnder t Ne Yes fan time of the warranty most he attachaa to thee
Subcontractors-Thecontractor agrees to be solely respousuble_for completion of the work described regardless of the actions of any third
party/subcontractor utilized by the contactor. The contractor fittthaagrees to be solely rerpoasible for all payments to all subcontractors for
malcrials and labor under this aarament
Contract Acceptance-Upon signing,this document becomes a binding;Contract under law. Unless otherwise noted within this document,the
counsel shall not imply that any lien or other security interest has heed placed on the rgaidence. Ravicw the following cautions and notices
carefully before signing this contract
• Dont be pressured into signing the Contract Take time to read and fully understand it Ask questions if something is unclear.
• Mahe sure the contractor bona valid Home Improvement ^retractor eaianatiea I(ter(raw tu(uhrot most home improvement contractors and
subcontractors to be registered with the Director of Home Ilnprovcmtut ContMCW RegfatmfimL You may inquire about contractor
registration by;writing to the Director at One Ashburton Place,Room 1301,Bostob MA 02108 or by calling 617-727-3200 or
1-800-223-0933.
• Does the contractor have insurance? Check to see dmtyour.k:ontractor is properly insured
• Know your rights and responsibilities. 6end.the Impo"M mt lnforination on the reverse side of this form and get a copy of We Consumer
Guide to the Homer Improvement Contractor Law.
You may onset this agreement if it has been signed at a place offier than the contractues,normal place of bmineas,provided you notify the
contactor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not lata than midnight of die
third business day following.the signing of this agreement See the ntisched notice of canceltetion form for an explanation of dds right
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES111
Two identical epi/ia,of
tboo conuses ram be emplered and aigoed One mpy sheidd go to the hihon m.'rbc other mpy a6mW be Iupt by&a moasehsr.
Homeowner's Signaturt ctor's Signature
Date'
Date
Information and Instructions
Massachusetts General Laws chapter 1,52 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract ofhire,
express or implied,oral or written."
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
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 work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be dimmed to be an employer."
MOL 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
applicant who has not produced acceptable evidence of compliance with the insurance coverage required"
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic 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),address(es)andphonenumber(s)along with their certificate(s)of
members or partners,are notrequired to carry workers'compensation insinsurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
urance. If an LLC or LLP doe shave
employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regardiug 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 number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if accessary)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 maybe 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 notrelated to,any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOTrequired to complete this affiddvit.
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:
`fie Go�n,�,,ox�i�eati�oA 1'i�assao'ooset'rs
Dapart eut of Industrial A ccideRts
office of Investigations
600 Washiiton fteet
Boston.,M&0211 X
U.#617-727-4900 ext 406 ox 1.-877-MASSAFE
Revised 5-26-05 Fax#617"727-7749
Www.mass.,gov/dia
The Commonwealth ofMassachusetts
Department of1'n0'ustrialAccidel is
Office oflnvestigations
600 Washington Street
. Boston,MA 02x11
VWW-mas
ovIdid
Workers'Compensation insurance Affidavit:cBuilders/Conors/Electricians/Plumbetract
A licant Information rs
. Please Print Le ibl
Name(Business/Organization/Individual): `G
'1 �Si� rhes1-51;1 eoX
Address: 2, A)
S /''IA C)\ C/�30
.City/State/Zipg Phone#:
Are y an employer?Check the appropriate box:
1. T am a employer with 4. ❑T am a general contractor and I Type ofproject(required):
2•EJemployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
I am a sole proprietor or partner- listed on the attached shgget. 7. ElRemodeling
ship and have no employees These sub-contractors have
working for mein any capacity. workers'comp.insurance. S. 0 T)emolitiou
[No workers'comp.insurance 5. ❑ We are a corporation and its 9• ❑Building addition
required.) Officers have exercised their 10.❑Electrical repairs or additions
3.❑I a homeowner doing all work
mysys right of exemption per MGL 11.❑Plumbing repairs or additions
elf.[No workers'comp. � c.152,§1(4),and we have no
insurance required.]t employees.[No workers' 12❑Roofrepairs
*Any applicant thacomp,insurance required.] 1311 Other
t checks box#1 must also fill out the section below showing their workers'compensatioupolicy information.
?Homeowners who submitthis affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such.
'Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and their workers'comp,polioyinformation.
1'am an employer that ispro
infopmation. viding workers'compensation insurancefas my employees Below is tlzepolicy andjob site
Insurance Company Name:
Policy#or Self-ins.Lie.#: Ct l 0 Ci.off
Expiration Date:
Job Site Address: 1y2_
City/state/Zi* — /IA
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
finime up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in thto theposition of criminal penalties of a
e form iof ma STOP WORK ORDER and a fine
Of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the D9 for insurance coverage verification.
I•do hereby cert�y and hepains andpenaltles ofperjury thatthe informationprovidedabove is true and correct. `
3inature:
Bate: 2 5 1
'.hone#: 7 of.`l ZG
Dffrclal use only. .Do not Write in tills area,to be completed by city or town official.
City or Towyn: Permit/Lfcense#
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other p
Contact Person:
Phone#:
ATLANTIC DESIGN 1/31/12
Phone: 978-423-9920 Fax: 978-312-1446
CSL # 69513 HIC# 143213
TO: Vinnie D'Alessandro Location: 142 Berkeley Rd.
142 Berkeley Rd. N. Andover, Ma.
N.Andover, Ma
Fixed Price Contact:
Kitchen Remodel:
►Demo & dispose of existing floor,walls & ceiling throughout kitchen/dining area
►Demo & dispose of kitchen/dining dividing wall
10-Remove triple window in kitchen & single window in dining room & window over
existing kitchen sink
►Frame side dining room wall to accept triple window from kitchen area
►Frame back dining room wall to accept double window
►Reframe kitchen window to accept new window per plans
►Reframe existing kitchen sink window area to create wall and finish inside and out
►Patch in exterior siding as needed to finish
►Rough in all recessed lighting, electrical and cable outlets & appliance feeds_ per plan &
to code (includes gas cooktop and hood vent)
►Install new sub-panel in basement
►Move existing switch box to family room
00-Move existing thermostat to central location
►Provide under cabinet lights feeds
►Rough in pendants over island and new kitchen sink
►Rough in plumbing & vent to new sink& refrigerator location
►Run gas line to new cook top location (Note: Gas cooktop also needs electricity)
10-Add 2 toe kick heaters to exterior wall run of cabinets
00-Add to existing baseboard heat in dining room & hall
►Install R-13 Kraft face insulation to all exterior walls
00-Build header at hallway to create a break in ceiling
10-Install %' blueboard to all wall & ceiling surfaces
►Apply skim coat plaster finish to all walls & ceiling
►Install new 3 1/4" gloss flooring throughout kitchen/dining area. ( 21/ Flooring will be
used if 31/4" exceeds allowance )
10-Install customer- supplied kitchen cabinets per Moynihan plans
►Coordinate installation of granite counter tops (quote includes balance to Ripano
Stoneworks)
►Install all interior trim to match existing
►Install all finish plumbing
►Install all finish electrical
00-Install all customer-supplied appliances
o 4
• Price includes $4.50 per sq. ft. hardwood flooring
• Electrical includes recessed lights, devices & under cab lights (fixtures by customer)
• Scope of work is limited to this contract, any work above and beyond this contract will
be priced on site at an additional cost
TOTAL LABOR & MATERIAL $34,909
• Price includes all building requirements and permits
• It shall be the obligation of contractor to obtain such permits as the owner's agent
• Owners who obtain their own permits or deal with unregistered contractors shall be
excluded from access to the guarantee fund
Payment schedule as follows:
1/3 to start
1/3 upon rough inspections
1/3 upon completion
DO NOT SIGN THIS CONTRACT IF THERE ARE ANYBLANK SPACES
Jason Wilcox/Atlantic Design Vinnie D'Alessandro
9326 Date. .Z/?Xzz,.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
• � a
SSACHUS
i`
This certifies that ./71 /2-. �� . . !'� !' -�. . . . . . . . .
has permission to perform ./T4.4f
.�-�.%. .�".5 �
plumbing in the buildi�s of .
at. . . /.�/Z- . . . . . . . . , North Andove Mass.
Fee. y/Z P0.Lic. No. f.S AlBNG I ECTOR
Check #
d
�� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
'CITY�/v c, J -i -c"� � Mlt DATE� � ��7''j' �PERMIT fFkv,"NIF JOBSITEADDRESS j /c4 Z 1?,, r--(C! -I OWNER'S NAME]. 11'A141U
�
OWNER ADDRESS V �y (e � {{ TELI 93 6`Z t IFAXY-
TYPE OR OCCUPANCY TYPE COMMERC L I EDUCATIONAL RESIDENTIAL
PRINT
CLEARLY NEW:I I RENOVATION:I REPLACEMENT: ( PLANS SUBMITTED: YES( { NOf J
fIXTURES 1 FLOOR BSM 1 2 3 4 5 6 7 8 9 10" 11 12 13 14
BATHTUB
GROSS CONNECTION DEVICE --
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS(OIUSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM ... .....
DEDICATED WATER RECYCLE SYSTEM -
DISHWASHER I
DRINKING FOUNTAIN I
FOOD DISPOSER I'
FLOORlAREADRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK i i-- -
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE/MOP SINK
TOILET
URINAL --.-i � _ - - -- —i _T, -
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES.
WATER PIPING
.OTHER }
r �
INSURANCE COVERAGE:
have a ctirrent liabilit iiisitrance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO
IF YOU CHECKED YE%PLEASE INDICATE TH PE OF COVERAGE,BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICOTHER TYPE OF INDEMNITY BOND I, I
OWNER'S INSURANCE:WAIVER:1 am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws,and that my signature on this permit application waives this require(stent.
---- _ CHECK ONE ONLY:- OWNER } AGENT I
SIGNATURE OF OWNER OR AGENT
I hereby certify that all of the details and infonnafion I have submitted or entered regarding.lils application are true and accurate to the hest of my knowledge
and that all plumbing work and Installations performed under the permit issued for this application trill be in compliance rAth all Pertinent provision of the
Massachusetts;State Plumbing Code and Chaptgr 142 of the General Laws.
AV 1 �Y1�q(,'a,t!ter,. _
PLU��BER' AME jLICENSE#j.)3 567 SIGNATURE i
MPII I CORPORATIONS -Idf113,266' ;PARTNERSHIP( !fl; LLC I' !N! /3
COMPANY NAME 1InA"6-/4w,Pie u I ADDRESS� 3 I f V-,i A
CITY I/'n Y �� 4— STATE ZIP el y y TEL ?r s
FAX .50`/rS0 d CELL' I EMAIL I
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IRouc-H Pmmm iNSPJEC7 roN 1V0'10ES. BELOW FSPR 0� + CE USC:QNLY FINAL MSIPECTION NOTES
US No �7
THIS APPLICATIONSMVES AS THE PERMIT ❑. ❑ r�
FEE::$ PER]Wrr 0
PLAN RE, W NOTES
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