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HomeMy WebLinkAboutBuilding Permit #231-14 - 175 SOUTH BRADFORD STREET 9/12/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: l��I— 1 Date Received (?11415 Date Issued: ' IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER ®C /�/'�� N,4.Q,7—X4 /V � Print 100 Year Old Structure yes 0- MAP NO: 16 ZONING DISTRICT: _ Historic District yes 0- Machine Shop Village yes net TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial L�Oepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic []Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name:'e,.6 Phone: �gid�� Address: / 7 S©, eR40, '' ey ,'7, CONTRACTOR Name: �/-� , li � Phone: Address: c;207 /-j/,-v7-4A 7, IJ4. Supervisor's Construction License: 0 q9/ ? Exp. Date: Home Improvement License: I � ��v2 Exp. Date:- ARCH ITECT/ENGI NEER ate:ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ © FEE: $ Y ��- 0 Check No.: 1 ` Receipt No.: 'T1 NOTE: Persons contracting with unregistered contractors do not have access to the gu ranty fu :Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan Stamped Plans ❑ i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF.SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art E] 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 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 Towo Engineer: Signature: Located 384 Os ood Street FIRE DEPARTML-NT - Temp Dumpster on site yes no Located at 124 Mair Street Fire Department signatureldate f 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 Q Notified for pickup - Date I l f Doe.Building Permit Revised 2010 Building Department The fol*wing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofivg, 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 ❑ 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 casos if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apoaal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subrra_tted with the building application Doc: Doc.Bui?ding permit Revised 2012 Location / 75" 1.4 4d-16`' No. 23 1—L Date . - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# .: �' Building Inspector NORT#1 Town of ndover No. - ,� oh , ver, Mass, COCHICNl WIC. y1. �d p�RgTEO �PpA S u BOARD OF HEALTH Food/Kitchen ERMIT T LD Septic System J THIS CERTIFIES THAT ................kcC1,6 ...... -�z..CJ��..VALeli.............................................................. BUILDING INSPECTOR has permission to erect buildings on r s .. �ke�. �S"T Foundation .......................... ... ...... ........... ................ J Rough to be occupied as ........ .... .�c:�.S' '1!�,�.......S.I�.A:�.d...... l.!: d.!!t ..—....... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 4b. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT n*TS Rough Service .............. ......... . .......................... U Final BUILDING INSPECTOR GAS INSPECTOR i Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE i .Massachusetts Department of Public Safety Board df Building R6gulations and Star tdatds Construction Supen-isor License: CS-072173 B: CHRISTOPHER FYtIVET' 207 WINTER ST N ANDOVER MA 0184 1 \ ✓.�..� Jjc � �} li`' Expiration 06/02/2014 Commissioner a efuid iqiad ewmuuctioa i Rich Hadjian 175 South Bradford Street North Andover, MA 01845 (H) 978-794-9689 (C) 978-930-9993 hadjian@msn.com September 12, 2014 Sliders & Window Replacement Work to be included includes: • Acquire Building Permit • Remove and replace existing sliders on back porch. • Replace all trim on exterior of porch with PVC Trim. • Install new Andersen TW-400 to replace existing windows. • Install new trim on interior& exterior. • Removal of all debris. Material $ 25,000.00 Labor $ 15,000.00 TOTAL LABOR AND MATERIAL $ 40,000.00 Terms: $13,000.00 upon signing of contract(not to exceed 1/3 of contract price) $27,000.00 when job complete Submitted By: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C)508-265-3115 (H)978-794-1165 North Andover,MA 01845 1 All Home Improvement Contractors shall be registered.Inquiries about a contractor relating to a registration should be directed to; Registration Division,Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel:617-727-3200 ext.25239 All building permits required will be the obtained by the contractor.Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authoriz d to do the work as specified.Payments will be ade as utlined above. Date Homeowner Signature Date1`0 Contractor Signature Contraefor Arbiixafion The Home Impi ovement C-It-ctor L-1 provides homeowners with the right to initiate an arbitration action(as an alternative to howecourt ver- if they have a dispute with a contractor. The same right is got automatically affordedto a contractor however. The contractor would have to resolve any dispute he/she has with a homeowner an 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 subs,;+the dispute to a private arbitr 'on Finn whit the Se o e cutive Office oP Consumer Affairs and Business Re n and the co er shall approvedeen equired tt arb* anon'as-provided In Massachusetts GeneralLaws,c r 2A,. meo er s Sign TFCC:The signa of the parties above a ° or' gnatur p apply only-to the agre int ofthe parties to alternative dispute resolution initiated by the contractor. The homeowner may in ternative dispute resolution even where this section is not separately signed by the parties. •��-'omeownez•'s Riglits p A holneovv-Aer`s ngAts-ander the Home Improvement Contractor Lir(y GL chapter 142A) and other consumer Protection laws(Ie-MGL chapter 93A)may not be waived in any way,even by agreement. 7Iowever,h maybe excluded i?oma certain_i�1 ;;-•Z,e confractor•they choose isnot properly registered as owever,h by owners 1omeowlzers who secure the, ows buildinge p a p Y the gone improvement Contractor`Law. The eo�nt actor is responsible for eonetxn Gualan� Y Ped provisions o:� e1y and worlonaniike me,. slomeownexs may be entitled to other ecificle g the work as described,in a gt1a�•antees or provides an express warranty for vrorlanan-s1u or materials. 7n addit on���if&e contractor pzovidedbythe contractor, all goods sQld.inldassaehusettscariy an implied waxran of orwarranlxes a pal-dcular purpose. An enumeration of other matters onwhich'�he homeowner and contractor IawfizllyTan Bess for added to the tents of the contract as long as tisey do not restrict a homeowner's basic consumer rig• maybe questions ab out your consumer/homeownerriglt'�s,contact the C qtr• 7fyotthave Consumer T.nformation Hoa- e(listed bellow). Er eci tion Of Con, ani- The contact must be erect<ed in dua�li.te and 1hould not be signed until a copy of an exhibits and refer documents have been attached. Pardes axe also advised not to sign the document until all blink sections teed "'led- or marked as void,delete o,• _ave been d, not applicable. One original signed copy of,&,contract wYaL atrachorents is to be given to the owner and the Other kept by the contractor. An T mo , + 1 _ and agreed to by both oarties. Contacted work may not begin mt�l b cpax es have received a fullt ere Takin �_~ - ..0.� 3.. ...w�J..?•i v�tlwng the contract;and the iluee day rescission period has ex»ired, Y clued copy°f A contactor may not demand 1�omeownex deems p en n aovauce of le dates specified on'dre payment schedule incases where',he I1imlLerse±i to$e fnancially insecure gowevex iu instances where a contactor deems him/herself- account to be financially insecure,the contractor as a prerequisite to contntiing'�heMaay requiretracted ha the w ince o lod•unot�ds you dere be placed in a j oint escrow sigoairtres of both parties. Workm said•account would require fire A4Edi'w0*`is y-dOT'7.-R4j+on 7f you have general questions ox need additional infosm.ation about the Home 15- ove e consumer rights,or if you wish a o obtain „ a taa17 a dee copy of A, 1�r m na Contractor Law or other contact: l�Sassachtzsea Consumer Glide to Rome;t5- provement„ Consumer�foirnationHotline Office Consumer Affairs and Business Regulator 617-973-8787,88g-28"-3757 or visittheOCAf3Rwebsiteva h Z?i6 - - t_tn.//wwti�.mass Dov/oclbil LAY°u want.to verify IL-e registration of a contractor or if you have questions or need addition about the contractor registration component of the Home Improvement Contractor Law,cont additional speciCcally ac,t. Iii e-tor of Home Improvement Contractor Registration OM' ce of Consumer Affairs and-Business Regulation 617-973-8787, =0 ParitPlaza,Room 5170 BostonA.,IV02116 888-283 3)57 or visit the MC website at bei 2116 v.mass.aov/ocabr/ Go o-all;,,e to view the status of a Home Improvement Contractor's Re ' i1LnJ:Ildb.siate.�na.us/liomeim rovement/licenseelist.asu glstration: , T"or assistance vita formal mediatiou of disputes or to re ger " formal complaiats against a business,eat: Consumer Complaint Section Office o--the Attorney General 617-727-8400 ANVOR 13 508-652-4800 50etter8 755r 5-2$8 o413-734,1114 %Zioa 2.1-11/22/20,0 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers lease Print ibl Applicant Information Name (Business/Organization/Individual): &,we/_< Address: �O City/State/Zip: . l���►�5.� ,�/�/ F� Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees full and/or part-time).* have hired the sub-contractors ?. [..]'Remodeling 2.01 am a sole proprietor or partner- listed on the attached sheet.t 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. [J We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their right of exem tion er MGL 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work p p myself.[No workers comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]f 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. 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: �.1�r� u` *^ ' Expiration Date: �o / Policy#or Self-ins.Lic.#: �� / Ya� Job Site Address: OAyrrorl D S� City/State/Zip: lam_ �iUaaveS ®'�� 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 cert lin! r tl pains and pen ies of perjury tl:at t1:e information provided abov is tris and correct. Si nature: G/'" . Date: � �3 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: OP ID: SHHE ,I� DATE(MM/DD/YYYY) ERTIFICATE OF LIABILITY INSURANCE DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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 Pohcy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT 978-688-6921 tJAME: ;Macdonald&Pangione Insurance 97g_688-5350 PHONE FAX I P.O.Box 428 A/c.No,KL0: i (A/c.No): 1:•104 Main Street E-MAIL North Andover,MA 01845 ADDRESS: — PRODUCER CHRIS-5 Michael Pangione CUSTOMER ID#: _ INSURERS)AFFORDING COVERAGE NAIC F INSURED Christopher Rivet INsuRERA:Preferred Mutual Ins Co Y 115024 207 Winter St. INSURER 8: i North Andover, MA 01845 - —---- —-------- -IN - i SURER C:_ _ INSURER D: i 114SURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT!RtITHSTANDING ANY REQUIREIAENT, 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. I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES-LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iIIJSR ADDLSUBR - — POLICY EFF ' POLICY EXP `— --- I_TR - TYPE 0.F INSURANCE INSR•INVD POLICY NUMBER IM169IDUNYYY MMIDDIYYYY LIMITS i GEtJERAL LIABILITY EACH OCCURRENCE '; 1,000,000 ^� A COMNIEP,CIAL GENERAL LIABILITY CPP 0180 57 01 05 09/26/12 ' 09/26/13 PREM SETO(Ea ITT-Erence) ,S 100,000 t.LAIf AF-MADl: 7 OCCUR N!ED EXP(Any One person) 1 S 5,00{1 PERSONAL&ADV INJURY i S 1,000,000 GENERAL AGGREGATE !S 2.000,000 iici•!'i-AGGREGATE L110IT APPLIES PER: PRODUCTS-COMP/OP AGG i S 2,000,000 is POLICY I IF T LOC ! S i AUT01,40BILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO .(Ea accident) - 1 —' BODILY INJURY(Per person) I S id I.OWNED AUTOS _ --- ------ BODILY INJURY(Per accident)i S ';i:HEDULED AUTOS '- PROPERTY DAMIAGE i S HIRED AUTOS - (Per accident) i HON-OV1NEDAUTOS -_--- —' '--- I1fa1,13RELLA LIAB EACH OCCURRENCE EXCESS LIAB -- —' CLAiiviS-iriADE AGGREGATE S j DEDUCTIBLE !S RETENTION S S V:'ORKERS COt:1PENSATION t4fC STATU- 50TH-? AND EMPLOYERS'LIABILITY Y1 IJ •—'TORY LIMITS ER I ,_ .Id'i PiiO?R(ErOP.ir:,PTiJEi<l=i:ECUTf i/=_ I _ E.L.EACH ACCIDENT 5 t1�FI^� iiriEFkB�R E::CLUDED? ,{— tvvendatory in It vosdcscriba under E.L.DISEASE-EA EIVIPLOYEEi S I . � .- — DESCPJPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT i 5 i i L_ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN '1600 Osgood St ACCORDANCE WITH THE POLICY PROVISIONS. No Andover. MA 01845 AUTHORIZED REPRESENTATIVE Michael Pangione ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD