Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Building Permit #364-13 - 177 CARLTON LANE 10/2/2013
BUILDING PERMIT ?°�,. . o" TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 1G Date Received •• � r *. Date Issued: 2' 1 4CHUg IMPORTANT:Applicant must complete all items on this page LOCATION 177 rint PROPERTY OWNER 4AV ZeA,) A qQ Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Meration No. of units: ❑ Commercial Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic ❑Well ❑Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer 74 v b f'1 -K_ Ott f Identification Please Type or Print Clearly) OWNER: Name: Gehl 11V Phone: Address: CONTRACTOR Name:Aw jj Phone: — o -3j.25— Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.0 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.0 PER S.F. Total Project Cost: $ FEE: $ V,,�L Check No.: `) D U I Receipt No.:;. NOTE: Persons contracti g with unregistered contractors do not have access o the guaranty fund Signature of Age 1/dAer Signature of contractor G'._.... _...yam•,.___ _-�_�_ J` e TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER__. _ __ a S-- Print 100 Year Old Structure yesIrfo MAP NO: __._ PARCEL: _ ZONING DISTRICT:_ Historic District yes no Machine Shop_V_.illage __yes , ^rio TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial [I Alteration No. of units: [i Commercial ❑ Repair, replacement 11Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic D Well ❑ Floodplain ❑Wetlands ❑ Watershed District 1iWater%Sewed.,__ DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: _ - one Ph .CONTRACTOR Name _ ., :_T — - - Address: _R_. ._._ Supervisor's Ognstruction License: Date:. Home Imrovement License . _ _ _ __ _ Exp_ -Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Person--coin'Pacting with unregistered contractors do not have access to the guaranty fund g S F—s i nature of contractor Signature of Agent/Owner _ ,-_ Plans Submitted UJ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ i Location a a No. hb�— M Date il 11 • • TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#�)60' �' wilding Inspector . _». =------ - - ---- - - -- - - -= - >. ... .�. . .. -- . . .. . . i . . . .. . . . , . .� _J - - � ` _ - - ..... - .. .. - ..- .. ... :.. .. :. :. ... .- -.: .. - .:... .... .. ....... . : ... .. .. -. .. .. ...: '.:.:::.. .. .: .:.1. - ...._- ..-... _. ..: .-.. - ... .. .. ...... ...... .....-.. _ - 1' .. ... .. .. F Y r . TI t . 1 Location i ,J L'j. No. ` - I Date t7 1"1 1 . . . ,.. -_{{ I • ' TOWN OF NORTH ANDOVER 11.16 ;� r f 4 . .:� • Certificate of Occupancy $ Building/Frame Permit Fee $ �'" y:'� Foundation Permit Fee $ Other Permit Fee $ .111 TOTAL I . ::� Check# `. 4 / G ilding Inspector S. sI. _ . w -, _ . _. .. . .. .. .._. . ._ .. .. ... .. :; .. ... . -_._ - t -. _.._:-_ - - - _ - -.. I. 1. r. . .. .. . . . Plans Submitted ❑ Plans Waived'❑ Certified Plot Plan ❑ Stamped Plans ❑ -TYPE.OF°:SEWERAGEDiSPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑. . ..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: DATEAPPR_OVED PLANNING & DEVELOPMENT' ❑' ❑ COMMENTS -CONSERVATION Reviewed on Signature COMMENTS N�—C,� I I 0 HEALTH Reviewed on /3 Signature COMMENTS___ f [��T�i r�✓ �G �$— t v l �+c�y-�r' c�r5 w Zoning Board of Appeals:Variance, Petition No: Zoning Decisionlreceipt 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 Depar`tmefit-sigriatu"reldate`- 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 ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 -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 IYes No DANCER ZONE LITERATURE: Yes No MGL Chapter 166.Section 21A-F and G min.$100-$1000.fine NOTES and DATA— For department use El Notified for pickup - Date f Doc.Building Permit Revised 2010 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 ❑ ..Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work o 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 ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 o 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: , 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 2008 Building Department The fol'�wing 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 ❑ 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 cans if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw-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!ding Permit Revised 2012 (.0 -� � tx \ I �` • vl �`. ........ � LOT 38 t ul LOT'* r7 LA s t 1, \ \\ \\ \ I \ � 'i MDQ \ \ \ \ 1 3 Xt c tk 1 IF 4 55 c� N EVA SHA t✓t...,OW PIT :5`�S7 E W 1 D G% F"�)�U 2 i2 SSE R Y E i An-EA . MAPLE,. 1 40 of 11 i r� OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 177 Carlton Lame_ _North Andover_ Owner: Volp Date of Inspection: 11/14/2001_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. F1 Pit#1 Driveway House Tank Water Meter B D-Box Pit#3 Pit#2 A to Tank=20'8" A to D-Box=50'5" B to Tank=22' B to D-Box=43' FLOORPLAN Borrower: William &Joanne Lauzon File No,: 03070082 Property Address: 177 Carlton Lane Case No City: North Andover State' MA Zip:01845 Lender:Chase Manhattan Mortgage Living Area - First Floor 16.0' _ 14.01 Wood Deck 14.0' 66.0' Family Dining Kitchen Dining Room 24.0' Room 28.0, Living Room N V = C co7 Co J Den/Office Foyer 26.0' 4.0 400' Sketch by Apex IV WiindowSTM AREA CALCULAl10NS SUMMARY LMNG AREA BREAKDOWN Code Description Size Totals Breakdown Subtotals GLA1 First Floor 1744.00 1744.00 First Floor P/P Wood Deck 224.00 224.00 28.0 x 40.0 1120.00 QLA2 Second Floor 1160.00 1160.00 24.0 x 26.0 624.00 Second Floor 29.0 x 40.0 1160.00 TOTAL LIVABLE (rounded) 2904 3 Areas Total(rounded) 2904 751 Main Street, Suite 26,Waltham, MA 02451, Phone:781-788-8822 Fax: 781-788-8439 r10 H Town of 2 �tAndover No. .564. 14 h h , ver, Mass, COC NICMlw1CK �7' rP�,�'(5 S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ..................l .�.l.�.�. •......... .. :1�...................................... BUILDING INSPECTOR .... .. ..... has permission to erect .......................... buildings on .... Foundation Rough ........ Rough to be occupied as ....I.Q.g.ap.....��. i�....... ........................................ 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR q;040 UNLESS CONSTRUCTI _ A Rough Service ............... .. ... ...................... .......................... Final BUILDING INSPECTOR GAS INSPECTOR 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 1806 Salem St. North Andover MAO 1845 978-689-2066/978-807-8925 Home Improvement Contractor# 157687 Job Name Job Location Bill and Joanne Lauzon 177 Carlton Lane 177 Carlton Lane North Andover Ma 01845 North Andover Ma 978-682-7644 617-799-8078 Scope of Work The work is to guide the homeowners through a rebuilding of an existing 12' x 20' deck which will included the following: 1. The contractor will obtain the building permit. 2. The contractor will layout the footings and will supervise the digging, inspection, and pouring of the footings. 3. The contractor will supply the materials needed to frame and support the new structure with all necessary brackets and hangers. 4. The contractor will supply, cut and fit the stairs to the elevation. 5. The contractor will set the 4x4 post for the railing system to be determined. 6. The contractor will make any necessary repairs to siding after the deck frame has been flashed. At this point, the homeowners will take over and complete the project with guidance from the contractor as needed at the contractor's hourly rate. ti �J Bill and Joanne Lauzon Page 2 of 4 HIC#157687 Permits are required. It is the obligation of the contractor to secure such permits as the homeowner's agent: NOTE: Owners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGLc.142A Work to begin during week the first week of October Expected Completion Date: The contractors portion of the work-the third week of October Bonenfant Const agrees to perform the work, furnish the material and labor specified above for the sum of$3,500 to be paid as follows: $1,200 upon delivery of materials $1,200 upon completion of the frame $1,100 upon completion of contracted work HOMEOWNERS: CONTRACTOR: Bi andJo�auzon Robert Bonenfant D Date Date You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller, which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later that midnight of the third business day following the signing to the agreement. See attached notice of cancellation for an explanation of this right. Bill and Joanne Lauzon Page 3 of 4 HIC#157687 Note: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place — Room 1301 Boston MA 02108 617-727-8598 Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the property. ARBITRATION 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 such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in M.G.L. c. 142A Contractor- meowner: Date: 16ZPQDate: ACCELERATION OF PAYMENT Homeowner's Financial Insecurity-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. Contractor's Financial Insecurity-In instances where a contractor deems him/herself to be financially insecure, the contractor my 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 from said account would require signatures of both parties. J Bill and Joanne Lauzon Page 4 of 4 HIC#157687 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE TO: Robert A Bonenfant, Bonenfant Construction, 1806 Salem Street, North Andover MA 01845 NOT LATER THAN MIDNIGHT OF OCTOBER 3, 2013 NO WORK WILL BEGIN UNTIL THIS Tl EX, IBES Date: / o X_ ��,,---- Bill a Joan a L6uzon Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS-042212 ROBERT A BONE,$FANT- `; Z 1806 SALEM ST ; s N ANDOVER MA 01845 r " "' Expiration Commissioner 04/29/2014 -/�_ ✓die U/am�rnuruuea� ay,.�lLaveac`u�Oe�f6 / Oitiee of Cocaumer.�_fN:e,_:i;f<�,ess ket: 'prion - - HOf.,E IMPROVES Registration: A57f87 Expiration: 10/29/2013 Indivic�:.i RO RT A BONENFgNl°. ROBERT BONENFANT .._ " 1806 SALEM ST _,, :` u� NORTH ANDOVER MA Ci845 Undeiseeret y i F f �-� JOHNAWEM CANDREWS ACORO" DATE YYY (MMIDDIY) CERTIFICATE_ OF LIABILITY INSURANCE 411612013 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 policy(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 North Andover Office North Andover ac°No Edj:(978)682-7203 q/C Ne:(978)682-7752 Harrin8ton Insurance Agency,Inc. E-MAIL 483 Chickering Road ADDRESS:northandover@harringtonsaves.com North Andover,MA 01845 INSURER(S)AFFORDING COVERAGE _NAIC# _ INSURER A:Norfolk&Dedham Mutual Fire Ins Co INSURED INSURER 13:Hartford Underwriters Ins Co John A Weir INSURER C: 39 Brightwood Avenue INSURER D: North Andover,MA 01845 INSURER 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. 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICYNUMBER MWDD MWDD GENERAL LIABILITY J EACH OCCURRENCE $ 300,000 A X COMMERCIAL GENERAL LIABILITY R0402473A 8/112012 8/1/2013 PREMISES E_a_oocurrence $ CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 600,000 X POLICY 1 JE� n LOC _ (CE OMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY Ea..dent $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acddent) $ AUTOS AUTOS NON-OWNED DAMAGE $ HIREDAUTOS AUTOS PERACCIDEN UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ _ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMN ER _ B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N NIA 6S60UB9775M79311 6/9/2012 619/2013 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,desaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if nwre space Is required) This Worker Compensation policy does not provide coverage for John Weir or Robert Bonenfant CERTIFICATE HOLDER CANCELLATION 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE" J Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN II Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 1 Town Hall i North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 J i ��t I i � a TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 7� Print - I PROPERTY OWNER Print irl MAP NO: 06 c. PARCEL. ZONING DISTRICT: Historic District yes o Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building On ' y Addition Two or more family Industrial Alteratio No. of units: Commercial Repair, eplacemen Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands p Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Ideati i tion Please T e or Print Clearly) OWNER: Name: Phone: Address: 7 ,p 6xG ll CONTRACTOR 'Name. Phone:: Address: Supeniisor`s Con`strucfion License: Exp Date. �j�) prvemntLcensee.,Home Ep. Date >� 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: $ "75�0� FEE: $ Check No.: 2 Receipt No.. C�` NOTE: Persons contracting with unregistered contractors do not have acc s to t e gu my and Signature of Agent/Owner Signature of contract ... Plans Submitted Plans Waived Certified Plot Plan meed Plans .. .. . , .. -- -. - M I. s. .:. .F' .... .;•:. .t -. ._ . :.5. . .. - -.... .. .. .. -.. ... 3 yy - .. .,. .' ,V I /� /4L�- ` 1. 1. Location �� C_"4.-lr� ti No. —�— Date ? ' - �.... N°RTM TOWN OF NORTH ANDOVER O'�«ao .a ,�C 3? �' ' C L F w . . a - } ° Certificate of Occupancy $ ,> ;�s' °''�� Buildin /Frame Permit Fee $ �� .. ._ . . ' JACMUSE 1. Building /Frame Permit Fee $ �_ . Other Permit Fee $ TOTAL $ r. Check # `f' �� ' 22't $6 ..= a- ' Buildin Ins ector 9 P _ . . ,. r , .. _ - .; .. _ .. _- .. - _. , - =', - .: - . L.. z - --_ _:- - ':. Fs i " s' ... _. . , .. ,. e: }L fr - ,.,.. 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 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 DU.mpster on site yes no Located at 124 Main Street Fire'Department sgnatureldate _ COMMENTS F NORTH Town of RAndover . 0 ti, _: = dover, Mass., �' • • o O -- LAKE COC MICME WICK ORATED CO �C E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........144/f.M�............ BUILDING ................................................. Foundation has permission to erect... ................ build' s on ....�.7.7...........&-on..,1.�.1 t........1�,w Rough ............. to be occupied as S +. • Chimney provided that the person accepti g this permit shall in every respect form to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to a 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 ELECTRICAL INSPECTOR. UNLESS CONSTRU S TS BUILDING INSPECTOR Rough ................................................................................. ......... Service 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 BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Pape No. of i ASCO ROOFING & CONSTRUCTION CO. CONTRACT LOWELL, MA 01852 HIC#108424•Super Contractor License#092469 978-937-5840 or 978-475-7544 PROPOSAL SUBMITTED TO – PHONE , DATE - i / STREET _ _ JOB NAME CITY, STATE AND ZIP'CODE JOB LOCATION ARCHITECTDATE Of PLANS JOB PHONE We hereby submit specifications and estimates for: f ' r ' a u We Pro PM . hereby'ta furnish material_and labor —'complete in accordance with.above specifications, for the sum of: dollars (S 1� l• Payment to �be made as .follows: - 1 All material is guaranteed to_be as specified. All work to be completed in a workman- like manner according to standard,practices. Any alteration or deviation from above Authorized t I f speci}feotions involving extra costs will be.executed only upon written orders, and Signature will become on extra charge over and.above the estimate. All agreements contingent upon strikes, occidents .or delays.beyond. our control. Owner to carry fire, tornado Note: This proposal may be rto dher necessary insurance. Our workers are fully covered by Workmen's Com- withdrown by us if not.accepted within doh n Insurance. ptance of Proposal -The above prices, specifications nditions are satisfactory and are:hereby accepted. You are authorized ti he work.os specified. Payment will be made as outlined above. Signature �f Acceptance. / ire Signature. r P Pale No. i� of - r, ASCO ROOFING & CONSTRUCTION CO. CONTRACT LOWELL, MA 01852 HIC#108424 a Super Contractor License#092469 978-937-5840 or 978-475-7544 PROPOSAL SUBMITTED TO PHONE DATE"/ /� y STREET JOB NAME 77 CITY, STATE AND.ZIP CODE JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: � J ` We PrOPM hereby to furnish material and labor — complete in accordance with.abov specifications, for the sum of: dollars (S Payment to be made as .follows: All motorial is guaranteed to be as specified, All work to be completed in a workman- like manner according to standard practices. Any alferation or deviation from above Authorized specifications involving extra costs wilt be."executed only upon written orders, and Signature will become an extra charge over andabove the estimate. All agreements contingent upon strikes, accidents or delays beyond. our control. Owner to carry.fin, tomodo Note: This proposal may be and other necessary insurance. Our workers on fully covered by Workmen's Com- withdrawn by us if not.accepted within days. pensation Insurance. A=eptafWe of Proposal -The above prices, specifications and conditions are satisfactory and are-hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature " Date of,Acceptance. - Signature " Massachusetts Home improvement.,Sample Contract Eni'sform satisfies all basic requirements of the state's Home ImproemearContractor Law(MGL chapter 142A),but does not inciude standard age to protect homeowners. Seek legal advice if necessary. Any perso4 arming home improvements should first obtain a copy a dachusetts consumer guide to horns improvement"before agreeing to any work on your residence.You may obtain a free copy bycalling the e of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617=973.8787 or]-885.283-3757. Homeowner Information Contractor Information am�'vV'��Ti�ti/ua• �a..C�/YL. tap Street Address(do not e a PostR) co Box.edt� L' ntraet esperson/Own Name ..Cityflo Zip6gdy IL / urines Ad s(mustinct ' Davtmte Phone Evening � Phone Ty/Town •: S Z'CCode Meiling Address(It different from above) usiness Phone edere]Emnloya ID qr S.S.Number law regrsi�es tort atos[inme>m• Home Pa•ammtoeaosams invee .� '��O°�0f-N[g.Notadcr Exphano.tleE The Contractor agrees to do the following work for the Homeo 'nermmuannamhe nap a o 7 / YP"-, req m u e t n Required Permits-The following buiiding,.permM are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent, be adhered to unle (Owners who secure,their own permits will be as circumstances beyond the contractors control arise excluded from the Guaranty.Fund provisions of D Date when con MGL chapter 142A.) vector will begin contracted work. Date when contracted work will be substantially completed Total Contract Price and Payment Schedule oe 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: r�A�t•v S 1�!J• upon signing contract(not to exceed 1/3 at the total bon tract price or the cost of special order items,whichever is greater) $ b3'_�/ or upon completion of or upon completion of $ / upon completion of the contract (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following materialiequipment must-be special $ ordered before the contracted work begins in order S to be paid for to meet the completion schedule.(") to be paid for NOTES:(+)Including all finance charges('•)Law requires that any deposit or dovan-pavmeut required by the contractor befo not exceed the greater of(a)one-third of'the total contract pri or(b)the acetal cost of any special equipmentor re work begins may custom made material which must be special ordered m advance to meet the completion schedule. Su cess Warranty-h an n resactor agrees bei irl r d by thecontrattor? Na Yes all terms of a warraotv.mvst be ettacbed to the contract Subcontractors-The contractor arras to be solely responsible for completion of the work described cardless of the actions of any third pertylsubcontractor utilized by the contractor. The contractor further a A 'als and labor.underth's agreement greets to be solc}y responsible for all payments to all subcontractors for 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 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. • Mike sure the contractor as a valid Home improvement Contracts R MUM81 o .Tire law requires most home improvement contractors and subcontractors to be,registered with the Director ofHome lmprovemetrt Contractor Registration. You may inquire about contractor registration by writing in the Director at One Ashburton Place,Room 1301,Boston,MA.02108 or by calling 617-72 7-3200 or 1-800-223_0933. • Does the contractor have insurance? Check to see that your contractor is properly insured. • Know your rights and responsibilities. Readthe-important Lnformation on the reverse-s Guide to the Home Improveide of this form and get a copy of the Covsumcr Improvement Contractor Law. E'Zhirdbu.sineRdav this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the ting.at hislher main office or branch office by ordinary mail posted,by telegram sent or by delivery•not later than midnight of following the signing of this agreement See the attached notice of cancellation form for an explanation of this right 7wa iaDOINOT SIGN THIS CONTRACT 1F TUMRE A BLANK SPACES!±! copies afthe cannammust be cpmpleted and signed.-OnceapyshotddgomthchW, -M t b a catraaornom er S gnetureConl Date t[G I 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 m 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 Re n and the consumer shall be required to submit to such arbitration as provided In Massachusetts General La4iaper Homeowner's Signature eNOTICE:The signatures of the parties above apply only to the agreemto alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative disven 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 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 descnbed,in.a timely and workmanlike manner. Homeowner;may be entitled to other spebific legal rights if the contractor guarantees. or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all,goods sold in Massachusetts carry an implied warranty of merchantability and fitness_for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do.not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below), Execution of 0mtratt 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 contact,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 sebedule 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)652-4800 (508)755-2548 (413)734-3114 RightFax N2-2 4/23/2009 6 : 06 : 36 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MM\DD\YY) 04-23-09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FRED C CHURCH INC HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO BOY 1865 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE LOWELL.\4A 0185 31865 COMPANY 29H5J A HARTFORD CROUP INSURED COMPANY B GYS JOSEPH DBA ABCO CONSTRUCTION COMPANY 10 MEGHANN LANE C LOWELL,\4A 01852 COMPANY D COVERAGE THIS IS TO CERTIFY THAT 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 THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM\DD\YY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OPAGG. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTOR'S PROT. EACH OCCURRENCE S FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-0448N539-09 05-01-09 05-01-10 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 100,000 PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR GYS JOSEPH. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORE THE CITY OF LOWELL EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS W RITTE14 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 375 \4ERRIM4ACk STREET FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NOOBLIGATIO14 OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. LOWELL,VIA 01552 AUTHORIZED REPRESENTATIVE ACORD 25-5(3/93) Ramani Ayer S • �1LQ l.'4/9LTrlO1l(llFYll�I1U�.i��nlLix1QCRtl.'!el{Q t . -', BOARD OF BUILDING•REGULATIONS License,; CONSTRUCTION SUPERVISOR Number: CS 092469 i Birthdate: 09/27/1954 Expires: 09/27/2009 Tr.no: 92469 Restricted: 00 ` JOSEPH J GYS 10 MEGHANN LANE / LOWELL,, MA,01852 Commissioner „A ✓1te Toarnrn�vruueal,C� c�Y�,aaa�u`zuvP,� Board of Building Regulations and Standards # HOME IMPROVEMENT CONTRACTOR Ys` Registration: 108424 • Expiration: 8/18/2009 Tri! 132909 Type: DBA ARCO ROOFING&CONSTRUCTION Joseph Gys 1UMEGHANN LANEy..�.o,,` LOWELL,MA 01852 Administrator w M