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HomeMy WebLinkAboutBuilding Permit # 11/23/2015 NORTH BUILDING PERMIT 0 � FD 16�ti - TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION h Permit No#: Date Received . IV. Date Issued: k I IMPORTANT: Applicant must complete all items on this page F flr'-r<-':b 7 3 ;:r,� F: >»;,.' Irru?„. .r tl2r ✓'. �'.:- �: l rl.:�.'.. r-'rr �” kr J,^.r k*r .�'{ lY-, 5 :r g H-t�..�r ' ,,,r;.�: f rflrff,.rtd�,< x£r`7{r,rsr" �' r'�:-.,;r ��-.✓< `;;✓?'<� ,�k.,"�' .:%^r` 11 a:,P .,rrr :�" Ir k:r.;�., filer f2' .tx` sY 1 f;r r r .t:' r c-:I r`"'"' �crru,.s �,,,,% ,�,�r r.^r..; fr..=:v�„✓I.y„„..; ,.,.. -„yr fr",r p r.c..r u / d':-:f y r � }r"1 :.r✓ t>< r'Ir f.u r a,,, � r r,. 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TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Sep�c ❑jlNell ❑ Floodplain ❑Wetlands ❑ Wate'rshed District r / ✓ r v is f r 1 1f { r r rr r r r '`1✓ rr r v DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address Contractor JNarn j `��Phone > t , r /�'rr'�lIrr��rar s Ir/ j r rrl w � r✓a�r�t ✓r rtr 'tri v rir- r.r ��, rf { sf. t� N^rrfrrfrj r r f,r rl ,err* � r�r`t�r dr _r "�"i. w/'§ ✓ j ''�J 1 I l l t / 4 �rr•1 7 r t / ,_:,� �:";. k1 x' .�'.' ry r'b R r..:/ j f t l r ,!_: .� A -:) r '.Y 2 s,J' h,rrr ,til' 1;/r.✓ ;..<'r �x rf/G / r; F TI' '� r �.vl' X�� /r' ...%: r ^T �r_ 1 t.i f y s'rr ,;r rr r r' � r: r rrf rrr ,✓, rr+•rr r r.� r,;f'f �� {x-.1 ,� .:`t 3kr- rr:-r r � r k-,:r r ✓ � '-r 7ixi t„r ,r ,t r .vr r j r,5 r.`,: r+ r` („f�r�� 1 j;; .,+' ''' r�1�Jj t,,tvl:'art" Ir t..:; fes,^' Sk°wr'y'1"f 'r �' '' c' , ,,; f.-�: t :fY �, tI'' S 7 C I r`✓+'>f`s#" ,.�`<rrr.` ✓c±;7�r .:�rryr r: f'x✓ Su e isor s Construction°Lice sef r r, r s , Yrt l fi Ex ate r-' r rrr i' c��,h". �z.. .r'c' .�'f��1 � .r.-"r� 1r lra^'r,• '� t �` .:u,J t~ r k' k' .'rr,: >`., r ,✓.:P�">s :.✓w. f� r` r'.x rel-::r,:,..>ir rk r„r?'._- r r,,ru,�,:;. t x. 7''r'�txryt�� ....�r�f rrr r ;,,✓ x ✓ff c';.r rf =f`,r�7 rft�:+„! r'/ t rT' r f 7`- r:, ck"rusr' ,,.::,r,.,�,s5f,„.r,��k„�.. j1� ,tri.3Jr''�sar'`.z!s' atF�r. rr.`✓.F=.r'' �r .r r r�{ �xrr ':.r'�riti ✓r ,..,,5rv,���-G'.xr'x f 'k ;%„�'%r ARCHITECT/ENGINEER Phone: is Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ I Check No.: '� Receipt No.: v 1� T-0 NOTE: Persons contracting with unregistered contractors do not have access to the uaranty fu Signature of Agent/Owner Signature ofcontractor i AM tkORTH 2 J[ AML Wn A"& 4 E. ...'.ieU U1 , 11.U 0%,v C", r No. ® %00 t z - y cert n �� ��� A SpA coc.acemcK 1 9 7 S U BOARD OF HEALTH Food/Kitchen Septic System THIS CERTIFIES THAT .................. ....... .. ................................ ...... ....� ........... ........................ BUILDING INSPECTOR ... has permission to erect ..a................. .... buildings on .J.!�.......... ..................��.,.�. Foundation Rough tobe occupied as ........... . ... .. .. ........... ... . ... .. ......................................................... 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 PERMITI S ELECTRICAL INSPECTOR UNLESSS 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 Lathingor Dry Wall To Be* Done FIRE DEPARTMENT Until Inspected a rove the Building Inspector. Burner Street No. Smoke Det. efi�alj iwtwi eow tut arPw,,vn, PROPOSAL#3 Mike Sady 9 Phillips Common North Andover, MA 01845 p qqd 0) otncast:.reel (H) 978-687-4455 (C) 617-840-5559 November 23, 2015 Bathroom Remodel Work to be included includes: • Acquire Building Permit • Removal of existing tub,toilet, vanity,tile floor. • Complete all required plumbing. • Complete all electrical. • Install new vanity. • Bump out closet to allow for 36 x 60 shower. (36 x 48 Cast Iron Base w/ 12 in. bench) • Re-hang existing closet door. (new door additional$185.00) • Install DenseShield Tile board on shower walls. • Install tile on shower walls. • Plaster patch where needed. • Install DenseShield the board on floor. • Install new tile floor. • Install new baseboard. • Install new toilet paper holder,towel bars. • Removal of all debris. TOTAL LABOR AND MATERIAL $ 10,750.00 Note: This quote does not include any plumbing fixtures,vanity,tiles, grout, granite, or painting. Custom Enclosure would be an additional$ 1,900.00 Additional plumbing required to change shower drain to 2 inch will be extra. Terms: $3,380.00 upon signing of contract(not to exceed 113 of contract price) $7,170.00 when job complete Submitted By: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C)508-265-3115 (H)978-794-1165 North Andover,MA 01845 All Home Improvement Contractors shall be registered.Inquiries about a contractor relating to a registration should be directed to; Registration Division,Program Coordinator One Ashburton Place Room 1301 Boston, MA 02108 Tel: 617-727-3200 ext.25239 All building permits required will be the obtained by the contractor.Homeowners who obtain their own permits are excluded from access to the Guarantee Fund. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory an -ar ereby accepted. You are authorized to do the work as specified.Payments will be WdVas outlined above. Date zj X4 Homeowner Signature ' µ Date '° Coptractor 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 d-th'e fiomeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract e contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive 0 ice of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided i Mass Chusetts Gen r aws,Chapter 142A. r Homeowner's Signature Contractor's Signature NOTICE:The s' atures the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor.T_ omeowner 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 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 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 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/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 Consumer Guide to the Home Improvement Contractor Law",contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787 or(888)283-3757 OP ID: OUJA .mac ®z CERTIFICATE OF LIABILITY INSURANCE 17�/21(MMIDDIYYYY) /2015 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 the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Phone:978-688-6921 NAME: Jane Ouellette Macdonald&Pangione Insurance Fax:978-688-5350 PHONE 978.688-6921 FAx P.O.Box 428 _(n/c_No ems: (A/c,No: 978-688-5350 104 Main Streetm E-MAIL ane ins.net ADDRESS:) � p North Andover, MA 01845 PRODUCER Michael Pangione CUSTOMER to#:CHRIS-5 INSURER(S)AFFORDING COVERAGENAIC# INSURED Christopher Rivet INSURER A:Preferred Mutual Ins Co 115024 207 Winter St. INSURER B North Andover, MA 01845 INSURER C INSURER D: i INSURER E: INSURER F: I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ITR I TYPE OF INSURANCE IPOLICY EXP ADDL SUBPo POLICY NUMBER POLICY EFF MM/DDYYYY MM%D YYYY LIMITS GENERAL LIABILITY _EACH OCCURRENCE $ 1,000,000 09/26/2015 09/26/2016 DAMAGE TO RENTED A j X COMMERCIAL GENERAL_LIABILITY iBOP 0100719749 PREMISES(Ea oc100,000 currence S CLAIMS-MADE X �i OCCUR j MED EXP(Any one person) $ 5,000 j PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY PRO-JECT LOC $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ -- (Ea accident) ANY AUTO ( i BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ _JISCHEDULED AUTOS i$ PROPERTY DAMAGE HIRED AUTOS ?(Per accident) I I i- NON-OWNED AUTOS i $ I UMBRELLA LIAB G 1 OCCUR i EACH OCCURRENCE I$ EXCESS LIAB I CLAIMS-MADE � jAGGREGATE $ I DEDUCTIBLE 1 I$ i I I - RETENTION $ i $ WORKERS COMPENSATION I TOWC STATU- I 1 OTH- AND EMPLOYERS'LIABILITY YIN I j RY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑I I E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A - (MandatoryinNH) ( � E.L.DISEASE-EAEMPLOYEEIS If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S I � I I i DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St No Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street ' Boston,MA 02111 •www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly �' Name(Business/OrganizaiionAndividual): , ; 94^� Address: �'�� �• ' '- 1 City/Sfiate/Zip:,/Jr: Aw'-,)a7eK'Phone#: Are you an employer?Check the appropriate boa: Type'of project(required): 1.❑ I am a employer-with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.Q 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 work' for me in an capacity. employees and have workers' � Y P t5'• 9. ❑Building addition [No workers'comp,insurance comp. insurance.# required.] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.'El 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 that checks box#1 must also fill out the section below showing theirwotkers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. lContractors 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 subcontractors have employees,they must provide their workers'comp,policy number. lam an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: � a Policy#or Self-ins.Lie.#: 1 6` '�'�% ,� V Expiration Date: `I ® ✓ f p F/f Job Site Address: �'���� ��°^�'^a�`�. City/state/Zip: 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 certrfy urn ldw p ns penalties of perjury that the information provided ab ve is ue and correct SDate: r Phone#: Official use only. Do not write in this area,to be completed by city or tower 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#: 5 ' assachuse tts -Ceparbheart Of Pubc Safety Board of Buildhig RegCiafians and Standards C ongtructiffm super%Nor I_&cease: CS-072173 t CIMSTOPIMR F`12IVET 207 WINTER ST.. N ANDOVER lid 01545 Expiration Crrmmiss¢oner 06/0212016 -Ilte t(' nliwAll ref('' rrcka.;r t/ Office of Constkner:A.ffa:rs&Business Reg«}:ttion OME IMPROVEMENT CONTRACTOR p registration: 139962 Ty?e: Expiration: 9/8/2015 Individual CHRISTOPHER F.RIVET ; CHRISTOPHER RIVET 207 WINTER ST. �y _ N.ANDOVER,MA 01845 Undersecretar, y