The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #226 - 505 GREAT POND ROAD 10/1/2008 BUILDING PERMIT o`tNORkORTF1 TOWN OF NORTH ANDOVER or APPLICATION FOR PLAN EXAMINATION 70 Permit NO: �� Date Received «�S� "o _ey V Ar ��SSACHUS�� Date Issued:,_/_0 IMPORTANT:Applicant must complete all items on this page LOCATION P , t , PROPERTY OWNER Print MAP NO: Y_PARCEL:� ZONING DISTRICT: Historic District yes !Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial AltwvitLQn No. of units: Commercial (fRepa placement Assessory Bldg Others: olition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: fe ti�(S GIpLNdf �.� l�'-fr (t' r Identification Please Type or Print Clearly) OWNER: Name: .� _ %��,H�� r� Phone: ` Address: CONTRACTOR Name: Phone:? j t Address: r Supervisor's Construction License; "r .� Exp. Date: L y Home Improvement License: l --~ Exp. -Date: Tn ( C ARCHITECT/ENGINEER '� Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE,TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 72 / 0 /- FEE: $ Check No.: n 4 Receipt No.: �J 1 NOTE: Persons contrac in with u e is r d contractors do not have access to the guar and Signature of erit/QW—ri rre of contractor '' 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 o 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) ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 Dutmpster on site es no Located at 124 Main Street Fire Department signature/date COMMENTS i I' 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 2008 Location 5�� r-L T �c�A No. Date MORTh TOWN OF NORTH ANDOVER 41 P Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # / y 2554 Building Inspector NORTH Town of � ; Andover , No. _ ]( o dover, Mass., T O LAKE COC HIC HE WICK TED C2 '9S E BOARD OF HEALTH Food/Kitchen Septic System PERMIT T . D BUILDING INSPECTOR THIS CERTIFIES THAT.....��1 ....... . Dry r��s-s ... ........................�......................................:............................................... Foundation has permission to erect................. ...................... buildings on ..........5.p.......4-es� ........... Rough to be occupied as....El.a in.... ..�.....�s1� �/.QI'Ur. /.4/�i .. .Q.. ..T..�d.d. ....�..'.... Chimney provided that the person accepting this permit shall in every respect 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 PERMITEXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRU STARTS Rough ............... ............................................. ............................................ Service BUI 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 FIRE DEPARTMENT Until Inspected and Approved by, the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. TOMAR CONTRACTING 21 Juniper Cr., Reading, MA 01867 781-944-0278 Office TOMARCON@verizon.net TOMAR CONTRACTING & CONSULTING AGREEMENT This Agreement is made on 2008 between TOMAR CONTRACTING with an address at 21 Juniper Cr., Reading`, MA and telephone#781-944-0278. Home Improvement mprovement Contractor#143932,and Mass. Construction Supervisors License#050275 hereinafter called "contractor"and &t 4.?nrg with an address atIV . 1. WORK: The following is a detailed description of the work to be done and the materials to be used. (see attached) 2. COMMENCEMENT&COMPLETION OF WORK: Work is scheduled to begin on 2008 and scheduled to be substantially completed on �3J 2008. 3. PRICE: Contractor and owner hereby agree that the price to be paid for the work to be performed on the Contract is$ F. k'exclusio nclusive n materials.(except as noted). 4. TIME SCHEDULE FOR PAYMENTS: Payments shall be paid by Owner to Contractor according to the following schedule: (See attached under terms). In the event a payment is due and remains unpaid for five(5)consecutive days,Owner and Contractor agree that contractor may,with seven(7)days written notice to Owner, terminate this Agreement and mover from owner payment for all work done to date and for all materials and equipment supplied to date, including reasonable overhead and profit 5. EXPRESS WARRANTY Contractor guarantees to Owner that all materials incorporated into the work will be new unless otherwise specified or agreed. Contractor also guarantees that work will be done in a workmanlike manner,free from defects and in conformance with any specifications mentioned in Paragraph 1. Work under this Agreement is guaranteed for one(1)year. If any defects in materials or Workmanship arises within this time, Contractor agrees to repair such defects and to bring the Work up to the standards required under the Agreement at no additional expense to Owner. This guarantee in no way limits or supercedes any other remedy under the laws available to the owner in the event of defective work. 6. NOTICE OF OWNERS RIGHTS (a) All Home Improvement Contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to registration should be directed to: Home Improvement Contractor Registration Date timate No. 03/23/08 13 Name/Address Dan& Beth Hennessy 505 Great Pond Road North Andover, MA 01845 Project Item Description Qty Rate Total Construction Remove old siding,comer boards,window trim, replace with 28,750.00 28,750.00 Azek brand PVC trim, install new"Typar"housewarp,install"hardi"brand fiber cement factory paint siding(white). Repair rot at garge center post,other rot or other problems uncovered will be done on a time and materials basis. Price includes 1 -30 yd dumpster,all labor and materials. Removal of rake trim carriers some risk of roof shingle damage. Every effort will be made to not damage shingles. Stock list will be provided to homeowner as a budget. Actual material costs will be adjusted up or down upon comparison with actual costs. Siding price is for white,but other colors are available for minimal cost. I will bring you a sample kit before I order the siding. Add apprx$10,00 for red cedar siding. 0.00 0.00 Construction Replace 5 DH windows with Andersen TW units,retrim and 3,300.00 3,300.00 paint Construction Replace bay window with Andersen DH/Picture/DH unit. 3,700.00 3,700.00 Construction Replace skylight with Velux unit. 100.00 100.00 Construction Remove tub, replace with Koehler brand white cast iron tub, 1,900.00 1,900.00 refile tub surround area. Construction Refile bath floor 380.00 380.00 Total $38,130.00 One Ashburton Place, Room 1301, Boston,MA 02108 Phone#617-727-8595 (b)The contractor's registration number must be on the first page of this Contract. (c) Owner's three(3)cancellation rights under Massachusetts General Laws, Chapter 93, section 498,Massachusetts General Laws,Chapter 140(d)Section 10 or Massachusetts General Laws Chapter 255, Section(d)shall be stated. 7. PERMITS (a) It is the obligation of the Contractor to obtain required permits,as the owner's agent,as sha be necessary for construction. (b)That Owners who secure their own construction-related permits or deal with unregistered contractors will be excluded from access to the guarantee fund. 8. INSURANCE See Certificate of Insurance(attached hereto and made a part hereof). 9. MODIFICATION This agreement,including the provisions related to price and time of performance and time for payment cannot be changed except by a written statement(change order)signed by both contractor and Owner. All hidden,concealed,or unforeseeable conditions, including, but not limited to code violations, that must be repaired,corrected or otherwise remedied shall result in a change order. A change order fee of$35.00, per change order will apply unless otherwise specified. 10. NOTICE OF CANCELLATION Owner may cancel this Agreement if signed at the place other than the Contractor's address, if owner notifies contractor in writing of his/her intention to do so no later than midnight of the third business day following the signing of the Agreement. The following language addressed to Owner regarding notice of cancellation is required by statute: YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN CONSUMMATED BY PARTY THERETO AT A PLACE OTHER THAN AN ADDRESS OF THE SELLER,WHICH MAY BE HIS MAIN OFFICE OR BRANCH THEREOF, PROIVDED YOU NOTIFY THE SELLER IN WRITING AT THIS MAIN OFFICE OR BRANCH BY ORDINARY MAIL, POSTED BY TELEGRAM SENT, OR BY DELIVERY, NO LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FROM THE SIGNING OF THE AGREEMENT. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. CON CT OR OWNER HERBY AGREE TO THE AB ERMS- p d D E WNER'S SIGN-7/; A D4 7 DATE RA OR'S SIGNATURE Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 143932 ExpiratJon ::8/16/2010 Tr# 272928 Type `-DBA i TOMAR CONTRACTING ANTHONY TORRA 21 JUNIPERCIR �,,� „` i READING,MA 01867 Administrator $card of Budding Itegula6ons and Standards * Constntction Sapernsor incense Incense: CS 50275 °$ Exp�rat�on 5/2/2010 T[# 24393 Restrictron ANTHONY N TflRRA �' �J 21 JUNIPER GIR READING,MA 01867 Comm►sswner The Commonwealth of Massachusetts (kDepartment of Industrial Accidents �...,I„ Office of Investigations 600 Washington Street uuv Boston, MA 02111 t ; www.niass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): G�'/'1 'M ( Address: �' �c,vn i�P/ L (•�G (� City/State/Zip: �iG"/ Phone#: Are yo n employer?Check the appropriate box: Type of project(required): I. am a employer with T 4. ❑ I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors ��/ 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. $ 7• El Remodeling P ship and have no employees These sub-contractors 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised.their 10:7 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp. c. 1.52, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13,7 Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who subniii.ihis a!;davit indicating they arc uoing 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'comp.policy information. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. , / Insurance Company Name: C/,L" Policy#or Self-ins. Lic.#: o Expiration Date: 0 Job Site Address: ic/l�5- 6' ct I- City/State/Zip:/UAHo6yt' - h 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. 1 do hereby certify Xdainsandpe 'es of perjury that the information provided above is true and correct Siartature: Date: Z (� Phone#: -7 / L? :;2-0 0.2— 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#: l 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,oral 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 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,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of 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 deemed 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 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 of public 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-contractor(s)name(s), address(es) and phone number(s)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 cavy 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 confirmation 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 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 reference 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(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 proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia 09/25/2008 08:50 IIII037e DTE, 'A� MD �tKiNUATE OF LIABILITY Cole-Insurance OP ID DC AM ? WYYY, TORRA-1 09125/01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER1tFICATE • Cole Iasuranca ;Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 194 Haven Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Reading 1A 01867 Phone:781-944-1245 Fax:781-942-1797 INSURERS AFFORDING COVERAGE WSNAIC4 `"RD INSIIRERA Harleysville Inz xance Co 26182 INSURER 8 t onC11+eAa1 Caws 2ty Callmarrsr Anthon . Torra DBA TWdar �DAStxl2Cit0aINSURER C 21 Juniper Eire-to Readings HI A 1867 INSURER0: INSURER E; COVERAGES THE POLICIES OF INSURANCE LWMD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PFAIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WINCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONNTIONS OF SUCH POLICIES.AGGREGATE LIMIr6 SHOWN MAY HAVE 04CN REDUCED BY PAID CLAIMS, L n TYPEOPMHSYRAHCE POLICY NUMBER 1E ATE MWD UMrm GENERAL LIANLI" EACH OCCURRENCE '$'300000 A COMMERCWUGENPJIALLIABLITY CB 807334E rrytEMISE — s Ee ooallenoe) s 100000 CLAIMS IIN4DE U OCCUR MSD EXP Wy cm pemA) 8 5000 X Businesjs Owners— 04/07/08 04/07/09 PERSONALLADVINJURY s 500000 I GENERAL AGGREGATE v :1000000 GElFLACGREGATELIMIT APPLIES PER: PRODUCTS-COM_PIOPAGG $1000000 $ POLICY: JECT LOC ANROMOB14E "T" COMBINED SINGLE LIMIT ANY AUTO t Me aeddem) i ALL OWNED ANTOS BOOILV INJURY f SCHEDULED 4UTOS (Per Deman) HIRED AUT09i BODILY INJURY 6 NON-OWNED i UTOS (Per-went) PROPERTY DAMAGE f (Pcr Kaiaint) GARAGE LIA" AUTO ONLY•EA ACCIDENT t ANY AUTO OTHER THAN EA ACC S - AUTOONLY: AC4 ; EXCFAENMBROLL A LIABdRY EACH OCCURRENCE S OCCUR CWMS MADe AGGREGATE T - DEDUCTIBLE ! - ~_ $ RETENTION ; S $ WORKOWCOMPENSATOLIABILITY N AND $ TORY LIMA S EMPLOYERS' 8cxArsexcars se cora zeAw 05/30/08 05/30/09 e.L,eAcHACCIDENT $100000 ANY PROPIUETORIPARTNERIEXECUTIVE OFFICERIAEMBER EXCLLFED? INSURANCE CO DIRE Y E.L.DISEASE-EA EMPLOYEE s 100000 Mdem u0m IAL PRO1,11SIONS tleldw G.L.DISEASE-POLICY LIMIT s 500000 OTHER I I I i J DESCRIPTION OF OPERATIONSr LOCATIONS I VEHICLES I EXCCLUSHONS ADDED BY ENDORbEMENT I SPECIAL PROVISIONS Job Location; 505 Great Pond Road, North Andover CERTIFICATE HOLDER CANCELLATION TNANDOV SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE THE E MRAT.M j DATE THEREOF,THE MUM INSURIR WILL A MNL 10 DAYS WRITTEN NOTHCE TO THE CERTIFICATE WXOER NAMED TO THE LEFT,BUT 11011KINWIXIMBNAI'C Town of INarth Andover wmE No oemATION OR UAN LM OF ANY MOND UPON THE INSURER,ITS AGENTS OR SuildiAg Inspector 1600 Osgood Street REPRESENTATNES North Andover MR 01845 A A ACORD 25(2001108) 0 ACORD CORPORATION 1888 I i I I