HomeMy WebLinkAboutMiscellaneous - 20 MIDDLESEX STREET 4/30/2018N
N. "VAE2p",
This certifies that ....31 �IOR AJ
has permission to perform ('A ........... . ..............
0 plumbing in the buildings of ... A. 1-b-i
..........................
at ...... Z<0. . �,l ........ North Andover, Mass.
Fee. Lic. No. 24S.15�. ................ ...
PLUMBING INSPECTOR
Check # I L p5D
P
TYPE OR
PRINT
CLEARLY
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY NORTH ANDOVER MA DATE /- Fr -l-? PERMIT # 914
JOBSITE ADDRESS ::z6 Lc , Sr OWNER'S NAME J2; 9-A .*�. G'/41� C��J
f �
OWNER ADDRESS S� eF TEL
OCCUPANCY TYPE COMMERCIAL EDUCATIONAL
NEW: _ RENOVATION: T REPLACEMENT:
FIXTURES 1 FLOOR -
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GASIOILlSAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR I AREA DRAIN
INTERCEPTOR (INTERIOR
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE 1 MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
WATER PIPING
FAX
RESIDENTIAL ix.
PLANS SUBMITTED: YES NOi;(
BSM 1 2 3 14 5 6 7 8 11 10 i1 1 12 1 73 1 14
1
;1 have a current liabilityinsurance policy or itssubstantial equivalent INSURANCE
wh ch meets the requirements of MGL Ch. 142. YESA.* NO
.A
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY ;?{. OTHER TYPE OF INDEMNITY BOND
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER °.. _ AGENT
I hereby certify that all of the details and -information I have submitted or entered regarding this application are true and accurate to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
/ - - -
PLUMBER'S NAME THOMAS HALLORAN LICENSE # 24833 SIGNATURE
MP. • JPx.
COMPANY NAME HALLORAN PLUMBING
CITY NORTH ANDOVER
FAX CELL
CORPORATION
# PARTNERSHIP;_ _ # LLC .T'#
ADDRESS 826 DALE ST.
STATE MA ZIP 01845 TEL 978-685-9504
EMAIL
C�j I met,
it /
N
6Z
AP -N, The Commonwealth ofMassachusetts
Department of Industrial Accidents
t Office of Investigations
== 600 Washington Street
.' Boston, MA 02111
-c��- www.mass.gov/dia
Wormers' Compensation Insurance Affidavit: builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Nalue (Business/organization/Individual): 11_17X�41_1
Address: '�(, 6/9 )e S1—
City/State/Zip:/1/4V,5 VS Phone #:
Are you an employer? Check the appropriate box:
1. ❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time)."
2.�E I am a sole proprietor or partner-
ship and have no employees
working for the in any capacity.
[No workers' comp. insurance
required.]
3. ❑ I am a homeowner doing all work
myself. [No workers' comp.
insurance required.] t
have hired the sub -contractors
listed on the attached sheet.
These sub -contractors have
employees and have workers'
comp. insurance.1
5. ❑ We are a corporation and its
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling
8. ❑ Demolition
9. [❑ Building addition
10.❑ Electrical repairs or additions
11.❑ Plumbing repairs or additions
12.❑ Roof repairs
13.❑ Other
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that clieck 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 sub -contractors have employees; they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #:
Expiration Date:
Job Site Address: City/State/Zi
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 DIA for insurance coverage verification.
I do hereby certify cinder the pains and penalties of perjury that the information provided above is true and correct.
Phone #: l /ef
Official use only. Do not write in this area, to be completed by city or town official.
City or Town:
Permit/License #
/V /3
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 #:
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TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies � that --T ! . ! '1 !7 `.t !!� Q R h^' ..... . ....... .
has permission for gas installation ... .. ? .. '2' ....... .
in the buildings of ... Cao� t .... ........................ .
at .....0. ......... North Andover, Mass.
Fee . 2-.O -... Lic. No.z4� . ". .. ..M bI .................. ...
GASINSPECTOR
Check # � Z-'�D
8558
- rn iaar%%&nU*C i UNIT -UK n APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
CITY NORTH ANDOVER MA DATE PERMIT #
BOOSTER
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM / SPACE HEATER
ROOF TOP UNIT
TEST
UNIT HEATER
UNVENTED ROOM HEAT
WATER HEATER
OTHER
yr vv�r�v-`V.
I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES +' N0
I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME
THOMAS HALLORAN LICENSE # SIGNATURE
MPMGF JP ? JGF __ LPGI'-- CORPORATION # PARTNERSHIP _ # LLC _ _#
COMPANY NAME:HALLORAN PLUMBING ADDRESS 826 DALE SL
CITY NORTH ANDOVER STATE MA ZIP 01845 TEL 4-k -moi, lJ V
FAX 978-208-0840 CELL EMAIL
��
G
JOBSITEADDRESS 2(JST
OWNER'SNAME �'��, �,�
OWNER ADDRESS 1 =� M
TEL
FAX
TYPE OR
PST
�.,.�..{
OCCUPANCY TYPE COMMERCIAL j..
EDUCATIONAL RESIDENTIAL
:__..
CLEARLY
NEW: ` RENOVATION: y' REPLACEMENT: X-< PLANS SUBMITTED: YES._ NO
APPLIANCES 1
FLOORS— BSM 1 2 3
4 5 6 7 8 9 10
11 12 13 14
BOILER
BOOSTER
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATOR
FURNACE
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM / SPACE HEATER
ROOF TOP UNIT
TEST
UNIT HEATER
UNVENTED ROOM HEAT
WATER HEATER
OTHER
yr vv�r�v-`V.
I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES +' N0
I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER AGENT
I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER-GASFITTER NAME
THOMAS HALLORAN LICENSE # SIGNATURE
MPMGF JP ? JGF __ LPGI'-- CORPORATION # PARTNERSHIP _ # LLC _ _#
COMPANY NAME:HALLORAN PLUMBING ADDRESS 826 DALE SL
CITY NORTH ANDOVER STATE MA ZIP 01845 TEL 4-k -moi, lJ V
FAX 978-208-0840 CELL EMAIL
��
1%
N-� 'A �� "i Mb
1�
The Commonwealth ofltMassachusetts
s- Department of Industrial Accidents
4 t:. Office of Investigations
600 Washington Street
Boston, MA 02111
+,k �V www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):_/
Address: S�Z r &4)e S"7 --
'a1- 4�%S i 5 Phone #:
Are you an employer? Check the appropriate box:
1. ❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub -contractors
2.�Z I am a sole proprietor or partner- listed on the attached sheet.
ship and have no employees
working for me in any capacity.
[No workers' comp. insurance
required.]
3. ❑ I am a homeowner doing all work
myself. [No workers' comp.
insurance required.] t
These sub -contractors have
employees and have workers'
comp. insurance.1
5. ❑ We are a corporation and its
officers have exercised their
right of exemption per MGL
c. 152, § 1(4), and we have no
employees. [No workers'
comp. insurance required]
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling
8. ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
11 -El Plumbing repairs or additions
12.❑ Roof repairs
13.❑ Other
'Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside 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 sub -contractors have employees, they must provide their workers' comp, policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #:
Expiration Date:
Job Site Address: City/State/Zi
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 DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
�v
#:
/V /3
Official use only. Do not write in this area, to be completed by city or town official
City or Town:
Issuing Authority (circle one):
1. Board of Health 2. Building Department
6. Other
Contact Person:
Permit/License #
3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
Phone #:
-
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Date......:.......................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
si a
r
b �'�! •�r�o � �'h
This certifies that ...:�.� ...�a s.I.........f... f...4.. yf..:..� . .. ..........................
has permission to perform �' - �'
......:...................................................:...................
wiring in the building of ...i.....�! .:?.<.? r r ��
.........................................................
at.......................:..r.::'..s ....... .
r, �� . v :........................... .North Andover, Mass.
Fee..................... Lic. No ............... ............... ...........................
ELECTRICAL INSPECTOR
Check #
n,32
ThECOMMOATWEALTHOF
DEPARMENATOFPUBI
BOARD OFFIREPREVE MON1
APPLICAHowoR PERMIT m
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE P
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION)
Town of North Andover
The undersigned applies for a permit to perform the electrical work described
Location (Street & Number) 2.0 1 jd �e
Owner or Tenant o d h in.z,> n
Owner's Address
Is this permit in conjunction with a building
Purpose of Building
Yes M No
Existing Service � 6 Amps YOVolts Overhead
New Service --j.� Amps /2(/��VVolts Overhead
Number of Feeders and Ampacity
ETA Office UseL�` yt .�
Permit No. Yj�[/J'
Occupancy & Fees Checked
ELECTRICAL WORK
TICAL CODE, 527 CMR 12:00
Date (%Oi/l Li
To the Inspector f Wires:
(Check Appropriate Box)
Utility Auth /��ainP
/
/Underground No. of Meters
Underground 1:3 No. of Meters
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets I No of H t T b —
No. of righting Fixtures
tt
No. of Receptacle Outlets Outlets
No. of Switch
No. of Ranges
No. of Disposalswa
No. of Dishshers
No. of Dryers
No. of Water Heaters
No. Hydro Massage Tubs
OTHER •
o u s No. of Transformers
R
Swimming Pool Above ri Below
Oil Burners
as Burners
ir Cond.
Total
Tons
Heat
Pum s
Total
Tonsrea
Heating
Nnd
DevicesKW
No. ofBailasisotors
Total HP
•.-..,...--6� ucy i ignung tsattery Units
FIRE ALARMS
Total No. of Detection and
Kw Initiating Devices
KwNo. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
KW IocalMunicipal
M Connections
Total
KVA
KVA
No. of Zones
-----... •--•� �.....n.�ur.vua.acalwtalIIlJV11V1�j$ LaVIS
have aamaltLiabl7ityh>s arr�epo?icy>t> tgC p] CowrWoritswb loquivalay YES
base attretadvalidploofof MheOffim YES � NO
bo L,�� hayedldl'l,ple�eirxlicethety/peofco �b
VSURANCE BOND OTiID2 Y)— / �lJ l / �i /Uv
JolkroStart ... bpectiorlDaleRegleslod
igled urJerTie Aries of perjtuy.
RMNAME 1� 6-4
Estimakd Vahte dBRmgh Mfiica1 Wolk $
r9w J,
Ii..No. u_
simalm �sAh
ATal'SINSURANCEWAAUR l mawatetliattheli=�sedoesriotha�
1d)atmysigmeonftl3etrraapp � ��t
lease check one) Owner Agent
--signature Ot Uwner or Agent
Other
LicenseNo
Bus�ffmTel.No.
Alt Tel No.
@>fins:uancecoveaageoritsgkstarWegzvalentasmqmedbyMasachusemGenetalLaws /
Telephone No. PERMIT FEE S
Location 22LcJ
.
No. Date
=� Date
N
v
,«-/I.9y
TOWN OF NORTH ANDOVER
Sewer Connection Fee $
Water Connection Fee $
c:c✓
TOTAL $
Building Inspector
4Q 7569
Div. Public Works
Certificate of Occupancy $
Building/Frame Permit Fee $
M�5 <� Foundation Permit Fee $
Gthw Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
c:c✓
TOTAL $
Building Inspector
4Q 7569
Div. Public Works
0. /too
MAP KJO.
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
PAGE 1
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED ANDAPPROVED �BBYY� BUILDING INSPECTOR
DATE FILED /49_ 12- / �
PERMIT GRANTED
__z_d -a/ 2 19
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BUILDING INSPECTOR
OWNER TEL. # /
CONTR. TEL. # /" J F26D <fl 7�7
CONTR. LIC. # 02-41 (o
H.I.C. a 1 o S
LOT NO.
2 RECORD OF OWNERSHIP DATE
BOOK :PAGE
ZONE
SUB DIV. LOT NO.
LOCATION %'1
Cl
PURPOSE OF BUILDING
OWNER'S NAME
NO. OF STORIES SIZE
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAME
BUILDER'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
SPAN
DIMENSIONS OF SILLS
POSTS
DISTANCE TO NEAREST BUILDING
DISTANCE FROM STREET
DISTANCE FROM LOT LINES - SIDES REAR
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
(BILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
A
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED ANDAPPROVED �BBYY� BUILDING INSPECTOR
DATE FILED /49_ 12- / �
PERMIT GRANTED
__z_d -a/ 2 19
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BUILDING INSPECTOR
OWNER TEL. # /
CONTR. TEL. # /" J F26D <fl 7�7
CONTR. LIC. # 02-41 (o
H.I.C. a 1 o S
OCCUPANCY
SINGLE FAMILY Si ORIES
MULTI. FAMILY OFFICES
::-4 �
APARTMENTS
CONSTRUCTION
2 FOUNDATION
CONCRETE
—I
8 INTERIOR
FINISH
PINE
HARDW D
B
1
2 to
CONCRETE BL K.
BRICK OR STONE
PIERS
PLASTER
DRY WALL
UNFIN.
3 BASEMENT
AREA FULL
FIN. B M'T' AREA
'/ 1/1 '/.
FIN. ATTIC AREA
_
N_O B M T
HEAD ROOM
FIRE PLACES
MODERN KITCHEN
_
_
4 WALLS
I 9 FLOORS
CLAPBOARDS
B
1
2
�_
3
_
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
CONCRETE
EARTH
HARDWD
COMMCN
ASPH. TILE
VERT. SIDING
_
STUCCO ON MASONRY
STUCCO ON FRAME
_
BRICK ON MASONRY
ATTIC STRS. 6 FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR POOR
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
I HIP
BATH 13BATH FIXE'
TOILET RM. (2 FIX.)
_
GAMBRELMANSARD
I
I
FLAT
SHED
WATER CLOSET
_
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
KITCHEN SINK
_
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
_
ROLL ROOFING
MODERN FIXTURES
_
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
7 NO. OF ROOMS
GOA`
B'M'T 2nd _
1st 13rd I
ELECTRIC
I NO HEATING
BUILDING RECORD
12
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
A.J. Walsh chi Sons Inc.
55 Pleasant Street
Nt�rlh Andmer, MA 01845
Mass. JY*FNSI. # 022080
l�latis. RL(ds IRA H( )X 1r 103 359
RESIDENTIAL CONTRACTING AGREEMENT
Read this agreement and make sure you understand it before signing it.
This agreement has legal force and effect and hinds those who sign it.
Notice: All home Improvement contractors and subcontructorsengaged In home Improvement contracting, unless specificully
exempt from registration by provisions of Chapter 142a of the general laws, must be registered with the Commonwealth
of Massachusetts. Inquiries about registration and status should be made to the Director, Home. Improvement
Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02109.
Designated Registrant's Namc:,....__.._...._..... -
Registration Number: -- _-- ----_-----
Salesperson's Narnc:.,..-.----
This agreement is made of betwecu_
(CONTRACTOR)
of
(PIIONT N1IMRFR)
hereinafter called "Contractor" and
37
% 11�(ownTK)
a U ----- � ��0 L
(ADnHI�.. )
-7 (%ZONE NUM111 R)
hereinafter called "Owner".
DETAILED DESCRIPTION OF 1VORK TO BF, PERFORMED
Contractor agrees to perform in a good and workmanlike manner all work detailed below. Such work consists of the following:
DETAILED DESCRIPTION OF MATERIALS TO BE USED
Materials to be used in performutg the above desctilx:d work consist of die following:
1I. PRICE 111� /l
Contractor agrees to do all work described in Section I for the total price of S___ , Ue v�
ILL. PAYMENT
Payment will be made as follows:
1.11 1131 `� CS ... _...) upon signing Contract;
_. _ .._.. _ `" (S ....... __.-----_. __._- ) upon completion of_ __._._ ;
and the renwininF 31� ($.- � �_.) inion verification of the work by Owner
and Contractor as having been satisfactorily completed, which verification shall take
place promptly after completion.
Notice: No agreement for home Improvement contracting work shall require a down payment (advance deposit) of more than
one-third of the total contract price or the total amount of all deposits or payments which the contractor must make,
In advance, to order and/or otherwise obtain delivery of special order materials and equipment, whichever amount is
ereater.
IV. COMMENCEMENT AND COMPLETION OF WORK
Contractor will not begin e work or order ate pals he
thth gtpghe third day following the signing of this Ageement, unless specified here in writing.
Contractor will begin tlt or on or t —_ (date). Balling delay caused by cireturtsutnces beyond Contractor's control, the work
will be completed by r�� (date). The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such
delays dull are not avoidable by the Contractor siu111 not lVe considered as violations of this Agnxnlcnt.
OFFICES OF
APPEALS
BUILDING
CONSERVA"IION
HEALTH
PLANNING
a
NORrp,
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NORTH ANDOVER
Ss"C"USES DIVISION OF
PLANNING & COMMUNITY DEVELOPMENT
KAREN H.F. NELSON, DIREC'ro R
120 Main Street
North Andover,
Massachusetts 01845
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number C�� is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S
150A.
The debris will be disposed of in:
(Location of Fac/ity)
Signature of erntit Applicant
to
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
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