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HomeMy WebLinkAboutBuilding Permit #626 - 15 DOUGLAS ROAD 5/18/2009 BUILDING PERMIT V10RTF1 OF t�eo qti TOWN OF NORTH ANDOVER cr '° o°, APPLICATION FOR PLAN EXAMINATION +� 0,� A 1, ,. Permit N0:0, Date Received .11 ��SSACHUS��(`' Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION I DO 0 Print PROPERTY OWNER_D or44 y (frmp,� Print MAP NO: PARCEL 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: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: 3+r )'I") Cn d rer,,.,T•( &-/ / - Identification Please Type or Print Clearly) OWNER: Name: Dorm y Cn-D ,11 Phone:&�)6F6 2/3L Address: /,S CONTRACTOR Name: ---)QmcS !-<eAer, GL Phone: (77r) 6,?3-a rl 01-, Address: 35a /Gh Supervisor's Construction License: Exp. Date: 1,12116 Home Improvement License: /ozl 772 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDINC PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASE,Df ON$125.00 PER S.F. Total Project Cost: $ o?DO.aC, FEE: $ a�Check No.: C�z� � Receipt No.:a O NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor �, Location ,//<--! ocation � 4 No. Date r 01 NORTH TOWN OF NORTH ANDOVER F 9 s° Certificate of Occupancy $ , �— ��s",•°•''��' Building/Frame/Frame Permit Fee $ s�cMuse 9 Foundation Permit Fee $ .� Other Permit Fee $ r TOTAL $ Check # 22U4L - Building Inspector 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COI'AMENTS 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 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 drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21 A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doe.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 ❑ 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 o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plata 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 o 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Page No. of Pages Proposal C� J & J Roofing Specializing in All Types of Roofing - Ventilation - Carpentry 928-683-2968 603-898-1058 PROPOSAL SUBMITTED TO PHONE DATE i STREET " [- r JOB NAME `f r ( R.4 CITY,STATE and 21DfODE JOB LOCATION ARCHITLCY" _ ' DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: .iTrrP4rP XrjnrcllcTor.0 u3 j' oS�•lic� �-r� 5�,�4I�`S . � J C,nV ry l Al ` syr,^ 7�, / ' t �,moi� �r ,f7- r, r-„ - f"17 2 r o r�raS5 r-c-c �L)rfe)1'0C,r)- �f r�J c�r1� r�; �r", ... Prr:�,�-4-Fr c;� ftsG . i?ip�1� :SCC Ce- ! rte r_xr� :..,Ce-k-r %'srP nol 'ree4 L,p r:1!fo$5 I'a�P c� (GG� c".11 CL T" s 'CGGi (!•JSTs1 d„ yt� t`Cw X3`1 30 ��,?�y:AC C' \.)t d°,•'$" �1�r' � i t�,��'°}i Irk�,� . r r75 c� I r ,�trnto railrt G�` r'Y1 Ui. -r rr(,,,; 1 !.:'v` r-Gs,oa 0�J{ tr? HIP propm hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: ,• -- ,r,r �.:� , -i- • , t .. t dollars($ Payment to be made as follows:i I All material is"guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized J / involving extra costs will be executed only upon written orders, and will become an extra Signature e' - wA charge over and above the estimate. All agreements contingent upon strikes, accidents �� or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days. Acceptance of Proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment will be made as outlined above. j Date of Acceptance: '' i Signature �ORTI-� own ® , t 4Andover . No. 6 4; (10 z = dover, Mass., T O LAKE A. COCHIC LAN 7�ADRATED '9S k BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.. D..0.A! ...0*4 ���' .�............................................................ Foundation has permission to erect........................................ buildings on .l .......DjoAq. �...•.... ...V........... Rough to be occupied as.... LotChimney provided that the person accep ng this permit shall in everyspect confor 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 sow-- PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR TARTS 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 SIDE Smoke Det. Client#:3854 JJROOFING ACORDTM 'CERTIFICATE OF LIABILITY INSURANCE DATE( WDDI Y") PRODUCER 2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HUB Int'l.New England(WILSB) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 299 Ballardvale St HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Wilmington, MA 01887 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Western World Ins Co JiRoofing INSURER B: Argonaut Insurance Co. Jimm Frederick 352 Island Pond Rd INSURER c: Travelers Indemity, Derry,NH 03038 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL.THF TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N RD POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MM/DD/YY LIMITS - A GENERAL LIABILITY REWNPP1145221 04/17/09 04117/10 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $50,000 CLAIMS MADE FE OCCUR MED EXP(Any one person) s5,000 X BI/PD Ded:1,500 PERSONAL BADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,000,000 POLICY PRO- JECT LOC B AUTOMOBILE LIABILITY BA3351685 05/22/08 05/22/09 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $100,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ _ RETENTION $ $ C WORKERS COMPENSATION AND 6KUB0482NO7209 03/07/09 01/28/2010 XI WC 1 TORSTATY U- OTH- IR EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $100000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Steve Desjardins Construction DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL lin_ DAYS WRITTEN 5 Carlisle Lane NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Salem,NH 03079 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZEPREPRESENTATIVE ZwtC406 wnnnn.ne tnnnwine.�..... _,... _.................................. __ __._ /.^�/'. _.�__�_ ... w.i.r+nn.ia.nn.�n w.ra.0•non... .� & J Roofing --- ----This form satisfics all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homwwuem Seek legal advice if necessary. Any person planning home imptovcmmts should fust obtain a copy of"a Massachusetts consumer guide to home improvement"before agreeing to any work on your rmidence.You may obtain afire copy by calling the Office ofConsumer Affairs and Business Regulation's Consumer Information Hotline at 617-9734787 or 1-888-283-3757. Homeowner Information Contractor Information as nuc pmY are Street Address(do dot use a Post Office Box address) oatracmd Salesperson/ tune N.AAdvvee ck CJ4415 'Mo4eS Ff e Je.,,G Cityrrown State Zip Cale i lusincss Address(must include n sneer address) (9 7� 6 f-d 131. 1" .303 Daytime Phone Evening Phone I Ityrrind State Zip Code 46 fj Mailing Address(It different farm above) Business Phone jedcrid Employer ID or S.S.Number. u..nyse,rhea men fuss©. toms vm,me romrc>asp.hYmba Eapiadmdae Pm '^d�eesde..Is.ee The Contractor agrees to do The 1foltowing work for the Ho\m �6 777 eo mer. � Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowners agen4 be adhered to unless circumstances beyond the contractors control arise (Owners who secure their own permits will be ` excluded from the Guaranty Fund provisions of 11 r Date when contractor will begin contracted work. MGL chapter 142A.) G e" 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 (�) Payments will be made according to the following schedule: S upon signing contract(not to exceed 1/3 of tho total contract price or the cost of special order items,whichever is greater) S by !1 or upon completion of by J / or upon completion of a> S5 upon completion of the contract (Law forbids demanding full payment until contract is completed to both party's satisfaction) 'Me following material/equipment must be special sl 44w Cc m be pvd for IVAf ordered before the contracted work begins in order S -" .CL' to be paid fa [-2 G to meet the completion schedule('") / NOTES:(e)Including all ftnanmcharges(ere)law requires that any deposit or down-payment required by the contractor before work begins may ant exceed the greeter of(a)une-third of the total contract pride or(b)tha acaal cost of any special equipment or custom me7c material which must be spedid ordered in advance to red the completion schedule. Express warranty Is an eaorw warranty being provided by the wairsdig? No Yes fall terms of the wnraaty mint be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor fitrther agrees to be solely responsible for all payments to all subcontractors for materials and labor under this awecrnent Contract Acceptance-Upon signing,this document becomes a binding contact under law. Unless otherwise anted within this document,the contract shall not imply that any licit or other security interest has 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 something is unclear. Make sure the contractor hay a valid Home Improvement Contractor Rettistration The law nequires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contrctor Registration_ You may inquire about contractor registration by writing to the Director at One Ashburton Place,Room 1301,Boston,MA 02108 or by calling 617-727-3200 or 1-800-223-0933. " Does the contractor have insurance? Check to see tlmt your contractor is property insured. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a plata other than the contractors normal plum of busin ss,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Seo the attached notice of cancdintion farm for an explanation of this right DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACESM Tun ideatictl copier ofrho moult mem he mmpletml and mgnc&ohm copy sbould no to the homeoses.no other copy rhenld he k pi by the malruror. � - I Iomeowner s Signature �ntmctor's Signature Date 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 not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws,ch ter 142, A. ' omeowner's Signature ntractofs i ature gr gn NOTICE:The signatures of the parties above apply only to the ment of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even 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(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 bylaw. 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,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 cavy 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 consumerihomeowner 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 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 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 him/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 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 Consumer Guide to the Home Improvement Contractor Law,"contact: 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 of a contractor or if 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 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)6524800 (508)755-2548 (413)734-3114