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Home My WebLink AboutBuilding Permit # 12/7/2015 %AORT#1 BUILDING IT ®��tL�a /bow TO F T 4g ° APPLICATION FOR PLAN EXAMINATION o Permit IVo#: Date Received �pTro �gssgCwus``�� Date Issued: a/#M�PORTANT:Applicant„must complete all items on this page LOCATION ” Print PROPERTY OWNER r " Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT- Historic District yes o Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building ❑ One family ❑Addition ❑ Two or more family ❑ In trial ❑Alteration No. of units: U o mercial ❑ Repair, replacement ❑Assessory Bldg ers: ❑ molition ❑ Other m DESCRI ION OF WORK TO BEPERFORMED: a , � 1 entificat' - Ple se Type or Print Clearly40 OWNER: Name: Phone: :, Add res�/,, ,6 ztj Contractor Name: Phone: ,r Email: Address: Supervisor's Construction Licens L" 2Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON 125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: m i un contractors r NOTE: Persons contracting with registered contra o do not have access to th gua anty fund zi Pians Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ [TYPE OF SEWER�.GE DISPOSAL ublic Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ ell ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ permanent Dwupster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On��1�I� Signature_ COMMENTS NNOe- AqqFLwe / /TV0 ffitrrior /1 AoJcJ'7vx -�v Lp /Zev�� / Lo flaAetilc CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on_ Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRL DEP ARTiViEIVT =Temp Dumpsfer onsite , yes Located,at 124 Main:Street Fire Department signaturar/date COMMENTS I r-11111111-9 A'V F t%ORTII ' irown oi adover ® e� • h ver, Mass,0 • COCHIC19WICK y1" AD4ATED lkV, S U BOARD OF HEALTH Food/Kitchen rE M I �T �T L mumoh" Septic System tl THIS CERTIFIES THATBUILDING INSPECTOR .... ...r .....*.....C... ......... ...... . ...C.......... .1.................. .................. has permission to erect .......................... buildings on .. ..... Q�� ,, ................... Foundation e Rough to be occupied as . �. . Vg . .... ..... *Ar........ ... .... .®... ........ ....� .... ....... Chimney .provided that the person ecce t permit s all 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. , ° /WAAW PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough MONTHS PERMIT I I M 6 ONTHS ELECTRICAL INSPECTOR UNLESST CTI TAR Rough Service ............... ......... ... Final BUILDING INSPECTOR GAS INSPECTOR ccupancy 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. I i Proposal HIC#136779 "Couldn't your home use a little TLC?" Specializing in Residential Additions 87 Belmont Street• North Andover, MA 01845 /� P: 9 85-17447 - F: 978-685-7446 NAME OF OWNER I 7 f /� ADRESS OF JOB TEL. 6 1� - / DATE: We hereby submit estimates for: AA -K 0 Ezc • d We Propose herby to furnish material and labor-complete in accordance with above specifications,fo he sum f: f dollars($ payps t to be made as follows Authorized Signatu e NOTE:This propos may be withdrawn by ,,44"If not accepted with inte6ays Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and are herby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Signature /� Date of Acceptance: __ J �� Signature HOME IMPROVEMENT CONTRACT TERMS AND CONDITIONS M.G.L.142A I. WORK:Provided the Homeowner performs under this agreement,the Contractor shall perform the work on the Property as specified Proposal,attached incorporated herein.The work does not include extraordinary conditions of which the Contractor could not reasonably be aware.If such conditions are encountered,this shall be an additional cost to the Homeowner.Materials selected by Homeowner may have to be ordered or custom made,which items are specified in the Proposal.The Contractor is not obligated to agree to any modifications,extras or change orders unless such items are agreed to in writing by the Contractor.All extras and changes shall be at an additional cost to the Homeowner.Contractor shall perform the work in a good and workmanlike manner using materials consistent with this contract.Lawn or Driveway may be damaged by dumpster or equipment.Due to material shortages Contractor may substitute materials of equivalent grade. 2. PERMITS:If a building permit is required for the work,the Contractor shall obtain same as Homeowner's agent.Contractor is not responsible for any other permits that may be required for the Work,and Homeowner is responsible to determine whether any zoning,planning or wetland related permits or approvals are necessary.Homeowners who secure their own permits or deal with unregistered contractors will not have access to the Guaranty Fund. 3. COMMENCEMENT AND COMPLETION:Homeowner acknowledges the commencement date of the work is fluid,and is subject to numerous factors such as scheduling other contractors,delivery of materials and weather.Contractor and Homeowner shall determine the commencement date of the Work when a more definite determination can be made and shall execute a written acknowledgment of same.The Work shall be substantially completed within 7 days of commencement,except for longer periods as may apply to particular projects as Contractor shall notify Homeowner in the Proposal,and subject to delays for circumstances beyond Contractor's control.Notwithstanding,the commencement date and substantial completion date may be extended,and the Contractor will not be liable for delays caused by,labor or material shortages,delays in delivery of items selected by the Homeowner,governmental action, and unforeseen events beyond the Contractor's control,including but not limited to weather,strikes,war,the acts of third persons or the acts of the Homeowner.The Homeowner recognizes that the commencement date may be delayed due to scheduling or the completion of Contractor's other jobs. 4. PAYMENTS:Contractor agrees to perform the Work and to furnish the materials and labor specified in the Proposal for the amount as stated in the Proposal.Thirty percent(30%)of the total is to be paid as a deposit with the signing Work,any remaining deposit will be returned less the costs for materials ordered for which Contractoof this contract. r was unablpon e tocancel.F nal payment to shall b the upon completion of the Work and Homeowner agrees it may not hold any retainage.Late fees may be applied for late a payment shall ll due Contractor's reasonable costs of collection,including attorney's fees and costs.Time is of the essence hereof. p yin -Homeowner shall pay 5. WARRANTY:For a period of 2 years after substantial completion of the Work the roof will be free of leaks caused by defects in workmanship, but not those caused by ice backing-up or extraordinary weather events,including blizzards,tornadoes,hurricanes or storms of greater than a twenty-five year duration or intensity.Contractor gives no warranties with reference to any materials or equipment installed in the Premises,passes any such warranties directly to Homeowner,and Homeowner agrees to look only to the manufacturer with reference thereto.This limited warranty extends to the Homeowner only and is not transferable to succeeding Homeowners.This Limited Warranty specifically excludes(i)all consequential and incidental damages;(ii) damage due to ordinary wear and tear,abusive use,misuse,or lack of proper maintenance;(iii)defects which are the result of characteristics common to materials used;(iv)defects in items installed or supplied by anyone other than Contractor;(v)work done by anyone other than by Contractor;and(vi)loss or injury due to the elements.There are no other expressed or implied warranties or representations made or given. 6. ENTIRE AGREEMENT:This contract and all documents referenced herein constitute the complete and final agreement between the parties.In the event that any of the provisions of this contract shall be held to be invalid,the remainder of the provisions of this contract shall remain in full force and effect.Two identical copies of this contract have been completed d signed.Homeowner acknowledges receipt of a completed contract signed by the Contractor. 7. HOME IMPROVTVjT IR�TION.�In a cord ince with M.G.L.c. 142 A §9 and Standards RCE1Stratl2 No• .Homeowner may verify by contacting the Director at(617)7ctor is 2'3200,exttered .25205.the Bureau Homeowner's Regulations under the Home Improvement Law(M.G.L.c. 142A)and other consumer protection laws may not be waived in any way_Homeowner acknowledges receipt of a copy of 780 CMR R6 and Massachusetts General Laws chapter 142A,and which are available online at www.mass.gov.Questions may be directed to the Consumer Information Hotline,(617)727-7780. 8. ARBITRATION: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 an Business Regulations and the consumer shall be required to submit to such arbitration as provided in M.G.L.c. 142A.No lien or security interest is imposed on the Property as a consequence of this contract,but Contractor has the right to record this contract or a notice of this contract,or seek a lien if the Homeowner breaches this Contract. 9. HOMEOWNER COVENANTS:The Homeowner agrees,represents and warrants that(a)the Homeowner grants permission to the Contractor to enter the Property to perform the work as covered by this contract;(b)the Homeowner has funds available to make full payment under this contract to the Contractor upon completion;(c)the Homeowner understands that construction as contemplated by this agreement creates a dangerous condition,and agrees not to enter portions of the Property under construction until the Contractor advises the Homeowner that the construction is completed;(d)Contractor may need use landscaped areas of the yard during the Work and Homeowner is responsible to provide protection for landscaping and(e)that code requirements may result in roofing nails penetrating through roof decking and will be visible on the underside of some surfaces.The Homeowner indemnifies,exonerates and holds harmless the Contractor from any loss,damage,claim,liability or expense(including reasonable attorney's fees,deposition costs and court costs)resulting from a breach of this provision.Contractor is not responsible for damage to landscaping that will grow back during the next growing season. 10.CANCELLATION:Home wner may ncel this cement provided Homeowner notifies the Contractor in writing at the address listed in the Proposal not later than midnight of the thir busin ss y fol win the signing of this agreement. HOMEOWNER: y � DATE: / DEPOSIT: The Commonwealth of Massachusetts Department ofIndustrlgl Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/ContractorsfElectricians/Plumbers Applicant Information Please Print Legibly Name(Business/Or anizatiorAndividual): Address: i City/State/Z ,_4& �� ; Phone#: 777 Are yow an employer?Check the appropriate box: Type of project(required): 1.a I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling ship and'have no employees These sub-contractors have 8. emolition working for me in any capacity. workers'comp.insurance. 9 ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roofrepairs insurance required.]t employees.[No workers' 1311 Other comp.insurance required.] *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 aie 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 their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy 4 or Self-ins.Lie.#/� � � ��°y Expiration Date: Job Site Address: Ci /State/Zi Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 maybe forwarded to the Office of Investigations of the DTA for insurance coverage verification. Ido hereby cert rc e 4 the pain penalties ofperjury that the information provided above is true and correct. Si ature: Date: / l Phone 4: 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 - - Contact Person: Phone#: ., x N2-2 1/13/2015 6: 42 :50 AM PAGE 2/002 Fax Server DATE(MM/DDIYYYYI - CERTIFICATE OF LIABILITY INSURANCE T. RI- IFICATE 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 BYTHE 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: DOHERTY INS AGENCY INC PHONE FAX PO BOX 1985 (AIC,No,Ext): (A/C,No): 21 ELM STREET E-MAIL ANDOVER,MA 01810 ADDRESS: 22YMX INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS INDEMNITY COMPANY OF AMERICA TWOMEY&LEGARE CONTRACTING INC INSURER B: INSURER C: INSURER D: PO BOX 366 INSURER E: NORTH ANDOVER,MA 01845 INSURER F: 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 RESPECTTO 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 PAD CLAIMS. '..... INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MIADDIYYYY) LIMITS '... GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE PREMISES OCCUR. ES( RENTED $ PREMISES(Ea occurrence) ED EXP(Any one person) $ ERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY PROD ECT❑LOC IRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND1 ;We sTATu TRY i OTHER EMPLOYER'S LIABILITY YM UB-029OM994-14 09/18/2014 09/18/2015 1 :LIMITS ANY PROPERITO"ARTNERIEXECUTIVE Y N/A E.L EACH ACCIDENT $ 500,000 OFFICERRdEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCA-nONSIVEHICLESIRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. .,....n............. � CERTIFICATE HOLDER CANCELLATION r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED t IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP RESENTIy f' ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1988.2010 ACORD CORPORATION.All rights reserved. Client#:13298 TWOMEY6 ACRD- CERTIFICATEF LIABILITY INSURANCE x;29/20 5"""'' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 1985 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 21 Elm Street Andover,MA 01810 INSURERS AFFORDING COVERAGE MAIC# INSURED INSURER A- Arbella Protection Ins Compan Twomey&Legere Contracting,Inc. INSURER B: 87 Belmont Street INSURER C: North Andover,MA 01845 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT.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 SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPEOFINSURANCE POUCYNUMBER POUCYEFFECTIVE POUCYEXPIRATIONLTA NSAH UNITS A GENERAL LIABILITY 9520040230 06/22/15 06/22116 EACH OCCURRENCE $1,000,(100 X COMMERCIAL GENERAL LIABILITY DAMAISE GE TOLF.RENTED $100,000 CLAIMS MADE 51OCCUR MED EXP awperson) $5000 PERSONALS ADV INJURY S1,000,000 GENERAL AGGREGATE s2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,000 X POLICY f7l PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Porporson) $ HIRED AUTOS BODILY INJURY NONdWNEDAUTOS (Per accident) S PROPERTY DAMAGE $ (Per aa#rMnt) GARAGEUABILJTY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTOONLY: AGG $ EXCESSAIMBRELLA UABIUTY EACH OCCURRENCE S OCCUR ED CLAIMS MADE AGGREGATE $___ S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND WCSTAIT OELL TH EMPLOYERS'LIABIUiY ELEACHACCIDENT S ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? F.L.DISEASE.EA EMPLOYEE $ 11 es,doscdbo under SPECIAL PROVISIONS below E.L DISEASE•POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS Covering operations usual to Twomey&Legere Contracting,Inc... CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL in DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILTTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATNES. AUTHORIZED REP ESE TIVE ACORD 25(2001108)1 Of 2 #S321931M32132 ML op6RD CORPORATION 1988 Massachusetts Department Of Public Safety Board of Building Regulations and Standards License: CS-067560 Construcflon� Supervisor SHAUN M TWOMEY 51 PATROIT ST NORTH ANDOVER MA 01845 Expiration: Commissioner 10!25/2017 �,„ c%fir�t oruixaurocrrr✓/�cif nt�lrslcrr�ntr^ll.t -_Office of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR registration: 136779 Type: o" xpiration: 8/26/2016 Partnership TWOMEY+LEGARE CONTRACTING INC. SHAWN TWOMEY 87 BELMONT ST. N.ANDOVER,MA 01845 Undersecretary