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Home My WebLink AboutMiscellaneous - 98 WAVERLY ROAD 4/30/2018CY 0 Location /C) WAUP-9LY 9d No. IfT Date TOWN OF NORTH ANDOVER 0,5 Certificate of Occupancy $ Building/Frame Permit Fee $ 2 CHUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 33 S�y 15891 'Building Inspector 00 m �o 3 z .o 1.7 Water SWjyM.CiI.C.4Q• .S4) Is. P)gadTona3dbmtio® 1.6. SeAersBeDnq�as�l6ystem. roLtic o Pdvice o Zone Opt�de P600d Zq�q a M1 0_ on see u.t sy:r�..a , SECTION 2 - PROPERTY OWNERS�tAUTHORIZED AGENT m 2. Chvnor of Reoord . • ... .. _. Sc -o4 Name (Print) Address fa{ Service : C Co��^c�„��i ��Rl L:��-t1r�zs� _.� �:1 ::�da�"or:.1.J1� r,►c�:u� SECTION 4 -. WORKERS COMPENSATION M G_L.0 142 s 2wm - .. Workers Compensation Insurance affidavit ni 'aid submitted vh& this eppficatibii, Failure to provide this affidavit will result in the denial of the issuance of the bail ' Signed affidavit Attached Yes ...... Zf No... �.;0 SEMON5-DescriDthien ofFrogoted Work' ekKAk" u New Construction 0 >anshttg dmg 1!Pdb.* ReRau(s) '. ❑ ` -Alterations(s)Go' Addition Accessory Bldg. a .... Demolition 0- Otber 0 Specify Brief Description of Proposed Waris nt SECTION 6 - ESTIMATED CONSTRiICTION COSTS hero Estimated Cosi (Dollar) to be - Cowleted by'Oermit a licant 1. Building (a) Building Permit Fee... - Multi 'er tri2 Eleccal (b). Estimated Total.Cost of.. ` Constmction 3 _ Plumbing Badding Permit fee — > 4 Mechanical AC O S .Fire Protection ... .. _ 6 Total 1+2+3-M+5. Check Number SECTION 7a -OWNER AUTIHORIUM TO BE -COMPLETED WHEN: . OWNERS AGENT OR.CONTRACTOR APPLIES FOR BUILDING PnbffT-• as 0.ww/Authorized Agent of subject property Hereby authorize to act on My behalf, in all mattes relative to work authorized by this building permit application. S' of Owner Date SECTION 76- OWNER/AUTHORIZED AGENT DECLARATION I> as Owner/Authorized Agent of subject .. property Hereby declare that the statements and infomtion on the foregoing application are tribe and accurate, to the best of my knowledge and belief. Print Name q .Date Signature of Ownerl t NO.OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TIMBERS iST2 3 SPAN DIMENSIONS OF SILLS DWENSIONS OF POSTS DIIv1EiiSIONS OP.GIRDERS . HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING % MATERIAL OF CRNMY IS BUILDING ON SOLID OR FILLED LAND, IS BUILDING CONNECTED TO NATURAL, GAS LINE North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision 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 c11,S150A. The debris will be disposed of in: Worc.eSl er (Location of Facility) Signature of Permit Applicant 9 °a.01 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit av F-1 am a homeowner performing all work myself. F-11 am a sole proprietor and have no one working in any capacity F�am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone #: Insurance Co. Policv # Failure to secure coverage as required under Section 25A or 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 ($100.00) 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 herby certify uAder 4,e peins and%ientffies of perjury that the information provided above is true and correct. Print nam Official use only do not write in this area to be completed by city or town official' ❑Check if immediate response is required Building Dept Contact FORA! WORKMAN'S COMPENSATION A O Building Dept p Licensing Board 0 Selectman's Office n Health Department 0 Other k L HOME 1MPROVEM NT INSTALLATION CONTRACT Branch Name: jeti 170 1_ Date: Sold, FeNniaht & Inolled by 1 f The Horne Depot Installed Sales Branch Number: 3 l Job tF:� 345A Greenwood Street. Worcester, MA 01607 Toll Free (800) 657.5182; (508) 756-6686: Fax: 508-756-2859 Federal IDM 75-2698460 Rt Cont. Lic# 16427 CT Lich 565522 MA Home Improvernent Consracq Rea. 012689933 Installation Address: C, L/ �� l / �„ ' J o�b�7J City State Zip Purchasers : SSM: Driver's License: Work Phone: Horne Phone: Home Address: (if different from Installation Address) City State Zip Protect Information I/We ("Purchaser'), the owners of the property located at the above installation address, offer to contract with The Home Depot (" Depot") to furnish, deliver and arrange for the installation of all materials as described on the attached Spec Sheet N , incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if, upon re -inspection of the job, Home Depot determines that it cannot perform its obligations due to a structural problem with the home or because work required to complete the job was not included in the contract. DEPOSIT PAYMENT OPTIONS — -- (Subject to fund verification andror credit approval.) AMOUNT S� *LESS DEPOSIT BALANCE DUE --� ON COMPLETION S" •25% of Contract Amount due upon execution of this contract (unless project is financed through Chevy Chase, In which case no deposit is required). Indicate Payment Method For BALANCE DUE ON COMPLETION H, L - 1. Check, Cashiers Check a US Postal Service Money Order e payable to The Horne Depot). Credit Card* and/or other payment options - Circle One Below Visa Mastercard Discover American Express - Ho1.W I prove70YC1ren, [Loan Horne Depot Credit Card Available Crtdit::��S//� t ( HIL & HDCC ONLY) Accth: _ Jx7v� /t� Exp. Date: cJ � Narne as it appears on card: y c•~ rin.r 14 - •By my'_c rsig re below. i/W a agree t now The Home Depot to charge the rdit for the de n .ndicated. Cardholders ignature Date if this is a finance transaction, the agreement for financing is contained in a separate document, which is incorporated herein by Reference, and made a part hereof. At -Home Services redit//L�oan Application Ref. -�-- 4 t R i ) k` )f- i/ / i✓ :1% (' �('� int tX Purchaser agrees that, li edietely upon actory compleuori oT the work, Purchaser wit zecute a om I tion Ce tficat�and pay any balance due (unless the job is financed, in winch case, upon submission of the executed Completion Certificate, Horne Depot will be paid in full by the lender). Purchaser also agrees to be jointly and severally obligated and liable hereunder. For Mass. Residents Only: Contractor, at owners expense, shall procure all permits required by law as follows: Owners who secure their own permits will be excluded from the guaranty fund provisions of MSL Chapter 142A. Unless otherwise noted within this document, this contract shall not imply that any lien or other security interest has been placed on the residence. Entire Aereement : This agreement and its attachments, including any financing agreement, contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. rk NOTICE TO PURCHASER �t Do not sign this contract before you read It. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep „c' t t,., r,V it to protect your rights. Do not sign any Completion Certificate or agreement stating that you are satisfied with the entire project before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner print- to the actual completion of the work to be performed under the contract. u You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice o Cancellation for art explanation of this right. There will be a service charge equal to 25'% of the contract amount if the job is cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE BELOW, VWE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. UWE ACKNOWLEDGE RECEIPT OF A CUPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION, BY MYfOUR SIGNATURE BELOW, VWE UNDERSTAND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MYIOUR CREDIT HISTORY P,ND 11WE AUTHORIZE HOME DEPOT AND RMA HOME SERVICES, INC., A HOME DEPOT AUTHORIZED CONTRACTOR, T,.) VERJ Y AND REVIEW Y/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE EM 0 AL ABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS. : _ Date:, 7 J Og"2S-0?_All: 19 RCVD SUBMITTED BY Salaa \Sul ri ` y ACCEPTED BY: ' Date: -- Homeowner OR -29-02p( 2:06 CF11D Date: _Homeowner NOTICE: ADDITIONAL `FRMS, CONDITIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT White - Branch File Yellow - Customer Pink - SWesConsuinnt 01.10-02 SA -SC Cl) J) C M m 0 m CCD O .. .. o !O CD 0 _ n� O CO) d CD 0 CD CD a, re CD CO) 0 0 zo CD CD <_ 0 S _ O S go O (S H aAm 10 y O=t m A m n h A tZA T Z ?"o H _1 O� •„ r -O m CL C '17 =r W =r n3 = y W -4 O W y p N O?W: W 2 > > CD C2 t0 p A ..► d O 0 CA =o calab C y � :fir O OD d am '� to O ? _E : : 0 dc W W W ti to C a m W o � a) N N CL tS CC O �� d �cc ...►�3E m N yCD. m W 3 �W t n: CD O O �= 4 M� CD I W, W d d O � CL M : C-) n M. 0= o='ol k c 0' MIt °= aGc y M °� 0 aq a' m t'" ►ti w aGa a r� b � . �= n oda nr :jo. a °' tb � C 0 cn oZ) 0 x ITI z M 0 c