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HomeMy WebLinkAboutBuilding Permit # 5/23/2016 thORTN BUILDING PERMIT TOWN GP NORTH ANDOVER 0 _ APPLICATION FOR PLAN EXAMINATION Permit NO: / Date Received Date Issued: � "�„ II1tP(JRT'ANT: Applicant must complete all items on this 7age LOCATION 0awe' 1 Print PROPERTY OWNER1)0,V i T w "`66 Print MAP NO PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building -i One family Addition Two or more family I Industrial Alteration No. of units: i Commercial Repair, replacement 1 Assessory Bldg i i Others: Demolition r 1i Other [Septic I I Well [I Floodplain a Wetlands EJ Watershed District 1=1 Water/Sewer C r ,/2 C\ i 1�0 aw4m_J room Identification Please Type or Print Clearly) OWNER: Name: Phone: Address. u A CONTRACTOR Name:Ae�aks hone:' `79-1_ JAQ_-.2030 Address: X2_3 � c�r Supervisor's Construction License: C)"73991 Exp. Date: Home Improvement,License: 12,91 T7 Exp. Date: 11 ARCHITECT/ENGINEER P4I 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 Cot: $ I 5 FEE: $ ".... Check No.: ", a Receipt No.: ]MOTE: Persons contracting wit r unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner mature of contractor, f tkORTH Town of Andover 01 A 5.2,6 to ® �AK � ver, SS' COCP41CMEWIC« 1' P Li \ BOARD OF HEALTH Food/Kitchen Septic System ER TT LD THIS CERTIFIES THATsx& I?" BUILDING INSPECTOR ........ ........................... ...... ............... ... . ...... .. ...... .. ............. ® Foundation has permission to erect .......................... buildings on ... .. .... .. . .... ................ .... ..... ......... % 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough Service ............ ........ ... . .. . . .. ... .. .,m,,,,,,.�................... Final ILDING INSPECTOR GAS INSPECTOR ccupancy Permit Required t® Occupy BuddznRough Display in a Conspicuous Place on the Premises — ® Not RemoveFinal No Lathing r Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Page 1 of 5 ILM mmmmilma Nexus II Carpentry and Construction Design P.O.Box 2823 Woburn,MA 01888 781 760 2031 Fax 978 975 1263 nexuscarpentryAaol.com Contract This is a contract between Nancy and David Phillips of 89 Old Village Lane,North Andover MA 01845 (Hereafter referred to as the"owners") and Nexus II Services (hereafter referred to as "Nexus") dated May 19t'2016. GENERAL SCOPE OF WORK DESCRIP'T'ION WE HEREBY SUBMIT SPECIFICATIONS AND CONTRACT FOR: work as stated below to 1St floor 1/2 bath and laundry Scope of work: General details ® Meet with local building official and apply for permits All work will be in accordance with local building code regulations and will be inspected by local officials prior to continuing with the next phase—Nexus will be responsible for arranging and being available for all inspections ® Nexus will contact"Dig Safe"prior to commencing any excavation work for their clearance ® All work will be coordinated directly between"owners" and Nexus ® Nexus confiims that it is fully licensed, insured and ensures any sub-contractors utilized on this site will have the appropriate insurance coverage ® Nexus will be responsible for the safe storage of all its property and any materials to be used on the site ® Owner is responsible for removal and return of all items of the house in the areas that will be affected and their safe storage prior to our work commencing SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT Page 2 of 5 ® Owner will then be responsible for returning all items to these areas of the home after completion of the scope of work ® Remove and trash into Nexus supplied dumpster all trash associated with this project NOTE: appliances are not allowed to be put in dumpsters without additional costs "owners" are responsible for removal from site Scope of Work—Window project ® Provide an onsite dumpster for the duration of the project ® Demolish and trash the existing 1/2 bath,hallway, closet and rear entry door- all down to studs on the walls and ceilings..........NOTE: SAVE the existing interior entry door and frame to be used in the new layout ® NOTE: existing window to remain in its current location- new trim to be installed ® NOTE: existing baseboard heat to remain in current location-only change is to be new covers ® Furnish and install framing to create new layout to drawing provided (attached) ® Furnish and install framing to close up the existing entry door ® Furnish and install exterior grade plywood with vapor barrier to exterior of framed opening ® Furnish and install plumbing to code and for 1 vanity with sink and faucet, a toilet, a washer and a"gas" dryer NOTE: fixtures and appliances to be supplied by the "owner"NOTE: some pipe work changes in the basement are required and included in this scope of work ® Furnish and install electrics to code inclusive of GFI, 2 x recessed 5" or 6" ceiling cans, 1 wall sconce over vanity(supplied by customer), ceiling vent fan with light on 2 switches and vented to the exterior ® Furnish and install insulation to the two exterior walls ® Furnish and install green board with smooth plaster finish to ceiling and walls ® Install tile, grout, threshold and sealant to the floor only ® Install fixtures, appliances and fittings supplied by the "owner" ® Install existing door and frame into the planned opening ® Furnish and install paint grade trim to the baseboards, door and window only NOTE: trim to match as closely as possible to the existing trim although it will not be a perfect match ® Furnish and paint bathroom walls, ceiling, door and trim ® Furnish and install new baseboard heat covers ONLY ® Furnish and paint the exterior new shingles to blend as closely as possible to the existing shingles ® Furnish and install 2 melamine shelves to the LH side of the existing window -Work not included in this contract —Building department fees —Engineering or architect costs —Permit costs —Unseen conditions SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT Page 3 of 5 Window changes Appliances Customer supplied electrical fixtures - wall sconce x 1 Mirror or medicine cabinet Bathroom toilet, cabinets, handles, countertops,faucet and sink Tile, grout, sealant for grout or Threshold as noted Customer supplied items as noted above Nor any other items not specifically included in the scope of work above. PERMITS "Nexus"will accept responsibility to obtain the necessary building permits. "Nexus"will act as a GC and work in accordance with fair and reasonable practices,and cooperate fully and under the guidance of the "Owners"and authorized parties.Nexus will pass the cost of the permit directly on to the"Owners"once advised by the Building department. Standard Exclusions: Unless specifically included in the "General Scope of Work" section above,this agreement does not include labor or materials for the following work(any Exclusions in this paragraph which have been lined out and initialed by the parties do not apply to this Agreement): Removal and disposal of any materials containing asbestos or any other hazardous material as defined by the EPA. Custom milling of any wood for use in project. Moving"Owners"property around the site. Labor or materials required repairing or replacing any"Owners" - supplied materials. Repair of concealed underground utilities not located on prints or physically staked out by"Owners", which are damaged during construction. Surveying that may be required to establish accurate property boundaries for setback purposes (fences and old stakes may not be located on actual property lines). Final construction cleaning ("Nexus"will leave site in"broom swept" condition). Landscaping and irrigation work of any kind. Temporary sanitation, power, or fencing. Removal of soils under house in order to obtain 18 inches (or code- required height) of clear space between bottom of joists and soil. Removal of filled ground or rock or any other materials not removable by ordinary hand tools (unless heavy equipment is specified in scope of work section above), correction of existing out-of- plumb or out-of-level conditions in existing structure. Correction of concealed substandard framing. Removal and replacement of existing rot or insect infestation. Construction of a continuously level foundation around structure (if lot is sloped more than 6 inches from front to back or side to side, "Nexus" step the foundation in accordance with the slope of the lot). Exact matching of existing finishes. Repair of damage to roadways, sidewalks, or driveways that could occur when construction equipment and vehicles are being used in the normal course of construction. The "Owner" is to enter into contracts for all of the above-mentioned services and provide direct payment to "Nexus"for all of the services we are to provide. "Nexus"will be responsible for removing all components and all construction materials relevant to the "scope of work" in this contract. SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT Page 4 of 5 Dumpsters, trailers and suns "Nexus"will provide as included in the cost of this project, a dumpster for the sole purpose of the removal of trash associated with this project. This dumpster should not be used by any persons for any other waste items or for any purpose outside of the specific use under the scope of work,unless authorization is received from "Nexus". Nexus may have on site for part, or the whole of the project, a trailer containing materials and tools belonging to "Nexus". This trailer will be parked in a position agreed to in coordination with the"Owners" and will be covered under the insurances of"Nexus"at all times. "Nexus"will have on site, a sign, with our contact details, in the event that anyone has a need to contact us directly. Photographs "Nexus" reserves the right to, from time to time,take photographs of the contracted work for use in its general marketing or for production on its web site. At no time will"Nexus" share any personal contact details of the"owner" for any photographs that it may use without seeking authorization from the "owner". Warranties All the components supplied by"Nexus"as part of the original order are covered under the warranty exercised by"Nexus" and supported by the vendors.All labor and materials purchased from other suppliers to achieve completion of contract are warranted(1) one year from completion of the construction. Expiration of this Agreement: This Agreement will expire 30 days after the date at the top of page one of this agreement if not accepted in writing by"Owners" and returned to "Nexus" along with the necessary deposits within that time frame. Changes in the Work: During the course of the project, "Owners"may order changes in the work (both additions and deletions). "Nexus"will determine the cost of these changes and the cost of this additional work will be added to"Nexus"profit and overhead. People Authorized to Sign Change Orders: The following pe _ le are authorized to sign Change Orders: Mark Gotobed or Ged White "Chi f' Nancy or David Phillips SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT Page 5 of 5 Concealed Conditions: This Agreement is based solely on the observations"Nexus"was able to make with the area in its current condition at the time this Agreement was bid. If additional Concealed Conditions are discovered once work has commenced which were not visible at the time this proposal was bid, "Nexus"will stop work and point out these unforeseen Concealed Conditions to"Owners"so that "Owners"and"Nexus"can execute a Change Order for any Additional Work. Schedule of work It is agreed by both parties that this work will be coordinated with the"Owners" and "Nexus"to be undertaken in various stages to avoid complete disruption of the home environment. "Nexus"will give"Owners"no less than 2 days notice prior to arriving on site for commencement of any of the agreed stages of work to allow"Owners"to prepare. "Owners"commits to have sites identified for construction work available for start at the beginning of the scheduled day so as to avoid any unnecessary delays. Contract Cost and Payment Schedule: Total cost of work description and materials included in the proposal(except materials/work stated) - $14,250.00 (Mine thousand eight hundred and twenty dollars and zero cents) PAYMENT SCHEDULE 1st Payment due upon signing this contract TOTAL$4, 750.00 2nd Payment due upon sign off of rough inspections TOTAL$4, 750.00 3rd Payment due upon installation of sheetrock TOTAL$3, 000.00 Final payment due upon completion of scope of work TOTAL $1, 750.00 Amount due upon signing this contract-$4, 750.00 I have read and understand, and I agree to, all the terms and conditions contained in the proposal above. Date...��.. ®...� ... "Nexus"Authorization.............. ..................:........ Date... "Client" Authorization..........{. ......... .............. .. ..... Date............................... "Client"Authorization................................... ................... SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT r rr/,rrr it �, sir/� r rr ell dr / r 1 r r ri/rr'/i�'rr r t rrir r/� The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite I00 Boston,MA 02114-2017 "t www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information ` cuPlease Print Let=_ibly Name (Business/Organization/Individual): iJe S 71ES+�O 1 CGS Address: T. 000)(. 2823 City/State/Zip: O�DUW(\ MA O k?'W Phone#: 1 -760 020 3 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. []Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 F�Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs of additions proprietors with no employees. 12.F1 Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sh&.i1 13.❑Roof repairs "Elrese sub-contractors have employees and have workers'comp.insurance.$ p(� (�` \e 6.F]We area corporation and its officers have exercised their right of'exemption per MGL C. 14.Q Other 152,§1(4),and we have no employees.[No workers'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. #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. I atn crit employer that is providing zvorlcers'cotzrpetzsation irzsurattce for ttzy employees. Beloit,is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: 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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify an z a d penalties of perjury that the information provided above is tare and correct. Signature: Date: .� Phone#• 70 -",760 :2,031 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 Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: q C®g'®® DATE(MM/DD/YYYY) f-1 f! CERTIFICATE OF LIABILITY INSURANCE 5/19/2016 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(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 Lauren Goldman NAME: Cross Insurance-Peabody A/CNNo Ex HOE (978)532-5445 ac No:(978)532-2217 139 Lynnfield Street AIL ADDRESS:lgoldman@crossagency.com INSURERS AFFORDING COVERAGE NAIC# Peabody MA 01960 INSURER A:Western World Ins. Co. INSURED INSURER B:Safety 33618 Nexus II Services LLC INSURER C: P.O. BOX 2823 INSURER D: INSURER E: Woburn MA 01888 INSURER F: COVERAGES CERTIFICATE NUMBER:CL15102253381 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDNYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO A CLAIMS-MADE 1:1 OCCUR PREMISES(Ea occur RENTED ) $ NPP8290737 8/12/2015 8/12/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 '.. GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT [_] LOC PRODUCTS-COMP/OP AGG $ 1,000,000 '.. OTHER: Damage to Rented $ 50,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident B ANY AUTO BODILY INJURY(Per person) $ 500,000 ALL OWNED JX SCHEDULED 3116632 11/10/2015 11/10/2016 BODILY INJURY(Per accident) $ 500,000 AUTOS AUTOPROPERTYDAMAGE $ 100,000 X HIRED AUTOSNON-OWNED AUTOS Per accident Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA -- ',..... (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE David and Nancy Phillips THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 89 Old Village Lane ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Lauren Goldman/MDI ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025omcm) / r, r W, ,, r,„ / ✓ir, ,,, ,, r p /„r, ,.or,,,/ / / /r ,..rrr „, r,,, �/a.,li D/�/ ✓. /i /, / c /... rri..✓ r / -„ // ,, ,r„. /.../ii / � r r/i ! f,. ! !r ..,.... , /r ✓rrr r, r/, r / // /, � / / ,✓ ,r r r / r // rr r r r / / / ._.rri a r /. ,r r o a / ✓ / r /� r� / ✓ / r �. rrr / / / r, as /i r ✓ r. � /,/. /„r, rrr ,, /, / / ✓ � ,,.�r re ,, f/„ a//.,, u;, /i ,�, .G � / / r ,... rr r r a .ter r/, ,.., ,,.. // ✓.r / / ,% /. ,, c ...,,/ ,,, ,,,/, r� ,rr,.,. r/,,,,, ,,, r ,:.r r / ,,.,,, //,/i, %.r.,„, /J,,,, .rr rr// /.. ,.✓� // i/ 1 ,,, i,ri' ,,,,,.;� %/ ,:m.. /% ,r, ,, ,.: r„rri ✓rr, „// e,/... /L rr, _., /�„ ,,//r.. .../�i// ,,,.// a' ,,.. / /. ../,,.rri, r.r r ,. .ri / r r/, /,,, / r. /ii /i„ rri f ,rrr ,� / ,,,;:,r/ :// ,./�/ ri//%r /�i r/ r„/ /,. 1�✓, //i 9„ c / ,r /r, / �./i /r///sr,rr //// >�✓ i iii d/i,�//. r//;�.o r///� /�r; / rr / i/rr, n c/ /i, J/, rr- r, //a rii/ z.., .; rr, / ., �, /Ir j/f! „// //I r /_. / r;; �./� /� /i„ ;//, a,, /� //. ri I /,✓i G, r/% a rrl�� jj/ i rte, ' r i1rrr .it ✓/ l� Office of Consumer Affairs and Business Regulation 10 ' Plaza - Suite 170 km � ri Boston, Massachusetts 0211 ome Improvement Contractor ctor Registration r/ . RetlistraUon. 129177 Type: individual Expiration: 711.9/2017 TO end rd.Mark re �a�on for change. rrs�and return Addr°ems T 1 Renewal i �� Employment rw.�t ratrt Card f7eAre.eAYA'PY //t� 1 r o/✓ r �//nr r, , J � I l'/rr��N�rrr YUYIness Regulationregistration1.irrnsc or valid for individu l use c rnry before the expiration date. rrfeunf return to: aCR t7ftlerof arsrrrer, 0rrs and orsinrss Regulation Typo: rtrrrirkPlaza smite 5170 / Boston,MA 0,r 14i 1 Not s°,ris1 wsllMrnut signature /ia /l ✓ �ijrr r / %/ / 1// / // �/ /I \\\ ;off