The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 6/4/2015 %%O RTF1 BUILDING PERMIT 01��`E° -b quo 46 C TOWN OF NORTH ANDOVER /S APPLICATION FOR PLAN EXAMINATION Y� e 4 � cocw"c ewrc may% ' O � ll fDate Received ��"�� Permit No#: Ar�ssvcNus�R Date Issued: I pp pall items an this page MPORTANT• A licant must corn lete r t TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building X One family ❑Addition ❑Two or more family ❑ Industrial Alteration No.-of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition El Other ., -U.....,� i ..,. lii,�r�nw:evn r �✓0'Ji Jdk1r✓�il'°��f°'+�'(AUIn^�ur�U//�ir��l�IV'966t1/j�//�.J "°rcI�m"( "Sr° ev m cu U, ❑�aIAraVr"�U�y�V�ei��I'�7� u V w r s �f U � 9U ,,,lfo'o�V�f9dNV�°I�tlaH�'�, " � ! ,1 etfa� �//U Jf.J,�.ar�),�1t�'yh1,1.!01 :0"W" %l DESCRIPTION Of WORK TO BEfPFRFORM�ED nnc] A Identificati - Please T pe or Print Clearly °. OWNER: Name: Phone: Address: �i a I� �S'R.gWll�a WkW'wWRul r Y �I UU. ¢rw � ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COSTBASED ON$925.00 PER S.F_ Total Project Cost ` W°" $ FEE: $ "PsCheck No.: Receipt,Na; NOT-E: Persons contra -with unregistered contractors do not have...access-to-th guara a e L GfJiii/,�i r tAORTH It E. Anu," over.:.'..,. I own ol �y o ver, h V� ' SSS' �/ COC NICHEwICK 1' � Q 00 C.1 � � `.1 BOARD OF HEALTH RM _T I IMD Food/Kitchen PE I Septic System THIS CERTIFIES THAT BUILDING INSPECTOR .......... ... ..... . ............................... .. .. ... Foundation has permission to erect .......................... buildings on .... 1. .............i�� I ....... Rough ' tobe occupied as .......MAW......... .... ........ ......... . .. .... ............................... 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 UNLESS PERMIT EXPIRES IELECTRICAL INSPECTOR ® ISMONTHS Rough Service .............. ...... .. .: :................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing r Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Massachusetts Some Improvement Sample Contract This form satisfies all basic requirements ofthe state's Home Improvement Contractor Law(MOL chapter 142A),but does not include standard language to protect bomeowners. Seek legal advice if necessary.Any person planning home improvements should fast obtain a copy of"A Massachusetts Consumes 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 company Strcet 4ddress do notuseaPostOfficeBoz�ddreas) Contractor/Salesperson/ ame City/ram State Zi Code B ( include a street address) Zip usiness Address _ DaytimePhono Evening Phone City own State Zip Code G4°k°;r^ Mailing Address(It different Som above) JBusiness Phone federal Employer ID or S.S.Number s"ortmp�.�tam+o<n�.xo� a�p®a"nar• Iaw regain it•tmert k•m '.. ImpmreraatmanacbR ane „� � � • ' ardld tr{Mrna•aa®bei �d�"'wy d. q^1' � �" �. �...�p 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 ifnacessar_v) y I'll e_"6_0 :c A r .< f`ncso-' '.; .. ,. „, ,� '114- -~t � o s & rower �/. p ��>,�,A.,111�', 0—% 1p Required Permits-The fallowing building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowners agent: be adhered to rmless circumstances beyond the tontrectces control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of m , ,Date when contractor will begin contracted work. MGL chapter 142A.) t ( Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,finnish the material and labor specified above for the total sum of C").�"; v) Payments will be made according to the following schedule: tea, $ _ Cc "upon signing contract(not to exceed 1/3 of the total contract price of the cost of special order items,whichever is grater) -! ori oncom letionof Xr:1 R Ck_zO � ..aa $ , �f.tt) "bY�=—_ P P / $�m b"y /_/ or upon completion of $ :'L. on completion of the contract (Iaw forbids demanding full payment until contract is completed to both party's satisfaction) The following materiaVequipmeat must be special $ to be paid Pot ordered before the oontraatad work begins in order to meet the completion scheduler(**) S '""" 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 vddoh must be special ordered in advance to meet the completion schedules Wi�rnntv is an exuress w4rrantybeingviicontractor? 1 terms of thewarrstity mustbe attacbed to the n ct Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subconhuctorutrlized by the contractor. The contractor fiuther agrees to be solely responsible for all payments to all subcontractors for materials and labor under 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 theresidence.Review the following cautions and notices cmefiMy before signing this contract • Don4 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 ofHome 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 thatyou can confirm cove agq or ask to Seca copy of a"proof ofinsurancd'document • Know your rights and responsibilities.Read the important Information on the reverse side of this fona 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 notify the contractor do writing at hisiber main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the I third business day following the signing of this agreement. See the attached notice of cancellation fame for an explanation ofjiLb right DO NOT SIGN'PSIS CONTRACT IF THERE ARE7ANY ""NKSPA SW r i Two identical kxofthe eoatnctmeatbo eompkxad•n.dri�a1 Qne espy abound go fo tk•han+e"wb�bkpt te Homeowner s � fir"",�i,r '".•..' . dmre Con da a Signature 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 nceming this contract the contractor may submit the dispute-to a private arbitration firm which h been approved by the ecretary ofthe Executive Office of Consumer Affairs'and Business Regulation the cons r s lie required' to mit to such ar itratioas provided In Massachusetts General Laws,chapter 4 Homeowner's mgnat a Con actor's Signature NOTICE:The es of the parties abo e apply only to the agreement of the parties to alternative dispute resolution initiate the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homedwnefs 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 eontractoris 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 may be 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 shouldnot 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/be' elf to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow . account as aprerequisite 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 hM://www.mass.gov/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 HomeImprovement 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 1-11C website atbft://www.mass.gov/ocabr/ Go online to.view the status of a Home Improvement Contractor's Registration: bitp://db.state.ma.us/homeimprrovement/licenseelistasp 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 The Conimontivealth of Massachusetts Department oflndustrialAccidents v . I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legib Name(Business/Organization/Individual): Address: City/State/Zip: Aetr"J(Ag,Lr_. ' V1', Phone#: c=°N , (a" Are youan employer?Check the appropriate box: Type of project(required): 1.P'l "am a employer with ( employces(full and/or part-time).* 7. El New Construction 2.F]I am a sole proprietor or partnership and have no employees working for me in 8. emodeling any capacity.[No workers'comp.insurance required.] 9. F1 Demolition 3.Q 1 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 ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 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. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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. I am an employer that is providing workers'compensation insurance for my employees.' .below is the policy and job site information. u Insrance Company Name: �_ ^ � IL.. Policy#or Self-ins.Lie.#: ,V c) k of` Expiration Date: ` Job Site Address: � � � l ,�'"`City/State/Zip: " � .5 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 WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby7=M17M411 hepains a dpe alties ofperjury that the information provided above is true and correct. µ. SignDate: . t 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.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Massachusetts -Department of Public Safety Board of.Building Regulations and Standards /� constructianards on.supe3 visor i cI '�ra3]l7lj' License: CSFA-045279 THOMAS W PRIC'k 41 ORCHARD Sx ' WRRIMAC M�018 Expiration Commissioner 11/18/2016 r(`n�IrlJrnl�cue[7((lt a C�/<'CC�JJCLC�rlJelt ' ffice of Consumer Affairs&Business RegulationLicense or registration valid for individul use only M#IMPROVEMENT CONTRACTOR " `' before the expiration late. If.fountl return,to: egistration: 109526 Type: Office of Consumer Affairs and Business Regulation . X piration: 9/21/2016` Private Corporatic`i 10 Park Plaza-Suite 5174 THOMAS PRICE INC, Boston,MA 02116 ' THOMAS PRICE 41 ORCHARD ST i MERRIMAC,MA 01$60 Undersecretary f i Not valid without signature y