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HomeMy WebLinkAboutBuilding Permit # 5/25/2016 .. ............................................................................. BUILDING PERMIT OORTH TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Date Received Permit Nae � ) ') �—�';� ived Date Issued: � IM#ORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER w AG cn 1QA S Print 100 Year Structure yesno MAP PARCELOJ�6 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE .,"Residential Non- Residential ❑ New Building �`S One family El Addition El Two or more family El Industrial El Alteration No. of units: 11 Commercial -'� Repair, replacement El Assessory Bldg U Others: El Demolition U Other DESCRIPTION OF WORK TO BE PERFORMED: ell Identification- Please Type or Print Clearly OWNER: Name: Phone: Address:--J-�fj i�)T ["1(,5 R"cl, Contractor Name: U 1kqL,6(I Phone: 1,2 1 Email: C��wi(:�k- a rJ f, cl>(0 vl�"N Address: Supervisor's Construction License: S-. I D, .8 Exp. Date: `21 11 I Home Improvement License: :D Exp. Date: 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: $ )1.() , Do� FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with un a istered co tractors do not have access to the c� rat d rnn .... tbr/ Siq, hatur-e-, .. PtOre'�of`. (-,7 U Vf Vf U FORTH Town ofIAndover Ver' MaSS' COC MICMl WIC. 4ATED #I? U BOARD OF HEALTH Food/Kitchen PER IT T LD Septic System THIS CERTIFIES THAT ....... BUILDING INSPECTOR . ..... ... ........ ...... ... .. . ..... .... .... . ........ ..................... ........ has permission to erect g ,. . .ara. Foundation ....... ................. buildin son ... ...... ....... . ......A ............ ... Rough to be occupied as ... r. ..a . .. ...... ..... .. ......... ... ........... ... ... ... .. ... .............................. 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 UNLESS CONSTRUCTIO S ARTS Rough ,�� Service ...............1....... . .. .. .. ............................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Bu Rough Display a Conspicuous Place on the Premises — Do Not RemoveFinal No Lathing r Dry Wall To Be one FIRE DEPARTMENT Until S ec a and Approvedthe Building Inspector. Burner Street No. Smoke Det. 'SPS Proposal for Services (PFS) Project: 109 Brentwood Circle 109 Brentwood Circle North Andover, ISA 01845 Prepared For: Denis Dragonas 109 Brentwood Circle North Andover, MA 01845 Prepared By: Chuck Huntley Schernecker Property Services, Inc. 283 Second Ave, Waltham, MA 02451 (781) 487-2516 chuck.huntley@spsinconline.com www.spsinconline.com SPS HIC #: 123615 Expiration Date: November 5, 2015 Date Submitted: August 27, 2015 Proposal #: 5440987 109 Brentwood Circle 109 Brentwood Circle I Proposal#:5440987 Scope of Work General Description: SPS,Inc.will provide the necessary supervision,labor,and materials to perform the work specified in this PFS in a good and workmanlike manner and in compliance with applicable laws and codes. The pricing provided in this PFS encompasses, in general,the following: Misc. Repairs at 109 Brentwood Circle in North Andover,MA. Included Areas: ',q ® Pressure wash with bleach/water to remove mildew, surface dirt, and dust to provide a clean surface for paint adhesion. ® Furnish and Install(19)Harvey Building Products "Majesty" Double Hung Vinyl Replacement windows with Clear Pine Wood Interior/White Clad Exterior,LowE/Argon,Simulated Divided Lites and Half Screens. ® Exterior Staining-Power wash to remove dirt,debris and mildew. Scrape to remove loose and peeling stain and spot prime bare wood with an alkyd Stain. Apply(2)Full finish coats of 100% Semi Transparent Alkyd Stain by Cabot to the exterior of the Home. Prep and Paint all Exterior Doors with 100%Acrylic Latex Paint by Cabot. This includes staining mailbox Stand. ® Spot Carpentry Replacement-Replace rotted Clapboards, Corner Boards,Storm Door Gasket at Breezeway,Front Door Trim Moldings,Lattice Repairs,Broken Deck Boards,Rear Garage Door . Gasket,Any Gutter Damage,Replacement of Woodpecker damaged T&G Siding and necessary repairs to Cupola. ® Re-Flash Rear Study at 2nd floor to Main House. ® Clean all Roof Shingles ® Clean All Gutters and Downspouts,Replace cracked and broken downspouts,Tar inside Gutters and fix gutter supports where necessary. ® Seal Chimney and Fix Rot at House Transition ® Install Gutter screens on all gutters. ® Furnish and Install new Shutters on(4)Front windows of main house only. ® Strip Breezeway roof,Install full Ice and Water coverage and flash roof to house transition properly and install new roof shingles. (6 feet up and 20 feet long-Total area= 1.2 squares) ® Repair Rear Spigot Leak ® Remove and Replace(2)Garage Doors with"Thermacore" Sectional Doors as manufactured by the Overhead Door Corporation(Doors only,existing motors will stay). ® Remove Weathervane from Garage Cupola,Transport to Don's Brass and Copper Polishing,Have it re-finished,Transport back to 109 Brentwood Circle and Re-Install(Allownace only until Don can see the weathervane). ® Stain(19)Interior Windows to match existing Interior Decor. Excluded Areas: ® All other requests Total Price for work as specified in the Scope of Work: $33,000.00 Additional Items, Alternate Items and Unit Prices Schemecker Property Services 1 283 Second Avenue,Waltham MA 02451 800.424.2468 1 spsinconline.com Page 2 of 8 109 Brentwood Circle 109 Brentwood Circle I Proposal#:5440987 Pricing provided on Page 5 is for specific items not included in the contracted Scope of Work. Please note that these items are additional to the"Total Price". Schedule of Work (determined at proposal signing)The work heretofore described is scheduled to commence on with an expected duration of approximately days. Substantial completion is expected by Acceptance of Proposal The undersigned,as authorized representative(s)of the property listed,have read the terms stated herein and accept the terms as written. 08/27/15 ' rir l evc,C j SIGNATURE DATE SIGITATURE DATE Chuck Huntl Vice President Denis Dragonas NAME TrrLE NAME T1TLE Schernecker Property Services 1 283 Second Avenue,Waltham MA 02451 1 800.424.2468 1 spsinconline.com Page 3 of 8 109 Brentwood Circle 109 Brentwood Circle I Proposalt 5440987 �rotal Price for work as specified in. the Scope of Worm Type of Price/Type Item Description Quantity Quantity of Quantity Extended Price 1. Furnish and Install(19)Harvey Building Products 1.00 Entire House $16,205.00 $16,205.00 "Majesty" Double Hung Vinyl Replacement windows with Clear Pine Wood Interior/White Clad Exterior, LowE/Argon, Simulated Divided Lites and Half Screens. 2. Exterior Staining-Power wash to remove dirt,debris 1.00 Entire House $5,900.00 $5,900.00 and mildew. Scrape to remove loose and peeling stain and spot prime bare wood with an alkyd Stain, Apply (2)Full finish coats of 100%Semi Transparent Alkyd Stain by Cabot to the exterior of the Home. Prep and Paint all Exterior Doors with 100%Acrylic Latex Paint by Cabot. This includes staining mailbox and Stand. 3. Spot Carpentry Replacement-Replace rotted 1.00 Entire House $3,500.00 $3,500.00 Clapboards,Corner Boards,Storm Door Gasket at Breezeway,Front Door Trim Moldings,Lattice Repairs,Broken Deck Boards,Rear Garage Door Gasket,Any Gutter Damage,Replacement of Woodpecker damaged T&G Siding and necessary repairs to Cupola. 4. Re-Flash Rear Study at 2nd floor to Main House. 1.000ne Location $750.00 $750.00 5. Clean all Roof Shingles 1.00 Entire House $300.00 $300.00 6. Clean All Gutters and Downspouts,Replace cracked 1.00 Entire House $500.00 $500.00 and broken downspouts,Tar inside Gutters and fix gutter supports where necessary. 7. Seal Chimney and Fix Rot at House Transition 1.00 Chimney $425.00 $425.00 8. Install Gutter screens on all gutters. 1.00 Gutters $375.00 $375.00 9. Furnish and Install new Shutters on(4)Front 1.00 Shutters $600.00 $600.00 windows of main house only. 10. Strip Breezeway roof,Install full Ice and Water 1.00 Breezeway $1,325.00 $1,325.00 coverage and flash roof to house transition properly Roof Schernecker Property Services 1 283 Second Avenue,Waltham MA 024511800.424.24681 spsinconline.com Page 4 of 8 109 Brentwood Circle 109 Brentwood Circle I Proposalt 5440987 and install new roof shingles. (6 feet up and 20 feet long-Total area= 1.2 squares) 11. Repair Rear Spigot Leak 1.00 Spigot Leak $50.00 $50.00 12. Remove and Replace(2)Garage Doors with 1.00 Garage $2,385.00 $2,385.00 "Thermacore" Sectional Doors as manufactured by Doors the Overhead Door Corporation(Doors only, existing motors will stay). 13. Remove Weathervane from Garage Cupola,Transport 1.00 Refinish $250.00 $250.00 to Don's Brass and Copper Polishing, Have it re- finished,Transport back to 109 Brentwood Circle and Re-Install(Allownace only until Don can see the weathervane). 14. Stain(19)Interior Windows to match existing Interior 1.00 Stain $1,045.00 $1,045.00 Decor. 15. REPEAVL,OYAL CUSTOMER DISCOUNT 1.00 DISCOUNT ($610.00) ($610.00) 'Total: $33,000.00 Additional Items, Alternate Items and Unit Prices Type of Price/Type Item Description Quantity Quantity of Quantity Extended Price There are no additional or alternate items to note. Schernecker Property Services 1 283 Second Avenue,Waltham MA 02451 1 800.424.2468 1 spsinconline.com Page 5 of 8 The Commonwealth of Massachusetts F .Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,lY14 02114-2017 www.rnass.goh/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE TILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/fndividnal):��p Address: ��� �' /�� o� City/State/Zip: rr`1 Phone#: Are you an employer?Che k, appzopriatebox: Type of project()requir'ed): 1. I am a employer with__LD! employees(full and/or part-time).' 7• Q New construction I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] El Demolition 3.F1 I am a homeowner doing all work myself.[No workers'comp..insurance required.]t 9. 10 []Building addition 4.❑I am a homeowner and will be hiring contractors to c onduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the atfached sheet. I . oof rep airs These sub-contractors have employees and have workers'comp.insurance.t ) 6.Q We are a corporation and ifs,offtcera have exercised their right of exemption per MGL c. 14. Other �b Q 152,§1(4),and wo have no employees.[No workers'comp.insurance required.] ALJ r; *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T homeowners who submif this affidavit indicating they are doing all work and then hire outside contractors niust submit a new affidavit indicating such. 1Contractors that check this box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have empluy ees. Ifthe sub-contractors fiave employees,they,must provide their workers'axnp.policy number. lam" an employer•that is pi ovidiizg ivoi kers'compensation insurance for my mployees.'Below is the policy and job site information. rr Insurance Company Name: J Policy#or S elf-ins,Lie.#: Expiration Date:_ lob Site Address: d ���� City/State/Zip: IV'' UY�V� Attach a copy of the_-wor(ers ocmpensation 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 WORD 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 DTA for insurance coverage verification. X do hereby certy and 'the pains nd lties ofperjury tleat the iiiformationprovided a ove is toe and correct. Si afore: Date Phone#• wl'z7 — - Official use only. Do not write in this area,to he 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#: Client#: 1025557 SCHERPRO ACORDDATE(MM/DD/YYYY) rra CERTIFICATE5/19/2016 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(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 Kathy Wagner USI Insurance Solutions, LLC PHONE 413 750 4222 F 610 537 9481 AIC,No Ext): AIC,No: 123 Interstate Drive E-MAIL ADDRESS: Kathyag Wner usi.biz West Springfield, MA 01089-3600 INSURER(S)AFFORDING COVERAGE NAIC# 855 874-0123 INSURERA:ABC Mass Workers Comp Self-Insu 99999 .INSURED INSURER B: Schernecker Property Services, INSURER C: 283 Second Avenue INSURER D: Waltham, MA 02451 INSURER E 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 CONTRACTOR 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 INSR WVD POLICY NUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES Ea occuence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- PRODUCTS-COMP/OP AGG $ POLICY D JECT LOC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION ABCMA12000116 01/01/2016 01/01/201 X PER ETH- TUTE AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE VIN N E.L.EACH ACCIDENT 0,000,000 OFFICER/MEMBER EXCLUDED? LN N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Massachusetts Workers Compensation Coverage CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S17877327/M17054616 PZTZP �� ® DATE(MM/DD/YYYY) CERTIFICATE LIABILITY INSURANCE 5/18/2016 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 Claire Boutilier NAME: HONE Cleary Insurance Inc AIC.No_ o Ext: (617)723-0700 FAX No: (617)723-7275 226 Causeway Street AIL ADDRESS:cboutilier@clearyinsurance.com INSURERS AFFORDING COVERAGE NAIC# Boston MA 02114-2155 INSURERA:Continental Western Insurance 10804 INSURED INSURER B:Acadia Insurance Company 31325 Schernecker Property Services, Inc. INSURER C: 283 Second Avenue INSURER D: INSURER E: Waltham MA 02451 INSURER F: COVERAGES CERTIFICATE NUMBER:2015-16 Liability 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 XP LTR TYPE OF INSURANCE ADDD SUED POLICY NUMBER MM/DD/NYY POLICY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS MADE1XI OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ CPA 0183614-19 12/31/2015 12/31/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS IAUTOS MAA 0163615-19 12/31/2015 12/31/2016 BODILY INJURY(Per accident) $ X NON-OWNED PROPERTY DAMAGE $HIRED AUTOSAUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ CUA 0183616-19 12/31/2015 12/31/2016 $ WORKERS COMPENSATION X PER 0TH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? B N I A (Mandatory in NH) WCA 5074780-13 12/31/2015 12/31/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under Excludes LAA DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Town of North Andover is included as an additional insured for general liability per insurance coverage form CLCG0492 (02/12) when required by written contract. 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 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE John Bernardin/CTB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025/9m4nn u r e of Consumer Affairs&Business Regulation j E IMPROVEMENT CONTRACTOR ,registration: 123615 Type: -'� Expiration; 3/14/2017 Supplement Cs-, Schernecker Property Services, Inc. CHUCK HUNTLEY 283 Second Avenue Waltham, MA 02451 Undersecretary Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-081428 ' Construction Supervisor CHARLES E HUNTLEY Jk,: 25 HEARD DRIVEx r ''��'°J �'' IPSWICH MA 01938 E � �.. CA-- Expiration: Commissioner 07/28/2017