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Home My WebLink AboutBuilding Permit #849-14 - 67 FOSTER STREET 5/23/2014TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: f�lf'/z' Date Received Date Issued: IMPORTANT: Applicant must complete all items. on this age j L®CATI0,NIr _ a 'f1S`7`/�� 7T P PROPERTV OWNER Pant s 1w0.0), OldlStructure� yes MAP�NO. �� PARCEL _ ZQNING�DIS�TRICT jHistonciDistric{t+ yesti --- _- - = . =� Machine;Shop£t OJbge yesa . os TYPE OF IMPROVEMENT PROPOSED USE Phone_ �- Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial Rol�epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑aSe__ptie. ❑+V1%ellr Flootl,plainp ®1Netlands, _ ®V1la_tershed®istrict ' ❑�1lVater/,S�ewer�_ : , �_ � � - DESCRIPTION OF WORK TO tit FhKI-UKIVItU. 4v --14-7"n< entification Please Ty a or Print Clearly) Q OWNER: Name: _�,,�irt t` i�%/077" U�' Phone: Arlrlrcee- r Phone_ �- 8' Pe- s�Constructlon, License Fiorne�Impement�LcenseDates . Q lS f" ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S. F. Total Project Cost: $? ate o. D O FEE: $ C6'. 69 Check No.: 7' 9 Receipt No.: ,:2 % 16 6 7 NOTE: Persons contracting with unregistered contractors do not have access to e guaranty fu gnatureof Agent/Ovvner gym. 'Sig-lature,of contras K ' Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan Stamped Plans 0 Location No. Date 7' 0 Check � 2-7607 TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL 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 PLANNING & DEVELOPMENT ❑ DATE APPROVED COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Plannifii-A Board Decision: Conservation Decision: Comments Co Water & Sewer Connection/Signature & Date Driveway Permit DPW Tow;! Engineer: Signature: FIRE DEPARTIifiE'. - Temp Dumpster on site yes Located at -124 Mair;` Street Fire ®epa�kine�t signature/date h' COMMENTS Located 384 Osgood Street no 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 HUTES and DA Ids — (tor deaartment use U Notified for pickup - Date Doc.Building Permit Revised 2010 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 ❑ 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 o 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 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 ❑ 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 app, -al 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.Buiiding permit Revised 2012 1 1 1 . ,1 1 E9 f" O U i=. J WLLI 2 LL O m L Ate+ 00 d Z z m C VWLLI d cn z d O v N z z J U yt W oc O Wa NLLJ N ZLU z c G o~C Q O LL N O LL Ln u Q. to `° C OO LL L GO d' v c t U n) C LL t W O �' <O O u. t m O CC ar •u � a) V1 O LL s j O K f6 O LL v i O m +, v �., Vl Y O E N C, C� o cc r' O � o 2 ;-0 CL CD m wa o C CL cn CD Y = UA r ^: .0. O A(v W y AJu Q• �• FI E cm i O L 04L ro- * O � J E L O CL r CD O `• O O O o > . t O � 0 o o Q N �> o CL Yams m v= 0 0 d : O N tm ' _ Q °> `° -a o N 2 Q. N a> O N pip m W = cc -0 t O LU w T) LL C NO •N N O LU V U a> 0 m Q ®:a F- C.ov > Z m CD Z W w CLx uiH LU a. L- w W O E Z 0 W .E L a .Q N C U cv R3 CL U) w c G O O CL CL CD Q c s � Cc Cc J O Z CL t a I I U I I uo Matt & Pam Rivet 67 Foster Street North Andover, MA 978-258-2580 May 22, 2014 Work to be completed includes: Acquire Building Permit Install two new windows, and new siding on one end of house.. Removal of all debris. TOTAL LABOR AND MATERIAL $ 7,000.00 Terms: $ 2,000.00 upon signing of contract (not to exceed 113 of contract price) $ 00.00 $ 5,000.00 when job complete Submitted By: Chris Rivet MA Lic #CS072173 HIC #139962 207 Winter Street (C) 508-265-3115 (H) 978-794-1165 North Andover, MA 01845 All Home Improvement Contractors shall be registered. Inquiries about a contractor relating to a registration should be directed to; Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and You are authorized to do the work as specified. Payment5 Nill ot Date 5 Homeowner Signature Date .� ' % Contractor Signature Homeowners who obtain their own are hereby accepted. ide as outlined aWvi 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 a equired to tc su on as provided In Massach e s General ws, Chapter 142A. - 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. 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 Consumer Guide to the Home Improvement Contractor Law", contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 1.0 Park Plaza, Room 51.70, Boston, MA 02116 (617) 973-8787 or (888) 283-3757 u Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor �. License. CS -072173 IIs r� CHRISTOPHER 207 WINTER ST s N ANDOVER IVIS 01845, Expiration Commissioner 06/02/2016 ✓Vrle 19n��rrrrnirun�(1!%aJSp�rrJe Office of Conslier ArPalr3,& 1TasiiiessRebahon fu ME IMPROVEMENT CONTRACTOR egistratlon 139962 /yxpiration 918/2015 - Individual CHRISTOPHER F. RIVET'; { CHRISTOPHER RIVET 207 WINTER ST. N. ANDOVER, MA 01845 - Undersecretary-' a I OP ID: SHHE A`coRO` CERTIFICATE OF LIABILITY INSURANCE DAT09/30D/YYYY) 1 09/30/13 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). PRODUCER Phone: 978-688-6921 Macdonald & Pangione InsuranceFax: 978-688-5350 P.O. Box 428(PA/C, 104 Main Street North Andover, MA 01845 Michael Pangione CONTACT NAME: PHONE FAX A/C No Ext : AIC No): E-MAIL ADDRESS: PRODUCER CHRIS -5 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Christopher Rivet INSURER A: Preferred Mutual Ills CO 15024 207 Winter St. North Andover, MA 01845 INSURER B: A MMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR INSURER C INSURER D: CPP 0180 57 01 05 INSURER E: 09/26114 INSURER F: MED EXP (Any one person) $ 5,000 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, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCE AD—DL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ 1,000,000 A MMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR CPP 0180 57 01 05 09(26/13 09/26114 DAMAGE T RENTED 100,000 PREMISES (Ea occurrence) $ , MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 rjG�EN'L GENERAL AGGREGATE $ 2,000,000 GREGATE LIMIT APPLIES PER: ICY JECT PROF LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ -- SCHEDULED AUTOS PROPERTY DAMAGE - $ (Per accident) HIRED AUTOS - NON -OWNED AUTOS is is UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ EXCESS LIAR AGGREGATE is DEDUCTIBLE $ RETENTION $ WORKERS MPENSATION AND EMPLOYE RS' L ABILIITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WC TORY L M TS ISTATU- OER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE) $ 1If yes, describe under E.L. DISEASE - POLICY LIMIT I $ 1 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) �n Town of North Andover 1600 Osgood St No Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED Michael F © 1988-2009 ACORD CORPORATION- All riahtc rpsnrve-d ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts rh Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AM 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 4& Address: a ® .;;7 Alb./u,1zsl� j City/State/Zip: /UQ,��ci •.r, f D rf < Phone #: Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I ,,,pmployees (full and/or part-time).* have hired the sub -contractors 2. I I am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3 . ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ['Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other kAny applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. 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 their workers' comp. policy information. i am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name://�,£G' //l�/'il� C_. /\l I!, ?olicy # or Self -ins. Lic. #:_CXG % 0l o Expiration Date: rob Site Address: City/State/Zip:A),, 40! l/ 10�a, 8'/s j attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). ,ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ane 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 )f 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. 'do hereby certify uydepdie pains and p,*aloes of per, jury that the information provided abovg is trite and correct. 'hone #.: ..d� 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 #: