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HomeMy WebLinkAboutBuilding Permit #354 - 880 GREAT POND ROAD 11/2/2009 ..TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: c5 . Date Received //" Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 4z / /Gd LL Pnnt. PROPERTY OWNER:. wrC- Cl,..�'Ay - Pnnt MAI'NO:�� y , PARCEI= /� Z0N1t*IG DISTRICT Historic District yes riga MachineZ-hop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 'New Building One family �- r Addition Two or more family Industrial Alteration - No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic ;1Nell :'Floodplain V1/etlancis U1/atershed District cWater Sed' ` DESCRIPTION OF WORK TO BE PERFORWD: ��dv� oG b �d r" � �5✓��t, IAV AfeC, C3 49 l�teL, nl�LY„s 4JY ,�H�-tea hOM� Identification Please Type or Print Clearly) OWNER: Name: GG �'S S /1�L, ��i( Phone: Address: 4 CONTACTOR Name: <7 . A ;Phone Supervisor s CanStruction License .Z Exp. ;Dates (D /� Home_Improvement}License- Exp. Date; ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING Pr- 1T.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. (yZ5 �O Total a-- Project Cost: $ cW, QDd FEE: $ � Check No.: �3 r Receipt No.: ^�'y NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund a ignature�of Agent/,Owner-: r _� `� ':: ,::, , Sig tuie ofcontrac#or 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 i CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed onSignature . � r r 1� COMMENTS Zoning Board of Appeals: Variance, Petition.No: Zoning Decision/receipt submitted yes y Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPAR-M:ENT TerraiDumpster:on site .ayes` no, 'Located at 124',M6in Street Fire Department signature/date COMMENTS 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) i 1 ❑ 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 permit to be obtained. Roofing, Siding,g, Interior Rehabilitation Permits a 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 g u Idin Permit Application ❑ 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 J 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 - Locations No. `J1 Date NpRTh TOWN OF NORTH ANDOVER 3? i _ ' • Op 7' F j° s i # Certificate of Occupancy $ Building/Frame Permit Fee JACHUSt ._. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ tea Check # 22592 Building Inspecto� NORTH TO" of t 4Andover , 3S = No. A K E = dover, Mass., COCHICHEWICN y1. t �d AERATED P'Pa` '`C) . S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............... ......... • . ......................................... Foundation 3 has permission to erect..:....................... ............ buildings on ............ Rough to be occupied as Chimney ............................................................................................................ provided that th person accepting is p�Fmit shall in every respect conform to the terms of the application on file in Final. this office, and to the provisions o t e 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 IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTION ARS Rough .................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. MASSACHUSETTS HOME IMPROVEMENT CONTRACT This forat satisfies a..11 basic requirements of the state's Home Improvement Contractor law(MGL chapter 142A) lint does not include siandiird language to protect homeowners. Seek legal advice if necessary. Any peisonplenning home rprovematts should first obtain a copy of"a Massachusetm consumer guide to homaimprovement"before agreeing to any work on yourresidence;You may<obtaina fi 6. copy by'calling the Office of Consumer Affairs and Business Rogulation's Consrimer Information Hotline atb17-973'4787'or 1.8887.283-3759.' Homeowner Information -onttactor Information Nim Ampany Name ;,fir': .;, /-� �f.Sb/�/,5 . tree[Addrrsv (do not use;a ostOffice Boz address). tractor Salespersoa/OwnerName ... G 61 QtyR own state Zip Code lusiness Address(must include a atreet address) . G,z�Hs&lysr A/a Iq Vy6_� Daytime Phone Evening Phone.- ityrlown State Zip Code Mailing Address(It different from above)` 5usiness phone ederal Employer ID or S.S.Nua_w _ - i."taph thslmoq bO=i' ` soma C®mWaep.N_bw .plmWwdltc:. oommlm have; I .,o�.� _ .. . . - neaWadw mtmbe The Contractor agrees to do the following work for the Hornet rner. floe r= avTffG s U//W- 0/)/ '194-14 67/4146S Required•Pet•mits-The-following building permits are required Proposed Start and Completion-Schedule-The'following schedule will and will besecured.bythe contractor as the homeowner's agent; be adh d unless circumstances*end:the contractor's'control arise (Owners who,secure their own permits will he 9 excluded from the:Guaranty Fund`provisions of l to when contractor will begin conrraeted sock MGL chapter 142A.). pp i�bte when contracted .work will bei ubstantially.'completed Total Contract Price and Payment Scbedule , The Contmctor.agmes to perform the work,furnish the material and labor specified above for the total sum of YM,ents will be made according to the following schedule: $ n\�1 upon signing contract(not:to exceed 1/3 of the total'.contract price gr the costof special order items,whichever is greater) $ by n completion of } by n completion of gDod.� --- $ r upon completionof the contract (Law forbids demanding full payment until.contract is completed to both party's satisfaction).. The following material/equipment must be special $ to be paid for /- ordered before the ttontraetod work begins m orderS to be paid for—�— :. to meet the completion schedule.(**) NOTES:(•)including all finance charges(••)Law requires that any deposit or down-paymant required by the contractor before work begins may not escced the greater of(a)one-third of the total contract price or(b)the actual con of tory spaaal.equipment or custom made materiel which must be special ordered in advance to meet the completion schedule. Express Warranty-is an express-warranty beink provided by therontractor" No Yes .(n fe.,..s fat, .� �. Subcontractors The contractor agrees to be solely responsible for completion of the work described regardless of the actions ofany 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 ibis a¢roement 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 inter eSt)as 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 end fully understand iL Ask'questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor R ¢ist.mfig The I&requite most home improvement contractors and. subcontractors to be registered with die Director of Home Improvement Coatractar Registration. You may-inquire aboutcourractor registration by writing to the Director at One Ashburton Place,Room 13QI,,Boston,MA 02108 orby..calling 617-72.7-3200.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 reverse Guide to the Home Improvement Contractor Law. side of this form and get a copy of the Consumer You may cancel this agreemem if it has been signed at a place other than the contractor's normal place of business,provided y=right contactor in writing at his/hermain office or branch office o Po ted,by tele sent or delivery,by rdinary mail s gram by cry,not later thrid business day following the signing 'this agreement.See the attached notice of cancellation form for an explanation of.t DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPAC'ESM TWO ideotinl eopim of the eemcact mast be coa*kmd and aiamd.One copy.ahoutd ao to the , .The OdW copl'sbwW be .. ... kept by ti1de/am�tr/act/m. We Co is Signature Dale —--� Date t., Contractor Arbitrstion The Home Improvement-Contmaor Law provides;homeowners withthe righvto initiate an arbitration action(as an alterative to court action)if they.have a dispute:with.a contractor. The samerightis not automatically afforded to'a contractor,however.:The contractor would have`p 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 ConsumeiAffairs arid Business Regulation and°the consumer shall be required to sub it to such arbitration as provided In.Massachusetts General Laws,c apter]42A. fi eownees s' Contractor's Si NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor: The homeownermay initiate alternative dispute resolution even where this sectionis not separated signedt+-:the parties•.'. Homeowner's Rights A homeowner's rights under"the._Home1nprovement 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. Homeownes� 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- Homeownersmay be entitled to other specific legalrights 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:fora particular purpose. An enumeration of other matters on whichthe homeowner and contractor lawfully agreeto the :may be added: terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consurner/homeowner rights,contactthe 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 fillet 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 c7iginal contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties havehreceived a fully executed copy of the contract,and the three day recission period has expired. Accelerated Payments. A contractor mgy not demand payments inadvance.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/hemelf 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 wouldrequire 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,orif 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 specifidaliy about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Bureau of Building Regulations and Standards One Ashburton Place,Room 1301,Boston,MA 02108 (617)727-3200 or1-800-223-0933 For assistance with:informal mediationof disputes or to register Formal complaints.against a business,call:' Co §iimer'Coinplaint'Section Office of the Attorney General (617)727-8400 AND/OR Better Business Bureau (508)652-4800 (508)755-2548 (413)734-3114 ikopool Page# of pages CS # 022680 978-688-6737 HIC# 103358 A. J. Walsh & Sons or 55 Pleasant Street 1-866-AJWALSH North Andover, MA 01845 Proposal Submitted To: v Job NameJob# Address Job Locatiorf ��J �,������✓ ��, �/��5 _ Date ly D 9 Date of Plans Phone# G�7 _ Fax# Architect FWe hereby submit specifications and estimates for:.......... �._.,.._............. /......_..,........- -...------..__..,.................................................--___._...........--...-......_...... ------------------.._._.._.._._.........................._..._..._.._..- ---.._.__..._............................_.. __ '2 rZ ._ �'�._l e rbc✓... — - - /....._.. ......—...........-.._.._............... _ Y�2 .........'7C _. ------..._-_.._.,......_..................--..-_-..._-------..__:_...._...._...... _--_...✓_....................; - ._._._._._..__..__._....._...._._.-_...... .._..---..._._....................._ . ,g G.......... _._. .41::. .._ uG... •i*,v c _/? � � . 1 ,(���t' I ..................................._.. _ - .._.. ._........_...__.: _.._._._� _.._..._....! , Gu __.= __. ._. V -- _ _ _.. ..................................._................._-._.._____.._.__...................__.__..__.___..._._-_.._..............-.........._.......__....__.____._._ .._.....__....._._....____...__ .._.___.__-.__._.___...__._..._.-.__....._.._.________. ...__.___.._.._.. .._:..__.._._..-___._._.._.____........_�.._. li-ad_.._. ....._._._..__9p ,�-rte ..,.___.....---- - e., C - v _ laz _ t:�_.__ ._. !:1_c .�... - - _......................._..._...C _. 'us _....-,.._.rte'./ r-Vic.-= ........__......... _. _......-....._....._..._..... l .......... «� ......... _.....__........................C� '!'t�-G'K_..._......,......._........._..._..._... -..:_. r% ..................._...................__.-........._......_..........._......................._......._-..._...__._....._......_............................................................._................_............_._.-..........._........._....--....._........-..........----...._........................_.------ ........_.................. .........__........... - ................................ ......._..... ..u _............. rs2% u..................................................-................._.........................-......-.......-..._....-........................................................_..................._-..._._..................................... oo We propose hereby to furnish material and labor—complete in accordance with the above specifications for the sufm of: o©Da $ Dollars with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully 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 / y beyond our control. Note—this proposal may be withdrawn by us if not accepted within days. acceptance of 3pyopogal �- � �j The above prices,specifications and conditions are satisfactory and are k,"Signature �� /�✓% �`%�"�'' hereby accepted.You are authorized to do the work as specified. (/ f V Payments will be made as outlined above. Date of Acceptance Signature The Commonwealth of Massachusetts Department of Industrial Accidents l Office of Investigations =( � �1 600 1.4 ashington Street Boston, MA 02111 rvIvw.mass.govVdia NVorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluai11be"rs A Pplicant Information Please Print Legibly NalIle (Business'Orgatuzation'lndi%,idu2): AEA/Wske A ddress: ��-- City/State/Zip: ef,I Phone #: Are io n employer? Check the appropriate box: �— FJO.ElElecuical roject (required): • l [?"J"am a employer with _ � 4. ❑ l am a general contractor and J employees (full and/or part-time).* have hired the sub-contractors construction ❑ i am a sole proprietor or parmer- listed on the attached sheen. i odeling ship and have no employees Tbese sub contractors have olition working for me in any capacity. workers' comp. insurance. ivro workers' comp. insurance 5. ding addition 1 p ❑ We are a corporation and its I equired ] officers have exercised their nical repairs or additions 3. ❑ 1 am a homeowner doing all work right of exemption per MGL bing repairs or additions myself. [No workers' comp. c. 152, §l(4), and we have no - 12. oof r airs insurance required] t employees. [No workers' comp. insurance required.) 112 Other l/1'1JY6 S/, y1V Any applicant that checks box 111 muss 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 afridavit indicating such. contractors that checb:this box must attached an additional sheet shoving the name of the sub-contractors and their workm,comp.policy information_ am an employer that is providing workerscompensation insurance for nr h employees. Below is the policy and job site r/brmation. isurance Company Name: o]icy #or Self.ins. Lic. #: 7d tV&�KF®l1/d®/ Expiration Date: ob Site Address: City/State/Zip; &p �/,�;�i ttach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). tilure to secure coverage as required under Section 25A of MGL e. 152 can lead to the re to $250 51;500.00 animposition of criminal penalties of a d/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine up to 5 .00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ves6gations of the DIA for insurance coverage verification. 'o hereby certify under the pains and penalties of perjury that the information provided above is true and correct ,nature: Date one#: ��� In c� ' l� ��� Official use only.'Do not write in this area,to be completed by city or town official. City or Town: PermitfLicense # Issuing Authority (circle one): L Board of Health 2. Building Department 3. City/To 5. Other Hn Clerk 4. Electrical Inspector 5. Plumbing Inspector -7ontact Person: Phnnv u• �i.1,,acttu.rtt. - Dcparttnent of Public sat•et+ Board of Building Reuulations and Stani,1111•tl" Construction Supervisor License License: CS 22680 Restricted to: 00 ARTHUR J WALSH JR 55 PLEASANT ST N ANDOVER, MA 01845 �� ,• Expiration: 6!912010 Tr4: 27002 ✓71e CpP»vrnaruuetr.G/�i � ,�� _ \ Board of Building Regulations and Standards NOME IMPROVEMENT CONTRACTOR Registration: 103358 Expiration: 7/7/2010 Tr# 271352 Type: Private Corporation A.J.WALSH&SONSJNC. Arthur Walsh,Jr. 55 Pleasant St N Andover,MA 01845 Administrator ow- The C6.mmonweaft.h Of Massachusetts Department of Fire Services Office of the State Fire Marshal P.0.Bax 102ipStiteRoad,Stow,MA 01775 PERMIT Date: /Z-2 North Andover JlermitNo (City of Town) (if Applicable) Dig Safe Num er In accordance with the provisions of/M:GSL^14 8.Ghapter_j_(L as provided in section 5 7 ('MR 34 Stmt Date This Permit is granted to:. FuU name of person,Finn or Corporation Permission to locate dumpster for construction/renovation/demolition of building. C°nunents: dumpster must be . 25 ' from structure if unable to place with required Restrictions:clearance dumpster must be covered wiythi� plywood or tarp end of work -day at e/e✓?/c P,� �/0 �J!'! CJ D Uyl\ /'�✓/T (Give location by street and no.,or describe m such mangey(/Q�.jtoparov adequate identification of location) Fee Paid$ 51,11 }r�//j Fire Chief This Permit will expire- (Signa=e of offical granting permit) Offtcal granting permit (Title)