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Home My WebLink AboutBuilding Permit # 8/10/2015 BUILDING PERMIT of„ORTHo�TH A TOWN OF NORTH ANDOVER ® APPLICATION FOR PLAN EXAMINATION ` a 4-'J �n Permit No#: l I '' Date Received Date Issued EV1PORTANT:Applicant must complete all items on this page LOCATION i' 1 - ° IkrP'�r^�I Print PROPERTY OWNER +Ml,-(l -LL n&, L7LS I ,, �r,� Print 100 Year Structure yeCno MAP �I PARCEL:6 G !U ZONING DISTRICT: Historic District y Machine Shop Village y TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building One family ❑Addition ❑Two or more family ❑Industrial ❑Alteration No.of units: ❑Commercial Repair.replacement 116- Assessory Bldg G Others: ❑Demolition ❑Other RIM111" Septic glkVel_I1\\ Co`oclp(a n 7 Welar ate` uVate�yedbls:`i �0 WaferlS�e erti�� \� ��.,�� \ DESCRIPTION OF WORK TO BE PERFORMED:F @7�fir✓' T $_ S}Yt�jf � Y r-SiJPL-�G'L7Y"Z5 !� 6�f1"RzZ ��51 / lC 91-9- �i. RiCCc 1L cs�y1 ,4 G zR!S�+t ram �c� rn c1+ KS1y4- nG�s C >(� c� 6 � 01C �a 1 a5 c�(v t,�'L �tour ,,roF Akm if � 5 421 I A extz Identi5catiqn-Please Type or Print Clearly 0-72Y � ✓ OWNER: Nr7a�me:(�b�� N'II C-k67> �(- L.tS Phone:14 Address: ) T a\I,lj1 (-,rp&-, 9 ,;E2 k J I LIA6 CAL(S _._ {12ro ft.5 T Ott IA) - -- ContractorName (-,))j ie ti' 5aI'ISMJC77cr+ Phone: �-,zX`Ll�� /�00 ff Email' tvcJttut55i °cinr� Address:,Z7 qq%fWtjd �t '+= � Il^ Supervisor's Construction License:(25-059'�Ja) Exp. Date:jlA1 -GIL Home Improvement License: Exp. Date: 1 i ARCHITECT/ENGINEER Phone: Address: Reg,No. FEE SCHEDULE:BULDING PERMIT..$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost:$ a FEE:$ f r� Check No.: � Receipt No.: � 1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund .. nictoverTown of 4 ..i,. Igoe _ /r — I h h ver, [ass, a �A An Lt BOARD OF HEALTH PER Food/Kitchen I I LU_ Septic System w BUILDING INSPECTOR THIS CERTIFIES THAT....... !.°..G ..Qy/6�. ........................... ...........................�t..F,M...... v ® Foundation has permission to erect..........................buildings on..I .� .. Q�......... ...........! ° ............... � Rough to be occupied as '1i....... b.lMrf�..... e... ..... . . .... Chimney provided that the person acceptin this permit shall ry 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 EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough J � f9�Y Service Final BUILDING INSPECTOR GAS INSPECTOR ®ccunancy Per iidt 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. contract Torn QuiffinEmployer ID# 0:(978)957-1200 QUINN9S CONSTRUCTION 27-1639714 C:(617)939-1353 -8684&mmot-h-RQad--Dracut,NIA 01826 tom@quinnsconstructton.com www.quinnsconstruction.com page l of 3 Property Owner Information Name 21 z-i j Street Address(Not Post Office Box) Date �7 cityrr.". state-- -i7V C-ihi Job Name Home Ph... Sell Phg.,--- r, Email -J, Job Location Mailing Address(If Different From Above) Contractor Registration#: CS-039732 Ex.Date: REQUIRED PERMITS The following building permits are required.It is the obligation of the contractor to secure such pennits 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 contractor? NO YES **Allterms ofthewarranty iy,ustbeattached tothe eontract** 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 Secretmy'ofthe'Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to sobit to such arbitration as provided in M.G.L.c.142A. Homeowner: Contractor: Date: Date: V 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/herselfto be financially insecure.. Contractor's Financial Insecurity-In instances where a contractor deems hityl/herselfto be financially insecure,the contractor may require that the balance offimils,not yet due be placed in ajoint 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 pan of the 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 Complete Agreement Between the contractor and the homeowner. Contract Employer ID# QUINN 7 � �T CONSTRUCTION O-(9 8)t 957-1200 lJ_ P1 27-1639714 C:(617)939-1353 _�_� �68-�EannnotlrRvad-Dracut,MA 01826 tom@quinnsconstruction.com www.quinnsconstructior com Pane 2 of 3 Modifications There shall be no modification,amendment,or change order made relative to this Constriction Contract,Contractor's Work,or the Plans and Specifications without the express mutual modification signed by Owner and Contractor. a.Required Change orders:The Specifications represent Contractor's best effort to be complete in detailing the scope of work to be performed.However,this contract is based solely on observable conditions of the structure in its status at time of Contract preparation. dfadditional 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 part of this contract.Additional costs,if any,shall be paid for by Owner in advance of execution of work specified in said Change Order.Failure of Contractor to request such payments in advance shall not be deemed a waiver of payments 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 Authorizations: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 part 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 andstated within the Additional Work Authorization. I,the Honteowih r have!eAd and unddrstand the above mentioned modification section and agree to the terms. Contractor's Signature Owner's Signature r 1 "„ Date Date =Scll��Lled e will be adhered to;unless�cumstances beyond the contractor's control arise_ Beg n: 4 !> Expected Date®f Completion:begin contracted work) (Date when contracted work will be substantially completed) TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE 3 The Contractor agrees to perforin the work,furnish the material and labor specified above for the SUM o& (*Include all finance charges in this amount") Pa3v ents will be de according to the following SCHEDULE upon signing contract("Not to eveced 1/3 of the total contract price OR the cost of special order items whichever rs,greater) $ k -} by or upon completion of —/—/—or upon completion of completion ofthe contract("Lawforbids demanding full payment until contract is completed to both parties'satisfactions) In order to meet the completion schedule,the following material/equipment must be special ordered before the contracted work begins("Law requires that any deposit or down payment required by the contractor before work begins may not ecceed 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,): $ i 1 to be paid for_; - FI i` �` 11) 'NOT SIGN 1 TAXIS CONTRACT IF THERE ARE ANY BLANK SPACES r G I Identic)']copies oft h''e contract should go to the homeowner and the contractor. Owners Sign itere'�.. Contractor's Signature .Date -Date You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his mai office or branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of the agreement. See attached notice of cancellation for an explanation of this right. Contract Tom Quinn Employer 11D# (617)939-1353 qUINN'S CONSTRUCTION 27-1639714 (978)265-2390 Dracut,MA 01826 i.4q...t.d.. www.quinnsconstnictioncorn Page 3 of 3 WORK TO BE PERFORMED AND MATERIALS TO BE USED Contractor Agrees To Do The Following Work For Owner: J/ < r1c, The Commonwealth ofMassachnsens Print F. Department oflndustrial Accidents Office of1ivestigations I Congress Street,Suite 100 Boston,MA 02114-2017 -�- www.massgov/dia Workers'Compensation Insurance davit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lez6bly Name(Business/Organimtion/individuat): J//AIA� t Bryn< c r7c, Address:16�tg i i iJ/0—))/�Vtz A.3 City/State/Zip: /6'X,111 LL9,L6 Phone#: -�8-�7?-/,3Gx' :� Are you an employer?Check the appropriate box: Type of project(required): 1.4 1 am a emplover with -2 4. ❑I am a general contractor and I employees full nd/or part-time).* have hired the sub-contractors 6. F1 New construction 2.❑1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.- 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 I I.❑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.N OtherZAIS aDIC comp.insurance required.] fbVNV-5i8in *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 aredoing all work and then hue outside contractors most submit anew affidavit indicating such. '+Contractots that check this box must attached an additional sheet showing the name of the sub-contactors and state whether or not those entities have employees.tribe 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. r Insurance Company Name: h>? ''�f � Policy#or Self-ins.Lic.#: �,��P_.Vq Expiration Date: t�$ Job Site Address: q 2 r 3 R t"l-r 1 k ny) Ci /State/Zi `1']"R)3`7 r 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 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the sins d en(ties o er' that thein ormation provided above is tree and correct -- P Si re: eaam ,..�-�- - 'Date Phone#: 9 q,5? �JJ�:0,00 tit FtrLr Oficial use only. Do not write in this area,to be completed by city or town offaciaL 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#: OP ID:JO a Trot�' CERTIFICATE OF LIABILITY INSURANCE DAEIMMDDn Y, OB/0BI15 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS AFFIRMATIVELY DOES NOT AFFIRMATELY pR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERft AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the c,ron,tte III N an ADDITIONAL INSURED,the PoRBy(iOA)must Be snored. If SUBROGATION IS WAIVED,allbJGM tO the terms and wndlSons of the policy,tens-;policies mey mq Wm en endorsement A sNttemaed an thio certificale,does not confer riOMe t°the —tiftatA holder In It..of such ehdoasemen s, P1.1-1 978.975-1300 xAMe Svs&HBO IrIsor.Assoo-Inc 878975-7598 PHONE Po,e 3nNorth Main 5t Etlwsrdr�MA019I Aooalas: THOMAS mimz HSUaER AFFOReING COVEPAGE xwCa INSURED IMSUREqA:ANan0c Casualty InsufanCe 42846 dba Qolnn's Construction -Uh.—Hartford Ina Cg. 1049 Lakevfew Avenue,Unita Dracut,MA 01828 INsuRER r.Arbetla ProteCtlon lies.Co. 41360 INSURERD:Commerce 94754 IxSURERE' INSVR6RF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE'FOR THE POLICY PERIOD..; INDICATED. NOTV ITHSTANDINC ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY.SE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERRIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN R£OUCED BY PAID CLAIMS. TYPE OF INSURANCE 1-111UMBER MMbohrrY MMA eu Loh. eENERAL LIABILITY EACH OCCURRENCE a 1,000.00 A jXSnomPlow NMEgOWL GENER?L LIABILITY 110350001230 01/15/15 01116716 pgEinlSEs aI 11— 100,00 cwA,s:MAOE X❑OcWh MEOExr fAayone p.nam 5,00 BGLLYN 11/26/14 11126/15 pSnoNALAAWINIURT 1,000,00 D OENERaLAGGAEOATE s 2,000,00 GEN'L AGGREGATE LIMIT AFPLIE9 PER: PRODUCTS-COMPIOP AOD 6 2,000,00 POLICY PRP IlK 6 AUTOMDBILELIABILTTY COMBINEDSIRGLEUMIT $ 1,000,00 Fq_c F- ANYAUTO BDDILYWJURYIPBrw w) S ALLOJr'NEDAUTOS ADOILYWJIIRY(Para deAI)3 C X $ONEDVlEO AUTDA 102OD29603 06107116 06/07/16 FROPERTVDAMAGE s X HIREDAUTOS pNrBmE q X HGwDWNEn AVrOs Underinsured s 100!3 Uninsured 1001$ UMBREYIALI4BOCLNq EACH OCCURRENCE S E%cE99 LIAR CLJMe.MADE NGGREC-ATE S DEDUCTI8LE 3 RET=NnOn 5 a WORI�RGOOMPENSATON )( VILSTATa T" puD eMPLDYeRs'u4eluTr671b 0111 .00 6!16 EL,FACN ACGOEM a 100 B O�FO—O—E—EXCLUOWaEGViIVEYNI0. 118P704 01/1 Imyyaaaaroryln NN] cI OISE49E-vq EMVLGYEE S 100,(x DESCRIPTION OF OPERATIONS NBImv E.L DISEASE-POLICY LIMIT 3 500,00 Sole n=oP=eEto=Tti®ae°Nn°u'inn`f.(exclud d°wiser"m z«=scneCa®pma,ayw�mAeu,.�a, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE OELIVERED IN ACCORDANCE TIIT1 THE PC—PROVISIONS. AUTH�O(�JR/It�Fy/°nePffRQR3{E�MAn- ®1988-2009 ACORO CORPORATION.All rights reserved. ACORD 25(2009109) The ACORD name and logo aro registered marls of ACORD " '' Office of Consw--per Affairs and Business Rea dation �u 10 Park Plaza-Suite 5176 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 121604 Type: DBA Expiration: 512412016 Trg 250333 QUINN'S CONSTRUCTION THOMAS QUINN 868 IUd.AMMOT H Ria. DRACUT,MA 01826 Update Address and return card.Mark reason for change. ❑Address Renewal V Employment ❑Lost Card _office orCom.. Afr rzs&B �ess Regiianon License er g—tratioa—lid for mdMd 3 use enly ;f34f19E IEAPROYEM N a CONTRACTOR before the expiration date.If found return to- -IFegistration: 12.604 Type: Office of Consumer Affairs and Business Regulation nim: 612412016 DBA III Pard:plaza-Suite 5170 P - Bestan,MA 02116 QUINN'S CONSTRUCTION THOMAS QUINN v 868 NIAMMOTH RD. DRACUT,MA 41826 U.derseeretwy Not valid with--signature _z�39 32 868 1s 7z.D , DRACUT WA 0=6 CERTIFIED 'iii'Y.SS3IN t.4ST LL s7h::4771 Qtfinn,Thor.tas Exp-sres:411}2017 868 Mammoth Rd €D#:17412 Dracut,MA 01826 Cerified Since:2414