The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 5/8/2015 NORTH BUILDING PERMIT oF��tieo ,bgtio TOWN OF NORTH ANDOVER °� � APPLICATION FOR PLAN EXAMINATION 0 1— Permit No#: g Date Received 'ygss aTEo Ps�eey ACHU Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �/ �lo °�� G� Print PROPERTY OWNER kf 15 Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no i Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building kone family [I Addition ❑Two or more family 11 Industrial A'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other r,.r 9 1 ..., .,f I ,r. .r. <.r - r❑ Flaod I r� s. ✓': ! ,=em r. ,` rr,",." '_ .,,.; ,--r�. rr Y4"... �," �Werll 1. r ri „y' f..., �t .-.Nv ✓ ra.4+�; r a,:Fl�r r;_ .. .�. 1i1,'. .t- ,� ,%fN'.:f ms=s.-,•,a .. ,7,r�r ,d7, -, v. Sept;. _� - .,,..,, r,. r y...„ ,��.,��,a"t{,,r+rr,r c��. ,rs tc- r-.> �`�a'�.<.a ^ hhi .r,/r� ;r%: r � ,f v,r`,',�€n tl�T.:; ✓i. �a' ?T. rr� "�r�?,.,, -..� „*t.�:fi_i r r� 1. r ��,r`�`'r..� r.�. ..� l` %..5� '�r�''`�i r` ��.✓i� ?� �/n ' s'� sM'�y,,: r rrz r-3..�n �cr�,`,. trrs;'. it..�`� ^-�It�rF'%r�rl�`:� t�.r ✓ � �. � x ?..:�k.:.r„�a+ r s �” ,c„`;` ”� .:.'r,�,; ,?�',�,,;:rs`=�.'Fri.�� s �.N? IF �nu..r'�r��r..r r�,�r',r �'uTrx'vl:.., ��- ,.,.r� -�r.uw+ �r �� d ��✓..., ' i�,r,�''s.��.: r terlSewe `f,'s,.r�P,.,�a?%f�F,rf ry .rf' rr,:'Y r1 ✓'r �3'n"rt .",; -.'lta`.,, f`,'.,^' .,f::rmc tr rr 7,...U.rs,✓5,:z.rr'r,,, ,,,,Iiric r, ;✓.r,'?�t",r~ :�t'{� „r.,r,r., r.,r!;,,,,, DES RIPTION OF WORK TQ BE PE FORMEP:L y VI,-AMY2L”e-- reI04 'e g, ,�� d 5� Identification- Please Type or Print Clearly OWNER: Name: rn 5 44� `?t1AL0- � Phone: Address: [Home ntractor Name: i Rhone: ail: dress: ✓a� � pervisor's Construction Licenser O L � 1 Exp. Date: tr' ' /7 Improvement License: l ✓ Exp. Date: ( /17 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ , FEE: $ Check No.: f7 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the aranty f d r - — r . t4i ORTH Town of `� T.", Andover 1,0 • T �O LAK! h Ver, ass, _'�A_/ �� CoCNIC Kl WICK �1. o 4A7ED AP6L�,c� U BOARD OF HEALTH Food/Kitchen E R M I T T L wu Septic System ��e- �%'�a BUILDING INSPECTOR THIS CERTIFIES THAT .......... �!�f.,%��...........L.................................................................................... . buildings on ......... Foundation has permission to erect ............ �� .r�r!.k......................... Rough tobe occupied as ...................:..%.'4.!.1...... f :.P.c>.S. .......................:............................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT IN 6 MONTHS ELECTRICAL INSPECTOR .UNLESSI ATS Rough Service ................ti..... . .................. .�.�.., Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Massachusetts Rome improvement ntract This form satisfies all basic requirements ofthe state's Home improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seelc 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 yourresidence.You may obtain a free copy by calling the office ofConsumer 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 Company Name -7,1 7 Street Address(do not use a Post Office Box address) Contract /V er5on/()wnerName city[rown state Zip Code Business Address(mpt inolu a a street add 41 DaytimePhone 'EvermagPlione City/T;oState Zip Code ell Malling Address(It different from above3 BusinessPhone =ederal Employer ID or S.Number — —lass requires thatmast home i Improremcnt U.-h .%aHd.jh1.(1oo`numberi The Contractor agrees to do the following worl,for the Homeowner: (1) detail the work to completed,specifying the typ brand,and mada of materials to b I e used,use additional shects;ifn 0 4 Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedolewill and will be secured by the contractor as the homeowners agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of !Date when contractor will begin contracted work MGL chapter 142A.) ate 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 ofthe total contract price or the cost of special order items,whichever is greater) $ by or upon completion,of by orupon comp 'onof Npon pjetjoja ofthe ZontiacQLaiv 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.(**) S to be paid for NOTES:(4)Including all finance charges(4*)Lawrequires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third ofthe 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 NV.irr.qn!y-Is an expresswarranty being providadlivithetontractor? El No El Yes(all terms oftheivarrnrity must be affnebed to the contirrict) Subcontractors-The contractor agrees to be solely responsible for completion ofthe work described regardless ofthe actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and laborunder this agreement ContractAcceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this docmneat,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 Imorovement Contractor Repistraflon 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 "proof of insurance"document. • Know your rights and responsibilities.Read the Important Information on the reverse side of this form and get a copy ofthe Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement ifit has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing ofthis agreement. Seethe attached notice ofcaracellation form for an explanation of this right DO NOT SIGN THIS CONTRACT IF THERE ARE,WANY BLANK PACES!!! "!R 'r.1"a NK Two'ht I copies ofthe cmitractinustba completed and signed.We copy should go to flizh eo er.The BLAND sh be I repy the conazctor. _to s 'i" ignature C ctor's �omeowner n Ea—to Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submi to 0 arbitration as provided In Massachusetts General Laws, ter I A. yy home a Si `grf ,,.; gnature p actor' gnat7e NOTICE:The signatures of the parties above apply only to the agreement of arties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative 'spute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree maybe added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at http://www.mass.ecv/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at http://mvw.mass.nov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: h#p://db.state.iiia.us/homeimprovement/licenseelist.asp For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734-3114 Version 2.1-11/22/2010 The Commonwealth of Massachusetts Department of IndustrialAccidents h I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/die 5. Workers'Compensation Insurance Affidavit:Builders/Contractors/El ectri:cians/Plumbex s. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le ibl Name(Business/Organization/Individual): v/a Address: Vao City/State/Zip: . ��V ''' klo 11h4l- o/ Phone#: 1�� 3� 7- A.re you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with employees(full and/or part-time).* 7. ❑New construction 2,N11 ain a sole proprietor or partnership and have no employees working for me in g. $a4emodeling any capacity.[No workers'comp.insurance required.] 9. F1 Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp,insurance required.]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.❑Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12.E]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.FJ Roof repairs These sub-contractors have employees and have workers'comp.insurance) 14.Q Other 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. jam an employer that is providirrgworkers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address- City/State/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 MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORORDER and a fine of up to$250.00 a mK day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert•y under t e7777777::::ion provided a ove is true and correct. Si ature: Date: /70/), Phone#: Official use only. Do 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 Contact Person: Phone#: Massachusetts _ Board or' Department of P Building Re Public Safety Orn;tr -_ gulations and Standards 41.L11I11 JU/l'-i 11.9'l/i License: CS-102589 KEvjNjSU'IIT11 63 INGLEWOO ' NorthT Andover 1►U 018gg Commissioner Expiration 03/05/2017 -Vlle �xa�zuleec�f�o1b/1�1'jj e XttJeft Office of Consumer Affairs&Business Reg llt.;,, —SOME IMPROVEMENT CONTRACTOR registration: 108511 xpiration: 8/19/2016; Type: - DBA SMITH CONSTRUCTION CO . I Keb;n SrAith 63 INGLEWOOD ST N Andover,MA 01845 = -- Undersecretary