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Home My WebLink AboutBuilding Permit #740-2017 - 372 MAIN STREET 1/26/2017BUILDING PERMIT vl T 0 WN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION' Permit No#: Date Received �) TYPE OF IMPROVEMENT USE -PROPOSED Residential Non- Residential 0 New Building 0 One family 0 Addition 0 Two or more family 0 Industrial ;Iteration No. of units: El Commercial 0 Repair, replacement El Assessory Bldg El Others: 11 Demolition El Other IJ F b�d'�iain t b VV5 tersho is riat (Nater /Sewer /86 "Ji, T, DESCRIPTION UI- VVUXK I U tit Vt=MrUM1V1r-LJ- , 01//oOdL- _jaentificati ,on - Please Type or Print Clearly' 4 ren - , 7" I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12,00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. 'O00000000� Total Project Cost: $ FEE: $ Check No.: Receipt No,, 3 N 7 (o NOTE: Persons �contracting with unregistered contractors do not have.- access to the marantypAd ---- --- -- - F. SigRqtqr6 of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ .T 13 SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On COMMENTS Signature CONSERVATION Reviewed on Sianature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes 6 Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT'- Temp Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS Located 384 Osgood Street no -)imension 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.$10041000 fine Doc.Building Permit Revised 2014 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 ❑ 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/Cross Section/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 act ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 40TE: 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 l_J Doc: Building Permit Revised 2014 Location -7X M A (!y No. 7,/ a 01-7 Check # xv X1476 Date C TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ f � i Building Inspector < C = - p 2) _ N -0 Cn C y CD • O CD n • _ CD m 5 � O rt�.+c x_ z O =; - c O to a; 'm• -n C ,Y 0 0. F Q �. m 3 Cl) W c�N O —1 �' �• CD ON 2 0 Q2) % -1 > 1 O CO)0.O n U)O to to U) p !v O O O nW: � `'i Z � C coE. `D � .0� �, y � CD O � Z -a o c� MCAcc 0 Q= c z �. cam. _ O a - OX rn =y �� ww>. CD U) ty Z y Q c g %e C7 < CD o TomCD CO) < CL cC _CD CD CDcr Z-1 Z �-iCD o%Z5ai c�o� h CD Q.pN 0 CD c� tea. �0 O '� •� T ^) f^ CD CD mw CD p CD CA � s c�D o c z. = s O c) > C C CD z :a) CD O -v : a) C 0CD � rt p: o CL N p V1 (D rD OZ co C 3 T m DH z T O D) ;Q O . C- N T j Dl (A O ;a O C m m A r z T O DJ x O C C W M M O Ol S ;a O C T O i O � C p Z m m N (D '6 N (D 3 T O O L S po °v OT m I 1 �-,qm efvd,6 i"avd-'Can6bu.tctic+n PROPOSAL Tom Licciardello 374 Main Street North Andover, MA 01845 tomlicc(r'gtnail.com (C) 978-502-1212 November 16, 2016. . First Floor Bathroom Remodel Work to be. included includes: • Acquire Building Permit • Complete gut of bathroom. • Complete all required plumbing. • Complete all electrical. • Install vanity. • Install medicine cabinet. • Install. acrylic Shower Base. • Install DenseShield Tile board on shower walls. • Install tile on shower walls. • Install new blueboard and plaster. • Install DenseShield tile board on floor. • Install new tile floor. • Install new trim. • Install new toilet paper holder, towel bars. • Paint Bathroom. • Removal of all debris. TOTAL LABOR AND MATERIAL $13,950.00 Note: This quote does not include any plumbing fixtures, tiles, grout. Terms: S 4,650.00 upon signing of contract (not to exceed 1/3 of contract price) $ 4,650.00 after plastering S 4,650.00 when job complete Submitted By: Chris Rivet MA Lic #CS072173 HIC #139962 207 Winter Street (C) 508-265-3115 (H) 978-794-1165 North Andover, MA 01845 All Home Improvement Contractors shall be registered.. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor. Homeowners who obtain their own permits are excluded from access to the Guarantee Fund ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Paymeio will be ma a as outlined above. Date It Zcr c Homeowner Signature Date Contractor Signature Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action (as an alternative to court action) if they have a dispute with a contractor. The same right is not automatically afforded to a contractor, however. The contractor would have to resolve any dispute helshe has with a homeowner in court unless both parties agree to the optional clause Provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a this contract, the contractor may submit the dispute to a private arbitration firm whic has approved t Executive Office of Consumer Affairs and BusinP s Regulation and the consum all requo su as prided in Maphusetts General Laws, Chapter 142A. t� Homeowner's Signature ute concerning I Secretary of the to such arbitration Contractor's Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner`s Rights A homeowner's rights under the Home Improvement Contractor Law (MGL Chapter 142A) and other consumer protection laws (i.e. MGL Chapter 93A) may not be waived in any way, even by agreement. However, homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts cant' 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). Eaecntion of Contract The contract must be executed in du licate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of the contract, and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However, in instances where a contractor deems him/herself to be financially insecure, the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights, or if you wish to obtain a free copy of "A Consumer Guide to the Home Improvement Contractor Law", contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787 or (888) 283-3757 --f— �i-f- lc i TC t -4-E- rJ 1'r.COD2- a C" rT arc r1 s Sad 1Y S w f< +V i✓ 1—t- a i-� VVI u C of L'i H A v 2,61 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organizadon/lndividual):, Address: .0 7 .�Illf 4: S, `' Are you an employer? Check the appropriate box: 1. ❑ I am a employer -with 4• ❑ I am a general contractor and I �, ployees (full and/or part-time).* E I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance, required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] have hired the sub -contractors listed on the attached sheet These sub -contractors have employees and have workers' comp. ius rance $ . 5. E] We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance rectuired.l Type*of project (required): 6. ❑ew construction 7.. Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roofrepairs 13.❑ Other - *Any applicant that checks box #1 must also fill out the section below showing their worker' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and Then hue outside contractors must submit a new affidavit indicating sueh 'Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractor; have employees, they must provide their workers' comp. policy number. I am an employer that isproviding workers' compensation insurance for my employees. Below is thepolicy andjob site information- instn ince Company Policy # or Self -ins. Lic. #: �O �� t:�' d :� ',�' f Expiration Date: Job Site Address: 3 7 sew//Vf City/State/Zip: /U®. 4001/g 11HAttach 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 u pains penalises of perjury that the information provided abpve is oe and correct / S e: Date: tt�har � r Phone #: 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 #: The Commonwealth of Massachusetts Department of Industrial Accuients Office of Investigations 600 Washington Street Boston, MA 02111 ' tl, WwwMass govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organizadon/lndividual):, Address: .0 7 .�Illf 4: S, `' Are you an employer? Check the appropriate box: 1. ❑ I am a employer -with 4• ❑ I am a general contractor and I �, ployees (full and/or part-time).* E I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance, required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] have hired the sub -contractors listed on the attached sheet These sub -contractors have employees and have workers' comp. ius rance $ . 5. E] We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance rectuired.l Type*of project (required): 6. ❑ew construction 7.. Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roofrepairs 13.❑ Other - *Any applicant that checks box #1 must also fill out the section below showing their worker' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and Then hue outside contractors must submit a new affidavit indicating sueh 'Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractor; have employees, they must provide their workers' comp. policy number. I am an employer that isproviding workers' compensation insurance for my employees. Below is thepolicy andjob site information- instn ince Company Policy # or Self -ins. Lic. #: �O �� t:�' d :� ',�' f Expiration Date: Job Site Address: 3 7 sew//Vf City/State/Zip: /U®. 4001/g 11HAttach 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 u pains penalises of perjury that the information provided abpve is oe and correct / S e: Date: tt�har � r Phone #: 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 #: OP ID: GOGL ACRO" CERTIFICATE OF LIABILITY INSURANCE DAog/1 /DDIYYYY) 09/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 Phone: 978-688-6921 Macdonald & Pangione Insurance 104 Main Street Fax: 978-688-5350 North Andover, MA 01845 Michael Pangione NAMEACT Kim Landry PHONE o .978-688-6921 FAX No): 978-688-5350 E-MAIL ADDRESS: KIM@mpins.net PRODUCER CUSTOMER ID g; CHRIS -5 INSURER(S) AFFORDING COVERAGE NAIC S INSURED Christopher Rivet 207 Winter St. North Andover, MA 01845 INSURER A: Preferred Mutual Ins Co 15024 INSURER 8: .INSURER C : INSURER D: INSURER E : INSURER F: COVERAGES CFRTIFICATF NIIIIARFR- Dc11101fUl wu 111ADCO. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INILKM DL UBR POLICY NUMBER EFF POLICY POLICY YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY --I OCCURMED CLAIMS MADE BOP 0100719749 09/26/2016 09/26/2017 _U PREMISES Ea occurrence $ 100,000 EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 hGE'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY JFCT PRO LOC $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ — BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ HIRED AUTOS $ NON -OWNED AUTOS $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATIONWC STATU- 10E ANYEMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? N/A TOR LIMITS ER E.LEACHACCIDENT $ _ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ E°vE5C IPTION OF PE AT10NS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) I ence 0� �nsu ranee Town of North Andover 1600 Osgood St No Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD « Massachusetts Department of Public'Safety Board of Building Regulations and Standards License: CS -072173 Construction Supervisor CHRISTOPHER F RIVET 207 WINTER ST N ANDOVER MA 01845 ' • `t ��./►L^^^ CA_—Expiration: commissioner 06/02/2018 � �c �na.na�rzarrruecrlf,/% af'C/%/�r�sac�rtsell; . Office of Consumer Affairs & Business Regulation - OME IMPROVEMENT CONTRACTOR Registration:139962 Type: Expiration; 918/01:7: Individual CHRISTOPHER F. RIVET-- CHRISTOPHER IVET 4CHRISTOPHER RIVET 207 WINTER ST. N. ANDOVER, MA 01845 �.,.; ;•. '�'='`"'r_ius Undersecretary h 0