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HomeMy WebLinkAboutBuilding Permit #899 - 172 CHESTNUT STREET 6/24/2013Permit NO: 01 LI Date Issued: I I ti'( TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONN61zq Date Received I X-1) I1qPORTANT: Anblicant must complete all items on this.Uai?e A I LOCATIO N PROPERTY OWNER 6'j' 'Print MAP NO PARCEL ZONING DISTRICT: 100 Year Old Structure Historic District Machine Shop Villa yes no n- ves k no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ Rew Building ❑ One family ❑ Addition 0 Two or more family 0 Industrial ❑ Alteration No. of units: 0 Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition 0 Other 0 Septic 0 Well ❑ Floodplain ❑ Wetlands ❑ Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Address: 9aTs CONTRACTOR Nam /� hone: Address. a Supervisors ons ruction License: �1I Exp. Date: 7--- Home Improvement License: 6lD0Exp. Date: ARCHITECT/ENGINEER Address: Phone: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BAS TM, 00 PER S.F. Total Project Cost: $ S� s >' 0� FEE: $ Check No.: 'D�� Receipt No.: 62 5 NOTE: Persons contracting with unregistered contractors do not have access to the guara fi Signature of Agent/Owner Signa of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stam Plans ❑ Location I No. Date,��,!�- k3 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $- TOTAL $ Check # 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 PLANNING & DEVELOPMENT DATE APPROVED El i COMMENT CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS ® OF Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments It Conservation Decision: Comments Dater & Sewer Connection/Signature & Date Driveway Permit DPW To -vv;^ ]Engineer: Signature: Located 384 Osaood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Mair Street Fire Departmerit signatureldate 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 21A -F and G min.$100-$1000 fine NOTES and DATA — (For department use D Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fol,owing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofiv,g, Siding, Interior Rehabilitation Permits 6 Building Permit Application_. m ❑ Workers Co - #fiida'vit Y s►- �� ❑ Photo Cop f H.I.C. And/Or C.S.L. Lic ses ❑ Copy of C tract ❑ -Pr Proposed Interior Work q,-EAcfinee4FKjAffidavits 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 app, -al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Bui";iing Permit Revised 2012 f C®nt r This 301M sages all basic requirements of the slate's Home improvement Contractor Law (MGL chapter 142A), but does not include standard language se protect homeowners. SeeTc legal advice if necessary. Any person planning home improvements should first obtain a copy of "A Massachusetts Consumer Guide to Home Improvement" before agreeing Office of Coto any work on your residence. You may obtain a free copy by calling the mer Affairs and Business Regulation's Cosumer information Hotline at 617-973-8787 or 1-888-283-3'157 or on ovr website. ' Homeowner mt"m� on 'Contractor 'n-matio»t ane contractor agrees to do the following work for the Homeowner: v v (Describe in detailthe worlcto completed, specifyingthe type, brand, and grade of materials to be used, use additional sheets ifnecessa nekuired Permits - The following building permits are required and will be secured by the contractor as•the homeowner's agent: Peters who secure their own perwaits'vvM be excluded from the Guaranty Ftmd provisions of MGL chapter 1.42A.) Proposed Start and Completion Schedule - The following schedule will be adhered to unless circumstances beyond the contractor's control arise when contractor will begin contracted work. 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 £Payments will be Cmade according to the following schedule: up -on signing contract (not to exceed 1/3 of the otal contract price $ D y f 3 or upon completion of $ by .ice/j or upon com letion of -- pVV✓'1t cosi of special order items, whichever is greater) t _ . rf — 1 upon completion ofthe contract, (Law forbids demandingfanpayment \I- - Until contract is completedto both 'party's satisfaction) The following material/equipmentmust be special $ to be paid for ordered before the contracted work begins in order to meet the completion §chedule.(* *) $ to be paid for NOTES: (*) Including all finance charges (*:1.) Law requires that any deposit or down payment required by the contractor before worlcbegins may not exceed the greater of (a) one third of the total contract price or ((m) the actual cost of any special equipment or custom made material which must be sgeeial ordered in advande to meet the completion schedule. Ex rens Warran -Xs an e. essw, girrantybeingrovided b the contractor? ❑ No El diothe Sub contractors -The contractor agrees to be solely responsible for completion of the work d sces ribed regardless of the actions of s of the ran any third ontracf Party/subcontractor utilized by the contractor. The contractor farther agrees to be solely responsible for all payments to all subcontractors for ate ials and aborunde this a Bement Contract Acceptance - Upon signing, this document becomes a binding contract under law. Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices caref-ally before si o*,i.,g t11;s ,.,,nt ,ct C Don't be pressured into signing the contract. Take time to read and fuliy understand it. Ask questions if something is unclear, aloe sure the contractor has a valid Home Trri rovement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director ofT_joie improvement Contractor Registration. You may inquire about contractor registration by writing to theTirector at 10 ParkPlaza, Room 5170,130ston, MA 02116 or by calling .617-973-8787 or 888-283-3757. Does the contractor have insurance? AsIc the Contractor for his insurance company information so that you can conium, coverage, or aslc to see a copy of a "proof ofisurance" document. o 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 place other than the contractor's normal place of business, provided you notify the contractor in writing at his/her main, of ace or branch office by ordinary mail posted, by telegram sent or U delivery, third business day following the signing ofthis agreement. See the attached notice of cancellation form for an exnation Ofthis not later thanht. ofthe D®lCT®T'SZGAT 7C[Q r*,O entical NTRA.CT 7F TITERE A1t� ANS co ' s ofthe contract must be completed and signed. One copy should go to the homeowner. The Date SPACE SIN ibe Iceptbythe contractor. M Contracior Arbitration The Home Impi ovement 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 fii�aa which has been approved by the Secretary of the Executive office of Consumer AiEairs and Business Regulation and the consum-er shall be required to submit to such arbitration as.provide d In. Massachusetts General Laws, chapter 14 H e is Signa we ontr or's S' ttiue NOTICE: The signatures of the paries above apply only -to the agreem .the pax • s to alternative dispute resolutimi initiated by the contractor: The homeowner may initiate alterative dispute resolution even where this section is not separately signed by the varties. Roameowner's Rights A homeowner's rights under the Home Improvement Contractor Law (MGL chapter 14.2A) 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 th 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 in 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 consumer/homeowner rights, contact the Consumer Information Hotline (listed below). ]Execution of Contract- The ontractThe contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced docuunents have been attached. Parties are also advised not to sign the document ental all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the contract with a ttachments -it, 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 frilly 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 -Payment schedule in cases where the homeowner deems him/herself to be financially insecuire. 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 j oint escrow account as a prerequisite to continuing the contracted work signatures of both parties. . Withdrawal of finds Cron said account would require the Additional Information .If you have general questions or need additional information about the Home Improvement Contractor Law or other consuuner rights, or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Impiovement" contact: Consumer Information Hotline Ogee of Consumer Affairs and Busin.css x�eg la don 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or-visittheOCABRwebsite atllttp:/lww�v.mass.gov/ocaU1l If you want to verify the registration of a contractor or if you have questions or need additional infornation specifically about the contractor registration component of the Home Improvement Contractor Law, contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and -Business Regulation 16 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or visit the BIC website at littp://wvnv tnass.aov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: hii7a://dU.state.ma.us/hoaneimytovement/licenseelist asn For assistance with inforrna7, mediation of disputes or to regisi:er formal. complaints against a business, calx: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau SOS -6S2-4800,508-.-755-2548 or 413-734-3114 Version 2.1-11/22/2010 The Commonwealth of Massachusetts Department of Industrigl Accidents Office of Investigations 600 Washington Street Boston, MA. 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Name (Business/Organization/Individual): M,f�(2 e4 jZ Address: P1,P,.5 ST q4 City/State/Zip: (i�% �U� t�/ !�� �%��y Phone #:M " -//UQ Z Are you an employer? Check the appropriate box: ❑ 4. PJ I I Type of project (required): 1. I am a employer with am a general contractor and 6. ❑ New construction employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. # �• FI 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. ElWe are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3111 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑Roofrepairs insurance required.] t employees. [No workers' 13.❑Other 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 ace 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:. �U1gi� /� ►�lP�i�ffr�/ //1/M4fi/Ce. !�2�P Policy # or Self -ins. Lic. #: j� i? zv 6 qy3OZ 3 - O -- IL Expiration Date: a �K- 2 3 �Z i°5 urs S� Job Site Address: City/State/Zip: &21 ]L /�/1l 4W14 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder 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. Ido hereby cert ypder thoains andpenalties ofperjury that the information provided above is true and correct. 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): 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 employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, • 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 j oint 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 deemed to be an employer." 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 applicant who has not producedacceptable 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 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 -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have 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 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 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 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 ofM-assacl,usetts Department ofladustdal .Accidents Office of Investigations 6.00 Washington Street Boston, AU 02111 TO, # 61.7-72.7-4900 oz t 406 or 1.-877, 'ASSAFB Revised 5-26-05 Fax # 617-727-7749 --wwwanass.gov/dia NOTICE TO EMPLOYEES NOTICE TO EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ZURICH -AMERICAN INSURANCE GROUP NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO MA 02344-1450 ADDRESS OF INSURANCE COMPANY (GZZUB-4873P23-0-12) 09-29-12 TO 09-29-13 POLICY NUMBER EFFECTIVE DATES ALBERT J TONRY & CO INC 300 CONGRESS STREET "'- QUI NCY MA 02169 NAME OF INSURANCE AGENT ADDRESS PHONE # ^ TEJADA, LUIS M DBA MIGUELIN 225 BROADWAY SUITE 203 o� CONTRACTING & METHUEN .� MA 01844 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably '— connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS nmaaa 1AIMPIe:A9 TO BE POSTED BY EMPLOYER iLlriiu•1.aA 110-1 07.LUIZU16 b:'L5:34 AM PAGE 2/002 Fax Server 'CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) T TIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA7 S CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: ALBERT J TONRY & CO INC 300 CONGRESS STREET PHONE (AIC, No, Ext): LA g QUINCY, MA 02169 E-MAIL ADDRESS: 2873Y INSURER(S) AFFORDING COVERAGE NAIC 4 INSURED INSURER A; AMERICAN ZURICH INSURANCE COMPANY TEJADA, LUIS M DBA MIGUELIN CONTRACTING INSURER B; INSURER C: 225 BROADWAY SUITE 203 INSURER D: IvIBTI-IUEN. MA 01844 INSURER E: INSURER F. - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIESDIFIRSURANCE LISTED BELOW-RAVFE-BEEN ISSUED TO THEINSURED 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD L SUB R POLICY NUMBER POLICY EFF DATE (MKDDIYYYY) POLICY EXP DATE (hftDDIYYYY) UMTS GENERAL LIABILITY =.ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE r7 OCCUR. EMISES (Ea occurrence) Ll ED EXP (Ary one person) $ GEN'L AGGREGATE LIMIT APPLIES PER: RSONAL & ADV INJURY $ ENERALAGGREGATE $ POLICY PROJECT ❑LOC ODUCTS - COMP/OP AGC $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE $ LIMIT (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ CEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY YIN UB -4873P230-12 09.29/2012 09/29,'2013 WC STATUTORY X LIMITS OTHFR ANY PROPERITOR/PARTNER/EX=CUTIVE Q N/A E. L EACH ACCIDENT $ 100,000 CFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 100,000 If yes, desmN under DESCR PTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTMCTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO TEE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. ATTN RICK CERTIFICATE HOLDER CANCELLATION�� GREY ROCK CONDOMINIUM] SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED C/O SUTTON MANAGEMENT BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IAUTHORIZEDTA IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 773, 200 SUTTON STREET REP TA._ .k�:.•--:.w NORTH ANDOVER, MA 01 845 i?g'T""" t ,; rt .' ,...•• ACORD 25 f9010/n51 Tha Arr)Ph name a d 1 �� - -� ...... n ogo are registered marks of ACORD 1988-2010 ACOR CORPORATION. All rights reserved. UO)MOCAN Ir,,"nqw=yV 8y; 6o uoMpq sutura a spa cs an • pow JO (PT66) lao.; arqno 000,;E Ump KOM= xtt Aw'WrKs M"Ityhown, slyseptlets putt VUO liemaal a *IPftnq p 84ftn4m Office of Consumer Affairs and Business Regulation s -- 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 175629 Type: Corporation Expiration: 5/28/2015 MIGUELIN CONTRACTING INC. LUIS TEJEDA 38 KENDALL ST. REAR #1 LAWRENCE, MA 01861 SCA 1 t3 20M-05/11 -��, --- CXe icoJuuta>tlae&1111 `L. Office of Consumer Affairs & Business Regulation ) ME IMPROVEMENT CONTRACTOR C ^Pegistration: 175629 Type: :expiration: 5/28/2015 Corporation MIGUELIN CONTRACTING INC. . Tr# 240852 Update Address and return card. Mark reason for change. l i Address ❑ Renewal F-� Employment ❑ Lost Card License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 LUIS TEJEDA 38 KENDALL ST. REAR #1 �4 _ LAWRENCE, MA 01861 Undersecretary of v i without ig ature t-. MIGUELIN CONTRACTING INC. 225 BROADWAY SUITE 203 METHUEN MA 01844 978-794-1182 Cell 978-420-8052; Fax 978-327-5599 * ROOFING * SIDING * REMODELATIONS * BOILER *LEAD PAINT REMOVAL * ASBESTOS REMOVAL CONTRACTOR LICENSE #CS -089346 HOME IMPROVEMENT LICENSE: # 175629 FREE ESTIMATE - FULLY INSURED E-MAIL: mi¢uelincontract(a)aol.com PROPOSAL SUBMITTED TO: SUTTON MANAGEMENT NAME: GRAY ROCK CONDOMINUM MANAGEMENT. ADDRESS: 136 Chestnut Street North Andover, MA 01845 PHONE: 978-689-9994 FAX: 978-388-2590 . DATE: MAY 20, 2013 WORK TO BE PERFORMED AT: 176 Chestnut Street North Andover, MA 01845 We hereby submit specifications and estimates for SHINGLE ROOF 52. SQUARE FEET): 1. Strip Roof 2 layers. 2. Replace 20% of Damage Wood. 3. Ice and Water Shield 6 feet. 4. 8" Aluminum drip edge on all edges of roof. S. Replace damage and all step flashing. 6. Install water shield around flashing. 7. Effective attic ventilation. 8. Labor ten years warranty. 9. New boots on vent pipes. 10. Shingle CertainTeed XT Extra Tough 30 years warranty stab black 11. Premises will be cleared of all debris, including any nails. JOB TOTAL: Fifteen thousand dollars»»>$15,000.00 The propose hereby to furnish materials and perform the labor complete in accordance with above specifications. COST SPECIFICATION: Fifteen thousand dollars»»»»»»»$15,000.00 Payment to be made as follows »»»»»»»»$ 5,000.00 is require to start work. When half of the work is done»»»»»»»»> $ 515000.00 Balance Upon Complexion»»»»»»»»»»>$ 5,5000.00 NOTE: MAKE CHECK PAYABLE TO LUIS MIGUEL TEJEDA 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 involving extra costs will be executed only upon written orders, and will become an extra 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. Our workers are fully covered by workmen's Compensation Insurance. Thank you for your business and look forward to our relationship. k- -.. .! I Authorized c'/ Signature Date: uis el Tejeda ACCEPTANCE OF PROPOSAL the above prices, specifications and conditions are satisfactactory and'are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature: Date of acceptance t This form satisfies an basic requirements of the slate's Home improvement Contractor Law (MGL caapter 142A.), but does not include standard language to protect homeowners. Seek Iegal advice if necessary. Any person planning home improvements should first obtain, a copy of "A Massachusetts Consumer Guide to Home Improvement" before agreeingto any work on your residence. You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer information Hotline at 617-973-8787 or 1-888-283.-3'757 or on our website. Homeowner Wormat,7loII1 J . ., Contractor IniF®l-matinn The Contractor agrees to do the following worIc for the Homeowner: , '..� � ,I (Descn'be in detail the woricto completed, specifyingthe type, brand, and grade of materials to be vsed, use additional sheets ifnecessar Required Permits - The following building permits are required and will be secured by the .contractor as•the homeowner's agent: (Owners Who secure their Owen Permlts :will, be excluded &OM the Guaranty' Fund provisions of MGL chapter 1.42A.) Proposed Start and Completion Schedule - The following schedule will be adhered to unless circumstances beyond the contractor's control arise when contractor will begin contracted work. when contracted work willl 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 o. Payments will bemade according to the following schedule: upon signing contract (not to exceed 1/3 of the oral contract price $ �l Y -7— �3 completion p on letion of $���j �by�/�q,�., or upon completion of -,,/(' Or 1G cost of special. order items, whichever is greater) T_ . — -rr upon completion ofthe contract, (Lawforbids demandingfull.payment until, contractis com letedto both •p party's satisfaction) . The following material/equipment must be special • $ to be paid for ordered before the contracted work begins in order to meet the completion schedule.(*".') $ to be paid for NOTES: ("D Including all finance. charges Law requires that any deposit or down payment required by the contractor before worlcbegins may not exceedthe greater of (a) one-third of the total contract price or (b) the actual costo£ any special, equipment or custom made material Which must be special: ordered in advaude to meet the completion schedule. Express Warranty -Ts an e-mresswarrant beim rovided b the contractor. Subcontractors -The contractor agrees to be solely responsible for completion of h work describedregardless ofthe actions ofeanythird Contract) pa renals Lntractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for Materials and aborundertiris a Bement Contract Acceptance -Upon signing, this document becomes a binding contract under law. Unless otherwise noted witbin this document, the eonteact shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carcfally before Si -n -b .q c^retract, C Don't be pressured into signing the contract. Take time to read and fully understand it. Ask questions if something is unclear.. o aloe sure the contractor has a valid Home Ymrlroyement Contractor Re et,•a tion subcontractors to be registered with the Director ofl-Iome improvement Contractor Registration You omayst ome improvementire itcontractors ox ctors and registration by writing to thoDirector at 10 ParkPiaza, Room 5170, aoston, MA..02116 or by calling .617-973-8787 or 888-283-3757. c Does the contractor have insurance? AsIc the Contractor for his insurance company information so that you can confirm coverage, or aslc to see a copy of a "proof of insurance" document. o Xnow your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Guide to the Home Improvement Contractor Law. Consumer You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the contractor in writing at his/her main offf cc 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 ofthis agreement. Seethe attached notice of cancellation form for an explanation ofthis right. DO NOT'SIGN TMS CONTRACT IF TI-CERE ARE M1Bk—AMKrtrxwo idenfi0 -cc' s of the contract must be completed and signed, One copy should go to the homeow5� �9 C�S ontractor. 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CD F- O N d v m d co W_ _ = - O O ''� z LL d) C O ujL w �� v � = V 0 Q F-� (n Q' (D '; _ FE cn m o _OCL 0 > 0 Z m CD z W w X LLI E-- W OL O U LUJ 0 W CL U) z 0 m ME W O W L O N Cl IM ^\ i _i W Q U MM M •� W W CL _ M O � O 0 O CL a. O. �a 0 -=- CL ='Q O ,a; CA Z � O 0 tU C c N 0 LLI ca YJ W W 6LL1 J N S 0,4, v j,, , 1 ry ` SHAHEEN GUERRERA & O'LEARY, LLC Jefferson Office Park Peter G. Shaheen** 820A Turnpike Street Nicholas S. Guerrera** North Andover, Massachusetts 01845 Sean P. O'Leary** Telephone: (978) 689-0800 Toll Free: (866) 665-5834 Carol A. O'Learyt Facsimile: (978) 794-0890 Kyle J. Scandore* E-mail: pshaheen@sgolawoffice.com * Admitted in MA ** Admitted in MA and NH t Admitted in MA, NH, ME and CT December 14, 2010 Gerald Brown, Inspector of Buildings Building Department I own of North Andover 1600 Osgood Street North Andover, MA 01845 RE: Grey Court Condominiums —172 Chestnut Street Dear Mr. Brown: .����•r�� a tt'c, iLy (rpt ► � ('�,�1 y"% , 6✓ C''� Please be advised that my office represents John DeAngelis. Mr. DeAngelis has requested that I respond to your letter of December 8, 2010. As an initial point, you should J know that there is currently a dispute ongoing between Mr. DeAngelis and the current Board of Trustees of Grey Court Condominiums regarding the use of two apartments located in the former stable building. Unfortunately, due to that dispute I believe that you have been given either incorrect or incomplete information. These apartments are currently located in the former stable and have been in continual use for approximately 20 years. Although I have not had a chance to review your file on this property, the absence of a building permit is not surprising given the fact that this is a pre existing structure. Moreover, pursuant to MGL Chapter 40A, §7 no action can now be brought to enforce a violation of the building code relative to their use. Therefore, the use and occupancy of these apartments is not illegal under current Massachusetts law. Thank you for your attention to this matter. Should you have any questions or wish to discuss this further, please feel free to give me a call. Very truly yours, Peter G. Shaheen PGS/jcj f cc: John DeAngelis V ,.. BUILDING DEPARTMENT Community Development Division John DiAngelis P.O. Box 660 North Chelmsford, Ma 01863 RE: Gray Court Condos 172 Chestnut Street North Andover MA December 8, 2010, Please Be Advised a recent Inspection revealed that a Building Permit was never issued for the two residential dwelling units in the stable/barn building. The Massachusetts Building Code 780 CMR 5110.1 Permit Applications: ( It shall be unlawful to construct, reconstruct, alter, repair remove or demolish a detached one or two family dwelling; which is regulated by 780CMR 51.0-99.0 without first filing a written application with a building official and obtaining the required building permit and all other required permits therefore). Occupying a structure without a Certificate of Occupancy is a violation of the Massachusetts Building Code 780CMR, and the Town of North Andover Zoning Bylaw. You must discontinue this Illegal use and Occupancy and remove the two illegal apartments immediately. Thank you for your attention to this matter. If you have any questions, please call the office of the Building Department at 978-688-9545. Very truly yours, Gerald Brown, Inspector of Buildings Building Department Cc: Sutton Management Co. 200 Sutton Street North Andover ma 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 918.688.9545 Fax 918.688.9542 Web www.townofnorthandover.com