HomeMy WebLinkAboutBuilding Permit # 11/16/2015 BUILDING PERMIT
TOWN OF NORTH ANDOVER ......E.
APPLICATION FOR PLAN EXAMINATION 0
Permit Notes Date Received
9SsDate ssu0cI,1 1/1 Ac
IMPORTANT:Applicant must complete all items on this page
LOCATION 7SV1i!Mn9q �rAA-)Q/H&J_)CV01 h1ft 6JR95
Print
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PROPERTY OWNERS-`VL t_S-4fi3O-R' S�n,
I, 1 Print 100 Year Structure yes no
MAP I U PARCEL: It-7-!', ZONING DISTRICT: —Historic District yest no
Machine Shop Village yes" no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑New Building X One family
[I Addition Ej Two or more family 0 Industrial
[I Alteration No.of units: U Commercial
X—Repair,—replacement--,�T6(1—F El Assessory Bldg 0 Others:
,
I Demolition 11 Other
N
IODINE
DESCRIPTION OF WORK TO BE PERFORMED:S'TR/A/,%axl',
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Identification-Please Type or Print Clearly PLMrsfoi,16
OWNER: Name: Phone:
Address: L�g)61W-5-agk-r 01d,5__
QL,LIx,4a15
Contractor Name:77Amn, T,_ 611AW Phone:
7zo,
Email 771p C Qe IA,�-)�l/
Address: 11Ql- "--Vi Plr01, A6
Supervisor's Construction License:C'S- R7 71� Exp. Date:.3
Home Improvement License: c�,1160t( Exp. Date:'s
ARCHITECT/ENGINEER Phone:
Address: Reg.No.
PEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F.
32
Total Project Cost:$ 6W,c2L FEE:$ i__7
Check No.: Z-7 Receipt No.. )5(,
NOTE: Persons contracting with unregistered contrFc1ors do not have access to the guaranty fund
NORI
Town of
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BOARD OF HEALTH
ILD Food/Kitchen" ERMIT mwO
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Septic System
THIS CERTIFIES THAT.....1.-TT VC..... ....................................................w%% BUILDING INSPECTOR
. ......................
e
1 Foundation
has permission to erect..........................buildings on...... R/MM ...,..s,,,,,,,,..
♦ g� �p i '
Rough
to be occupied as. . .. . ... !. . .... .? .4- ...l*,.aL.... i.A.o.. e.................... Chimney
provided that the person aftepting this permit shall in every respect conform to the teral the application Fnal
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 CONSTRUC, RTS Rough
Service
.......... ...... ..... ..........................INSP.......ECTT.... OR.... Final -
BUILDING
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildin 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 Quinn Empkije,fD#
0.-(978)957-1200 QUINN'S CONSTRUCTION 27,1639714
C:(617)939,1353 1049 Lakeview Ave.#8-Dracut,MA 01826
toin@quinnsconstrzcctiomcom www.quinnsconstnictimLcaln Page I oW
Property Owner Information Date
Name Job Name
".$ 9—
Street Address(Not Post Office Box) Job Loc,atio.
Q
City/TownZip Code
State
/--, -1
Home Phone Cell Pho.e, Emad
-
Mailing Address(If Different From Above)
Salesperson(s): Registration#: 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 owner'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
**All terms of the warranty must be attacked to the eoontract**�--,-
NOTE:All building 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 owner 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 Regulations and the consumer
shall be required to submit to such arbitration as provided in M.G.L.c.142A.
Owner's
er s Signatures J Contractor:
Date: Date: 7/
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
Owner's Financial Insecurity-A Contractor may not demand payments in advance of the dates specified on the payment
schedule in cases where the owner deems him herself to be financially insecure.
Contractor's Financial Insecurity-In instances where a contractor deems hiniflierselfto be financially insecure,the
contractor may require that the balance of funds 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 part of the agreement;
2. A List and Description of other matters upon which the contractor and owner 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 owner.
Contract
Tom 8Employer 94®:(97 )957-1200U NS CONSTRUCTION 971
C:(617)939,1353 1049 Lakeview Ave.#8®Dracut,MA 01826
tom@quinnscons&uction.com www.quinnsconstruction.com Page 2 of1;.4'
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 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.
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 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 reuuest such payments in advance shall not he 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 and stated within the Additional Work Authorization-
I,the owner have read and understand the above mentioned modification section and agree to the terms.
'1
i
Owner's Signature -' Contractor's Signature
Date Date
The following schedule will be adhered to unles�ircumstances beyond the contractor's control arise:
Work Scheduled To Begin: :' / /✓5 Expected Date Of Completion: / ✓ /
(Date Contractor will begin contracted work) (Date 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 SUM of:
(*Include allfinance charges in this amount*)
a.
Payfixien'ts wtllbF-made according to the following SCHEDULE:
5 �` upon signing contract(*Not to exceed I/3 of the total contract price OR the cost of special order items,
whiche ever beater*).
by_! / or upon completion of
>'-_: _
V
$ by_/ l or upon completion of
upon completion of the contract(*Law forbids demanding full payment until contract is completed to
both parties'satisfacfion)
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
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*):
$ -C - to be paid for
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
— Identical'eopies of the contract should go to the owner and the contractor.
Owner's Signature Contractor's Signature T"
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 main
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.
Tm Quinn A7 Contract
O:(9 8)957-1200 �J 1�9S CONSTRUCTION27-1Employer 97#
27-1639714
C:(617)939-1353 1049 Lakeview Ave.#8®Dracut,MA 01826
tom@quinmconstruction.com www.quinnscmish'uction..com Pageoff$
WORK TO BE PERFORMED AND MATERIALS TO BE USED
Contractor agrees to do the following work for owners
Contractors agrees to 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.
❑frSchedule the delivery of all materials,dumpster,cleanup.
Q Proper protection of property.
Q Proper removal and disposal of 4:layea of roofing,additional layers removed for 500 a Square Foot per layer.
Run Magnets at end of day.
0'Renailing of roof decking as needed.
Q Replacement 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.
0' (Optional)Installation of custom Heavy Duty F8 color of choice single and double drip edge.
0'Installation of Owens Corning Weather Lock Flex High Temperature Ice and water barrier 3,6,9 Feet wide and
as needed in critical areas of roof.
Er Installation of Owens Corning Deck Defence for shingle underlayment.
0!Installation of vent pipe boots,step,base and counter flashing as needed,
0-Installation of a Owens Corning Duration Lifetime Shingle Roof using 6 nails per Shingle Exceeding the
Manufacturers Specifications.
(Optional)Installation of Owens Corning Duration Designer Shingles.
❑(Optional)Installation of Owens Coming Energy Star Duration Shasta White Shingles.
Installation of Owens Corning Ventsure strip ridge vent with baffles and caps on ridges and hip vent as needed.
,r-
Installation of 12 inch lead flashings on the chimneyslk.';;;
Q Installation of continuous/circular,rectangle,Facia,in flow vent for Eave Ventilation as needed.
❑`Block off Gable Vents as needed.
❑`f Roof System to be covered by Owens Corning System Advantage Preferred Non-Prorated Lifetime 50 year
material warranty and 10 year workmanship protection.
❑ Installation of PVC Trim,Facia,&Rake Boards$20.00 a Lineal foot.
Other Specifications and Conditions
?',(_ z',
Contract Tom Quinn QUINN'S CONSTRUCTION Em °
(617)939-1353271639974
(978)265.2390 �' u`
868-Mammodt-Road®Dracut,MA 01826
tam@quinnsconstruction.com %='" www.quinnsconstniction.com Page 3 of-4-1,
WORK TO BE PERFORMED AND MATERIALS TO BE USED
Contractor Agrees To Do The Following Work For Owner:
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CERTIFICATE OF LIABILITY INSURANCE DAEIMMfpDN YI
08!06115
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED-
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT;If Me certificate holder iB an ADDITIONAL INSURED,the policy(iaa)must ba endo Red. If SUBROGATION IS WAIVED,subject to
the tens and condl8ons of the Policy,certain Poifcies may require an andom—L A statement on thin certificate dose not confer right&to tha
cartlfleate holder In ff..o}such eAdorseman s.
goovc.. 978.9764300 rvaxE
SegRYe&Hall lnnuT.A99Pe.lnc PHONE
305 North Mal.St. 978-976-7588
ndnaovvder�MA 0810In
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aD0RE55:
THOMAS
mSUREge AFFOROINa COVERAGE Na1-
INSURED Tbomas QuInn INSURERA:Atlantic Casualty Insurance 42646
dba Qutnn's Constru0tlo0
1049 Lakevlew Avenue,Unit 8 m$uReq 0:Hartford Ins Co.
Dracut,MA 01826 trimaRc:Arbella Proteollon Ins,Co. 41360
INSU S—Commerce 34756
NSUReRe'
INSURERF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT TRE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. N07W TH87AN DING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TD ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIPTS S40MM MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICYNUMBER M.— DMITS
VENERALLIA81lITY EACH OCCVRRENCE 1,000.00
A X comMERGwLcenERaL LIABIUTr M0350001230 01/15115 01/16118 REMISEsrea«a;nPme s 100,00
crams-MaDE�Dooua xlsD om ram^n^wrE^m a 6,00
�BGLLYN 11/26116 11/26116 PERSOdIAL3AD—MAY 1,000,00
D ,X Snow Plaw oEN=RALAccaEOATE s 2,000,00
GEN'LAGGREGATE LIMITAPVLIES VEP: PRODUCTS-TAMPIOVA00 3 2,000,00
POUCY "' LOC 3
AUTOMDULELIABILnV COM9INEDSINGLELIMIT E 1,000,00
ANYAUTO aPvq
BODILY INJURY(Pa'peraaN
ALL OKNEOAUT03 BODILY INJURt(Pe:a^otlertl)9
C X $cHEOVLEOAuros 1020029603 06/07/16 06/07/16 PROPERTY DAMAGE
X MIREDAVT09 V r..-I) E
X
C.—A Underinsured s 100/3
Uninsured 100r3D
UMBAEILA UAB OCLUR
EACH OCCVRRENCE 3
DEDUCTIBLE
CLAIM°-MADE AGGREGATE ESE
SCpMPENSATION X YvO STATU- TH-
pNDVRPvk EToRmU Revery
BA4Npa?xEcanvEY�N 118P704 01116116 O1N6/16 EL,PACR ACDOENr s 100.00
I^*Y+^�sE^r+l+l EL DISEASE-Ea EMFlQ.e s 100.00
06CRIPTION OF OPERATIONS peIPry G.L.—-POLIOY LIMIT S 500,00
LOPANON9 vveHlctaF(AeyanaCOTN r01,AddiNe.,el0.ameNm Sc uN P mvpam m,eyµlnal
Sole H=op=fetor 113®ae QuiOa is Excluded under'w—kere R Cwpm�
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLEDBEFORE
T11E EXPIRATION DATE THEREOF, NOTICE WILL BE DEWERED IN
ACCORDANCE WITH TME POLICY PROVISIONS
.—Am RE'Re—ATIVE
®1988-2009 ACORD CORPORATION.All rights reserved.
ACORD 25(2009109) The ACOR13 name and IoOo are registered marks of ACORD _
The Commonwealth ofM assachusetts Print Fcr^7
Department ofTndustrialAccidems
Office of Investigations
1 Congress Street,.Suite 100
Boston,MA 02114-20I7
—`` www. assgosv/dila
Workers'Compensation Insurance davit:Buaiders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(susmess/Organization/Individual): [j1jlA)`S ( 12-r,Stz3LIct-1C4-7
Address: t L,0} f=VI L-L)A >c ;
City/State/Zip: G Oi' b Phone 7-/)(
Are you an employer?Check the appropriate box: Type of project(required):
4. I am a general contractor and I
1. I am a ees er with 3 ❑ 6. EJ New construction
employees f;;-,:i or part-time).* have hired the sub-contractors
2_❑I 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.El Electrical repairs or additions
3.❑1 am a homeowner doing all work officers have exercised their 11.E]Plumbing repairs or additions
myself.[No workers'comp. right of exemption per MGL 12.M Roof repairs
insurance required.]t c.152,§1(4),and we have no
employees.[No workers' 111]Other !}t K
comp.insurance required.] Ge
"Any applicant that checks box 41 must also fill on'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-
-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.
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. ��
Insurance Company Name.__/AAr?&Z EA,,'aRr Q7
Policy#or-Self-ins.Lia#: �f J� Expiration Date: I
Job Site Address:7h/tlli7flS� r City/State(Zip: Q }) (1 tit3t fi =) t
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 oft,
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.
1 do hereby ce ' under the ains and pen hies of perjury that the in ornaation provided above is true and correct
- -
Signature t�Yu✓L" Dated l 1 1 i 9a
Phone
QffZclal use only. Do not write in this area,to be completed by city or town oiciaL
City or Town: Permit/License# 1
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#:
Office of Consumer Affairs and B6siaess Regulation
1 €ark Plaza-Su to 517€3
Boston,-Massactausetts 02115
Home Improvement Contactor Registration
RegisVafion: 121604
Type: DBA
. Expioafion: 5124/2016 T19-250333
QUINN'S CONSTRUCTION
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858 M&MMOTH RD_
DRACUT,MA 01826
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,NI-WSY-issoil: 121604 Type: Office of ConumnarArBiks and Budaesa 'oa
£xpiraY-or,-$124112.016 DSA IQparkilan-suite 5119
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Quinn,Thomas Expires:4/312017
868 Mammoth Rd €D#?:27412 _
DmWt,MA 02825 Certified Sine:2014