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HomeMy WebLinkAboutBuilding Permit #462-2016 - 252 SUTTON HILL ROAD 10/13/2015TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION PermitNO: a �Zv Date Received .r Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATI Print PROPERTY OWNER/ � / &/f'/r, AJ 50 Print MAP NO: PARCEL ZONING DISTRICT: Historic District Machine Shoo yes yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial ,--Aliration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer OWNER: Name: Address: Ol.� CONTRACTOR Name: ut5GRIP1ION OF WORK TO BE PERFORMED: Please Type or Print Clearly) Ph V Address:%NSU'`/, 4 Supervisor's Construction License: 07,�j 7 *7 Exp. Date: e5- - f Home Improvement Date: '' / 7 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: $ of/, 0 Q FEE: $ 2 -5 -7 -- Check No.: Receipt No.: 2 I NOTE: Persons contracting with unregistered contractors do not have access to the guar my f d ignature of Agent/Owper Signature of contras J 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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes e Planning Board Decision: 4 Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site Located at 124 Main Street Fire Department signature/date COMMENTS Locatea 3t54 usgooa street yes no 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 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 o 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 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) ❑ Copy of Contract ❑ Mass check Energy Compliance Report Li 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 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 Eq* r S� x d• (" W W 0 6 0 w 0 0 EEO = LL oz O m L \ o O E ? V) U a In V LU vaf z m O a -0 LL L W C U LL O W z J O. L w O Ji f. S °�° cr " o 0 w 0 0 EEO = LL oz O m L \ o O E ? V) U a In V LU vaf z m O a -0 LL L W C U LL O W z J O. L w LL 0 a z a W W S °�° cr U Z (n LL U a z C7 t LL z W oc W uiU OC LL E CO z v N 4j N p Y o (n C C Q .Q RS O �• Q 0 D �a 0 c E a L A Q O 0 o � ,the,� dw v L MONO N O 0 3 ♦/'1 0 M r' CL J i m 0 r ' U L _ 0 0 0 •OO o U) — 0 "o O �0 as o rz �— c a o0 L QCL . 0t Cn cn�0cn ccm W C 'a- O O LL 'o 0 0 Q.,O 0 0 r+ 4- W r L Q 0 0 L V Q. -a_ 0 �. co m y 0 •> y= y U) .0 o 0 0 F- t Z. Q 0 U z Lu i� CL xz Wo � U C0 cn W JCL Z ti H O E o z CD O C I O .a N Q .E m m O �+ V L a0 C- Q O� 'o v_ J 0 .CL O .d+ z 0 U) U) d. 4. PROPOSAL Larry Pahigian 252 Sutton Hill Road North Andover, MA 01845 1pahigian@gmail.com (H) 978-686-1593 August 17, 2015 Master Bathroom Remodel Work to be included includes: • Acquire Building Permit • Removal of existing, toilet, vanity, tile floor. • Enlarge bathroom into closet area to accommodate new shower. • Install new closet door. • Complete all required plumbing. • Complete all electrical. • Install Pedestal sink. • Install new Shower base and walls. • Plaster. • Install DenseShield tile board on floor. • Install new tile floor.. • Install new 2 Ft. Electric Baseboard. • Install new toilet paper holder, towel bars. • Removal of all debris. TOTAL LABOR AND MATERIALS $10,920.00 Note: This quote does not include any plumbing fixtures, vanity, tiles, grout, granite, or painting. Terms: $ 3,640.00 upon signing of contract (not to exceed 113 of contract price) $ 7,280.00 when job complete Submitted By: Chris Rivet MA Lic #CS072173 1 -HC #139962 207 Winter Street (C) 508-265-3115 (H) 978-794-1165 North Andover, MA 01845 All Home Improvement Contractors shall be registered. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor. Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Paymen will be made as o dined above. !.: � 7 � 2 Jaz, � , Date Homeowner Signature'Kell, Date/� Contractor Signature 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 in the event the contractor has a dispute concerning this contract,hpe contractor may submit the dispute to a private arbitration firm which has been approved the Secretary of the Executive JOffice of Consumer Affairs and Business Regulation and the consumer hall a requ' os t to such arbitration as j d in Massachusetts eral Laws, Chapter 142A. Signature Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even 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 described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts 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 Contract 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 contract, and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially 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 (888) 283-3757 "Iyumunriss, =/I 'JAM F - h ', "um, t- V in, - 0aler-010 PROPOSAL Larry Pahigian 252 Sutton Hill Road North Andover, MA 01845 1pahijzian@gmail.com (H) 978-686-1593 August 17, 2015 Full Bathroom Remodel Work to be included includes: • Acquire Building Permit • Removal of existing tub, toilet, vanity, tile floor, wall tile and blueboard. • Complete all required plumbing. • Complete all electrical. • Re -locate wall on left side of bathroom. • Install vanity. • Install new tub. • Install DenseShield Tile board on tub walls. • Install tile on tub walls. • Plaster. • Install DenseShield tile board on floor. • Install new tile floor.. • Install new 3 Ft. Electric Baseboard. • Install new toilet paper holder, towel bars. • Removal of all debris. TOTAL LABOR AND MATERIALS $10,500.00 Note: This quote does not include any plumbing fixtures, vanity, tiles, grout, granite, or painting. Terms: $ 3,500.00 upon signing of contract (not to exceed 1/3 of contract price) $ 7,000.00 when job complete Submitted By: Chris Rivet MA Lic #CS072173 HIC #139962 207 Winter Street (C) 508-265-3115 (H) 978-794-1165 North Andover, MA 01845 All Home Improvement Contractors shall be registered. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor. Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized t do the work as specified. Payments 1 be made as outlined above. Date / K Homeowner Signatur � ' Date /19 57 Contractor Signature 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 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 by the Secretary of the Executivebffice of Consumer Affairs and Business Regulation and the cons er shall be required t ubmit to such arbitration as proyvi6d in Massachusetts General Laws, Chapter 142A. Gam// ZIP - Homeowner's Signature Contractor's Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even 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 described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts 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 Contract 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 contract, and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially 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 (888) 283-3757 The Commonwealth of Massachusetts Department of IndustrialAccidents Office ofInvestigations ! ! 600 Washington Street Boston, MA 0211.1 -www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers nnlicant Information PIease Print Leeibt Name (Business/Organization/Individual): Address: e907 7 S'T //(X #: S"00F--A<5'- _?/l 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 6. F1 New construction = Ployees (full and/or part-time).` have hired the sub -contractors 2. &3'1 am a sole proprietor or partner- listed •on the attached sheet 7.. ❑ Remodeling ship and have no employees These sub -contractors have g- Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance required.] comp. insurance.# S. El We are a corporation and its 10.❑Electrical repairs or additions P 3. [1 I am a homeowner doing all work officers have exercised their I II] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.El Other employees. [No workers' comp. insurance reauired.l *Any applicant that checks box #1 must also ffii out the section below showing theirwoikers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the mune of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that 1s providing workers' compensation insurance for my employees Below 6 thepolicy and job site information. . . Insurance Company Policy # or Self -ins. Lie. #: /Yo 4-"7 �' /�'y 4 Expiration Date:A a Job Site Address: 57& •o AJ iL t'_ 10q 0 City/State/Zip:_Zf Q, 41y gcv'jQJ Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. OP ID: OUJA "%C- """ CERTIFICATE OF LIABILITY INSURANCE D09/21/2015 ) 09/21 /2015 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 978-688-6921 Macdonald & Pangione Insurance Fax: 978-688-5350 P.O. Box 428 104 Main Street North Andover, MA 01845 Michael Pan lone g CONTAPhone: NAME: Jane Ouellette PHONE 978-688-6921 FAx 1AIC, No. E:t): AIC No): 978-688-5350 E-MAIL @mpin ADDRESS:anep's.net PRODUCER CHRIS -5 CUSTOMER ID #: INSURERS) AFFORDING COVERAGE I NAIC # INSURER A: Preferred Mutual Ins Co 115024 INSURED Christopher Rivet 207 Winter St. INSURER 8: North Andover, MA 01845 INSURER C: 09/26/2016 INSURER D: DAMAGE PREMISES Ea ENoED ccurrence $ 100,000 INSURER E: PERSONAL & ADV INJURY $ 1,000,000 INSURER F: — — %'V V CKAUC.9 CERTIFICATE NUMBER• Dcvrr`inni ur rneorn. �N"vr.,nwilt rwrrior=r%. 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! LTR TYPE OF INSURANCE (ADDL SUER WVD { POLICY EFF POLICY NUMBER IMM/DD/YYYY I POLICY EXP MMIDDlYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL_ LIABILITY CLAIMS -MADE [ X OCCUR f I I I BOP 0100719749 I I (09126/2015 i 09/26/2016 I EACH OCCURRENCE $ 1,000,000 DAMAGE PREMISES Ea ENoED ccurrence $ 100,000 MED EXP (Any one person)$ 5,000 PERSONAL & ADV INJURY $ 1,000,000 — — i I I —JI GENERAL AGGREGATE I $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: X] POLICY PRO- �� LOC AUTOMOBILE LIABILITY ANY AUTO PRODUCTS - COMP/OP AGG $ 2,000,000 I ( ( `$ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) S HIRED AUTOS I NON -OWNED AUTOS I $ UMBRELLA LIAB EXCESS LIAB _ ! OCCUR I CLAIMS -MADE I I EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE I RETENTION $ I $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED., I N / A WC STATU- OTH- TORY LIMITS I I R E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below j E.L. DISEASE - POLICY LIMIT I $ i f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER r-Aklflci r ATrnkl ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St ACCORDANCE WITH THE POLICY PROVISIONS. No Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Massachusetts -,Department of Public Safely .. . Board of Building Regulations anti Standards' Construction"Supern-isor License: CS -072173 ! CHRISTOPHER F Y, T" ' 207 WINTER ST -�`' r� N ANDOVEk Mk 011345. , Expiration Commissioner 06/02/2016 �e tpa�u���ancue(rfJ� o�A/l/las;rac�usellr _ —Office of Consumer Affairs & Business Regulation 'W=- OME IMPROVEMENT CONTRACTOR Registration: =Registration: .139962 Type: _ Expiration:918/20172 Individual CHRISTOPHER F. RIVET._ CHRISTOPHER RIVET�:;�?', 207 WINTER ST. N. ANDOVER, MA 01845 ` ` _ Undersecretary