HomeMy WebLinkAboutBuilding Permit #469 - 588 OSGOOD STREET 11/3/2016{ /
L tiUILU1NV FtKMI I V/
i" TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
ermNO: Date Received
I
Date Issued: t1—
I IMPORTANT: Applicant must complete all items on this page
I' LOCATION 161- 8 ( /, oaz S7"
PROPERTY OWNER ��J C,,r`ohint p��6
Print
MAP NO: 10 PARCEL: 000 1 ZONING DISTRICT: Historic District yesrn
Machine Shop Village yes
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
9 Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
❑ Water/Sewer
0M /���lha,s
nn Identification Please Type or Print Clearly) `
OWNER: Name: V�lh C/1 ko-rLon �lill'l� Phone: q%g -"171-Z
Address: ur o sf
CONTRACTOR Name- P Phone:
Address: k /" e1111Y%
Supervisor's Construction Lice se:/70 Exp. Date: Za
Home Improvement License: 7 l Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. 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: $ 06 FEE: $ 13 G -^
Check No.: a P- &V Receipt No.: 31t a -s
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor
{
Permit No#:
Date Issued:
r
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
Print 'lob Year Structure yes no
MAP PARCEL: _ ZONING DISTRICT:�Historic District yes no
Machine Shop Village ve_s no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑Well
0 Floodplain El Wetlands
ElWatershed District
❑ Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification - Please Type or Print Clearly
OWNER: Name:
Address:
Contractor Name: ;Phone:__ .
Address:
Phone:
Supervisor's Construction License:_ _ _ -. - Exp. Date:
Home'Improvement License: Exp. Date:.
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
rota) Project Cost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have: access to the guaranty fund
Signature of Agent/Owner Signature of contractor
C ` ; r' a
Plans Submitted ❑
a - -
Plans Waived El. Certified Plot Plan ❑ Stamped Plans ❑
T F- ' F SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art ❑
Swinuning 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
COMMENTS
Signature
CONSERVATION Reviewed on Signature
COMMENTS
d
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision.- Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT -Temp Dumpster on. site yes
L,ocated.at 124. Main -Street
Fire Department signatureldate
C0MMENit,
r
Locatea Jd4 usgooa Street
no
limension
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
Doc.Building Permit Revised 2014
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
r �
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/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
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
VOTE: 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 5 8, 9 O S G UO i--� S-7
No. jlr `X01-7 Date /1- 3— PO'
a
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $13
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
Building Inspector
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October 22, 2016
JP Lynch General Construction
105 Liberty Street Haverhill, MA 01832
Ph: 978.372.4439
MA Lic: 051708 REG: 106121
To: Ron & Karen Rudis
588 Osgood Street
North Andover, MA 01845
978.771.2793
Re: Deck re -surfacing
Scope of work to be completed
1. remove existing railings, decking and trim skirt
2. place Timbertech Express (white) post sleeves over existing rail post
3. new railings are placed using Timbertech Radiance Rail Express
Systems
4. skirt board on deck is replaced using white PVC
5. pressure treat 4 x 4 knee braces will be added to 4 x 4 support post
6. re -deck using Azek PVC Decking - slate grey
6. two 4 x 4 posts are added to stairway to reduce railing length
7. all debris is removed from site
8. permit is obtained
Total Cost: $11,400.00
Thank you,
John Lynch
4.
Massachusetts Home Improvement 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 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
Name: Ron & Karen Rudis
Street: 588 Osgood Street
City: North Andover State: MA Zip:
01845
Day phone:
Cell phone: 978.771.2793
CONTRACTOR INFORMATION
Company Name: JP Lynch General Construction
Owner Name: John P. Lynch
Street: 105 Liberty Street
City: Haverhill State: MA Zip: 01832
Day phone: 978-372-4439
Cell phone: 978-228-8889
SSID #/Fed Emp. ID: 04-3116125
Law requires that most home improvement contractors have a valid registration number
Home Improvement Contractor Reg. Number : 106121 Expiration date: 7.22.18
The Contractor agrees to do the following work for the Homeowner:
Replace decking, railings and skirt board on existing deck that meets or exceeds applicable building codes
according to the agreed upon plan and specifications from spec sheet. (please see spec sheet for additional
details).
Required Permits - The following building
permits are required and will be secured by the
contractor as the homeowner's agent:
(Owners who secure their own permits will be
excluded from the Guaranty Fund provisions of
MGL chapter 142A.)
Proposed Start and Completion Schedule - The following
schedule will be adhered to unless circumstances
beyond the contractor's control arise.
November, 2016 Approx. date when contractor will begin
work.
December, 2016 Date when contracted work will be
substantially completed.
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: $11,400
Payments will be made according to the following schedule:(Law forbids demanding full payment until
contract is completed to both party's satisfaction.)
Start of project $3,000
Job complete $8,400
Total: $11,400.00
}i
Express Warranty - Is an express warranty being provided by the contractor?
_x—No _Yes (all 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 later 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 SPACESIII
Two identical copies of the contract must be completed and signed. One copy should go to the homeowner. The other copy should be kept by the
contractor.
The Contractor agrees to perform the work, furnish the material and labor specified above for the total
sum of: $11,400 (Eleven thousand, four hundred and 00/100)
Homeowner's Signature
Contractor's Signature:
Date: o L�)-— / �.
Date: _� 31,1
. + 4
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 submit to such arbitration as provided In
Massachusetts General Law*�chaptey �42A.
Homeowner's Signature
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.
W 1
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.gov/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 http://www.mass.gov/ocabr/
Go online to view the status of a Home Improvement Contractor's Registration:
http://db.state.ma.us/homeimprovementAicenseelist.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 - 11/22/2010)
. '.
NOTICE OF CANCELLATION
(Complete this ONLY if canceling contract)
You may cancel this transaction without penalty or obligation within three business days from the above date.
If you cancel, any property traded in, any payments made by you under the contract or sale and the negotiable
instruments executed by you will be returned within ten business days following receipt by the seller of your
cancellation notice and any security interested arising out of the transaction will be cancelled.
If you cancel, you must make available to the seller at your residence, in substantially as good condition as
when received, any goods delivered to you under this contract or sale: or you may, if you wish, comply with the
instructions or the seller regarding the return shipment of the goods at the seller's expense and risk.
If you do make the goods available to the seller and the seller does not pick them up within twenty days of the
date of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make
the goods available to the seller or if you agree to return the goods to the seller and fail to do so then you
remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed an dated copy of this cancellation notice or any other written
notice or send a telegram to (name of seller) at (address of sellers place of business) not later than midnight of
(date).
I hereby cancel this transaction.
Date
Buyers Signature:
The Commonwealth of Massachusetts Nnnt:r
Department of IndustrialAccidents
Office of Investigations
e
5 1 Congress Street, Suite 100
Boston, MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information . Please Print Legibly
Name (Business/Organization/Individual):
Address:
/S
Phone #: 979
Are you an employer? Check the appropriate box:
1.0 I am a employer with '
4. 0 I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2. I am a sole proprietor or partner-
listed on the attached sheet.
ship and have no employees
These sub -contractors have
working for me in any capacity.
employees and have workers'
[No workers' comp. insurance
comp. insurance.:
5. 0 We are a corporation and its
required.]
3. ❑ I am a homeowner doing all work
officers have exercised their
myself. [No workers' comp.
right of exemption per MGL
insurance required.] t
c. 152, § 1(4), and we have no
employees. [No workers'
coma. insurance reouired.l
Type of project (required):
6. 0 New construction
7. ® Remodeling
8. 0 Demolition
9. 0 Building addition
10.0 Electrical repairs or additions
11.0 Plumbing repairs or additions
12.0 Roof repairs
13.0 Other
'Any applicant that checks box #1 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.
:Contractors 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 is providing workers' compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #:
Job Site
Expiration Date: JJ �/
City/State/Zip: "W �n 1�0Iat/el— "O`9
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 under the pains qnd penalties of perjury that the information provided above is true and correct
/, .1-10/6
Phone #: U 979 9 3 7z —7 Vs %
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 #:
CyTlze �pomvrreaouoea� q�C�cuiurae%a
Office of Consumer Affairs & Business Regulation
HOME IMPROVEMENT CONTRACTOR .
Registratio • 06121 Type:
Expti --18 DBA
JOHN PETER LIZ �. NSTRLICTN
.a
John Lynch %r
105 LIBERTY ST. A
Haverhill, MA 01832 Undersecretary
Massachusetts - Department of Public Safety' i
Board of Building Regulations and Standards 4
C0nvtr6ctIofi Sunervisor
License: CS -051708 ;1
JOHN P
105 LIBERTY STS �f
j HAVERHILL iA 01 Z
•r Y
•Yy� �
Expiration
Commissioner • 06/20/2017