HomeMy WebLinkAboutMiscellaneous - 851 JOHNSON STREET 4/30/2018 (2)Xv
906;
Date. V�./. .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
1 %
This certifies that . �..-`�.! ..5.�j��.� ?� ...�vc. ��....... .
has permission to perform .. -j-(�.�.... .�i! �. n ............
plumbing in the buildings of . C ke j,f. i ! 4 6 t .............
at. s` /... �.�t - 5.= :...:........ . , North Andover, Mass.
Fee?). .,5.0... Lic. No.. ......
"OIPLUMBING INSPEC
"tDRI""
Check # 10
z
Installing Cnl�IName: R11 _TJ -.I- j
Address City/Town:l0 1924if �./
State:J%I ✓`�
Business Tel: 7 :� Old (� Fi 2`0 Fax: 51"k24- e
Name of Licensed Plumber:
Mel in.
1,4-8.1f01I -e
Check One Only certificate #
(corporation
❑ Partnership
❑ Firm/Company
�...-..vc �,vvGKHht:
have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes Q>No
If you have checked Yes, please indicate the .type of coverage by checkingtheappropriate box below.E]
A liability insurance policy. 19� Other tvnP of inrle.,,.,s., r—i
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
3i nature of Owner or Owners Acient Owner ❑ Agent ❑
I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurzfe to the bast of my
Knowledge and that all plumbing work and i nstailations performed under the permit issued for this application will be in compliance with all
Pertinent provision Of the Massachusetts State Plumbing Code and Chapter of th�General Laws.
By
- Type of License:
Title
Lumber
-ity/i own L�'1 I�/laster
APPROVED (OFFICE USE ONLY) ❑.lourneyman
if ZI L�7 : L,
Signature of Licen d Plumber
License Number: QY)
1
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town:�D
, � Vi o &L4,%, MA. Date: f �/
Permit#
r
Building Location: c5 ( aYl•a.� Owners Name: 2 �S
Type of Occupancy:
Commercial
❑ Educational ❑ Industrial ❑ Institutional ❑ Residential
New: ❑
Alteration: ❑ Renovation: ❑ Replacement: [L]� Plans Submitted: Yes ❑ No ❑
FIXTURES
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1ST FLOOR
2ND FLOOR
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3RD FLOOR
4T" FLOOR _
5T" FLOOR
6T" FLOOR
7T" FLOOR
3T" FLOOR
Installing Cnl�IName: R11 _TJ -.I- j
Address City/Town:l0 1924if �./
State:J%I ✓`�
Business Tel: 7 :� Old (� Fi 2`0 Fax: 51"k24- e
Name of Licensed Plumber:
Mel in.
1,4-8.1f01I -e
Check One Only certificate #
(corporation
❑ Partnership
❑ Firm/Company
�...-..vc �,vvGKHht:
have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes Q>No
If you have checked Yes, please indicate the .type of coverage by checkingtheappropriate box below.E]
A liability insurance policy. 19� Other tvnP of inrle.,,.,s., r—i
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
3i nature of Owner or Owners Acient Owner ❑ Agent ❑
I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurzfe to the bast of my
Knowledge and that all plumbing work and i nstailations performed under the permit issued for this application will be in compliance with all
Pertinent provision Of the Massachusetts State Plumbing Code and Chapter of th�General Laws.
By
- Type of License:
Title
Lumber
-ity/i own L�'1 I�/laster
APPROVED (OFFICE USE ONLY) ❑.lourneyman
if ZI L�7 : L,
Signature of Licen d Plumber
License Number: QY)
_C_\ Commonwealth'of Massachusetts
mom
City/Town of
W° System Pumping Record,
Form .4 1 17
'DEP has provided this form for use by local Botls,o
information must be substantially the same as that p
local Board of Health to determine the form they use.
the local Board of Health or other approving authority.
•^'moi `\.. .
A. Facility Information
1. System a ion:.L&ft+
Cit -' own
2. ` System Owner.
! ,' 1.'
-lealth. Other torm$,ma be used, but the
his form, check with your
ord must be submitted to
�y . t.
\�R ytii
,ide of house, right side ofhous
j%%,right rear'of building, under deck.
State x, Zip Code
right front of house, left
rvame
Address (if different from location)
City/Town ' _ . Stated
.w Zip Code
' All Telephone Number,
B.Pluming
•..-" 1. Date of Pumping Dem 2 Quantity Pumped:
Gallons It
•
3. Type of system: Ele
Gesspool(s) Sptic Tank El Tight Tank
❑ *er (descr4A"
4.
'F _ ra .
4-: Effluent Tee Fllter,pr`,esent? E] Yes. [ No ' j' 'Myes, was It cleaned?
qj` e x y , ❑ .Yes ❑ No
5. Condition of Syst ,: •- .+ 'I N/'
,s:l. y
— d
., 6. System Pumped B,.
Neil J. Bateson •F5821
'
Name-_*.-_..� vehfcle License'Number
Bateson Enterprises Inc. _ , ` t ,
Company - r • -- W
x .
k 1
7. Logatihere contents were dls""posed:4
l_.S. Lowell' 1;te' ter..
�. a .. Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
i � .
/' ; _
. 1 ' .. i
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..
.� .�.
�� v:... �.-. �... -
Date.. d /0
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
SAC14US
This certifies. that7� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
has permission to perform ....... ...................
plumbing in the buildings of ........... .. .................
at ... ...... North Andover, Mass.
. ......
PLUMING INSPECTOR
Check
8' 8 0
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
-NORTH ANDOVER, MASSACHUSETTS
r ��! �( Date "
Building Location ✓ O ee- Oa Owners Name , �-/J/G
� o d Permit #
Amount
Type of Occupancy
New ri Renovation Replacement Plans Submitted Yes ❑ No
(Print or type) % eck one: Certificate
Installing Company Name Corp. 3C
Address
Partner.
t`� O 2
usmess Telep one Firm/Co.
Name of Licensed Plumber:
Insurance Coverage:. Indicate t�e type of insurance coverage by checking th ppropriate box:
Liability insurance policy Other type of indemnity ❑ Bond
LL....11 ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner ❑ Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
Title
City/Town
APPROVED (OFFICE USE ONLY
Signature or Licenseuum er
Type of Plluumbibing License
icense um e6er Master Journeyman t
/
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AFI
.J
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•
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No
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OMMMMMM
ON
MW
WM
MN
NON
NNW
MMN
MW
MINNOW
No
..��MMM���o�
, .. � IMMMOMMMOM
MMMMM
MIMMEMM
(Print or type) % eck one: Certificate
Installing Company Name Corp. 3C
Address
Partner.
t`� O 2
usmess Telep one Firm/Co.
Name of Licensed Plumber:
Insurance Coverage:. Indicate t�e type of insurance coverage by checking th ppropriate box:
Liability insurance policy Other type of indemnity ❑ Bond
LL....11 ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner ❑ Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
Title
City/Town
APPROVED (OFFICE USE ONLY
Signature or Licenseuum er
Type of Plluumbibing License
icense um e6er Master Journeyman t
! l3
s i
j' `'�
The
} \
Common i«,terrlfh of Mazachusetts
•
k� Ji
!
Department of Industrial Accidents
Office
l'
of Investigations
a , r
600 Tf ashin ton Street
Boston, MA 02111
www rrmassgov/dia .
Workers' Compensation iusiira.nce Affidavit: Builders/Coatractors/Eiectricians/P
A licant Information lumbers
Name (Business organirdhon/Individual)-
Please Print Legibl
Address:
City/State/Zip:
Phone #: .
Are-------
you as employer? Cheek.the appropriate box:
1. ❑ I am a employer with 4. ❑ I am a general contractor and I
Type of project (required):
employees (full and/or part-time).*
2. ❑ '; I am.a.ati}e proprietor. or
have Lured the sub -contractors
Listed
6 ❑New construction .
partner.
ship and have no employees
on the attached sheat i
These sub -contractors have
7• ❑Remodeling
8. Q Demolition
working forme in any capacity,
[No workers' comp, insurance
workers' comp. insurance.
5. ❑ We are a corporation and its
9. ❑ Building addition
required.)
3. ❑ I terse a homeowner doing all work
myself.
officers have exercised their
right of exemption per MGL
} 0 ❑Electrical repairs or additions
1 l.❑ Plumbing repairs
[No workers' comp,
I required.]
q ]
c. 152, § 1(4), and -we have no
.employees. [No workers'
or additions
12.❑ Roof repairs
comp. insurance required.]
`any eppiitLT; that ehedcs botClf l must also fiat out the section below showing their workers' compensation
t homeowners who submit this aiiidavit indj®ting they
131-1 Other
policy information
ars tieing all work and then hie outside contractors musf submit a new affidavit loth '
' �Cantractors that chedk this box roust ettadhed an additional sheat showirS such.
rg thename of the sub -contractors and their work=, come_
I e,=t ars employer feat is provi&ng:workers' co ensaion
informafiom A+P insUrmwefOT nxy errrployees:
Insurance Company Name;
Policy # or Self -ins. Lic. #:
Job Site Address:
Below is the Polk/' and job site .
Expiration Date:
City/state
Attach a copy of the wo�p;
rkers' 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 tate 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 sttement may be forwarded to the Office of
Investigations of the DIA for insuranc
2 e coverage verification. _
I do hereby;ce?*-fy under the pains and penalties of perjury that the informadOn provided above is true andcorreet
O, fftcial use only. Do riot write in dds area, tv be contpleW yy fy or town offidd
City or Town .
Permit/License # .
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Tovvu Cierk 4. Electric t Inspector S. Pi..mr,:....
6. Other
Contact Persons
Phone #:
r' .3
r
ia.'
The commonwealih of Massachusetts
Department o. f Industrial Accidents
Office of Investigations
600 TEasfiinaton Street
Boston, M4 42111
www -nu ssgovldia .
Workers' Co
polio nsuectri
mpensation insurance Affidavit: Builders/Contractors/Eicians/pinmbers
tnt' Information
Name
Address:
City/State/Zip:
Phone #: .
Are you aD employer? Check -the appropriate box:
1. ❑ I am a employer
with
4. ❑ I am a genes contractor and I
employees (full and/or part-time).*
2. ❑ I am .a sole proprietor or
have hired the sub -cont cxorors
listed
partner-
ship and Have no employees
on the attached sheet,
These subcontractors have
working for me in any capacity,
[No workers' comp. insurance
workers' comp. insurance.
5. ❑ We are a corporation and its
required ]
3. ❑ t am s homeowner doing
officers have exercised their
all work
right of exemption per MGL
myself. [No -workers' comp.
r 152, § 1(4), and -we have no
insurance required, t
]
.employees. [No workers'
COMM insurance uired_j
Type of project (requires:
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 epplicarn that checks } (must also fill out the section below showing their workers' bompensatiori Policy mformahoa I
r Homeowners who submit this affidavit indicating they are doing all worst and then hue outside connectors must`subrnit a new affidavit indi such.
i �Co:ttractors that check, this box must attached an additional sheat showing• the rramE of the sub- °6
contractors and their worksms comp. policy inib"natior..
1 asst are loyerThat is pro &n9':workers' c0ntpensad0n insurance or a !o
infarnrafion, f �Y �P Ye= Be&w is the poEcy andyob site .
Insurance Company Name:
Policy # or Self -ins. Lic. #:
Expiration Date:
Job Site Address:
City/state/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration da*4
Failure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal
fine up to $1,500.00 and/or one-year imprisonment, as well tis 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 ofPerlury shat the information provided above is true and rowed
Si tore: i
Date:
Phone #:
Of,}`tcial use Only. 'Do not write in this area, to be con plered by rite, or town o rurL
City or Town:
# .
Issuing Authority (circle one): Permit/License
I. Board of Health 2 Building Department 3. City/3own
6. Other Clerk 4. Electrical Inspector S. Plumbing Inspector
Contact Person:
Phone #:
Information a �d Instruction
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for theirempbyees.
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 includir-Rg the legal representatives of a decaased employer, or the
receiver ortnust—m-of an individual, partnership, associatioin or other legal entity,, empioying 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 an such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an empioyer."
MGL chapter 152, §25C(6) also states that "every state or [oral licensing agency shalt 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 complertely, by checking the boxes that apply to your situation and, if
necessary, supply sub -contractors) 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. Ifan LLC or LLP does have
empioyees, 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, pleastcall the Department at the nLzmber listed below, Self irsu ed oornpanies should en+t +ham*
self insurance'iicense 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 w -ill be used as a referhence number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating cutrerut
policyinformation (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)." A copy oftlhe affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affideVit. is on file for future permits or licenses. A new affidavit must be filled out each
year. When 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 bum leaves etc.) said person is NOT required to complete this affidaviL
The Office of Investigptions would Ike 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 WasIxi.ngton Street
Boston, MA 02111
TeL # 617-7274900 ext 406 or 1-9.77-MASSAFE
Fax # 617-727-7744
Revised 5-2trQ5 www-mass.gov/dia
1.
CC I1104.O RINEALT4 OF MASSACHUSETTS
IN NLUiVi�E91, AND CA5FITTERS
LICL-NSED AS A hiAsm PLUNIBE►i
ISSUES THIS LICENSE TO
SEAN C MCLATC.HY
71 LITTLETON RD
CHELMSFORD MA 01824-2623
15346 05/01/10 506374` $'
Fold, Then Detach Along All Perforations
w
Leathe, Brian
From: eacchristopher@gmail.com
Sent: Tuesday, February 16, 2010 10:39 AM
To:- Frank Carta
Cc: Philip Christopher; 1st Rat lumbing & H
Showroom; Leathe, Bria , colem@angies
Subject: Re: Follow, up
Okay. I will call Kathie
Sent via B1ackBerry by AT&T
LLC; Geoff Hamilton; Kathie
•
From: "Frank Carta" <fecarta@comAst.net> VAW
Date: Tue, 16 Feb 2010 00:15:58 -050;
To: Liz Christopher<eacchristopher@gm.com>
Cc: <phil_christopher@3com.com>; 1 st Rate P uxnbing & Heata
LLC<1 strateplumbing@comcast.net>; GeoffHamilton<g amh ilb
Kathie Bonchack - Bedford Showroom<kathie@fwwebb.com>;
<bleathe@townofnorthandover.com>; <colem@angieslist.com>
Subject: Fw: Follow up
Page 1 of 1
- Bedford
.com>;
Liz
I have had no response to my last email sent on Feb 9. Please respond.
Thank you
Frank
----- Original Message -----
From: Frank Carta
To: Liz Christopher
Cc: Phil christopher6a�3com.com ; Kathie Bonchack - BedfordShowroom ; 1 st Rate Plumbing & Heating
LLC; Geoff Hamilton
Sent: Tuesday, February 09, 2010 9:51 AM
Subject: Follow up
Liz,
As a follow up to my last email. I talked to Kathie at webb and she is willing to provide you, at no cost, a
kohler cast iron tub and have it shipped to your house.
-Frank
2/17/2010
A
101"
Page 1 of 4
Leathe, Brian
From: Frank Carta [fecarta@comcast.net]
Sent: Tuesday, February 16, 2010 12:15 AM
To: Liz Christopher
Cc: phil_christopher@3com.com; 1st Rate Plumbing & Heating LLC; Geoff Hamilton; Kathie Bonchack -
Bedford Showroom; Leathe, Brian; colem@angieslist.com .
Subject: 2nd email Fw: American Standard Tub/Surround
Liz
I have had no response to my last email sent on Feb 8. Please respond.
Thank you
Frank
----- Original Message -----
From: Frank Carta
To: Liz Christopher
Cc: Phil christopher(cD3com.com ; 1st Rate Plumbing & Heating LLC ; Geoff Hamilton
Sent: Monday, February 08, 2010 3:58 PM
Subject: American Standard Tub/Surround
Liz,
As we spoke back towards the end of December we decided to let this situation sit due to the
holidays and your new baby. We had a number of scheduling conflicts, in regards to inspections,
where we both had to cancel due to your new baby, the flue and other issues. I heard from Sean
that you were trying to schedule a plumbing inspection directly with him and the North Andover
building dept. and trying to circumvent me for some reason. I decided to go to the North
Andover offices this morning and discuss with Jim. I ended up in an impromptu meeting with
Brian and Jim at the North Andover building dept. and discussed the issues with the bath tub and
surround. Jim has told me, in no uncertain terms, that he will NOT do an inspection unless Sean
and/or I am present so we need to schedule a time that is agreeable to all involved. Both Sean
and I will be present.
Before we make any inspection appointments there are some issues that I feel need to be
resolved. Brian told me he was over to inspect the tub/surround unit at your request. He said
both the bathrooms look great but yes the tub has issues. He told me the same as he told
you. He. believes the tub/shower surround is of "Builders Grade" quality. He was a little more
descriptive to me but he basically said it is of lesser quality than higher grade units not to
mention 4 piece units are inherently harder to make fit properly. I told him it was installed as per
manufactures specifications and there was a Manufactures rep on site when we installed the
second time. Both Jim and Brian agree that manufactures specifications supersede MA code in
most cases. He has made it very clear the tub/surround issue is between the manufacture, you
and I to settle. It has nothing to do with him or his office. His job into make sure the work is
done to the MA building code. This is a tub/surround quality issue. During our conversation,
Brian mentioned to me you would now like a cast iron tub and tile application. I will address
this later.
As I have said many times in the past I want to resolve this issue with your tub. I have been
2/16/,2010
y..
Page 2 of 4
nothing but professional and cordial with you throughout this entire project. The last attempt was, at
your request, to go in through the shower closet wall and your sons wall to shim and fill under the tub to
fix the deflection issues. I did go into the shower closet wall and fill under the front of the tub but you
decided not to let me go in through your sons wall to fix from the back.
I am going to put in list form what has transpired and what I propose to rectify:
1 At the beginning of the project you told me you did not want tile on the walls in the upstairs shower
as you have had issues. I told you I can install tile with new backer -board technology that would
eliminate those issues. You decided you wanted a fiberglass tub and surround. At that time I said I can
not do a 1 or 2 piece unit due to the limitations of your stairs and doors. 1 or 2 piece unit would not fit.
I said you can do a 3 piece and there are good quality 3 piece units out there. Sean from First
Rate, Kathie at webb and I VERY STRONGLY suggest not to use a 4 piece unit as we have found they
are of poor quality and are very hard to fit. I made it very clear, many times that I have had issues with
the 4 piece units.
2 You wanted to get certain contractor discounts for purchasing plumbing fixtures and you decided to
purchase on your own. You said you were going to use your previous companies account to secure
those discounts. I was not to be responsible for finding, choosing, ordering or securing plumbing
fixtures. This is stated in the contract, as you were aware. I recommended you talk to Kathy at
Webb in Bedford as I have had a great business relationship her and she would be able to give you
my contactor pricing. Not one job I have done with Kathy has had plumbing issues.
3 You went to Kathy with very specific criteria for the upstairs tub and surround. Kathy presented
you with options in direct correlation with your criteria to which you chose and purchased the unit
you currently have.
4 During install I made mention to you and Kathy at Webb that I did not like the quality of the shower
surround unit. (and still don't) I went as far as to take a piece of the cut out over to Webb to show
them the thickness, or lack of thickness, of the unit. Kathy or I had not seen or used that American
Standard unit prior... We were told by American Standard at that time that we have the standard
thickness of the unit.
5 After the unit was installed and plastered I went back to remove tape and tub protector to caulk. As
I started to clean the gaps you pointed out there were some large gaps and excessive deflection at the
tub/wall connections. I agreed. I immediately called Sean from first rate and he was at your house
that next day which was a Saturday. It was my impression that First Rate workmen installed the unit
incorrectly and did not glue it to the studs.
6 Sean from first inspected the unit and agreed. While the walls were flimsy it was not glued to the
studs. Both Sean and I offered, at our cost to remove the walls and reset. Both you and Phil decided
that the unit was "defective". Phil pulled Sean aside while he was there and made a comment to him
stating you wanted to "play the defective card" so you could get a completely different unit as this
one was not to your liking.
7 American standard and their representative, Geoff Hamilton of Davenport Associates, were
contacted. American standard sent a private contractor that does a lot of cosmetic repairs for
American Standard over to inspect. The contractor contacted Geoff with his findings. The contractor
agreed that the unit was of "builders grade" quality but did not feel the tub. itself was defective or
installed incorrectly
8 American standard offered to replace the surround walls but not the tub to which you and Phil
agreed. (American Standard did later agree to send a "ticket" for a tub for cosmetic reasons not
structural reasons) The order for the new walls delayed the job by over 5 weeks. As before, I offered
at my cost to replace the surround walls. Sean and I replaced the unit walls and installed to
manufactures specifications using their directions. Geoff Hamilton was there to see the install to
make sure it was installed to manufacture specifications. I then, at my cost, had the walls re -
2/16/2010
Page 3 of 4
plastered.
9 At that time I met with Phil and showed him the newly installed walls. I specifically remember
telling Phil up in the bathroom that there was going to be deflection in the walls due to the thickness
of the walls themselves. He told me he understood and agreed.
10 I was then told by you that I installed the tub incorrectly because there was movement in the tub and
walls. The initial tub installation was not changed or tampered with. As a part of due diligence the
tub installation was inspected when we removed the old shower walls. Sean, Geoff and I agreed the
tub was, installedcorrectly. I again told you that the unit you purchased was of `Builders grade"
quality. They are made to hit a certain price point for builders and are usually not of the quality of
higher price units which you did not purchase. There will always be some deflection with the tub
you have. This unit has none of the strengthening properties of standard tub units. I called American
Standard's contractor line and talked to 3 different people and they all said the same thing. It is a
light weight contractor grade unit that will have deflection.
11 We talked and I offered to fill in under the tub by cutting into the shower closet wall. You asked me
to go into yours son's closet wall and do the same there but I suggested we wait and see if this will
fix the problem in deflection as I did not want to cut into any more walls than we had to. You told
me the first attempt did not fix the issue. I offered to go into your son's closet wall but you declined
stating you did not believe it would fix the issue. The one thing I need to reiterate and I have said it
many times in this email, other emails and in person. I told you from the beginning NOT to
purchase a 4 piece unit. Your tub surround issue is not due to installation. It is due to the fact it is a
4 piece, Price point,. inexpensive tub/surround that you purchased. Kathy nor I suggested that unit to
you. In the paperwork for that unit that, which is available on line and from FW Webb, it clearly
states "Builders Grade". You made it very clear to me that I was not to be involved in the
procurement of plumbing fixtures. You purchased the tub/surround and I did the best I could to
make it work. I have taken ownership and responsibility of my issues that have surfaced with this
project.
With that said, I am still willing to resolve the issue as I have stated all along. I have never, not finished
a job or walked away from a job. If as per Brian you have changed your mind and would like a cast iron
tub and tile application I am willing to make that change under certain circumstances.
I would do the tub/surround swap donating my time and have the job finished within 5 business days as
long as I have the appropriate access. This work will be done with a written addendum and signed by
both parties. Plumbing and building inspections to follow install.
Scope of work:
1. As per the original contract you will be responsible for securing the plumbing fixtures. You
would have the cast iron tub on site prior to starting.
2. Donating my time, I would remove the old shower walls and install "dense Shield" shower wall
backer board which you would pay for at cost or provide. I would also install "Hydro -Flex"
shower water proofing tape and membrane at all seams which you, would pay for at cost or
provide.
3. Sean at "First rate" will remove the tub fiberglass tub and re -install the new customer supplied
cast iron tub. He will have to re -set the valves as they are set for the thickness of the current
shower walls. You can pay First Rate direct.
4. I will coordinate the installation of the tile and grout you supply with my tile contractor that
installed your floors. As we discussed previously when you were looking to replace the tub, there
may be additional work with the floor as it is set to the existing tub. You can pay him direct.
Brian also made mention he discussed with you the shimming and fixing of the deflection in your
2/16/2010
existing surround.
Le me know what you would like to do.
Frank
2/16/2010
Page 4 of 4
Page 1 of 6
Leathe, Brian
From: Liz Christopher [eacchristopher@gmail.com]
Sent: Tuesday, February 16, 2010 8:21 PM
1
' To: Frank Carta
Cc: phil_christopher@3com.com; 1st Rate Plumbing & Heating LLC; Geoff Hamilton; Kathie Bonchack -
Bedford Showroom; Leathe, Brian; colem@angieslist.com; Philip Christopher
Subject: Re: 2nd email Fw: American Standard Tub/Surround
Frank et al:
In lieu of a lengthy narrative, this is not a complete list, just some Project highlights to consider:
1. Contract signed, permit pulled 7/31/09 for complete demo and reconstruction of two full baths
2. Contract. states job duration of 3-4 weeks
3. Phil & I were told to use FW Webb in lieu of our choice, of Metropolitan Bath, you agreed to
allow us to purchase products and you would inventory and warranty all products shipped to our
house just as if you made the purchase.
4. We requested your guidance on the purchase of a "durable, child -friendly bath surround with
shelves that a child could reach." I visited 7 supply houses in MA and was not able to locate a
product and moved forward with Kathie's recommendation on the AS Acrylux per your
recommendation of Acrylic OVER Fiberglass. You said 4 pce was not ideal but that you
installed the exact same unit successfully in chelmsford. At no point in the process did you state
that this product was "builders grade" or "inferior" until you proved incapable of satisfactory
installation.
5. when I raised concern following the 1 st installation, Sean and I met, he said the unit was
installed incorrectly, you again were not on-site to take part in this conversation,
6. You stated that the product was faulty and contacted Geoff Hamilton,
7. We advised Geoff of our concern with your dishonesty at his first visit, when he came to
inspect the surround and tub. Geoff inspected the walls, Jack came thereafter to inspect the tub
and were told there was a molding defect(we have an open ticket on this item)
8. We agreed to have the new walls installed b/c I was about to give birth and you again installed
them incorrectly even after we recommended ways you could install including opening up the
adjacent wall, following the installation directions, placing plywood over the studs, etc.
9. 10/9th - electrical inspector arrived unannounced and you were not present. GFI corrected,
inspection passed once complete.
10. Birth of our child on 10/22, followed by surprise visit by plumbing inspector within days of
my return home (no notice again), and you were again not present
11. You withheld keys to our home following many (documented) requests and demands, this
lingered for weeks, even after Phil offered to pick them up from you whereever was convenient,
but you wouldn't answer your phone or return messages.
12. You continue to withold $2,450 for the Porch project, violation of MA law. I have agreed to
pay the supposed restocking fee for the windows, but you cant provide documentation that you
ever even ordered them.
13. Further demonstration of your lack of oversight includes: Missing property (brooms & trash
can), Personal trash left strewn throughout the house, Abandonment of construction debris and
2/17/2010
Page 2 of 6
trash to be removerd and disposed of per contract (posing health hazard to our son), leaving the house
open(unlocked) and unattended, We agreed to vacate the house for 4 weeks to enable you to complete
the job even though we originally agreed that we would remain in the house during the work, failure to
inventory the FW Webb products resulting in a "missing" Symmons faucet, toilet handle, other misc.
hardware.
14..Now we have a home with no functional upstairs bath/shower. The tub moves and squeaks, the
walls can be pushed in exposing between approx. 1/2" - 1" gap, this presents a leak and mold hazard.
15. The downstairs shower has begun to leak as well.
16. Your floor vendor was alone on-site and told me to leave the house after I arrived home 7 Mos.
pregnant w/ our son to put him down for nap. I pulled up to the house to hear the smoke detectors going
off, and Jimmy (floor vendor) telling me that he used "scrap" wood from another job. This resulted in
failure to use the correct species of wood thresholds in both baths, we agreed to let the upstairs remain
due to dust/health concerns assiociated with sawcutting in the house. you claim it will cost $150 to
remove & replace the threshold with the correct wood and repair and repaint the adjoining doorway
trim ...really Frank?
17. Lack of regard for our home was again exhibited when I witnessed a complete stranger to You, Your
vendors and Us, walk right into our house looking for someone to give him directions. You and your
unsupervised crew had propped both front doors open in the middle of the Summer, exposing us and our
belongings... we are very fortunate that we only lost lesser expensive items during your complete
disregard for our home.
18. Lack of ability to work on the project and perform as promised, the house remained vacant for days,
all vendors had delays, everyone had an excuse starting right at the beginning when Sean's wife
supposedly had a baby in July! we later learned it was August/September.
19. I can provide email and text documentation to support this in much greater detail.
20. Nearly 7 months after the permit was pulled we have paid MiCaven Bathrooms just short of $19,000
and have no functional bathing/shower unit in the upstairs bathroom, The fact that our son has a
congenital defect and is not able to soak in a tub has presented further risk to his health,. We again
request reimbursement of moneys owed for the Porch deposit and the bath/shower completion as you are
not competent. It has been proven.
21. For the record, Brian indicated that "You would not hear from Frank" when I asked if he thought I
should contact you about the plumbing inspection. He stated to Phil and I that it is the responsibility of
1st Rate (the Sub on the job) to complete the plumbing inspection w/ the inspector, and since you were
not present or available at the inspections I witnessed and for much of the job in general, why would I
call you?
We are prepared to pursue all consumer protection avenues available.
Regards,
The Christophers
On Tue, Feb 16, 2010 at 12:14 AM, Frank Carta <fecarta a,comcast.net> wrote:
Liz
2/17/2010
Page 3 of 6
have had no response to my last email sent on Feb 8. Please respond.
Thank you
Frank
----- Original Message -----
From: Frank Carta
To: Liz Christopher
Cc: Phil christopherYd-)3com.com ; 1st Rate Plumbing & Heating LLC ; Geoff Hamilton
Sent: Monday, February 08, 2010 3:58 PM
Subject: American Standard Tub/Surround
Liz,
As we spoke back towards the end of December we decided to let this situation sit due to the holidays
and your new baby. We had a number of scheduling conflicts, in regards to inspections, where we
both had to cancel due to your new baby, the flue and other issues. I heard from Sean that you were
trying to schedule a plumbing inspection directly with him and the North Andover building dept. and
trying to circumvent me for some reason. I decided to go to the North Andover offices this morning
and discuss with Jim. I ended up in an impromptu meeting with Brian and Jim at the North Andover
building dept. and discussed the issues with the bath tub and surround. Jim has told me, in no
uncertain terms, that he will NOT. do an inspection unless Sean and/or I am present so we need to
schedule a time that is agreeable to all involved. Both Sean and I will be present.
Before we make any inspection appointments there are some issues that I feel need to be resolved.
Brian told me he was over to inspect the tub/surround unit at your request. He said both the
bathrooms look great but yes the tub has issues. He told me the same as he told you. He believes the
tub/shower surround is of.`Builders Grade" quality. He was a little more descriptive to me but he-
basically
ebasically said it is of lesser quality than higher grade units not to mention 4 piece units are inherently
harder to make fit properly. I told him it was installed as per manufactures specifications and there
was a Manufactures rep on site when we installed the second time. Both Jim and Brian agree that
manufactures specifications supersede MA code in most cases. He has made it very clear the
tub/surround issue is between the manufacture, you and I to settle. It has nothing to do with him or his
office. His job is to make sure the work is done to the MA building code. This is a tub/surround
quality issue. During our conversation, Brian mentioned to me you would now like a cast iron tub -and
tile application. I will address this later.
As I have said many times in the past I want to resolve this issue with your tub. I have been nothing
but professional and cordial with you throughout this entire project . The last attempt was, at your
request, to go in through the shower closet wall and your sons wall to shim and fill under the tub to fix
the deflection issues. I did go into the shower closet wall and fill under the front of the tub but you
decided not to let me go in through your sons wall to fix from the back.
I am going to put in list form what has transpired and what I propose to rectify:
1 At the beginning of the project you told me you did not want tile on the walls in the upstairs shower
as you have had issues. I told you I can install tile with new backer -board technology that would
eliminate those issues. You decided you wanted a fiberglass tub and surround. At that time I said I
can not do a 1 or 2 piece unit due to the limitations of your stairs and doors. 1 or 2 piece unit would
not fit. I said you can do a 3 piece and there are good quality 3 piece units out there. Sean from First
2/17/2010
Page 4 of 6
Rate, Kathie at webb and I VERY STRONGLY suggest not to use a 4 piece unit as we have found
they are of poor quality and are very hard to fit. I made it very clear, many times that I have had
issues with the 4 piece units.
2 You wanted to get certain contractor discounts for purchasing plumbing fixtures and you
decided to purchase on your own. You said you -.were going to use your previous companies
account to secure those discounts. I was not to be responsible for finding, choosing, ordering or
securing plumbing fixtures. This is stated in the contract, as you were aware. I recommended you
talk to Kathy at Webb in Bedford as I have had a great business relationship her and she would be
able to give you my contactor pricing. Not one job I have done with Kathy has had plumbing
issues.
3 You went to Kathy with very specific criteria for the upstairs tub and surround. Kathy
presented you with options in direct correlation with your criteria to which you chose and
purchased the unit you currently have.
4 During install I made mention to you and Kathy at Webb that I did not like the quality of the
shower surround unit. (and still don't) I went as far as to take a piece of the cut out over to Webb
to show them the thickness, or lack of thickness, of the unit. Kathy or I had not seen or used that
American Standard unit prior. We were told by American Standard at that time that we have the
standard thickness of the unit.
5 After the unit was installed and plastered I went back to remove tape and tub protector to
caulk. As I started to clean the gaps you pointed out there were some large gaps and excessive
deflection at the tub/wall connections. I agreed. I immediately called Sean from first rate and he
was at your house that next day which was a Saturday. It was my impression that First Rate
workmen installed the unit incorrectly and did not glue it to the studs.
6 Sean from first inspected the unit and agreed. While the walls were flimsy it was not glued to
the studs. Both Sean and I offered, at our cost to remove the walls and reset. Both you and Phil
decided that the unit was "defective". Phil pulled Sean aside while he was there and made a
comment to him stating you wanted to "play the defective card" so you could get a completely
different unit as this one was not to your liking.
7 American standard and their representative, Geoff Hamilton of Davenport Associates, were
contacted. American standard sent a private contractor that does a lot of cosmetic repairs for
American Standard over to inspect. The contractor contacted Geoff with his findings. The
contractor agreed'that the unit was of "builders grade" quality but did not feel the tub itself was
defective or installed incorrectly
8 American standard offered to replace the surround walls but not the tub to which you and Phil
agreed. (American Standard did later agree to send a "ticket" for a tub for cosmetic reasons not
structural reasons) The order for the new walls delayed the job by over 5 weeks. As before, I
offered at my cost to replace the surround walls. Sean and I replaced the unit walls and installed
to manufactures specifications using their directions. Geoff Hamilton was there to see the install
to make sure it was installed to manufacture specifications. I then, at my cost, had the walls re -
plastered.
9 At that time I met with Phil and showed him the newly installed walls. I specifically
remember telling Phil up in.the bathroom that there was going to be deflection in the walls due to
the thickness of the walls themselves. He told mehe understood and agreed.
10 I was then told by you that I installed the tub incorrectly because there was movement in the
tub and walls. The initial tub installation was not changed or tampered with. As a part of due
diligence the tub installation was inspected when we removed the old shower walls. Sean, Geoff
and I agreed the tub was installed correctly. I again told you that the unit you purchased was of
"Builders grade" quality. They are made to hit a certain price point for builders and are usually
not of the quality of higher price units which you did not purchase. There will always be some
deflection with the tub you have. This unit has none of the strengthening properties of standard
2/17/2010
Page 5 of 6
tub units. I called American Standard's contractor line and talked to 3 different people and they all
said the same thing. It is a light weight contractor grade unit that will have deflection.
11 We talked and I offered to fill in under the tub by cutting into the shower closet wall. You
asked me to go into yours son's closet wall and do the same there but I suggested we wait and see
if this will fix the problem in deflection as I did not want to cut into any more walls than we had
to. You told me the first attempt did not fix the issue. I offered to go into your son's closet wall
but you declined stating you did not believe it would fix the issue. The one thing I need to
reiterate and I have said it many times in this email, other emails and in person. I told you from
the beginning NOT to purchase a 4 piece unit. Your tub surround issue is not due to installation.
It is due to the fact it is a 4 piece, Price point, inexpensive tub/surround that you purchased. Kathy
nor I suggested that unit to you. In the paperwork for that unit that, which is available on line and
from FW Webb, it clearly states "Builders Grade". You made it very clear to me that I was not to
be involved in the procurement of plumbing fixtures. You purchased the tub/surround and I did
the best I could to make it work. I have taken ownership and responsibility of my issues that
have surfaced with this project.
With that said, I am still willing to resolve the issue as I have stated all along. I have never, not
finished a job or walked away from a job. If as per Brian you have changed your mind and would like
a cast iron tub and tile application I am willing to make that change under certain circumstances.
I would do the tub/surround swap donating my time and have the job finished within 5 business days
as long as I have the appropriate access. This work will be done with a written addendum and signed
by both parties. Plumbing and building inspections to follow install.
Scope of work:
1: As per the original contract you will be responsible for securing the plumbing fixtures. You
would have the cast iron tub on site prior to starting.
2. Donating my time, I would remove the old shower walls and install "dense Shield" shower wall
backer board which you would pay for at cost or provide. I would also'install "Hydro -Flex"
shower water proofing tape and membrane at all seams which you would pay for at cost or
provide.
3. Sean at "First rate" will remove the tub fiberglass tub and re -install the new customer supplied
cast iron tub. He will have to re -set the valves as they are set for the thickness of the current
shower walls. You can pay First Rate direct.
4. I will coordinate the installation of the tile and grout you supply with my tile contractor that
installed your floors. As we discussed previously when you were looking to replace the tub,
there may be additional work with the floor as it is set to the existing tub. You can pay him
direct.
Brian also made mention he discussed with you the shimming and fixing of the deflection in your
existing surround.
Le me know what you would like to do.
Frank
2/17/2010
Sincerely,
Liz C. Christopher
H: 978.688.4315
C: 978.973.0024
2/17/2010
Page 6 of 6
_� .. Date
TOWN OF NORTH ANDOV
it .�.-.'• �o�
° p PERMIT FOR PLUMB]
This certifies that..1. .. �'` '� ../.P/y ............... • • • •
has permission to perform ....P.( !!° F/� r r. 6 ..............
plumbing in the buildings of ......... ..................... .
at ......'. /.. , l.c. l t >-.......f:�.... , North Andover, Mass.
Fee ... 7.0...Lic. No...f?:.? `mac............. ......
PLUMBING INSPECTOR
Check # 9 `/ G
828b
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS j
Date
Building Location :� f ✓0 IiJG� f%L permit # r
Owner Amount 7 u
New Renovation Replacement Plans Submitted Yes ❑ No
FIXTURES
(Print or type) Check one: Certificate
Installing Company Name �/ G �G4., Co;.
13
Address ❑ per.
,par
Business Telephone — -O 1:1 Firm/Co.
Name of Licensed Plumber: e%% G L—
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, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature pwner❑ Agent11
I hereby certify that.all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts P bin r Cha 142 of the General Laws.
.
By: rgna e o rcens um
TitleType of Plumbing License
CitylTown /.,) 3 t,.-!
LicenseNumber�Master ® Journeyman
APPROVED (OFFICE USE ONLY
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,ll! 02111
www.mass.govldia
Workers' Compensation Insurance Affidavit: Builders/Cont
ractors/Electricans/Plumbers
Applicant Information Please Print LeQib
ly
Name (Business/Organization/Individual):
Address:
City/State/Zip:
Phone #:
Are you an employer? Check the appropriate bog:
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. ❑ I am a sole proprietor or partner-
listed on the attached sheet
ship and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. ❑ We are a corporation.and its
required.]
officers have exercised their
3. ❑ I am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
,t
c. 152, §.1(4), and we have no
insurance required.]
-employees. [No workers'
comp. insurance required.].
cii:+O nit OUT me Se" Lion K'1 t
K'1_
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling
8. ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
11 -0 Plumbing repairs or additions
12. ❑ . Roof repairs
13.[] Other
s owing then workers compensation poky information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
xContractors 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 insurancef mJ' or amP toy em Below is theP olic1' and1 'ob site
information.
Insurance Company Name:
Policy # or Self -ins. Lic. #:
Expiration Date:—
Job
ate:.
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 $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 pain's and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone #:
Official use only. Do not write in this area, to becompleted 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
6. Other
Contact Person:
4. Electrical Inspector 5. Plumbing Inspector
Phone #:
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 152, §25C(6) also states that "every state or local Iicensing 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 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-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 permittlicense 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 bum 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
(Vice of Investiigations.
600 Washington. Street
Boston, MA 0.2111.
Tel. 4 617-7274,900 ext 406 or 1-877-MAS.SAFE
Fax # 617-727-7749
Revised 5-26-05
uww.mass.gov/dia
Date ..... e-.. //—. e,... 9
... ..................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that . .. ... ...... I".—.,,. ...... ...........................................................
/`17�-
has permission to perfornmn..... ........... ......... �. X--'......................
.........................
wiring in the building of... ....................................
at .... . . ...... . North Andover, Mass.
Tic. Nolp�.�Z?1.4 .............. -j
F .. .................. . ...... . .......
ELECTRICAL INS
PECTO
Check # - XV
b Lit:,Narrmenrorr-ir ziervtces j Permit No. X91 3
BOARD OF FIRE PREVENTION REGULATIONS Date Issued: ;�M
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Fode (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL IAt c'ORMATION) Date. �' l 1�Q9
City or Town of: ,U
By this application the undersigned gives notice of his or her intention to perform the electrical To the Inspector wok Wires:
Location (Street &.Number) g•S/ � a � work described below.
�U , ,�,�,,r�--
Owner or Tenant
Owner's AddressTelephone No.
Is this permit in conjunction with a building permit? Yes
91 NO ❑ (Check Appropriate Box)
Purpose of Building (�)
�' ��'� Utility Authorization No.
Existing Service /CSO .Amps /2,C7/ Zrt� Volts Overhead
Undgrd ❑. No. of Meters !'
New Service . Amps / Volts
Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Z V �20✓
Location and Nature of Proposed Electrical Work.
W,v i c,.s o�1R ry p
Cotncletion of the /bllowine tahl" "In„ ho ..,,,;.,e,r t....t._ r..____._
usp. (Paddle) Fans No. of Total
Transformers KVA
bs Generators KVA
of Above ❑ In- ❑ o. o Emergency ig ung
rnd. rnd: Battery Units
ners FIRE ALARMS No. of Zones
rners No. of Detection and
InitiatingDevices
Con TotaTons/ No. of Alerting Devices
Number_KW No. of Self -Contained
Detection/Alertin Devices
He KW Local ❑ Municipal C3 Other
Connection
ances KW Security Systems:
No. of -Devices or Equivalent
No. of Data Wiring:
Ballasts No. of Devices or Equivalent
Total HP Telecommunications Wiring:
No. of Devices or Equivalent
Attach additional detail tfdesired, or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the lict
see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi.
that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE J BOND 0 OTHER ❑ (Specify:)
Estimated Value of Electrical Work: C/L, (Expiration Date)
// (When required by municipal policy.)
Work to Start: Illi' Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I cenif},, under the pants and penalties of perjury, that the information on this application is true and complete.
FIR�'YI NAME: h ^ ,� ���z��,
LIC. NO.: A:
Licensee: , r►'tore.�� Signature
(Ijaoplicable, enter "exempt " ur rhe license number line.) LIC. NO.: E:
�ddress:�=� Qo= 7-,�tlau�v�-� Bus. Tel. No. •
OWtiER'S INSURANCE �V (VER. Zia: dl$?�co Alt. Tel. No. �!'" 3—ou�I
�m aware that the Licensee does not have the liability insurance coverage normally required by law. By my
signature below, I hereby ,vain c this requirement. I am the (check one) ❑ owner ❑ owner's agent.
denature
Phone:
e❑
Lx
Permit Fee: Receipt 0: Date:
No. of Recessed Fixtures
No. of Ceil.-S
No. of Lighting Outlets
No. of Hot Tu
No. of Lighting Fixtures
Swimming Po
No. of Receptacle Outlets Z
No. of Oil Bur
No. of Switches (�
No. of Gas Bu
No, of Ranges
No. of Air Co
No. of Waste Disposers
Heat Pump
Totals:
4
No. of Dishwashers
Space/Area H
No. of Dr} ers
HeAppli
No. of 1Vater
Heaters KW
No. of
Signs
No. Hydromassage Bathtubs
No. of Motors
i
Gg
OTHER:
usp. (Paddle) Fans No. of Total
Transformers KVA
bs Generators KVA
of Above ❑ In- ❑ o. o Emergency ig ung
rnd. rnd: Battery Units
ners FIRE ALARMS No. of Zones
rners No. of Detection and
InitiatingDevices
Con TotaTons/ No. of Alerting Devices
Number_KW No. of Self -Contained
Detection/Alertin Devices
He KW Local ❑ Municipal C3 Other
Connection
ances KW Security Systems:
No. of -Devices or Equivalent
No. of Data Wiring:
Ballasts No. of Devices or Equivalent
Total HP Telecommunications Wiring:
No. of Devices or Equivalent
Attach additional detail tfdesired, or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the lict
see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi.
that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE J BOND 0 OTHER ❑ (Specify:)
Estimated Value of Electrical Work: C/L, (Expiration Date)
// (When required by municipal policy.)
Work to Start: Illi' Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I cenif},, under the pants and penalties of perjury, that the information on this application is true and complete.
FIR�'YI NAME: h ^ ,� ���z��,
LIC. NO.: A:
Licensee: , r►'tore.�� Signature
(Ijaoplicable, enter "exempt " ur rhe license number line.) LIC. NO.: E:
�ddress:�=� Qo= 7-,�tlau�v�-� Bus. Tel. No. •
OWtiER'S INSURANCE �V (VER. Zia: dl$?�co Alt. Tel. No. �!'" 3—ou�I
�m aware that the Licensee does not have the liability insurance coverage normally required by law. By my
signature below, I hereby ,vain c this requirement. I am the (check one) ❑ owner ❑ owner's agent.
denature
Phone:
e❑
Lx
Permit Fee: Receipt 0: Date:
Attach additional detail tfdesired, or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the lict
see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi.
that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE J BOND 0 OTHER ❑ (Specify:)
Estimated Value of Electrical Work: C/L, (Expiration Date)
// (When required by municipal policy.)
Work to Start: Illi' Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I cenif},, under the pants and penalties of perjury, that the information on this application is true and complete.
FIR�'YI NAME: h ^ ,� ���z��,
LIC. NO.: A:
Licensee: , r►'tore.�� Signature
(Ijaoplicable, enter "exempt " ur rhe license number line.) LIC. NO.: E:
�ddress:�=� Qo= 7-,�tlau�v�-� Bus. Tel. No. •
OWtiER'S INSURANCE �V (VER. Zia: dl$?�co Alt. Tel. No. �!'" 3—ou�I
�m aware that the Licensee does not have the liability insurance coverage normally required by law. By my
signature below, I hereby ,vain c this requirement. I am the (check one) ❑ owner ❑ owner's agent.
denature
Phone:
e❑
Lx
Permit Fee: Receipt 0: Date:
v
The C'ommonivealtla of Massachiisetts
Department of industrial Accidents
Office of Investigations
' 600 Washington ,Street
Boston, MA 02111
www mass gov/dia
Workers' Compensation Insurance Affidavit: Bugders/Contrac.tors/EiectriciansIPlumbers
AvDlicant information Please Print Leeibly
NaMe (BusmeWOrganizatio0ndividual):_ 3/ efl).'c
Address:_ G �,
City/StateMp:_ D/ar? Phone #: g �j q0_c�
Are you an employer? Check the appropriate box:
I 1 am a employer with,__7
4. ❑ i am a general contractor and 1
employees (fiull andlorput time).*
2. ❑.1 am'a sole proprietor or partner-
have hired the sub -contractors
listed on the attached sheet. T
ship and have no employees
These sub -contractors have
worldng for me in any capacity.
workers' comp. insurance -
[No workers' comp_ insurance
5_ We are a corporation and its
required.)
officers have exercised their
3. ❑ 1 am a homeowner doingall work
right of exemption per MCTL
myself. [No workers' comp.
c_ 152, § 1(4), and we have no
insurance required_] t
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
"Azy appucant that cheers box #1 must also fill out rhe section below showing their workers' compensation policy inforrutiorL
i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a zrew affidavit indicating such
rContractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers' comp. policy information_
1" am an employer that isproviding workers' compensation insurance for my employees. Below is the policy and job site
i information. '
Ynsurance Company Name: 16_1� �✓kScr�.�
Policy # or Self -ins. Lic. #:_ f � SCy `���� Expiration Date: 1,161 eole(
Job Site Address:_5k--57 Sjin Q,j City/State/Zip: 1'0i 14-7 �-
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 fq insurance coverage verification.
I do hereby certify under -the pains and penalties of perjury that the information providedabove is true and correct_
Sionatiir�` Date-
Phone #:
Official use only. to 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 - - _-
Date.�
IaORT"
ko /OWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ......................
has permission to perform ... </.,, . 1. ' . ' ...........
plumbing in the buildings of ..................................
at Q V:-7": . . . . . . . . . . . . . . . . I North Andover, Mass.
Fee .3. 7. L i c. No -1" Y C7�. � . . . . . . . . . . . . .
PLUMBING INSPECTOR
Check # /'t L -)
6573
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Date o?-
Building LocationtJya� 1- 0kmSAi lj Owners Name Permit # ^
Amount 3n —
Type of Occupancy
New Renovation Replacement 0 Plans Submitted Yes No
FEKTURES
(Print or type) Check one: Certificate
Installing Company Name Vt/1 / 1-3 Corp.
Addres *O' Partner.
1 G
usmess e ep one - !, Frm/Co.
Name, of Licensed Plumber: Ed= 94G.,17
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity 0 Bond ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner ❑ Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massa osetts�tV PluT Code and Cbapia 142 of the General Laws.
Type of Plumbing Licensre
OcensNumoer Master
D (OFFICE USE ONLY
Journeyman jam/ 3
L�7
Location
No. 6s- 1
Date
&ORTN TOWN OF NORTH ANDOVER '
C.�t�,� �•1tip �I
Certificate of Occupancy $ _
Eta Building/Frame Permit Fee $
JACMUS
Foundation Permit Fee $
Other Permit Fee $ _
TOTAL $
Check # / -
14248 Building Inspector
TOWN OF NORTH ANDOVER
'BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAId%,.RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING
$ � ° 4 �srey,�yAh' f �`i�✓�. `��"a�l', � tR .
BUILDING PERMIT NUMBER: A DATE ISSUED:
SIGNATURE:
Building Commissipner/i tor,of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address: O 2
1.2 Assessors Map and Parcel Number:
Number Parcel Number
WMap
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Areas Frontage ft
1.6 BUILDING SETBACKS 00
Front Yard Side Yard
Rear Yard
Required Provide Required Provided
Required Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public ❑ Private ❑ Zone Outside Flood Zone 0
1.8 Sewerage Disposal System:
Municipal ❑ On Site Disposal System D
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record e
cJ N 81 ls� l ST d�-►.1
Address for Service
lauG2� �0!
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature r Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor.
`
Address
Signature Telephone
Not Applicable ❑
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
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SECTION 4 - WORKERS COMPENSATION (MGL. C 152 § 25c(6)
«,, rke -
•<...u„ w' uipicwd and suom►ttea with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Si ned affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 Description of proposed Work(check aii applicable)
New Construction ❑ Existing Building X Repair(s)Alterations(s) � Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
S liv � le Leu;cm Ao w3(.7 AX4)
ojda,K be0y A7VO R? [--krS Le t, f) e s o Ic
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost ) (Dollarto be
l /
i3..I?k�'ICIAL
USE�ONLY� � t�
Com leted b ennit applicant
_ , ti
.
1Building
rv.. _r��
(a) Building Permit Fee
rf�
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbin
(�
Building Permit fee (a) X (b)
4 Mechanical (HVAC)
5 Fire Protection
6 Total 1+2+3+4+5
3 00-0
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS
OWNERS AGENT OR CONTRACTOR APPLIES FOR>BUILDING PERMIT
—kr
� i , .' i
I' as Owner/Authorized Agent of subject property
Hereby authorize I,
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
I, � t � C.iU d
Owner Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of mhknowledge
and belief
Pri ame
C Z.oc�
Signature of Owner/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TINMERS 1ST 2ND 3
SPAN
DRAENSIONS OF SILLS
DM ENSIONS OF POSTS
DMIENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CfMvINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
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Town of North Andover
Building Department
27Charles Street
North Andover, Massachusetts 01845
(978) 688-9545 Fax (978) 688-9542
DEBRIS DISPOSAL FORM
f NORTH
O �t��o ,6 ti
7 o
y ?,
-4/4
T O AN/
9- fOCMh[WwKM _ 1"
In accordance with the ovisio,s of MGL c 40 s 54, and.a condition of
Building permit . # the debris resulting from the work shall be disposed
of in a properly licensed solid aste disposal facility as defined by MGL cl 1, s150a. %U / 0
The debris will be disposed of in /at:
Facility location
Si
Date
NOTE: A demolition permit from the Town of North Andover must be obtained for this
project through: the Office of the Building Inspector.
cocatior IQ
' No. .3 Date c.
40RTN � � .TOWN OF NORTH ANDOVER.
p Certificate. of occupancy $
�o Building/Frame Permit Fee $
'ssAGMUS Et Foundation Permit Fee
Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
� _4,OTAL $ = .
JULI2'
`'Building Inspector
Mo
6301, Div. Public Works
PER:IiIT NO. - APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
'AGE 1
MAP 440.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK 'PAGE
ZONE
SUB DIV. LOT NO.
-I
URPOSE OF BUILDING Sj% (,yaL �"
1 ,_'
ATION f3 J 1'}�/L 1[oA ) f
O,NNER'S NAME C` IV1l/W�
NO. OF STORIES SIZE
Z;WNER'S ADDRESS Q1 1 . ` �j,�q S. GT
V l v v L U t
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME Ao b (j,j� 5G i ms PIAS '�j L
[II/�l/�+ `i! C-' 1, �--
SPAN
DISTANCE TO NEAREST BUILDING
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 X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
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
1
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLAN MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
/FILE C�. T5
v
SIGNAT OF OWNER OR AUTHORIZED AGENT
FEE T7 NJ,
-� OWNER TEL, � � I
PERMIT RA TED ___ll TEL #
23 19 _ 1- -W TR. LIC.�-
r
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
IV?
45
EST. BLDG. COST PER SQ. FT.
EST.' BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF S[LECTMEN
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY
STORIES
MULTI. FAMILY
OFFICES
APARTMENTS
_
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
3 1 2 13
PINE
CONCRETE
CONCRETE BL K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
_
UNFIN.
3 BASEMENT
AREA FULL
FIN. B'M'TAREA
1/4 1/2 l/,
FIN. ATTIC AREA
_
NO B M
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
_
4 WALLS -7-7I
9 FLOORS
CLAPBOARDS
DROP SIDING
WOOD SHINGLES
B
_
1
2 3
�_
_
_
_
_
CONCRETE
EARTH
HARDNVD
COMMCN
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
11
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. & FLOOR _
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIORI� POOR _
ADEQUATE NONE
10 PLUMBING
5 ROOF
GABLE
HIP
BATH (3 FIX.)
GAMBREL
MANSARD
I
TOILET RM. (2 FIX.)
_
_
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
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
GAS
7 NO. OF ROOMS
OIL
B'M'T 2nd _
Ist 13rd
ELECTRIC
NO HEATING
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.
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OFFICES OF: �� r
APPEALS :i.w; NORTH ANDOVER
BUILDING
CONSERVATION DIVISION OF
r
HEALTH
PLANNING PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIRECTOR
Ito Main Street
North Andover.
Massachusetts 01845 QJ
(617)685.4775 -
1
In accordance with the provisions of MGL c 40, S 54, a, condition of Building Permit
Number .3 25" is that the dcbris resulting from this work shall be
disposed of in a properly liccnscd solid waste disposal facility as dcfincd by MGL c 111, S
150A.
The debris will be disposed of in:
0
F67Z S►„IGz
(Location of .Facility)
..i
ture of Pcrmit Applicant
J F3
ate
/-, 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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Town of North Andover NORTN
E 1
' OFFICE OF 3�° "`� a'apL a
COMMUNITY' DEVELOPMENT AND SERVICES p
27 Charles Street 4 ��
North Andover, Massachusetts 01845
WILLIAM J. SCOTT SSACHUSE
Director
(978) 688-9531 Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE
JOB LOCATION (1Sl �bnyn� �✓
Number Street Address Section of Town
"HOMEOWNER 6 k / L140 `my -?%9 —Zl f
Number Home Phone Work Phone
PRESENT MAILING ADDRESS X51 z S0A) S/
f1d /LT�f 1*100wz- ✓nlq- 6IN5,
City Town State Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings
of six units or less and to allow such homeowners to engage an individual for hire who does
not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1)
DEFINITION OF HOMEWOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a one to six family dwelling, attached or detached structures as
cessory to such use and and/or farm structures. A person who constructs more than one home in a
two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official,
a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the
building permit. (Section 109.1.1)
The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other
Applicable codes, by-laws, rules and regulations,
The undersigned "homeowner" certifies that he/she understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedu
HOMEOWNER'S SIGNA
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with
State Building Code Section 127.0 Construction Control.
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
WILLIAM J. SCOTT
Director
(978)688-95;1
n
SSACHUSJ
Fax(978)688-9542
In accordance with the provisions of MGL c 40 S 54, a condition of Building
Permit
Number 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 11, S
150 A.
The debris will be disposed of in:
6fur��0
(Location of f=acility)
Signature of Permit Applicant
I qC& q i
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
BOARD OF APPEALS 638-9541 BUILDING 688-9545 CONSERVATION 683-9530 HEALTH 688-9540 PLANNING 688-9535
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