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HomeMy WebLinkAboutBuilding Permit #482-11 - 34 COLUMBIA ROAD 12/14/2010"'r- � ;1W Permit NO: M BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received \meq-10R,T.o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other _ ��--- -�-" Welles � � � a Septic ' �'- "I n - ,'Fl©odpam f 11Vetlads F - � - Wa,$ rslieFdFp talc #� ' �INate�/Sewers - DESCRIPTI D i'_ /?C />7 e v/'�" /�ogC UI- WUKK I U tat rKtrUKwJCU: Please Type or Print Clearly) OWNER: Name: 1iY V / Address: /r+nA1T�Ti(T nom. l�rlr=l�cccF ? -D /�— Super;yisor{s Co struction License " t Exp �Date� AL�- �isii . //-4, Date: ARCHITECT/ENGINEER . Phone: Address: Reg. No. FEE SCHEDULE: BULDING $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cast: $ � FEE: $ Check No.: Receipt -No.: NOTE: Persons contrac ing with unregistered contractors do not have access e guaranty f®ndl� l, Locations rpt ll^ 4,4 )PY No.Date 40RTol TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ +SJACHUS <�' BuildinglFrame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 237$ Y21-51 - Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tannin g/MassageBody Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster ou. Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DP i T, WEngineer: Signatures 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 Nu i t5 and DATA — (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ .Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo. -Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of. Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits.for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all 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 2008 MASSACHUSETTS HOME IMPROVEMENT CONTRACT This form satisfies -.all basic requirements of the state's Home Improvement Contractor Law language to prnteebhomeownera: Seek legal advice linecessary. Any chapter 142A�, but dttec not include standard pernonplanrung home j tprovements shouid'firsf ain a copy of"a Massachusetm.consumer guide to home,improvement" before agreeing to any work on yourresidenee. You may obtara-a freeobtcopy by'cailingthe ' Office of Consumer:Affairs:and Business • Regulation's Coni mer Information Hotline at617-973,8787 or 1..888+.283-3757, Homeowner Informatinn vvusrxcwr 1111ormanon - .� 144 �L Street !may. ame O>/ Addiew (do not use a Post Office Boz address) USCF tractor/Salesperson/ Owner Name 3 v Lug int �l 1- lrZ l cam% City/fown State Zip Code lusiness Address (must include a street address) . Daytime Phone Evening Phone 9 7�- ? own state ry K/ ZIP CodeCodeAIC) Mailing Addressdi hom above N usaess Phone ederal Employer M or S.S. Number . Law R9=0 nanum Lomeim- Pmmmt eomsomnhrves acme C®mnmaea M®her / `-Bsparriondne' The Contractor agrees to do the following work for the Homeo ner� / /J ��� 1 Ll p xe!.'r7Q 1/& cor 0 - /'9 "iC- 53 yR /4'/e G ( /Ce Q w; -i e_2,>h > 66D ISA%r > e_c.TNew RW 88 C'e POO s�► i�Iw��eS Required,Permits - The -following building Permits are required Proposed Start and Completion Schedule - The fiillowmg schedule will and will be secured.by the contractor as the homeowner's agent; be adhered to unless circumstances beyond the eontractot'a control arise (Owners who; secure their own permits wW be excluded=from the Guaranty Fund`provisions of Date when contractor will begin contracted work MGL chapter 142A.) �� Date when contracuid .work will be substantially:completed, . Total Contract Price and Payment Schedule pG The Contrector.agrees . I perform the work, famish the material and labor specified above for the total sum yments will beTade according to the following schedule: e➢ $.uponsigningcontract (nottoexceed 1/3ofthetotatcontractpricer, gr the cost.ofsped`lorder items,whicbeveris: :greater) $ by —1=T= or upon completion of D_/_/ or upon completion of o (r $ upon completionof the contract. (i,aw forbids demanding full payment until .contract is completed to both party's. satisfaction) 71e following nuterial/equipment must be special S GGGto be paid for ... . ordered before the contracted work begins in order to be paid for _ ^ to met the.. completion schedule.(••) NOTES: (o) Including all finance charges (••) Law requires th9 any deposit or down -payment r0qu red by the contractor before work begins not exceed the greeter of (a) one-third ofthe total 0001310t Price or (b) the actual cost of in" which must be special ordered in advance to meet the completion schedules � apeeral.eguipmeat or custom made material Exams Warranty Is an ".oresrwa ntv being.nrovided by the cont"doep No Yes len term ..4'rl. . Subcontractors The contractor agnea to be solei ■� n b the r y responsible for completron of the work described regardless of the actions of any diii'd Par oatractor utilized by the contractor. The contractor further materialserials and lat agrees to be Solely responsible for all payments to all subcontractors for borurder hi a2rcemrn Contract Acceptance Upon signing, tbiS document becomes a bmdmg.nontract under:law, Unless otherwise noted within this do contract shall not imply that any lien or other =urity interest utas been placed on the residence. Review the focurrent, the llowing cautions and notices carefully before signing this contract • Don't be pressured into signing the contracL Take time to read and'"'1 • fully understand it Aak'questions ifsomet Q is unclear. Make sure the contractor h a valid Home Immovement ontra to u 71e Via; requires most home improvement contractors and . subcontractors to be regWM'Dd with the Director ofHome Improvement Conlra= Re 'stratioa. You registration by writing to the Director at One Ashburton Place, Room 1301,13oston, MA 02108 or �Y inquire abtrut.contraotor. 1-800-223-0933. bY.�g 17 727-3200.or • Does the contractor have insurance? Check m We that your contractor is properly iavured • Know your rights and responsibilities. Read the Important Information on Ili reverse side of this form and get a copy of the Consdmer Guide to the Home lu*vvement Contractor Law: You may cancel this agreement if it has been signed at a place other than the commetrifs normal lace of business, provided contractor in writing athis/her main office or breech office o p p you notify the thrid business day following the signingrdtnary mini poSem scot or by delivery, not later than midnight of the. of this agreement, . Seethe attached notice of cancellation form for an explanation of.this right DO NOT SIGN THIS CONTRACT IF THERE ARE ANy BLANK SPACES!!! '�v%° / / wmpletedaodsiaoed One sopyahwld,aotothe Theorber .. mvr should be kept M the matraaer. / Contractor s Srg/�mt'ure /, ' . Date - ;Dau i. Contractor Arbitrsition The Home Imp rovement-Contractor Lawprovides;homeowners with thenght•to4nitiate an arbitration action (as an . alternative to court action) if they; have a dispute with a contractor. The same tghtis not automatically' afforded to'a. contractor,.however.. he contractor would have. tp resolve any dispute lid/she .has with a homeowner in court unless' both parties agree to. the optionalclause 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 Executive Office of Consumer Affairsand Business Regulation and be consumer shall be required to it to s trati vided In Massachusetts General Laws, cha 142A. GL meowners Signilture Contractor's Sign 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 �d..e.4i;.1., r:onP�ii�v.t}re earttes - Homeowner's Rights A homeowner's rights under the HoWe'Improvement Contractor Law (MGL chapter 142A) and other consumer chapter may not be waived in any way, even by agreement:_ However, homeowners protection laws (i.e. MGL 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. u a timely andmork manlike 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 fora 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. 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 du_upiicate 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 contractwith attachments is to be given to the owner and the other kept by, the contractor. Any modification to the c(riginal•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 recission 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 wherea. 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 Cgnsumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787 or 1-(888) 2833757 . If you want to verify the:'registration of a contractor or if you have.questions or need .additional information specifically about the contractor registration component of the Home Improvement Contractor'Law, contact: Director of Home Improvement Contractor Registration Bureau of Building Regulations and Standards One Ashburton Place, Room 1301, Boston, MA 02108 , (617)727-3200 ort -800-223-0933 For assistance with informal inediation of disputes or to register formal complaints against a business, call: Co ' Office of the Attorney General (617)727-8400 AND/OR Better Business Bureau - (508)652-4800 (508)755-2548 (413) 734-3114 Cd 0 oX CA u 'b O LE v U) x IS . j G p w C CD O w C U G w x 0 �--� DD OG w w o w W W p r2 v V cn id G w" o 0 X00 O w G w W G 5 PQ Z i' i cn Q aG cn g c � W o � c � VWj v v � C co : A :.c c ca Ee C mE . o a E� �L CO o :mE a .c.+ L m o CD N m .� ca Em Amo A U N m ; �/ J r o =C2 cm EC� :+rc os c c � ►--� a W o m N Z c �J O Ha m C �C 2 ® ®� o N ~ �p y Ors..~ N L UJ ":s =2 c •y P _ cs e Z °c Maui a - •o Co .N o y a O� s� FE` y•- O F- rC 1 R y14 U O CD O CD L O o Z O H � C C C y 0 � O._ A O O 'r= m m CD O CD CL CD :Ift I.a3 Lft O O i eC3v o a CL vma c cc yO., O Z d v c O cc CL C CO) U) N 19 W LLI LLIW 0 CS # 022680 HIC# 103358 r0 Dial _ A. J. Walsh & Sons 55 Pleasant Street .North Andover, MA 01845 If of Proposal Submitted To: Job Name Job # Address 4 Job LocationA, &� 978-688-6737 or 1 -866 -AJ WALS H 11 A) �'% a,0 Date !/ / Date of Plans Phone # l (r —,06 5 / 'Fax # I Architect We hereby submit specifications and estimates for: _ ...... _...... ................... ....... -.._....._......_... _._........................ __..-._-............ .... _.._--------- ..---.._.__...__--.---_---........---.._....__.._._..____..--------.......__.__.---..._.................. We 7 pose hereby to'furnish matehal'and labor = complete,iri ac with payments to be made as follows: the above specifications for the sum -of: Dollars 44 0 76 6cT?6 ' J Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order, and will become an extra charge over and submitted { above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. Note — this proposal may be withdrawn b/�us H not accepted within days. Zcceptance of jropool The above prices, specifications and conditions are satisfactory and are � ignatuire �L==;&I- -- /:E hereby accepted. You are authorized to do the work as specified. ' Payments will be made as outlined above. Date of Acceptance �� -7�47 ",-"Ii Signature s The Commonwealth of Massachusetts E Department of Industrial Accidents Office of Investigations 600 Washington Street ,a :.11'n =a j ; Boston, MA 02111 ,t r www.mass.govIdza Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �✓ �L!cJ gC�Oi`yS Address: k5 6- V", Z, */ �/ r S/ City/State/Zip: IY,6f 1¢iY U.�y� e2 AN14hone #: 97k--6 d'e -{ 73 % Ar�yoan employer? Check the appropriate box: employer with Z 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Pl tng repairs or additions 12. Roof repairs 13.❑ Other *Any applicant that checks box # 1 must also fill out the section below showing their workers' 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 name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: z� /��`% /'�JGt/��/ //(s CC) Policy # or Self -ins. Lic. #(/ �d /�<v��'O /�d !( Expiration Date: l Job Site Address: 7 �G Al �/� %��i City/State/Zip: ✓W 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. I do hereby certify deer the pain, ssaann�d/peenaltiesoof peijuiy that the information provided above is true and correct. 4ionntiirP- AS��.���L/'r f/L//L�%La�G� - Date- ////,? //L/) - 6S -k 6 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: _ Office of Consumer Affairs & Business Regulation =s=; -_HOME IMPROVEMENT CONTRACTOR Registration: 103358 Type: ^' Expiration: 7/7/2012 Private Corporatior A. J WALSH & SONS,INC. Arthur Walsh,Jr 55 Pleasant St N Andover, MA 01845 tindersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 di Y/vel:'��=������I•r�'�vt,_—____---.- \tot valiwithout sig Lure Nt(.. uhtiwtt. I) I)irtmvnt of Public safetN �k{ Biiard ut Buildin, Rcul,itiun.and ltandar(IN License: CS 22680 ARTHUR J WALSH JR 159A WAVERLY RD N ANDOVER, MA 01845 �unmi.�i„ni r Expiation: 6/9/2012 Tr=: 29327