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Home My WebLink AboutBuilding Permit #247-13 - 7 COMMONWEALTH AVENUE 9/28/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: t IMPORTANT: Applicant must complete all items on this page LOCATION " Print. PROPERTY OWNER �� ' Print 100 Year Old Structure es no MAP NO: PARCELZONING DISTRICT: Historic District yesOno Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ATwo or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION Ol�VYORK TO EJE PERF J1 ED: �10 st S-rX Wff 1�vepj r rL - ----.:::& 7 1—) Identification Please tipe or Print Clearly) OF OWNER: Name: Phone: Address: CONTRACTOR Name: �- Ke'z"c Phone: Address: r "i f � tr kr,( u /xw/ F C4-C4,4re- � i- X05 � V/Supervisor's Construction License: Exp Date: Home Improvement License: t ` MI � Exp. Date: / dre ARCHITECT/ENGINEER Phone: S. Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$112.000 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ PIP P FEE: $ ltJ Check No.: Receipt No.: �� NOTE: Persons contra ting with unregistered contractors do not have access to the guaranty fund Signature of Agent%Ovvner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ J _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ i 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 — S ig n a t u rA COMMENTSJL Ila J I J 14A A/A r A 0 " a 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 Dumpster on site yes no Located at 24 Main Street Fire Departinent signature/date COMMENTS Location No. Date 2 + ` 6jhf TOWN OF NORTH ANDOVER • Certificate of Occupancy Buildin 9/Frame Permit Fee $ Foundation Permit Fee $ ' Other Permit Fee $ TOTAL $ Check# v'- 25760 Building Inspector f NORT11 own of ndover 0 No. - * h .-. 'h ver, Mass, Ic"IKK 1. COC NK N.W A�RATEO ►P�,�'�y S U BOARD OF HEALTH PER LD Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT ............... .......... ....................... ...................... ................................ ............... Foundation has permission to erect ..... buildings .. .. .... ...... �.... .... .......... ......... Rough to be occupied as ........ 2al ...6.1.T.&........... .. ... ..........�.. .1i.0...................................... Chimney provided that the person accepting this permit shall 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 o PERMIT EXPIRES IN 6 TH ELECTRICAL INSPECTOR UNLESS CONSTRUCT S Rough Service ..................... ........ .................. ....... 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. IF SEE REVERSE SIDE Yassac��se s I�[ome Improvement Sample (Contract This form satisfies all basic requirements of the s'tate's Home Improvement Contractor Law language to protect homeowners. Seek legal advice if necessary. ,An planning (MGL come hapter encs should but does not include standard Massachusetts Consumer Guide to Home Improvement"before agreeing to any work ohur residence.Youmayobtain a free copy by calling the Offiot of Consumer Affairs and Business Regulation's Consumer Infoimation Hotline at 617-973-8787 or 1-888-283-3757 or on our website. e/T/,A eowner in—formation� Contractor Information / Alm ! Name Company Name Street Address(do not use a Post Office Box address) Contractor/Salesperson/Owner Name -16,- City/Town State Zip Code Bpsiness Address(must include a street address) laytime Phone Evening Phone City/Tom State Zip Code -e 4 a 6i Mailing Address(It different from above) Business Phone Federal Employer M or S.S.Number Law requires tLat most]some Home Improvement contractor Reg:Number Expiration date ' ,,JJ improvement contractors / �((' �__/-i n valid registration number ( (/ (TV/ The Contractor agrees to do the following worIc for the Homeowner: ,Q�cribe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets ifnecessary p orc l 0-14 ,-vv-F• ?1q 4UJO ` r 1�qFoo-- • 6(✓1,ivL lieta �C�i�S (lu1 a.iv deh►S � �u\ I c) P�,_rnlI dbdoc/, Required Permits-The following building 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 oven permits will be excluded from the Guaranty Fund provisions of 2 R/I�L Date when contractor will begin contracted work. MGL chapter 142A.) / r 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: } �� Payments will be made according to the following schedule: upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items whichever is $ � ��'�• b (D p � greater) Y / d / or upon completion of�t.��r �Q�� ll-e � $------_ by / / or upon completion of $0 GO upon completion of the contract. (Law forbids demanding full payment until contract is completed to both p party's satisfaction) . The following material/equipment must be special $ �� to be paid forQ PG /fC.( ordered before the contracted work begins in order to meet the completion schedule.(ft) $ to be paid for e on,` ,4, ,) NOTES:(")Including all finance charges(11`1)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(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 warranty being provided by the contractor? ❑ Subcontractors No 13 Yes(ail terms of the warranty must be attached to the contract) The contractor agrees to be solely responsible for completion of the work described regardless of theactions of any thir parVsubcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors at-erials and labol•under this a Bement actors for Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within flus document,the contract before 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. o Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear, o aloe sure the contractor hasa 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 888-28actor . 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. o 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 tel sent or by delivery,not later than midnight of the third business day following the signing of flus agreemnet. See the attached notice of cancellation form for an explanation of this right. 1)0 NOYSIGN TIMS CONTRACT IF RE ARF ANY IBLA ,,'SPACE S►!! Two identical copies of the contract must be completed and signed One copy should go to the homeowner. The other copy shottidbe kept by the contractor. Ho eowne ' ignature Contractor's Signature .Date Date — I 1 1 Herve Boucher Construction Invoice �o. 519 Westminster Hill Road Fitchburg,MA 01420 978-880-1009 fax 978-345-2988 INVOICE - Customer Name keith &Amy Harley Date 6/15/2012 Address 7 Commonwealth Ave. City North andover ma Phone Porch Repair Brace 2nd floor roof over deck. Remove 2nd floor porch. Brace 1 st floor deck. Dig and install 2 cement piers 4'deep with big foot bottoms Strip existing roof. Install rubber roof with trim to match existing as close as possible. Frame 2nd floor deck with 5/4 P T flooring. Frame 2x4 rails on both floors 42" high with sq. edge ballisters 3.5"o.c. Flash deck with copper flashing. Haul away all debris. Building permit is included. Cost$5450 $2750 when job started, balance due upon completion. icy Thank you for your business!! Herve Boucher Construction Invoice No. 519 Westminster Hill Road Fitchburg,MA 01420 978-880-1009 fax 978-345-2988 INVOICE - Customer Name keith &Amy Harley Date 6/15/2012 Address 7 Commonwealth Ave. City North andover ma Phone Porch Repair Brace 2nd floor roof over deck. Remove 2nd floor porch. ' Brace 1st floor deck. Dig and install 2 cement piers 4'deep with big foot bottoms Strip existing roof. Install rubber roof with trim to match existing as close as possible. Frame 2nd floor deck with 5/4 P T flooring. Frame 2x4 rails on both floors 42" high with sq. edge ballisters 3.5" o.c. Flash deck with copper flashing. Hau0aall ebris. Builis included. Cos$27b started, balance due upon completion. Thank you.for your business!! The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 ,Washington Street Boston,MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): # k� „ES eta a4caG Address: �(T �t"a,� lljn{'y(t-4 #:r& City/Stat �" A A9 040-0 Phone#: 7 2 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 7. Remodeling 2.( I am a sole proprietor or partner- listed on the attached sheet.t 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.❑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.kQ Roof repairs insurance required.]i employees. [No workers' 13.0 Other comp.insurance required.] *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 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: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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 and penalties of perjury that the information provided above/is tree and correct. Si nature: Date: ( �^ p- / Phone#• 14� 0 I I ! �� Official itse 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#: i • I Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen icor License: CS-012690 1 HERVE J BOUCHR 519 WESTNMSTER HILL RDS FITCHBURG MA 01420 rr 954.— Expiration Commissioner 05/22/2014 I Herve Boucher Construction Invoice No. 519 Westminster Hilt Road Fitchburg,MA 01420 978-880-1009 fax 978-345-2988 INVOICE - Customer Name keith &Amy Harley Date 6/15/2012 Address 7 Commonwealth Ave. City North andover ma Phone Porch Repair Brace 2nd floor roof over deck. Remove 2nd floor porch. Brace 1st floor deck. Dig and install 2 cement piers 4'deep with big foot bottoms Strip existing roof. Install rubber roof with trim to match existing as close as possible. Frame 2nd floor deck with 5/4 P T flooring. Frame 2x4 rails on both floors 42" high with sq. edge ballisters 3.5"o.c. Flash deck with copper flashing. Haul away all debris. Building permit is included. Cost$5450 $2750 when job started, balance due upon completion. Thank you for your business!! Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration ^ - Registration: 105203 _ Type: DBA HERVE BOUCHER CONSTRUCTION'=. Expiration: 7/16/2014 Tr# 228314 Herve Boucher 519 Westminster Hill Rd. Fitchburg, MA 01420 - Update Address and return card.Mark reason for change. DPS-CAI 0 50M-04/04-GIOI216 _ Address" Renewal ❑ Employment Lost Card ��ie -Vor/t�nzoozusP.a%`�b�✓v�p,�aude�6 _ - '_ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: — Registration:,,;`.'105203 Type: Office of Consumer Affairs and Business Regulation wN= Expiration:--. ?/16/20:14 DBA 10 Park Plaza-Suite 5170 HERVE`BOUCHER„CONSTRUCTION Boston,MA 02116 - Herve Boucher ==` 519 Westminster Hill'Rd Fitchburg,MA 01420 Undersecretary Not valid without signature