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HomeMy WebLinkAboutBuilding Permit #002-12 - 374 SHARPNERS POND ROAD 7/1/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ( � Date Received f Date Issued: 7 IMPORTANT:Applicant must complete all items on this page LOCATION -3r74 S o zs Po PcL PROPERTY OWNER J rn f-' OL Print MAP NO: r{ .�PARCEL: 00A ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family KAddition 11 Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other t®Sephcy D Well �. D.Flood"Iairi- ❑'Wetlands ' 'Wafershed;�D str ct m ❑Wa_t_er/Sewer _ DESCRIPTION OF WORK TO BE PERFORMED. ki�c1�Q^n�d�hi nG r®erm ao1r�►�-���m /re M c�e1 , remau&--I e M4 - �,�h Identification Please Type or Print Clearly) OWNER: Name: ack m e C, tea.9-c) Phone:q 1 ��- \_ Address: �� � �-YIC�'�-T��=�� ' \d YW CONTRACTOR Name: �1 G1 (' _�� ►�'1 ll C)Y15� Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: 0 �-Q Exp. Date: �O ARCHITECT/ENGINEER-al vzry&i- � Arclit -G�,s -_ Phone: (�(�`� SJ9 LHS Address: aaL� Nc,,A-54 0n,Y Sig 1,14-0 DO N l 030;eg. No. K:21 FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9 .00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ O flOqEE: $ 6 O Check No.: Receipt No.: 3 3 NOTE: Persons contra c ' with u registered contractors do not have access to the guaranty fund Signature of Agent/Ovvne = Signature: -- - - - ------ "-- - -- i Plans Submitted 5( Plans Waived ❑ Certified Plot Plan R- Stamped Plans FPublic WERAGE DISPOSAL ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ ❑ Tobacco Sales ❑ Food Packaging/Sales ❑c tank,etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on d Signature A64, f' COMMENTS ji / S HEALTH Reviewed on 3 Si nature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp p on Dum ster 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.$10041000 fine NOTES and DATA-- For department use ® Notified for pickup - Date Doc:.Building Permit Revised 2009 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 �2�euilding Permit Application orkers 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: II dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks �/BL ' ding Permit Application ed Surveyed Plot Plan kers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses ❑ C y Of Contract Floor/Crosse ction/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) :�4ngisneering check Energy Compliance Report (If Applicable) Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc-Building Permit Revised 2008mi Location 2 7 '� No. 0�2 /2- Date NORT1y TOWN OF NORTH ANDOVER � A + ; ; Certificate of Occupancy $ CNUSE<�' Building/Frame Permit Fee $ ,• Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #1 ' 24. J ;jJ Building Inspector NORTH Tovm Of 0x1n No. .�,_. -7 zzzt dover, Mass., 0 LAKE Ai I� COCHICHEWICK y�. %ps RAT E D P � 7 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System L" ". � BUILDING INSPECTOR THISCERTIFIES THAT............................................................................................................................................................... Foundation has permission to erect........................................ buildings on .3.74/......�/. .o..�' .moi ��"... ........ Rough to be occupied as.... .............................................................. Chimney provided that the person accepting this permit shall in every respe conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ......... ...... . .. ... .....�...,.�.�................. .... ................ Service UILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIR_ E-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Office of Consumer Affairs&Business Regulation — s HOME IMPROVEMENT CONTRACTOR Registration:;- 156364 Type: .' Expiration:--.-'-6/25/20-1-3 DBA 1 K&R CONSTRUGTIQN' SHAWN FALES 34 EVERGREEN ROAD- STONEHAM, MA 02180- Undersecretary ' T A,11i/111�ilUlllll) i Z lOZ/6Z/8 IIdx3 1 WSO HN `NOSNIAIV 3AV LW3(3VOV 9t' r� S3l`d=l NMdHS 9SU3ij1 I;1O51nJadn$ UOgfihJaSUO3, ) :�t.il:Itu,.}5.j,ur. �uoi11'•tt1,;�� ;iitlpt�na J u:partt9 � i '� .2:�JrS <<gis� }u iu,..,�„�It_,� - �11��nt��t:��►;1�, j lillA i'�U Diu i e oz'bd w S IA4(�! 1 L� I: G. :' I. 1{, 2 1 '• 1 1:\ OUR,Y$ OR,Y, HOME 1:9PROVENNENT CONTPACTO. 1 ” �^ tl L.41p1 ti6;� ; ! 1 e n to i _ � ' i.it=l1 01 l3tiil�' od.{ev li a ..tl,�t n,:arcls ReGistration: '156364 (}I,e`.�alt'�ui tpn,f'licc ,.1:, 131,1 Expiration: 6/25/2011 Tr# 28!15Q B tau,. 1a.02108 F- ; Type: DBA K&R CONSTRUOTION SF:,'WV'q FALES'�,- -- 34 EVE;-G,.EE N ROAD _ Gam--�,��, _ - ---• . � , I STONEHA!JI,,-MA 02100' :ral..a l:1S:Y.It: In ormation and Instrnetions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more ofthe foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity, -flPloYeas. Ho owner of a dwelling house having not more than three apartinents and who resides therein,or�the occupant ofther the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or-on the grounds or building appurtenant thereto shall not because of such employment be.;deeined to bean employer." MGL chapter 152,§25C(6)also states that"every state or local Iicensing 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 insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation'affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)naine(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confinnation of 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,questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Oficials Please be sure that the affidavit is complete and printed legibly. The Deparhnent 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 perinit/lieensenumber which will be used as a reference number. In addition,an applicant that must submit inultiple permit/license applications in.any given year,need only submit one affidavit indicating current policy information(if necessary)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 provided to the applicant as proofthat a valid affidavit is on file for future pen-nits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or pen-nit not related to any business or cornmercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. 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. The Department's address,telephone and fax number: The Commonwealt Of Massachusetts DTartment of Industrial.Accidents Office of Investigations 600 Washington Street Boston,ISA 02111 Tel.#617-727-4900 ext 406 or 1-877 MASSAFE Revised 5-26-05 Fax#617-727 7749- www mass.gov#dia • The Commonwealth of Massachusetts Department oflndustrialAccidents '� "` , It Office of Investigations '� :1 •�u 600 Washington Street r t3uBOSton,MA 02111 www.mass gov/dra Workers' Compensation Insurance Affidavit:Builders/Contractor•s/FIectricians/Piumbers A.ppEcant Information . Please Print Legibly Name(Business/organization/fndividual): k "r I 1 r an S�^UC--01 Address: 3 q •�JP� t-��°h AACity/State/Zip: Sfcm e I c_y n (,11-� 0 kI Whone#: 7D -9 S5`39 16 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2.9 Iain a sole proprietor or partner- listed on the attached sheet.t 7. F1Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance, g. JABuilding addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 ain a homeowner doing all work right of exemption per MGL - 11.0 Plumbing repairs or additions myself.[No workers'comp. c. 1,52,§1(4),and we have no 12.[]Roofrepairs " insurance required.]T employees.[No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box#1 must also,fill out the section below showingtheir workers'compensation policy information. t Homeowners who submit this affidavit indicating they ate doing all work and thep hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors acid their workers'comp.policy information. f am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: I i° .sq-ri Policy#or Self-ins.Lic.#: C '¢•fit;H ] 55 Expiration Date: Job Site Address: 13 211 L5 ha r r)�,oy16'S Pd nA B�A City/State/Zip:1V, An km Gr- Q/RL-S Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL,c.-152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby Geri fy under the pains and penalties ofperjury that the information provided above is true and correct.' Signature: 41M, O ( Date: (L>17111 Phone#: 4 3 f� —34 F FFPerson: only. Do not write in.this area,to be completed by city or town official. n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: t=ax:17814385028 Oct 18 2010 10:12 ACORQ. CERTIFICATE OF LIABILITY INSURANCE 10/18/2010 ig/istzo><a � T1418 CER7IFICATS IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEFL,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BV 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 GeRifoat0 holder is on ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the temts and conditions of the policy,Certain policies may require an endorsement. A statement on this cer(tfirate does not confer rights t0 the certlficste holder In lieu of such 4ndorvement s. rrOD000R CONTACT NAM- New England Heritage Insurance Agency Group, Inc. M r.*781.438.5000 Arc No.781.438.5028 335 Main Street ADDRESS; Stoneham, NIA 02180 MIMID*k INSU B A"ORDING COVERAGENALCO IN3UM ;NBURERA: TRAVELERS INSURANCE 10038 K & R Construction INSURERS: Granite State 1000111 DBA: Richard & Shawn Fales INSURER C: 34 Evergreen Road INSURER D: Stoneham, MA 02180 Iia, i� un;F COVERAGES CERTIPICATE NUMBER:Master 10 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO T4E INSURED NAMED ABOVE FOk 7r.E POLICY PERIOD INDICATED. NOY'NITHSTANDING ANY PEQUIREMENT,TERM OR CONDITION-OF ANY CONTRACT OR OTHER DOCUMENT WITH P.ESPECT TO WHICH THIS CERTIFICATE MAY LE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$SUBJECT 0 AU_THE TERLS$, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAI BEEN REDUCED BY PAID CLAIMS. "LTR EFF TYPE OF INSURANCE INSR WVD I POLICY NUMBER NAVPOLA MD Y ! umft XGENERAL LIABILITY 680-3979M40 0711812010107118/2011 I EACHOCCURRENOE .s 1,000.0 I C0L4AASRCIAl GENERAL LIASILnY i I nomj B 3110,0 cuvn a Ex-J occuRI MoD D(P t"ane tenon! s ?0.0 A ` I I PERSONAL&AD'V INJURY $ 1 000 ID0 GENeRAL AGGREGATE ;S 2,000,00( 3EteL A()GKE3Ar1E LIMIY.APPLIEB FFft; I FRODUCTE•COMF;OrAGG 8 2.000100 POLICY� 11 SGT I LOC E AUTOMOBILE LIABILITY COMSINEDSINGLE LIMIT (Es Seeder $ 1 ANY AUTO i BODILY INJURY(Perpefson) t. ALL O1WNr.D AUTOS BODILYINJURY(Perscoded) S SGNEDULED AUTOS PROPERTY DAMAGE (f�11 HIRED AUT09 (Pet 9cd0ent) s {NO"WHEDAUTOS I I 6 r UIUBRELLAUAB OCCUR I EACHOOCURRENGE 13 EXCESS LIAR GLAIM"AOE AGGREGATE Sr DEDUCTIBLE ! ! S - RMNTION € I 1 I s oRRrrt caMPeNsa WC 743541 08!27/2090 08!27/2091SAT - H AND EMPLOYERS'LIABILITY YIN I D1ER �ANYPROPRICrOPPARTNEWEXECUTIVEIN/AI I E.L.SACHAG:IDENT 3 100100 g OFFWeA%T.ISfiREJ(CLUDED? �J (I161ndalarY in NHI I ! 1;-L.09EASE-EA EMPLO '$ 3.00,00 I ITYeE.desolbe'O TI W. E.L.DISEASE,POLICY I ImT S 5()0,00( I EICRIPTiON OF OPWT10NS I LOCATIONS I Ylt11CLE3(AMM ACORD 101,Addkicnai Rz-.w a SehMub,iTmom space Ii,reVAred) rpentry contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF YHE ABOVE DESCRIBED POLICIES as CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE%ITN THE POLICY PROVISIONS. AUTHORIZED RErRESE ffAnVC - Wi11iam Kell VIM / 01988.2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009108) The ACORD name and logo are registered marks*f ACORD ,, �Py K& R COnstl"uction w 34 Evergreen Rd,Stoneham MA,02180 Office 781-438-3418 Diglt@comcast.net HIC#156364 CS#96874 This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Co ractor Information Name Com any N me �t Caris�ry Street Address(do not use a Post Office Box a ress) Contractor/Salesperson/Owner Name 3��( �har neer-5 rang RA Jhaw rtle5 Aic6scl Fude5 City/Town State Zip Code Business Address(must include a street addresAs � Ar,Aauelr- MA 01`sLi S 3H Fver- -, Daytime Phone Evening Phone City/Town State Zip Code ►�1-7331 (040-5 S4vnc�Narj V)I� x.( 60 Mailing Address(It different from above) Business Phone Federal Employer ID or S.S.Number Law Home Improvement Contractor Reg.Number Expiration date tha improvement cot mostcontractors have (S�3 �q improvement contractors have a valid registrntion number The Contractor agrees to do the following work for the Homeowner: (Des ribe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessaU.) (Des quc 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 */// Date when contractor will begin contracted work. MGL chapter 142A.) Date when.contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,famish the material and labor specified above for the total sum of: 4 6, 3 0 Payments will be made according to the following schedule: Q�'-upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) s35 by /_/_ or upon completion of -t-r�UV�ae�T( -N191 �- $ by / /_ or upon completion of $ 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 be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ to be paid for NOTES:(*)Including all finance charges(**)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 warranty being Provided by the contractor? ®No❑Yes fall 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 further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Contract Acceptance-Upon signing,this document becomes a binding 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. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make 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 of Home 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. • 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 1 ater than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies the contract must be completed and signed. One copy should go to the homeowner. The other copy should be kept by the contractor. H om wner's Si ature Contractor's Signature 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 would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to sub ' to such rbitration as provided In Massachusetts General Laws, ch a ter 1442 Ho eowner's ignature 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 carry 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 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 Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline 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 http://www.mass. ov/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 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the HIC website at hM2://www.inass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: !=:Hdb.state.ma.us/homeimprovement/licenseelist.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 413-734-3114 Version 2.1-11/22/20 10 Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la Checked By/Date TITLE:FARO RESIDENCE ADDITION CITY:North Andover STATE:Massachusetts HDD:6322 CONSTRUCTION TYPE: I or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE:06/24/11 '✓ DATE OF PLANS:5/16/11 PROJECT INFORMATION: KITCHEN ADDITION COMPANY INFORMATION: K&R CONSTRUCTION COMPLIANCE:Passes Maximum UA=99 Your Home=97 2.0%Better Than Code Gross Glazing , Area or Cavity Cont. or Door Perimeter R-Value R-Value ll Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 212 38.0 0.0 6 t Wall 1:Wood Frame, 16"o.c. 470 21.0 0.0 20 Door 1:Glass 21 0.330 7 Window 1: Wood Frame,Double Pane with Low-E 106 0-330 35 Basement Wall 2: Solid Concrete or Masonry,8.0'ht/3.0'bg/8.0'insul 288 0.0 10.0 23 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 212 38.0 0.0 6 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release Ia. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%9fthe design load as specified in Sections 7WCMR 1310 and J4.4. Builder/Designer Date p�V / r Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release I Checked By/Date TITLE:FARO RESIDENCE ADDITION CITY:North Andover STATE:Massachusetts HDD:6322 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE:06/24/11 DATE OF PLANS:5/16/11 PROJECT INFORMATION: KITCHEN ADDITION COMPANY INFORMATION: K&R CONSTRUCTION COMPLIANCE:Passes Maximum UA=99 Your Home=97 2.0%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 212 38.0 0.0 6 Wall 1:Wood Frame, 16"o.c. 470 21.0 0.0 20 Door 1: Glass 21 0.330 7 Window 1:Wood Frame,Double Pane with Low-E 106 0.330 35 Basement Wall 2: Solid Concrete or Masonry,8.0'ht/3.0'bg/8.0'insul 288 0.0 10.0 23 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 212 38.0 0.0 6 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release la. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or coot the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date I MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release I DATE:06/24/11 TITLE:FARO RESIDENCE ADDITION Bldg. Dept. Use I Ceilings: [ ] I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation I Comments: I Above-Grade Walls: [ ] I 1. Wall 1:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments, I Basement Walls: [ ] I 1. Basement Wall 2: Solid Concrete or Masonry,8.0'ht/3.0'bg/8.0'insul, R-10.0 continuous insulation Comments: I Windows: [ ] I 1. Window 1:Wood Frame,Double Pane with Low-E,U-factor:0.330 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: I Doors: [ ] I 1. Door 1:Glass,U-factor:0.330 #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: I Floors: [ ] I 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-38.0 cavity insulation Comments: Air Leakage: [ ] I Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfin(0.944 Us)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.571bs/ft2 pressure difference and shall be labeled. i Vapor Retarder: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. I Materials Identification: [ ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] I Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. Duct Insulation: [ ] I Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] I All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I Heating and Cooling Equipment Sizing: [ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] ( Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120°F or chilled fluids below 55 OF must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe,Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Unto 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pie Sizes Piping System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) K & R Construction '_ _ Estimate 34 Evergreen Rd Stoneham MA, 02180 Date Estimate# Name/Address 12/30/2010 265 Jim and Marie Faro 374 Sharpeners Pond Road North Andover,MA 01845 Project Description Total Foundation- 13,800.00 Excavate full basement and install continuous concrete footings Install poured concrete foundation walls as per plan Install compacted gravel and 4"concrete floor Install damproofing on foundation as necessary There is no allowance made for ledge removal if it is encountered during excavation.Soil will be stock piled until backfilling is complete.Excess will be removed. Floor framing-1st Floor 2,020.00 Supply all materials and frame floor as per plan 16"O.C. 3/4"T&G Advantech glued and screwed Beam installation- 6,800.00 Construct temporary walls to support second floor of house Frame in pocket for steel beam W 12x58-weighs approximately 1972lbs(assuming engineering has been done for sizing) Build supporting structure to rest beam on and maneuver into desired location 3 posts will be needed to support the beam-steel columns will have to rest on top of foundation wall and new footing Wall Framing-1st Floor 1,625.00 Supply all materials and frame first floor walls as per plan 2 X 6 Exterior with appropriate headers and blocking 1/2"advantech sheathing Floor framing-2nd Floor 1,980.00 Supply all materials and frame floor as per plan 16"O.C. 3/4"T&G Advantech glued and screwed Wall framing-2nd Floor 2,520.00 Supply all materials and frame Second floor walls as per plan. 2 x 6 Exterior walls with appropriate headers and blocking 1/2"zip Syst sheathing and taped seams 2 x 4 interior ails Signature LA� Total Page 1 K & R Construction Estimate 34 Evergreen Rd Stoneham MA, 02180 Date Estimate# Name/Address 12/30/2010 265 Jim and Marie Faro 374 Sharpeners Pond Road North Andover,MA 01845 Project Description Total Strap ceilings-first and second floor addition and existing living area 880.00 Roof framing- 3,600.00 Supply materials and labor to frame roof structure as shown in plan 16"O.C.rafter spacing 5/8"Zip system sheathing and taped joints Roofing Allowance-approx 650 sf 4,060.00 Ice and water shield-valleys and perimeter Iko architectural shingles to match existing,dripedge flashing ect. Exterior trim-Frame in soffit overhangs and finish with white vented vinyl 1,334.00 Pine fascia and rakes-wrapped with Alcoa-White Aluminum trim stock Siding-Vinyl Siding to match existing 4,760.00 Demo and disposal costs-Allowance 3,500.00 Windows-Allowance 8,500.00 Supply and install Andersen windows specs to be determined before ordering(13 total) Doors-Allowance- 2,500.00 Supply and install Andersen Exterior door onto patio,6ft sliding Install 10'6"LVL Headers over new opening to dining area 1,650.00 Finish new opening with arched trimwork,remove foyer closet and dining room wall,repair ceilings 1,250.00 (flooring unknown) Insulation Allowance-Fiberglass batts,proper vent in roof,seal around windows and doors,vapor barrier 3,480.00 Fireproofing n f 300.00, - I Signature Total Page 2 K & R Construction Estimate 34 Evergreen Rd Stoneham MA, 02180 Date Estimate# Name/Address 12/30/2010 265 Jim and Marie Faro 374 Sharpeners Pond Road North Andover,MA 01845 Project Description Total Electrical Allowance-basic layout and devices,no fixtures(wall or hanging) 10,000.00 Plumbing/Heating Allowance-Layout as shown in plans 17,000.00 Blueboard and plaster(Allowance) 5,000.00 Interior Trim-Allowance 2,200.00 Install 7 1/4"MDF primed Baseboards throughout new areas Interior doors-Allowance 3,100.00 Supply and install prehung interior 6 panel doors(qty 6) Supply and install pocket door into master bath Install kitchen-Allowance 4,500.00 cabinets,appliances and trim Heated floors-warn tiles-electric cables under tile 3,500.00 Flooring allowance-Supply and Install 5 1/4"Walnut flooring-foyer,dining room,family room,kitchen 15,550.00 Radiant heat allowance-downstairs area-kitchen/living room 10,000.00 (Allowance)Remove Existing front doorway and install new Therma Tru fiberglass entry door with azek 2,000.00 casing and kickplate(many styles available-broad range of pricing Install railings on front entry-Azek composite rail system 2,150.00 Install perimeter drain around new foundation and along existing east side foundation wall.Install filter 2,000.00 fabric and 4"corrugated pipe surrounded by crushed stone.Drain pipe may run to sump pump catch basin in new basement floor or to daylight depending on depth and available locations to do so.(allowance) Cut doorway through existing foundation wall to new addition. 950.00 Install siltation fence and hay baI s to meet state requirements 1,600.00 Signature Total Page 3 K & R Construction Estimate 34 Evergreen Rd Stoneham MA, 02180 Date Estimate# Name/Address 12/30/2010 265 Jim and Marie Faro 374 Sharpeners Pond Road North Andover,MA 01845 Project Description Total Remove asphalt driveway section as shown in plan and install loam then plant wild seed mix.Install 2,200.00 shrubs as shown in plan. This estimate is based on the plans provided by Silverwatch Architects LLC for 374 Sharpners Pond Rd. 0.00 Realistic allowances have been made to provide an appropriate estimate for the project as a whole.Not all aspects of the project have been included in the estimate as they have not yet been determined.(For example-Tile,skylights,trim style,landscaping ect..)Any work that is not quoted in this estimate will be discussed before it is performed,and all applicable charges will be in addition to this estimate.As work progresses,an invoice will be sent for work completed to date. Signature Total $146,309.00 Page 4 y _ •'' TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received f �1 Date Issued: IMPORTANT:Applicant must complete all items on this page II '' LOCATION 3 74 Saf-, o 'u -.- (Jod .P,�, .-ont PROPERTY OWNER M CC 12 Print MAP NO: PARCEL: 00A ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family SAddition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition El Other p£S.eptc 0 Well �Flood Flaur. '0 Wetlands WatershedDistnct . _I on, JL �(t�. s.. t_ R_ _.._. DESCRIPTION OF WORK TO BE PERFORMED: reprm aAd\Alcn remockg-- 1 Irem\aua-i-e m454-� > .b C,Y a h Ck )IA VV\ rs�- t Identification Please Type or Print Clearly) j /" OWNER: Name: C mES Q� b� Phone• 7E- -;5)- �J Address: 2) �� YIC CZ-��1��� �O CNC , yw f CONTRACTOR Name: a c- Co n5+, Phone: 7& -13 ;3 e Address: 3 �A itcl , Supervisor's Construction License: �l-+ CJ �p Exp. Date: j Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone:_(,()� �q q Address: Da`� Mci,\AS ✓ n) SIS 1,�-n2N�J 030 eg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 1 6A , vil FEE: $ Check No.: Receipt No.: NOTE: Persons contrac ' with ut,registered contractors do not have access to the guaranty fund Sig69uw of Ment/OMe_ : Signafiure;of contractor :;:.. Plans Submitted Ly Plans Waived ❑ Certified Plot Plan Stamped Plans Q' TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on -d c Signature COMMENTS - c�j /� -21 - -. ,j T ` HEALTH Reviewed on Signature COMMENTSry `� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConnectioY7/Signature Date Driveway Permit I)-PW Town.Engineer: Signature: FIRE DEP TMENLocated 384 Osgood Street T -Temp Dumpster on site yes no Located at 124 Main Street Fire Departnaent signature/date COMMENTS CUT OR TAX MAP 90B PARCEL 16 RICHARD GRAHAM -�I A TED 2177 SALEM STREET oz LOT AREA , a TAX MAP 908 PARCE 47,590 S.F.f �' EDWARD SKINNEF ot- -ca) 2189 SALEM STREI -° vk )3°zr o ( r SyF �g�P. PROP• f ( SOIL I ` / S1pCK 1L E 71.3Of- t SEX. EPIT Of- .*'EX. / DBOX t y Q t` PROP. ADDITION ABOVEGROUND ? X. 1,500 v POOL O GALLON. �\ SEPTIC TAaK z VP4 ` � ,. acs OECK�,o 3' .6 �` y PROP i VP5 \ IH 69:9-' AREA _ SjpR jib X RE • m � S RUClU / P5A LB a, X OR00M - / o U 4BE Z I BIT. CONC. `�-JK DRIVEWAY .NO. S 1. THE TOPOGRAPHY, SITE DETAIL & SUR FACE IMPROVEMENTSILURVEY CONDUCTED ON HEREON WERE OBTAINED FROM A PA JUNE 5, 2010 BY SULLIVAN ENGINEERING GROUPLLC. , DISTRICT R1. 2. THE LOCUS PROPERTY DEPICTED IS LOCATED IN ZONINGTHE 3. THE LOCUS PROPERTY IS DEPICTED I - M P AS PARCEL ON TOWN OF NORTH ANDOVER ARE MA WN 4. THE LOCATION OF ALL UNDERGROUND UTILITIES SND COMP/LA�ION IOFTE AND ARE BASED UPON A PARTIAL FIELDS EPI COT OR NOT DEPICTED. PLANS OF RECORD. THE DESIGN ENGINEER NOT WARRANTY NOR GUARANTEE THE LOCATION OF ALL UTILITIES CONTACT DIG SAFE AT THE CON PRIOR TO COMMENCEMENT OF CONSTRUCTION, SHALL VERIFY THE LOCATION OF ALL UTILITIES 1-888-344-7233. R UNWRITTEN 5. THIS PLAN DOES NOT SHOW ANY UNRECORDED ATTEMPT HAS EBEENEMADE WHICH MAY EXIST. A REASONABLE AND D AT NO SUCH EASEMENTS EXIST. TO OBSERVE ANY APPARENT, VISIBLE USES OF THE LAND; HOWEVER, THIS DOES NOT CONSTITUTE A GUARANTEE T N AN ASSUMED DATUM. 6. THE ELEVATIONS DEPICTED HEREON WERE BASED UPON AS DEPICTED ON THE 7. THE LOCUS PROPERTY I CE RATE MAP.D WITHIN A FLOOD SPECIES LATEST FLOOD INSURANCE 8. THE LOCUS PROPERTY IS LOCATED WITHIN PRI EQITIHABITAT N1 DATED OCT 1 S 2006 PER THE MASSACHUSETTS HERITAGE ATLAS, 374 SHARPNER S p oND ROAD SITE PLAN OF LAND A. LOCATED IN r1 s MASSACHUSET o. NOR TANDOVER, CO UNI') c (ESSE X PREPARED FOR JAMES & MARIE FARO so 0, DAIS; FEBRUARY 21) 2011 SCALE. I 2 R P.REPAED BY "RING GROUP, LL ENGINESULLIVAN 22 VOUNT VERNON ROAD BOXFORD, MA 01921 f s3 (978) 352-7871 � AL SHEET No. 1 0F