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HomeMy WebLinkAboutMiscellaneous - 70 FERNVIEW AVENUE 4/30/2018 1 r^' 3 46/y pf NOR71 , V = Town of North Andover HEALTH DEPARTMENT CHU i CHECK#: DATE: LOCATION: H/O NAME: CONTRACTOR NAME Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ther. (Indicate) Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Date. /. h..? . . ..... � NORTIy 4 3� TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION � f SACMUSES This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . .�./ �l`. . . . . . . . . . . . . . . . in the buildings of . . . 7 T. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .,fl! . . f�'h.�'. .. .`.. . . . . . . . . . . . North Andover, Mass. Fee. Lic. No . . . . . . . . . . . . . �. . . . . . . . . . . . . . GAS INSPECTOR Check# 7067 Off"J The Commonwealth of Massachu s i Permit No. Department of Public Safety Occupancy d Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1 2:00 13/90 (leave blank) APPLICATION FOR PERMIT TO ERFORM ELECTRICAL WORK All work to be performed in accordance with t Massachusetts Electrical Code,527 CMR 12:001 (PLEASE PRINT IN INK O PE ALL INFORMATION) Date � -7�/ To the Inspector of Wires: The undersigned applies or to perfor7i//J electri I work described beyo . Location(Street&Numbs 7, ' l AIM DAtner or Tenant 1 ` Owner's Address Is this permit in conjunction with a building it: Yes No ❑ (Check Appropriate Box) Purpose of Building i Utility Authorization No. ,\ Existing Service i4b Amps Volts Overhead ❑ Undgrd ET No.of Meters w Servlc� Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of lighting Outlets No.of Hot Tubs No,of Transformers KVA No.of Lighting Fixtures ` Swimming Pool gmmde 11Abovmd, C1 Generators KVA Na of Receptacle Outlets No.of Oil Burners Ba of Units Lighting 1 No.of Switch Outlets No.of Gas burners FIRE ALARMS No.of Zones No.of Ranges No.of Air Cond, Tota( No.of Detection and tons IMtiating Devices Na of Disposals No.of p� To s tal TKW otal I No.of Sounding Devices No.of Dishwashers Space/Area HeatingKW I of Self Contained Det Detectlon/Sounding Devices MuniNo.of Dryers Heating Devices KW Local❑ Conne�bn[]Other No.of Water Heaters KW No.of No.of Low Voltage Signs Ballasts Wiring No.Hydro Massage Tubs No.of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws ET" I have a current Llabillty Insurance Policy including Complet perationC s '°� E or its substantial equivalent. YES NO ❑ I have submitted valid proof of same to this office. YES UNO ❑. /`G ' If you have checked YES,please indicate the type of coverage by checking the appropriate bx. INSURANCE El BOND❑ OTHER❑ (Please Specify) ����✓� (Expiration Date) Estimated Value of Electrical Work$ Work to Start Signed under the penalties of Jury. //1► FIRM NAME LIC.NO. 3 Licensee_5L A /�C r Signature LIC. NO. 7 Bus.Tel, rt' 3 Address �� / Alt.Tel.Na a6 " 10;7 6WNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as inquired by Massachusetts General laws,and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) Telephone No. PERMIT FEE$ Ok- t.�— 2 z— o r' R.T .' 1 Z MASSACHUSETTS UNIFORiAA!,°PLICATION FOR PERMIT TO DO GAS FITTING Illy Cityffown:-�\ . h'1t>,�OV e.'C' MA. Date:\� � c5� Permit# 205 7 Building Location:—) C.� Y1 o �W S� Owners Namelws_'\� Q' Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes❑ No Q�,yptiq. FIXTURES Cd Z H V = Q: Q WO �, � 2NW p=p = O0 LU J O = H 0 0 2 w w z I- z o D W p Q H O w (0 w pp 0 Q a E- o w X W I^ Q: Q w w ILLIZOW z 9 N 2 W O N = z. W W W t z w N J k Q m ~ Q F- SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR -iTwFLOOR 7 FLOOR 8 FLOOR \\ Check One Only Certificate# Installing Company Name '-_t+� �Corporation Address: \v+rh City/Town .9 �c.T * State ❑ Partnership Business Tel:�-w 403's Lk%w% Fax: 1` ElFirm/Company Name of Licensed Plumber/Gas Fitter:V rRA Q..V tt� "Max`Rqvvs INSURANCE COVERAGE: 1 have a current liabili insurance policy or its substantia(equivalent which meets the requirements of MGL.Ch.142 Yes No❑ if you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy 9 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. Check One Only Owner ❑ Agent ❑ Si nature of Owner or Owner's A ent By checking this box❑;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. Type of License: By ®Plumber ❑Gas Fitter Signature of icensed Plumber/Gas Fitter Title [ Master q city/Town ❑Journeyman License Number: `z. APPROVED OFFICE USE ONLY ❑ LP Installer C 4 FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S) FEE: $ PERMIT# APPLICATION FOR PERMIT TO DO GAS FITTING NAME&TYPE OF BUILDING LOCATION OF BUILDING SKETCH i PLUMBER GASFITTERR LP INSTALLER LICENSE NUMBER:" PERMIT ❑ DATE: RANTED G t t GAS FITTING INSPECTIOR i i Date. ..AA . ...... . ,FORTH joy .,,ao ,•�tiOp TOWN OF NORTH ANDOVER ` FO . � • PERMIT FOR GAS 1 T TION ,SSACHUSES This certifies that . . . ",I� ... . . . . . . . . . . . . . . . . . has permission for gas installation . . . 14 •. . . . . . . . . . . . . in the buildings of -4.r l:.--- . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . ., North Andover, Mass. Fee. . . . Lic. No.5.3.? GAS INSPECTOR Check# 5975 MASSACHUSETTS UNIFORM APPLICATION FOR'PERMIT TO DO GASFITTING (Print or Type) i -9lA41�IJ4,Aass. Date ' 20 P m t# Building tocaU /r ers Nam Type of Occupancy New Renovation❑ Replacement: Plans Submitted: 'Yes❑ No❑ ,y^, YL �2 W 0 m G to Z O l�u ill �. >- z Z O 1- � 9 m in 1¢- g 0 0 a w or z t6 z �Z �- p _ Q) w Ce � W z O , O .� w �a 2 O OU 9 > D a O. ' SUB-BSMT BASEMENT 1ST FLOOR t 2ND FLOOR 3RD FLOOR. 4TH FLOOR ' STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR -Installing Company Name Irri �OW-Check one: Certificate Address -0u )2y2:79yen ❑ Corporation Business Telephone - 3 ❑ Partnership irm/Co. Name of Licensed Plumber.or Cas Fitter INSURANCE COVERAGE: 1 have a current fi blllty insurance policy or its substantial equivalent,which meets the requirements of MCL Ch. 142. Yes be- No p If you have checked yes,please Indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity p Bond ❑ OWNER'S INSURNACE WAIVER: 1 am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on tffls perm application Waives this requirement Check one: Signature o Owner or Owners Agent Owner p Agent ❑ I hereby certify that all of the details and Information I have submitted lot entered)In application are true and accurate to the best of my knovNedge and that all plumbing work and installations performed under the pe tis !ed for this a ation will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the I ws. Type of License: By []Plumber na re o t ed Plumber or Gas Fitter Title ❑Gasfitter City/Town t4ikaffer License Humber APPROVED(OFFICE USE ONLY) p Journeyman r Date. f HORTM, tiTOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUS� This certifies that . . . .�. . . . .. Y`. . . .. elf s has permission to perform plumbing in the buildings of � . . . . at. . . . . . . . ., rth Andover, Mass. Fee:- . .Lie. No��d . . �. . . . . . . . . . . . (; PLUMBdfNSPECTOR Check AlI 6430 MASSACHUSETTS UNIFORM APPLIC ION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS .,� % Z`-Qi n Date - p1ding Location wners Name Permit // Amount Type of Occu a Renovation Re1:1placement Plans Submitted Yes 11NoNew 1-3 FIXTURES Cn rr SL&HM B SEWM BE it" av1)FIOCR i 2MHOM 4IH HBM SIH HDOR J 6IH HDCR 7IH HDCR SIH Hj" t (Print or type) heck-one: Certificate Installing Company Name Corp. Address Partner. usiness Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy �� Other type of indemnity Bond ❑ Insurance Waiver: I,the undersigned,h ve been ma aware that the licensee of this application does not have any one of the above thr� ins afice _ _ gna ure Owner 'p3' AgentEl I hereby certify that all of the details and information I have submitted(or entered)in above application are true d accurate to the best of my knowledge and that all plumbing work and installdt' ns performed under Permitsu for is ap i'cation will be in compliance with all pertinent provisions of the Mass ' s State Plumbing Code and C.Sf 2 0 en�al Laws. By �gna ure 01 Llcenseuum r Type of Plumbin License Title City/Town 77cense um er Master n_--Journeyman ❑ APPROVED(OFFICE USE ONLY Location 70 -•�-v�•"'"� No. '� Date `� y Ma"T" 1 TOWN OF NORTH ANDOVER 40 Certificate of Occupancy $ b''••° Nu•''I Building/Frame Permit Fee $ �ss+csE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check # r i at �' ���Building Inspector V t Date.......... .. r t NOR711, TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACNUS� R This certifies that V .0 IJ/ L.i.( j ................ 1 � .�p �- has permission to perform ... ,,.f..: .................. ..................... wiring in the building at 1�.. �t 11 �25 �L, f, ... �j �,........, o th.An�d�er,Mass. Fee�� ro. Lic.Nd-5-�3, �/..... !. �...�_!•• bLECTRiCAL INSPECTOR Check # 5 Tl 4 Office U The Commonwealth of Massachu s Permit No. r/'47-1 CC Department of Public Safety Occupancy d Fee Checked s1%EPEE BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 2:00 13/90 (leave blank) APPLICATION FOR PERMIT TO ERFORM ELECTRICAL WORK All work to be performed in accordance with t Massachusetts Electrical Code,527 CMR 1200 c (PLEASE PRINT IN INK O PE ALL INFORMATION) Date ' To the Inspector of Wires: The undersigned applies ory� t to perform e�eiectri I work described below. , Location(Street&Numbe / if '� l I Owner or Tenant Owner's Address Is this permit In conjunction with a uilding ermit: Yes No ❑ (Check Appropriate Box) Purpose of Building t Utility Authorization No. Existing Service Amps /,10-- (1Z � Volts Overhead ❑ Undgrd ET No.of Meters Kw kava Amps j Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No,of Transformers Total KVA 4No.of Lighting Fixtures 1 Swimming Pool A and❑ In- ❑ Generators KVA No.of Receptacle Outlets No.of Oil Burners BNE aa erI of Units envy Lighting Nw of Switch Outlets No.of Gas burners FIRE ALARMS No.of Zones No.of Detection No.of Ranges No.of Air Cond. TtonsotalInitiating Devices and Heat Tota! Total No.of Disposals No.of pun Tons KW No.of Sounding Devices i No.of Self Contained N�.of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal No.of Dryers Heating Devices KW Local❑ Connection❑Other No.of No.of Low Voltage No.of Water Heaters KW Signs Ballasts Wiring No.Hydro Massage Tubs No.of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws ,�/ a I have a current Uabliity Insurance Policy including Comp let Perations Covera or its substantial equivalent. YES U NO ❑ I have submitted valid proof of same to this office. YES NO ❑. Cover or you have checked YES,please indicate the type of overage by checking the appropriate box. INSURANCE BOND❑ OTHER❑ (Please Specify) 61 (Expiration Date) Estimated Value of Electrical Work$ y /� /• / y� /IM Work to Start L12�4 CCS Signed under the penas of perjury: FIRM NAME 1� � �� ZIUC.NO. 4r- Licensee d - / .�� Signature UC. NO. Bus.Tel. "I3 _ + Address �C° Z111414 Alt.Tel.No. -;kJ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial equivalent as + n3quired by Massachusetts General taws,and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) Telephone No. PERMIT FEE$ (Sianature of Owner or Agent) TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT aEtAa RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING M BUILDING PERMIT NUMBER: �-� S-Y3 DATE ISSUED: SIGNATURE: d1j4j "'l Building Commissioner for of Buildings Date SECTION i-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O F-e m V, et,) /AVe r Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ZoninR District Proposed Use L.ot.Area Fronto ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided a 1.7 Water Supply M.G.L.C.40.1 34) 1.3. Flood Zone Information: 1.8 Sewerap Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT i::ti!Ct: M 2.1 Owner of Record Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: 0 z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ ,'P:d6 t,--6 Lc.-R.e-x, Licensed Construction Supervisor: l�� r e ` w „ F rn 1n `! ',� License Number Address 4—� G� Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Q S'C Company Name Registration Number Address �_rrr a Expiration Date `� Signature Telephone G) SECTION 4-WORKERS COMPENSATION(M.G.L C 152 f 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building it. Signed affidavit Attached Yes.....X No.......0 SECTION 5 Description o Pipposed Work(check aH a bie New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify 0 Brief Description of Proposed Work: ff rew-vievie SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee -)d Multi lien 2 Electrical (b) Estimated Total Cost of /0 t)O Construction 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Co `7 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT L as mer/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, �?0 6 e'i as Owner/Authorized Agent of subject property ' Hereby declare that the statements and information on the foregoing application are Lrue and accurate,to the best of my knowledge and belief r Print N —Sianature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2 ND3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE V a0jejisiUiw^ pd 45840 dW '-1'13AA0- 1S d 311 v-Lb l£Z L 2ln3��d'1 12i3802i 00 ;p81314998 8001 :OU'JI 900Z/8Z/80 :sajldx3 £961/8Z/80 :01ONVIS LZ8840 so :jagwnN ?JOSI/\ 13+in5 N0110n'81SN0a;:asuQ:)11 ,y sNomwinoaa viowine ao aados &Mao4u4{�4 `f 'n Re ula ons and Standards Board of Building One Ashburton Place - Room 1301 Boston. Massa UfluzScUb 02108 t Home Improvement .ontractor Registration ` .. Registration: 117932 Type: Pri: to Corporation Expiration: 12/8/2006 BUILDING PRbFESSIONALS INC. .r�--- ROBERT LAFLEUR - 123 LAFAYETTE ST LOW ELL, MA 01854 -----_- Update Address and return c rd.Mark reason for change. Address i 1 Rene,vld Employment Lost Card DPS•CA1 0 50M•04/04-Gi01216 —--_- The Commonwealth of Massachusetts Department oflndustrial Accidents #meow MKODUMUUMN 600 Washington Stree4 7°r Floor 3J Boston,Mass. 02111 + Workers'Comensahon Insurance Affidavit:Building/Plnmbing/Electrical Contractors. city /-6 state• /n Zip ()/3,5-4L phone# 92 0 '7?0 Work site IocatiQn(full addressl• 7.0 AJo vim, m� lV da it ❑ I am a homeowner performing all work myself. Project Type:l yp El Constructlon,�Remodel I am a soler netor and have no one workin man ca act °� $ Y „h' ❑Building Addition ❑ I am an employer providing workers compensation for my employees working on this job. company name: address: - city.. phone# insurance co. 0oHcV# the Iamale proprietor, s,._'� 4 e�;�,-s.�f"�-. �os+.... ',.�5� ,.;, .- �, ;:� _:` � s.; ,-..-� •r �:.�-�dt-..�'..�. .r. �+:.,e:�. ' >.s�'-: :may p p ,general contractor,or homeowner(circle one)and have hired the contractors listed below who have following compensation polices. company name• address: . city phone# insurance eo olI # company name: address: city. phone# ins prance co • Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under thepains and penalties ofperjury that the information provided above is trueandcorrect Date `f7 ��J�> Print name 2f 0,6.e•-z- 4 Q Pe ur- Phone# 9?8 970 Tzl -- 471 official use on o nowrite n this area to be completed by city or town�' dnot i wn official city or town: permit/license# []Building Department ❑check if Immediate response is required OLicensing Board ❑Selectmen's Office contact person: phone#; Onealth Department (revised sept 20 B) (]Other a i Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",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 152 section 25 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,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' Y Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, ..please do not hesitate to give us a call: :'�`s r g` � .r,.� ,s�'.,,i;ys wr.�k•4 � 4" v k ,fir a ,� �` ty t '��� '�- �. r._:,-� b y fr >r �. '� �,r._ +�.; The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Inllosdgadons 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#:(617)727-7749 phone#: (617)727-4900 ext.406 ACM CERTIFICATE OF LIABILITY INSURANCE 'pD01 ' THIS CI:RTIMMM IS MMM AS A MATTER OF INFORMATION ONLY AND CONFERS NO IEGHT8 UPON THE CER>IIFICATE HOLDER. TMS COFMCATE DOES NOT ANIM EXTEND.OR CLOUTIER INSURANCE AGENCY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1470 LAKEVIEW AVENUE 6OJURERS AFFORDING COVERAGE ssuaERaACUT. MA..03$2!s SRA: PENN—ANERICAIIIABILM 808 LAFLEUR BUILDING PROFESSIONAL INC :IMMEW 123 LAFAYETi''LE STREET LOWELL. MA 01864- =SuRMft aasunER� OVERAGES- THE POUCIES OFINSURANGE LISTED BELOW HAVE SEEN ISSUED TOM*INSURED NMAAED ABOWE FORT$&POLICY PERIOD INDICOM NOTWITHSTANDIM ANY R8C3UIF0MWr,TERM OR COMMON OF ANY COPD a OR OTMER OOGUMMT WITH RESPECT TO WMCH TICS CERTIFICATE MAY BE ISSUED OR MAY PERTANJ,THE MRANCE AFFORDED BY W POLICIES DESCIEBED HEREIN IS MMMT TO ALL THE TER A&EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AMRMATE LUM SHOWN MY HAVE BEEN REDUCED BY PAID CLAod& OR Tm4maFa3811RMxE PoLmim mmmmma—Now LaIOS PAC6405307 06121/04 06/21/06 E�acauaRENCE s 500.0@0 r�+EnaA ^1A—L�UAenm Fn�oASIAaE oiuAre) s 50 CLAaiI MME LJ*=m oee Delsonf s 5 OQId I'Mo AL SAm out RY S �0@ 04MMAL AMMMASB s �Q0 000 004AUGREOAYEUMrAPPUESPEI! ` Ptatlum.cmwwms S seg 01 0 POliCY IAC {F Mmmm AUf0610dlLE L1AaiLB'Y "NAM i SMIfiO E um E ALLOYY�AIfIOS } � 8006.Y tNR1RY Sl'F�lA.EDAUfOS � lFeQelaodl S wrlEoauros PIX ft DAAAAGE s Ama".mAccMIM f ANY A171O OTIIJ17tlIW . „fiAaCC s AM Gds A Ada S Pxcess LIAMW FACUMCLOMMM s acwa CLAMFSAIAOE I MITE s s aNQRxEllscaaPENSATa1/AND � EMPLOYERS•UAgu7v EACH Riff- s iR ss.aeEASE•EA As�lv4o : 1 0n1e11 EA 01BEASE•Pwc r Lnnr s >eSCRiPigro OF OPERR11ON6tLOGAl ADBED 8Y PRDVrg= • :EIiTtPICATEHOLOER AnollPulA�elNSRrts:aIRLEY1aR CANCELLATION SHWAILDAKV 6FT="MM0EMeR=MP8UC=neANCOLLIMitM= MEtMMnCM TOWN OF NORTH ANDOVER °AW °P'TX° ML ENDEAVOR M Oft oAYs artarrEll BUILDING DEPT. "WMT0TMOOMMI AU MOLIM PUMTOTNa LM. FALMT000 30 SPAM ODOM$10 OBLIMATM OR UABLM OP A11Y RIND iMM IN MMM%US A66M an NlPR$BE.YTAYgiCa AlInNFA 0 "a &&OAS WORD 25S(7AM B A RPORATION 1M 1 4,_0„ Remove existing shower, install new shower pan, mud floor, and Remove existing exhaust fan and ceramic the floor and walls install new. Connect to existing ductwork. Remove existing toilet & install new Install new wall the 48" high on walls0 � Remove exisitng vanity cabinet and lav and install new pedestal sink. Install underlayment and ceramic 2268 E(3 t the on floor Fernandez 70 Fernview Ave. Unit#11 North Andover, MA 01845 I I I E7 I I i O T • a I I 7 BuildingProfessionals, I nC. NARI TIONA Professional Building&Remodeling On time On Budget or We'll Pay You Guaranteed in Writing THE NAIIATION NDUS R L ASSOC OF M E M B E R AGREEMENT FOR SERVICES This Agreement,along with the attached plans and specifications(if applicable), is the entire Agreement,and replaces any prior agreements. Date of this Agreement: March 7,2005 Name of Salesperson: Robert A.LaFleur Description of work to be completed: Bathroom remodel. See attached specifications. Limitations on work to be completed: Any items of work or services not specifically provided for in this Agreement are excluded. This excludes,but is not limited to,any unspecified alterations to existing structures or disposal of unrelated existing materials on site. Client name and address: Mr. James Fernandez, 70 Fernview Ave.,Unit#11,North Andover,MA 01845 Job Location: Same Price of specified work to be completed: $6,171.00 Payment Terms: $1,000.00 NON-REFUNDABLE deposit due upon execution of Agreement for Services. Equal payments of$2,500.00 due on start date and continuing weekly thereafter for a total of two weeks. Balance of$671.00 due upon completion. Completion: Work to be completed within 15 business (Mon—Fri) days of start date. (Excluding custom aluminum shower enclosure). Building Professionals Inc. will incur a penalty of$100.00/day beginning on day 16 and continuing until work is completed. Work shall be deemed complete when all stated services have been substantially completed. It is understood that routine "punch-list" or repair items, are beyond the scope of completion and are covered under builders' warranty obligations. Builder is not responsible for delays incurred due to the actions or inactions of city/town officials, strikes, Acts of God, unfulfilled customer obligations, customer supplied or specified items, or other delays beyond our control with regard to this agreement. Additional work: Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders,and will become an extra charge over and above the amount specified above. Change orders effect completion date. Insurance: Owner to carry fire, tornado, and other necessary insurance upon above work. Public Liability Insurance on above work to be taken out by Building Professionals, Inc. Notice: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration,One Ashburton Place,Room 1301,Boston,MA 02108,Tel.(617)727-8598. Your cancellation rights: Subject to the provisions of MGL c.93, s.48; MGL c. 140D, s.10 or MGL c.255D s.14, as may be applicable,the owner may cancel this contract within three business days of the date the contract was signed. Warranty: Building Professionals, Inc. warrants its work and the product(s) used therein against defects in materials and workmanship for a period of three years from the date on the Invoice for final payment. During the warranty period, Building Professionals, Inc. will, at its option, either repair or replace products or workmanship which prove to be defective. This warranty shall not apply to defects or damage resulting from improper or inadequate maintenance by the customer, customer supplied products, unauthorized modification or misuse, damage incurred as a result of Acts of God or Civil Strife. The warranty set forth above is exclusive and no other warranty, whether written or oral, is expressed or implied. Building Professionals, Inc. specifically disclaims the implied warranties or merchantability and fitness for a particular purpose. Owner's Rights: You are dealing with a registered Home Improvement Contractor and are entitled to certain rights MCLS# 048827 HICR# 117932 FEIN# 04-3407556 123 LAFAYETTE ST. LOWELL,MA 01854 978-970-3215 r Liens: There are NO liens or security interests on the residence listed above as a consequence of this contract. Final Payment: If final payment is not received on the completion date, the owner shall be responsible for all court costs and other costs incurred by the contractor,in attempting to collect final payment. Utilities: Building Professionals will endeavor to notify the homeowner in a timely manner of any interruption of utility services (electricity,gas,water,heat,etc.),however there may be instances when we must shut down these services without advance notice. You must arrange for emergency backup services for any utility critical equipment such as medical devices,computers,etc. You must notify Building Professionals at the start of the workday if you will be engaged in any utility critical activities.Notification must be done in writing by making an entry in the daily logbook on the jobsite. Colors:You will need to choose colors and finishes for the products being used in your remodeling project including,but not limited to, stain,paint,flooring,cabinetry,and decking. It is important to remember that a color/finish you see at a store or in a showroom may not,in fact probably will not,look the same in your home. Uwe understand that any color/finish changes requested after a product has been ordered,received,installed or applied will only be done after a written change order has been executed and paid. Allowance Items: This contract contains allowance items and/or customer supplied items. These are items that you must shop for. You,in essence,become one of the subcontractors on the project and your cooperation is critical to the timely and satisfactory completion of your remodeling project. Building Professionals,Inc.works on one remodeling project at a time. This allows us to give your project the complete attention it deserves. Building Professionals Inc. will not go to another job in the event that an item doesn't show up on time or is incorrect. For this reason Building Professionals will charge$500.00/day for every day or portion thereof that work cannot proceed because of missing/late allowance items. Work will not resume until full payment has been received. The completion date specified in this contract will be extended by change order. Permits: All necessary construction-related permits will be obtained by the contractor or its subcontractors. Any owner who secures a construction-related permit on their own,shall be excluded from access to the Guaranty Fund. Unregistered contractors: Any owner who deals with an unregistered contractor will be excluded from access to the Guaranty Fund. Building Officials: Any additional costs incurred by Building Professionals, Inc. as a result of decisions made by building officials will be the responsibility of the homeowner. The cost of the additional work will be calculated as follows: Material cost plus an hourly rate of $75.00/man hr. Arbitration: 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 such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in MGL c.142A. DO NOT SIGN THIS CLAUSE IF THERE ARE ANY BLANK SPACES O /errss Name(s) r/ 2_0 hDatt)e President,Robert A.LaFleur Date N45TICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. All work to be completed in a good and workmanlike manner. All changes shall be indicated on this Agreement, plans and specifications(if applicable)and initialed by both parties. The above prices,specifications and conditions are satisfactory and are hereby accepted by all parties. Building Professionals,Inc.is authorized to perform the work as specified. Payment will be made as outlined above. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES 0— IL 3 / o ers Names) Date President,Robert A.LaFleur Date tAORTH Town 0 t 4Andover 0 . . .... No. dw73 OWN over, Mass., y'`�'� COC MIC HEWICK Fl? C7 7v 4 of�ATED BOARD OF HEALTH Food/Kitchen PER , IT T D Septic System THIS CERTIFIES THAT...... . ......... BUILDING INSPECTOR ...... ......................I............. .......... Foundation has permission to erect........................................ buildings or ... ..0........ ................................................. Rough to be occupied as. Chimney .......... .......... .0 .. 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 PERMIT EXPIRES IN 6.MONTHS UNLESS CONSTRUCTION 4T, S ELECTRICAL INSPECTOR '� AOL Rough ................................................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE JI Smoke Det.