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HomeMy WebLinkAboutBuilding Permit #148-2017 - 33 WENTWORTH AVENUE 8/16/2016 NORTH BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: � Date Received gSSRCHus�'C Date Issued. I ORTANT: Applicant must complete all items on this page LOCATION Q'�` VM Print PROPERTY OWNER �� '^^'► u f o Prifit 100 Year Structure yes MAPN'l PARCEL. °2 ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- El New Building NfOne family ❑ Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Ji°Repair, replacement ❑Assessory Bldg ElOthers: ❑ DemolitionElOther _� = Watersheds Dstnctb ;Septic; 11Nell? ❑ Fl©odplain, [ Wetlantls:, _ -_._ � q DESC IPTION OF WORK TQ BE PERFORMED: aentification- Please hype or Print Clearly OWNER: Name: �� T 1., Phone: Address: 33 Contractor Name: <®1�- C -� Phone: �u� �- Email: FFc Low Address: Supervisor's Construction License: C' S - 6 S D ?2 � Exp. Date: �1 t -2 q ' �7 Home Improvement License: �� 2 �2 3 Exp. Date: I 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: $ d 45�>0 FEE: $ Check No.: v ' Receipt No.: NOTE: Per ons contracting with unregistered contractors do not have ac ess to the uar fuqpnt( nor nd Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DIS S _ Public Sewer Tanning/Massage/Body Art F1Swimming Pools Elwell ❑ Tobacco Sales ❑ Food Packaging/SI.ales ❑ Private(septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF ll FORM , l PLANNING a DEVELOPMENT Reviewed On ill ��� Signature_ r COMMENTS 14II " /I It 7� CONSERVATION Reviewed on � 1 � �� Si nature _ COMMENTS HEALTH Reviewed on_ Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes R i Planning Board Decision: Comments r I' Conservation Decision: Comments Water& Sewer Connection/Signature Date Driveway Permit f DPW Town Engineer: Signature: t Located 384 Osgood Street FIRE DEP�lR� ENT; �Ternp Dumpster on site ,`esu >Mir t t`Loc t,i124.M,. � - yam, no . �. :.. ated a, ainfSt�tree Frge Departments gnafureL p" _� t 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 DANCER 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 I 1 r 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 � OTE. All du pster permits require sign offrom Fire Departmentartmentprior 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) �. Engineering Affida_v its for En ineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) i i 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) 4 Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 l Location No. Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ y Other Permit Fee $ TOTAL $ Check# "^ A 0 Building Inspector ` ■ °� Installer's Name: Instl�hatian Checklist�tw Franchise I.acatlan: Installation I: ul menta GolfathliTech Calibratd�draulic Drill with P51 Gun a Tor ue In icator installation bete; Name� of Customs r or Contractor: Descrl flan of customer pro act: �� Address of ro alt; d °� 0•x'4 Achieved Cut-off inallnation of Achieved Tension C Achieved a ed slor Regired Total Pile Length Elevation(If Pita(IPnot 90 Torque Capacity Ca aclt Compression Required not 8"+•2 Do rees+•2 Achieved v Pile Serial Number Ca aclt Tor ue pile Usud Helix Used If not 7' Pile is L Pile 21 Pile S: Ci - Pile 4., Pile 5: Pile 6: Pile 71 Pile,_ Pile lo°. w � Pile 11: Pile 221 Pile 191 Pile 141 — � Pile 151 Pile 16: Pile 171 Pile 18: Pile 191 Pile 201 (I as ihopnrxroecJthhdooumaellnShrnJbtntaNObsalhdlhimrM,don etNn wNheMhnbsmepprowdhxdru snsdueNpnWourwnlanr, oeaetola for Gamand 111100001t Document Name:10e161181ion Checklist 0013001110 9013 pde:2017 Jury 17 QotlethYlch f L Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DIS S % Public Sewer Tanning/Mas s age[B o dy Art ❑ Swinmning 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 m U FORM yl —PLANNING & DEVELOPMENT Reviewed On `l f�� Signature_ COMMENTS Zti/►/7 Itn CONSERVATION Reviewed on �0 Si nature COMMENTS j,, ( (no" WEALTH Reviewed on_ Signature COMMENTS /1 L17�- Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Da$e Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FFIi DEPARTMENT Tempj 1 umpster onfsitex eyes�, �u `j � n ed at12 Street`"} 4 '`r +- 3 ``" " "4 Main �; '� .: �.�,r ,, .� .z�� x:�.,� ., °--�c^-- M�- rl� ki Zi{4 f etC'V. .1-r+ ', ?,* ff -I—, .: i, t Departmentsi nature/date "� ' ,T<� t, f4 a k � �L�r�'.k+ { �.•EK i�l'�iiif"s�s',��„ �,. �.•�*f' -�«-mow ^17^�•re-� �'.[-i COMMEIVTS:�. ° `' ,- r -I NORTH - . W. .. ? At. ve" **a O I No. o4�h ver, Mass COCMICN.WICK p0AATEg) A'Pa,`�5 S V BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ......................... .. . . .... .. V1r .. ..... ................... 3 t��� � Foundation has permission to erect buildings on ..... .............................................. Rough t0 be occupied as SAO 4A Aee.Jc ... Chimney p .... ' . ►! !!........ ...... ..�p�!�I ................... .�.... ............ 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 UNLESS CONS TIO Rough Service . .... . . ....... . Final CTOBUILDING IN 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. AGREEMENT FOR SERVICES This CONTRACT satisfies all basic requirements of the State's Home Improvement Contractor Law(M.G.L.c. 142A),but does not preclude parties from adding language to protect their specific interests. Seek legal advice if necessary. Before agreeing to any home improvement work on your residence you should obtain a free copy of"Consumer Guide to Home Improvement Contractor Law"by calling the Office of Consumer Affairs and Business Regulation's Information Hotline at 617-973-8787. You may cancel this Agreement if is has been signed by a party thereto at a place other than an address of K&R Contractors,Inc.,which may be its main office or branch thereof,provided you notify K &R Contractors,Inc.,in writing at its main office or branch by ordinary mail posted,by Telegram sent or by delivery,not later than midnight of the third business day following the signing of the Agreement. See Attached Notice Of Cancellation For An Explanation Of This Right. Homeowner Information Contractor/Owner Name: Kathy Murphy Kenneth Roy,President 33 Wentworth Ave Business Street Address North Andover,MA K&R Contractors,Inc. 1 Campbell Road North Andover,MA 01845 Business Phone:978. 726.5062 Federal Employer ID: 000961723 Salesperson(s): Kenneth Roy,President Contractor Registration: 80721 Exp.Date:4/29/17 MA Sup.License: 137557 WORK TO BE PERFORMED AND MATERIALS TO BE USED Contractor Agrees To Do The Following Work For Homeowner:Replace rear deck with same size one Remove front deck and replace with similar size one with Island Oak grey decking,white pvc trim around frame,white vinyl lattice around base,Railings will be white Timber Tech Radiance Rail.New stairs will face pool The following schedule will be adhered to unless circumstances beyond the contractor's control arise* Work Scheduled To Begin: 8/16/16 Expected Date Of Completion : 8/31/16 TOTAL CONTRACT.PRICE AND PAYMENT SCHEDULE The Contractor agrees to perform the work,furnish the material and labor specified above for the SUM OF$10500 Payments will be made to the following SCHEDULE: $3000 upon signing of this contract $4500 due upon completion of frame $3000 due upon completion of project 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 of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule* )No final payment shall be demanded until the contract is completed to the satisfaction of the parties thereto. OTHER IMPORTANT PROVISIONS You are dealing with a Registered Home Improvement Contractor and are entitled to certain rights under the provisions of 780 CMR R6 and M.G.L.c. 142A. Payments: If payment is not received as per the Contract,then the Owner shall be responsible for all attorneys' fees,court costs,and other costs incurred by the Contractor and enforcing Contractor's rights hereunder. Pets: Homeowner agrees to keep all pets out of the work area and take whatever steps are necessary to safeguard them from any harm that may come to them as a result of the work being performed under this Contract,including but not limited to injury on or outside the Premises or ingestion or inhalation of,or contact with,hazardous substances. Company assumes no responsibility for any harm to the pets as a result of the work performed under this Contract. Further,Homeowner shall take all steps necessary to protect Contractor, its agents, servants,contractors and employees,from any harm as a result of contact with said pets. Characteristics of wood: Wood is a hygroscopic material. Wood swells and/or shrinks in relation to the humidity,temperature and environmental conditions of its surrounding. Generally,wood flooring is expected to shrink in any conditions and expand when exposed to moist conditions. Natural wood also contains variations of graining,texture,hardness and/or knots,depending on the wood chosen. Contractor cannot be responsible for the natural features of the wood chosen. Contractor is not responsible for shrinkage,checking,swelling,or other conditions which are the normal condition of wood or the result of household or environmental humidity,heat,cold,or other conditions. Colors: You may choose colors and finishes for the parts being used in your remodeling project. It is important to remember that a color or finish you see at the store or in a showroom may not look the same in your home,especially after all of the different colors and finishes are brought together upon the completion of a project. In addition,one manufacturer's named color is not the same as another manufacturer's named color.The Contractor cannot be responsible for the appearance or lack of coverage from Homeowner/chosen paints and/or stains and finishes. Building Officials: Any additional costs incurred by Contractor as a result of decisions made by Building Officials will be the responsibility of the Homeowner.The costs of additional work will be calculated as follows:cost of materials plus an hourly rate of$45 per man hour. Liens: In the event of non justifiable non-payment,Homeowner's residence or property may be subject to a Mechanic's Lien as a consequence of signing this Contract. Utilities: The Contractor will use reasonable efforts to notify the Homeowner in advance of any interruption of utility services. However,there may be instances where the Contractor must shut down these services without advanced notice. Homeowner must arrange for emergency backup service for any utility critical equipment such as medical devices and computers. The Homeowner must also notify the Contractor at the start of the work day if you will be engaged in any utility critical activiti Contractor makes a notification in writing in the daily log book or otherwise. es in that the Additional work: Any additional work requested by the Homeowner which is beyond the scope of the work to be performed as set forth in this Agreement,shall be the subject of a separate agreement,and/or if not,subject to the same terms and conditions as set forth in this Agreement and billed on a time plus cost of materials basis at Contractor's normal hourly rate. Contractor's normal hourly rate per man hour is$45. In the event that additional work is to be performed on an hourly plus cost of materials basis,the Homeowner shall be required to execute a Change Order which shall include Contractor's best estimate as to the time required,together with the cost of labor as well as the type and cost of materials necessary. Delays: Contractor is not responsible for delays attributable to Homeowner initiated modifications or additions,or for delays incurred due to the actions or inactions of city/town officials, strikes,acts of God,unfulfilled customer obligations,vendor delays, interference by other tradespersons,customer supplied items or other delays beyond Contractor's reasonable control. Contractor will use reasonable efforts to stay on each job until substantial completion by allotting specific time periods to each Homeowner to complete each job in as timely a manner as possible. In the event that Homeowner does not allow Contractor and/or his employees or sub-contractors access to the residence or property so as to allow Contractor to perform his obligations and/or to complete the scope of work in as timely a manner as possible,other than for reasons of safety or other reasons mutually agreed to between Homeowner and Contractor,then the Homeowner shall be responsible to pay Contractor the sum of $500.00 per day,on a pro rata basis,to cover the costs of delay. Contractor reserves the right to suspend work and/or delivery of materials in the event of unjustified non-payment. In such event,the Contractor shall have no liability to the Homeowner for alleged delays or damages due to said suspension. Punch-list Items: The Homeowner agrees that routine"punch-list"or repair items after substantial completion are outside the agreed scope of services,and covered by Contractor's warranty obligation and will be completed as soon as practicable and according to Contractor's and Homeowner's mutual availability. Homeowner agrees that it shall use his/her best efforts to make himself/herself available to observe and/or sign off on the completion of any such punch-list Items,and that the approval of one Homeowner regarding the completion of any such punch-list items,as well as change orders shall be binding upon all Homeowners. Unforeseen Conditions/Circumstances: Contractor shall not be responsible for any changes at the request of the Building Inspector. Contractor shall also not be responsible for any unforeseen bedrock/ledge or latent defects such as structural and/or dry rot or insect damage to the existing structure,or for preexisting faulty or inadequate wiring or plumbing. Contractor shall also not be responsible for any pre-existing code violations or responsible for correcting contiguous work completed by others not under the Contractor's authority. Insurance: Homeowner agrees to carry fire,theft,vandalism,liability and all other necessary insurances to protect their personal property while construction is in progress. Contractor will carry all required and necessary insurances including worker's compensation insurance. Contractor will ensure that all personnel including sub-contractors will be covered by all required and necessary insurance including worker's compensation insurance. Homeowner's Cancellation Rights: In addition to the rights the Homeowner has,as set forth in the attached Notice of Cancellation,the Homeowner may have rights under other Massachusetts Statutes, including M.G.L.c.93 §48,M.G.L.c. 140D, § 10 and M.G.L.c.255D§ 14. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Identical copies of the contract should go to the homeowner and the contractor. Homeowner's Signature: Date: 8- . 1(0 . Contract04 Signature K&R Contractors,Inc.: Date: By: K nneth Roy Its: President 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 than midnight of the third business day following the signing of the agreement. See attached notice of cancellation for an explanation of this right. NO WORK WILL BEGIN UNTIL BOTH PARTIES SIGN THE CONTRACT AND THE OWNER RECEIVES A COPY REQUIRED PERMITS The following building permits are required.It is the obligation of the contractor to secure such as the homeowners agent: Electrical rough and finish Plumbing rough and finish Insulation Framing insp. Finish and occupancy NOTE: Owners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGL c. 142A. EXPRESS WARRANTY All workmanship and materials to be free of material defect for a period of one(1)year. During the Warranty period,the Company may,at its option,either repair or replace products or workmanship which prove to be defective. This Warranty shall not apply to defects or damage arising from improper or inadequate maintenance by the customer,customer's applied products,unauthorized modification or misuse,damage incurred as a result of acts of God or civil strife,or normal characteristics of the materials such as wood shrinking,expanding and otherwise reacting to moisture or environmental conditions. The Company's liability is limited to the repair or replacement,at its option,set forth herein and Company shall not be liable for any consequential,sequential,incidental or other damages not set forth herein.The Warranty set forth herein is exclusive,and no other Warranty,whether written or oral,is expressed or implied. Company specifically disclaims the implied Warranties of Merchantability and Fitness for a Particular Purpose. NOTE:All home improvement contractors and subcontractors shall be registered and any inquires about a contractor subcontractor relating to a registration should he 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 residence, ARBITRATION The contractor and the homeowner hereby mutually agree in advance that in the even 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 co sumer shall he required to submit to such arbitration as provided in M,G,L.c.142A. Contractor: Date: A Homeowner: Date: /�i NOTICE:THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETFLEMENT INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOTSEPARATELY SIGNED BY THE PARTIES. ACCELERATION OF PAYMENT Homeowner's Financial Insecurity-A Contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems hint/herself to be financially insecure. Contractor's Financial Insecurity-In instances where a contractor deems himself/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 from said account would require the signatures of both parties. Homeowner agrees to allow reasonable access to allow Contractor to reasonably attempt to remedy any outstanding uncompleted,disputed or non-satisfactory item. If you have general questions or need additional information about The Home Improvement Contractor Law,contact: Consumer Information Hotline Commonwealth of Massachusetts Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 51.70 Boston,MA 02116 617-973-8787 If you have questions about Contractor Registration,contact: Director of Home Improvement Contractor Registration Board of.Building Regulations and Standards One Ashburton Place,Room 1301 Boston,MA 02108 617-727-3700,x25205 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION,WITHOUT PENALTY OR OBLIGATION,WITHIN THREE (3)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(10)BUSINESS DAYS FOLLOWING RECEIPT BY THE CONTRACTOR OF YOUR CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. I IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE CONTRACTOR AT YOUR RESIDENCE,IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED,ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT;OR YOU MAY,IF YOU WISH,COMPLY WITH THE INSTRUCTIONS OF THE CONTRACTOR REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE CONTRACTOR AND THE CONTRACTOR DOES NOT PICK THEM UP WITHIN TWENTY(20)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 CONTRACTOR 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 OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM TO K&R Contractors,Inc. I Campbell Road,North Andover,MA 01845 NOT LATER THAN MIDNIGHT OF TBD. I HEREBY CANCEL THIS TRANSACTION. Date: Buyer's Signature: Received: I I I. I , -�-- -� I I _ 1 42 77 IV 1 4- —'�—'`—i---Pol A, , i - , I - ! I _ _ ANN I I 1 ' I -�- I ' I i � � ' i I' �I' _ _ —�—— -- — — � �' . i� I _.._. _ �. .. - 'r_ � _ i `, I � _.�1.._ I._ + E i j � _. s �� � + � i , . � i I � ., �- _ . i � � I - � � j i. - -,--a--� - -- � I � T� � i � --� -�- ---+- I I � �. + -r-I--�- � - � + - ,-- ,_ � i - -�. i j + � � I ' � I -r-t-?- i � J PLAN OF PROPOSED POOL LOCATION ON PROPERTY LOCATED AT 33 WENTWORTH AVENUE — NORTH ANDOVER,MA Prepared for James and Judy Murphy N, f Proposed ti 16 z 32 Pool Deck, Existing tJp 1&1/2 Story Wood Garage 40 e 136" oe� WENTWORTH AVENUE Date: August 3, 2006 Scale: 1"=20' OWttE y� Engineers: Henry R. Himber E. wrraiouFo ti Dante Bartolomeo 1&33 Ref: N.E.R.D.—Deed Book 6056 Page 122 & Plan#0358 ° �4;WG r . 4CEx-t'1 x1r*xE30 3PPI3LQT pLBLN ,00roperty Located At �- 33 Wentworth Avenue,North Andover ,MA 01845 Prepared For James&Judy Murphy . Date: October 22,2003 Scale-.1"=40' H&B Survey Service 219 Salem Street Andover,MA 01810 978-475-8232 a AV,n 1 •• � . o �3 COS = r r /•SlY�2� NM API MON t d✓Dol.'s �' • 1 / g.4. r1 yt/EF/V-r wo RT H AV E I hereby certify that.the structures shown on this of �� �y plan are located as shown and that tbey conformed o DANTE to the Zoning By-Laws of the town of North Andover E. �''. when conswicted. ;3 BARTOLOMEO y No.75304 �CIST to �-. Ref: N.-E.R.D.—Deed Book 6056 page 122& Plan#0358 North Andover MIMAP August 16, 2016 1;o$ o�oo�i°g 1080:0-`qu 1.0 08U:0=OU24 [0660009; 'o 108000""0331 - o 41�tWEN�T}WQRITH AVE;' Ln p (o o 0 r N t (42a�PROSP,ECT ST N 1 (—VW;,-ooZ9) 0 WENTxW.OF2aT4ti AVE �, 1 t }33'�aWEN,�TaWORR�TN?trAVE.' 1 R4 +os"s;o=0042. W i t 1067:0 0002 G34:WENTWWW RTRANLE i 1 1081:0"=0030; !t X30 PROSPEC}TJ[SjTJ X30 WENTWORTH`&E, O s G (0 G �255'�,W ENTaWORv'[M�AVE f011�:•0 00'40 [067:0 0004: 22PRO5PE6T S, �081`O 00383 MVPC Bo Zoning Overlay Zoning (3 Municipal Boundary 0 Adult Entertainment Distric Busine s 1 District Machine Shop Village Ove 13 Busine s 2 District Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Rail Line ®Watershed Protection Dist E Busine a 3 District Meters Data Sources:The data for this map was produced by Merrimack Interstates 0 Historic Mill Area GBusine s 4 District AORTN Valley Planning Commission(MVPC)using data provided by the Town of —I 0 Medical Marijuana O Genera Business District Of o q� North Andover.Additional data provided by the Executive Office of —SR ©Downtown Overlay District O Planne Commercial Dev = e<<SOO Environmental AffaimtMassG IS. The information depicted on this map is Roads 0 Historic District 01 Corrido Development Dist ,; (, for planning purposes only.It may not be adequate for legal boundary 0 Osgood Smart Growth(40 d Corrido Development Dist p _ A definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER i r Easements C Hydrographic Features n Comdo Development Dist A MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING IndusM I 1 District ❑Parcels Streams Industn 12 District ✓R THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY Rt Industn 13 District . ^ OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Wetlands 4 o `� • ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF O Industd I S District 9 A Exempt Lands po4.'10 rw``�y THIS INFORMATION P Reside ce 1 District 1/ �r�o C Reside ce 2 District SSACNUS� C Reside ce 3 District dei ce 4 District 1"=41 ft wq T=de ce 5 District Y de ce B Distnct a e esidential District North Andover MIMAP August 16, 2016 flu � 080.0-0032 � ' t,: a 080.0-0024 e iPROSPECT ST 081.0-0029 5' w. ._ +� 33 WENTWORtTH AVE • �$ Y � 0&1.0 0042 T� _•,, G 067.0-0002 � tty��' �.w t ^�x, ly 34 WENTWORTH ANE ��" 0-0030 "F 30 WENTWORtTH AYE � _�� H G t CD 25 -EN TWORTH AYE *� ` OS•1.0-0040 t 081.0-0032 S Ng 2 — 08:1.0-0038 ❑MVPC Ba Interstates Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —I —SR Meters Data Sources:The data for this map was produced by Merrimack Roads NORTH Valley Planning Commission(MVPC)using data provided by the Town of Of tato. q� North Andover.Additional data provided by the Executive Office of t r Easements ? bat .�tt 00 Environmental Aftairs/MassGIS.The information depicted on this map is ❑Parcels 3' L for planning purposes only.It may not be adequate for legal boundary O — to definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING 11 >F THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY i OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT t �o _ �� ♦ ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION 1SS,4 us t� 1"=41 ft w�° The Commonwealth ofMassachusetis Z . Department ofIndtastrialAccidents 1_ ,_ d 1 Congress street,suite 100 f Boston,MA.02114-2017 . ......'sY,,-`K www mass.govldia Workers'Compensation Insurance Affidavit:Builders/Contractors/EIectricians/Plumbers. TO B] FILED WZTR THS PIl2N.QT'�TC AUTHORITI'. A licant Information • Please Print Legibly e �- Name(Basi.Hess/Organization/Tndivzd-nail/): r Address: City/State/Zip: /�1 A o•tom- /�A Phone Areyou an employer?Checkttie appropriate box: Type of project(required): 1. I am a employer with employees(full and/or part time).* 7.• 0 New coristruction 2. I am a sole proprietor or partnership and have no employees Working for me in 8. IKA Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.Q I am a homeowner doing all work myself[No workers'comp..muranee required.]? 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will o ers'com enation insurance or are sole 11.0 Electrical repairs or a dditions at all contractors either have w rk p ensure that , proprietors withno employees. 12:h Plumbing repairs or additions 5.❑I ani a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.'[]Roof rep airs These sub-contractors have employees and have workers'comp.insurance ' : • 14.[(Other 6.Q We are a corporation and ip officers have exercised their right of exemption per MGL c. 152,§1(4),andweh iveno.employees.[No workers'comp.insurance required.] `Any applicant that checks box41 must alsofff out the section below,showing their-workers'compensation policy information. t Homeowners who submit tbx affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. iContractors that check this box must•attaghed an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-conirac€ors fiave employees,they must provide thein-workers'comp.policy number.' I erre an enipZoyer diet ispi�ovzdingworkers'compensation insurance for my employees'Below is thepolicy acid job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date:r ^ 1 rob Site.Address: 7,� �A/P��n. � � —City/State/Zip: /V 0 (Q q5 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a S'T'OP WORK ORDER and a fine of up to$250.0 0 a day against the-violator.A.copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u er the pains d ties ofperjury that the information provided alcove is true and Correct Si ature- Date: ' Phone#: 7C6- Official use only. Do not-write in this area,to be completed by city or town offieiax City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I 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 traAoe of an individual,partnership,association or other legal entity,employing employees. However the k owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of anotherwho 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 lias not pro duced 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 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=tha boxes that apply to your situation and,if necessary,supply sub-contractoi(s)name(s),address(es)and-phone numbers)along with their certificates)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 affidavitmay be submitted to the Department of•Tn.dustrial Accidents for confirmation ofinsurance 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-ii'surecl 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 areference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current olic information if necessary)and under"Job Site Address"the applicant should write"all locations in city or P Y ( �Y) PP in_( city "A copy of the affidavit that has been officially stamped or marked by the city or town maybe 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts - Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA.02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax##617-727-7749 Revised 02-23-15 www.mass.gov/dia i ��®® ✓lee ZJartUneo�aurealll o�._/�aaaacluaelta �1- Office of Consumer Affairs&B siness Regulation License or registration valid for individul use only HOME IVP CONTRACTOR before the expiration date. If found return to: Registration:;-462123 Type: Office of Consumer Affairs and Business Regulation Expiration: :1-%20%2017 Private Corporation 10 Park Plaza-Suite 5170 �. # - Boston,MA 02116 K& CONTRACTORS;i- C KENNETH ROY :- 1 CAMPBELL RD. _ N.ANDOVER,MA 01845 = .; :.. a -g� -;_- Undersecretary Not Vali�ithout Signature Massachusetts -Department of Public Safety Hoard of Building Reguiati;,tis and Standards Construction super-viGOr License: CS-080721 KENNETH R ROY-` 1 CAMPBELLRD North Andover Nfk 0 z r Expiration 04/29/2017 Commissioner