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Building Permit #395-2017 - 885 FOREST STREET 10/13/2016
%AORTIH l �e� BUILDING PERMIT . T®WN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION * = n Permit No#: 3q 5-- 2-017 Date Received EftRATED "'ya gSSACHUSE� Date Issued: 10 " ®l IMPORTANT:Applicant must complete all items on this page LOCATION ��-� ��5�� - 5_1 Print PROPERTYOWNER P nt 100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes tno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ _vv 0-ell p!F�loodplan Wetlands ❑ '1Na�t rs.hed;Distnct E DESCRIPTION OF WORK TO BE PERFORMED: 74 Identification- Please Type or Print Clearly OWNER: Name: /d � ®.vis Phone: 01 Address: t�Y J_ Contractor Name S.1, I/T Phone: Email: Address: �Zo 7 4-,,/,71-114 N06 WM' Supervisor's Construction License: L�27'::Z� 7 FL —Exp. Date: �s Home Improvement License: _Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ � �� ®� `� FEE: $ Check No.: a� ! �/ Receipt No.: 3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund st Location 8�� Fc-)"S'1 5 No. 3q5- 0 r7 Date 10 - f?j — a o • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $-Y Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# t f ,_ v N I"Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ TanningiMassage/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 m 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 Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/si nature ®ate Driveway Permit DPW Town Engineer: Signature: m, tESIytVxrie,T era 384 Located OsgoodStreetFIREDEPA,RT pmster►an;site y ' , 1n0 AA Fire(Depar�tme;y`ntlsignature/date , t • '` ,, s 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, mash or service drop requires approval of Electrical Inspector yes No DANGER ZONE LITERATURE: yes No MGL.Chapter 166 Section 21A—F and G min.$10o-$1000 fine NOTES and DATA-- (For department use) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 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 4� Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: 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 Copy Of Contract Floor/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 4, Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit a- Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 i NORTfy { own of 6 ndover O - R' No. 41 0440 h ver, Mass, O COCNIC K@WICK ��1 p�RA,r nPa�.(y S U BOARD OF HEALTH Food/Kitchen PERMIT - T LD Septic System THIS CERTIFIES THAT ...........�.lam..�............. .............................................. BUILDING INSPECTOR has permission to erect buildings on ....... 644sr Foundation � �. ...... ..........1/ .......g. ...... � L Chimney to be occupied as ..................1. ..... .... y provided that the person accepting this permit shall n 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 IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTI N TART Rough Service ........ . .. ........w....... .......................................... 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. I i a d a PROPOSAL Jane Running&Per Oines 885 Forest Street North Andover, MA 01845 (J) 978-314-0258 (P) 978-314-0257 (H) 987-686-1904 runoines e verizon.net Kitchen Remodel August 26,2016 Work to be completed includes: • Acquire Building Permit • Demo of kitchen,including removal of all cabinets and appliances,ceiling,floor. • Demo of back hall floor,half bath floor vanity&toilet,laundry floor. • Demo of tile floor in foyer,Living room floor,dining room floor. • Electrical-Install 10 new 5 in cans in kitchen ceiling,Two 4 inch cans over sink. Install new undercabinet lighting.Install new plugs and switches. Run new curcuits where needed. • Complete plumbing in kitchen and half bath. • Hang new blueboard and plaster. • Install new red oak flooring in kitchen,back hall,Foyer,living room&dining room. Sand floors and apply 3 coats of poly. • Install Base and Wall Cabinets.Install all moldings and crown. • Install Granite counter tops.(Group III) Cost of granite will change if from another Group. • Install tile backsplash. • Install tile floor in bathroom&laundry room. • Install all appliances.(New Fridge to be installed by others.) • Install new interior trim where required. • Removal of all debris. TOTAL LABOR AND MATERIAL $40,710.00 Terms: $13,570.00 to start $13,570.00 after plastering $13,570.00 when complete Note:This quote does not include the cost of cabinets,tile,plumbing fixtures,pendants,or appliances. Painting is also not included. 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 ccepted. You are auth rized t do the work as specified.Payments will be ma as o med a Date /3 �/ Signa Date Signature �. y 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 9f the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be require sub it to such arb' do provided in Massachusetts General Laws,Chapter 142A. 40eowner's Signature Contractor's Sign re 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 10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787 or(888)283-3757 281 B" .r 12" 30" 8'=---7r--30' 30`—, 15' ' 112185' 72" 21;8' 21',-6' 8."— 78a" 23e" 70 s"— 291" 39" 142;4' -33"---T-18' T----3J' 12" 3 " 15' 11215 W3033WCM (V W3033MM W3015WCM ' 1 33 /1 ih M � $ I BD8920PSS T 0-GAS-RANGE: —5 M -- =- - - -- 1 / U mlu a I `° n �I - . � j N H-18 3DB36 618E10 {-2218I 22 36,ei mW 104 " I CO t LO t M __.. . _. j r ^, _ _ j BEPVRSWCS-01* 824SDL U368724SS f W4833 .o- .93-V -- 2 24" 38" 207 — Srr 1 7 r, 105a 1Z 8 35z 9a 193;" 9;" 38" 2818" All dimensions-size designations Copyright 2015 This is an original design and must Designed: 9/23/2016 given are subject to verification on Pridecraft, Inc not be released or copied unless Printed: 10/4/2016 job site and adjustment to ft job All Rights Reserved applicable fee has been paid or job conditions. order placed. Running Kitchen Rev 1 All Drawing#: 1 No Scale. The Commonwealth of Massachusetts Department of Industrial Accidents ` Office of Investigations { d �1 ` 600 Washington Street " - Boston,MA 02111 - '1+ •www.mass ov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeitbly Name(Business/Organization/Individual): Address: 490 7 �/'A.1�i?J City/State/Zip:,/`Ur,, Are you an employer?Check the appropriate bog: Type'of project(required): 1.❑ I am a employer-with 4• ❑ I am a general contractor and I �Ployees(fall and/or part-time).* have hired the sub-contractors 6. ❑ ew construction 2.91 am a sole proprietor or partner- listed on the attached sheet 7.. 11Remodeling ship and have no employees These sub-contractors have g. E]Demolition working for me in any capacity. employees and have workers' insurance.: 9. ❑Building addition [No workers comp.insurance comp. required.] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3.❑ I am a homeowner doing all work 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c.152,§1(4),and we have no employees.[No workers' 13.❑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 hue 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 state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. lain an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. _ Insurance Company Name: � i�; •• ,� Policy#or Self-ins.Lia Expiration Date:��t f-7 Job Site Address: .OF��� / � City/State/Zip:_ m ; •'YN��'v�a�.j 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 o€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 Zoeder p 'ns penalties of perjury that the information provided abp istr andcorrect Date: oZ fb Phone# � �' Official use only. Do not write in this area,to be completed by city or town of eial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector . 6.0ther Contact Person: Phone#: OP ID:GOGL CERTIFICATE OF LIABILITY INSURANCE DATE DD016 09/15!2016 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(les)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 endorsemen s. PRODUCER Phone-978-688-6921 NAME: cT Kim Landry Macdonald Pangione Insurance PHONE A/C o g]8-688-6921 FAX No,g]8-61W 350 104 Main Strr eet Fax:978-688-5350 North Andover,MA 01845 E-MAIL Michael Pangione ADDRESS:KIM@mpins.net PRODUCER CHRIS'S -CUSTOMER ID;t: INSURER(S)AFFORDING COVERAGE NAIC d INSURED Christopher Rivet 207 Winter St. INSURER A:Preferred Mutual Ins Co 15024 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. ILTRR TYPE OF INSURANCE L UBB POLICY NUMBER POLICY EFF POLICY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY BOP 0100719749 09/26/2016 09/26/2017 DAMAGE TO RENTEIT__ PREMISES Ea occurrence) $ _ 100,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,0 X I POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ^ ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N T RY L S ER ANY PROPRIETOR/PARTNER/EXECUTIVE .OFFICER/MEMBEREXCLUDED? 0 N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ ESC IPTION OF OPE ATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space is required) vl ence OT [insurance 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 1600 Osgood St ACCORDANCE WITH THE POLICY PROVISIONS. No Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public'Safety t Board of Building Regulations and Standards License: CS-072173 Construction Supervisor CHRISTOPHER F RIVET 207 WINTER ST N ANDOVER MA 01845 . r rt��jzzK Expiration: Commissioner 06/02/2018 �_-Once of Consumer Affairs&Business Regulation ^� OHOME IMPROVEMENT CONTRACTOR 'Registration: 139962 Type: ` Expiration: 9/8/2017 Individual CHRISTOPHER F.RIVET CHRISTOPHER RIVET 207 WINTER ST. N.ANDOVER,MA 01845 -- Undersecretary h