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HomeMy WebLinkAboutBuilding Permit #746 - 90A PLEASANT STREET 5/21/2010TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: -�v Date Issued: Date Received 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 . Floodplain 'Wetlands Watershed District Waft erewe- = m DESCRIPT? PIF /TOO K0OR � O E PERFORMED,:, Identification Please Type or Print Clearly) OWNER: Name: �J �l /'i i9y'/Q� Phone: Address:_ % 1Z1e1YP%1r'C-- sy /yO �&YD006'e CONTRACTOR Name 1 ct l�' 4I/� Phone:: Address:_ w�s1/l,400 C1G? upervlsor's,Constructicin License: - C-1 X2loif &� , .Exp: SDate, f / H©me�Improvement L cense: ` % vvr Exp: abater ., ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT: T. 0 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: FEE: S Check No.: E3::5;7 Receipt No.: � l q� NOTE: Persons contracting with unregistered contractors do not have access tomfteuaruninfi 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 DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature _ COMMENTS 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 Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. 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 - Date Doc:.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permitio 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 Li Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ 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 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 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 must be submitted with the building application Doc: Doc.Building Permit Revised 2008 Or- LocationUon No. Date NORT1TOWN OF NORTH ANDOVER 0 p i y Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 23 94 Building Inspector w w a o c u p w° p, cin w z z Q W o o Ccoa w° a°' v U w o a a a°' Ta w a o a u w W r�° cnw m x w - a ono z m w H z A a W v rA o z , cn v Q o E ch m c c v O O C : O N O C3 C.) •ate Q• c �v m :mom := o p i CD �i E a r, c _ 0 Ca m CL 440 N �o m A4 mcm K.0 N A m 3 A N : CD cm : m N C C � C m A 'O fl y C O CO :ave m • m m ; c�COD c o N CL p = cum m C CD :ono c Q o :cmc •o x m CD N :a COD W C f+� •CA CL=O C Z oc E CJ `rm •N o C.3 o ®®mac COD d CD O :0 xca .0 cc 10 CO .A -kM U O 4 O E co � o Z a3 CL O y Q C CO CM I O •� y Q � CD.� Ll co •E m m co CD co C DO ca L o. O O d Co a. �a CD ccCc� C v�J'C •O. O 43 ca c40 Z � V H O ; C C ev � 0. CA Q LLI Y/ Y/ W W 19 W co z m c c v O O C : O N O C3 C.) •ate Q• c �v m :mom := o p i CD �i E a r, c _ 0 Ca m CL 440 N �o m A4 mcm K.0 N A m 3 A N : CD cm : m N C C � C m A 'O fl y C O CO :ave m • m m ; c�COD c o N CL p = cum m C CD :ono c Q o :cmc •o x m CD N :a COD W C f+� •CA CL=O C Z oc E CJ `rm •N o C.3 o ®®mac COD d CD O :0 xca .0 cc 10 CO .A -kM U O 4 O E co � o Z a3 CL O y Q C CO CM I O •� y Q � CD.� Ll co •E m m co CD co C DO ca L o. O O d Co a. �a CD ccCc� C v�J'C •O. O 43 ca c40 Z � V H O ; C C ev � 0. CA Q LLI Y/ Y/ W W 19 W co MASSACHUSETTS ROME IMPROVEMENT CONTRACT chis form satisfies all basic requirements of the state's Home Improvement Contractor Law (MGL chapter 142A) but does not include standard .. anguage to protect homeowners. Seek legal advice if necessary.' Any peisonplanri home Oaprovem6nts Should feat obtain a copy of "a Nassachusenmeonsumer guide to home,improvement" before agreeing to any work on yourmmidinim You may obtain free copy by'calling the )Mce of ConsurnerAliairs:and Business.Regulation's Consumer Information Hotline at617-973 8787 or 1 *888,281-3757. uvmwnuca auaus Ma un '4um etor ln[orinafion . name CodPetry Name... KSS A`1,llGS/S�S Street Address (do not use a Post Office Boz address) tractor/ Salesperson/ Owner Name 10 TO.RN-PI Ar Qty/Town Zap Code ess A include a street address) . A(o �-rlp dick -®,ice ,9�uIZ fts# Daytime Phone Ev ' Phone R �g ty own State Zap Code jw) gtyOv 11ek j1o / S— Mailing Address (h different from above) 3usinesi Phone liederal Employer ID or S.S. Number la"ngai,u am awn homeim. Acme // C®tndm RCa:Mamhv 'Seery%tiondge%'.; �egimsa®mmbv ✓✓✓ The Contractor agrees to do the following work for the Homeotier: . 1111 me woric Id tZinplared, spectrying me �® o r 16.901104-- .�� 01-7 Gvw.7'*' . sI �` r _r kA 10 `1e 4 PC 0 '19F` fie j2 oc f t l�cv h � j 14 L Lj M71 AICI 1 Djj 'j J'> t) 6 R � e-- t� Fav✓ ltequired Perndts - The -following building permits aro required Proposed Start and Completion Schedule - The following schedule will and will besecured..by the contractor as the'homeowrices agent be adh �/; nless circumstances beyond:the contractor's' ccmuol arise (Owners who secure their own periult s will be q excluded from :tlite; Guaranty Fund'provisions of �f when contractorwill begin contracud work. MGL chapter 142A.) • �9site when connactid .work will be substantislly.eompleted. Total Contract Price and Payment Scbedule , The Contractoragrow to perform the work, furnish the material and labor specified above for the total sum of. (") Payments®�1 "ide according to the following schedule: $ V Upon signing contract (not:to exceed 1/3 of the total.contract price. gt the costof speci`I order items, whichever is greater) $ or upon completion of p`_/_/ or upon completion of p L o �` ' r o Pd P (Law forbids demanding full.payment until .contract is completed to th r $ upon lotion of the contrsct, rep party's satisfaction) The following material/equipment must be special S to be paid for ordered before the contracted workm'begins in order S to be paid far to nice &a completion schedule.(**) NOTES: (h Including all finance charges (••) Law requires that any deposit or down -payment spared by the contractor before wor%begins may not exceed the greater of (a) one-third of the total contract price or (b) the actual con of any specialegttipmant or custom made materia] which must be special ordered in advance to mat the completion schedule ExPrer warranty- Is an express. warranty being n, ovided t.., s.econt etorl No Yes( "ash ti h to the eontraetl Subcontractors The contractor agrees to be solely responsible for completion of the work des ;n'bed 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 laborunder this a¢rcrment 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 fru been placed on the residence Review the following cautions and notices carefully before signing this contract. • Don't be sumd into signing iffiini i 1� going the contract. Take time to read and felly understand it Ask'questions if something is unclear. • Make sure the contractor a a valid Home Immovicm,f q14 The Iativ requires most home improvement connectors and . subcontractors to be registered with .the Director ofHome Improvement Contracw Registration. You may inquire about contractor - registration by writing to the Director it One Ashburton Place, Room 13Q1, Boston, MA 02108 or by 61.7-727-3200.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 ieverscside offt form and get a copy of the Consumer Guide to the Home Ialprovement Contractor Law. You may cancel this agreement if it has been signed at a place' other than the comractor's normal place of business, provided you notify the contractor in writing at his/her main office or branchoffice 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 o£ cancellation form for an explanation of this right DO NOT SIGN Tuic rnNTW Ar -r Tr mutr n V ,t me A W-1 — . ?coo ideatial copies of the ecatraet moat be Ieted and a' • i rJ"f%J I K%. Of t1\.1.' t .. COtop ,fined. Oce copy shouldaotothehomeowner. other COPY tbMWbekeptbythe contractor. c eHeo s Stgria tt�mtt�m / Con is Signature Dau Date Total Contract Price and Payment Scbedule , The Contractoragrow to perform the work, furnish the material and labor specified above for the total sum of. (") Payments®�1 "ide according to the following schedule: $ V Upon signing contract (not:to exceed 1/3 of the total.contract price. gt the costof speci`I order items, whichever is greater) $ or upon completion of p`_/_/ or upon completion of p L o �` ' r o Pd P (Law forbids demanding full.payment until .contract is completed to th r $ upon lotion of the contrsct, rep party's satisfaction) The following material/equipment must be special S to be paid for ordered before the contracted workm'begins in order S to be paid far to nice &a completion schedule.(**) NOTES: (h Including all finance charges (••) Law requires that any deposit or down -payment spared by the contractor before wor%begins may not exceed the greater of (a) one-third of the total contract price or (b) the actual con of any specialegttipmant or custom made materia] which must be special ordered in advance to mat the completion schedule ExPrer warranty- Is an express. warranty being n, ovided t.., s.econt etorl No Yes( "ash ti h to the eontraetl Subcontractors The contractor agrees to be solely responsible for completion of the work des ;n'bed 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 laborunder this a¢rcrment 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 fru been placed on the residence Review the following cautions and notices carefully before signing this contract. • Don't be sumd into signing iffiini i 1� going the contract. Take time to read and felly understand it Ask'questions if something is unclear. • Make sure the contractor a a valid Home Immovicm,f q14 The Iativ requires most home improvement connectors and . subcontractors to be registered with .the Director ofHome Improvement Contracw Registration. You may inquire about contractor - registration by writing to the Director it One Ashburton Place, Room 13Q1, Boston, MA 02108 or by 61.7-727-3200.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 ieverscside offt form and get a copy of the Consumer Guide to the Home Ialprovement Contractor Law. You may cancel this agreement if it has been signed at a place' other than the comractor's normal place of business, provided you notify the contractor in writing at his/her main office or branchoffice 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 o£ cancellation form for an explanation of this right DO NOT SIGN Tuic rnNTW Ar -r Tr mutr n V ,t me A W-1 — . ?coo ideatial copies of the ecatraet moat be Ieted and a' • i rJ"f%J I K%. Of t1\.1.' t .. COtop ,fined. Oce copy shouldaotothehomeowner. other COPY tbMWbekeptbythe contractor. c eHeo s Stgria tt�mtt�m / Con is Signature Dau Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the nght-to.initiate an arbitration action (as an r ; altematrve to court action) if they, have a. dspute;with.e coatractor. The same right is not automatically afforded to'a contractor, however. The contractor;: would have tp resolve any, dispute he/she .has.with a homeowner in court unless both parties agree to the optionat clause provided below. .This clause wouldgive 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 and1he�consumer shall be'required to su o su arbitration as provided In. Massachusetts General Laws,!chapter, 2A. H�M5y! rs Signature Contractor's Signatu N The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution it the contractor. jhe1otneownermay initiate alternative; dispute resolution even where this section -is not aenstmtely sienedirv:the tyatties. Homeowner's Rights A b3meownees rights under-tlte 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. , Homeownet� 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 sn.express warranty for: workmanship oi• 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 whichthe homeowner and contractor lawfullyagree: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 du Lica a 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 clriginal coniract,must be in writing andagreed 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 recission period has expired Accelerated Payments A contractor may not demand payments inadvance.of the dates specified on the payment schedule in cases where the homeowner deems hitn/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 Lawor other consumer rights,. or if you, wish to. obtain a free copy of "A Consumer Guide to the Home Improvement Contractor Law,"• contact:.. . Cgnsumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787 or 1-(888) 2833757 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: r of Home Improvement Contractor Registration. Bureau of Building Regulations and Standards One Ashburton Place, Room 1301, Boston, MA 02108 T (617) 727-3200 or 1-800-223-0933. For assistance with informal mediation of disputesor to register formal complaints against a busMi P,, call_: ConjuiiierComplaint'Sedtion Office of the Attorney General (6.17)727-8400 AND/OR Better Business Bureau (508)652-4800 (508) 755-2548 (413) 734-3114 The Commonwealth of Massachusetts Department of IndustrialAccidents 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): Address: VZ et1-swwj— "Pl City/State/Zip: 0 19ND 2 Phone #: / 974 J�e­o; 73 7 Are you ployer? Check the appropriate bog: Type of project (required): al d I 1. 2. Q 3. Q I am a employer with 4. Q I am a gene r contractor an employees (full and/or part-time).* I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers'. comp. insurance.$ 5. Q We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers'. camp. insurance required.] 6. Q New construction 7. Q Remodeling 8. Q Demolition 9. Q Building addition 10.Q Electrical repairs or additions 11.Q Plumbing repairs or additions 12. [],Roof repairs 13.Q 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 condichors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheetshowing 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. r Insurance Company Name: /M '1105�Q /� q — .Policy # or Self -ins. Lic. #: zo/4/6, �'� � �� Expiration Date:�1l/ `7 d �l %1�Y �$ l Ci /State/Zi Via►/,o���2'- Job Site Address: �' City/State/Zip: P� 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 MGI, 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 cer ' under MePains aanndpen ofperjury that the information provided above is true and correct. C;n„oh,ra• (/��R C7�y7/`L - - mate: Phone #: 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 #: 41 x CS # 022680 HIC# 103358 A. J. Walsh & Sons 55 Pleasant Street .North Andover, MA 01845 # of pages 978-688-6737 or 1-866-AJWALSH j k lJ l i d 5 A c ProposaIS ubmitted To: ! ►O� JobName Job # ��°"-• fit; �_,,.�,. � i n� �lallri /( Address Date 30 r Date of Plans Phone # Fax # Architect We hereby submit specified estimatC��- _- --- -�._ _ ..._. .___...._..._.. __ ----- ---- -- -- -.� _�.�.. / ._ —.._ . .... Vl1 ... -- ------ -... c-°��n_ _ - - -- -- --._ .._._... - ---- -------------- - __ _...._........ *N I s l t' V-'_ CA-, el-( ' 4�pu 62, Wire OF We propose hereby to furnish -,material and.labor—_complete in accordance_tn<rith.the aboue_specifications-for.the sum of -� $ r!p5 OD-4f� UJ wt G+�- �U�^l� 1 /4 D tl Dollars r C� with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully i executed only upon written order, and will become an extra charge over and submitted above the estimate. All agreements contingent upon strikes, accidents, or delays i beyond our control. Note — this proposal may be withdrawn by us if not accepted within days. acceptance of proem; The above prices, specifications and conditions are satisfactory and are Signat ''"!`'�• hereby accepted. You.are authorized to do the work as specified. Payments will be made as outlined above. f Date of Acceptance Signa I