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HomeMy WebLinkAboutBuilding Permit #396 - 148 MAIN STREET 11/13/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION i 'A 13-0� Permit NO: Date Received � Date Issued: 00 �9SSAGHUSE��� IMP pORTANT: Applicant must complete all items on this age LOCATION �p �/��N Print PROPERTY OWNER Print MAP NO.: PARCEL: ZONING DISTRICT: i TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ A ration No. of units: epair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED m A2e.4 /tee <&J &4aJ Identification Please Type or Print Clearly) OWNER: Name: 5z�,-VAA, / 0,&,/ -Iaone: v Address: &Al"j CONTRACTOR Name: /��—/� �l�StG� Phone: Address: 4& Supervisor's Construction Li ense: 60 Exp. Date: T 16 �a Home Improvement License: /3(p 94 3 Exp. Date: 2—lo D ARCHITECT/ENGINEER ✓r��d�IY� Name: Phone: Address: �o�( A gflA) eg. No. FEE SCHEDULE:BULDING P T.•$1 0 PER$ 000.00 OF THE TOTAL ESTIMATE COST BASED ON$125.00 PER S.F. Total Project Cost S 9 FEE:$ 1 .� 14 �. Check No.: Receipt No.: Page Iof'4 TYPE OF SEWERAGE DISPOS Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public Sewer ❑ Tobacco Sales Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to proj ect NOTE: Persons contracting with unregistered contractors do not have access to the guaran f Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ St a ed Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ e ` COMMENTS a FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 C ,I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits i ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of HJ.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 Location/4C No. �� Date TOWN OF NORTH ANDOVEd F 9 Certificate of Occupancy $ s'•�� E<� Building/Frame Permit Fee $ 31CHUs Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �Q 19800 ._ Building Inspector NORTH Town of tAndover No. 3 �� s = = dover, Mass., • 2O COCMICMEWICK / V � RATED PPG �� S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...yo#vv..... ... I'1.............6A.................. !►................................................... Foundation has permission to e ........................................ buildings on....844........ /. ....$.l..................................... Rough ...........t0 be Occupied 8s ...��. ....��'...,��t�'.+.�"o.ir....d�n0�ta.....+�........Ace Chimney Ch' e provided that the person accepting this permit shall in every respect conform to the terms of the pplication on file in Final 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU TS Rough ... .... . ................. . ..................................... Service BUI SPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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 Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. The Conmtonwealth of Alassaehusetts Department of Industrial:Iccidents Office of investigations 1 600 Washington Street Boston, ,J14 02111 www.mass.gov/dia Workers' Compensation insurance affidavit: Builders/Contractors/Electricians/Plumbers ,kpplicant Information Please Print Legibly Name tl�usincss;(hganiialitmi ul vidual); //� .� e�' J��•" address: 1ILq -- -_— City;State;Zip: y /�" Phone ' 6�� 7�� y F u an employer?Check the appropriate box: Type of project(required): am a em to er with �4. ❑ 1 am a general contractor and p y �— 6. ❑ New construction mployees(full and'or part-tune).* have hired the sub-contractorsam a sole proprietor or partner- listed on the attached sheet. = ❑ Remodeling ship and have no employees These sub-contractors have 3. ❑ Demolition working for me in any capacity. workers' comp. insurance. y• ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof r° airs insurance required.] t employees. [No workers' 13.El Other � '�'K' comp. insurance required.] \ny applicant that checks box r1I must also fill out the section below showing their workers'compensation policy information. +I lomeowners 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 soh-contractors and their workers'comp.policy information. /am tin employer that is providing workers'compensation insurance Jim my employees. Below is the policy and job site inf wination. Insurance Company Name: _ S_ ----- --- ----- Policy 't or Self-ins. Lic. .41 _`S/ — —__ Expiration Date:__ lob Site Address: 1799 ��1� y/ City State'Zip:�f1�/�J!/�iL 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%IGL c. 152 can lead to the imposition of criminal penalties of a Fine up to S 1,500.00 and/or one-,year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine Of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of lnvestigations of the DLA for insurance coverage verification. I do hereby certijy r e pains d p oj*perjury that the in/armation provided above A trite and correct. I <Yjic•iul use only. I?o not tor'ite in this arca, to be .vrmpleted hp•el'0-nr town o1jiicial. City or Town: Permit/License# Issuing,Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk T. Vectrical tAtspector i. Plumbing Inspector 6.Other Contact P^_r>alvt: __--.– ----_— Phone#: i - - Gf'!ie �oainnco�wraa�,l,J� a�,./�oaa�u�aella t BOARD OF BUILDING REGULATIONS • License: CONSTRUCTION SUPERVISOR Number.'CS' 074731,0 Blrtl4a6k CW16A955 , zplr9s3�1Q07 Tr.no: 10643 + RestNeted. 00 MICHAEL F CURLEY 1 HOLLY LANE 01834. /J GROVELAND, Commissioner 11/13/2006 10:39 FAX 978 462 4434 CHASE & LUNT 1&02/002 A ORD„ CERTIFICATE OF LIABILITY INSURANCEOP ID CIRCL-3 11/23/06 PRODUCER THIS CERTIFICATE IS ISSUED A MATTER OF INFORMATION Chase E Lunt ins. Agency Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFI f.ATE P O Box 590 HOLDER THIS CERTIFICATE ES NOT AMEN,EXTEND OR 47 State Street ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. Newburyport MA 01950 Phone- 978_462-4434 Fax:976- 65-6204 INSURERS AFFORDING COVER GE I MAIC 0 INSURED NSU MRA.' Safe I -ae Cmpany 39454 INSURER& Penn america!Insurance Co. Circl CyConstructiori INSURER C: Guard Insurance GrRM Gravellnd M� 01833 INSURER a INSURER E' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEeN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTMTHSTANDNG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VIHICH THIS CERTFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLVES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,01CLUSION3 AND COJIOR10N8 OF SUCH POLICIES.AGGREGATE LMIS SHOWN MAY HAVE BE REDUCED BY PAD CLAMS. POLICY NUMBER 1E Ulm TYPE OF I LTR tIENERAL LUIBBJTY OCCURRENCE is1- 000000 B X COMMERCVLLGENERALUABILITY PXC6576310 05/17/06 05/17/07ISE$w-opmwam* $300000 CLAMS MADE E OCCUR M*D EXP wy ow Pa) $000 PkRSONAL&ADVNJURY $1000000 NM6ERALAGGREGATE $2060000 0E141 AGGREGATE LMR APPLES PER: PRDoms-COMP/OP AGG $20 00000 PoucY ,M'T LOC AUTOMOBLE UMUTfI CpIAB NED SINGLE LIMIT $ A ANY AUTO 3116419 04/04/06 04/04/07 I0"O0e'") ALL OVINEDAUTOS LYNJURY $300000 X SCHEDULED AUTOS (' ) X HmmAvros I $300000 X NON-OWNED AUTOS =rMAGE $.300000 GARAWLMI BJTI AAROONLY-EAACCIDENT $ ANYAUTO L�TMER7IVW EA ACC $ AUiOONLY.. AGG s EXCESMU RELLA LIABILITY EACH OCCURRENCE $ OCCUR 0 CLAMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION S $ WOmERSCOMPIMSATIONAND I X TORYLMRS ER C EYPLOYERS'LIABLTTY CiI4C624250 02/08/06 02/08/07 O.L.EACH ACCIDENT x500000 ANT PROPRIETORIPARTNERIEXECUTNE oFFlCEILI AEMBER EJLCLLR B.L.OI EASE-EA EMPLO N 500000 "V",SPECI�m"s DISEASE-POLI;YLMIT 1500000 OTHER DESCWPTION of OMMJWNSJ LOCATNM S I VDNCLEDI EXCUg M AUDED BY ENDORSEMENT I MUNAL PRON$WN$ Re: Sutton Pond Condoniniuosa. CERTIFICATE HOLDER CANCELLATION ,lrROANW $MOULD ANY OF THE ABOVE MSM POUCWS ME CANCELL®BSPOFE THREXPIRATION DATE T vmw,THE N{S{a1G INRIREO��Y1Bm eeUVOR TO MAL 10 DAVO W rMN ICE NOTTO THE CERTLFICATE NOLDERpAMLD TO THE LEFT,BUT FNLURS TO 00 SO SMALL Town of Borth Andovelr IMPOSE NO OBLIGATION OR LIABLTIYbF ANY WIND UPON THE NSUFIE1%ITS AGENTS OR Attn: Building Dept 1600 Osgood Street REPRESENTAW411S. North Andover MA 01045REPREtEITA Crai S. Childs - ACORD 25(2001!08) V V 0 ACORD CORPORATION 1988 ARTICLE 3 DATE OF COMMENCEMENT AND FINAL COMPLETION 3.1 The date of commencement shall be the date of this Agreement, as first written above, unless a different date is stated below or provision is made for the date to be fixed in a Notice to Proceed issued by the Owner. 3.2 The Contractor shall achieve Final Completion within a period agreed upon by the Owner. 3.3 For every Calendar Day after the agreed upon date, a liquidated damages penalty shall be assessed at the rate of$150.00 per day until the project is 100%complete. Extensions will be given for unusual weather patterns and inclement weather that cause delays in the project. ARTICLE 4 CONTRACT SUM 4.1 The Owner shall pay the Contractor in current funds for the Contractor's performance of the Contract the Contract Sum of$95,383.00, subject to additions and deductions as provided in the Contract Documents. 4.2 Unit Prices are as follows: Description Contract Qty Unit Price BRICK MASONY REPOINTING $12.00 per s. f. SEALANT(JOINT)REPLACEMENT $7.00 per 1. f COSTS ASSOCIATED WITH PROVIDING ALL MATERIALS AND LABOR TO COMPLETE THE INSTALLATION OF THROUGH WALL FLASHINGS,PAN FLASHINGS,AND NEW DOORS AT A TYPICAL UNIT $5,020.16 per Unit HOURLY RATE FOR LABOR(including OH) $45.00 per hour MARK-UP FOR MATERIALS,ETC. 15% ARTICLE 5 PROGRESS PAYMENTS 5.1 Based upon Applications for Payment submitted to the Designer(for review and approval)on AIA for G702&G703, and forwarded to the Owner, the Owner shall make progress payments on the account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents. 5.2 Each Application for Payment shall be based upon the Schedule of Values submitted by the Contractor in accordance with the Contract Documents. The Schedule of Values shall allocate the entire Contract Sum among the various portions of the Work and be prepared in such form and supported by such data to substantiate its accuracy as the Designer may require. 5.3 Applications for Payment shall indicate the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.4 The amount of each progress payment shall be the approved percentage of completion (less previous payments) less 10%retainage. Payments shall be made within 30 days from the date of approval of the Application for Payment. ARTICLE 6 FINAL PAYMENT Final Payment, constituting the entire unpaid balance of the Contract Sum, shall be made by the Owner to the Contractor when(1)the Contract has been full y pformedthe including the submission of all warranty related paperwork, (2)a final A b lication for Pa Contractor has been submitted and approved and(3)Release of Liens forms from all suppliers have by ennt submitted. ARTICLE 7 TERMINATION OR SUSPENSION The Contract may be terminated or suspended by the Owner or Contractor as provided for in the General Conditions. This Agreement is entered into as of the day and year first written above and is executed in at least three original copies of which one is to be delivered to the Contractor, one to the Designer for use in administration of the Contract and the remainder to the Owner. OWNER CONTRACTOR (Signature) ( ature) (Printed Name and Title) 1 I CONTRACT This agreement is made as of: Between the Owner: Sutton Pond Condominium Trust C/o Shawmut Property Management 733 Turnpike Street, Suite#221 -) North Andover, Massachusetts 01845 and the Contractor: Circle C Construction 1 Holly Lane Groveland,Massachusetts 01834 The Project is: Masonry/Carpentry Restoration and Associated Work Sutton Pond Condominium 733 Turnpike Street North Andover,Massachusetts The Engineer is: RMX Northeast,Inc. 126 Main Street, Suite#4 Milford,MA 01757 The Owner and Contractor agree as set forth below: ARTICLE 1 CONTRACT DOCUMENTS The Contract Documents consist of this agreement, AIA General Conditions(1993), Drawings, Specifications,Addenda, and Bid Form issued prior to the execution of this Contract,and are as fully a part of this Contract as if attached to this Agreement or repeated herein. ARTICLE 2 SCOPE OF WORK The Contractor agrees to perform all of the work necessary for the completion of the project. The Work shall include the Masonry/Carpentry Restoration and Associated Work, as described in the Specification and shown on the Plans bearing the title"Roof Replacement and Associated Work", prepared by the Designer.