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HomeMy WebLinkAboutBuilding Permit #932-15 - 77 BRIDGES LANE 6/4/2015 BUILDING PERMIT NORTh 1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION SOP w y'14y Permit No#: Date Received 0 c5 �SSgcHus�`� Date Issued: IMPORTANT: Applicant must complete all items on this page (LOCATtION; - fPRORERTY - - Year Structure. ly s n: j (MAf-�6_ PARCEL.(1-/£ZONING DISTRLCT fHistoricaDist_0— - Machine Sho Ulla e z� . - TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑ eration No. of units: ❑ Commercial epair, replacement ElAssessory Bldg ❑ Others: ❑ Demolition ❑ Other -Y ❑'Septic ❑`1Nelly _, ❑Floodplain p 4Wetlands . ❑ 1Natershed 1p%stnct; 1�1 Water/Sewer , DESCRIPTION OF WORK TO BE PERFORMED: Identification- lease Type or Print Clearly OWNER: Name: J ry G�' ,r / Phone: �`2���— /W02- Address.- 2 ` "ContractoriNam ��i � �9St 1Phone �p � / '°Acltlress � ✓��iJc`"/� ( .; _�Yi7J�' f'. T_ -� ervisor's�Gons`tr.uctioI fLicense� _ _- e lHomellmproent^'License r 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not haveaccess to he guaran and Signature .of Agent/Owner'a, ,} Signature�of contract ij Location Ar 1,�, N Dat No. e i . - TOWN OF NORTH ANDOVER _ Certificate of Occupancy F $ ._ Building/Frame Permit Fee b)-00 i Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# i a LJ Building Inspector r n. 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS -Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: FIREI EDED PARTMENT Tem Durn _ - 84 Osgood f Located 3 Street P,40.0 steron site es _ t 124 Main t. p = - 110 4Locateda 1. StreetY � 6 . �_.m,- Fire�De - `-- k partmentF,si "date _ gnature/ a - - f --Eol 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 Call Email s Date Time Contact Name Doc.Buildnig Perinit Revised 2014 1 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 Li 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) o 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 o 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 o 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 i must be submitted with the building application Doc:Building Permit Revised 2014 i I Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 16,640.00 m $ - $ 199.68 Plumbing Fee $ 24.96 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 24.96 Total fees collected $ 349.60 77 Bridges Lane 932-15 on 5/16/.2015 Bath Remodel F NORTH . Town of E ndover No. 1-0 116 ver, Mass, COCHIC"IWIca �1 ��S RgTEo 1'P���S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .................. BUILDING INSPECTOR has permission to erect .......................... buildings on ........ Foundation .............. � . ...... r d ..... ...... Rough g to be occupied as ....... ... ........ ............................................................... Chimney provided that the person ccev41% ng this perm! 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 PERMIT EXPIRES IN6 N S ELECTRICAL INSPECTOR __ UNLESS CONSTRUCT 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. d a a R Janice Piasecki 77 Bridges Lane North Andover, MA 01845 (H) 978-686-1442 janpiaseckigaol.com November 1, 2014 Full Bathroom Remodel Work to be included includes: • Acquire Building Permit • Remove existing toilet and vanity top. • Demo of existing tub and floor. • Install new tub with tile walls. • Install custom tub door. • Complete all required plumbing. • Complete any electrical.. • Install new tile floor. • Install new Panisonic vent unit. • Install new baseboard heat cover and baseboard. • Install new granite vanity tops,undermount sinks and faucets. • Install new toilet paper holder, towel bars. • Removal of all debris. • Paint bathroom. TOTAL LABOR AND MATERIAL $ 16,640.00 Terms: $5,500.00 upon signing of contract(not to exceed 1/3 of contract price) $11,140.00 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.Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payments will be m de as outlined above. Date 4/0�— Homeowner Signature Date. / ��5- Contractor Signature /� I 1 I 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 t ubmit to such arbitration as provided in Massachusetts General Laws,Chapter 142A. (11 owner'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 asprescribed 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 financial) insecure.However,in instances where a contractor deems him/herself to be financial) insecure, Y y secu e, 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 10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787 or(888)283-3757 The Commonwealth of Massachusetts Department of Industrial r4ccidents Office of Investigations 600 Washington Street Boston,AM O2III avfvIt.iwass gov/dia Workers' Compensation Insurance A-idaN it: ]builders/Contractors/Electricians/Plumbers Applicant Information Please Print lLeeib%- Name(Business/Organization/Individual):-- _f Address: 0 _` 1,14-1i 1 , �,,r<_ \ �. City/State/Zip: /L/�. A'%f!74 L' 1 = f< Phone it: rio Are you an employer?Check the appropriate box: Type of project(required): I.❑ 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 2.❑ I am a sole proprietor or partner- listed on the attached sheet.i ?• 2'ltemodeling ship and have no employees. These sub-contractors have S. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. EJ Building addition [No workers' comp.insurance S. ❑ We are a corporation and its required.] officers have exercised their . 10.❑Electrical repairs or additions 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.j Any applicant that checks box is l 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 indicative such. Contractors that check this box must attached an additional sheet shotiving the name of the sub-contractors and their workers'comp.policy information. am an employer that is providingivorkers'compensation insurance for m}r employees. Belolp is the policy and job site reformation. nsurance Coma Name: �,5 S� 'oIicy 1-or Self-ins.Lic.- !�� � 'C f f if f'v^ Expiration Date: % ob Site Address: City/State/Zip:_�°�/o, 4AJ.00 A� Z, X kttach 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 ine 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 avestigations of the DIA for insurance coverage verification. do hereby cef t l oder lie pains ani,ppfialties of perjury that the information provided above is trite and correct. ianature: Date: / honey _; Official irse only. Do not write in this area,to be completed by city or town offrciaL ' I City or Town: PermitUcense i Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector � 6.Other Contact Person: s. Phone T. OP ID:SHHE CERTIFICATE OF LIABILITY INSURANCE DAT09130//YYYY) 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 CONTACT NAME: Macdonald&Pangione Insurance Fax:978-688-5350 PHONE Fax P.O.Box 428 _(A/c No Ext): A/C No): 104 Main Street E-MAIL ADDRESS: North Andover, MA 01845 PRODUCER CHRIS-5 Michael Pangione CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Christopher Rivet -INSURER A:Preferred Mutual Ins Co 15024 207 Winter St. North Andover, MA 01845 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: 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 ADDL BR SUPOLICY EFF POLICY EXP LTR I TYPE OF INSURANCE POLICY NUMBER I MMIDDlYYYY MM/DD/YYYY I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X I COMMERCIAL GENERAL LIABILITY CPP 0180 57 01 05 09/26/13 09/26/' DAMA E TO RENTED PREMISES Ea occurrence $ 100,000 _ CLAIMS-MADE F OCCUR MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,00 X POLICY PRO JECTLOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE S HIRED AUTOS (Per accident) NON-OWNED AUTOS $ i $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION ( WC STATU- 1OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT I $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St No Andover, MA 01845 AUTHORIZED REPRESENTA IV Michael Pangion ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD i 43 Massachusetts -Department of Public Safety Board of Building Regulations and Standards 6 Construction Supervisor License: CS-072173 CHRISTOPHER F LIVET— 207 WINTER ST N ANDOVER IVIk 01845 t r Expiration Commissioner 06/02/2016 i re o��rn�zn�rcuea L�.o. �autc ru�P,Jlt� _ 'Office of ConsOner Affa'rs&Business iZe n elatioSi _ ME IMPROVEMENT CONTRACTOR : eegistration: 139962 Type. xpiration: 9/812015 Individual 1 CHRISTOPHER F.RIVET i CHRISTOPHER RIVET sk 207 WINTER ST. N.ANDOVER,MA 01845 Undersecretary':