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HomeMy WebLinkAboutBuilding Permit #493 - 148 MAIN STREET 1/22/2010 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page 4 � LOCATION Print PROPERTY OWNER_. Qbdq 1p� Print MAP NO: �PARCEL:�ZONING DISTRICT: Historic District dyes no Machine Shop Village no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Ind I to No. of units: Comm Repair, ep Facemen Assessory Bldg ers: Demolition Other Sep is Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORME r` oyll- Identification Please Type or Print Clearly) OWNER: Name: ��J ��_ 1 ��t L 6VMe// Phone: 92k5::- Address: 2k5::-Address: CONTRACTOR Name: 4g4e l �AP h o n e , 6,5 26�4 5-0C Address: c/- n?-yo Supervisor's Construction License: jS Exp. Date: Home Improvement License: r Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED/ONN$125.00 PER S.F. Total Project Cost: $ FEE: $ . 0(/ Check No.: Receipt No.: 2 2 -4 NOTE: Persons contracting with unregistered contractors do not have access o the guaranty un Signature of Agent/Owner _ Signature of contracto Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature i COMMENTS HEALTH Reviewed on Signature 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. I land area, . ft.:q ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No r MGL Chapter 166 Section 21A—F and G min.s10041000 fine NOTES and DATA— (For department use i t I ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses. o 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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: Doc.Building Permit Revised 2008 Location No. �� Date 7 �0 NQRTIy TOWN OF NORTH ANDOVER 3: • OL Certificate of Occupancy $ . � S E< Building/Frame Permit Fee $ V " ACNUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 11 j 2z- 0 / — Building Inspector 01/21/2010 11:39 FAX 603 698 8269 FOY INSURANCE SALEM w UUa DATE(MMIDDIY'YYY1 AC= CERTIFICATE OF LIABILITY INSURANCE of/21/2010 PRODUCER 603.398.6320 FAX 603.$98.8269 THIS CERTIFICATE 18 ISSUED A5 A MATTER OF INFORMATION Foy insurance Group - Salem ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1;q Main St - Suite 103 ALTER TWE COVERAGE AFFORDED BY THE POLIC LOW Salem, NH 03079 INSURERS AFFORDING COVERAGE MAIC# Terri Truhn INSURERA: American Safety Indemnity Co 25433 MSURCD Carignan TtTgat On ervices, L DBA: PuroClean Disaster Recovery Services INSURER 8; 32 Kristin Drive INSURER C: Derry, NH 03038 INSURER D: IN6UROE R E' vERAGES IND THIE POUCIES OF INSURANCE LIS75D BELOW HAVE 9FEN ISSUED TO THE INSURED ANY REQUIREMENT TERMOR CONDITION OF AN CONTRAC OR OTHER DOCUMENT WITH RESPECTOTO WHICH THIS C£R�FICAT�EAMAY BE I SSUED 4 POLICIMAY ES.AO.THE INSURANCE N U M 1 S SHOWN MAY HAVE BEEN LIES DES BY ED HERE CLAIMS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS 1NSR DD POLICY NUMBER POLICY EFFE V LICY IR11TK7N LIMITS TYPE OPINBINLANCE EACHOCCURRENCE S i Aix GENERAL LIABILITY ENV0174S7-O8-03 10/15/2009 10/15/2010 DAMAGETORENTED $ 50.0 04 i X COMWRCIALGENERAL LIASIOTY i MEDEXP(Arq"W8m+) I JC)00 i X CLAIMS MADE �OCCUR A X Professional PERSON ALLADV INJURY S 1,00 GENERAL AGGREGATE S 2 00PRODUCTS•COW1OPAOG I 2.0 GEN'L AGGREGATE Limn'APPLIES PER: ,OLICY jE OT lOC AvroMDBILELIADILm ENV017457-'08-03 10/22/2009 10/15/2010 COMBINED SINGLE LIMIT 3 (64occkurt) 10000,000 j ANY AUTO ALL OVVN90 AUTOS BODILYINJURY ; i tear F. SCNEOULED AUTON A X HIRED AVTOS (PrseciODILY e INJURY S 1 X NON-OVVNEO AUTOS PROPERTY DAMAGE 3 (Per- dem) TO ONLY-EA ACCIDENT S GARAGE LIABILITY OTHER YHAN EA ACC S ANY AUYO AUTO ONLY: AGO S EACH OCCURRENCE 3 QXCEEStUMBRELLA LIAYSY BB OCCUR CLALVA MADE AGGREGATE S 3 DEDUCTIBLE RETENTION 3 —MUST. 3 VVC STATU OTH- WORKERS COMPENSATION AND EMpLpYERS'LIABILITV E.L.EACH ACCIDENTANY 3 OFFICERIMEMSER EXCLUDED?EOUTIVE E.L DISEASE•EA EMPLOYE I K Ya,dowbe under E.l.DISEASE-POLICY LIMIT S SPECIAL PROVISIONS b*10w OTHER i DESCRIPTION OF OPERATIONS I LOCATIONS I VEWOLEC I CXCLVSIONS ADDED BY ENDORSEMENT/SPECIAL pROVIMONS dditional Insured: Mary O'Donnell CE ATE HOLDER COCELLAMON SHOULD ANY OF YHE ABOVE OEBCRTED POLICIES W CANCELLED BEFORE THE EXPIRATION OATS THERE#.THE ISSUING INSURER WILL ENDEAVOR TO MAIL Q_DAYS WRITTEN NOTICE TO TN!CERrFK ATE HOLDER MANED TO THE LEFT, Mary O'Donnel l BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBWAY10M OR LIABILITY 148 Main Street Unit 0437 OF ANY KliD uporj THE wsurqw RS mwwdR REPRESENTATIVES. North Andover, MA 01845 AUTHORIlBDRlP NT TI Terri Trut ACORD 26(2001/08) FAX: 978.68$.9542 CACORD CORPORATION 1988 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 157719 10 Park Plaza-Suite 5170 Expiration: 10/31/2011 Tr# 289895 Boston,MA 02116 Type: DBA PUROCLEAN DISASTER RECOVERY SERVICES / c RICHARD CARIGNAN 232 N. BROADWAY gam _ SALEM, NH 03079 Undersecretary Without--- — Not valid signature NORTH Town of 4 over No. o �, . ., r 3 0 _ _ RIP LAKE y dover, Mass., I COC HICHE WICK OOATED ll BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT..,/' BUILDING INSPECTOR ' J9L. .-.......... .. ...d�!.h.F. --............................................................................. """' Foundation has permission to erect........................... ' / I/ buildings on .17 .c,�i..��' .. 1 .lv.............. Rough to be occupied as.. .......W.....A.' ..... , ....44)WA'J..'!. .......................................... . . Chimney provided that the person accepting this permit .. all in every respect conform to the terms of the application 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 UNLESS CONSTRU N S ELECTRICAL INSPECTOR Rough ........ ...................................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Finalh No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. Notice of Right of Cancellation Descr' tion of goods sold and/or services to be performed r ,t ene— p r t Notice of Cancellation Date You may cancel this transaction, without any penalty or oblig ion, ex luding any non-refundable deposit, within three business days from the above date. If you cancel, any property traded in any payments made by you under the contract or sale, excluding any non-refundable deposit, and any negotiable instrument executed by you will be returned within 10 business days following receipt by the seller of your cancellation notice. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received or installed, any goods delivered to you or installed under this contract or sale, If this is not able to be accomplished, you must reimburse the seller for any goods that have been delivered or installed at your residence under this contract. To cancel this transaction mail or deliver a signed g d and dated copy of this cancellation notice within three business days of the date of the contract's execution to: PuroClean Disaster Recovery At 4 Raymond Ave, Salem, NH.03079 . 411 Not later than midnight of 2l�or-f �DJ? (Date) (D te) Wuye "s Signature) Owner acknowledges receipt of a copy of this contract, and that they have read, understood, and agree with the terms of this contract and the payment schedule for this job. ( to_ lea is st ecovery) (Date) 1 This construction contract is entered into on the day of 20 1('21 by PuroClean Disaster Recovery (MA Lic# ) hereinafter called Contractor or PDR, and the party(s) signing below, hereinafter called Owner. The above specifications and conditions are satisfactory and are hereby accepted. PDR shall furnish all labor to do the work described in the above specifications and Owner agrees to pay PDR as follows: TOTAL CONTRACT PRICE $ l DOWN PAYMENT $ ©© INITIAL PAYMENT AT START OF WORK $ Q FINAL PAYMENT AT COMPLETION OF WORK MATERIAL AND STOCK PAYMENT To be paid by owner as job progresses ATTENTION: PDR will do only that work which is written in the above specifications for the above agreed upon amount. The terms and conditions stated are part of this contract. This contract is subject to PDR's office approval. You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the attached noti of cancellation form for an explanation of this right. 71 V(Owner's signature) (Date) (Owner's signature) (Date) I indirect, or consequential damages resulting from work shutdown or termination of this agreement. c. Payments not made by the due date are delinquent and shall bear interest at the rate of one percent per day, or the maximum allowed by law, whichever is more, until paid. d. Owner shall pay reasonable costs incurred by PDR in the collection of any delinquent amounts, including attorney fees and costs of preparing and filing liens, regardless of whether suit or action is instituted. IX. Owner understands and agrees that any checks or other medium of payment presented to PDR by the Owner, or Owner's agent, that is returned to PDR for insufficient funds, or any other reason that delays the deposit by PDR of monies due as outlined below in the payment schedule for this job in this contract document, will incur an additional charge of$50, plus any and all fees assessed by the bank or other institution handling these monies, and any and all other resultant charges, fees, or late fees, regardless of the reason or the extent of those charges or fees. X. Owner understands and agrees that all and any unsupervised children must be kept out of all work and storage areas between the hours of 7:30 am and 4:30 pm Monday through Friday. a. PDR employees and sub-contractors will not perform work on the Owner's premises in the presence of unsupervised children in work and storage areas. The Owner agrees that a delay of work caused by the presence of unsupervised children in work and storage areas will result in a charge of$35 per man hour lost for each hour that work is delayed. XI. Owner understands and agrees that PDR will charge $35 per man hour lost and $.50 per mile per vehicle for the inability of.moo access any work and storage areas during the hours of XII. 7:30 am to 4:30 pm Monday through Friday. r XIII. PDR will not move furniture or personal items, unless otherwise stated in this contract. If PDR is unable to perform the work in this contract without moving furniture or personal items, PDR will move the items at the rate of$100 per hour. XIV. Unless otherwise stated in this contract, PDR not be responsible for trash removal. If trash is to be removed and it is not otherwise stated in this contract, Owner shall be responsible for the cost of trash removal, including PDR's employee's time at $35 per man hour, dumpster rental, dump fee, and any other associated costs not listed here. XV. Owner will be responsible for the cost of any and all permits and associated fees, unless otherwise stated in this contract, including $100 per hour for PDR to secure and maintain permits. XVI. Owner understands and agrees to reimburse PDR for all materials and stock used for the work stated in this contract. a. Materials and stock invoices will be presented to Owner on a regular basis, with the agreement that the total due for materials and stock be paid in full on the due date. b. Any overdue material and stock payments will be subjected to the terms and conditions listed above for labor payments. agreements made between Owner and any party(s) other than (Project Manager) IV. Owner understands and agrees that any and all animals that may inflict injury on PDR staff or PDR sub-contractors will be kept out of all work areas and all storage areas for the duration of this job. Owner will provide access to all work and storage areas from 7:30 am to 4:30pm pm, Monday through Friday, for the duration of this job. If at any time access to the work or storage areas is not available to PDR crews or sub-contractors due to the presence of and potential harm from the Owner's pet(s), Owner agrees to reimburse PDR or PDR sub-contractors for expenses incurred for travel and lost time at the rate ofer 35 $ p man hour lost, and $.50 per mile per vehicle. a. Owner understands and agrees that PDR personnel and GLE sub- contractors will not attempt to enter any work or storage area if Owner's animals have open access to that area. b. Owner also understands and agrees that PDR employees and PDR sub-contractors will not be responsible for any pet(s) leaving the home due to doors, windows, gates, or other openings in the home being left open due to work in progress. V. PDR is solely responsible for securing all labor, materials, sub- contractor work and other related items included in this contract, and for scheduling, construction techniques, and procedures, and the coordination of all trades and sequences hereunder. VI. Owner, Owner's agents, or any other parties, are prohibited from directing, or attempting to direct in any way, the progress of the work. Any questions, problems, or requests f r changes of work will be solely directed to theDJ7tc, Rroject Manager) VII. Owner shall be solely responsible to pay any and all sub- contractors for work performed at Owner's direction without written authority of PDR, and Owner shall indemnify, defend, and hold PDR harmless from loss or liability which results from claims of any sub-contractors or others arising from the performance of such work. a. In addition, Owner will be solely responsible for all costs resulting from delays or interference on the part of the Owner, Owner's agents, or Owner-solicited sub-contractors working on this job. All resulting corrective work, including labor, materials, subcontract or any other costs and construction liens resulting from that work will be the sole responsibility of the Owner at the rate of cost plus 40 percent. VIII. Owner has read, understands, and agrees with the total payment schedule as shown in this agreement. Owner will pay PDR the initial investment, progress payments, and the final payment, as per agreement and without retention. Final payment of the entire contract price is due on the day of SUBSTANTIAL COMPLETION of the work and by use of the Owner. a. If net amount due on progress payment is not paid by the Monday of the week following the due date, PDR reserves the right to stop work until the progress payment has been made, increased by a rate of 1% for each day payment is overdue, costs of shutdown, delays incurred, and startup. b. PDR reserves the right to terminate this agreement altogether if work is stopped for ten (10) continuous calendar days due to failure of the Owner to make prompt progress payments. PDR further reserves the right to recover payment for all work executed and losses from delays or stoppage of the work, including reasonable overhead, profit, and damages. In no case will PDR be entitled to less than their total expenses plus an additional sum of 40 percent of the total expenses incurred. PDR is excluded from all special, Conditions of This Contract I: Owner understands and agrees that all communications concerning the job status, job changes, pricing, or any other job issues outlined in this contract, will only be between the owner and PuroClean Disaster Restoration. PDR will not be held liable for any discussions or agreements made between Owner and any other parties including PDR employees, PDR hired sub-contractors, or suppliers. II. PDR will not be responsible for any bills, charges, debts, invoices, or other encumbrances incurred in, on, or for this fob by anyone other than PDR or its immediate authorized employees. III. Without invalidating this agreement, Owner may order extra work or change the existing contract by the use of a change or additional work order. A change may consist or additions, deletions, or modifications to the original contract work (the contract sum and time being adjusted accordingly), providing the document is mutually agreed to and signed by both the Owner and PDR. Such modifications to the original contract, or subsequent contracts or change work orders,rs, may only occur with a signed change work order. This change of work order may change the job completion date. a. Any additional sum shall be paid in full (100%), at the next progress payment due or the final payment due, whichever may come first. b. Owner understands that a design/estimating and coordination fee of$100 per hour will be incurred on the design, drafting, and pricing of the change or additional work, whether the change is elected or not by the Owner. c. PDR will not be liable for any changes made without a completed and signed change work order. PDR will not be liable for any [!se Par¢r.ea<c*of ProFrstr Va�1ge 4 Raymond Ave Salem, NH. 03079 (603)-890-8911 This agreement for professional services is entered into on this aday of ��v , 201 a , by and between PuroClean Disaster Recovery (MA L i c# TALVI ), hereinafter called "PDR" or"Contractor," and the party(s) signing below, hereinafter called "Owner," governing work to be performed on the property and building located at: ��ff �YI,9�:► s1 ;tl tl.��ode•' .Q /fs�-r 5' ZIA,, — (Address of building to be built or remodeled) for:6;) (Name(s) of all legal owners of the building) Phone: (All phone numbers of legal owners, home and business) PDR shall furnish all labor to perform the work described in the following specifications and incorporated by reference as part of this Contract and any addendum attached hereto. ✓fie �arrvnxaruuealCl o�✓�,�zaacufuioelta Board of Building Regulations and Standards Construction Supervisor License License: CS 96473 Birthdate: 9/29/1976 Expiration: 9/29/2010 Tr# 96473 Restriction: 00 JAMES SOUTHER 8 JENKINS DRIVE BILLERICA,MA 01862 Commissioner