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Miscellaneous - 15 BEACON HILL BOULEVARD 4/30/2018
15 BEACON HILL BLVD 2101058.6-0005-0000.0 j Location A� °IV No. 7AW` Date 6 �i , TOWN OF NORTH ANDOVER L 10 . Certificate of Occupancy $ Mu9 Buildin /Frame Permit Fee $ J�cst Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # a1 s 9 241 j1 1Building Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0:7,W o,,"/ Date Received Date Issued: 4 1 ORTANT:Applicant must complete all items on this page LOCATION 8SAaKI 4ILl aWJ Print PROPERTY OWNER AWE� lk-A�iQ Print r MAP NO:� L PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 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 ❑OtherEl w 01Septic, ❑WellltFloodplau � ®Wetlands 0 WatershedD strict D Water/,Seweri DESCRIPTION OF WORK TO BE PERFORMED: ('cfifi-krU�c (Cof ow Q�;lsiiro, I2,XlZ ( k pec P�a�S �a A . 4-bAL [UZeW6k0- NI&A I entificatio Please Type or Print Clearly) OWNER: Name: ttAAQ�f -k�e�c6 I'h Phone: Rl� 6%3 4oG Address: 15- 1�4ccy�-,J< CONTRACTOR Name: 4 l�of�- � Phone: W 5 � Address: A C�A&4ka 'I26 PA fi l Supervisor's Construction License: 7ggZ,l Exp. Date: Home Improvement License: KV644 Exp. Date: 1 a l Z ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 2i$aa FEE: $ 26 r Check No.: - Receipt No.: OTf: Persons contracting ivith unregistered contra toys do not have access to the guarantyfund L_ tur&offAgent/Ownerp _ Signaturetof�cor-tor? 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 ❑ BuildingPermit rmlt Apphcatlon ❑ 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 TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit I all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording iust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools 0 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 Ponservation Decision: Comments ,Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. fit.: 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 21 A—F and G min.$100-$1000 fine NOTES and DATA— For department use Ll Notified for pickup - Date Doc:.Building Permit Revised 2008mi ORTH ToNvn of 6And - over 0 n�. dover, Mass., A- COCMICMEWICK V o'QATED V �J BOARD OF HEALTH PERM . IT T D Food/Kitchen Septic System ,�.� BUILDING INSPECTOR THIS CERTIFIES THAT............... .............................................../.................................... Foundation has permission to erect........................................ buildings on ... �� c�.�%c� ...t'1�i.�,1 .. .�, f% ........... ... Rough to be occupied as............... 6^�s��'�r S'ii fpd .... UE r..../= /.S `�/ y��^G. ... . .�' Q��/ + Chimney .... ... ......... . .... ...... ............ .. .. provided that the person accepting this permit shall in every respect conform to the terms of a application file in Final . 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 CONSTRUCTION STARTS Rough ............................... Service ����BU�LD G 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 SURE Smoke Det. Oftice�C �°nvn20 1f irs&%inesR guta� on jpe { HOME IMPROVEMENT CONTRACTOR Registration: (152844 Expiration tl?�-42012 TYLtd Liabilit M ETT BUILD �R w� JOHN MORETTI , t 4 CHANDLER RUA ? r� BOXFORD, MA 01921", - Undersecretary YI 4ssachusctts- Department of Public. Safet, Board of Buildin« Regulations and Standards Construction Supervisor License License: Cs 79425 JOHN C MORETTI 4 CHANDLER RD €3OXFORD, MA 01921 Expiration: 8/8/2012 ('um�niseoner Tr#: 1238 The Commonwealth of Massachusetts t ' Department of Industrial Accidents 1 Office of Investigations 600 Washington Street �Y Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please PrintLezibly Name(Business/Organization/Individual): Nil Mkt^ Address: 4 G�nr�V 26 City/State/Zip: MA Phone#: qJY bGI Are you an employer?Check the appropriate box: Type of project(required): l.qI am a employer with Z 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.1 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers'comp.insurance. 9. ❑ Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.F] Electrical repairs or additions 3.❑ I atn a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]f employees. [No workers' 13F]Other comp.insurance required.] *Any applicant that checks box 41 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 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. p Insurance Company Name: AN�wei.? Policy#or Self-ins.Lic.#: kJ)GL 150a q 01- Za k Expiration Date: Job Site Address r5 GLa^ l-1>>� >W _ �. City/State/Zip: 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 of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c�nerpains and penalties of perjury that the information provided above is true and correct. Si natur . Date: 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#: it • Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house oronthe grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please•be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pen-nit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future pen-nits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.govldia Massassa_.c_huseffs I3onie Ina 7°oyement Sam le �antract This Form satisfies all basic requirements of the state's]Rome]inprovemerit'Contractor Law language to protect homeowners. Seek Iegal advice Ifneeessar . Amy (MGL chapter]A2A),but dogs not include standard itiassachusetts consumer guide to home imprpvemenvemen t"before agreeing ten ny wok on our r ag sidenceaYou may obtain a free cop by calling the , Office of ConsumerAffaits end Business Regulation's Consumerinfatmation[iodine at 617-973-8707 or]=888-283-3757. PY ts should first obtain cof"a e Homeowner Information - Con,Xactor information oma . • °mP�Y ame Kt>fc*, Nu mi Address(do mat use a Post Office Box address Contntcttn!Salespt�gal OwnerName �� ac N,11 VV_ l�lor� CI )TOv a State Tip Code usiness Address(must include a street address) Daytime Phone Evening Phone 8 !B g0r.4 Ityrrown S,,tateAA Zip Code • - Mailing Address(lt differentfrom above�� rv1 nq?Z usin¢ss Phone 9'18il} ed rat PmplayerID ar 5.5.Number • Law requires Wal most humdlm- H'me 1n vV= rCaaanceur • : pm�mtcatcammatominvea 'I lleg•NamMr fixlmaliond�rc The Contractor agrees to do the'following work for the Homeo ner:Ictaanaamanha tm e w r- o comp a spm g e a ran '1 �hSf41� s �I�f QititS�tvtq �Z,Xl?��, euA6�1P n ece Regtiired.'lsermlis-The followin K nildingpermits are required Proposed Start and Completion Schedule-The f4lIowing schedule will and ill be secured by the contractor as the homeowner's agent, be adhered to unless circumstances beyond the contractor's control arise (O ners who secure their own permits will be exclpded from the Guarant3i Fund provisions-of MGL chapter 142A.)' -----:,_Date when contractor will begin contracted work. !_ ,Date when contracted work will be substantially completed. IatalContract Price'andPaymentKhedule ' The Coauactoragrecs to perform the work,furnish the materiel and labor specified above for the total stun of `21 abb Payments will be made according to the following schedule: (*) .• Qa upon signing contract(tint to exceed 113 of the'tota]contract rice ar P rite cost of'special order i(ems,whichever is greater) —+=�/� by ��/ or upon completion of ro; 4z,t,ytn,,K e S b by -or upon compl°tion of _upon completion of the contract (Law forbids demanding fu]1 paymentuntil contract is eomplet¢d to both party's satisfaction) The following fiweriallequipment must be special S ordered before the canhacted work begins in order to be paid for t to meet the campletion schedule.(**) S to be paid for NOTES:M Including all finance charges(**)Law requires that any deposit or dowm- not exceed the greater of(a)one-third of the total contract Payment required by the contractor before wed;begins may which most be special otderedJa,a`dvanca to meet We completion schedule. 21111 cost of any special equipment or custom made material xpress Wa anh-Ts an express warm.; t r resided h H SahybFu raetotp titer ontractor agrees to be solely responsible fetor otnplr tiov of the wort des;n�ed egardlessof the a tioAtLLke ns of any thi tinct paitefials and ab _be utta ustb or utilized by the contractor• Tho contractar further h1TeeS to be solely'respbnsible for all a aterials and laborunderthis a Bement Payments to all subcontractors for Contract Acceptance-that an igning,this dacumentbecomes a binding contract under law. Unless otherwise noted within this document,the ca carefully shall not imply that any]ten or other security interesthas been placed on the residence. Review the following cautions and notices carefully before signing this contract • Don't be pressured into signing he cottiract,Tako time to read and fully understand it, Ask questions if something is unclear. • ' fvlake sure+hP contractor hue a, r,,tlnme Tm Co ent subcontractors y to be g to the with the Director ofHotge Improvement Gontractor Registration You may inquire about contractor cror x.es±r, 's_era__tion The law requires most home improvement contractors and registration by;writin g to the Director at One Ashburton Place,Room 1301,13osttl AU 02108 or by calling 617.-727-3200 or 1-800-223-0933. 9 Know• Does the contractor have insurance? Checle to see that your contractor is properly insured Guide your rights and responsibilities. Read the Important Infarillalinla on the reverse side of this form and get a copy of rite Consumer Guide to the I3ame•ImprovementContractorLaw, - , You luny cancel this agreement if it has been signed at a place otKer•than lire cannnctor'a normal place of bus' contractor in witting et his/her main office or branch office by ordinary mnil'posted,6 tel third business day following,the signing of this agreement See the attache notice of cancellation form furan explanationeo=thzi.d you you DO NOT SIGN THISCONTRACT ,T]E�ET� A R F m sent orby an ex la not lateTwoidentiealw les ofthe• t 7�rrr d]��j P cantractmast6ac°mptucdsndt. sisneJ onec"py�,°uld ntothbltnYx g— ""' SPACES!1! & meowrimThe°thcrcupyshauldbelccptbythmcontractor. r .2 ° Br's Signature n Contra to ' igna • Date "a .� 2 :�\ Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an.arbitration action as an. alternative to court however. The they have a dispute with a contractor. The same right is not automatically affordel to a' contractor,however. The contractor would have to resolve any dispute he/she has —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 h6meow6r by the Home Improvement Contractor Law. The contractor aqd the homeowater hereby mutually agree in•advance that in'the event the contractor has a dispute concerning this-contract,the contracfor may submit the dispute to'a private arbitration firm which has been appmved,}3y e Secretary of the Executive Office-of Consumer Affairs and Business Regulation and the consumer shall.be r$quired to submit to such arbitration-as provided In Massachusetts General Laws,chapter 1 A. 'R7 Zl : . owner's Signature Co tractor`s Signature OTICE:The signatures of the parties above apply only to the agree 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 th-e parties. , ' Homeowners Rights A homeowners rights under the Home Improvement Contractor Law(MGL chapter.142A)and other consumer protection laws(i.e-MGL chapter 93A)may not be`waive:d in any way,.eden by agreement : However,homeowners may be excluded-from certain rights if the contractor they choose is not properly registered as prescribed by Iaw, Homeowners who secure their own building permits are'automatically excluded from all Guiranty•Pund 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 warraniy for workmanship or materials. In addition to guarantees or warranties pzovided,by the contractor,all goods sold in Massdchusetts 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 consum6r/homeowner rights,contact the Consumers Information Hotline(listed below). Execution of Contract ti , The contract must be executed in du liedte 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 filledan or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to Ire 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 co the contract,.and the three day recission period has expired. py of Accelerated Payinents 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 ltimlr et elf to be financially insecure,the contractor may require that the balance of funds not yet due be placed tri a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal o signatures ofboth'parties, f funds from said account would require the 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 Corovement Contraptor, Law,"contact nsumer Guide,to the Home im Consumer Information Hotline Office of Consumer Affairs and Business'$egulation .I0 Park PIaza,Room 5170,Bostonx MA 02116 (617)973-8787`or 1,(8.88)2833757 'y If you want to verify the registration of a contractor or if you have questioIls Or need adtlifxonal in ' about the contractor registration component of the Home lmprovement Contractor Law,contact: hon specifically Direct6i,of Home Improvement Contractor Registration Bureau ofBuildingRegulailQns and Statidards One•Ashburton Place,Room.I301,Boston,MA 02108 ' (617)727-3200 or 1-800-223-0933. For assistance with informal mediation of disputes or to register formal complaints against a business,call: ' Consumer Complaint Section Office of the Attorney General ' (517)727-8400 AND/OR _ •Beiter$usiness Bureau (508)652-4800 .(508)755-2548 (413)734-3114 No proposed improvements are shown hereon. 75.0' —� No o SHED °D cQ Deck 3.0' Above 15.1' 26�. ' i Roof iv De4t k T" Above 66 OWNER: 14.7' 14.6 Annette M. Beaudoin o Deed Bk. 1505, Page 66 2 Story c+i PARCEL INFO: 0' #15 AREA=6,926± S.F. 1 Story ASSESS. PARCEL ID: 14.6' 210/058.B-0005-000.0 14.7' Roof PLAN INFO: Above Plan#381 Plan#2051 SBDH(fnd) I_ 49.68' — — L=25.32' IP(fnd) BEACON HILL BOULEVARD "I CERTIFY THAT THIS PLAN AND SURVEY WERE PREPARED AS A RESULT OF AN ACTUAL ON THE GROUND INSTRUMENT SURVEY PERFORMED IN APRIL 2011." k. : 4; RICHARD W. REID, JR. N0.46861 L 9EGISTEREO PROFESSIONAL NAL LAN URV YO DATE (signature is not original if not signed in BLUE ink) �- CERTIFIED PLOT PLAN DATE 04-11-11 15 Beacon Hill Blvd, North Andover, MA REVISION n/a ® 2h th o uOye SCALE: 75 Kimberly Road,Taunton MA 02780 TEL 508 287-0896 �/ 1" _ ' ( ) 20 r t � . 1.411 i 7} 'Fit 4 1��#�$¢' �¢ ♦ i i iiiiiii 4 ♦ iii ♦ 4i ♦ , ,f ar ^vyc AZ x M. „} *�• -� o ",� " �`;�`�`.'� ,�. -gip,,. it 'Y '_� .''�B �,: �� ,,,,,,,� ��"`►'-+�.. w ,A A6 4 . 0 00 .,, r, �r � j r, • + � �Y ®, 1� � �, ® � � � � `I �T�r-f�".. j 3' t� {l�� ��Q(;���r�a�'Y' r�,a f . •� ,,,.� �„�`' +/ �� V 'Y}�Y�� YY � ��A�e if ca+ X01•Y�♦ � � *'k �4 .._.. , zl r v - - _ K 1 { f ! D x, 41, . 1 r } �• fit. .�! •.a4'w `�� � - _ � !i �`�-� - �, 0 LOWER DECK IS 12'X24' AND IS PARTIALLY COVERED BY SECOND 12" TUBE FOOTING X5 TYPICAL FLOOR DECK 4X4 POSTS B/W EXISTING DECK FRAME O AND NEW ROOF FRAME a3' O,C, 12'-O" 6'-O" TYPICAL THIS SIDE z n111 6'-O.. 61-01� A b• I 2-2X10 HEADER ' SHADED AREA REPRESENTS ' 2-2X6 DECK ABOVE EXISITNG DECK ` Q Q i POST OVER EXISTING VW FOOTING Q I ' I I Q 4X4 POSTS B/W EXISTING DECK U FRAME AND NEW ROOF FRAME a 4' O.G. TYPICAL THIS SIDE 1 I N S LINE OF NEW ROOF ABOVE I ' I � I I � I I � I EXISTING CONDITIONS O PROPOSED CHANGES u W ''V' to �Q 2x8 RAFTERS a 16" O.G, —� z m W/5/8" CDX PLYWOOD r� 12 AND RUBBER ROOFING GENERAL NOTES: U O 1, ALL SAVE POSTS TO RECEIVE AC(E)POST CAPS AND BASES '7 O7 H2.$CLIPS EACH TWO ROWS 3 3/8" LEDGERLOK 2. ALL RAKE POSTS TO BE HALF LAPPED TO RAFTER RAFTER SCREWS INTO EACH STUD AND 3. ALL SIMPSON HARDWARE TO BE 'ZMAX' I' LUS28 JOIST HANGERS ON EACH II I� I I I I 11 RAFTER I PRIVACY LATTICE 111 r I li U } z tu Q � 111 } = Q zzz � Od ads Luho cQ z 0 LOWER DECK 15 12'X24' AND 15 12" TUBE FOOTING PARTIALLY COVERED BY SECOND }X5 TYPICAL FLOOR DECK 4X4 POSTS S/W EXISTING DECK FRAME O AND NEW ROOF FRAME s3' O.C. 12'-O" 16'-O" TYPICAL THIS SIDE Z 2-2X1O HEADER SHADED AREA REPRESENTS 2-2X6 DECK ABOVE EXISITNG DECK U Q Q i POST OVER EXISTING � I I , FOOTING I ' I Q 4X4 POSTS BIW EXISTING DECK U FRAME AND NEW ROOF FRAME I 4' O.C. TYPICAL THIS SIDE 9 ® N I I N I N I I LINE OF NEW ROOF ABOVE I I I � I I � I I � I EXISTING CONDITIONS PROPOSED CHANSES 2.6 RAFTERS Is 16" O.G. Z' W/5/8" CDX PLYWOOD r` AND RUBBER ROOFING GENERAL NOTES: U O t- I. ALL EAVE POSTS TO RECEIVE AC(E)POST CAPS AND BASES 7 H2.5 CLIPS EACH TWO ROWS 3 3/8" LEDGERLOK 2. ALL RAKE POSTS TO BE HALF LAPPED TO RAFTER RAFTER SCREWS INTO EACH STUD AND 3. ALL SIMPSON HARDWARE TO BE 'ZMAX' I LUS28 JOIST HANGERS ON EACH RAFTER F N- - PRIVACY LATTICELuI />� __ ui l iF- Q Q O 0 .4 � Lu O Z Date . . . . . 4, TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING 40 �Ss�cNusE� , This certifies that . . �L"��'� G� '.Lr T has permission to perform . . c�` °.` ' {'.`` .`. . . . . . . . . . . . . . . . . . plumbing in the buildings �of . . . reY. P. .. . . . . . . . . . . . . . . . . . . at. . .` . North Andover, Mass. Fee. V l. :. .Lie. No../( /.° . . . . . . . . �- ---�� LUMBING INSPECTOR Check # Z `� &645 i .:�. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (PriJnt Cr T pe) t = lj Akocl s "ass. Date � y City, Tow:-, (2E = PeI-rr.i1 AT: Lova tic:� "� � d � /��j`Ly� 1Jame_�j.�����l� ,w�Clfllt %rteType of Gcc,,lpancy : New ❑ Renc."atiOn P.epiacement ❑ Plans FIXTURES Submitted Yes ❑ No ❑ _z Z y y Z Y Q h- N y y O Zy i W Y J y > U Q y V W W l O W f- W a = ¢ y = O = Z Z p O J N y N Y y f• U W y z Q fA LLa _ f.. S V Z � m y Y Q H y Z � a C7 Q a x W O cc d W S q W - a d y Z z d Z O to W O p ;' J y Y G ¢ LL a F- tJ > f O S IL = N f. Y a O = = q W W Y W O y ►- 3 Y J ID = y y Z a d 0 d J ° d Q 0 U = O d F- Nf y 0 ` SUB•—BSMT, BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TN FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR I Ll BTH FLOOR (Print or Type) Check One: Certificate Installing Company Name 13 .14-L 6 f la 6 h�O PLA15 ❑ Corp. Address �c'i �> Lra�ems, ❑Zirm ership , Company Business Telephone jy 2 Z F ' 5,2 ;2,'3 L 1cf Name of Licensed Plumber or Gasfiner 1 hereby certify that all or the details and information 1 have submitted lot emered)in above application are true and accurate to the best of me knoµiedge and that all plumbing work and installations performed under Permit issued for this application will be it compliance with all Pertinent P,ovisions of the Massachusetts State Gas Codc and Chapter !a of the Gencral Laws. 1 hate informed the owner or his agent that 1 do not have liahilin insurance including completed operations cmcrage. tiignamrc of Or.nr. 4Rrm 1 have a current liability insurance policy to include comr!cted operations coverage By 'Title Signature of Licensed Plumber Lits, Town Type of Plumbing Liccnsc Mister APPROVED (OFFICE USE ONLY; � L "P�� � l�Tourne mar. v r the Commonwealth of Massachusetts Department of Industrial Accidents I Office of Investigations 600 Washington Street Boston, ALA 02111 'y "w.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Conti-actors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/orgaivzation/Individual): Address: Vic,x i City/State/Zip: 1 6 iz��r 7'0 u. >H�� Phone #:___b__ !7 r-136 2 2 F_/employees re you an employer? Check the appropriate box: TN pe of project(required): ❑ I am a employer with 4. ❑ l am a general contractor and 1(full and/or part-time).* have hired the sub contractors 6. New construction 2. 1 am a sole proprietor or parmer- listed on the attached sheet. I 2 ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ElWe are a corporation and its 9. E] Building addition required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL l 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. l 52, §1(4),and we have no 12.❑ Roof repairs ' insurance required.] T employees. [No workers' comp.insurance required.] 13.0 Other *Any applicant that checks box#/1 must also fill out the section below showing their workers'contpensofion policy information: T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must subn- t e new affidavit indicating such. rContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance T or m employees.) p )ees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: 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 of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of I nvestigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofpeijury that the information provided above is true and correct Signature: 1 'hone#: 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 At: 9413 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SACHUS This certifies y ........4�7............................................. has permission to perform ...................... wiring in the building of ...... ............................... . .... eNorth Andover,Mass. 0 .. ... .. Fee ....... Lic.No. ..�Jk ........iL4 ELECTRICAL IN14� Check # 17 Commonwealth of Massachusetts Official Use Only j Department of Fire Services Perm"No- mu o. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev Il/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICALWO All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 RK (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER - _ ` ad t p By this application the undersigned To the Inspector of Wires: gn gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) J4,- I ��I ^ Owner or Tenant f�h �-f-� l��Q�s ^ Owner's Address Telephone No. G°7� • 3fo1 Is this permit in conjunction with a building permit? y Purpose of Building �" N° ❑ (Check Appropriate Box) e� c�.a Utility Authorization No. Existing Service a0 0 Amps ) 0 / ac�pVolts Overhead Undgrd❑ No.of Meters New Service Amps / —volts Overhead ❑ Undgrd❑ No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1,e-OQn� Complesion of the followin table maybe waived b the of Wires. No.of Recessed Luminaires No.of Ceil.-Sus No.of Ins ector Total p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming pool Above ❑ In- o.o mergency tg g d. d. ❑ Bat-to=t att Units ---, No.of Receptacle Outlets 3 No.of Oil Burners FIFE ALARMS No.of Zones No.of Switches � No.of Gas Burners 0.of Detection and No,of es Ran Initiatin Devices Ranges No.of Air Cond. °� No.of Alerting Devices No.of Waste Disposers eat PSP umber Tons Tons' KW o.of elf- Detection./Alenfing Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal A Connection ❑ Other No.of Dryers Heating ppliances KW Security Systems: o.of WaterKW No.of No.of No.of Devices or Equivalent Heaters Si s Ballasts. Data Wiring: } No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total Hp I elecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 72�rC)n c1J (When required by municipal policy.) Work to Start -a O -.10 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify-) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ) — LIC.NO.��J� Licensee: k Signature-� (If applicable,enter-exempt"in the h ense number line.) LIC.NO.:3 S Address: Bus.Tel.No.: b 3-4"✓�_ [ems j *Per M.G.L c. 147,s.57-61,security work requires Department nent of Public Safety„S„ AIL Te1.No..Ao 3-7z o License: Lic.No. ,/,p S S_ x-6,41(01 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner owner's a� nt Owner/AQe ��� _ 276 Signatur Telephone No. �PfMIT FEE:$ S t Y � � � � The Commonwealth of Massachusetts Department of Industrial Accidents Office ofInvestigations 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leggibly Name(Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4. Type of project(required): ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 1 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp,insurance. com .insurance 5. 9• E]Building addition [No workers p.p ❑ We are a corporation and its required.] officers have exercised their 10.[1 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' comp.insurance required.) 13.❑Other .ny applicant that checks bay 41 must also fill out the section below-shewin. compeu.sationpolicy mf6_ t Homeo%m-�who submit this affidavit indicating they are doing all work and then hire 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job sit.- information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: y 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 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 DLA for insurance coverage verification. I do hereby certify under the pains andpenaldes ofperjury that the information provided above is true and correct. Signature: Date,: 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#: 4 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 15.2,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be.returned to the city or town that the application for the permit or license is being requested,not the Department.of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insu-rance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant w Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business.or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Iuvestigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 wwvs,.masa.gov/din Location- L "c n Act No, Z Date 1 � NaR*►► TOWN OF NORTH ANDOVEF p Certificate©f Occupancy $ Building/Frame Permit Fee $ �— �'�s''^� Foundation Permit Fee $ s�CHU Other Permit Fee $ kR Sewer Connection Fee $ Cn Water Connection Fee $ TOTAL Building Inspector 1'�= 9706 Div. Public Works Pftmrr No. APPLICATION FOR PERMIT TO BUILD—NORTH ANDOVER, MASS. V PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. LOCATIONCl RPOSE PMN=bIG U n i, OWNER'S NAME n�n PY ,s7eau -/y 1�I NO. OF STORIES SIZE WNER'S ADDRESS/! SO r'1 LJ 11 BASEMENT OR SLAB ARCHITECT'S NAME Aj,2 SIZE OF FLOOR TIMBERS IST 2ND 3RD I LDER'S NAME /'_'� SPAN DISTANCE TO NEAREST BUILDING o� DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING R IS BUILDING ADDITION MATER:AL OF CHIMNEY BUILDING ALTERATION A/ !1 IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE e ` IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY Ye-.S_ `7 IS BUILDING CONNECTED TO TOWN SEWER ////// IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 1U y'V 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES / j'+ BT. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 -3 EST. BLDG.COST PER . FT. PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG.COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PL�.NS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR LooDATE FILED BUILDING INSPECTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT cc FEE ow 'sd� 04�22 19 PERMIT GRANTED CONTR.TEL.# 0& " V f ` a (J 19 CONTR.LIC.# l — H.I.C.a BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY sroPIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS.,.WITH PORCHES. GA- APARTMENTS _ RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE 3 1 2 13 ` CONCRETE BL K. PINE BRICK OR STONE HARDWD PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ FIN. ATTIC AREA _ N_O 8 MT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 watts 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARD"4'D _ ASBESTOS SIDING COMMON _ VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS.d FLOOR I_ ' BRICK ON FRAME CONC.OR CINDER BLK. STONE ON MASONRY WIRING - STONE ON FRAME , SUPERIOR POOR -ADEQUATE _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR R GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES A TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE ✓ FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR _ WOOD RAFTERS -' '_ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS a 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ CT ELERIC 1st 13rd NO HEATING ToVM of . "OOr Over No. 126 a '` =_ NoK dover, Mass., 19 do c BOARD OF HEALTH PERMIT TO BUILD Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT.............................. '. /Y............................................................................... Foundation V '0� has permission'to erect...0..(..a./.t�(.4........... buildings on .......45 ........M5 06�614......Ek. �.. hough tobe occupied as....................................................... /../ .6. ........F'74'"!i............................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 j ELECTRICAL INSPECTOR Rough ................. r ........................... Service BUILDING SPECTOR Final Cu1y Peri:` R: 7u;red Eo Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. %, WENGLAND BRICKMASTER EXTERIORSSalesman �tJ � / ,l:>,-�-- • / T �_�' ,7 . Date 951 EAST STREET • TEWKSBURY,MA 01876 • TEL.(508)851-5100 toy THIS AGREEMENT,between NEW ENGLAND BRICKMASTER WINDOWS&EXTERIORS,INC.,OF TEWKSBURY,MA herein referred to as"Contractor",and (CUSTOMER NAME) _ 'r < /�,/{ �?�' ((�`V / ? herein referred to as"Customer"of (ADDRESS) xirel—, 1 1 (ZI 1 CUSTOMER �1! TELEPHONE - !' NUMBERS BUSINESS RESIDENCE JOB WITNESSETH in consideration of the undertakings herein expressed,Contractor and Customer do hereby agree as follows: JOB NAME: i. JOB ADDRESS. TRUCK DIRECTIONS: YES No - •� PROJECT SPECIFICATIONS ERECT SCAFFOLDING WHERE CONTRACTOR DEEMS NECESSARY ij APPLY VAPOR BARRIER WHERE CONTRACTOR DEEMS NECESSAR " APPLY 3.4 DIAMOND MESH GALVANIZED STEEL LATH TO SPECIFIED WORK AREAS APPLY INSTANT-CRETE FORMULA SCRATCH COAT 0F, EM ENT TO SPECIFIED WORK AREAS ZY APPLY NEW ENGLAND BRICKMASTER SPECIFICATION'NUMBERS: i ! IN SELECTJNG NEB BEAUTY TONE COLORS •Q' "'"'' Is ELEVATIONS WORK AREA DESCRIPTIONS COLORS FRONT FINISH (DESCRIBE) / - . MORTAR R (DESCRIBE) FINISH ' MORTAR LEFT 77 - FINISH (DESCRIBE) MORTAR RIGHT y FINISH (DESCRIBE) MORTAR REMARKS AND ADDITIONAL WORK(LOCATION AND DESCRIPTION) LX REMOVE AWNINGS REPLACE? a .f REMOVE SHUTTERS REPLACE? REMOVE SIGNS 'REPLACE? REMOVE LEADERS REPLACE? COPING I CHIPPING MAXIMUM NO.OF SQUARE FEET: VIV TUDOR BOARD MAXIMUM NO.OF LINEAL FEET: 1 i SCRATCH COAT MAXIMUM NO.OF SQUARE FEET: .CORNICE I OTHER OTHER OTHER CONTRACTPRICE DEPOSIT PAID (guidelines: under$5,000: 50% $50 o$15,000: 35%: $15,000 and over: 25%;Trade Deposit:20%) . . . . ... . . .... . . . .. . . . . ... . .. .. .. .. . ... . .... .... . .. r BALANCEDUE . .. . . .. ... .......... . . . .. .. .. . . . .. ......... ...... ...... ...... . . ...... $ Q PAYMENT SCHEDULE "«" r ON SCAFFOLD(35%) .......... ... I• / D CASH ❑ ON WALL PREPARATION(50%) FINANCE ❑ ON COMPLETION(before removal of scaffol (15/°)... . .... . $ Contractor warrants and represents that adequate Workmen's Compensation and Public Liability coverage has been secured and Is applicable to the work to be performed under this contract and proof of some will be forwarded to Customer prior to commencement of work if requested. It is agreed that in the event Customer refuses to allow Contractor to commence performance of the work to be rendered,or to continue performance under this agreement, Contractor as a measure of damages,will be entitled to receive from Customer the profit Contractor would have earned under this agreement,plus the reasonable value of labor and materials supplied.Customer agrees to pay Contractor's reasonable attorney fees and expenses in the event of Customer's breach of this agreement. No representation shall be binding upon either party hereto,unless it has been incorporated in this agreement.Contractor shall not be responsible for damage or delay due ctl to strikes,fire,accidents or other causes beyond Contractor's control nor shall Contractor be responsible for landscaping damages,hairline cracks or efflorescence.The color after application may vary from color sample selected by customer,or when applied over different building surfaces or as a result of effects caused by the weather;therefore, Contractor shall not be liable for any shade variation or failure of color after application to match color sample. In the event that Customer shall by act or failure to act require additional time to make any payment hereof,the due date for such payment shall not be extended and customer shall be obligated to pay an additional charge 11/2%per month of said consideration therefore. Any changes in project specifications resulting from customer change order or structural condition beyond Contractor's control b it n subject asupplemental charges. Cir shall acquire any permits necessary for Contractor to perform the work provided herein.These permits will include all building,sidewallk,electrical permits and the costs incurred to obtain all permits including the costs of police details,if necessary.Customer shall take necessary precautions to protect interior walls and premises,and x) Contractor shall not be subject to back charges.Customer to arrange for access to job site.In order for Contractor to ensure consumer satisfaction at completion of job.Con- ` tractor will not remove its scaffolding until final payment is received.Customer is responsible to repair and install all roofs,coping,gutters,flashing and caulking to protect A contractor's work. a Zi Customer warrants and represents the above work is not go �Mn unded or sponsored and Contractor will t be re ired to pay its labor"prevailing wages".Should it be determined Contractor is obligated to pay"prevailin aomer agrees to reimburse Contracfo s c7The parties estimate that the work shall commence onAnd be substantially completede'dates are not of the essence.The start and completion of the work may be delayed due to weather,strikes, ' ages of materials and manpower,or"(,.ustome�s actor failure to actor provide timely written notice to �i Q proceed.These dates may be extended. Contractor to issue one year guarantee upon full payment. Arbitration.Any controversy arising under,out of,in connection with,or relating to,this Agreement,and any amendment thereof,or the breach thereof,shall be determined and settled by arbitration in Boston,in accordance with the rules of the American Arbitration Association.Any arbitrator's award shall be binding and shall include Contractor's legal fees and costs and a judgement upon such award may be entered in any court having jurisdiction and will include interests,costs and attorney's fees. This constitutes an offer only until approveci by the contractor at his home office in TEWKSBURY,MASSACHUSETTS. NOTICE TO CUSTOMER DO NOT SIGN THIS CONTRACT IN BLANKI YOU ARE ENTITLED TO A COPY OF THE CONTRACT AT THE TIME YOU SIGN IT. KEEP IT TO PROTECT YOUR LEGAL RIGHTS. WE, THE AFORESAID CUSTOMERS, CERTIFY THAT IMMEDIATELY AFTER THE SIGNING OF THE AFORESAID AGREEMENT, A COMPLETELY EXECUTED COPY WAS FURNISHED TO US. YOU,THE BUYER MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. SPECIFICATION COLORS MORTAR TONING TEXTURE NUMBER FINISH ! H NAME fl NAME k NAME ? { ' X• � � -,rL.S.WITNESS DATE J (CUSTOMER) , S . • L.S. x VIED wAYE t NTIAL REV.4192 (CUSTOMER) r MITE — ORIGINAL, YELLOW— CUSTOMER COPY, PINK — DUPLICATE OFFICE COPY - I I a TOWN of NORTH ANDOVER AFFIDAVIT Hme 7 Ruma rt Cutactor Law 5AP1Walt to lit Apgliratirn M3.c. 142 A ra}rirns that the Ice=st33 rticn altar, iaiwatia�, nor, ern, ootHasm, 1 im�zv -? tial, dazali tirn, QQ ostti ztis,of an adltiai to any Pte"e:dstirg bund- ing carntairri at lest one hit not mxe than far X11 g units...or m sb=b*es Bch are adjaoat to a h<tesidare of adld*'be done by r%istBmd acntnctoLs, xath certain ecVtiats, slag with other Type of Work: W U c/o u.J s Est. Cost o2 Gd O Address of Work ✓Owner Name: e, P /tel e u cZ ,� n -"'bate of Permit Application: /6 I hereby certify that: Registration is not required for the following reason(s): Far office Use Qtly Work excluded by law Fit ND. _Job under $1,000 Date Building not owner-occupied _ CLOwner PulLinS own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEAL1 G WTIH UNRECISZFRID CDNIRACTORS_ FOR APPLICABLE HOME DfiWAi M WORK DO NOT HAVE ACCESS TO THE ARBnRA- TION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed ude` pan lti.es of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name