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Home My WebLink AboutBuilding Permit #384 - 505 GREAT POND ROAD 10/28/2011 t TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: f Date Received Date Issued: 0",-h�C IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER f)a4 tk -4,1�5S �� Unit# Print MAP NOU� U PARCEL: 0017 ZONING DISTRICT: Historic District yes . n Machine Shop Village yes no 100 year-old structure yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building *ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial -1 Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑_Other Sepc We113 ®1�Floodplain ®�Wetlanis S D Watershed astnctj r. T F ®�W,ater/Sewers _ ` ESCRIPTION OF WORK TO BE PERF0 D: e o /� (Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: �%1 /®/r Phone: ? 76- Address: 6Address: ( r' r Weq A Supervisor's Construction License: 7 —5 Exp. Date: �L Home Improvement License: T 3 �3 v� Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL Z ESTIMATED COST AS ON$125.00 PER S.F. Total Project Cost. $ 0 6 FEE: $ Check No.: Receipt No.: NOTE: P so s contra n nregistered contractors do not have access to the guaranty fund Signatur '. r :' Signaturib) ;ofrcontraetort 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/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: Doc.Building Permit Revised 2008mi E A Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools El Art ❑ 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 Sinature COMMENTS HEALTH Reviewed on Signature COMMENTS 6 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 Dumpster on 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.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi I Location Pow( /z. No. Date ! �i R' NORTH TOWN OF NORTH ANDOVER 3 F 10 ,a�' Certificate of Occupancy $ —4z,.. ,. cNuS Building/Frame Permit Fee $ � y Foundation Permit Fee $ Other Permit Fee $ TOTAL $ a 1 Check # 24776 Building Inspector s `I /��Q�� r I Sheetl 210/023.0-0077-0000.0 54 BREWSTER STREET JONES, REBECCA', 210/023.0-0078-0000.0 62 BREWSTER STREET MAC DOUGALL, NADI 210/024.0-0006-0000.0 31 BREWSTER STREET HART-SHIPP REALTY T 210/024.0-0007-0000.0 30 BREWSTER STREET PRONOVOST, KEV 210/024.0-0036-0000.0 9 BREWSTER STREET MURPHY, FRANCIS 210/024.0-0063-0000.0 14 BREWSTER STREET CHISHOLM JR, DONAi 2101024.0-0074-0000.0 38 BREWSTER STREET RUMORE, DANIEL 2101024.0-0077-0000.0 21 BREWSTER STREET SHELDON, BARRY', 2101024.0-0078-0000.0 29 BREWSTER STREET KARRI,SRINIVASA RE 2101024.0-0079-0000.0 36 BREWSTER STREET BRACEY, PHILIP 2101024.0-0083-0000.0 6 BREWSTER STREET TANG,WAI CHEON 210/104.D-0020-0000.0 53 BRIDGES LANE WALSH, PATRICK i 210/104.D-0063-0000.0 11 BRIDGES LANE ECKEL, ROBERT A. 210/104.D-0071-0000.0 20 BRIDGES LANE BIANCHI,THOMAS' 210/104.D-0072-0000.0 32 BRIDGES LANE BENSON, BYRON C& CARC 210/104.D-0073-0000.0 44 BRIDGES LANE TAVANO, MARK, C 210/104.D-0074-0000.0 56 BRIDGES LANE MORGENTHALER,JEFFREY 210/104.D-0075-0000.0 80 BRIDGES LANE FAVORAT, BRUCE 210/104.D-0076-0000.0 92 BRIDGES LANE LEWIS,THEODORE&SUS/ 2101104.D-0077-0000.0 104 BRIDGES LANE ROSS, GORDON,&JL 210/104.D-0078-0000.0 116 BRIDGES LANE MAGLIOCHETTI, MICHJ 210/104.D-0079-0000.0 128 BRIDGES LANE FARIS, MARY E 210/104.D-0080-0000.0 140 BRIDGES LANE SULLIVAN, THERES 210/104.D-0081-0000.0 150 BRIDGES LANE REEVES, GARY 210/104.D-0082-0000.0 164 BRIDGES LANE MARCIN, MARY AN 210/104.D-0083-0000.0 178 BRIDGES LANE MASTALERZ,JAME; 210/104.D-0084-0000.0 190 BRIDGES LANE PAULIK, ERIC& DELNICKi 210/104.D-0085-0000.0 200 BRIDGES LANE D'AGATA, SALVATORE TF 210/104.D-0086-0000.0 210 BRIDGES LANE D'AGATA DOROTHY,TRI 210/104.D-0087-0000.0 222 BRIDGES LANE GOUDREAU, ROGEF, 210/104.D-0088-0000.0 234 BRIDGES LANE MCGOVERN, PAU( 210/104.D-0089-0000.0 248 BRIDGES LANE FAVREAU, GREGORY& M 2101104.D-0090-0000.0 258 BRIDGES LANE MAGAURAN, MAUREE 210/104.D-0091-0000.0 261 BRIDGES LANE WOELFEL, MATTHEVj 210/104.D-0092-0000.0 247 BRIDGES LANE MC GRATH, CATHERj 210/104.D-0106-0000.0 225 BRIDGES LANE KITABJIAN,ARA 210/104.D-0107-0000.0 209 BRIDGES LANE CONTRADA,JOSEPh Page 34 i � I ! Massae ,nsetts Home Improvement Sample Contract 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 homeownersSeek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide toHome Improvement"before agreeing to any work on your residence.You may obtain a free copy by callingthe 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 Wormation Contractor Information Name Company Name 94 �csr i Kr StrZ(et Address(do not use a Past Offic' !Box.ad ss t Contractor/Salesperson/Owner Name �r1Ja'tp� City/Town State ' ! Zip Code Business Address must inc Jude a street address) Daytime Phone Evening Phone City/Town St to Zip Code Mailing Address(It different from above) BusinessPhone Federal Employer 11)or S.S.Number Home Improvement Contractor Reg.Number Expi tion date Lmv requires that most home improvement contractors linve n valid registration number 5 % J The Contractor agrees to do the following work for the Homeowner: l/ ('- (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessaryctl .) el 14�r/S /� for lc�s+► Required Permits-The following1building 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 6'wn permits will be excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work. MGL chapter 142A.) �� ( Date when contracted worlcwill be substantially completed. . i Total Contract Price and Payment!Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: Z CC) e? (*) Payments will be made according tothe following schedule: 0 upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) $ by //_; or upon completion of X42 lie $ 7��@ by /_ or upon completion of $ U pon completion 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 1(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 warrlqnty being rovided by the contractor? No❑Yes all terms of the warr nly must be attached to the contract Subcontractors-The contractor agrees to be solely responsible for completion of the work'described regardless of the actionsof any thir Party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subd contractors for In and labor tinder this a eement 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! I e 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 alV.alid Home Im rovement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registeredlwith the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Parlc 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. ; i 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 mainloffice or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Seethe attached notice of cancellation form for an explanation of this right. DON SIGl�T wo identical c S CONTRACT IF THERE ART.ANY BLANK S CLS!!! 's o he must be completed and signed. One copy should go to the homeowner. The other c ould be a contractor. meowner's S' afore Contractor's Si ature Date Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate anjarbitration 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. it The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute coneg this contract,the contr ctor may submit the dispute to a private arbitration firm)which has been approved by the cre ary of the ecutive ice of Consumer Affairs and Business Regulation and the consumer shall be required to s to such provided In Massachusetts General Laws,chapter 142 omeowner's SignatureContrac or's e NOTICE:The signatures of the parti ovapply only to the agreement of the parties to',alternative dispute resolution initiated by the contractor '4'homeowner may initiate alternative dispute resoilution 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.i 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 si ed co of the contract with attachments is Pp � copy 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 fiends not yet duel be placed in a j oint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. I 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 Condoner Guide to Home Improvement" contact: Consumer Information Hotline Office of Constumer Affairs and Business Regulation j 10 Park Plaza,Room 5170,Boston,MA 02116 j 617-973-8787, 888-283-3757 or visit the OCABR website at http://wvwvA!ass.r ov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additii nal 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 http://www.mas1s.aov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: I http: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 j 508-652-4800,508-755-2548 or 413-734-3114 j Version 2.1-11/22/2010 I � ; i NORTH 1 ® oAndover .. 0 . ..... No. o , dover, Mass., I ' 1 S Olt LAKE COCHICHEWICK ADRATED `S BOARD OF HEALTH PERM. IT T , D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........D00S.........14610.tMoat Foundation has permission to erect................................ ...... buildings on n'T ..... Rough to be occupied as............e . .�...... ..:. ........... 0... .. .....! ....... ...., �AJI ... ..... .��r• Chimney h' provided that the person accepting this permit shall in ry respect for o 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 CONSTRUC1(............... T Rough ................ ............................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lellibly Name (Business/Organization/Individual): Address: J Jl/ ✓l i ro—e"'`.0 City/State/Zip: 14 /00 Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with �— 4. El am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 1 7• ❑Remodeling ship and have no employees These sub-contractors have 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 10.E]Electrical repairs or additions required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 13.❑ 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 submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is it:e policy and job site information. Insurance Company Name: lie Policy#or Self-ins.Lie.#: 6 Expiration Date: 5-1? COW— Job Site Address: C7 C�-�C � �/d`�( City/State/Zip: /y/,V 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 cert' der the rns .W 1 penal ' f perjury that the information provided above is true and correct. Si nature: � Date: 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#: Massachusetts- Department of Public Safct} _ oulations and Standards Wkwowt Board of Building Re� Construction Supervisor License T15UPkiIZV'Solt i" License: CS 50275 TORRA ANTHONY N I 21 JUNIPER CIR '' READING, MA 01 g67 I Expiration: 51212012 I 3864 } ('�nunisiuncr ,�a V/��dY/Y//7Z09ZG(1GC000IZ 0��.1GCfLtG6G'��Q \ Office of Consumer Affairs&Business Regulation �t+gOME IMPROVEMENT CONTRACTOR egistration: :143932 Type: - xpiration:..,-,8/16/20__1,2 DBA TOMAR CONTRACTING- ='' ANTHONY TORRA 21 JUNIPER CIR. i READING, MA 01867 Undersecretary