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HomeMy WebLinkAboutBuilding Permit # 4/21/2015BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: r �/ Date Issued: Date Received IMPORTANT: Applicant must complete all items on this page TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition C'teration ❑ One family ❑ Two or more family No. of units: ❑ Industrial Commercial ❑ Repair, replacement ❑ Demolition ❑ Assessory Bldg ❑ Others: ❑ Other � `N'z Y%ro'J � ;d 9 r .::,�+. +s!�!+ �r� 2.! ,, See 0 lc Wells J � : r✓rl f w- llt t'j .: ,�9„Srtin'i!.M, f"`ff f 5 . `° NEl Wa ershedDistrict „. ,Y,i ,�Nl , .=G ❑ F; ood lain r Wetlands f DESCRIPTION OF WORK TO BE PERFORMED: 1 iv CJIltr,C\ V\I66i,S AC ciAr t/ Identification - Please Type or Print Clearly OWNER: Name: -) r c ' Address: `2 1,') ca <1, _,t AD R. ARCHITECT/ENGINEER Phone: c11:-3 HLA,./e kr k � \ Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ OC' FEE: $ Check No.: 1/ L/� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund co) a co a) • n -0 0 CAD -0 a) • 03 =� = o Cam. U) -0 • O CCDD CD CAD O CO co3 CO C0 en CDD I to CD 0O ® CD 2 O CD woo oi paaln 210133dSNI JNI41If18 m cn cn 0 cn m Cl55 C) 0 Co VIOLATION of the Zoning or Building Regulations Voids this Permit. o 0-0 CD 0.0 _ CD 0 C) �:c o 7 O 0 .—I..41 0 C � vi CD • ° 0 co 0- = Cl) 0 0 =a'0� amt. cu 0-0- 0<co -' 2 0 —.. cn MT D CD fR 0y Q 0 CD N C. 0 0 w rN 0. cfl m 0 0 c1 0� 0 a r+ cv 0" =-I. 0 0 Cn 0 - 0 CD 0.) m CD -0 ® U) 0. }oaaa o} uolss!aued seq cn cr c. 0 0 .LVHl S313I12133 SIHI Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements of the states Home Improvement Contractor Law (MGL chapter 142A), but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of "A Massachusetts Consumer Guide to Home Improvement" before agreeing to any work on your residence. You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information Name 1NY•1--Ckt Mc—V Company Name L cX,rr,'1oC‘r V P,0t�P;; •,CI Street Address (do not use a Post Office Box addr s) 211 OS�oal Seed N O6` -f5 Contractor! Salesperson/ Owner Name R.iGnG,rJ\ Lc r City/Town State Zip Code CT-76 P 1 IZoco Business Address (must include a street address) 2l0 W)r\-Cy &VCc'i' 0.Ues(In Daytime Phone Evening Phone Z4 e&- IVeetrl-ov p4 City/Town State Zip Code 1-76 -4.1 cezy1 Mailing ddress (It different from above) Business Phone IFederal mployer ID or S.S. Number 1 , AN I ,\, ©b }V,�, t f /) 4. Law requires that most home improvement contractors hove a valid registration number Hamermpsovement ContractorReg. Numhzr Expiration date The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed, specifying the type, brand, and grade of materials to be used, use additional sheets if necessary) w4_1.1S ctpr9� t��\co,t Required Permits - The following building permits are required and will be secured by the contractor as the homeowner's agent: (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of MGL chapter 142A.) Proposed Start and Completion Schedule - The following schedule will be adhered to unless circumstances beyond the contractor's control arise Date when contractor will begin contracted work. Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work, furnish the material and labor specified above for the total sum of. Payments will be made according to the following schedule: $ upon signing contract (not to exceed 1/3 of the total contract price or the cost of special order items, whichever is greater) (*) $ by / / or upon completion of $ by / / or upon completion of $ upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ to be paid for NOTES: (*) Including all finance charges (")Law requires that any deposit or down -payment required by the contractor before work begins may not exceed the greater of (a) one-third of the total contract price or (b) the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty -Is an express warranty being provided by the contractor? ❑ No ❑ Yes (all terms of the warranty must be attached to the contract) Subcontractors - The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor fiuther agrees to be solely responsible for all payments to all subcontractors for materials and labor tinder this agreement Contract Acceptance - Upon signing, this document becomes a binding contract under law. Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract. Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza, Room 5170, Boston, MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage, or ask to see a copy of a "proof of insurance" document. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you noti e contractor in writing at his/her main office or branch office by ordinary mail posted, by telegram sent or by delivery, not later •tl "(bight of third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation o •s ht. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY PACES!!! Two identical copies of the contract must be completed and signed. Ono copy should go to the homed , o eth er copy shrould kept by the conirac Homeowner's Signature bpntractorr's Sinrature SIN,M ©t tA-3 Date HSK PROPERTIES, LLC 1211 OSGOOD STREET, NORTH ANDVOVER, MASSACHUSETTS 01845 March 20, 2014 Town Hall Building Department North Andover, Massachusetts 01845 To Whom It May Concern: Please be advised that Kristen McVey and Victoria A. Ross, dba The Soul House, have permission to obtain any permits necessary to begin build out work on a space at 1211 Osgood Street. Her contractor is Shane Gannon of Gannon Built. We thank you for your attention to this matter. Very truly yours, HSK7POPERTIES, LLC Harry Kanellos Manager A C R C "°TIFICAT F LIA = IL TY I DATE (MMIDDIYYYY) 04/07/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ALLAN INSURANCE AGENCY INC. 63 1/2 Jefferson Avenue 2nd Floor P.O. BOX 511 SALEM MA 01970-0511 CONTACT Jerrold Kameras NAME: PHONE Extl: (978) 745-5905 (A/9 No); (978) 745-5483 E-MAILESS: Jerrold@allaninsurance.com ADDR INSURER(S) AFFORDING COVERAGE NAIC M INSURERA:Assoicated Ind Ins Co INSURED TGLRC dba: Lambert Roofing Co. 265 Winter Street Haverhill MA 01830- INSURERB:Safety Insurance Co INsuRERc:National Union Fire Ins Co. INSURERD:Ace American Insurance Co. INSURER E:Ace American Insurance Co. INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF IMMIDDIYYYY) POLICY EXP IMMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY AE31028029 / / / / 11/12/2014 / / / / / / / / / / / / 11/12/2015 / / / / / / / / EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 1,000 X Per Project Agg PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES —1 POLICY Ill 1 E PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X UABIUTY ANY AUTO ALL OWNED x x SCHEDULED 6203819 / / / / / / 07/16/2014 / / / / / / / / 07/16/2015 / / COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS LIAB X O OCCUR CLAIMS -MADE BE18430331 / / 11/12/2014 / / / / 11/12/2015 / / EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below/ Y / N N N/A % 6362UB-2E09875-2-14 MA / / / / 03/25/201503/25/2016 / / / / / / / X WC STATU- 70RY l IMITS OTH- FR E.L EACH ACCIDENT $ 1,000,000 E L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 W Worker's Compenstaion NH 6362UB-8D81311-6-14 NH 12/22/201412/22/2015 / / / / samelimitsas 1,000,000 policy above 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more spaco Is required) CERTIFICATE HOLDER CANCELLATION ( ) TGLRC dba Lambert Roofing 265 Winter Street Haverhill MA 01830- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR! E REPRE ENTATIVE % ACORD 25 (2010/05) INS025 (zo10o3).01 © 1988-2010 ACORLO CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • T.G.L.R.0 dba Lambert Roofing Company RICHARD LAMBERT 265 WINTER STREET HAVERHILL, MA 01830 CS-078130 RICHARD J LAMBERT 265 WINTER STREET Haverhill MA 01 06/02/2016 Office. of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 149221 Type: Private Corporation Expiration: 12/6/2015 Tr# 246813 Update Address and return card. Mark reason for change. 0 Address rj Renewal El Employment Lost Card