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HomeMy WebLinkAboutBuilding Permit #1300-2016 - 1590 GREAT POND ROAD 6/13/2016 %40RTH q BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received * Z Date Issued: !3 �9SSACHUs���y IMPORTANT:Applicant must complete all items on this page LOCATION d jt" on � tt Pft PERT,Y OWJ ER'' Aatr An 4V, 6ao at, p WWI � - Rnnt � . � +IIAP NO: J PARCEL: ZONING DISTRICT�Historlc Distrryesr. -no Machine Sho � Ila gZa y es no per... , TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ` Commercial Yf�epair, replacement ❑Assessory Bldg Others: ❑ Demolition ❑ Other TSeptic 14lt Floodplain U Wetlands "❑ Watershed Oistnct � 1Naterow il�Q S�rn I (%CT Identification Please Type or Print Clearly) OWNER: Name: vru. A_ Phone: Address: Grek4- " CONTR CTOR I :,R Phone: - �- AddressAAVe . Supe Cvisor's Con"s wuct,ior cense Exp. Date: ° � ;' 1W a Q Iffie Imprortementtcerse: ' T Exp. ?ate: � . �; .. (P �. .. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 12— �U FEE: $ r Check No.: 7681 Receipt No.: NOTE: Persons contract' ' z unre Bred contractors do not have access o t e r raMd S gnature of Ager filt3wner _ S�gnattare of_contran nr . . '.. . Plans Submitted ❑ Plan' `Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swiumning Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent DuanP ster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS li 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: 8 *FIRE DEPi4RTMENT Tern Dum sterroti site. es, Located Osgood Street ed _ ►yam s �sno L6 4oct` at r124IVlain�Street - , _ k _ t ,_�i_re{De�artnient�si n to" COMMENTtS�.. j I Dimension i i Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10o-$1000 fine NOTES and DATA— (For department use) i i ® Notified for pickup Call Email f • Date Time Contact Name Doc.Building Permit Revised 2014 � 1 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 OTE: 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/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) i 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Clerics 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:Building Permit Revised 2014 Location 1 y7C9`/`��' No. 1 ✓l�l�. Date , • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ , TOTAL $ Check#x / t� �• }, i r Building UInspector N0RT1y Town ��j . _ LAndover O .� 'y"• � 0 9111 26(, Z , h ver, Mass,© / COC HICNtwICM x,95 RATED �Pa��S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ... �r...Q... .... .. ....�,��..N/,,: /. ,1.......... .. BUILDING... B DING INSPECTOR . Foundation has permission to erect ......................... buildings on Z.F.°9-10.4W.7....�!�!^! ... ...... � Rough to be occupied as .................................... Chimney .... .. ... .. .. r........................................ 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 CONS C 10 Rough Service .. . .. . .... 4BUILD6VIIN�SPE ...... ........ Fina TOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. v � s NC Inc. 314 Clark Street North Andover MA 01845 978-685-0568/fax 794-3780 Roof Installation June 1,2016 Proposal submitted to: Roger&Annette Fasnacht Address: 1590 Great Pond Road, North Andover, MA 01845 Service Address: same Phone, Email: rafasnacht@verizon.net Salesman: Norman V. Lee GC# 102750; 104295 HIC#167900;291658 We hereby submit a description of work and materials to be used with estimated cost,subject to all terms and conditions as follows: Strip roof of(1) layer of shingles; Re-nail all loose sheathing; Replace plywood as needed for an additional cost of$65.00 per sheet installed; Apply GRACE Ice and Water shield six(6)feet up from edges of roof; Apply paper to remaining roof surface up to ridge. Type: IKO Cool Gray; Install 8'aluminum drip edge—color(white); Replace(2)pipe boots. Size: 3-2%" Reroof with IKO Cambridge Lifetime Shingles. Color: Earth tone Cedar; Install Lomanco ridge ventilation; Clean up and removal of waste and debris; Magnetic sweep of property; Walkways and driveways swept of debris; Dumpster provided and included in job price Total Price: $12,440.00 IF Permits required to be obtained, obtained by Contractor AT COST TO CLIENT Owners that secure their own construction related permits shall be excluded from Guarantee Fund Mold, ledge, rotting materials,code related issues or other unforeseen situations encountered that affect pricing,job duration,or other issues will be discussed with the client,and change order submitted and signed off on by client to continue work. Like or similar material will be substituted in the event that contractor is not able to obtain specified material,pending designer's and/or client's approval.Slight fluctuations in texture,colors can be expected-contractor will make diligent effort to match Items as close as possible. This contract will act as the final bill,and final payments will be made from this document.Any additional work in change orders will be collected in the same manner. Massachusetts provides a three day cancellation right to homeowners.Non-payment can lead to liens on your property. Questions?Call us,write us and check out our website @ www.ncsne.com for more information on our other services. TERMS&CONDITIONS PAYMENTS AND DISBURSEMENTS: Customer is responsible for obtaining any financing he deems necessary to comply with this Agreement. If Customer is obtaining financing form a third party,Customer agrees to apply for such financing without delay and this Agreement is subject to Customer being approved for such financing. All payments are due and payable as specified in the Proposal/Contract. Northeast Contracting Solutions reserves the right to assess a$25.00 fee if Customer requests us to re-invoice them for any reason. Overdue payments will bear a 1.5%service charge. Failure by Customer to pay any invoice within five(5)days after payment is due per contract shall constitute a material breach of this Agreement. All legal, court or otherwise collection cost incurred by Contractor are to be paid by Customer. LABOR AND MATERIALS:Contractor agrees to furnish the materials for the project and complete the work to be done in a workmanlike manner. All materials furnished under this Agreement shall be construction grade and meet industry standards. Where brand names have been specified, Client Initials - 1 - Coptractor n1ay at his option select substitutes when such substitutions are due to unavailability or previously specified. Contractor shall pay all subcontractors,laborers,and material suppliers, unless specified differently in writing. SPECIAL CONSIDERATIONS: For those selections of materials requiring special considerations including,but not limited to,cash deposits to insure their production,Contractor may at his option require Customer to pay such required deposits directly to distributor or manufacturer rendering such services. It is understood that when matching existing conditions such as color,size,planes and texture,Contractor will provide materials so as to match,as closely as possible,the existing materials. However Contractor does not guarantee materials will match existing conditions. DISCLAIMED WORK: No soil testing,surveying,plan design or engineering are included in this Agreement unless expressly specified. Contractors shall not be held responsible for any existing violations of applicable building regulations or ordinances,whether cited by the appropriate authority or not. Contractor is not responsible for any abnormal or unusual pre-existing conditions including,but not limited to,damage caused by termites or dry rot, filled ground or ground of inadequate bearing capacity, rock and other material not removable by ordinary hand tools, inadequate electrical wiring systems for the load imposed by the work under this Agreement,and plumbing,gas,waste and waterlines not shown on documents or plans furnished by Customer. Correction of any such violations or abnormal conditions by Contractor shall be considered additional work. ADDITIONAL WORK: Contractor shall promptly notify Customer of any additional requirements necessary to facilitate the project's completion. Any additional work required or ordered by Customer(or any regulatory agency having jurisdiction over the project)shall be set forth in a signed change order,and the agreed price shall become due and payable as agreed upon between Contractor and Customer,or within 30 days if not specified, payment is due in full. Contractor,his employees,subcontractors and agents are unauthorized to perform any additional work or to enter into any agreement to perform additional work unless agreed to in writing by Customer and Contractor through a properly executed change order,which shall become an integral part of this Agreement. PROPERTY RIGHTS AND RESTRICTIONS: Customer represents that he owns the property described as"property address",or has authority to order and sign for work. Customer shall locate and point out the boundary lines of the property to Contractor. Customer shall be solely responsible for accuracy of markers and boundary lines indicated to Contractor and as detailed on plans and specifications approved by Customer. If a land survey is required for any reason to confirm markers or boundary lines,Customer agrees to pay for such survey. Prior to the start of construction,Customer shall give Contractor a copy of any restrictions,easements or rights of way relating to the property. ACCESS AND FACILITIES: Customer agrees to provide free access to work areas for workers and vehicles,and to provide areas to store materials and debris. Unless otherwise specified,all water,sewer,gas and electric utilities from the servicing agency to the point of entry at Customer's property line(or to the metering device if such devices are required)are the responsibility of the Customer. Customer agrees,at Customer's expense,to provide electricity at the project site as may be required by Contractor to effect the work described herein in compliance with federal,state and/or provincial law. Contractor shall not be held liable for minor damage to curbs,driveways,walks,patios, unless caused by the gross negligent movement of workers, vehicles,equipment,materials or debris. START, DELAY AND COMPLETION OF WORK: Contractor agrees to commence work and to continue to work in a timely fashion so as to insure the project's consistent development and ultimate completion. Contractor is bound by the terms and conditions regarding start of work imposed by any licensing or regulatory agency having jurisdiction over the project. Contractor shall not be held responsible for project delays caused"acts of God,"civil unrest,acts of Customer or Customer's agent,inclement weather,strikes, labor disputes,material shortages,licensing or regulatory agency inspections, or any other actions or causes beyond the Contractor's control. CANCELLATION CLAUSE: Option of Customer to terminate contract in the event of Contractor's failure to complete work. If the Contractor shall refuse to or fail to perform the work with such diligence and force as specified in this contract,or shall fail to complete said work in a timely manner,or if Contractor does not perform the work in a professional manner according to industry standards,Customer reserves the right to give written notice to the Contractor of its intention to terminate this contract unless said violations of the specifications are corrected within fifteen(15)working days after serving of said notice. If after fifteen(15)working days the violations have not been corrected or satisfactory arrangements for the completion thereof made,this contract may,at the option of the Customer,be terminated. In the event of termination,payment in full for all services performed to date by the terminated Contractor shall be made immediately at the time of termination. Option of Contractor to terminate contract in the event of Customers failure to make timely payments as specified or to abide by all terms and conditions as outlined by this Agreement hereto,also,but not limited to any actions by the customer to circumvent,interrupt or otherwise,any relationship with a subcontractor and the Company. Contractor's option to terminate will be immediate and communicated in writing. DAMAGE AND INSURANCE: Contractor agrees to carry worker's compensation and business liability insurance to insure the Customer against damages or defects caused by Contractor,his employees,or any agents acting in his behalf. A valid insurance certificate will be furnished upon request. MISCELLANEOUS: Contractor may subcontract all or any portion of the work and may assign this Agreement to another Contractor,provided such assignment shall not affect the rights and privileges of Customer under this Agreement. In case one or more of the provisions of this Agreement or any application thereof shall be invalid,unenforceable or illegal,the validity,enforceability and legality of the remaining provisions and any other application thereof shall not in any way be impaired thereby. If any legal action shall be instituted to interpret or enforce this Agreement,the prevailing party shall be entitled to recover all litigation costs,including reasonable attorneys'fees. It is agreed that this Agreement shall be governed by,construed,and enforced in accordance with the laws of the State of Massachusetts. CONTRACT ADJUSTMENTS: In the event of an unanticipated increase in the cost of fuel or materials used by Northeast Contracting Solutions,Inc., reserves the right to pass through to the Customer such increases or, if the Customer does not agree to pay any such increases,to terminate the contract. LIMITED WARRANTY: Northeast Contracting Solutions guarantees workmanship,subject to the following conditions. • Contractor warrants all labor for 2 years,and manufacturers warranty on materials is a 25 Limited Residential Warranty on materials(please see individual Company policies online). is purchased. This limited standard warranty extends only to Customer and is not transferable. • Contractor will provide replacements as stated above on a one-time basis only at the request of the Customer,at no charge to the Customer except for supportive materials deemed necessary and labor. Please note,however,that Contractor is not liable under this limited standard warranty for actual of consequential damages resulting from"acts of God,"excessive weather conditions(extreme cold/drought,washouts, etc.),soil conditions,abuse,vandalism,poor drainage,salt damage,theft, or fire. Client Initials - 2 - • Aqy warranties given by manufacturers pertaining to materials used by Contractor in with the project will be passed through and inure to the benefit of the Customer. • There is no implied warranty of merchantability or any implied warranty of fitness for any particular purpose. There are no warranties either express or implied beyond the description within this section. All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza,Suite 5170 Boston,MA 02116 Phone:(617)973 8700 The contractor the homeowner herby mutually agree in advance that in the ev t that the con has dis to concerning this contract,the contractor y sub it su ute to a private arbitration service which has been r ved t Offi ons er Affairs and Business Regulation and the c nsume hall a requi d to submit t c arbitration as proved in MG c ,[Owner= Contractor Accepted:The signatures below indicate that the above prices,specifications and conditions are satisfactory and hereby accepted.Payment will be made as outlined above. O )OSIG THIS CONTRACT�TEARE ANY BLANK PA ES! ,Ow,_�er Signature:` Date: Kl v Contractor Signature: Date: 1 Date to be started* Date to be Completed— Payment Schedule 50%Due Upon Acceptance 50%Due Upon Commencement of Work Company Policy requires credit card number,v-code and expiration date on file to process project. CC# V-Code Exp.Date *Based on receipt of bankable check,and availability of materials. **Assuming no weather,material availability or unforeseen issues. ***Excluding change orders,unforeseen issues. Client Initials - 3 - The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street, Suite 100 Boston,MA 02114-2017 M °a www mass.gov/dia Workers'Compensation Insurance Affidavit: General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le ibl Business/Organization Name: )Cj4r rc„ Address: City/Siate/Zip: r V- AJ., , a'A' ( z( `Phone#: -w Are u an employer?Check the appropriate box: Business Type(required): 1. Are am a employer with employees(full and/ 5. ❑Retail or part-time).* 6. ❑Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers' comp.insurance required] 8. ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c. 152, §1(4),and we have 10.❑ Manufacturing no employees. [No workers' comp.insurance required]* 11.❑Health Care 4.❑ We are a non-profit organization,staffed by volunteers, with no employees. [No workers' comp.insurance req.] 1213 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing w,9�rs'co ensation insurance for my employees. Below is the policy information. Insurance Company Name: i rev Tkrs Insurer's Address: -l57 vt It ( City/State/Zip: r J)4,6 Policy#or Self-ins.Lic.# P J (& O'I "I— �—l`0 Expiration Date: 0 1 1-1 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expi ation date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA f in rance co rage verification. I do hereby c r nd ai s pe allies }of perjury that the information provided ab ve is tr a and correct Si nature: ((�� p�'Gt7" Date: Z.G j�D Phone#: 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 Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.gov/dia VDAC TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (7POUB-8D88464-9-16) RENEWAL OF (7P,JUB-8D88464-9-15) INSURER: TRAVELERS PROPERTY CASUALTY COMPANY DF AMERICA 1 NCCI CO CODE: 13579 INSURED: PRODUCER: NORTHEAST CONTRACTING MTM INS ASSOCIATES SOLUTIONS INC 1320 OSGOOD ST 314 CLARK STREET NORTH ANDOVER MA 01845 NORTH ANDOVER MA 01845 Insured is A CORPORATION Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 01 -07-16 to 01 -07-17 12:01 A.M. at the insured's mailing address, 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s)listed here.- MA ere:MA �= B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: =" Bodily Injury by Accident: $ 500000 Each Accident Bodily Injury by Disease. $ 500000 Policy Limit Bodily Injury by Disease: $ 500000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: .� COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06B D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE cl= 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 01-11-16 WC ST ASSIGN: MA OFFICE: DIRECT ASSIGNMENT 701 PRODUCER: MTM INS ASSOCIATES 7766P 002460 I Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-104241 Construction Supervisor _V i i, , MARK DELGRECO 2 FOX HOLLOW ROAD) , DERRY NH 03038 ,nom Expiration: Commissioner 08/18/2017 1 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5 17 0 Boston, Massachusetts 02116 Home Improvement3Contractor Registration Registration: 167900 Type: Private Corporation _.:x.....:. Expiration: 11/17/2016 Tr# 258009 NORTHEAST CONTRACTING SOLUTIONS NORMAN LEE 314 CLARK ST N. ANDOVER, MA 01845 - Update Address and return card.Mark reason for change. SCA 1 20M-05/11 Address ❑ Renewal R Employment Lost Card ' ��; �� &fie W61292-9ba92eaeCtL//tI a19�/��//,,//-11ceelleldef Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: :167900 Type: Office of Consumer Affairs and Business Regulation xpiration 1 T{?7/2016 Private Corporatio; 10 Park Plaza-Suite 5170 B9ston,MA 02116 NORTHEAST CONTRACTING SOLUTIONS INC. "f1. NORMAN LEE 314 CLARK ST //� N.ANDOVER, MA 01845 Undersecretary Not(valid without ignature r