HomeMy WebLinkAboutBuilding Permit #413-4 - 20 ROSEMONT DRIVE 11/6/2013 BUILDING PERMIT
TOWN OF NORTH ANDOVER ° f"0- i %
I (i 1 APPLICATION FOR PLAN EXAMINATI N ,
Permit NO: Date Received
44r 0,
Date Issued: I �sSACHUs��
IM ORTANT: Applicant must complete all items on this page
LOCATION o?d R ost MQnl r Dry.
Print
PROPERTY OWNER G y 0"A
Print
MAP NO: 01
PARCEL: ZONING DISTRICT: Historic District yes6no Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building V One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
5( Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑ Wetlands ❑ Watershed District
❑ Water/Sewer
13 u I L J /2 )< 2 0 PE CK w 174 5-1418 S An/D tl#V yL C EiL 11/G
MD1=i� acc►C .
Identification Please Type or Print Clearly) r
OWNER: Name: �G'7�� G /012D�} Phone: �.
Address: 0 DSE N7- tZ,I VC
CONTRACTOR Name: 91� - 20q-Sa 6 Phone:
M 2I< 6AL-1 V tV M• D. , ru6G/V117V $ &4)leV 6- Canl�
Address:
4 M i cN ar- f79, c 54L,1S.3IJkV J/H
Supervisor's Construction License:- 0,-? 7 ' �7 Exp. Date: / I - Z F-
20
13
Home Improvement License: Exp. Date:
D CD - 2l '2,016-
ARCH ITECT/ENGINEER
nl6-ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COAST BASED ON$125.00 PER S.F. r
Total Project C st: $ I �, or?S, FEE: $ t �'
Check No.: (AI i Receipt No.: 2—1 D-1 k d
NOTE: Persons contracting with unregistered contractors do not have access to the zuaranty fund
Signature of NgenvOwnerra�nl�',�- Signature of contractor
TOWN OF NORTH ANDOVER
` APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
Date Issued:
s
IMPORTANT:Applicant must complete all items on this page
LOCATION
- Print
PROPERTY OWNER
Print 100 Year Old Structure yes no
MAP NO: _ PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement 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.: y Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor !
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
Plans Submitted-11 Plans Vllaived ❑ Certified Plot Plan ❑ Stamped Planq ❑
TYPIJ_OF--:SEWERAGEDiSPOSAL
Public Sewer ❑
Tanning/Massage/BodySwimming❑. _ g 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 ❑ ] lJ
COMMENTS-1
�.
:CONSERVATION Reviewed on l l 3 Si nature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
i
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 Tow;: Engineer: Signature:
Located 384 Osgood Street
.-...'FIRE DEPARTMENT -`Temp Dumpster on site yes no
Located-at 124,Mair Street -
Fire Depar m—wit signatu"re/date '
COMMENTS .M
- 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-Chapter166 Section 21A-F and G min.$10041000.fine
NOTES and DATA— For department use
VALIVwrj
�Jn' 40
El Notified for pickup - Date
E
I
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
❑ 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 cas<s 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 submAted with the building application
Doc: Doc.Buhding permit Revised 2012 .
j Location (ZD S e y\Ao N� ,
No. 1 Date W
. - TOWN OF NORTH ANDOVER `
• fi .
Certificate of Occupancy $
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check#
r Building Inspector
NORTH
own of
O " 1
No. -
� Ii
z a �J QM Z'Q 3
� o h , ver, Mass,
COC MICKf WICK y1.
A�RgTED
S V
BOARD OF HEALTH
PER LD Food/Kitchen
Septic System
..........YR.............................................. BUILDING INSPECTOR
THIS CERTIFIES THAT ........... .. . Tk ........... ..............
has permission to erect �bS��� 16's, Foundation
p .......................... buildings on ............................. ................................ ...........
Chimney
�j Rough
to be occupied as J1L..It.�. Dealt.t.1 • •• • • •�•� ••••
r vided that the person accepting this permit shall in eve re pect conform to the terms the applic Final
provided p p g
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
UNLESS CONSTRU STAR 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 t�a Building Inspector. Burner
Street No.
Smoke Det.
SEE REVERSE SIDE
� NORTit�
Town o : � E : 1j . Andover
0 z.
41� Iai ti
o h , ver, Mass,
ulew4w� i-3
COCNICHR WICK y1.
�d p�RATEO 1'P��'�5
S V
BOARD OF HEALTH
PER LD Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT ...........M..... .. . &.
has permission to erect 2o RA5�6� Foundation
p .......................... buildings on .......................�.... ................................ ...........
Rough
to be occupied as ........ C.,T0.....� .. ..4!!. .. ... ..�. ..... .y�...... �. l........ ... Chimney
he terms oR thea lic
provided that the person accepting this permit shall In eve re ;Dect conform tot pp Final
pro p p 9 p every
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
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRU STAR 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
Circle Insurance Fax:978-777-4898 Oct 17 2013 0806a P0016001
V'ER-"nFICATE
l�� UAM(MIVII U7YYY1
CERTIFICATE OF LIABILITY INSURANCE 10/17/13
RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
DOF_S NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
. . 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(ie9) 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 ondorsemengs).
PROWCeR CONTACT
NAME:
Circle Buainess Ins. Agcy, Inc PH NIF FAx (978) 777-4898
978 777-5619 No:
247 Newbury Street E-MAILADDRESS: PaulaHala9@CircleIrisurance.net
Danvers, MA 01923 INSURERIS)AFFORDING COVERAGE NAIC6
__..—..---.._.---.•_-- INSURER A;AIM Mutual
INSURED INSURER B
MD Sullivan Building ContraCto INSURER C:
Mark Sullivan
INSURER D;
4 Michelle Drive INSURER E:
Salisbury, MA 01952
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 SUB.IECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POl_ICIE;S,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR AWL U6 POLICY EFF POLICY EXP
LTR TYPEOFINSURANCE POUGYNUMBFR (MM MY
MM/DDfYYYY LIMITS
GENURAL uA01LITY EACHOCCURRENC6 S
I COMMERCIAL GENEPALLIABILITY DAMAGE TO RENTED i$
I CLAIMS-MADE :J OCCUR I MED EXP(Arryone person) 1 $
iPERSONAL&ADV INJURY 1$
GENERAL AGGREGATE $
GEN'LAGGREGATE LIMITAPPUES PER: 1 PRODUCTS-COMP/OP AGG $
POLICY F7 JE CT PRO � LOG I ! $
AUTOMOBILELIABIUTY C NBEN LIMIT
a accloen $
ANYAUTO BODILY INJURY(Per p¢rson) $
ALLOWNED
AUTO$ AUTOSULEO I I BODILY INJURY(Per sccloont) $
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS I er®
i $
UMBRELLA LIAR00UR EACH OCCURRENCE I$
r==29SLIABFC�LAIMS-MDEIAGGREGATE $
DED RETENTION
A MKKER4COMPEN8ATION VWC6005399012011 5/22/13 5/22/141 X WC5TATU- OTH-
1 AND EMPLOYER LIABILITY y N
s ANYPROPRIEIORIPARTNEWEXECUTTVIEE.L.EACH ACCIDENT 5 100,000
OFICERIEMBER OCCLUDED? Y
� (MardamryinNH) I DI F_AS6-EAEMPLOYEE 5 100,000
IfyyeB 09aCrMeundor
0ES4RIPTIQN QF OPERATIONS below I E.L.DISEASE-POLICY LIMrr S 500,00c)
I
I
DESCRIPTION DF OPERATIONS/LOCATIONS/VEHICLES (ARech ACORo 1 D7,Additional Rerrario Schedule,if more epsco Is rzgUr¢d)
CERTIFICATE HOLDER CANCELLATION
SHOULp ANY OF THE ABOVE DESCRI89F)POLICIES BE CANCELLED 13UORE
THE EXPIRATION DATE THEREOF, NOTICE WI)_L BE DELIVERED IN
Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS.
Gerald Brown
Town Hall AUTHORIZED REPt�.EN-TA�?M
North Andover, MA
Janet Nich Account Executive
® 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
Phone: Fax; (978) 688-9542 E-Mail:
The Commonwealth of Massachusetts
Department ofIndustrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
U1 www.mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): ,4 , 0 �A LY 4,044, /-moi_
Address:
City/State/Zip: /1/I (0,r 2 Phone
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 0` 1 4. ❑ I am a general contractor and I 6. 0 New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. F1 Remodeling
ship and'have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp.insurance. g El Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.El Electrical repairs or additions
3.❑ 1 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.❑Roof repairs
insurance required.]t employees. [No workers'
comp.insurance required.] 13.[i Other
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
lam an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information. t /�
Insurance Company Name:. fi 1 t ✓- l r
Policy#or Self-ins.Lie.#: Expiration Date:
`4)
Job Site Address: [OS EM 6V 7- &L19 IVA AQ Q)& City/State/Zip:
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 tine
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.
X do hereby cer ffy under t ains andpenalties of perjury that the information provided above is true and correct.
Signature: c, Date: 1 3
Phone#: I 2 6 q s-Z o q
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 employeiis defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be 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 produced-acceptable evidence of compliance with the insurance coverage required"
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-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 may be 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 of Mossachusetts
Department of Industrial.Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
TO,#617-727_4900 ext 406 ox 1-877:MASSA.FE
Revised 5-26-05 Fax#617-72`T-7749
ww.mass.gov/dia
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DeK` ZONING INFORMATION:
+$• X5 ZONING DISTRICT: R2
MIN. BLDG. SETBACKS
NBr•\ \ R-10800' /C FRONT: JO FEET
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NO1ES: NORTH ANDOVER WSSACHUSET
1. TIE TOPOGRAPHY SITE DEW R stAIFACE IMPROVEMENTS DEPICTED
HEREON KERS OBTAFED FROM A PARTIAL FILO SURVEY COMDUCIED ON (g�J,�(C07DdTY — NORTN6RN D)STRIC!)
A#E 6,2011,BY SL11.tIVAN E/NQN.E'ERFNG cleDtx;LLG OWNER/APPLICANT
2 PC LOCA MW OF ALL UNDERGROUND UTYIDES SHOW ARE APPROXIMATE PR6PARRD FOR
AND ARE BASED UPON A PARRAL FIELD SURVEY AND COMWLATION OF PETER&KRISTEN GYOROA PAM GYORDA
PUNS OF RECORD. RIE DESIGN ENGLNEER DOES NOT WARRANTY NOR 20 ROSE DRIVE !"=20' DATE. JDNS 7; 2011
GUARANTEE THE LOCATION OF ALL UWTES DEPICTED OR
NOT DEPICTED. NORTH ANDOVER. MA 018{5 SCALE'
nE CONMACyM PRIOR TD CCWMENGE•MENT OF CONSTRUCIM SNALL PREPARED BY
VvWY THE LOC4MW OF ALL UWTE5 AND CONTACT DIG SAFE AT
I-BW-344-7P= nFED REFERENCE.
Im PLAN DoEs Nor sHow ANY w EcOR=OR UNNRITTEN EASE•MENrs - SULLIVAN ENGINEERING GROUP,
Wcm MAY DnK A REAStiNABIE AND DiU ENT ATTEMPT HAS BEEN MADE BOOK: 5758 PAGE: 61 2Z LIOUM YIRNON MAD
M OBSERVE ANY APPARENT, NSIXE USES OF 1NF LANG•NONEIER, IMS BOX/ORD.MA MZf
00<S Nor CONSRTWE A GUARANTEE INAT NO SUM EASEMENTS 604 r d (978)B6t-ftn
4. RE LEVAIKINS DEPICTED NE%EDW KERS BASED UPON AN ASSUMED OATIA,L OW ITE ASSESSOR MAP 989 PARCEL 93 Sff6Ef No. I OF 1
_._.___..........,...,�-r I ty-AIm WDM A FLOOD ZOW AS DEPICTED
a
Detailed description of work
Remove existing deck and stairs and remove from property.
Cut back existing siding to accommodate new 20 foot wide deck
Dig three holes to support deck using 10 inch sons tubes and set fasteners in concrete
to hold 64's.
Dig 4 holes to support landing of stairs. Pour cement and set fasteners in concrete to
hold 4x4's
Install new 2x10 pressure treated ledger and bolt into the house at 16 inch intervals.
Install new flashing above and below new 2x10 ledger.
Frame for new deck 12x20, using all 2x10 pressure treated wood. Deck to sit atop beam
that
sits below on 6x6 posts. Beam to be set back 2 feet from the 12 foot depth of deck.
One row of solid block bridging to be installed at midpoint of deck floor.
4 -2x12 stringers used to build new stairs that will have a finished width of 4 feet.
Stairs to go down 7 steps onto landing (5' x 4')and tum left ,with 4 steps to the ground
onto cement pad.
4x4 posts to be installed at12 locations to accommodate railings.
Azek grey PVC decking to be installed throughout deck and stairs using screws and
plugs to fasten.
White vinyl boards to be installed on stair risers, upper deck frame sides-(3) , sides of
stairs and sides of
stair platform. Material to be fastened with white nails.
Vinyl sleeves, bases and caps installed over pressure treated 4 x 4 posts.
New white vinyl Expanse railings to be installed (13 total) for railings for deck.
Install new white "Dry Snap" ceiling underneath deck 12' x 20'
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Detailed description of work
Gyorda Residence
20 Rosemont Drive
No. Andover Ma.
Remove existing deck and stairs and remove from property.
Cut back existing siding to accommodate new 20 foot wide deck
Dig three holes to support deck using 10 inch sona tubes and set fasteners in concrete
to hold 6x6's.
Dig 4 holes to support landing of stairs. Pour cement and set fasteners in concrete to
hold 4x4's
Install new 2x10 pressure treated ledger and bolt into the house at 16 inch intervals.
Install new flashing above and below new 2x10 ledger.
Frame for new deck 12x20, using all 2x10 pressure treated wood. Deck to sit atop beam
that
sits below on 6x6 posts. Beam to be set back 2 feet from the 12 foot depth of deck.
One row of solid block bridging to be installed at midpoint of deck floor.
4 -2x12 stringers used to build new stairs that will have a finished width of 4 feet.
Stairs to go down 7 steps onto landing5 x 4 and turn left with 4
( ) steps to the ground
onto cement pad.
4x4 posts to be installed at12 locations to accommodate railings.
Azek grey PVC decking to be installed throughout deck and stairs using screws and
plugs to fasten.
White vinyl boards to be installed on stair risers, upper deck frame sides-(3) , sides of
stairs and sides of
stair platform. Material to be fastened with white nails.
Vinyl sleeves, bases and caps installed over pressure treated 4 x 4 posts.
New white vinyl Expanse railings to be installed (13 total) for railings for deck.
Install new white "Dry Snap" ceiling underneath deck 12'x 20'
wDa
�� DATE
�SS�e�1 sic s oe i -roveam.em�
This form satisfies all basic requirements of the state's Rome Improvement Contractor Law(MGL chapter 142A but do
language to protect homeowners. Seelc Iegal advice if necessary. An )� es not include standard
Massachusetts Consumer Gtitide to Home Improvement"before aeeingto any woxlc on yourmreesidenrce.Youtmay obtain afr e a copy of"A
Office of Consumer.A�aixs aadBusiness R,egulation's ConsumerliafoxmatioaHotline at 617-973-877 ox x-888-283-3'757 or on ouyrbwebg�e
JALomeowner�orm�.it®� .
Name p
D D'A C,to�mpannyNama
StreetAddress(do notuse aPostOffice Box address) / ' U .SUIS/vA�� NG
_ Contractor/Salesperson/Ownerjgmn
City/Tow R S� I Stato Zip Code I� 5ZXZ-111
p iD� 4BlU'sin'_AA_6ddre_ss(must include.a street address)
1�► r O
Dhyrnne r'1 p one l G 17 F,l-E DJ2_f V
EvemngPhone CitwTown
e State Zip Coda
Mailing Address(Ti difFerent from above)
Business Phone Federal>;mpIoyer ID or S.S.Number
Homelmpmvement contmotorlLeg;A7omber
' 7nwreRnirestbntmostHoma �
kxpiraeandste �
Improvement contractors bavn
n valid razistnition nninbor
(AesDes Contractor agrees to do the following Work for the$omeowner:
cnbe in detailthe worlcto completed,spec*Ingtlle type,brand,and grade of materials to be used,use additional sheets if ecessa •) '
��' SE SSE ATT�crf WNLEP �tSc�iono� I�A7�J Il-�-l3
r
]iZ d ill b Permits.The following building permits are required Proposed Start and Completiozx Schedule The followin schedule and will be secured by the contractor as•the homeowner's agent: be adhered to unless circumstances Schedule
T e fOII ctox's controldiearise
i
(Owners who secure their own Permits:WM be
excluded from,the Guaranty FMd provisions of
:KGL chapter 142A.) Date when contractor will begin contracted woxlG
Date when contracted work will be substantially completed.
'T'otaI Contract Price and Payment Schedule
The Contractor agrees to peri'orm•the work,fmmishthe material and labor specified above for the total sum,of T
Payments will be made according to the following schedule: y ('F)
upon signing contract(not to exceed 1/3 bf the total contract price or the cost of special,order items,whicheve
$ r is greater)
39 02 by�i �S'i �3 oxupon completion of rAA�ME 4�' j�r-GK CON�GL
$J_3 C S by.�,! �9/ /3 orupon completion of GL DE 9IN6 /VSTA1_1Jr 0 '
s 33 6 8' NJ R���In/GS 4lll SITE
Upon completion of the contract, (Law forbids demanding full,payment ulztil contract is completed to both party's satisfaction
Thefollowingmater!Wequipmentmustbespecial $ ) '
ordered before the contracted work be ins' to be paid for ,
to meetthe completion schedule,(�MI) g is order
� tobepaidfor •
NOTE'S:(4)Including all fuzance charges .i..i� •
g ( )Law requires that any deposit or down payment required by the contractor before workbegins may
not exceed the greater of(a)one third of tho total contract price or(b)the actual cost of any special equipment or custom made material
which must be special ordered in advande to meet the completion schedule.
A
ress'Warran -Is,n exresswar ant beinroviled the con iractor7 ❑
Subconia actors-The contractor agrees to be solelyxesponsible for completion of waxlt descr bed regardless ofthe actions oxaaustben ached�t I;e contract
Many/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors s for
ate rats and abo•• de tI is a eem t
Contracs all not imp -Upoa signing,this document becomes abinding contract under law. Unless otherwise noted within,this documeat the
contract shall not imply that nay lien or other security interest has been placed on the residence. Review the following carefully before signing dais contract, wing cautions and notices
O Don't be pressured into signing gning the contract.Take time to read and fully understand it. Ask questions if something is unclear..
Maice sure the contractor has a valid tome lmroxovement Contraeto a 'stration,
subcontractors to be xegistrered tvath rhe Director ofPSome Improvement Contractor Re
The lawrequires most home improvement contractors and
registration bywri6ng•to the•Direetox at 10 ParkPlaza,Room,5170,x3oston,MA D2116 or by calling,617--973 8787 or 888 283-3757.
Does the contractor have iusuraace? Ask the Contractor for his insurance company information•So h YOU may
inquire about contractor
a see a copy of a"proof of insuraace"document. y u earn confnxo.coverage,or aslcto
7�v.ow your rights and responsibilities. Read the Important xn:fouination on the reverse side of this form and get a copy of the Consumer
Guide to the 73ome 7xnprovemezLt Contractor Law:
Youmay cancel this
agreement.if it has been signed at aplace other than contractor's normal place ofbusiness,provided o
contractor in writing at his/her main office or branch oflYce by ordinary mail posted,by telegram sent or delivery,
third.business day following tht;si � p you
g going oftbis agreement See the attached notice of cancellation form for an expatt'onto£this than
of111t
Jiro NOT'SIUN TMS CorTTRACT]T'-Tl-I�RE
Two identical copies ofiha contractmust be completed and signed, One c ANY IBL��SPACE,S 111
apyshouldgotot ohomeouw. The oihorcopy shottldbelcepthyfhecontrootor,
P,o owner's Signet •e
ontractor's Si
Rate
C'073 2P-i'O r Arbitration
The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an
'altexnati�e to court action)if they have a dispute with a contractor. The same right is Zol•automatically afforded to a
contractor:,however. The contractor would have to resolve any dispute he/she has with a homeowner.in court ed
both pardes agree t0 the 000nal clause provided below. This clause would give the contractor the Sadao court
,unless
arbitration as is worded to the homeowner by the Home Improvement Contractor Law, rightto
The contractor and the homeowner hereby mutually agree'a advance that in the event the contractor has a dispute
coneeaniug this contract;the contractor may submit the dispute to a private arbitration ff�which has been approved by
the Secretary of the Exectittive Office of Consumer Affairs and Business Regulation and the consLimer shirr be required
to submit to such arbitration as.provided In Massachusetts General.Laws, chapter 1g2A..
Ho eoners SigatuwA
NOTICE: Contractor's ignattixre
The signaittres of the paard� s above apply only-to the agreement of the parties-to alternative dispute
resolution initiated by the contractor: The homeowner may tiate al tey,�ative dispute resolution even where this
section is not separately signed by the parties,
Romeowner's Bights '
A homeow.nees 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.an Guaranty Fund provisions of
the Home Improvement Contractor-Law. The contractor isr responsible for completing the work as described,in a
timely and worl=anlilte martn,er. Homeowners may be entitled to other specific legal,rights if tb e contractor
guarantees or provides an express warranty:for woxlananship or materials. Sia addition to
provided by the contractor, all goods sold-in Massachusetts cavy an implied'warranjy of anexchaaltabxohx'ty and fitness for
a particular purpose. An enumeration of other maiters on which the homeowner and contractor lawfully agnea maybe
added to the terms of the contract an long as'they do not restrict a homeowner's basic consumer rights. If yott havo
questions about your comsumer/hoaneowner rights, contact the Consumer Information Hotline(listed below).
Execution of Contract
The contract must be executed in du Beate and should not be signed until a copy of all e7hibits and referenced
documents have been-attached. I'm-des axe,also advised not to sign the document until all blanit 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 tmtil both parties have received a filly 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 a
ent schedule in.cases
homeowner deems him/herself to be financially imsect�re. However,au instanceshpwe a contxacto deems wwherhim/ et elf
he
to be financially insecure,the contractor array require that the balance of:Rmds not yet due be placed in a joint escrow
signatures of both parties.
account as a preregtusite to continuing the contracted work. Withdrawal 0f fr�,nds C-rom said account would require the
:additional Wor>m,ation '
,If you have general questions or need additional info=ation about`the Horne Improvement Contractor Law or outer
const*ner rights, or if you wish to obtain a free copy of "A Massachusetts Consumer Gude to Home improvement"
contact:
Consumer lufortnationHot i e
Office of Consumer Affairs aaa d Business Regulation
10 • s . 021/617-973-8787;888-283-37$7 or'vxsittthe OCA 3R bt at� wvrw.
mass:�•oylocabr/
If you want to verify the registration of a contractor or if you have questions or need addi
about the contractor registration component of the Home Improvement Contractor Law, cotionantactlinfoxmatioai sped fically
Director of Home Improvement Contractor Regisia:atioxr
Office of Consumer Affairs and Business Regulation
16 Par1c Plaza,617-973-8787, 888-2 83 3757 or visit the x3CC Website OOM 5170, n'�'02116 .
` atlatln://WwwiTiass gov/oc_ ab1J .
Go online to view the status of a Home Improvement Contractor,s Registration:
lea://db•state.ma.L1s/laoxneimorovelx�ent/licenseelist.as
For assistance with informal mediation of disputes or to register-cormal complaints against g a business, calx:
Consumer Complaint Section
Office of the Attorney General
617-727-8400
AND/OR
Better Business Bureau
508-652-4800,508-7755-2548 or 413-734-3114
c