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HomeMy WebLinkAboutBuilding Permit # 10/25/2016 BUILDING PERMIT a ,r� 4v I,.aP ,ba o� TOWN OF NORTH ANDOVER ° t 17 APPLICATION FOR PLAN EXAMINATION * Y ea Permit NO: Date Received SSHC HUSEK•�y Date Issued: IMPORTANT: Applicant must complete all items on this eaae LOCATION PROPRTYVIdN6R = Print MAP Nth I'ARCIL BONING DISTRICT HEst�r� District gees nes IVfIat;Ftlr[� �ha� Village �e� ,nn TYPE OF IMPROVEMENT PROPOSED USE " Residential Non- Residential i New Building (One family 1-iAddition 11 Two or more family industrial Alteration No, of units: _ -1 Comm cial Repair, replacement i Assessory Bldg ❑ Ot rs: Z Ce i:i Demolition D Other Septic ❑1lVell Flccdplain C7'Wetland O INatershd Dlsfirict i I�V1�aterfSe►nFer . . . . Str%I 'Re Sk'%V) e__ A:� V)Q t- zx_m-� D U 1.1 Z Identification Please Type or Print Ciearly) OWNER: Name: 1e& 11110_ MEPhone:40 ' Address: OITRACT{]R N rn Done Address Super�lol`s c�nstrtrci®rt Llceltse .. &, ; Home t mpiro�erneTkt �rc�nse T j4 ARCHITECT/ENGINEER �A hone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.000PPER '$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $��✓ LJ —FEE: $ Check No.: i` -- Receipt No.: 3 NOTE: Persons contracting with unre listened contractors do not have access to the guar my fund Signature aen w, Ignature ofi contract own , of :, 6 ndover 0 f _ No. 17 * - h ver, Mass, /QZ:F W 16 COCNICNEWOCK V S U BOARD OF HEALTH Food/Kitchen PERMIT . D Septic System THIS CERTIFIES THAT ...... . ,r.J10. ..................................... .. BUILDING INSPECTOR has permission to erect ................ .. buildin s?on ....uu.....��!v. w ..,�. :7 . . ...5 Foundation . Rough to be occupied as 0000 l 00,00. .. .......................... Chimney provided that the person accepting this p rmi shall very 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES 16 MONTHS ELECTRICAL INSPECTOR UNLESS CONST IO Rough Service ...... ............... 04. ..00,... 0000. Fina] BUILDING PECT R GAS INSPECTOR OccupancE Permit Required to Occupy BuRough - 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. Burner Street No. Smoke Det. Page 1 of 2 CONTRACT TERMS AND REQUIRED NOTICES Notice: All home improvement contractors and subcontractors engaged in tE 1 home improvement Contracting,unless specifically exempt from registration by the provisions of Chapter 1 42A of the general laws,most be registered with the Commonwealth of Massachusetts. Inquiries about registration and ��f1lJ1,-Ie 1lw of Aw, status should be made to the director,Home Improvement Contractor Registration,One Ashburton Place,Room 1301,Boston,MA 02108. 400 West Cummings Park, Suite 1725, Woburn, MA 01801 888-49BUDGET• Fax X978) 299-0218 • budget-exteriors.com I/We hereby agree and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the specifications,terms and conditions,on the premises below described which IMIe represent that we have good record title in our own name. Owners Name: William Baker Home Phone 407-435-1996 Work Phone Email billiambaker@gmaii.com Job Site Address 152 Andover By Pass St N Andover MA 01845 Massachusetts Contractor Registration #161932 Work Specifications described attached on pages of. Permits: The contractor agrees to apply for and obtain all construction related permits(buildinglelectricallplumbing)but shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting,or inspection agencies,authorities or individuals. Notice: The homeowner who secures his own permits will be excluded from the guarantee fund of MGL Chapter 142A. Price:The contractor agrees to do all work described by the contract for the total price of $8,280.00 Notice: No agreement for home improvement contracting work shall require a down payment(advance deposit)of no more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must,in advance,to order and for otherwise obtain delivery of special order materials and equipment,whichever is greater. Payment Terms: Advanced Deposit $2,760.00 Payable on signing of contract Interim Payment 1 $4760 nn Payable at start. Halfway Payment Halfway through project. Final Balance $2,760.00 Payable on completion unless otherwise specified. Work Schedule: The contractor will not begin work or order material before the third day following the signing of this agreement unless specified in writing. The contractor will begin work on or about . Furring delays caused by circumstances beyond the contractor's control,the work will he substantially completed on or about The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the contractor shall not be considered as violations of this agreement. The contractor shall not be liable for any delay or non-performance caused by strikes, accidents,weather or any other contingency beyond its control. Insurance: The contractor agrees to maintain workers compensation and comprehensive general liability insurance during the operation of this job to cover the acts of its employees and or agents. Warranties: The contractor warranties its workmanship for up to a period of 7(seven)years and assigns the rights to any manufacturer's warranties to the homeowner after substantial completion and payment of the contract terms. You may cancel this agreement if it has not been consummated by a party thereto at a place other than an address of the contractor,which may be his main office or a branch thereof,provided you notify contractor in writing at his main office or branch by ordinary mail posted,by telegram sent or delivered,not later than Midnight of the third business day following the signing of this agreement.The instrument and any and all other documents attached hereto and signed by the parties set forth the entire contract between parties and may be modified only by written instrument executed by both parties.Receipt of a copy of this contract and duplicate notice of cancellation and explanation thereof is hereby acknowledged. Notice: Cancellation of this agreement after three business days will result in a restocking fee of up to 33%on custom products and 25%on non- custom order products. HOMEOWNER: Do not sign this contract if there are any blank spaces. IN WITNESS WHEREOF, the parties hereutito signed their ames on 10/19/2016 k Budget Exteriors, Inc. Rep. HomeownerL� s.-.,.. Accepted Budget Exteriors, Inc. Homeowner Page 2 of 2 Owners Name: William Baker r t <.�i��ali�i� ��1��f���;a�� r�/'`��i��rl for fc�:�7�• 354 Merrimack Street (Entry C, Suite 500) • Lawrence, MA 01840 Work Summary 888-49BUDGET• Fax (781) 333-5240 • budget-exteriors.com We hereby propose to furnish and perform the labor necessary to: • Drape outer wail of house with tarp to prevent damage to house and adjacent landscaping from falling debris • Strip and dispose of all roofing material down to roof boards of which the first two layers are free then only 35¢ per square foot for each additional layer • Provide a comprehensive inspection of deck to include replacing damaged lumber, of which up to 64 square feet of plywood or 64 linear feet of roof boards will be replaced free of charge. Additional square feet/linear feet is $3.00. • Inspect and replace damaged step flashing, where needed. • Install 8" white drip edge on all edges of roof • Install Cobra style ridge vent at peak of home • Install Bitumen self-adhering high temperature ice shield 6' up from bottom edge of roof, 3' in valleys, and around all protrusions • Install synthetic underlayment where no ice and water shield is installed • Install GAF Pro-Starter Starker Strip Shingles and GAF Timbertex Hip and Ridge Cap Shingles • Replace all pipe boots • Storm nail (6 nails) all roofing shingles • All manufacturers product warranties will be provided to homeowner at job completion • Budget Exteriors will obtain all permits and shall be reimbursed by customer for cost of permits and/or any city fees • All workmanship guaranteed by Budget Exteriors for 7 years • Project does not include any outbuildings • Project does not include the garage Remove dome vents and replace decking USE GAF AMERCAN HARVEST For Low and Steep Roofs Only Roof Color Nantucket Edge Metal Color White The Commonwealth of Massachusetts x Department of.Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 b 4 www.nruss.gov/rlia NVorkers'Compensation Insurance Affidavit, Builders/Contractors/Electricians/Plumbers. TO BE FILED VVITH'I'HE PERMITTING AUTIIORITY. Applicant Information Please Print Legibly Nalne (Bnsi€tess/Organization/Individttal): Budget Exteriors/CIO Lou Milano Address: 354 Merrimack Street ( Entry C, Suite 500 ) City/State/Zip; Lawrence, MA 01840 Phone #: Home/Fax:860-315-5266 Cell:860-753-0452 Are you an employer?Cheelc the appropriate box: Type of project(required): 1.r7j I am a employer+vitlt -,10 employees(full and/or part-time).* 7. ❑ New construction 2❑lam a sole proprietor or partnership and have no employees working for me in S. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑ DC[nt3lltlon 3.❑I ant a homeowner doing all work myself[No workers'comp.insurance required.]' 14 E] Building addition 4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. l will ensure that all contractors either have workers'compensation insurance orate sole I LP Electrical repairs of additions proprietors with no employees. 12,❑Plumbing repairs or additions 5. am a general d I hhid the bttlisted the allached s contractor and hired su -conracors steoheet. ❑l11M Roof repairs '1'hesc stab-contractors have employees and have+vorkers'comp-insurance., H. Other 6.❑We are a corporation and its onicers have exercised their right of exemption per MGI,c. 152,$l(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box N 1 must also fill out the section belo+v shoving their workers'compensation policy inrormation. V I lomeo+vtters who sub€nit this affidavit indicating they are doing all work and then hire outside contractors m€€st submit a new affidavit indicating such. :'Contractors that check this box inust attached an additional sheet showing the name ol•the sub-contractors attd state whether or not those entities have employees. 1111le sub-contractors have employees,they must provide their workers'comp.police'number. I ani an enrplaVer that is providing wor•lfers'compensation insurancefor n(V errrplt vees. Below is the polish and job site information. Atlantic Charter Insurance Co. 1 781-593-1200 Insurance Company Name:_ Policy#or Self-ins. l ic. #: CBC20000017401 Expiration Date: 07/31/2017 7 j� dr }► OI Job Site Address: e L 1 �'j� �1-� fit City/State/ZiAnZw5p M A V49 Attaeh a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tender MGI,c. 152, §25A is a criminal violation punishable by a fine tip to$1,500.00 8 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 D[A for insurance j coverage verification. I do hereby ce• 'y ides ter ams acrd p wallies o perju :l'that the irrforrr:atiorr prov/i€died above is trite and correct. 5igitat _ - — - —Date G 1/-Zd 14; -_..-- Phone#: Home 1 Fax : 860-315-5266 Cell : 60-753-0452 Official use orrlp. Da trot write in this area,to be completer/by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.Cityl"I'own Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone#: RESET FORM DATE(MMIDDIYYYY) ARS CERTIFICATE OF LIABILITY INSURANCE 0712812.016 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 have ADDITIONAL INSURED provisions or be endorsed- If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on °2 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). a PRODUCER CONTACT 'p Aon Risk Services Central, Inc, -NAME: PHON -- �.-._..._._.�. FAX Chicago It Office (PJG.No.Cxsl: (866) 263--7121. (AIC.Nn.): (800) 363-OIDS D 200 Fast Randolph E-MAIL- p Chicago Il- 60601 USA ADDRESS: T INSURER(S)AFFORDING COVERAGE NAIC H INSURED INSURER A: mmACE American Insurance Company 22667 Sears Holdings Corporation INSURER 13: ACE Fire Underwriters Insurance Co. 20702 dba Sears Home Improvement PradOtts, Inc Attn: Risk Management E3-219A INSURER C: 3333 Reverly Road - INSURER O: Hoffman Estates IL 60179 USA — INSURER F: INSURER F: COVERAGES CERTIFICATE NUMBER:570063208310 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 REC]UIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS GERTIFICAIE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE[)HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested 1XP i: LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDnfYYYY MEMIODIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG 8 3 08 01 2016 08 Ol 2017 EACHocCURRENCE 35,OU0,000 CLAIMS-MADE 1XI OCCUR E TED $5,000,000 PREMISES EaNTEDnee MED EXP(Any one person) Excluded PERSONAL 8 ADV INJURY SS,000,000 GENT.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S5,606,6-00 X POLICY 1 I LOC PRODSICTS-COMPIOP AGG SS,OOO,OOO _ n OTHER: r- A AUTOMOSiLE LIABILITY ISA 1109O4419A 08/01/2016 08/01/2017 COMBINED SINGLE LIMIT $5000,000 m A ISA 1109044188 08/01/2016 08/01/2017_(Ea ace �_ m A ANY AUTO ISA H09044176 08/01/2016 00/01/2017 BODILY INJURY(Per person) X OWNED SCHEDULED RODILY INJURY(Per accident) AUTOS ONLY AUTOS u HIWA)AUTDS NON-OWNED PROPERTY DAMAGE f0 X XPeraceidepi = _ ONLY AUTOS ONLY - ba 411111'RE�-LIAR OCCUR EACH OCCURRENCEBCLAIMS-MADE AGGREGATE ETENTION A WORKERS COMPENSATION AND wCUC486092S9 08/01/2016 08/01/2.017X s7ATUTE I IOl EMPLOYERS'LIABILITY Y1N OH, WA, 4W - ANY PROPRIETOR I PARTNER 1 EXECUTIVE F.L.EACH ACCIDENT 12,000,000 A OFFICER10.tEAluERExcLu0ED9 NIA WLRC48609247 08/01/2016 08/01/2017 __ (Mandatory inNHl All Other States E.L.OisEASE-EA EMPLOYEE $2,000,000 If yes, Oe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S2,000,000 D CESCRIP TION 01:OPERATIONS I LOCATIONS I 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 THE EXPIRATION DATE THEREOF, NOTICE. WILL BE DFLIVEREO IN ACCORDANCE WITH THE POLICY PROVISIONS. Ci ty of North Andover AUTHORIZED REPRESENTATIVE -�y�- 1600 Osgood street sem. North Andover MA 01845 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD s d 6 e d s Office oI C,onsuicr Affairs a d Busincss Re( tion � 10 Park Plaza - Suite 5 I70 Boston, Massachusetts 02116 Home Its proWcmen.t.C:ontrac;tor Registration � Registration: 177704 Type: Supplement Card BUDGET EXTERIORS Expiration: 211/2018 1 LUBOS SVEG 354 MERRIMACK ST ENTRY C LAWRENCE, MA 01840 tlptlate,Address and return cart!.\"lark reams for change. Address '- Rmcsval Lost Card `=OH'Ice n,0)[18rr€ncr Arrair's c'K 011%ill"'i iicgulaliorr L,iccnsc or rc�fistrafloll valid f€3a'individold use only j l{ }MP IMPROVEMENT CONTRACTOR txfurc the expiration(elate.. if fnuncl returnlo'. QI'fice o€Consruner:Affairs and Businem liegutatiott Registration. 177.704 Type: l©Pi -h Plaza-Suite 5170 Expiration: 2/112018 Supplernent Card Boston,NTA 02116 t=UD SET EXTE=RIORS I p LUBOS SV€_.C: 354 MERRIMACK ST ENTRY G v i.AVvtP! NCL,MA 81840y [inrler•�cr r etur�' Vot z°rllirl«*ifltont sil;�tlifCCTe--- e t s i Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-097519 Cons[ructic?n yUpervi:;or LUBOS SVEG 827 THOMPSON ROAD . THOMPSON CT 06277 CA— Expiration: Commissioner 08/31/2018 I