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HomeMy WebLinkAboutBuilding Permit # 4/15/2016 TOWN OF NORTH ANDOVERAPPLICATION FOR PLAN ,a�w „s & � e. Permit NO .> Date (deceived , ax a ...... Date Issued: _ IMPORTANT: Applicant must corn fete all items on thisa 7e PROPERTY', ' ,MAP MAS' M ;: dktrr�e h Vile rir ' TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 4 One family ,°Addition ❑ Two or more family ❑ Industrial LkAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Uter, rNtrshd'DistrictpFc CilVtr/s' wdi F a < (' _A ; Identification Please Type or Print Clearly) OWNER: Name: � :� � �d S�..�� Phone: Address: i NTATR Nre phone` i Address:' Suerviscar' crrae >Ini �� erxer Nome Im rorrernenf t r ens � �. I i „r, o ARCHITECT/ENGINEERK1 Ap V' Phone: A l I F>I Address: r .10 , a' s M4\ Reg. FEESCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST EASED ON$125.00 PER S.F. Total Project Cost: ! 4 ego FEE: $ ,.,.. Check No.. Receir° pt No, NOTE: Persons contracting with unregistered contractors dna not have access to the guaranty fund Signature of Agent/Owi-ne r Signature of contractor mm " Town of ndover No. --� - LAKE \ ver, ass, coc HIc MEWIcK n' ATE C) S U R BOARD OF HEALTH PtRMIT IF Food/Kitchen L NEW Septic System THIS CERTIFIES THAT .... ��-� °`Z yl.. G�?................................................................................... BUILDING INSPECTOR .. ................. has permission to erect ��oc/�� Foundation p .......................... buildings on ...7....................�.............................................. to be occupied as ..................... Rough...........�../ ...........................,............................................................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Final Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Reg ulations Voids this Permit: Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESSI STARTS Rough Service ......................................................... Final BUILDING INSPECTOR GAS INSPECTOR ccupancy Per it Required t® Occupv Building- Rough Display in a Conspicuous Place on the Premises — ®o Not Remove Final No Lathing or Dry Wall To Be ®one FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. r' p l Adam Brien CSL 104428 417 Waverly Rd. HIC 168512 North Andover, MA 01845 LLC 978-479-1526 3/31/16 adambrico@gmail CONTRACT ME MIM—WmuumrarmemiaiurniaNiuurnumniRMIRIMrumiumaimuaiaiuuuuirmirimlumuuwrcaiouxwmrrrsmnuuirmirWwuma+amnivnnionawmwwixmvnauruiUrruuuutamaivuum¢eiireiuiuma�rriuwrnonmrmiuniuomi+rrmureinuwnmimamivewMnt�vauv,miiiwrr�nrcreiriiwmiiauaaiiniu.4navmmiwmimimunniihuunvnm'i Herb Lynch 77 Court St North Andover MA 01845 JobDescription: Expansion of 3 season sunroorn onto existing deck approx. 121x12' incorporating a 8x12" screen porch. All construction to follow architectural plans provided. ® Existing deck to receive temporary protection during construction. All construction related debris to be removed from site. A dumpster will NOT be placed on site. All furniture located in existing room to be moved and stored by owner during construction. • All framing to plan. Underside of deck screening to be removed for structural framing. • Supply and install 2 Anderson patio doors, location per plan, 2 Anderson fixed panel units to plan, 1 "Velux", skylight to plan. Remove and reinstall 3, fixed window units located in wall area that is to be removed per plan. ® Screen porch to be built on existing deck as well. The screen porch roof to be framed and incorporated into the existing house and sunroom extension per plan. Construction of screen unit with turn clips to remove screens for winter and cleaning. Existing deck rails to be removed and reinstalled per code at screen area. Supply and install full view screen door at top of existing stairs. ® Rubber roof to be installed per plan matching existing look. Existing gutter to be modified for new roof line • Walls, ceiling and floor to receive insulation. Underside of deck to receive pressure treated plywood where insulation is exposed. Underside of screen porch area to receive screening only. • Exterior of sunroom walls to receive clad-board siding and pvc trim boards on all new work. On exterior wall of inside of screen porch to receive matching clad-board siding and trim • All interior walls to receive blue-board and plaster. 1 wall to have blended wainscoting. On either side of patio door. • Interior ceiling to receive matching tongue and groove knotty pine, material to be stained to match existing ceiling. • All windows, doors, skylight, base board areas to receive primed pine trim matching existing style. • Floor style to be 1 x6 planks matching existing area, entire floor new and old to be sanded and stained alike. • Electrical outlets and light switch to be wired to code. Ceiling fan installed on the ceiling in Sunroom and screen porch. Fans supplied by owner. Electric baseboard heat installed with Thermostat in located in sunroom (exact location to be determined) • New exterior trim and siding to be painted. Interior walls and trim to be painted. Colors supplied by owner. • Permit Fees included. The Owner agrees to pay BriCo Building and Remodeling $45,815.00, for doing the work outlined above. The following payments will be paid to the contractor in the following manner: • Initial Payment of$3615.00 is due at contract signing. This is non refundable. It includes architects stamp plans fee and permit fee • First Payment is of$20,000.00 is due once permit is on site and construction is to begin. This payment will also coincide with the window and door order. Doors and window generally take 3 to 4 weeks for manufacturing.20 • Second Payment of 11,000.00 is due once structure is weather tight, glass is installed, roof is complete, electrical rough begins and exterior siding. • Third Payment $7,000 is due at completion of all interior finish except floor and punch list • Final payment is due after final inspection from the building department is complete and punch list is 100%. All subcontractors that are hired by BriCo or the homeowner must carry the appropriate license and insurance to perform work in the state of Massachusetts. The contractor agrees to perform this work in a competent and skillful manner according to standard industry practices, and all work performed shall be subject to final approval by Owner. All work to be done incompliance with Massachusetts building code. BriCo takes on full responsibility of all necessary inspections. All craftsmanship is warrantied for one full year from completion of construction. Warranty is voided if repairs are necessary due to a natural disaster. All glass installed meets state energy code for performance and efficiency. Each glass unit will contain its own energy certificate. Any unforeseen work or necessary repairs found during this project to be brought to the owners attention as soon as possible. Any extra work resulting from unforeseen problems will be priced accordingly on site and be done with written approval. BriCo is not responsible for anything that occurs on site that is not directly involved with the construction of this project. BriCo Building and Remodeling is a fully licensed and insured LLC company. License numbers are provided in the header above and current insurance documentation upon request. BriCo is a full service general contracting company. We take pride in our work look forward to the opportunity to work with you. Customer Signatur w Date Contractor Signature Date 3 The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations 4 ✓✓ ✓ F9 1 Congress Street,Suite 100 .Foston AIA 02114-2017 fvlvw.nrtass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/E4 lectricians/P'lutnbcrs A>�>olicant IMfor»natian Please hriMt L egibly Name(Business/Organization/Individual): L?x1(' Address:—4)7 ft rt -,r t r-/ 1;�� City/State/Zip: oy Phone#: ` 1 � ... Are you an employer?Check the appropriate box: Type of project(required): 1, I am a employer with 4. ® I ani a general contractor incl I have hired the sub-contractors 6 E]New construction employees(full.and/or part-time).* 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q'Remodeling ship and have no employees These sub-contractors have g• ®Demolition working for me in any capacity, employees and have workers' 9. El Building addition. [No workers' corn #p•insurance comp. insurance. required.] 5. ® We are a corporation and its 10.El Electrical repairs or additions 3.® I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [Na workers' camp. 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 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. tContractors 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 jab site information. Insurance Company Name:'- -, , - -- Policy#or Self-ins.Lic.#: mls 61 Expiration Date: l Job Site Address::7% C ,) -T City/State/Zip:' OCX 1r1 Y`JDt)� 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 forin 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 cern under the pains and penalties ofileijury that the information provided above is true and correct Signature: - Date: 44 L Phone#: 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 Pei-son: Phone#: AC"R" DATE(MM/DD/YYYY) CERTIFICATE LIABILITY INSURANCE 03/08/2016 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(les) 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). PRODUCER CONTACT NAME: Trudy Lawler MICHAUD INSURANCE AGENCY PHONE CC,No. t: (978)685-2549 a NO1 ADDRESS: trudylawler@michaudinsurance.com 105 HAVERHILL ST. INSURERS AFFORDING COVERAGE NAIC# METHUEN MA 01844 INSURERA: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B: BRICO BUILDING&REMODELING LLC INSURER C: INSURER D: 417 WAVE RLEY RD INSURER E: NANDOVER MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER: 35806 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSID POLICY NUMBER MM/DD MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ '.. N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JET E LOC - PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ '.. ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ '.... HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB Id CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERSCOMPENSATION �/ PER OH- AND EMPLOYERS'LIABILITY Y/N /� STATUTE ERT '.. ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICERIMEMBEREXCLUDED? I NIAI N/A NIA 7PJUB4618P50715 04/19/2015 04/19/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Herb Lynch ACCORDANCE WITH THE POLICY PROVISIONS. 77 Court St AUTHORIZED REPRESENTATIVE North Andover MA 01845 Daniel M.Croy,CPCU,Vice President-Residual Market-WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AliC [7DATE(MMDDMTI ILIABILITY I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS16 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED T 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). PRODUCER CONTACT Michaud Insurance NAME: Konnie Phifer PHONE , (978) 683-7676 105 Haverhill St FAX N (978) 794-5909 Methuen, MA 01844 aDr ESS: Konniephifer@michaudinsurance.com INSURE S AFFORDING COVERAGE NAIC# INSURED INSURER A:Northland Insurance BRICO Building & Remodeling LL INSURER B: Adam J Brien INSURER C: 417 Waverley Rd INSURER D: N Andover, MA 01845 INSURER E: COVERAGES INSURER F: 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. LTINSR ADDLSUBR LTR TYPE OF INSURANCE POLICY EFF POLICY EXP POU CY NUMBER M/DD/Y MM/DD/YYYY LIMITS A GENERAL LIABILITY WS201172 4/13/15 4/13/16 EACH OCCURRENCE $ 1 000000 X COMMERCIAL GENE RAL LIABILITY DAMAGE TORENT�ED c $ 100 000 CLAIMS-MADE OCCUR -EREMI,9ES We MED EXP(Arryone person) $ 5 000 PERSO NA L&ADV I NJU RY $ 1 000 000 GEN'L AGG REGA TE LIMI TAPP LIES PER GENERAL AGGREGATE $ 2 000 000 '. POLICY PRO- LOC PRODUCTS-COMP/OPAGG $ 2 000 000 AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT' ANYAUTO a accident $ ALLOWPED SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS NON-OWNED BODILY INJURY(Per accident) $ HIRED AUTOS _AUTOS PROPERTY DAMAGE $ er a ccident UMBRELLA LIAB $ OCCUR EXCESS IIAB CLAIMS-MADE EACH OCCURRENCE g : AGGREGATE $ DED RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WCSTATU- OTH- ANY PROPRIETOR/PARTNER/ExECUTNE Y/N OFFICERMEMBER EXCLUDED? 7 N/A E.L.EACH ACCT DEW (Mandatory in NH) $ If es,describeunder E.L.DISEASE-EAETAPLOYEE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY L IM IT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is requi red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Herb Lynch THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 77 Court St ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Konnie Phifer ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: (978) 685-2549 Fax: (978) 258-6953 E-Mail: konniephifer@michaudinsurance.com Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 168512 Type: LLC Expiration: 3/1/2017 Tr# 262853 BRICO BUILDING AND REMODELING LLC ADAM BRIEN — 417 WAVERLY RD NORTH ANDOVER, MA 01845 Update Address and return card.Mark reason for change. SCA 1 G 201VI-05/11 Address Renewal ❑ Employment Lost Card <„.�rr �nrarirrrvrrr,r<rrA/�rr ��cr,�.�rrt`�nrtci'/.a Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 4 OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �Y;Afegistration: 168512 Type: Office of Consumer Affairs and Business Regulation t Expiration: 3/1/2017 LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 BRICO BUILDING AND REMODELING LLC ADAM BRIEN 417 WAVERLY RD 7-7> NORTH ANDOVER,MA 01545 � �- Undersecretary Not valid without signature %Mµ husetta DePaFtm niofk°''Ud,)itl " Mlety Board ()i BIMinn Ra gUi afions and Standzuds �"dn:n�t6'ndri¢e��o �t�lr�:w ienQar` Li ensu, CB-104428 1 ADAM J B;v1„s,gL1V /D 417 WA` FRLSI RSO'AjD ll� North Andover ACA41 , i t :n un:n� :,rkreusn:n 05/12/21116