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HomeMy WebLinkAboutBuilding Permit #126-15 - 34 GLENORE CIRCLE 8/5/2014 BUILDING PERMIT 0* NOt%ORTH TOWN OF NORTH ANDOVER o2 APPLICATION FOR PLAN EXAMINATION '' ' Permit No#: I low Date Received ATE I>T ACHUS Date Issued: b 4 H IMPORTANT: Applicant must complete all items on this page LOCATION 34 G IC r1 at-c- C t r _ Print PROPERTY OWNER_ He-40-/ Iy Print 100 Year Structure yes no MAP k-372 PARCEL: '741 ZONING DISTRICT-Historic District yes o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Resi ential Non- Residential ❑ New Building One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial J6 Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: kc, 13 ec�.c rc r ve v ecti v�� e_ Identification Please Type or Print Clearly OWNER: Name:_ He-v%vii 1 v Phone: q,. 1 � Address: Contractor Name:JI,M kv o res Phone: 9 7 g Ill 7 9730 Address: 216f 14ycig 4ve- M-G cir 5— Supervisor's Construction License: C 5,FA O Y 7,'G 7 Exp. Date: 11/7 4 Home Improvement License: l 7 3 0 7�o Exp. Date:, ARCHITECT/ENGINEER Phone: Address: Reg. No. J FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ _ /d,v00 FEE: $�7 Check No.: So Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Location �34 C-�r'P t-� 2 P C I R- aL No.J (-0 (I5 Date • • TOWN OF NORTH ANDOVER t Certificate of Occupancy $ Building/Frame Permit Fee $A Foundation Permit Fee $ Other Permit Fee $ TOTAL $ f ���(^ I Check 1 10 GU Building Inspector r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales 1 ❑ 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 Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/recei t submitted yes Planning Board Decision: Comments ! Conservation Decision: Comments s Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application a Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o 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 a Mass check Energy Compliance Report o 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 i Doc:Building Permit Revised 2014 NORTH own 0-f ., Andover 0 - to No. 2 * _ 1 (9 -46 C% h ver, Mass St �� o A- COCNIC0111WICM ��• 7�ADRATED jkVP �5 S U BOARD OF HEALTH Food/Kitchen PER IT T LD Septic System THIS CERTIFIES THAT Q N BUILDING INSPECTOR ............. e. .....7. ....... .............................................. ........ �. '� Foundation ' has"permission to erect .......................... buildings on ... ..................... .. �O�C ...,� Rough kQ to be occupied as rv"0�4n W....de.. k .. ..... (C ................. Chimney ..... ........... ..... provided that the person acceptingthis permit shall in eve res ec-nform to the terms of the application p every p pp 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO , T Rough Service ...... ......................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina. No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. C�/e`�ainmwa�,�oea�a�'C%lifaa9ac�u�leCts Office of Consumer Affairs&Business Regulation 'rjME IMPROVEMENT CONTRACTOR elgistration: '173076 Type: piration:__�kt}1.6. Corporation LYONS DEVELOPMENT CORP JAMES LYONS _ 261 HYATT AVE BRADFORD,MA 01835 � �— Undersecretary Massachusetts.-Department of Public Safety Board of Building Regulations and Standards Construction Supen•isor.1 &2 Famillk- 7 License: CSFA-047567 JAMES H LYONS= 261 Hyatt Avenue: Haverhill MA 01$35 i . t -�-�--��•� Expiration Commissioner 11/07/2015 Massachusetts Home Improvement Samble Contract This form satisfies all basic requirements of the slate's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek Iegal advice if necessary. An Massachusetts Consumer Guide to Home Improvement"before agreeing to any worlcson on your resideng home ce.You may obtain a free vements should first e co a by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3157 or on our website. Homeowner Information Contractor Information Name Company Name Street Address(do not use a ost Office Box address) ff Contractor Salesperson/Owner Name 3 ! G Is ji ce v e C t 6 /� A Av✓�,r cJl�y a ttit e {. (� Vks City/Town State Zip Code Business Address(must inc de a street address) ©ve-,r dM G t k j Daytime Phone Evening Phone Civrown p f State Zip Code 97� �3 f�3 2 l� 2 (13 J l�►+?�r'{1',✓cl Hej «3g� Mailing Address(It different from above) Business PhoneFederal Employer ID or S.S.Number o Law requires that most home Home ImprovementContmctorneg:Number Expiration date • improvement contractors]rave n valid registration number / 7 i3 cSFlIlr The Contractor agrees to do the following work for the Homeowner: A oy � �, /(Describe in detail the workto completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) KC Kd vc— Q"e - v-v.n. cIct,� q- S ret t✓� citid r C �Q�� t- �D'4L' e L:,f � C.GM�OaS/T2 �C'G�1!`✓I�f Required Permits-The following building permits are required Proposed Start and Completion Schedule-'The following schedule will and will be secured by the.contractor as-the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of / /tt Date when contractor will begin contracted work. MGL chapter 142A.) 3 C Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,fiunish the material and labor specified above for the total sum of: - /0'(_90- 0 ti Payments will be made according to the following schedule: $ y o o cJ upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) $_ by / / or upon completion of $ by ____L_L_ or upon completion of $ 002 upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) . The following material/equipment must be special $ to beaid for ordered before the contracted work begins in order p to meet the completion'schedule.(**) $ to be paid for NOTES;(*)Including all finance charges(*i°)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. Express Warranty-Is an express wan•anty being provided by rhe contractor? ❑No I®''Yes Gill terms of the warranty must be attached to the contract). Subcontractors The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor fiuther agrees to be solely responsible for all payments to all subcontractors for materials and labor under this a Bement Contract Acceptance-Upon signing,this document becomes abinding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. o Don`t be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear, alce sure the contractor has a valid Home improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director ofHome Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. o Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home 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 notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the t1bird business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. ]DO NOYSIGN TMS CONTRACT IF THERE ARE ANY 13 LANK SPACES!!! Two identical copies of the contract must be completed and signed. One copy should go to thellompmfter. The other copy shot d be Icept by the contractor. 4HOmener' Si e f @ofitractor's Sigh e 31 vo j V 7 .3< c Date Date 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 world 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 Affairs and Business Regulation and the consumer shall be required to s mit to uc arbitration as provided In Massachusetts General Laws, chapter 142A.. Ho eo er's i attire �itractor's Signa, ire 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 cavy 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 fiends not yet due be placed in a j oint escrow account as a prerequisite to continuing the contracted work. Withdrawal of fiends 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 Massachusetts Cons-timer Guide to Home Improvement" contact: Consumer Lormadon T-Tot1_ine Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the OCABR website at hitp://ww,,v.mass,gov/ocabr/ 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 Office of Consumer Affairs and Business Regulation 16 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the I-RC website at lim://www.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: . ltt- 3://db.state.•ma.tis/homeimprovement/Iicenseelist asp For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800, 508-755-2548 or 413-7343114• Version 2.1-11/22/2010 Alae Commonwealth gfMassachusetts - De�aYtmentaflnc�u��icclAcczc�ent� • - Office oflnvestigaflons 6`00 Washington Street ' .Boston,.A 02111 Uf wwl muss go-PIdIa w9r keys'comp en.sat on bsuran.ce Affidavit:Bui ders/Contrac Foxs/B+lectxiciansl?lt n.�M � Applicant hforrbaa ion Please.PrIntLeONY j Name(Businessiorganizationl.CnWdud): � o w..5 e,y e-/0,0, � . Address: ate 1 e, a� City/State/71.p: rad Gi r'� C u �+43 hona B: .322- 0,2-4-2 - ' I 2 v- a o?4-2 Ara you an employer? eckthe appropriate box: Type of (required Ct 4. El I am a general contractor and I LEI I am a employer with________ 6. New constmotion employees(aRmdloxpmt tim.a)•* have hired the sub-contractors 2.El ani a sole proprietor ox partner listed on the attached sheet. 7• Remodeling ship and`havena.employees These suis-contractoxshave 8. E(Demolition. working forme in.any capacity. erg'comp.insurance. 9• ❑Building addition [No workers'comp.jnsurance 5. Q We axe a corporation and it's 101]Electrical repairs or additions required.] officers have exercised-their 11.. Plumbin re airs or additions g right of exemptionpexMGL p 3.Q Z am a honaeownex doing all w oxk g Myself PTOW9rkers'comp. c.152,§l(4),and wehave n.o 12.P gflofxepairs mrancexe ed. v employees.[No workers' comp.insurancerequired.] 13.[j Other Any applicantthat checks box#f mustalso fill outthe seetion beldwshowingtheir workers'compensagoapoEryinformatiOn. or' ntractors mus submit anew aftidavitfudicatiiig suoh. 'Homeowners who submittbis afi7davitindicatingthey ere doing allw kmdthenhko outside co ' ofr information x addifional sheet showin the name of the sub-contractors and their workers camp.p y •Coirtractors that checkthis baxmnstattached an g I am tw employer that 19,v oo ding wosIfer.s'eompeligation insu,-aneg for ray eWfoyeey Below isiftevolley and joh site inforination. insurance Company Name:. Policy#or 8ell ins.LIG.#: ExpirationDate: lob Site A.ddresq: City/8tate/Zip: Attach a copy of tete workers'comp ensatiowp olxcy declaration.page(showing.the policy number and expiration.date). Failme to secure coverage as xaT'duader Section 25A.of MOL o.152 can,lead to the imposition of eriminalpenaltzes of a fmo up to$1,500.00 and/ox one-year imprisonment,as well.as civil penalties in the form.of a STOP WORD ORDM and a fmo ofup to$250.00 a day against the Wolatos.: Be advised that a copy oft1a statementmay be foxwarded to the Office of. Investigations of the DIA.for insurance coverage versf cation. xdo itereby ee fy ulider fiiej'a"' s and penalties of perjury treat flee informadon,provitle2"U v is trite and eorreet, - Si afore• . Date: � f � Phone#•v Official use oily. Do not write in flus area,to he eomplefed by city or town official. City or Town: PermitllGiceuse# fssuingAuth.ority(circle one): 1.Board of Health 2.BuildingDepartment 3.CitylTowa Clerk 4.Electrical)!nspector S.RIUMbingl uspector 6.Other