HomeMy WebLinkAboutBuilding Permit #209-14 - 25 COLGATE DRIVE 9/6/2013 I
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: ` f` Date Received
Date Issued: 6 -/�
IMPORTANT:Applicant must complete all items on this page
LOCATION
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Print
II PROPERTY OWNER1
Print 100 Year Old Structure yes n
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
j Residential Non- Residential
❑ New Building One family
❑Addition ❑ wo or more family ❑ Industrial
Alteration No. of units: ❑ Commercial
Repair, replacement ❑Assessory Bldg ❑ Others:
❑ emolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
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Jdentificatio Please Type ar Print Clearly) h i
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OWNER: Name: E Phone: f
Address:
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CONTRACTOR Name: Phone:
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Address:
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Supervisor's Construction License: Exp. Date: ; =' i
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
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Address: Reg. No. +I
FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. I
Total Project Cost: $ �b-o FEE: $
Check No.: Receipt No.: �.�
NOTE: Persons contracts ith unripgistered contractors do not have access to the guarantyfund f
Signature,of Agent/O rSignature of contractor_
Plans Submitted ❑ Plan Waived 0 Certified Plot Plan ❑ Stamped Plans ❑
Locatioo;
No. Date /
• - TOWN OF NORTH ANDOVER
. Certificate of Occupancy $��-�—
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check#
Building Inspector
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Plans Submitted-[] Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
.. TYPE OF:SEWERAGE:DiSPOSAL -
Public Sewer ❑ Tanning/Massage/Body Art ❑... Swimming Pools ❑
Well ❑. Tobacco.Sales ❑
Food Packaging/Sales ❑
Private(septic tank,etc... ❑ - Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE.APPROVED
PLANNING'& DEVELOPMENT ❑ ❑
COMMENTS
.CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Siqnature
COMMENTS
Zoning Burd 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:
77- Located 384 Osgood Street
FIRE-DEPARTME"Nt =Temp Dumpster on site yes no
Located at 124,Mair, Street-- ;
Fire Depar`tment.signature/date`' l - •
COMMENTS
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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
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NOTES and DATA— (For department use
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B Notified for pickup - Date
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Doc.Building Permit Revised 2010
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Building Department
The foltswing it-a-:list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
D` Building Permit Application
o Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
L3 Copy of Contract
o 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
Li Building Permit Application
o Certified Surveyed Plot Plan
o Workers Comp Affidavit
o 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)
o Mass check Energy Compliance Report (If Applicable)
Li 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)
Li Building Permit Application
o Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the 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.Building Permit Revised 2012
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T0"OF j%R.Tff•ANDOVER II
OFFICE OF
BUILDING DEPARjTA NT
:'].60013sgood Street Building 20,-Suite 2-36
'�s gcuus�c�5 North Andover,Massachusetts 01845 I
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Gerald A.Brown
Inspector ofBuildings Telephone(978)688-9545 I
HOMEOW:�TER-LICENSE P-XrMpTION • Fax (978)688-9542
,y
BUIDIN PE1tNIIT APPLICATION
Please print I
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DATE: /• 3 '
JOB LOCATION:
Number Street Address
Map/Lot
IMMOWNER
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Name. Home Phone
Workphone I
-PRESENT MA iNG.ADDRESS
'r i;fwtti (
lip Code
The current exemption for"homeowners"
to allow subb ho,neov, was extended to cludeowper-occupied dwellings to two units.0r less and
�ners to engage an incavidual.for hire who does not possess a 71cense,provided that the owner
acts as supervisor). State Buulding (Code Section 108.3.5.7)
DEFINITION OF HOMEOWNER
PerSO49)who gwns a parcel of land on which he/she resides or ince
be,a one or two family structures" A person who constructs more that one homends to in a two which on azer en od orisintended to
considered a homeowner. Y p hall not be
The undersigned"homeowner"assumes responsibility for coznpIiances with the I
Applicable codes,by-laws,rules andregulations• State Building Code and other
The undersigned",homeowner"certi es that he/she understands the Town of North Andover Building Department
minimum inspection procedures and requirements and that he/she will com Iy with,said Procedures and
requirements,
HONMOWN•gRS SIGNATURE
APPROVAL OF BUILDING OFFICIAI,
Revised 7.2009
Bonn Homeowners Exemption
'130ARb OF APPEALS 688-9541 CONSERVATION 688-9530 `•.
HEALTH 688-9540
PLANNING689-9535
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The Commonwealth of Massachusetts
Department ofIndustrial Accidents I
Office of Investigations
UV 600 Washington Street
Boston,MA.02111
www.massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
NaMe(Business/Organizationgndividual):
Address:4 2�6
j� 'r
City/State/Zip: Phone#: _ "—
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Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
� have hired the sub-contractors 6. E]New construction
mployees(full and/or part-time).
2.A I am a sole proprietor or partner- listed on the attached sheet.1 7• ❑Remodeling
ip 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. El We are a corporation and its
required.] officers have exercised their 10.El Electrical repairs or additions
3.❑ I 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' 13.❑Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i
i Homeowners who submit this affidavit indicating they aie 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. j
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:.
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: 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 fine i
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.
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Ido her certify 4nder the pains nd penalties of erjury that the information provided above is true and correct
Simature: Date: r
e#:
Offccial use only. Do not write in this area,to be completed by city or town official. I
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City or Town: Permit/License#
Issuing Authority(circle one): I
1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector
6.Other - - -
Contact Person: Phone#:
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Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a 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 producedacceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit 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.
e addition,Please be sure to fill in the permit/license number which will be used as a reference number. In addi applicant
an a lic
ant
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 Massachusetts
Department of Jndustrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel,#617-727-4900 ext 406 or 1-8777MASS.AFE
Revised 5-26-05 Fax#617-727-7749
WWW-m.ass,govldza
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R()me Ym -'®vexn eAnt Saiz • le CO
This farm satisfies all basic requirements le the
language to protect homeowners. Seek legal S�.t&s Home Improvement Contractor Law(MCTL chapter 142A),but does not include standard
gal advice if necessary. An
Massachusetts Consumer Guide to Home Improvement before a eein to any planning home improvements should first obtain a copy of t'A
�� $ any wont on your residence.You may obtain,a free copy by calling the
Office of ConsumexAffairs audBusiness Regulation's Consumer lnformationHotline at 617-973-8787 or 1-888-283-3757ox on o
HOMeow ner hforlmn.ajaon 'Contractor Idbrlm>lation urwebsite.
N ,
Company Name
beet A ddr s notnse aPost 0 ce Box address D�
5 ) Contractor/Salesperson/Owner
Name
Cityo ice--
jT0 State Zip Code Bpsiness Address(must include.a/street address)
D e 'One Evenin Ph
�/ g ° City/xawn
s.
Zip Code
�/
Mailing Address(It different from bove) ` �" " �G / �� ��U 4"Ea '
Business Phone Federai>;mnployer ID or S.S.Number
HomeImpmvement'contmotorReg.Number k�cpirntandnte
xnwregnires thatmostliome
improvement contractors It.
n valid rcgistratian nnmvcr
The Contractor agrees to do the !I
foIIowing work;for the Homeowner:
(Describe in detail the worlcto completed,specifying the type,brand,and grade of materials to be used,use additional she ifnecessa
Required Permits-The following building permits are required Proposed Start an•d Completio><x Schedule-The following schedule
and will be secured by the contractor as•the homeowner's agent: be adhered to unless circumstances beyond the e foil o i g shed arise l
(Owners who secure their own pernnits SVM be � 2
excluded freta the G>$aranty JFUnd provisions of /e 'l/
Date when contractor will begin contracted woxlc
MGL chapter 1.42.A..) f. .
ate when contracted work will be substantially completed.
Total Contract Price and Payment Schedule
The Contractor agrees to perform,the work,furnish the material and labor specified above for the total sum o£ ��l a 0- �rl
t —Z ()
Payments will bemade accordingto the following schedule:
0�--a upon signing contract(not to exceed 1/3 t)f the total contractrice or th
cost
e
p .� of special order items,whichever is greater)
p qy / 1 3 or upon completion of O�, O O
$-- by / / or upon completion of
UPM completion of the contract. (Law forbids demanding full payment until leted to both contract is comp party's satisfaction) .
The following mai�erial/equipmentmust be special $ '
ordered before the eoniractedwork begins in order to be paid for
to meetthe completion schedule.(.i°°i°)
to be paid for
N®TDS:(.i)Including all mance charges .i°'!° •
g ( )Law requires that any deposit or down payment required by the contractor before work begins may
not exceed the greater of(a)One-third of the total contract price or(b)the actual cost o£any special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
E,x ressWarren -Is an et ress warrant heir rovided b the contractor.
Subcontractors-The contractor agrees to be solely responsible for completion Of tNo he
work described regardless ofthe actions of anyes(all terms tbird ontract
party/subcontractor utilized by the contractor. The contractor further agrees to be solei res onsible for all a y
materials and lobo•under this a Bement y p p yments to all subcontractors for
Con-iMetAcceptance-Upon signing,this do lent becomesabinding contract under law. Unlessotherwise noted wi`thin,thisdocumcnt,the .
contract shall not imply that any lien or other security interest has been placed on the resi
carefully before signing this contract. dence. Review the following cautions and notices
° Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear,
o I ub co sure the contractor has a valid Home 7m rovement Contractor Reiasiration. The law requires most home improvement contrac
subcontractors to be registered vnth.the Director ofl3ome Improvement Contractor Registration. You may inquire about contractor tors and
o
registration by writing to the-Director at 10 ParlcPlaza,Room 5170,Boston,MA 02116 or by calling.617-973-8787 or 888-283-3757.
Does the contractor have insurance? Aslc the Contractor for his insurance company information so that you can,conrnm coverage,or askto
see a copy of a"proof of insurance"document.
Ino e t oche Xots a mpro emenliti s.n Read the Important Information on the reverse side of flus form and get a copy o£the Consumer
Guide to the Dome Improvement Contractor Law:
You may cancel this agreement if it has been signed at a place other than,the contractor's normal place of business,provided you no' the
contractor in writing at his/her main,office or branch office b ordinarytlfy
third business day following the signing ofthis agreement.
yn'a'1 p°fid'by sent or by delivery,not .
Seethe rY� likter than midnight
attached notice dmgbt o£the
tree of cancellation form for an explanation o£this right.
DO NOT'SIGN TB1 18 CONTRACT JT'TICTRE ARE ANY J31G
o identical c pies oftlte contractmustbe completedand signed. One c INIK SPACES!i l
opy should go to the homeoVvner. The other copy shouldbe Icept byflee contractor,
V I
eownex's gnatuxe
actor's Signature i
'Date
Date --------------
Cont rae1
or.Axb'
xtratZoix .
The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an.
'alternative to count action)if they have a dispute with a contractor. The same right.is not automatically aifoxdedto a
contractor,however. The contractor would have to resolve any dispute he/she has with a home
owner.in court unless
both parties agree to the optional[clause provided below. This clause would give the contractor the same right t
arbitration as is worded to the homeowner by the Home Iimprovement Contractor Law, g o
The contractor and the homeowner hereby mutually agree iu advance that in the event the contractor has a dispute
concerning this contract;the contractor may submit the dispute to a private arbitration firm.which has been approved b
the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required
to submit to 'such arbitration as.provided In Massachusetts General Laws, chapter 14.2A..
I3omeowner's Signature
NOTICE: Contractor's Signature
The ted b signature ofthe paries above apply only-to the agreement of the parties to alternative dispute
resolution initiated by the contractor: The homeowner may initiate alterative dispute resolution even where this
section is not separately signed by the patties.
Mlomeowner's Rights
A homeowner's rights under the Home Improvement Contractor L?.w(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
maybe excluded from certain rights if the contractor they choose is not properly registered as prescribed m law.
Homeowners who secure their own,build'itgpermits are automatically excluded'•
the Home Improvement Contiactor-Law. The contractor is responsible for completing e o•lac as described,,lu a ions of
timely and worlsmaulilce manner. Homeowners may be entitled to other specific legal rights if the contractor
guarantees or provides an express warranty for workmanship or materials. In addition to
arranties
provided by the contractor,all goods sold.in Massachusetts early an implied'warranty of m xchhaantabilitor y and.fitness for
a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree maybe
added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. Eyou have
questions about your consumer/homeowner rights, contact the Consumer Information Hotline(listed below).
1Execution,of Contraet
The contract must be executed in duplicate and should not be signed until a co
documents have been ati:ached. Parties are also advised n � copy of all exhibits and referenced
filled in car , adeleted, of to sign the document until all blasXc se,&.Lons have
marked been
d as void, of 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 be
gin ttntil both par9xes have received a fully executed copy of
the contract,and the three day rescission period has expired.
Accelerated l?ayments
A contractor may not demand payments in advance of the dates specified on the•payment schedule in cases where the
homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems
to be financially insecure,the conerself
tractor may requite that the balance of funds not yet due be placed in.a j obaiieescrow
account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the
signatores of both parties.
Additional Worxm.atioxa
If you have general questions or need additional information about the Home Improvement Contractor Law or other
constuner rights, or if you wish to obtain a free copy of "A Massachusetts Consuumer Guide to Some 7m
contact: provement"
Consumer Information Hotline
Office of Consumer Affairs and Business Regulation
10 ParlcPlaz�,ROOM 5170,Boston, 16
617-973-8787,' 888-283-3757 or"visitt the OCABRwebs to Natt t-1://ww�vmass.
' �v/ocabx•/
Ifyou 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
O C-Rea of Consumer Affairs and-Business Regulation
Id 617-973-8787, 888-283-3757 a
57 orvisittheWCwPlaza,Room 5170,Bebsite'atostonbt 0211,6
—rJ.//. 'I11aS5
Go online to view the status of a Home ImprovemerLt Contractor's Registration: _
]11.-L7�://db.state ma t2s/hoyneimtrovement/licertseeTist.as
For assistance with informal mediation of disputes or to register formal;compla•-ats against a business, call:
Consumer Complaint Section
Oface of the Attorney General
617-727-8400
AND/OR
Better Business Bureau
508-6S2-4800,508-!755-2548 or 413-73431:14
Version 2.1-
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A_ COCHIC141WIC« ��•
7�A�R�TEO APp��S
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BOARD OF HEALTH
PERMIT T LD Food/Kitchen
Septic System
THIS CERTIFIES THAT ........ dk ......................................................................
BUILDING INSPECTOR
Foundation
has permission to erect .......................... buildings on ..., ...�.�. . .. .............................
Rough
tobe occupied as ......, .. . ....... !! i c�. .... .. ..................................................................... Chimney
provided that the person ac epting this permit shall 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
o PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCS TS Rough
Service
.............. .............. ............................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildinz 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.
f Smoke Det.
SEE REVERSE SIDE
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Attention To Detail
Building and Remodeling
166 Lakeshore Drive
Dracut, MA 01826
(978 ) 995-5875
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CONTRACT TO REPLACE SHINGLES ON ROOF j
25 Colgate Drive Andover, MA 01810
Work to be performed
Strip shingles off roof
Install ice&water shield
Install felt paper
Install new shingles
Remove all debris.
Material - 2,254.04
Labor- 4,245.96
Dumpster- 600.00
Total- 7,100.00
A deposit of 2,500.00 is regwr prior to the start of the project for material with a
remainder of 4 600.00 due u o ompletion e project. Homeowner is responsible for
pullin permit.
meo r G Date��
Con actor Date f- -7-1-3 I
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PaIge 1 of l
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�� CERTIFICATE OF LIABILITY INSURANCE 71c
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,ITHIS
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). AUTHORED
REPRESENTATIVE OR PRODUCER.ANDTHE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the Policy(los)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of file Policy,certain Policies may require an endorsement. A statement on this certificate does Trot confer rights to the
certificate holder In lieu of such ondorsomont(s).
PRODUCER _ KaihyCamahnn )
7FayStalo ido Insulance.I.LC Ell-(GA 5 ,
81,1,)571.8 :1;
AI
ADDRESS:
211 South St.SUitQ U IIISUREAWAFFORTNNG COYERAGO IIAIC 6
I'A llord IIH 03055 tnsuRERA:Amslican Evlop-R,4an j
INSURED RISURER 0: {
JOHN GAYR ON PISURER C:
JOFW GAYROI'f RISURER a:
16u"LAKESHORE DR NJ SURER E j
DRACUT 1,1A 01826-1008 NISURERF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I
THIS IS TO CERTIFY THAT THE POLICIES OF ZISUR VICE LISTED BELM7I-LAVE BEEN ISSUED TO THE INSURED NAIJED ABOVE FOR 1t1E 1'OUCY PERIOD
INDICATED, NOTYeiTHSTANDRIG ANY REOUIREMENT.TERki OR CONDITION Gf•ANY CONTrZACT OR OTHER DOCUrIEfIT 1A1T1•I RESPECT TO;".HiCH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORtIFD BY THE POLICIES DESCRIBED IIEREVI IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEII REDUCED BY PAD CLAIMS.
HIsR
=1 POLICY E)'JP
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CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE
John Gayton T7•E EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN I
165 ti$mshol0 Dt ACCORDANCE WITH THE POLICY PROVISIONS,
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AUTHORRED REPRESEIITA71VE
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ACORD 28(2010105) '-91988-2 1 D'ACORD CORPORATION. All rights reserved
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httl)s://acord.age)icymatrix.com/APPortal.axd?rt=c&dk=0011 A4A 18BG00J0H4RVQ61... 8/30/2613
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MASSACHUSETTS FEDERATION OF BUILDING
OFFICIALS, Inc. I
President—Dan Walsh Past Presidents
Vice President-Curtis Meskus David Moore, Steve Frederickson
Treasure—David Jensen Paul Tacy,Robert Camacho
Secretary—Michael Mendoza l
Why homeowners should not obtain the building permit for construction projects.
Massachusetts homeowners are allowed to obtain their own building permit for renovations and I
improvements to their homes. Obtaining your own building permit comes with significant responsibility
and risk. Professionals recommend that only homeowners with significant experience and skill renovating
homes and up to date knowledge of building codes pull their own permits.
Before you decide to apply for your own building permit be sure you know what will be required to j
comply with the new Massachusetts building code and all related state and local requirements. Not I
knowing can cause significant project delays and inconvenience and potentially cost you thousands ofl
dollars to rectify mistakes. For example, if work on a project is halfway done and it is not compliant with
structural or energy code you may have to remove the work and replace it to meet the new code. I
The Risks of Homeowner - Obtained Permits
I
Excluded from the Guaran Fund: When the homeowner obtains a building permit they are not eligible to
access the Guaranty Fund established by the Home Improvement Law, M.G.L. c142A. This fund was
created to protect homeowners from losses incurred as a result of contractor or sub-contractor work performed
in a poor or un-workmanlike manner, or work that is in violation of common law or code. For example if a
homeowner obtains the building permit and hires a contractor who abandons the job because he priced it too
low, the money lost cannot be recovered from the Guaranty Fund.
Responsible to ensure work meets code: The Commonwealth of Massachusetts adopted a new building
code in February of 2011. The code is based on the 2009 International Residential Code, with Massachusetts
amendments. If you are not intimately familiar with these publications and how they impact renovations and
home improvements in Massachusetts you may unknowingly expose yourself financially to unwanted risks
when obtaining your own building permit.
Contractors you hire must be registered: Even though a homeowner obtains the building permit, ever
yone
hired to perform construction work, is required to be registered in accordance with the Home Improvement
Law (M.G.L. 642A). This includes contractors who perform remodeling, window replacements, siding,
insulation, demolition, roofing and masonry work. If the work performed is over $1,000.00 the contractor is
mandated to be registered with The Office of Consumer Affairs and Business Regulation, and provide a'
contract that includes mandated clauses provided in M.G.L. c142A. For these reasons professional contractors
rarely agree to do work for homeowners who pull the building permit. I
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Note: I
Contractors who ask or agree to work without permits for code related work, for cash payments,
or who do not provide evidence of insurance should always be avoided.
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