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Home My WebLink AboutBuilding Permit # 6/12/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: r Date Received - Date Issued: l� IMPORTANT:A licant must complete all items on this page ;'MA�NO�� PARCEL ��O�NG DIST�RIGi � � �blstncl\��. des no,�• � Hlslo[�c .TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building One family ❑Addition 1i Two or more family -1 Industrial ❑Alteration No.of units: ❑Commercial Repair,replacementgt)L'� ❑Assessory Bldg ❑Others: n.Demolition E Other o'Septic C Well IlMetlands 'Ei Watershed District D Water/Sewer ''I,,: ..:; ' DESCRIPTION OF WORK TO BE PERFORMED.St 1' '� Ide 'atiflcatioa Please Type or Print Clearly) OWNER: Name: / CEfz L Phone'•.I-r— tLCC-L5Z,�) CLQ Address:. mH CONTRACTOR^,IQame3 rcry Phone' " Addressj�,,g� F�€�e��`��' � t13�'"•#11t�-� Supelisors Construction License `3 Exp Date f Home ImproJement icense ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$12500 PER S.F. Total Project Cost:$ G I��%'• FEE:$ Check No.: 8�� Receipt No.: "J NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund} Signature of Agent/Owner• :.lure of contractor " 7u✓L. Plans Submitted Li Plans Waived❑ Certified Plot Plan 0 Stamped Plans❑ '.. Town ofa �..NORrr� Andover h ver, Mass, UIQ �M9 gOg4reo�eP,�,th S U OPE R M BOARD OF HEALTH TUFood/Kitchen Septic System �4t BUILDING INSPECTOR THIS CERTIFIES THAT...................�............ �j/'5.. .............,.......................... _.`.............. has permission to erect..........................buildings on.f..WV_75^'.J fs.... .IM.•.......... Foundation provided that the person accepting this permit shall every conform to the terms of the application hugn to be occupied as......... imney P � P p�9 p p PP� 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 EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough S—ice ...............�.�1 :.p. .......................... 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. 13 f,e Street Nn, Smal<e Det. o CJS --,D Contract Tom Quinn S Employer ID# 0:(978)957.1200 , ,Q 1 I NA'V,,S CONSTRUCTION 27.1639714 C:(617)939-1353 �..�"'� c-`858"Mamnaoefi-lload-a Dracut,NfA 01826 tom@quinusconsbuction—ir www.quinnsconstruction.com Page?m3 Property Owner Information Nam Street Add s(.i'ot P�lt Offio,B is) Date ciryrs _ state zip code Sob Nam - - - -r Home Phone Cell PhoneEmail — _ Job Location Mailing Address(If Dinerevt From Ahove) Salesperson(s)c Contractor Registration q:CS-039732 Ex.Date:."' REQUIRED PERMITS The following building permits are required.It is the obligation of the contractor to secure such permits as the homeowner's agent:List any and all necessary construction-related permits Note:Owners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGL c.142A. Is an EXPRESS WARRANTY being provided by the contracto(.- NO LYES —All tests of the ivarranty most he attadted to the contract" '— NOTE:All home improvement contractors and subcontractors shall be registered and any inquires about a contractor or subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration One Ashburton Place,Room 1301 _ ' Boston,MA 02108 617-727-8598 Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. ARBITRATION 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 such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Revelations and the consumer shall be required to submit lq, ch arbitration as provided in M.G.L.c.142A. Homeowner: .._.....---- .G.:. Contractor -Date: Date: 'rpi NOTICE:THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT INITIATED BY THE CONTRACTOR.THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. ACCELERATION OF PAYMENT Homeowner's Financial Insecurity-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.. Contractor's Financial Insecurity-In instances where a contractor deems him/herselfto 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 from said account would require the signatures of both parties. THE CONTRACT MUST ALSO CONTAIN: 1. A Complete Description of any other documents which are par[ofthe agreement; 2 A List and Description of other matters upon which the contractor and homeowner lawfully agree; 3. Any Other Provisions otherwise required by applicable laws of the Commonwealth. Remember,the Contract must be the Coa plete Agreement Between the contractor and the homeowner. Contract Tom Quinng �7 g }�, Employer ID# O:(978)957-1200 QUINN'S CONSTRUCTION 27-1639714 C:(617)939.1353Dracut,MA 01826 tom@quinnsecnsintction.cem www.quinnsCottStructom cam Page 2 of3 Modifications There shall be no modification,amendment,or change order made relative to this Construction Contract,Contractor's Work,or the Plans and Specifications without the e press mutual modification signed by Owner and Contractor. a.Requi,ed Change Orders:The Specifications represent Contractors best effort to be complete in detailing the scope ofwcrk to be performed.However,this contract is based solely on observable conditions of the structure in its status at time of Contract preparation. if additional concealed.unknown conditions are discovered in the course of construction,Contractor shall point out these conditions to Owner so Owner and Contractor can execute a signed Change Order for any additional work.Such orders shall specify additional fees. materials,labor and services,and become pan of this contract.Additional costs,if any,shall be paid for by Owner in advance of cation ofwork specified in said Change Order.Failure of Coutractor hi request such o eats'v ad va a shall not be deemed a er of oavments due.Any delays in Contractor's Work caused by required change orders shall not be deemed the responsibility of Contractor,and shall automatically extend the time of completion.Additional time required shall be stipulated within the Change Order. b.Additional Work Amborizations:In the event that required work cannot be priced in advance of completion of such work,(i.e. discovery of rot needing repair),an Additional Work Authorization shall be executed.Such orders shall describe work to be completed, and shall specify method of calculating additional fees,materials,labor and services to be charged upon completion,and become pan of this contract.Payment shall be due upon presentation of Contractor invoice.Any delays in Contractor's Work caused by required change orders shall not be deemed the responsibility of Contractor,and shall automatically extend the time of completion.Additional time required shall be estimated and stated within the Additional Work Authorization. 1,the Homeowner have read and understand the above mentioned modification section and agree to the terms. Own C s Sis name, Contractor's Signature rt r rc' �; Date Date The following schedule will be adhered to unless eirpumstances beyond the contractor's control arise, Work Scheduled To Begin: Expected Date Of Completion: (Date Contractor will begin contracted.work) (Date when contracted work wilt be substantially completed)- TO'T'AL CONTRACT PRICE AND PAYMENT SCHEDULE ,��xf..: The Contractor agrees to perforin the work,furnish the material and labor specified above for the SUM of.$ (`Include all finance charges in this amount) Payments will be made according to the following SCHEDULE S -upon signing contract(`Not to exceed 1/3 of the total contract price OR the cost ofspecial order items, whichurce S - by_/ / or upon completion of - S by_/_/ or upon completion of S - 'upon completion of the contract('Law forbids demanding fall payment until contract is completed to both parties'satisfaction In order to meet the completion schedule,the following material/equipment most be special ordered before the contracted work begins("Law requires that any deposit or downpayntent required by the contractor before work begins may not reed the greater of(a)one-third of the total contract price or(b)the acral cast of any special equipment or cusann made material which must be special ordered in advance to meet the completion schedule): Contract Tom plo 0:(98706.6000 QUINN'S CONSTRUCTIONnn E 27 1639714 ID# C:(617)939.1353' -' -^ $6$- gp ...Dracut,MA 01826 tom@quinnsconAruction.com www.quirmsconstnwtlon.corn Page 3 of3 WORK TO BE PERFORMED AND MATERIALS TO BE USED Contractor agrees to do the following work for owners Contractors agrees install a premium Owens corning duration lifetime shingle roof systems(scope of work) Contractor to obtain building and other permits as needed.Customer to pay for permits at cost. 7*hedule the delivery of all materials,dumpster,cleanup. C]'Pfoper protection of property, p'rProper removal and disposal of 1 layer of roofing,additional layers removed for 50T a Square Foot per Layer. 0/Run Magnets at end of day. Q'Renailmg of roof decking as needed UReplacement of up to 100 square or lineal feet of roof decking above this replaced for$2.80 a foot. 'Installation of F8 Mill,white or brown Drip edge on all roof edges. -�(Optional)Installation of custom Heavy Duty F8 color of choice single and double drip edge. Pristallation of Owens Coming Weather Lock Flex High Temperature Ice and water barrier 3,6,9 Feet wide and as needed in critical areas of roof. Deinstallation of Owens Corning Deck Defense for shingle underlayment. 0 Installation of vent pipe boots,step,base and counter flashings as needed. 0'.Installation of a Owens Comings Duration Lifetime Shingle Roof using 6 nails per Shingle Exceeding the Manu- facturers Specifications. ❑(Optional)Installation of Owens Comings Duration Designer Shingles. ❑(Optional)Installation of Owens Comings Energy Star Duration Shasta White Shingles - _ - - - U'lnstallation of Owens Comings Ventsure strip ridge vent with wind baffles and caps on ridges. Installation of 12 inch lead flashings on the chimneys#. [(Installation of continuous circular,rectangle,or Facia Vents for Eave Ventilation as needed. b 6*ock off Gable Vents as needed. 'Roof System to be covered by Owens Comings System Advantage Preferred Non-Prorated Lifetime 50 year material Warranty and 10 year workmanship protection. 171 Installation of PVC Trim,Facia&Rake Boards$20.00 a Lineal foot. Other Specifications and Conditions .z l' //�ASCi9C'Y. 4/9/�LJC✓ The Commonwealth afMassachusetls Prhrt Forme Department oflndustrial Accidents Office oflnvestigations .: I Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Bmin ss/Orgmization/Individuap: 1S (tea iS SCC 6 I- Address:/GLL1 City/State/Zip:lam ' rrc,.' hY 3 b °, I Phone#:: Are you an employer?Check the appropriate box: Type of project(required): I am a em to�y�'witb �_ 4.E]I am a general contractor and I 111111 I employees( �/(full and/or part-time).* have hired the sub-contractors 6.F1 Nm construction 2.❑I am a sole f'oprtetor or partner- listed on the attached sheet. 7. E]Remodeling ship and have no employees These sub-contractors have g,❑Demolition working for mein any capacity, employees and have workers' [No workers'comp.insurance comp.insurance.> 9. ❑Building addition required.] 5.❑We are a corporation and its 10.❑Electrical repairs or additions 3.❑I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12. Roof repairs insurance required.]T c.152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required] 'Any applicant Wat checks box#1 must also 511 out Nc section below showing Weir workers'eompensavon polity intbrmaeom P Homeoxmers who submit this affidavit indicating Wey are doing all work and Nen hhe—ide eontacmrs must submit a new affidavit indicating such, .Contmemrs Nat check Nis boa must attached an additional sheet showing the name of the sub-contmetots and state whether--hNose entities have empioyees.If We sub-contactors have employees,they must provide Nei,w,rkcrs'comp.policyb- 1=an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information ,,77 n Insurance Company Name: q�2 r&-,(n Policy#or Self-ins Lie.4: 4_ tt1 Expiration Date: Job Site Address: / �i y" C��-r-' City/state/Zip:k,Ll wj ft or VL-R oy,,✓ISMS' 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 wet]as civil penalties in the form of a STOP WORK ORDER and a time of up to$250.00 a day against the violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. t hereby c '�er ed erlalties aj erjr that the i!Ybrmafiom provided above is true and correct Signature.. f(;;,'7�t; � Date Phone 4 9 Y— L-hr�1d C0 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): I.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#' OP ID:JG CERTIFICATE OF LIABILITY INSURANCE DA aENIUCE THIS CERTIFIGATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANO 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/9),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:D Me can wo,holler®nn ADDITIONAL INSURED,fila polley(ie.)must be.,d.m.d,If SUBROGATION IS WAIVED,111,110 t° the terms entl condMons of the polity,certain policies may re9uire en endore.manL A stelement.n tnie certificate doae na confer ri9h1.fo fila aDIfl 4 held.,],Ile,OH,Che,d1PMUNB.s Seg°yveB Hell l.sor�Lssoe.I.0 9]8-9I6-9300 xA DOS N.dh—B SL 978-976-7698 P" Ed— Bt0 THOMAS REo unn A:AUantic Casuallylnsum ae 42848° dba OUInn'S GON.U.-UD° a:Hartford Ins Co. D cuy MA 10 9 LB AVE—,Unite c Arbella PERIBellon Ina.Co. 41360 MA 01 D1eas Eao Commerce 347$4 COVERAGES CERTIFICATE NUMBER REVISION NUMI IS IS TO CERTIFY TNAT THE FOUCIES OF IN61RANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THEPOLICY PERIOD NDICATEO.NO-1$TAN NG Al REQUIREMENT.TERM OR CONDITION OF NY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO_CH THIS BS CATE E ISSUED OR MAY FENPAIN'.TNI INSURANCE AFFORDED E POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THE TERMS. EXCLO$ONS AND CONDITIONS OF SUCH FOUCIES.YLIMITS SHOWN mAY FAVE BEEN REDUCED BY PAID CLAIMS. •�TY11.1 of a.000.DD A Xvc L MO360001230 01/15/15 01/15/18 1Da,RD � o ms mApe®c cuR 6,00 ISULYN 1112611, 1186/16 1,000,00 D X Snow PIRW 04 1DCAEeprERY 12,000,00 a,DDD,00 DELLE LI comBlusos Le umn 1,000,00 �,a.Eee,B IxD ..v Rt IPE:",AA C X s < as 1020029603 06RDES D6107/16 utrv(Po;am°en6 6 X N1nEooAVSros ur POvBEwRIv1OANAOE X .P.—EPA Undennsumd 10013 URlnsur.d 10013 _CU_O, wO_DCRMPE X v2TAIL B 11P CAN. r EYO uI 118P704 01116/16 01116,16 100.00 oca seD,RD I DEC.P=NOF.0 t z°Nine°"D'ari;u ss sx�i�aae 01i�ri°ce:"mo:�e a c° p 'P• Aaw I CERTIFICATE HOLDER CANCELLATION LO'NPOF THEABO E OESERI POUG E3 BE CANCEOLLE BORE EMPRATION RATE VTHEREOF.BNOTIGEI WILL BE ELNER IN ttORDANCE WITH TMB POucY PROVISIONS. nu*"exlrm ne�nvE @I Z-2009 ACORD CORPORATION.All rlgh mserved. ACORD 26(2009109) The ACORD name and OF,are registered marls of ACORD - flfrice of Consumer Affairs and Business Regulation 0 Par'.{Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 121604 Type: DSA EXpira6on: 5224t2016 Tri 250353 QUINN'S CONSTRUCTION THOMAS QUINN 868 MAMMOTH R€3. DRACUT,MA 09826 Update Address and return rard.Mark reamange �E j Address Ej Renews§ E]Empeoymemt ;"Lwi Card OTce m;C A£i irs&B R u3a nE or reg:straa:mn raid Far admdm4 use only F =33DMEIMPROVEMENT COfiTRkCTQR before the eapir dondata Lfoundreturato: , �egistatlon: 121604 Type: x' €3fxece of Consumer A*fairs and Baseness Regulai'son of-d--1: 5/2412016 DBA UIP ark Pian-suite5I70 Bostmn,MA 02116 QUINN's cONSTsIucMoN n-iOVA.S QUINN 568 h MMOTH RD. DRACUT,VA 01826 Umders —7 Y tv lidwithonas:gna[ure 'y =--=782 ass �U- G DRA=Mak%916 -11FIE 1 - I�A3SA��3 €1uim'Thomas 'sxp"s-8,112037 868 Mammcth Rd ;Ck:17412 Dracut,MA 01826 Certi`ed Sin—2014