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Home My WebLink AboutBuilding Permit #9657 - 36 FOSS ROAD 9/15/2010NOT 1 9,657 D at � b ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... / "14 . . . .. ................. ................ has permission to perform . ... .. ...... . el. ell ... .. jv�. �ev'K' P wiring in the building of ... M.6 . . . . .. ........ at . .... . ...................... North Andover, Mass. 77 0. 0;7 Fee ... Lic. N RICAL INS R Check# 22)-3.3 ol Majjaclm ielb Official 13se 011h.. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. '/071 (leaveblankl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perlbrined in accordance with tile M.-issachlisetis Flectrical Code (NJEC). 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPEA L L IATF(-)R,,l M TION) Date:-, W//—() CityorTownof- To thV (1,60eclor of lVires.- By this application the undersigned gives notice of his or iier —intention to perform the electrical work described below. Location (Street & Number) ci Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes F J No (Check Appropriate Box) Purpose of Building ("Itilit, Authorization No. 9��Y201 Existing Service a70- Amps 12C) I -2q0 Volts Undgrd No. of Meters New Service Amps Volts Overhead D Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Cany-)Iefiort ofihe/oll)i -in i ble nial- be iraivedbi- the Inspector offf'ires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans ! 0. t Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above F n- 1 0. gency ig ing 1!rnd. rn Batterw I J.it. ;;rn No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners 1 0* 0 etection an ------To-- Initiating Devices No. of Ranges No. of Air Cond. taT— — Tons No. of Alerting Devices IN& of Waste Disposers atyu-M—FTN-U-mp�r ITOPS No. of Self-ContaineJ— Jotals: I Detection/Alert evices on/Alerting D ipal n No. of Dishwashers Space/Area Heating Kw Loca I ff CMoun ne cipa: n F-1 Other No. of Dryers Heating Applian Security Systems:* 0.0 ater No. of Devices or Equivalent Heaters KW of Data Wiring: Signs Ballasts I No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP I elecommunication s Wirm — val: OTHER: No. of Devices or Equi ent Estimated Value of Electrical Work: Sl;�o CX.7 Affach UtWilional Iletelil �1-elrsirrd. or as required bY the Inspector ofivirev. Work to Start: -Z0 (�Vlien required by municipal policy.) ,,4&zvo Tilspections to be requested in accordance with MEC Rule 10. and upon completion. INSURANC9 COV9RAGE: Unless waived by tile Owner. no permit for tile performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force. and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ZJ BOND F-1 01 -HER EJ (Specify:) I cerdfy, under thepains andpenaldes ofperjut:i,, that the infortnution on this application is true and complete. FIRM NAME: BENJAMIP. ELECTRI_C, INr LIC. NO.,2 g A Licensee: BEN MOREY Signatur LIC. NO.: - line.) (Ifapplicable, enter "exempt - in the license numbei Address: 6 TF!gr)m MA QIQ-7C Bus. Tel. No. -A 8 0 0 Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-6 1, security work requires epartment of Public safety -S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the I -iceilsee does not hai-e the liability insurance coverage normally, required by law. By my signature below. I hereby waive this requirement. I am the (check one) F-1 owner 1:1 owner's agent. Owner/Agent Signature Telephone No._ ��. `�41� �� Print Form Qj five hitigloti Sireet HONM#11- MA 02111 NWN' * MUNS. A10 I 111fill Workers' COMpensation InSuranceAffidavit: Btiii(fers/('ontractors/Electricians/Plumbers ArlInfirant InMil-mati�_ Name (Bus iness;0rgan I zat I lid I %I djl�j I,: Ben)arnin Address..6 Jerome Road G ly/stale// i p: Tewksbury, MA 01276 ],jlt)ljC 4.978-640-8800 Are you an employer! Check the appropriate hov I I am a employer w i til 3 'rvpe of project required): -i -time). employees j I'Lill and/or par - am a'sole proprietor of- [[:I\,. ti, 0. Ne\� con-�tructl()ll partner- Remodelinu, ,hip and have fit) employee.s I hc"k. 0 Demolition Working t6r ine Ili an\ capacil\. jNo �%orkers- conip. Insurance k'"1111) Q 1011 l3tilidin't, Ziddit' req U I red. I f I k_j - I 0 Flectrical repairs or additions ani a hoineowner doing all \,,ork CWI k 11111hin-g Illyself. [No kvorkers' comp. Olt I" R I repairs or additions insurance required. 1 1,4). all'i Root'repairs CIIlpI0\'V' jNo 0I It e r applicmi that elleeks F.)X All filkmt 111V w"11.111 _j lilt. Ill"ll. "olk"I, floilicowner% %%ho suhmil this indicati1q; tllc� tIIk"Io1II._-..III ill"ll fill, "llilld" 0"W -MIN' that check this ho\ ))list altached an :I(j, 111:1, 'Im I loiN inu,z �whnijj i,i(_iicjjiIIg sl4ell Il'the sub-wntractor, jl;t\c cnipio\ccs. Ill,:\ 111(illt jlill� idt, I am tin emplqrer that ivProvitfing, sw.*rkers information. Belo iv is the polk.:1- andjobsite I il-lUrance Compan) Name: Peerless Insurance Company Polic\ ;;or Self -ins. I.ic. p:WC8673446 Joh Sitr Address: 3G_ (011 el Attach a cop), of the workers' comp cli'llsation Pifolic% declarallitill pa�gc itshomin.. the number and expiration date). Failure 10 ScCtlre Coverage as r0i'Llt'll-ed under Sect it A ot . kl(d title lip to $1.500.00 and/or one -\ear imprisonnicill call lead ,,, file "I"POsillOn ot'criminal penalties t)l'a I Ill tile G)J-111 01'J N*I 0P WORK ORDER and a title ,)I tip 10 $250.00 a day against tile 'olalor. fie akk Icd :11,11 �l 011)\ )I- Ill], he I'or\�ar 111%estlizations ofthe DIA t�v insurance covel,.1-c \cI-ij-clt, ded to the Office of I da herebt, certif .1, under IhepainN andpenalfies jo/*p rjury M111 flit- infi;rtn"fit)n prm-itleil ahtive iv Irue and correel. )hone P:978 -64e-8800 Ujjifelal u.ve onj .1 Danol lt'rileinllli-s area. -hlz City or Town: Issuing Authority (circle one): L Board of Health 2. Building Department 6. Other Contact Person: Verfalif/Lic ense 4 3. ('i (\ I I t I\% 11 Cler k 4, Fle,* I ric., I I ospCC(() jr 5. Plumbing inspector .__ Phone g: 1,7 I '? 1� Location No. Date f �) / Z) 6622 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation R,6tk1t,Fee $ 1. * \ ' bZ41 Other Permit Fee $ Sewe 4, onnection F e6 ection Fee, Waier ��h TOTAL Building Inspector Div. Public Works PwAuT Np. w ot APPLICATION FOR PERMIT TO RUILD — NORTH ANDOVER, MASS. ,�//PAGE I MAP 4-40. LOT NO. 3 -L- 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. LOCATION Avi-s- gy PURPOSE OF BUILDING r�yvjo-C- 11�00? oc(��/000 OWNER'S NAME NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMEJ-y7� , C SPAN DISTANCE TO NEAREST BUILDING v DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES SIDES REAR GIRDERS AREA OF LOT I -� a --) 's �- FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING / 0 x IS BUILDING ADDITION MATER:AL OF CHIMNEY 15 BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS EE BOTH SIDES AGE I FILL OUT SECTIONS 1 3 PAGE 2 FILL OUT SECTIONS 1 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED / (3 1 g / .3-3 SIGNATURE OF OWNER OR AUTHORIZED AGENT F E E C) OWNER TEL. # PERMIT GRANTED CONTR. TEL. # - �6q�oi S- 1�f 19 CONTR. LIC. # 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST OD EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING INIFic'u. I OCCUPANCY SINGLE FAMILY SLATE STORIES NO PLUMBING MULTI. FAMILY OFFICES ROLL ROOFING APARTMENTS MODERN FIXTURES HEAD ROOM CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE -- 2 13 CONCRETE BL K. PINE BRICK OR STONE TILE DADO HARDW D 9 FLOOR$ CLAPBOARDS 6 FRAMING HEATING PIERS 1 PLASTER 3 DROP SIDING FORCED HOT AIR FURN. DRY WALL WOOD SHINGLES STEAM -i�5TH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING HOT W'T'R OR VAPOR �TARDVV D COMMCN lkspli -TILE STUCCO ON MASONRY -�N -FI N. 3 BASEMENT RADIANT H*T'G UNIT HEATERS AREA FULL FIN. B M'T' AREA SLATE '14 1/1 NO PLUMBING FIN. ATTIC AREA NO BMT ROLL ROOFING FIRE PLACES MODERN FIXTURES HEAD ROOM MODERN KITCHEN TILE DADO 4 WALLS 9 FLOOR$ CLAPBOARDS 6 FRAMING HEATING 8 1 2 3 DROP SIDING FORCED HOT AIR FURN. CO NCRETE WOOD SHINGLES STEAM -i�5TH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING HOT W'T'R OR VAPOR �TARDVV D COMMCN lkspli -TILE STUCCO ON MASONRY AIR CONDITIONING RADIANT H*T'G UNIT HEATERS STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME -AT_ IC STRS. & FLOOR CONC. OR CINDER BILK. WIRING STONE ON MASONRY 5 ROOF 11 10 PLUMBING WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING HEATING WOOD JOIST I.-' PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER EMS. & COILS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H*T'G UNIT HEATERS 7 NO. OF ROOMS 01 ELECTRIC NO HJEAT im'_T 2nd 7 t rd BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF 113'17'�Al`�6i��A*�" A- F R 0 M LOT LINES AND EXACT DIMENSIONS. OF BUILDINGS. WITH k,RlbRC�IkS. GA- RAGES. ETC. SUPERIMPOSED. THIS RkPLAcEs PLOT PLAN. I V) I f Q1. Vj� I FORM U - LOT RELZASE ' INSTRUCTIONS: This form isused to that allnecessary s and DepaxtMMts apprOvals/permits from Boa=L verify having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills Out this Section***************** APPLICANT: M Phone LOCATION: Assessor's Map Number Parcel Subdivision Lot (s) Street V A St. Number 34�1 Use RECOMMENDATIONS OF TOWN AGMITS: Date Approved )6175 Conservation Administrator— Date Rejected Comments Date Approved Town �Pl a n�e r, Date Rejected Comments Health Agenz Comments Public Works - sewer/watEr ccnnec----:cns - driveway permit Fire Depart"-nent- Date Armraved Date Re�ected Received bv Building Inspectcr Dat- �,v L� �� , L,) q C, 0 1 Z,q C- 0 L4 0 01 0 LA 4- ol 1� �b LA >4- 3 p I 0 1141BI.VA4 (�, zek-- 1� /&Tt CYR ENGINEERING SERVICES INC 300 CANAL STREET LAVffiENCE,!-AASSACHUSETTS NOTE: T117S IS NOT A SURVEY AND IS TO BE USED FOR MORTGAGE PURPOSES ONLY. N.B.- Do NOT USE OFFSETS FOR ESTABL7SH7NG LOT LINES FOR THE ERECTION OF FENCES, WALLS, HEDGES,:ETC. I HEREBY CERTIFY THAT THE FOUNDATION ON THIS PROPERTY IS LOCATED AS SHOWN ON PLAN AND COMPLIES WITH THE ZONING SET BACK REQUIREMENTS OF THE TOWN OF NORTH ANDOVER. I �URTHER CERTIFY THAT THE ABOVE PROPERTY IS NOT LOCATED IN A FLOOD PLAIN ZONE. KAREN H.P. NELSON, DIRECTOR �'- '17' %� In accordance with the provisions of MGL c 40, S 54, a. condition of Building Permit Number y — is that the dcbris resulting from this work shall be disposed of in a properly licenscd solid waste disposal facility as defined by MGL c ill, S 150A - The debris will be disposed of in: (Location of.Facility) Signature of Permit Applicant , b ) <Z� I '� .3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. 120 Main Street OFFICES OF: APPEALS NORTH ANDOVER., North Andover. Massachusetts 0 1845 1b BUILDING DIVISIOr4 OF - (617)6854775 CONSERVATION HEALTH PLANNING & COMMUNITY DEVELOPMENT PLANNING KAREN H.P. NELSON, DIRECTOR �'- '17' %� In accordance with the provisions of MGL c 40, S 54, a. condition of Building Permit Number y — is that the dcbris resulting from this work shall be disposed of in a properly licenscd solid waste disposal facility as defined by MGL c ill, S 150A - The debris will be disposed of in: (Location of.Facility) Signature of Permit Applicant , b ) <Z� I '� .3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. a 0 aN T-4 0 0 E C/) u -Z w 0 u z z -4 �) .2 - cz -0 r. z to = 0 E u cz x w 0 u M4 W r .4 to cz �c 0-4 u 0 0� u > u w 0 —cz w U u U) 0 C/) CD C2 CD C=2 C.2 CD E;Z- :!Za:�B C:F ts cm *i W.= E Oft Cos ca C2 cm CA Cc = Ce 4�. E 75 cm CO Co CO - cc* C=M 0 :5 CO3 .5 4A C.2 cm CE =CL, CD CCDL a PQ Le C=l CL.= cl, LU E C-� cz b- ca Im C.3 co C2 =.s co CL. 0.5 CD :2 FE 92 m a CO2 -5 CD S C'L co S. ;17 C/� Cf, cri co ;Z E U- co CO CO2 co cm CO2 CD co co) co cc ca LU C/) 2� co a) C) C-) CL 75 CD >. co co C.2 CL m CD CO2 -6-0 C CIO CO) q u < co 2-11 CD CL.) CO) m ca clu ;Z, :23, CL N'R 3735 Date.�� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING T h i s c e r t i fi e s t h a t . /,? . J.. . e-?,- . 5 ............... '0� has permission to perform ........................... plumbing in the buildings of . J. at .... y ........... North Andover, Mass. Fee. Lic. No. J4,,� � ... ............. ................ PLUMBING INSPECTOR 06/23/98 08:40 WHITE: Applicant 15-00 PAID CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICAT7/-0FOR PERMIT TO DO PLUMBING , /_ y (Type or print) NORTH ANDOVER, Building Locationj_ Pemit/#—/—'? Amount Owner's Name New Renovation Replacement Plans Submitted V1Y%Tr1r3YT"'VQ Check one: Certificate (Print or tvne) __P 14 AM r installing Company Nam (Ij F. - Address 4_2 1:3 Partner. Girm/Co. Business Telephone Name of Licensed Plumber: insurance C erage: Indicatithe —type of insurance coverage by checking the appropriate box: Bond Liability insurance policy [3-- Other type of indemnity insurance Waiver: 1, the undersigned, have been mAcre aware that the licensee of this application does not have any one of the above three insurance 5—ignature Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the 519 under Permit Issued r this plication will be in best of my knowledge and that all plumbing work and install i ps performed Code Chapt 42 General Laws. compliance with all pertinent provisions of the Massachu tate rn�g By: I re -of Licensou rluiuver,� Type of Plumbing License Title K, 0 -2 G - City/Town -M—cense Number Master Journeyman -APPROVED (OFFICE USE ONLY SEUTION I- SITE INFORMATION I - 1. 1 Property Address: Foss ?J TOWN OF NORTH ANDOVER 1.2 Assessors Map and Parcel Map Number Number: Parcel Number KAvkV42�- BUILDING DEPARTMENT APPLICATION TO CONSTRUCT RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1.4 Property Dimensions: Lot Am (sf) Frontage (ft) BUILDING PERMIT NUMBER DATE ISSU ED: SIGNATURE: Front Yard Building Commissioner/InERector of Buildings Date SEUTION I- SITE INFORMATION I - 1. 1 Property Address: Foss ?J Historic District: Yes No 1.2 Assessors Map and Parcel Map Number Number: Parcel Number KAvkV42�- 1.3 Zoning Information: Zoning Diii�d— Propbsed Use Address for Service: 1.4 Property Dimensions: Lot Am (sf) Frontage (ft) 1.6 WELDING SETBACKS (ft) 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Front Yard Side Yard License Number Rear Yard Required Provide Required Provided Required Provided Registration Number Address . 1.7 Water Supply M.G.1-C.40. 54) Public 0 Pnvatc 0 Zone 1.5. Flood Zone Information: Outside Flood Zone 0 1.8 Municipal Sewerage Disposal System 0 On Site Disposal System 0 SEUTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record tk 644JA-CUJ �C --'c, Ralime; (Print) �---36 Voss' Address for Service Si re Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone A Not Applicable License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable D Company Name Registration Number Address . Expiration Date Signature Tele phone 00 M X z 0 0 z M go 0 ic M I'm rau" SUNNI z G) I SECTION 4 - WORKERS COMPENSATION (T*LG.L C 152 6 25c(6) I Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ....... 0 No ....... 0 SECTION 5 Description o Proposed Work (check applicable) New Construction Existing Buildmg 11 Repair(s) 0 Alterations(,*). .0 �,TTAdditiion 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: SECTION 6 - ESTIM[ATED CONSTRUCTION COSTS Item I Building Estimated Cost (Dollar) to be Completed by permit licant (a) Building Permit Fee Multiplier 9 b N, .... .. LY 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbipj Building Permit fee (a) x (b) 4 Mechanical (RVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number V -e-7 SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, k& - Is as Owner/Authorized Agent of subject property He^ authoriz to act on ,r, 41atw -11 authorized by this building permit application. MyWalf, in all m tt � It' e to)�o vl'li4 f �� I 10 it 6 1 & , 0 1 V Signatare or Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Owner/Authorized Agent of subject property Hereby declare that the statements an oing application are true and accurate, to the best of my knowledge and belief Print Name N Signature of Owner ent NO. OF STORIES Date SIZE BASEMENT OR SLAB SIZE OF FLOOR TRVMERS I ST 2 No SPAN DIMENSIONS OF SILLS DEVENSIONS OF POSTS D110ENSIONS OF GERDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF CHDvMY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE rumm u - Lu i KI=Lr-J%Qc r%jw%m Al - INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT PHONE LOCATION: Assess&s Map Number PARCEL ?(bs SUBDIVISIO LOT (S) _ 34 STREET4 1F�S5JZQ0-& ST. NUMBEkaQ_ USE ON!6.yh******* MEr_-T__r'_y.0 T I T ! - I , .. $1, Pei V5 90 �� coftERVATION ADMINISJ COMMENT4 b J VIVI, TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWERIWATER CONNECTIONS, DRIVEWAY PERMIT, FIRE DEPARTMENT. IWECEIVED BY BUILDING INSPECTOR —DATE— RGVISW 9197 Jfn t 2). Z Ti r Ld 1;4' LOGATQN OF STRUCTURE(S) BASED ON LINES OF OCCUPATION ONLY WA -L HEQUIRE A�IKISIRUMENT SURVEY. J(" S. I Ai Scale: ROFESSIONAL LAND SURVEYOR, HEREBY CERTIFY THAT THE )VE AMERICAN SURVEYING COMPANY MORTGAGE INSPECTION N WAS PREPARED FOR 1264 Main Street, Waltham, MA 02451 (781) 893-6477 INECTION WITHA NEW MORTGAGE IS NOT INTENDED OR REPRE- TED TO BE A LAND OR Mortgage Inspec* ion P .... ....... Morti t PROPERTY SURVEY. NO CORNERS WERE IT THE LOCATION OF THE ORIGINAL RECORDED A 41- LAULQI BE USED FOR ES- LISHING FENCE, ,T COUNTY REGISTRY OF DEEDS DWELLING SHOWN HEREON EITHER BOOK PAGE L.C. HEDGE OR DING LINES. THE LAND AS SHOWN Cert. WAS IN COMPLIANCE WITH THE LOCAL PLAN REFERENCE: - '�2 �' 14 - APPLICABLE ZONING BYLAWS IN EF. EON IS BASED ON CLIENT FUR_ ED INFORMATION AND MAY BE DRAWN PER TOWN OF FECT WHEN CONSTRUCTED WITH RE. MAP # PARCEL# ZSESSOR-S DATED SPECT TO HORIZONTAL DIMENSIONALi ADDRESS: JECT TO FURTHER OUT -SALES, 4;_ REQUIREMENTS ONLY), OR IS EXEMPT 14GS, EASEMENTS AND RIGH TSOF Na RESPONSIBILITY IS EX_ FROM VIOLATION ENFORCEMENT AC. BORROWER: '�v TION UNDER MASS. G.L. TITLE VII, CHAP. )ED HEREIN TO THE LAND OWNER )CCUPANT, IT IS NOT INTENDED 40A, SEC. 7. UNLESS OTHERWISE SU13JECT DWELLING LIES IN FLOOD ZONE NOTED OR SHOWN HEREON. E RECORDED. A CON- AS SHOWN ON NATIONAL FLOOD INSURANCE PROGRAM FLOOD FIRMATORY INSTRUMENT SURVEYlINSURANCE RATE MAP DATED IS ADVISED WHEN STRUCTUR ES AREICOMMUNITY PANEL# _-Z -10 Si 'WiN TO i r BE 1' OR LESS FROM ppnnrn�ll -1 - ___ I I — --------- ,&OWTH TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 0 1845 D. Robert Nicetta, Building Commissioner HOMEOWNER LICENSE EXEMTTION Please print DATE:- 10/1g)(),5 Telephone (978) 688-95454 Fax (978) 688-9542 JOB LOCATION:- 3 to cc�i� --:Rood _V_ Number Street Address Map/Lot -T�Aq, RoMko,7�o-LS 97n (o%3 1qq0 (,I::� 5S6 -613-Q- HOMEOWNER Name Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5. 1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and that he/she will comply with said procedures and requirements. 1; HOMEOWNERS SIGNAT URE APPROVAL OF BUILDING OFFICIAL I U)A RD OF, WJ1F,.\LS 6."-9541 CONSFIRVATION 699-95:30 1 ]YA], Il I 6SX-9540 PJANNING (,)."-0�35 N 0 0 z a ; cle cc LLI ca scl. CL C CC cam C� ts cm W.S CL C2 cm mo M .40D W 0 CLC.) CD ca =0 CL W= a 31 4CDL C, *roi CL= c=j o" a ca C3 cm 06 4D J2 CL= 4.. 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C.3 CIO cc cc LU cl 19 LU LU 19 uj LU U) 12 X gilr ra7m COD W or - 165 C.3 CIO CL= m ca M E CE ts 0 CL =4D cm 45 co am 100 0 0 C=M-m.� c N IS CM3 E's ra 0 CL CD CDs -0 ?A ro Im col ca 0 CL 4D .2 CLS W 4 - -ui E a- 32 0 CD ID cc CD I S 0 cc 0 cm z CD zip C/) 0 C/) C/) z 7 re1wd H C/) z 0 u U) C/) 2 mi LN, I E z CL. 0 CA C3 cm 0.— CM MA E CD JE CD C3 cc 0 cm CL. 0 Cc M 00 CL. 0 G) ca Z ts c G3 0 CL. C.3 CIO cc cc LU cl 19 LU LU 19 uj LU U) Date. ...... 0 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ....................... has permission for gas installation ................. in the buildings of ... /�. f ............................ at .............. I North Andover, Mass. Fee. .... Lic. .. ...... GAgINSPECTOR Check# L'It u 3 5 I"j' 5 4ASSACHUSETFS L NIEFORM APPLICATON FOR PERMU TO DO GAS MING or print) 1-1kin I rl A1'qUVyL1-A, iy1Aa3^%_r1Uar_ Ila Date Building Locations 66 Fos -5 F -co-d Permit 9 1 �) a- �) Amount S 210 Owner's Name _VrP--r,0r Gwrbe_r- New Renovation Replacement [a - Plans Submitted 11 (Print or type) Ch5c� one: Certificate Insialling Company Name— Andover Md. & Htq. Co., Inc. M Corp. 2122 L:j Address 20 Agean-Dr., Unit -10 FI Partner. ness i e Name of Licensed Plumber or Gas Fitter Geor(je Lagor ,e F1,Firm/Co. INSURANCE COVERAGE Check one - I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked ves, please in(Xa e the ty appropriate box. pe coverage by checking the t Liabilit-v insurance policv Other type of indemnity Bond M El Owner7s Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: E3 Si2narure of Owner or Owner's Agent Owner E] Agent i herebv certify that all of the details and informadon I have submitted (or entered) in above application are true and accurate to the best ofnly knowledge and that all plumbing work and installations performed under Permit Issued lor this application will be in compliance with all pertinent provisions of the Massachusetts Stat Code and,2h !X.— S - _� mer 142 of the General Laws. By: Title Cirv,Tjw—n-- 4LPPP 0 VED (oFiici: USE ON1. Y) IdSignature,1617 Licensed Plumber Or Gas Fitter Plurnber 9983 Gas Fitter License Numoer Master Joumeyman Location No. Date oz7 1,9v, 40PTN TOWN OF NORTH ANDOVER 0"Okse Certificate of Occupancy CH Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # !�Ia5a �- 18987 Building Inspector Permit NO:!�? Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received I IMPORTANT: Applicant must comi)lete all items on this -oaae I LOCATION 3�. Fns -s Roc,-J� Print PROPERTY OWNER Ma++- -S unit M NO:Y Print AP PARCEL ZONINGDISTRICT: Historic District yes Machine Shop Village ye n no 100 year-old structure I ye -q TYP OF IMPROVEMENT PROPOSED USE Residential Non- Residential 11 New Building Xone family 11 Addition El Two or more family El Industrial XWteration No. of units: 11 Commercial 0 Repair, replacement D Assessory Bldg D Others: El Demolition 11 Other f -7Tv=,n� -T 79c I - i lot SY qpp-lbAp- - , - -- main,", V T "t T r 7 RTN sEd bMsc efs I W DESCRIPTION OF WORK TO BE PERFORMED: 4�1e_ CIV—Ck -�-7 (Identification Please Type or Print Clearly) OWNER: Name: r-')aV+ ov,,�A Phone: ') 7�?'- Address: 3(n Fo-, CONTRACTOR Name: C- -S mo -t Phone: 97��-4�09-12-92�, Address: OV�to Supervisor's Construction. License: C 'S:. 7�� Date: —I Home Improvement License: )4T-(�7- 1-3a 13 Exp. Dat I e: -0 2- IZOZ _-_3 ARCH ITECT/ENG IN EER Phone: Address: Reg. No FEE SCHEDULE. BULDINGPERMIT.'$IZOO PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F. Total Project Cosit: $ 3L500 FEE:$_ Check No.: Receipt No.: NOTE: Persons contracting with u(thegistered contractors do not have access to the guarantyfund ,4 9110 I 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 v'Building Permit Application V'Workers Comp Affidavit b -""Photo Copy of H.I.C. And/Or C.S.L. Licenses m -'Copy of Contract Ej 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 Building Permit Application Certified Surveyed Plot Plan., u 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) o Building Permit Application Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses a Workers CompAflidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) a Copy of Contract u Mass check Energy Compliance Report ci 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 of hice 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 raust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi 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 LITE ZATURE: Yes —No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine Doc:.Building Permit Revised 2011 June/mi E ; Plans Submitted F1 Plans Waived F1 Certified Plot Plan El Stamped Plans TYPE OF SEWERAGE DISPOSAL Swimming Pools Public Sewer El Tanning/Massage/Body Art Well El Tobacco Sales El Food Packaging/Sales El Private (septic tank etc. El Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATEAPPROVED PLANNING & DEVELOPMENT El El COMMENT Sinnature CONSERVATION Reviewed on COMMENTS HEALTH Reviewed on qinnature f( e ("POMMENTS Zoning Board of Appeals: Variance, Petition No:__________--7oning Decisionlreceipt submitted yes Planning Board Decision: Comment Conservation Decision: Comm Water & Sewer Connection/ nrivpw2v P--` DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Durnpster on. site yes. Located at 124 Main Street Fire Departrnent signature/date mmi COMMENTS Located 384 Osgood Street no Location —3,�, --I L) -n - No. In T . 11 - Check X -�- &� 25204 Date /1/14 TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost 81,500.00 m -$ $ - $ 978.00 Plumbing Fee $ 122.25 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 122.25 Total fees collected $ 1,322.50 36 Foss Road 747-12 on 4/18/2012 Kitchen Remodel New Contractor as of 5/18/2013 Construction Contract This construction contract (the "Contract"), dated J is by and between the following homeowner(s) and contractor: Homeowner(s): Property address City, State, Zip Contractor: Representative: Address City, State, Zip Telephone Federal Identification Number: Massachusetts License Numbers: Construction Supervisor Home Improvement Dena and Matt Paris 36 Foss Road North Andover, MA 01845 Red Apple Renovations, Inc. Chris Matey, President 206 Andover Street, Unit 10 Andover, MA 01810 978 '409.1293 56-2309042 CS 083511 138132 1.GENERAL In consideration of the mutual promises contained herein, Contractor agrees to perform the following work: furnish all labor, materials, tools, equipment, and supervision to construct or renovate the Homeowner's residence according to this Contract and the following documents (collectively with this Contract, the "Contract Documents"). The project is generally described as Remodel the Kitchen and First Floor (the "Project"). The Contract consists of this document, Exhibit I - General Conditions, Exhibit II The Project, and Exhibit III - The Plans. Change orders and modifications shall be in writing and shall become part of -this Contract. 2. PRICE 4 @- ), 5--(9 0 cz—m -3:? The total projected price for the work agreed upon is -$891,36!5. Payment terms are set out below In Paragraph 6. 3. STARTING AND SUBSTANTIA ETION PROVISIONS The work will 4egig on or 4bout /S- LD -1. The work will be substantially completed on or about '5-Izvla 4. SPECIFIC REQUIREMENTS FOR MATERIALS AND WORKMANSHIP a. This Contract will be completed by the Contractor in a good and workmanlike . manner, using good quality materials. b. If applicable, the Contract price includes the allowances listed in the Contract Details Section. Red Apple Renovations Page 1 S. EXPIRATION OF THIS CONTRACT This Contract will expire thirty (30) days after the date first written above if not accepted in writing by Homeowner and returned to Contractor within that time. 6.PAYMENT a. Timely payment by the Homeowner of all sums due under this Contract is of the essence to this Contract. The part* t the following schedule of payments: !p6 agree o 1. Initial payment: P", 50 (due at time of Co-'ritract signing). 2. Progress payments: The Homeowner will be billed once a contract mil SAO �/is substantially completed. Invoices are due upon receipt. If a design deposit was paid by the homeowner, it will be credited towards the final invoice. Permit Obtained $2,000 Demolition Started $6,50 0 Rough Electrical Work Started Rough Plumbing Work Started Floor Installation Started $7,000 Wall Repair and Installation Started $6,500 Cabinet Installation Started $6,500 Countertop Installation Started $6,000 Paint and Trim Installation Started $5,000 Final Payment $4,935 The Contractor shall provide the Homeowner with his own waiver or cumulative subcontractors' waivers equal to the amount paid for any progress payment. b. The Contractor may cease operations if the Homeowner as required herein does not make any progress payment, and proceed to collect any balance due with any legal remedy. Alternatively, the Contractor may continue operations, as set forth in the attached. 7. SIGNATURE Attached hereto as EXHIBIT I are General Conditions governing the rights and obligations of the parties to this Contract. The parties are further subject to the laws of Massachusetts governing contracts and mechanics' liens, and acknowledge the right of the Contractor to place a lien or security Interest on theproperty of the Homeowner. WITNESS WH5REOF, we have hereunto set our hands and seals this day of qV)U4!-T —, 20 Do OT SIGNIT'HIS CONTRACT.IF THERE ARE ANY BLANK SPACES ,$) Homeowner(s) Contract Homeowner(s The Homeowner may cancel this Contract if it has been signed by the Homeowner at a place other than the office of the Contractor, provided that the Homeowner notifies the Contractor in writing at the Contractor's office by ordinary mail, telegram or personal delivery, not later than the midnight of the third business day following the signing of the Contract. See attached Notice of Cancellation for further explanation of this right. Red Apple Renovations Page 2 EXHIBIT I GENE"L CONDITIONS These General Conditions are part of the Contract between Dena and Matt Paris ("Homeowner") and Red Apple Renpv ions, Inc. ("Contractor") for work at 36 Foss Road, North Andover, MA 01845, dated 1 -.1 1. CONTRACTOR'S DUTIES — GENERAL a. To direct and control the work contracted for in accordance with the terms of this Contract and all applicable codes, laws, and regulations, and as the building permits, if any, issued for this project require. b. To Inspect the site, examine the plans and specifications, If any, and supervise all of Contractor's employees, and to direct the work of all subcontractors selected by Contractor. c. To maintain the work site In a safe and clean condition, to the extent consistent with the Contract. The worksite will be left in a "broom clean" condition. d. To advise the Homeowner promptly if concealed conditions are ascertained which require additional or different work, and to proceed in such event in accordance with this agreement. 2. HOMEOWNER'S DUTIES — GENERAL a. To provide adequate utilities for the work agreed upon. b. To advise the Contractor of any condition of the property which affects Contractor's ability to perform. c. To provide secure storage areas for materials delivered to the work site. d. To execute in a timely manner all permit applications and other documents necessary for the work to proceed. e. To perform no work on the project without a written agreement with the Contractor. f. To avoid interfering with workers. g. To make no agreements with any tradesperson, subcontractor, or Contractor's employee outside the scope of this Contract without the written consent of the Contractor. h. Homeowner shall notify his insurance agent of the execution of this Contract and obtain any necessary Riders to his current coverage or any locally customary forms of coverage. 3. DELAY Contractor shall not be responsible for delays caused by events beyond the control of the Contractor, including but not limited to: strikes, war, acts of God, riots, governmental regulations and restrictions. Delays caused by Homeowner's failure to make allowance materials' selections or caused by the performance by Contractor of additional or necessary work shall likewise be excusable delays. Red Apple Renovations Page 3 4.PERMITS The contractor will obtain the following permits: Town of North Andover Building Permit It is the obligation of the Contractor to secure such permits as the Homeowner's agent. Note: if the Homeowner secures its own permits or deals with unregistered contractors, the Homeowner is excluded from the Guaranty Fund provisions of MGL c. 142A. S. INSURANCE Contractor agrees to maintain all necessary forms of insurance to protect the Homeowner from liability for any occurrence arising from the performance of this Contract. Contractor agrees that he shall cover his own employees for worker's compensation and carry general liability, and that all forms of insurance carried hereunder shall be with reputable companies licensed to do business in this state. Homeowner agrees to carry full coverage on the subject property covering Homeowner's risk of loss during the construction period, together with all special forms required by reason of the performance of this Contract. 6. HIDDEN, CONCEALED and UNFORESEEABLE CONDITIONS The parties agree that in the event Contractor discovers a condition requiring an extra cost that they shall proceed as follows: The Contractor shall notify the Homeowner verbally at once to expedite agreement as to the charge to correct or cure such condition, and provide a written estimate as soon as practicable. The parties must agree to such extra charges, or agree to a resolution method, or this Contract may be canceled by either of them. For purposes of this section, a "hidden, concealed and unforeseeable condition" shall mean a condition not readily observable to a prudent contracto r inspecting the subject property for the purpose of performing this Contract. 7. ADDITIONAL WORK — CHANGE ORDERS Any additional work or materials desired by the Homeowner after the Contract has been signed will be agreed upon In writing or in email and all those additional items will become part of this Contract. Unless otherwise agreed, the cost of all changes to the Contract are payable when the change is agreed to, either in writing or by email. Failure of the homeowner to sign a change order shall not preclude recovery for the same by the Contractor, and acceptance of said additional work or materials shall be presumed unless there is written notice to the contrary. Contractor shall advise Homeowner at the time of agreement on any additional work as the any additional time required to perform this Contract. S. TERMINATION and CANCELLATION Contractor shall have the right to stop all work on the project and keep the job idle if payments are not made to Contractor in accordance with the payment schedule set forth above, or if Homeowner repeatedly fails or refuses to furnish Contractor with access to the job site or product selections or information necessary for the advancement of the work. Simultaneous with stopping work on the project, Contractor shall give Homeowner written notice of the nature of Homeowner's default. If work is stopped due to any of the above reasons (or for any other material breach of Contract by Homeowner) for a period of seven (7) days after notice, and the Homeowner has failed to cure the default, then Contractor may, without prejudicing any other remedies Contractor may have, give written notice of termination of the Contract to Homeowner and demand payment for all completed work and materials ordered through the date of work stoppage, and any other loss sustained by Contractor, including the balance of the Contract. Thereafter, Contractor is relieved from all other Red Apple Renovations Page'4 contractual duties. Upon such termination, the Contractor shall have all remedies provided by law, including such lien rights as then apply. The Homeowner may terminate this Contract upon the following conditions: a. Any other failure to perform this Contract required by the terms of this Contract. c. No termination shall be effective unless 10 days notice of Homeowner's intent are given as provided below, during which time the default may be cured by the Contractor. 9. DISPUTE RESOLUTION AND ATTORNEYS' FEES a. Dispute Resolution. The Contractor and the Homeowner hereby mutually agree in advance that in the event that 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 Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitratio_n-,as provided in M.G.L. c. 142A. Homeowner: Homeow NOTIC9: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not signed separately by the parties. b. Small Claims Court. Any controversy or claim arising out of or related to this Contract involving an amount of less than $2,500.00 (or the maximum limit of the court) must be heard in the Small Claims Division of the District Court in Essex County. c. Attorneys' Fees. In the event of any litigation between the parties relating to this Contract, the party against whom any adverse final judgment is entered (as specifically determined by the Court), following the expiration or exhaustion of all appeals, shall reimburse the other party for such party's costs and expenses (including, without limitation, all reasonable attorneys' fees, expenses and disbursements) of such litigation. d. Inquiries Regarding Contractor. All home improvement contractors and subcontractors shall be registered and that any inquiries regarding a contractor or subcontractor relating to a registration should be directed to: Registration Division, Program Coordinator One Ashburton Place, Room 1301 Boston, MA 02108 Tel:. (617) 727-3000 ext. 25239 10. WARRANTIES a. The work of the Contractor, including materials and labor, shall be guaranteed for a period of three (3) years during which period Contractor shall at Its own expense correct any defect arising from Its work unless Paragraph 7 of these General Conditions applies. This provision is in lieu of all other warranties, express or implied, Red Apple Renovations Page 5 and Homeowner has no action at law or in equity against the Homeowner after said date. b. Any and all warranties for appliances or mechanical systems shall be delivered to Homeowner when Contractor's final payment is received. c. Notwithstanding any manufacturer's warranty of any component, appliance, or system, no action may be brought against the Contractor on this contract, for the performance of this work, except as provided above. 11.0THERITEMS a. The Contractor may place a- trash container, commonly called a dumpster, on your property during the course of the project. The Contractor will make every effort to locate the dumpster in a location that is convenient for the Homeowner. The Contractor is not responsible for any damage to your lawn or driveway caused by the delivery or removal of the dumpster. b. The Contractor may place a portable restroom on your property during the course of the project. The Contractor will make every effort to locate the portable restroorn in a location that is convenient for the Homeowner. The Contractor is not responsible for any damage to your lawn or driveway caused by the delivery or removal of the portable restroom. c. The Contractor may place a lawn sign on your property during the course of the project. The Homeowner will notify the Contractor of any objections to the sign being placed prior to the start of the project. d. By signing this contract, you are giving Red Apple Renovations permission to use video footage or photographs of your project for internal use as well as use on our web site and other forms of advertising. The street address of your home as well as any video footage or photographs of you or your family will not be used unless you give separate explicit permission. e. Red Apple Renovations places orders for the materials required for your project in the way that is most efficient for your project. In some cases, the cost of an item may increase in the time between contract signing and ordering the item. If this occurs, the Homeowner will be informed of the change in price and can choose to approve the additional cost or select an alternate item. Also, In some cases, an item may no longer be available in the time between contract signing and ordering the item. If this occurs, the Homeowner will be informed and can select an alternate item. Red Apple Renovations is not responsible for any changes in the cost or availability of an item between contract signing and the time the item is ordered. f. During the course of the project, Red Apple Renovations may send you documents to sign via electronic signature. You will have the opportunity to review these documents prior to signature as well as to review the terms of the electronic signature process. The Homeowner agrees that any documents signed by a electronic signature are valid as If they were signed by a handwritten signature. 12. NOTICES Notices may be sent to either party at the addresses shown above, or mailed by certified or registered mail, Any mailed notice shall be deemed given as of the date of mailing. 13. SEVERABILITY If any portion of this agreement Is found Invalid or unenforceable by any court, the remaining provisions shall remain in force between the parties. 14. ENTIRE AGREEMENT This Contract consists of the documents defined above, and constitutes the entire agreement of the parties. It can be modified only by a written document. Red Apple Renovations Page 6 NOTICE OF CANCELLATION You may cancel this Contract, without penalty or obligation, within three (3) business days from the date this Contract is fully executed. If you cancel, any property traded in, any payments made by you under the Contract, 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 Contract will be cancelled. 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 Contractor'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 Contractor, 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 of the Contract. To cancel the Contract, mail or deliver a signed or dated copy of this Cancellation Notice or any other written notice, or send a telegram to RED APPLE RENOVATIONS at 206 ANDOVER STREET, UNIT 10, ANDOVER, MASSACHUSE77S 01810 not later than midnight of the third (3 rd ) business day after the execution of the Contract. I HEREBY CANCEL THISCONTRACT. Date: Homeowner: Massachusetts's law requires that all home improvement contracts contain two notices of cancellation. If you do not intend to cancel this contract, please do not sign this page. Red Apple Renovations Page 7 NOTICE OF CANCELLATION You may cancel this Contract, without penalty or obligation, within three (3) business days from the date this Contract is fully executed. If you cancel, any property traded in, any payments made by you under the Contract, 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 Contract will be cancelled. 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 Contractor'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 Contractor, 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 of the Contract. To cancel the Contract, mail or deliver a signed or dated copy of this Cancellation Notice or any other written notice, or send a telegram to RED APPLE RENOVATIONS at 206 ANDOVER STREET, UNIT 10, ANDOVER, MASSACHUSETTS 01810 not later than midnight of the third (3 rd ) business day after the execution of the Contract. I HEREBY CANCEL THIS CONTRACT. Date: Homeowner: Massachusetts's law requires that all home improvement contracts contain two notices of cancellation. If you do not intend to cancel this contract, please do not sign this page. Red Apple Renovations Page 8 IBM* P_� vLL:JDV_AFJPL R E N 0 V A T 1 0 N1 Exhibit 11 -The Project The following work will be done. Overall • Obtain all necessary Town of North Andover building permits and oversee all required inspections. • The job site will be broom clean at the end of each day. • A portable restroom will be on-site during the project for use by the construction team. A dumpster will be on site for the duration of the project for the disposal of construction debris, Demolition • Install dust protection and floor protection as needed to separate the construction area from the rest of the house and to protect the floors. • Remove all cabinets, countertops, fixtures and appliances from the kitchen and first floor bathroom. • Selective demolition of the walls and ceiling will be performed as required. • All debris from Red Apple Renovations projects is currently recycled in accordance with LEED (Leadership in Energy and Environmental Design) standards. Heating 0 Relocate existing heating as needed. Red Apple Renovations Page 9 Rough Plumbing and Electrical • Install new water and waste lines to support the new location of the first floor half bathroom. • Install new wiring to support the lighting and electrical plan for the kitchen and first floor half bath. • This contract includes the installation of eleven new recessed lights in the kitchen. • This contract also includes the installation of one vanity light and one bathroom fan in the half bathroom. This contract includes an allowance of $200 for a vanity light. Windows & Doors • Install new windows in the dining room and living room as shown on the plans. The windows will be double hung windows to match the size and type of the existing windows. • The door to the closet across from the existing half bathroom will be removed and reinstalled to reverse the swing of the door. Walls • Patch and repair the walls and ceiling as needed. • Install a smooth surface of plaster over the ceilings in the family room, front hallway and living room. • The new ceilings in the kitchen, dining room and bathroom will be made smooth. Kitchen • Remove and dispose of the existing tile floor in the kitchen. • Install new cabinets in the kitchen. This contract contains an allowance of $15,650 for new cabinets. The final cost of the cabinets will depend on the material, finish and layout of the cabinets. Red Apple Renovations Page 10 Install a new countertop. This contract contains an allowance of $5,000 for new countertop material. The final cost of the countertop will depend on the type of material, backsplash height and edge detail selected by the homeowner. • Install and vent new appliances as needed. • This contract does not include the cost of new appliances. • The exhaust from the vent fan for the over the range microwave or range hood will be vented to the outside. • Install a new sink and faucet. This contract contains an allowance of $750 for a new sink, faucet and garbage disposal. Bathroom • Reinstall the existing fixtures from the existing half bathroom into the new half bathroom. • Install a new tile floor in the bathroom. • The tile will be installed on top of one-fourth inch cement board mortared and nailed to the existing subfloor. • This contract includes an allowance of $350 for new floor tile and grout. Flooring • Patch in flooring in the rest of the first floor as needed. • Finish or refinish all hardwood flooring on the first floor with two coats of polyurethane in a satin finish. Paint & Trim Install new paint -grade door, window and baseboard trim in the project area where needed to match the existing trim. Paint all new interior walls and trim in the project area with one coat of primer and two coats of finish paint in colors selected by the homeowner. Red Apple Renovations Page 11 Client#: 237039 REDAPPLERE ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDNYYY) 1 1/18/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS '--�ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES -LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED --4iPRESENTATIVE 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 HUB International New England 299 Ballardvale St CONTACT NAME: Certificate Department HONE JFAXC A/C, No, Ext): 978 661-6600 'V , No): 866-475-7959 E-MAIL ADDRESS: nee.certificates@hubinternational.com IINSURER Wilmington, MA 01887 978 657-5100 INSURER(S) AFFORDING COVERAGE NAIC # A: Selective Insurance Company of 19259 INSURED INSURER B: Associated Industries of MA Red Apple Renovations, Inc. 206 Andover Street, Suite 10 Andover, MA 01810 INSURER C: INSURER D: INSURER E: INSURER F: �J $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MWDDNYYY) POLICY EXP (MWDDNYYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1FW_1 A I OCCUR S1929031 D3/25/2011 03/25/2012 EACH OCCURRENCE $1,000,000 RENTED RAW%1R?E..cc"'.nc.) $100 1 000 MED EXP (Anyone person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY F] JECT 7] LOC PRODUCTS - COMP/OP AGG s3,000,000 $ AUTOMOBILE X LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS A9092834 D3/25/2011 03/25/2012 COMBINED SINGLE LIMIT accident) $1,000,000 (E., BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERT AMAGE (Per . , d en to) $ $ UMBRELLA LAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERVILIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECU111 N i OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If Ins r Vex ibe under D RIPTION OF OPERATIONS below N/A WMZ8006243012011 D6/0&2011 06/08/2012 WC STATU- CTH- TQRY Ll ER MITS I I - E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEE $100,000 E.L. DISEASE - POLICY LIMIT s5OO,OOO DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Plumbing and electrical work done for Matt & Dena Paris, 36 Foss Road,North Andover, MA 01845 as additional insured as respects to general liability when required by written contract. For carpentry, plumbing and electrical work. 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 Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE *ZV4401 .9 czo-- @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of I The ACORD name and logo are registered marks of ACORD #S645869/M609167 KKO05 -Imbfis- %Lv-sachtisetts - Depailment of PlIblic Silret, vBoNlrd tot' Btjildinu Regtdation% and Stim(l.,11-ds I Construction Su�;rvisor License License: CS 83511 CHRISTOPHER J MATEY 32 WASHINGTON AVE ANDOVER, MA 01810 Expiration: 10/28/2012 Tr#: 6065 '7' Office of Consumer Affairs and Ausiness Regulation 1 -6- �n 10 Park Plaza --Suite 5 170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 138132 Tvpe: Private Corporation Expiration: 2/20/2013 Tr# 208672 RED APPLE RENOVATIONS, INC. CHRIS MATEY 32 WASHINGTON AVE. ANDOVER, MA bi8lo Update Address and return card. Mark reason for change. E! Address L7 Renewal [-j Employment 7 Lost Card DPS-CA1 0 50M -04/04-G101216 Office License or registration valid for individul use only before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR 71, ---Registration: 138132 Type: Office of Consumer Affairs and Business Regulation Expiration: 2/20/2013 Private Corporation 10 Park Plaza - Suite 5170 F=7 Boston, MA 02116 f��PLE RENOVATIONS, INC. CHRIS MATEY 32 WASHINGTON AVE. ANDOVER, MA 01810 Undersecretary Nf5t,611d ithoti attire C0f0jAj'i0NWE&,.TH OF hAASSACHUS'El.—Irs I "� 0 W ' I �51M Ml� �'PARDRR ME mo. LICENSED AS A MASTER PLUMBER T'fiE ABOVE 1 7c JOHN J MYTYCH JR Rt \4 18 DOBSON STREET WILMINGTON MA 01887-181 12583 05/01/12 780831 COtOMON�A[EALTH OFIMASSACHUSET,rs RIMP. I ENDS T.0% UNP -M-1 LICENSED AS A JOURNEYMAN PLU tB 1,S'S � J E " TI i F. A b 0 V F. f � I (, ENS E TO: JOHN J MYTYCH JR 18 DOBSON STREET WILMINGTON MA 01887-181 24475 05/01/12 78083-2 The Commonweauh ofmassachusetts Department oflndustridlAceide�ts Office of Investigations 600 Washington Street Boston, MA o2_1.11 www-mass-govldia W01rkers' Compensation Insurance Affidavit: Buflders/Contractors/_Electriciansfriumbers Inliefinf Y1Mfnrr..4-;__ Name (Business/Organizatiozgndividual): Address: 2(06 6,_1Gk,0 -SA_,c__e j.,p QX M City/State/Z`i.p:.Ar.,J,��,j-,e� /tM- () 10 Phone #: 11 L 12- 9 ��!s I Are you an employer? Check the appropriate box: 1 .;41 am a employer with 7-5— 4. El I am a general contractor and I employees (full and/or part-time).* 2.0 1 am a sole proprietor or have hired the sub -contractors listed partner- on the attached shget. ship and have no employees These sub -contractors have working for me in any capacity. [NO workers comp. msurance workers' comp. insurance. 5. El We ate a corporation and its required.] 3.0 1 am a homeowner doing Officers have exercisedtheir 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 renifired J Type of project (required): 6. E] Now construction 7. ORem.odelig 8. El l5emblition 9. El Building addition 10. El Electrical repairs or additions li-ElPlumbingiepairs or additions 12.E] Roofrepairs 13.0 other !Any applicant that checks box #1 must also fill out the section below showing their _J L workers' compensation policy infbrm�tion. 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' WHIP. Policy information. lam an employer thatisproviding w 0'TkeWcOmpensation iftsuranceformy employees. Below is thepollcy and bsife inforinatioll. jo Insurance Company CP M, A Policy # Or Self -ins. Lie. #* I I _1 Expiration Date: 0 6 .2 - Job Site Address: �51 21acl� City/State/Zip: Attach a copy of the workers, compensation Policy declaration page (showing the policy Failure to secure coverage as number and expirati date), -required uhder Section 25A of MGL c. 152 can lead to the imposition of criminal penaltliles of a fmc UP to $1,500.00 and/or one-year finprisonment, as we as civil Pe alties fo of a TOP Wo ORDER and a fine - Beadvise'd that a copy of this statement may be forwarded to the Office ok Of up to $250.00 a day against the viorlator 11 n 'a the IM S RK Investigations of the DIA for insurance coverage verification. I'do hereby certify u d eriury thatthe infoTmationprovided above is true andcorrect. SiRnature: Official use only. 3 Do not Write.in this area, to he completedby elly Or to WN official G'11 1 -7 / 2 City or Town: FermitfLicense # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 6. Other 4. Electrical Inspector 5. Plumbing Inspector Contact Person: Phone 4: 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, orA 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 ajoint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartiments and who resides therein, or the occupant of the dwelling house o . f another who employs persons to do maintertance, construction or repair work on such dwelling house or on . the grounds or building appurtenant thereto shall not because Of such employment be cl�eemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall'withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence Of compliance with the insuranc6 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 perforniance ofpublic work until acceptable evidence of com�liauce with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary� supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of - insurance. Limited Liability Companies (LLQ or Limited Liability Partnerships (LLP) with no emp oyee o er th members or partners, are not required to ca I s th than e rrY workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of In'dustrial Accidents for confumationof *insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any qyestions rega�ding the law or if you are required to obtain a workers' compensation policy.;please call the Depahment at the number listed below. Self-insured companies should enter their ,self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete, and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.' Please be sure to fill in the permit/license number which will be used as a referencd number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current Policy information (ifnecessary) and under "Job Site Address" the applicant should write "all locations in ____�_(city or town)." A copy of the affidavit that has been *officially stamped or marked by the city or town may be pro vided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A now affidavit mustb'o filled out each year. Where a home owner or citizen is obtaining a license or permit not related tor any business or commercial venture (i.e. a dog license or permit to bum leaves etc) said person is NOT required to complete this affiddvit. The Office of Investigations would like to thank you*in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. 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