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Building Permit # 11/8/2015
BUILDING PERMIT Nosy„ TOWN OF NORTH ANDOVER �o APPLICATION FOR PLAN EXAMINATION >r Persalt No#: Date Received ¢M e ttyg 9ss,r.o. Date Issued: { _ ORTANT Applicant must complete all items on flys page k�`: � NvN �• jZ r t �. TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑Addition ❑Two or more family ❑Industrial Iteration No.of units: �v Commercial ❑Repair,replacement ❑Assessory Bldg ❑Others: Ll Demolition ❑Other _ �eptle;,'�U�eII, >� t »0 Floodplalh� ❑WJetlands < r 0 Wate s'�.eci,D s c"t a ater/,Se er ''e,. '.°�' ^t.L*" .Es Q DESCRIPTION OF WORK TO BEP RFORMED: V Idenh�fica ion-Please Type or Print Cl rly OWNER: Name: >-,n tai�ar<or�y7 ftv fir' Phone:JJ% I-?.5 3�® Address:100 r3 Ci5 �: cx¢ir 1^c ftC A WonCracjor tame n Phone Elnat se ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F. Total Project Cost:$��t y 1 FEE:$ Check No.: l C'Jl Receipt No.: NOTE Persons contracting with Bare sstered contractors do not have access to the guanantyfund Signature of Agent/Qw 1,'� � .Signature of cori`t[actor _ '�_ -�=-`''-1 � _�.�1 -._fir-�..��. -� ��Lin.®'a\\�, Mme,- — ___ ___. �- � - S— 13'-6 1/2' 1014 5/8. -4 5/8' 3`4 MECHANICAL LOCKERS--> Ln AB 11-10 5/8, cBENCH I ,Fr RETCHING/AES S 'N 45 LOCKER ROOM ROOM ct =o]A ........ ... —DRINKING FOUNTAINS:(D HANDICAP JACCESS11 W/ 13 A SPOUT HEIGHT OF Y-O' A.F.F.MAX.,PRO 91- LO SP 1. L Y-0 L ll 0 CLEAR AREA OF FLOOR SPA '0' X C JL Ilb Its, ®® L 31-8. 51-8 5/81 81-0. FURS OUT COLUMN AND WRAP W/ G.W.IP TO 48' A.F.F.,PAINT ABOVE d'op L f e-7 054,o 3A te,24 cel kLF WALL W/ WOOD CAP, NING, SEE DETAIL ,%ORTH Town ofAndover h ver,Mass,_ I'o�A � 9p S DU OP" E R M I T T I OLD BOARD OF HEALTH Food/Kitchen J Septic System THIS CERTIFIES THAT........�..y.L 1.` -........ cS. .............................................................�. BUILDING INSPECTOR ,�iy Fndation has permission to erect..........................buildings on.....` .�I..5.....�,.t:}.-f�..K.2.f.�1.... ........ ou ......... 'n Raugh to be occupied as.......61).o.�a...L1 ...... .1.1 ...c. .LL,.L.-........i �.tYA....—................ cnimneY provided that the person accepting this permit shall in every rest 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. Ro.gh Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TART Rovgh Sen-lee ........... ....... .. :..ILDI..................OR 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. B�ener Street No. Smoke Det. MASSACHUSETTS HOME IMPROVEMENT CONTRACT Homeowner Information SE Fitness LLC Sean Nickerson&Eric Broadhurst North Andover,MA 01845 -*"rte°°' °1-40 3-;�-2-'6911 Contractor Information Giant Construction Corp. 29 Lamoille Ave Haverhill,MA 01835 978-994-1059 License Holder CSL#108738 EXP 10/17/2018 Ryan Turner HIC#178626 EXP 5/5/2016 17 Baypoint Ln. Tax H)46-4976419 Haverhill,MA 01835 978-478-7756 WORK TO BE PERFORMED AND MATERIALS TO BE USED � Work to be done by contractor: Contractor agrees to do the following work for homeowner:Hang tape and finish 288 sf of drywall.Hang 832 sf of sound board.Remove chairrail and trim.Install 1 steel exterior door. Wall framing.Install 360 sf of drop ceiling.Electrical work to include 3 outlets,6 wall sconces, 2 LED ceiling lights,drop ceiling fan.Painting.Vinyl baseboard. Materials Expected to be used: Gypsum sound board,drywall,steel exterior door,KD framing lumber,Armstrong ceiling tile and grid,paint,vinyl baseboard Work Scheduled To Begin 11/12/2015 Expected Date of Completion:11/26/2015 The following warranty will be provided by the contractor under this contract:1 Year Workmanship and material warranty any materials under warranty will be through manufacturer of such materials. Please note that all home improvement contractors mud subcontractor shall be registered and any inquiries about a contractor or subcontractor relating to registration should be directed to: Director,Home Improvement Contractor Registration,One Ashburton Place,Room 1310, 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. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)mrd 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 aid 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. 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 Regulation and the consumer shall be required to submit to such arbitration as provided for in MGL C.142A. Contractor: O� Homeowner. — Date: 6 Date:---- 3 ate:_3 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 ofthe 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/lrerself 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 from said account would require the signatures of both parties. 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 OCABR website 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 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283- 3757 or visit the HIC website at http://www.mass.gov/ocabr/Go online to view the status of a Home Improvement Contractor's Registration: littp:Hdb.state.ma.us/homeimprovement/licenseelist.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 OTHER CONTRACTUAL DOCUMENTS This contract includes as contract documents the following additional enumerated documents: 4 TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE 'the Contractor agrees to provide the work,furnish the material and labor specified above for the sum of$15,412.00 Payments will be made according to the following SCHEDULE: $5,085.96 before work is started. $10,326.04 upon completion ofthe contract. In order to meet the completion schedule,the following material/equipment must be special ordered before the contracted work begins: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Customer Signature Contractor's Signature Sean Nickerson or Eric Broadhurst Ryan Turner 111�n`1S /i < �-S Date r— to You may cancel this agreement if it has been signed by a party thereto at a place other than at the 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 stator 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. REQUIRED PERMITS The following building permits are required:Town of North Andover,MA Building Permit.It is '.. the obligation of the contractor to secure such permits as the homeowner's agent and any costs which contractor will incur in doing so are included in the price for thisjob as set forth above. Please note that homeowners 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 X z The Commonwealth of Massachusetts Department of lndustrialAceidents 1 Congress Street,Suite 100 2114 Boston,MA 0ovIdI017 www.mass.gov/dta Workers'Compensation Insm•ance AfRdavlt:Builders/Contractors/PlecGlcians/Phtmbexs. TO BE FiLPLll WFTHTH6P=ITTBVG AUTHORITY. Please Print Le'bl Applicant Information --� Naine(Bnsiaess/organ,zarior,/lnaiviaoat): \.fiAri r' Address: ``,, City/State/Zip: vttl '\ Phone#:Nl"? Ace yon nv amp]°ym's Cheek the nppioprixta box: Type oFproject(;agaired): 1 fnh aad/orpart-time),* 7.❑New consfmction 1.01 -- ,oyees 2,❑Imv asolepropdetoror paMemhip evd haveno ainplcyaes working for me in S.'�Remodaling vry capacity.[No workers'comp.insururce enquired.] 9.❑Demolition 3.❑Iamahomeowncr doing ell work mysalP.[Noworkers'comp.inenrenoe mgwradit 10❑Building addition a ❑ a audwill beludvg conhaotorato conduct all wo+k on my Pr°Percy-Iwlll 11.❑Eleotrioal repairs or addition 4 I aro that sllcouttectore ald+ar hvvo workers'compensatim wsvnnceoraro sole 12.❑Plumbing repairs or additions proprietors with vo employees. erel ru vector andI hate liked aha sub-contractors listedonthc attached sheet. 13.❑Re fr'epairs v er 5 These gab-conhactocs have employeesaw have workers comp.insu 14.❑Other ❑ taf'exc er MGL c. 6, Weare acorpe+at�onund ibe9�'¢gars have exmcisadMvrdPJrm�mpty�n�l 152,gtDbend—havena.,.ployets.[Nn rvnrknrs'cmF.,n em . 'M licant that chectcs box#1 must alsoPrll out Ne scctionbclow showingthe'v Z." orkers'compen I'as policyinforma[ion gsuc Y aPP n aLLwork andthen tine outside contractors mast submitanew affidavit indicatin h S Hom rswho sub�iiit this afFdavit iridicatingthey aro doi g iConkacmrs that checklhisbox mustattached en additieval sheet showivg the name ofthe sabconttacmrs andsfato whether or vo[thosc entities ave 1 If the sub-conhactom fiave employees,they must provide their workers'comp.policy nwnI., amp ogees. I s Bedmv is'she policy andjob rite ram an employer unit is pi•ovirling ww'ka's'compausation insurance fm•n y engi dyes. infonna[ian. Insurance company Name,-S-\ Policy#or Self-ins.Lie.9-CT2w Sb ExpirationDat:��3 �� my/State/Zip�,— ���`�5 L'R \I\Y. I s Ble l• bei and,,pfration date). Sob Site Address, S kers' patio tiny dedarahon pogo(s roe lug Po tcymnn Attach a copy of tine workers'em Pe. probs P and/meoto ne-year unpall-mnenicas weh as oiviMGL Ides inthe form of a STOP 25A i,l a alkaloid WORK ORDER Ia dye fine of up to$250.00 man--a peva day against the violator.A copy of tris statement maybe forwarded to the Office of Investigations of the DIA for insw'ance siege verification. r da hereby c,,ttJyder unp tel O✓y1e',m that theinformaNma/n•ovided nbave e'nne and ewrect Dt' store Phone#: 6? ,7 77 offtetal use only.Do notwrife in flubs area,to be completed by cdty or toren ff tab- Permit/Lfnense 4- -City or Tnwn: Issuing Aathority(eirole one): 1.Board of fIealth 2.Building Department 3.CityYrown Clerh A.Electrical Inspector S.Phunbing Incpec for 6.Other Pha an#: Cmrtant Persmc 0a(MM,eD"") q CERTIFICATE OF LIABILITY INSURANCE 11/3/2015 TNIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLV AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS BELOWCTHIS CERTF LATEFOFSA MAI I El, ESANOT LCONSTITUTEXTND ORALTER THE EN OTHER SSUINGAGE FWSURER(S),TAUTHORIZED REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE HOLDER. dorsement.A statement on this certificate does not IVED,suec confer ighls to the IMPORTANT:It the certificate holder is a„ADDITIONAL IYSeUq E D,an en olicy(iss) f be entlOrsatl.If SUBROGATION IS WA the terms antl conditions of the policy,ce a n po icies ma ced{fcate holderin lieu of suchendorsemenl(s. coxTgcT Lisa Lembezt__---- -�6031gzs-1ea3 (800)258-1776 5lawsby insurance Agency °>L,HIM se�e�. -----------Iiuc,xoL-.---_-- 11 Ncn 3 Movnd Ct, Suite B Ix u - - 23329- PO Be.1807 M chant M t 1 L - NH 03059-1807 ---- --- Merrimack -- n- P._-=- --- -. ------------ s:Guaxd Insure ce.Grou I y- -- --- - Giant Construction C-P ----_. -.---- INs�asae: IxsxRaa_oo.;__ _ 29 Lamoille Avenue --- Haverhill NIA 01835 11xsuxaar: REVISIONNUMBER: RIOD COVERAGES CERTIFICATE NUMBER:2015 Master TERM I-CONDITION.; ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE INDICATED.NOTWITHSTANDING ANA REQUIREMENT, TERMS, EXCLUSIONS ANOYCONDITIONS OFMAY S SUCH PORLICIES LIMITS SHOWN MAY HAVEBEENEEN REDUCED By PAID CLAIMS.HEREIN IS SUBJECT TO ALL THE _ POLLO Air -.-I EXP UMns q of sUOR - ..a.IYYY I MMIonYY ---- uR 5 1,000,000 xSR aA ADAVE R -15 500 000 X gcIAL a aA L - 15 000 ILA 0]CIAMSMAOEa LX� CUR O eozE0s76a6 11/3/2015 11/3/20 ( - I 6 E'L cc -- s --1 000 000 2,000,000 —TI w B s z,000,000 OATELm T/ DES PE- l0 G oft ]� �LO ns 5 100,000 % T g _ OTnelLaLH Igelum I ��o rNnlRr(Per persunl s----_. — l aBOIpE IN DRP Eae demi=------ ,WhID BABB1aTTBs ----- I ---- - - eRaLLALIga LL—,-s,� � A�------- ---- X --- --- WOaKe ScOMPE - I -_100 000 Axo aMILOYERs y NIq 11/3/2015111/3/2016 5 -- 100 000 y -n- ------- n § SOB 000 B I,M,a ryR„ IToEN we6s,B56 m,.,senaal,. alme,a,xe �,e loxsl as Lo.worksrs c omp Policymev a I x oEm.re l Carlson Tis excluded f=om theft CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIIIENOPOCEI WIRLL CBECOEUVERED IN THE E%PIRATION DATE THEREOF, HE Fitness LLC. AGCORDANCEWITH THEPOLICV PROVISIONS. 5901 Chickering Road ssx.Am6 North Andover, MA 01895 T10"Ar 11Pa6 Lisa Lambert/LISA ©1988-2074 ACORD CORPORATION.All rights reserved. ACORD 25(2074/01) The ACORD name and logo are registered marks of ACORD E TE IMMmorcWn ACo CERTIFICATE OF LIABILITY INSURANCE v,6ao,5 THIS CERTIFICATE IS ISBUED AS A MATTER OF INFORMATON ONLY AND CONFERS NO RIGHTS UPON THE CERTFICATE pIOjTHORIZED BELOW.CTH 5 CERTIF LATE OFMINSURANCOE pOEESANOT CONS ITUTE A CONTRACT BETWEENOTHE SSU NG WSURER(S�HE POLICIES REPRESENTATIVE OR PRODUCER,AND THE CERTFICATE HOLDER. IMPORTANT:Tithe certificate holder is an AODPo'esLmay lrequlDrehanentlorsiement sA Statement on th sUe rtlOFlCcaale does nolconDfer rl9hlstto the the terms and conditions of fhe policy,ce certiflcate holder in Ileu of such endorsemenl(s). Mari SCM1aarschmidl 800-347-4935 ao c I_(802)661-5401 PNew England Excess ExcM1enge,Lltl meri�neee.can PO Box 650 MsuRE s1AEFoaDlNgcovEMOa 17370cs Nautilus lnsumnce Company Berle VT 05641 uaso Ryan Turner Tumor Carpentry 17 BB,.,Dt Lane Bradford MA 01835 INsuREa F: REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: THIS IG TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HERAVEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO11BRIO SID THE INSURANCEAFFORDED 8Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, INDICATED.NOTWIT TANDINGANYREQUIREMENT,TERM OR CONDITION OF ANY CON TRACT OR OTHER DOCUMENT WITH RESPEDT THWHICHT CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, EXCLUSIONSANO CONDITIONS OF SUCH POLICIES LIMITSSHOWN MAY HAVE BEEN REDUCED BV PAID CU11M 000,000 MITES lCY NUMBER 50,000 nH LLIAeIUTv uRANc t 5,000 XNERA 11, enEalLr - 1,600,gDO X 06242015 0624rz016 P S NN582525 S 2,000000 cvP c S 2,000,000 --- P aLm' R X elo. RY lverpMrsTl S oeILEUA Rv(Perecdae,t1 5 _IRT- .-ED S FONlros Tofi S -H OICIIIRENCL "C', lEGATE 11AWLITY 11. oenaEoniSnUNHImTNEIFIICUTNF CLuoE" nN NIA ILID le I ora apo Is renulretl) SCmemON of OPEPATIoNs I LOCATONs I VEHICLES(Allam ACCRO tot,Aatltllanal RemaAs Scneau, CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED MULL BE OELWERED IN BEFORE THEEXPIRATIONOATH THEREOF, TICE Town of North And Wer ACCORDANCE NCE WITH THE POLICY PROVISIONS. Building Department -� 120 Main Street AurHowzEo�NSAEW� And— 04846 North Antl _ plggg,20'Ipp RO CORPORATION.All rlghfs reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD &B11 I` ocr Ico.. A(! sn� o R x 1 11 G --,fIOME IMPROVEMENT CONTRACTOR It flan. 178828 Type: pi t m 5/512016 .BA TURNERCARPENTRY RYAN TURNER 17 BAY POINT LN al HAVERHILL,MA O'1835 Onderrearelur� ' � M; A rtfN-II p rt h'Pf if I�.fy 13sr ! f @ lrFii70 lii,ryitlaEon,,a d�4a�cfrovtLa C5 108738 RYAN TURNER 17 BAY POINT LANE H...cHllil MA OIR85 r.anrn�.�wi�i.i--2V--4W- 10117/2018