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Home My WebLink AboutBuilding Permit #1100-16 - 524 REA STREET 4/22/2016 BUILDING PERMIT 01 No°T b q1O Al'�IYVW4L,�, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONC. e� Permit No#: l< v �`� Date Received �i9SSgcHLIS ��c`� Date Issued: ' IMPORTANT:Applicant must complete all items on this page LOCATION Prin 6 � PROPERTY OWNER Pri l 100 Year Structure yes to MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residen - Non- Residential ❑ New Buildingne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain [],Wetlands ❑ Watershed District WaterlSewer DESCRIPTION OF WORK TO BE PERFORMED: ntification- Please Type or Print Clearly _ OWNER: Name: �,1 !'�� - Phone: . Address: /g- Contractor Name: ,��`�13-LSf ScvyS Phone: 917e -64FJ� lr 73 Email: Address: e4lV y &we)c Supervisor's Construction License: Exp. Date: Home Improvement License: /U3.�� Exp. Date: -71-711 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PEI 12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. �.. Total Project Cost: $ �L�,k�"D� FEE: $ Check No.: -3/ yg Receipt No.: �d NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Taming/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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Si qnature : COMMENTS WEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafter& Sewer Connection/SDriveway Permit DPNV Town Engineer: Signature: Located 384 good Street FIRE DEPARdTMENT piDump•ster onsite;., es ,f d* Temph y t . Locatedjatir124tMain►Street 'FireiDepartment signature/date 1 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 DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$100o fine NOTES and DATA— (For department use) ® Notified for pickup Call Email I Date Time Contact Name Doc.Building Permit Revised 2014 i I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits 4� Building Permit Application 4. 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products . OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 Location No. Q J —�� Date �/! ?x 1111r, i . - TOWN OF NORTHAN DOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector � c10 R T!y Town o ndover No. Ibb. a 01 Y h ,- Wo- ver, Mass, z COC NIC«lwlcw �1• x.95 RArED U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT e� 1,zl1vBUILDING INSPECTOR .......... ................. .... ... ............................................................... has permission to erect.......................... buildings on ...'.$?. ........................................ Foundation. Rough to be occupied as � �F,( c ................................... Chimney ...................... . ..../eri�it/shall ................................... provided that the person accepting this in every respect conform to the terms of the application 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TARTS Rough Service ......... .... ... ... . 1.%............................... 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 Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Propool 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 Submitted ToJob Name Job# / t n �»-�- Address r„� , � Job Dat* a Date of Plans Phone# j �. Fax# > > ! Architect We hereby submit specificatio and estimates for. �- v 144 Ooe&IZ�K� fi T771 ' G!J aZ6 v We propose hereby t6fumish material and labor—complete in accordance with the above specifications the sum of: $ 43n a, 0-W Dollars 1 with payments The made as follows: Any attention or deviation from above specifications involving extra vests will be Respectfully executed onlyupon written order,and will become ann extra charge over and above the estimate.AN agreements contingent upon strikes,accidents,or delays submitted beyond our oohtrol. Note—this proposal may be withdrawn by us R not accepted within days. SlcicPt�tice iof a�a� The above prices,specifications and conditions are satisfactory and are �-'Signature hereby accepted You are authonzed to do the work as specified. '' D Payments will be made as outlinetl ' ov'e� / Date of Acceptance (-� ( Signature MASSACHUSETTS HOME IMPROVEMENT CONTRACT This form.satisfies-all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but doer not Include standard language to protect homeowners. Seek legal advice if necessary. Any peson'planning homeinprovements should'.fusf obtain a copy oi'"a Massachusettssconsumer:gtlide to home,improvement"before agreeing to any work on yourresidence.You may obtain-a free copy by'calling the Office of Consumer.Affairs:and Business•Reguladon's Consumer Information Hotline SM7-973�8787'or 6888*283-3757. . Homeowner Information Contractor Information company .. � k: .... Str ddms(do n6ae. Pon Office Box address) tractor/ er Name CityRg ��tau Zi Code / usiaess/Adt4eas(most include astreet / Daylime Phone Evemag Phoae 'ry?own State Zip Code Mailing Address(lt different from above) usiness Phone txleral player or S.S.Ntlmtirs • lav xegnim tWtmon homeim• Acme tCD>utamerRea:di—hb AePitsU-4W: toausotm taw� ' bmtiee smnMf /C/11`a �� ..f �� The Contractor agrees to do the following work for the Homeowner: :..: -/� Ci��d�% s'j Pte✓ `� /c� i��f Required PeriWts-The-following building pcimitt arc required Proposed Start and CompletlonSohedale-The following schedule will and will be secured:by the contractor as the'homeownet's agent; be adhered to`unless circumstances*ond:the contractors'control arise (Owners who.aecure their own permits will be excluded from;the Guaranty Fundprovisions ofDate when eoutractorwill begin contracted work MGL chapter 142A.) Date when contracted .work will be aubstantu ly completed. Total Contract Price and Payment Schedule , �//The Contractor.agrecs to perform thework,furnish the material and labor specified above for the total sum of (s) 1Paymcnts wil0ide according to the following schedule: upon signing contract(nottn exceed 1/3 of the total-contract price.2r the cost of special order items,whichever is.greater) by_// or upon completion of or upon completion of S t/ upon completion of the contract (Law forbids demanding full payment until contract is completed to both party's.satisfaction) The following i t r must be special be paid far ordered befomthe contracted wok'begins in order . S to be paid for . to meet the completion schedule.(**) .. NOTES:(•)lnrluding all finance charges(••)Law requires that any deposit or down-payment required by the contractor before wodc begins may aot'ecceed the greater of(a)one-third of the total contract price or(b)the actual con of any special.equipment or custom made material . which must be special ordered in advance to meet the completion wwiedule. Express Warranty-Is an express.warranty being provided by the eontraetm? No Ves .(at terms of the runty mast be attached to ffie 122 -11 Subcontractors The contractor agrees to be solely responsible for completion of the work described regardless of the actions ofiny third . party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors foi materials and labor under this agreement Contract Acceptance-Upon sign. 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)ms been placed on the residence. Review the following cautions and notices carefully before signing this contract • Doe,be pressured into signing the contract Take time to mad and fully understand it Ask'quesdo»s if sooh`ething is unclear. • Make sure the contmcto*has a valid Home Immeyement Contractor R 'cmxd .....z�,49• The hiw requires most home improvement contractors and. subcontractors to be registered with the Director ofHome Improvement Contractor Registration. You may inquire about.eontractor registration by writing to the Director it-One Ashburton Place,Room 1301,2oston,-MA 02108 or-by:calling 617-727-3200 or 1-800-223-0933. • 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 of this foim'and get a copy of the Consumer Guide to the Home hrlprovement Contractor Law: You may cancel this agreement if it has been signed at a place other than'the-coutractbes'normal place of business,provided yo�mi� ify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sett or by delivery,not later tght of the. thud business day following.dhe signing of this agreement.See theattached notice of cancellation form for an explanation of.thh DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! ?coo ideodnl cop' of fM contract mart be coVleed=d sinned.One copy.ahoutd ao to the ho .The other copy should be t the .. lug by coatrsGor. LlAl Homcowher's Signa Contractor's Signature Dau Lo Date �� O V�� WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE A.I.M. Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800) 876-2765 NCCI NO 26158 POLICY NO. AWC-400-7014648-2015A PRIOR NO. AWC-400-7014648-2014A ITEM 1. The Insured: Arthur Walsh DBA: A J Walsh&Sons Mailingaddress: 159A Waverly Road FEIN:**-***6792 y North Andover, MA 01845 Legal Entity Type: Sole Proprietor Other workplaces not shown above: See Location 2. The policy period is from11/14/2015 to 11/14/2016 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTRA 40579 INTER SEE CLASS CODE SCHEDU E GOV GOV STATE CLASS MA 5403 State Assessments/Surcharges $.00 x 5.7500% $ This policy, including all endorsements, is hereby countersigned by 11/05/2015 Authorized Signature Date Service Office: Durso&Jankowski Insurance Agency LLC 54 Third Avenue 11 Saunders Street Burlington MA 01803 North Andover, MA 01845 WC 00 00 01 A(7-11) Includes copyrighted material of the National Council on Compensation Insurance, used with its permission. 111f Massachusetts •"tepartt-rtent of Pubic Safct.. Board-of Building Rcgulatior-- and Construction super%icor License: CS-022680 - ARTHUR J WAILS JR '- 159A WAVERLYAiD N ANDOVER M., 01845 'I ok Expiration Commissioner 06/0912016 !�`��c�iiitirtrirraerr�C�rlC�i�lrra�rrc�rr�e/ls Of$ce of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR Type: ff'negistration: 103358 Yp i3,== �� x �JExpiration: 7/7/2016 Private Corporatio.. A.J.WALSH&SONSJNC. Arthur Walsh 55 Pleasant St N Andover,MA 01845 Undersecretary