Loading...
HomeMy WebLinkAboutBuilding Permit #347-15 - 45 SAWYER ROAD 10/9/2014 TOWN OF NORTH ANDOVER PLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: IMP RTANT: Applicant must complete all items on this page LOCATION %q PROPERTY OWNER A/ Print 100 Year Old Structure yes o MAP NO: -'��— PARCEL:?;(- ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Reside Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands i] Watershed District ❑Water/Sewer PESCRIPTIONOGFWORK TO PERF �R�MEP Identificat' lease Typ or Print Clearly) OWNER: Name: /� ,�o /� Phone: Address: Z-/� CONTRACTOR Name: 2-�— Phone: ?`7� 6W--407z7— �7 � ��c�1� �� - r Address: _ /�y/9 'G YAz A 500,56)(fo /V//-US Supervisor's Construction License: 0o4,k6 Exp. Date: �o Home Improvement License: � 3yr Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PEP E :$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: FEE: $_�i-a Check No.: Receipt No.: NOTE: Persons ontracting with unregistered contractors do not have access tot the guaranty fund 8ignature;of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE ORS: 'W—ERAGE DiSPOSAL Public Sewer ❑ Tanning/Massage/Body 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 i CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS a 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 T owo Engineer: Signature: Loca d 84 s ood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located-at 124 Mair, Street Fire Departinerit,signature/date' COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A-F and G min.$100-$1000 fine NOTES and DATA— For department use ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fol+:wining is-a-list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o- Building Permit Application ❑ Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o 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 o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 o 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 o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apsral period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building Permit Revised 2012 Location 4-C HJ e- No. Lr Date b 1q b • • TOWN OF NORTH ANDOVER .. Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#- ��L/ .� (} uilding Inspector NOR Town of ? : ., Andover No. h h ver, Mass, coc Nlc Hl WlcH y�• 7.9 p�R�rEo �PP��S S U BOARD OF HEALTH Food/Kitchen PERMILD Septic System THIS CERTIFIES THAT ................. .a... ..... � 1/! ................................................., BUILDING INSPECTOR has permission to erect ..... Foundation on .......... buildings .. .. �........��:M��.�R... � Rough ..... .... ... ............................... Chimneyto be occupied as . . ......� ...... provided that the person acce ting is permit shall in every res ect conf tothe. terms of theappli Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 M NT S Rough ELECTRICAL INSPECTOR UNLESS CONSTRU N TS Service ........ ... ............ .......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT I Until Inspected and Approved by the Building Inspector. Burner Street No. i Smoke Det. I I Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-022680 ARTHUR J WALS�O JR • 159A WAVERLYMD;, {� N ANDOVER Mk 018451 ; \ Expiration Commissioner 06/09/2016 ��e�a�nn�aaicsoerz�/�o��G/�i�nadnc�uae//a ' �L, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only IMPROVEMENT CONTRACTOR before the expiration date. If found return to: V, ,.,MEati gistrat! n• 103358 Type: Office of Consumer Affairs and Business Regulation pon: 717/2016 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 A.J.WALSH&SONS,INC. Arthur Walsh 55 Pleasant St N Andover,MA 01845 Undersecretary Not valid with t signature I he Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street F. Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): � G%A�,s/7 Address:_. /u` 4 vIgle 4/ ��V(_ City/State/Zip: � (-Ia000&G A'79%one #: 97e, z e__4 7_3 Are y an employer?Check the appropriate box: Type of project(required): i. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers comp. insurance comp. insurance. # 9. Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11. Plu ❑ g repairs or additions myself [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] `Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, lContractors 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-contractors 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•and job site information. Insurance Company Name:. / � Gfr�/ � sy Policy#or Self-ins.Lic.#: Z� —20/_ Expiration Date: / Job Site Address: _S�qq) vele City/State/Zip:,/110"JioMe—le o"/ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der the pains and penalties of. that the information provided above is true and correct. Signature: Date: �d Phone L. _ Oficial 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 i DATE(MMIDDNYYY) ACC)RO� CERTIFICATE OF LIABILITY INSURANCE 12/04/2013 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(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). CpNTACT IRODUCER 00775-001 NAME: Durso&Jankowski Insurance Agency Inc PAIHC.No.EtI; ( )978 682-5175 ac.No.: (978)794-0313 x 198 Mass Ave Suite 101B EMAIL ADDRESS: North Andover,MA 01845 FF DING COVERAGE NAIC INSURERA. A.I.M.Mutual insurance Company 33758 INSURED INSURER 8 Arthur Walsh A J Walsh&Sons " u 55 Pleasant Street s R North Andover,MA 01845i IN U E E INSURER F! 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, SHOWN MAY HAVE BEEN REDUCED THE INSURANCE AFFORDED BY THE LI TESD . POLICIES ED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.g� �� I`SR TYPE OF INSURANCE ANSPR UWBD POLICY NUMBER MMIDDnEYYY MMIDDIYYXYY LIMITS T EACH OCCURRENCE $ GENERAL LIABILITY DAMAGE TO RENTED $ COMMERCIAL GENERAL LIABILITY rr e CLAIMS-MADE ]OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ OLICY ED OC COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY Ea:'den ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS NON-OWNED accident) $ AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS MADE AGGREGATE $ $ DED RETENTION $ �yc g7p�U _ WpRKEPtCpMPENSATI N X TORY LIMITS ER ANyyD EMppPPPLOIIYEEE7TROoSRR'tISqARRBTTIL�EETRY yyyyyy/��/I�N�NI�� E.L.EACH ACCIDENT $ 100,000.00 A OFFICERlAAEMBERPEXCLUDED7ECUTIVEf�1 NIA AWC-400-7014648-2013A 1111412013 11!14!2014 (Mandatory in NH) uu E.L.DISEASE-EA EMPLOYEE $ 100,000.00 UgegIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION Town Of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 Osgood Street North Andover,MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. n��Tu�ol:Fn AFDp ECFNTATIVE f/ � /��r`77� �`JH, ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD MASSACHUSETTS HOME IMPROVEMENT CONTRACT This form.satisfies-all basic rtrquirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but not include standard language to protecthomeowuera. Seek legal advice if necessary. Any person'planuing ho''6 0proveme.nts sheuld.5rsf obfain s copy of"a Massachuseft.consumer guide to home,improvement"before agreeing.tu any work on yourresidemce,You tna obtain,a free- Office of Consimer.Afiairs and Business Reguladoes Consumer Information Hotline at6'17-973'8787 or 1:888 283-37.57. copy stag the Homeowner Information Contractor-Information Name ..� piny am ... ff S©�S Street Address( as use Poat Office 13ox address) tractor/Salesperson/Owner Name LS7�t . atyrrnwn s Zip Code I lusiness Address(must include a street address). Daytime Phone Evening Phone ityff�� State Zip Code d--� ll�N1�� Mai g Address(It different from above) upness Phone Moral Emp Oyer ID or S.S.Number ' lav regoitn tWtmoo Some mr Acme tConoadorag5NamtivEapumioa -. AWm9knoso+etm+Wwa �7 I mrimada m®he The Contractor agrees to do the following work for the Homeo ner. ]tequired''Perntits-The-following building peimits are required 1 Proposed Start add Completion Schedule-The following schedule will and will besectued:by the contractor'as the'homcowner's agent; be adhered to'utiless circumstances beyond the contractor's control arise (Owners who.;secure their own permits will be (� f Lj excltidedfrom;the Guaranty Fnndprovisionsof MGL chapter 142A.) 7 �Dafewhericontractor will begin eonuactedwork when eontracuid .work willbe substantially completed. Total Contract Price and Payment Schedule ry O The Contractor.agrees to perform the work,famish the material and labor specified above for the total sum of: ��Cr� (s) •4ayrn-its will be made according to the following schedule: upon.signing contract(not:tb exceed 1/3 of the total.contract price,g the cost;of special order items,whichever is.greater) r�� $ b3'-------- %~or upon completion of ------------ by _/_�or upon completion of upon completion of the contract (Law forbids demanding full payment until.contract is completed to both P Party's satisfaction) The following matmial/equipment must be special S be paid for ordered before pleb ntra had workbegias in order S be paid fol W'meet fliaceinpletioa schedule -- NOTES:(h Including all finance charges(••)Law requires that my deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)onethird 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 WhOdule. Exorew Warranty-Isere express wartasvty being provided by the eontraeMrT Na Yes (all re'.• sw. Subcontractors The contractor a regard n -a t ,. groes to be solely responsible for wmplenon of the work described regardless of the actions'ofany ffiiid 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 ih+e a ore Contract Acceptance-Upon signing,this document becomes a binding.conlract under-law. Unless otherwise noted within this document the carefully before signing this contract contractSWI not imply that say lien or other security intorrst�ilas lacca placed on the residence. Review the following cautions and notices carell • Don4 be pressured into signing the contract Take time to iead'and fully understand it Ask' uestions • •Make Welk contractor has a valid HomeImmnveme*r qifsomething is unclear ontrac++ u 'amnti The hiiv requires most home improvement contractors and. subcontractors to be registered With the Director ofHoaie Improvement Contractor Registration. You may registration by writing to the Director at One Ashburton Place,Room 1301,Boston,MA 02108 or. y inquire about.contractor, 1-800.213-0933. by.celling 617-727-3200 or • Does the contractor have insurance? Check to see that your contractor is properly insured • Know your rights and responsibilities. Read the Important information on the reverse side of this foim'and get a copy of the Consumer Guide to the Home hbProvement Contractor Law: Ethiid cancel this agreement if it has been signed at a place Other than thacomtractdr'a normal lace ofbusiness, rovided r in writing at his/her mesio office or branch office oidia P p you notr�the ness da followin tbe si by Wry marl posted by telegram sent or by delivery,not later than midnight of ffie. Y g. signing of this agreement.Seethe ausched notice of cancellation form for an explanation of.this right DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract mud be comptped mad signed,om eWy should go to tbehomeo tiac . Dopy I//d be lupt the contractor. .. Homeowner's Si L6�7sC� Contrector's Signature t� Dau Date Contractor Arbitraiion :.. The Home Improvement Contractor Law provides-homeowners with:the righvto<initiate an arbitration action(as an altematNe to courtacftcO if they have.a.dispute;with$contractor. The.same right,is not'automatically afforded to a. contractor,however.:•Yhe,con tractorwould have;.p resolve any,dispute heJshe.has with a homeowner in court unless both parties agree to,the optional clause piovided 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.beenapproved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and°the consumer shall be required to submit to such arbitration as provided In.Massachusetts General Laws,chs 142A. Homeowner's S' Con tot'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.Jbetomeownermay initiate alternative dispute resolution even where this section;is not s stately signeftq`tire parties. Homeowner's Rights A homeowners rights under thg Iome'Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chip tei 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 responst'ble-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 pmvides.an.express warranty for:workmanship or materials. In addition to.guarantee§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 dunlicate 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 griginal'coniract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day recission period has expired. Accelerated Payments A contractor may not demand payments in advance.of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances 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 fi.ee copy of "A Consumer Guide to the Hm oe.Improvernent Contractor Law,"•contact Cgnsumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787 or 1-(888)2833757 If you want to verify the registration of a contractor or if you have questions or need:additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Bureau of Building Regulations and Standards One Ashburton Place,Room 1301,Boston,MA 02108 (617)727-3200 or 1-800-223-0933 - For assistance with informal rtreiliation'of disputes or to register formal complaints against abitsiness;'call Consuffitecoiiiplaint`section Office of the Attorney General (617)727-8400 AND/OR Better Business Bureau (508)652-4800 (508)755-2548 (413)734-3114 ikapoal Page# of pages CS # 022680 978-688-6737 HIC# 103358 A. J. Walsh & Sons or 159A Waverly Road 1-978-912-2853 North Andover, MA 01845 Proposal SubmittedjJ4.--- Job Name Job# Address Job Location Date /G Date of Plans Phone# Fax# Architect t We hereby submit specifications and esti t for. � GVGL/ aa A 60, We propose hereby to furnish materia and labor—complete in accordance with the above specifications for the sum of: $ . � � � � Dollars with payments to be made as follows: Any alteration or deviation from above specifications Involving extra costs wi0 be Respectfully executed oniy'upon written order,and will become an extra charge over and Submitted raccepted. inate.Ad agreements contingent upon strikes,accidents,or delays ohtrol. Note—this proposal may be withdrawn by us H not accepted within days. SCCeptallm 0t 0p0.0al rices,specifications and conditions are satisfactory and are �l/5lgnature pted.You are authorized to do the work as specified. ill be made as oudined above. f cceptance 1 DTI `i Signature