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Home My WebLink AboutBuilding Permit # 6/16/2015 o� %AORTH q BUILDING PERMIT �4,ED � TOWN OF NORTH o ^ p APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received TEDW^Pa" �SSgCHus�c Date Issued: ORTANT: Applicant must complete all items on this page AIVr LOCATION .. � ' �' ) Print PROPERTY OWNER ED Print 100 Year Structure yes (!no o MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Nteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ,rr �, rrr � y �/ rrr ��, , � r, �o . cin / 101, r, , r r r r o ri r rrr /� r ri o r r r l,. ,.l t rs ed tsfri f , ,.✓ r / // / � ,// v r,, / �/Wetla Cls/ � r�.d ✓ r, / � it /r �� rc ❑Well.,if/i,/ / �'„ , f � / � r a �/ i 1 w ii! M 11 � � rl,/i/�� / DESCRIPTION OF WORK TO BE PERFORMED: f"c &ct e� L c; Identif cation- Please Type or Print Clearly OWNER: Name: Phone: � � Address: V� r Contractor Name:::I: �',S tebCeC&Iii l Phone: ! Email: Address ��f Supervisor's Construction License: Exp. Date: Home Improvement License: /C r" Exp. Date: " ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST B SED ON$925.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.'), J 1) Z NOTE: Persons co racting with unregistered contractors do not have access to the guaranty fund x ttORTH 0VV11 UfAndover 2 ^E. ...'.i, C No. bis I... soh ver, Mass, Im COCmCNl WICK °RATED P'V U BOARD OF HEALTH PERMIT Food/Kitchen 1i Septic System THIS CERTIFIES THAT ................I.�It.l.l"�....... BUILDING INSPECTOR .a.0.�. has permission to erect ..................... buildings on .... .3„ Foundation ..... ........................a...... Rough tobe occupied as ........... .. ...."�'..... ..:.. .... ........_................................................ Chimney provided that the person accepti this permit shall In every respect onform 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 EXPIRES IN 6 MnAITAS ELECTRICAL INSPECTOR ® UNLESS CO ST CTIO Rough Service .. .. ... .................. ..... ................................... 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 Home Improvement Sample Contract 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. 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 Nam f CompanyName U6nAre bc,, e FIR-Mil )ec'b" 1 t Stre ddress(do not use aPost 9 ice Box address) Contracted Salespe on/OwnerName City/rovm State Zip Code Business Address(must include a street address) Daytime Phone Evening Phone City/rown f State Zip Code Mailing Address(It different from above) Business Phone deralE oyerIDorS.S.Number Horn piovement ContraciorRV.Number Eapkauondale Taw requires that most home bn 11d ght...n.orshave n validregtstmtion cumber 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.) cS>- Required Permits-The following building permits are required Proposed Start and Completion Schedule-Thefollowing schedule will and will be secured by the contractor as the homeowner's 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 u+ileOi�when contractor will begin contracted work MGL chapter 142A.) dine ate when contracted work will be substantially completed. Total Contract Price and Payment Schedule p j The Contractor agrees to perform the work,furnish the material and labor specified above for the total sumo. / AY-SA Payments will be made according to the following schedule: 7 $ 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 materiattequipment must be special $ 0 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 exoresswarranty being provided by the contractor? ❑No1 es(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 further 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 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 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 tbird business day fallowing the signing of this agreement. Seethe attached notice of cancellation font for an explanation of this right. DO NOT SIGN THIS ONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of tha contract be ompleled and signed.One copy should go to the homeowner.The oth y should be kept by the contractor. � 1 Homeowner's Signature Co actor's Signature Date 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 isnot 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 submit to such arbitra iorrprovided In Massachusetts General Laws,chapter 142A..,/- - ✓ F/Iomeowner's Signa e Co actor's Signature NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute 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 perio d has expired. s' 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 0CABRwebsite at http://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 Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 ParkPlaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at http://wvvw.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: http://db.state.iiia.us/hoiaiciMrovement/ficeiiseelist.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 2.1-1 1/22/2010 The Commonwealth of Massachusetts . F Department of IndustrialAccidents X Congress Street,Suite 100 Boston,MA 021142017 www.mass.gov/dia ' Workers' Compensation insurance Affidavit:Builders/Contxactoxus/�lectricians/Plmbexs. TO BE FILED WITH THE PERMTT'NG AUTHORITY. Please Print Le 'bl A licantlnformation Name (Business/Organization/Individual): � t Address: � C Phone City/State/Zip: Are you an employeType of project(required): r?Checic the appropriate box: em to ees full and/or part time).* 7. L]New•construction 1.�am a employer with P y 2.❑I am a sole proprietor or partnership and have no employees working for me in 8• El Remodeling any capacity.[No workers'comp.insurance required.] 9• ❑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 1 LE]Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole 12,0 Plumbing repairs or additions proprietors with no employees. 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13 Wf rep airs These sub-contractors have employees and have workers'comp.insuranceJ 14.❑Other 6.❑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. �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. I am an employer that is providing workers,compensation insurancefor my employees. Below is the policy and job site information. Insurance Company Name: yyrr� —7-9 O Expiration Date: / Policy#or Self-ins.Lie.#:/7N/L®�O(? '' / c_a� f� Lo City/State/Zip: Al(A-01, Job Site Address: Attach a copy of the workers' compensation policy deciaratron page(showing the policy number and expiration date). on punishable by a fine up to$1,500-00 Failure to secure coverage as required under MGL c. 152,§25A zm of criminal TOP1WOIRK ORDER and fine f up to $250.00 a and/or one-year imprisonment,as well as civil penalties in the f 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 hereby ee• .y under tl in andpenalties ofperjury tliat the information provided abJeve is true and correct. Date: / Si nature: ` 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 Phone#• Contact Person: _Office of Consumer Affairs&Business Regulation r ME IM?k?OVEMENT CONTRACTOR Type: egistration: 122385 DBA xpiration: 8/2612016 J&D WEATHERSEAL i JA MES.DEBRECENI 2 TANAGER WAY LONDONDERRY,NH 03053 . Undersecretary Sated. trnent otic ds c'n' efts -Gepawa rd Staniar �! as �egiatati°ns a '1. Nassaullding S c_ialt�' �0� d 3t -xi""Superiisor P onetra CSgL-09g685 p f SAW pG g� pp53� zVN E CNH. - aJ Comrnissione�