HomeMy WebLinkAboutBuilding Permit #015-13 - 984 TURNPIKE STREET 5/1/2018 BUILDING PERMIT oFtN°RDT#j
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TOWN OF NORTH ANDOVER c
APPLICATION FOR PLAN EXAMINATION `'
Permit NO:0/<_ /�
Date Received
�.9SSAre
CHoUs��gS
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATLON
Print
PROPERTY OWNER'. QAV;19-_ (t-4-Gl -
Pnnt _
MAP NO'. PARCEL: . ZONING DIST
_ RICT_. ( � -Historic.District yes no-
_ ;Machine Shop Village , yes •. no
I
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 . V1/etlands Watershed District'
Water/Sewer.
,c DESCRIPTION OF WORK TO BE PREFORMED:
c
Identification Please Type or Print Clearly)
OWNER: Name:_S;� Phone:
Address:
CONTRACTOR, Name, td1 fi,"z. Phone:_
` Address: _
Sury
pe isor Construction License: 3 5_ �'y. _ Exp. Date:_/ !
Home Imp_rovemen License: Z. CJ Date; 3�
__.- _
ARCHITECT/ENGINEER Phone:
I
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
T
Total Project Cost: $_ fes, �d U FEE: $
I Check No.: /0/ 7 (- eceipt No.: q�e
NOTE: Persons contracting with unregistered contractors do not have access to the guy an fund
Signature of Agent/Owner- Signature of contracto
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans f
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 6> / Signature
COMMENTS C0 aid
HEALTH Reviewed on Signa ure -
COMMENTS OK ms✓ v G' L ---L E C-
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� Ij)J 'e'
r•
e 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``Dum`psteron site yes° nog .x
:;Located.at 124'Mam:Street r
-Fire Department-,signature/date
17
COMMENTS
I
Dimension
'I Number of Stories:Total square feet of floor area, based on Exterior dimensions.
I
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.$10041000 fine
NOTES and DATA— (For department use)
❑ Notified for pickup - Date
i
i
Doc.Building Permit Revised 2008
J
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
❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
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Location �7 n f 7�r n-/ , 1(��
No. O�. Date
r
a • ' o,. TOWN OF NORTH ANDOVER
0
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL �
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40
Check#
25488 fl ing Inspector
Massachusetts Home Improvement Sample Contract
This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard
language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A
Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the
Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website.
Homeowner Information Contractor Information
Name Company Name
D4ul�
Street Address(do not use a Post Office Box address) Contractor/Salesperson/Own r Name
City/Town
n State Zip Code Business Address(must include a street address)
Alp',V fit,.
Daytime Phone Evening Phone City/Town State Zip Code
19
Mailing Address(It different from above) Business Phone Federal Employer ID or S.S.Number
Home Improvement Contractor Reg Number Expiration date
Law requires that most home
improvement have
a valid registration number er
The Contractor agrees to do the following work for the Homeowner:
(Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.)
Z ���-.�, �•�.�-�.e �rGo��' . /=nom �a ��
7 X a $
Required Permits-The following building permits are required Proposed Start and Completion Schedule-Th6following 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 own permits will be 12—
excluded
Zexcluded from the Guaranty Fund provisions of asDate when contractor will begin contracted work.
MGL chapter 142A.)
p !Z
Date when contracted work will be substantially completed.
Total Contract Price and Payment Schedule p
The Contractor agrees to perform the work,fiunish the material and labor specified above for the total sum of-
Payments
fPaymsents 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 greater)
$ 0 UUbyl / / or upon completion of n.se ..,,
$ 016 6 U by 77- 12 or upon completion of F4 4-9-t>c
$
YO-So 0 upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction)
The following material/equipment must be special $ 4 0 0'0 to be paid for `- Oo n hq,
ordered before the contracted work begins in order
to meet the completion schedule.(**) $ 21oaO to be paid for _4�zq� S
NOTES:(*)Including all finance charges(**)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 bein>r provided by the contractors No❑'Yes fall terms of the warranty must be attached to the contract)
Subcontractors-The contractor agrees to be solely responsible for completion of the work described 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 labor under this asreement
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 has been placed on the residence. Review the following cautions and notices
carefully before signing this contract.
G Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear..
G Make sure the contractor has a valid Home Imrorovement 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 888-283-3757.
o 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.
G 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 telegram sent or by delivery,not later than midnight of the
third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right.
DO NOT SIPN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!!
o identical copies of ontract must be completed and signed. One copy should go to the homeowner. The other copy sh d be ke y the contractor.
Homeowwne 's Siggaillre Contr or's Si nature
(02D (Z- . Z/
Date Date
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 t1le Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required
toi it o su h ation a vided In Massachusetts General Laws, chapter 142A..
-Z
Homeowner's Signature Co acto ignature
NOTICJE: 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 leave 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 fiends 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 Massachusetts Consumer Guide to Home Improvement"
contact:
Consumer Information Hotline
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787, 888-283-3757 or visit the OCABR website at http://wwNv.mass.gov/ocabl•/ .
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:
Director of Home Improvement Contractor Registration
• p
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
617-973-8787, 888-283-3757 or visit the HIC website at littp://www.mass.gov/ocabr/
Go online to view the status of a Home Improvement Contractor's Registration:
lftp://db.state.ma.us/b.omei=rovement/licenseelist.=
For assistance with informal mediation of disputes or to register formal complaints against a business, call:
Consumer Complaint Section
Office of the Attorney General
617-727-8400
AND/OR
Better Business Bureau
508-652-4800, 508-755-2548 or 413-734-3114
Version 2.1-11/22/2010
Date....... ' .fi .................
OF NONT�y,h
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
88'�CIIU`3�
This certifies that � pe.&I.9.10V......................
...............
has permission for gas installation ....Lie ( ;.........'......... ...................
inthe buildings of...........................................................................::.......................:...............
at...�. ....... a .�.1C ........'"-..............................L
.. No�rtth Andover, Mass.
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Fee3d:.I)..... Lic. No.
S�NSPECTOR
Check# /D;*a i/
9504
Date.114.114.............
:10711
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ti TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that... b;04.........r......Prm.c.;.o...L)................................................
...................... .....
has permission to perform.....cv
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plumbing in h buildings of
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at.. ..... ...................................................... North Andoi�er Masi.
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Fee.30.1...U........Lic. No. J 1.13�. .......
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VPLUMBING INSPECTOR
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