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HomeMy WebLinkAboutBuilding Permit #757-2016 - 173 INGALLS STREET 12/23/20152IIl� BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO:Date Received Date Issued: IMPORTANT: Applicant must complete all items on this paize LOCA ..0. MAP NO: /PARCEL:y ZONING DISTRICT: Historic District yes no !Machine Shop Village y no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg 0 Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well 0 Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer � I�> 6k l i .f cy 11tn-c ol'e_n t d st d cell on Identification Please Type or Print Clearly) OWNER: Name: Mas 1, QnI Phone: 500 Address: 1-12) C SS�• U CONTRACTOR Name: %J-flbnA R Mui( -_Phone: Address: q FI 11) k S�-, Mar We. head, MA 61 9L4S- a2 - S+ Int' C9 Supervisor's Construction License: Exp. Date: Home Improvement License: 5 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: $ `� FEE: $ Check No.: 0 —1, Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce , toWmy fund I Permit No#: "•� BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWN �No rarN ���.�LffD jbq�O t 46 Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ® Septi �D ". mlµ_®I`o©ted` Iai •°®Wetlands =.!. Watershed ®strict Water/Swer�LP,I DESCRIPTION OF WORK TO BE PERFORMED: Identification - Please Type or Print Clearly OWNER: Name: Address: Contractor Name: Phone: Email: Address: Phone: Supervisor's Construction License: Exp. Date: Home Improvement License: ARCHITECT/ENGINE Exp. Date: 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: $ E: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 47 Plans Submitted ❑ Plans Waived ❑ Certified Plot PlIn Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Well ❑ Private (septic tank, etc. ❑ F Tanning/Massage/13ody Art n Swimming Pools El Tobacco Sales El Food Packaging/Sales F1 Pennanent Dumpster on Site n THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On . Signature. - --- --- ----,---CONS E RVATION - -- Reviewed -on— --Siqnature­­­­ .. . ....... ..... ----.1-1-...---- ----------- - -- ­­­, COMMENTS, HEALTH COMMENTS_ Reviewed on Sianature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection Driveway Permit DPW Town Engineer: Signature: i f1 1 Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. 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.$100-$1000 fine Doc.Building Pennit Revised 2014 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 ...4,. -Photo- Copy of H.I.C. And C.S.L. Licenses Copy Of Contract 4. Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) 4. Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products . IOTE: 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 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 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 Doe: Building Permit Revised 2014 -1-7 Location "�4 No. J� A�r Date TOWN OF NORTH ANDOVER SIT Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # v 4t Building Inspector 29854 u mr C x � Q xca/1 LL O O cc O m N u o LL ? N u a a) {n p W z z m c O a+ v o LL t o W T c :c U LL O ~ U tail z z C J d t °�° o c LL O U ~ CA z U U J W s °�° o K o u .2 ar {n c LL oC 0 W N Z Q (7 s oo o = — LL z Nd oC a w ui 5 LL O Z v v a o c O0 O CL aD Ca ® . o Ea) m o �+ c Z' o 0 Q O L �m >_ O O d O to — UO r- � 0 c t a E 0 c a� N z CL W U) O O :E� `) = o0 L Ell: Q Q. yr _ �+ c-0tm v O O C Q L L LC Q. a = O 'a).2 m W _ '0— O O uj P O LU E �. W C-) Q 0-0 m as> N -Q O C F— .� L- a 0 *S O. 0 C.i Z G z W W N W a O V W :a. U) ca 1Cl)— F— Z U I.L c . O U criJ ti N Aq z V O lw L d U) 0 :2 m m � s 0o O CL C �a t � cc cc J O !� Z CLN i REVISED HOME IMPROVEMENT CONTRACT March & Martin, Inc. 16 Winter Street, Peabody, MA 01960 Office (978) 532-3224 Fax (978) 532-3245 www.MarchandMartin.com HIC Registration Number: 108405 Expiration Date: 08/18/2016 Federal Employer .ID: 04-2629083 Mr. Mark Guarini 173 Ingalls Street North Andover, MA 01845 Mark@guarini.net SCOPE OF WORK Supply and install Icynene spray foam to air seal and insulate the following: Note: client will remove existing sunroom sheathing and insulation for our access. V Floor Sunroom Cathedral Roof 2 x 8 R-38 closed cell foam 1st Floor Sunroom Floor -Crawl Space 2 x 8 R-30 closed cell foam Note: client will have sheathing sections removed for our access Master Roofs remove existing fiberglass, bag and dispose of Master Roofs 2 x 8 R-38 closed cell foam (client remove all sheathing) Master Attic Exterior Wall 2 x 6 R-20+ open cell foam Main Attic Roofs 2 x 8 R-38 closed cell foam Main Attic Exterior Wall 2 x 6 R-20+ open cell foam * = when provided in conjunction with other work or below minimum Contractor shall furnish all labor and materials for such work. December 22, 2015 $1,170.00 $ 900.00* $ 300.00* $ 3,552.00 $175.00* $ 4,992.00 $ 260.00* By its nature, insulation can be a dirty endeavor. Contractor will leave the premises "broom swept." A more detailed cleaning is the responsibility of owner. In a tight building, ventilation/air supply should be planned to avoid the combustion equipment back drafting and humidity problems. Inadequate ventilation is hazardous. Icynene Inc. MSDS declare job sites are safe for occupancy twenty-four (24) hours after installation. Local building codes may require ignition barrier paint over foam in attics and crawlspaces or areas not receiving drywall. March and Martin will ventilate the jobsite during installation. However the odor of a considerable depth of installed foam can last for quite some time. There are also other materials in attics that can add to this situation. Continued ventilation when possible will reduce odor buildup. March & Martin is not responsible for overspray that may cause damage to items within the home/property Page 1 of 4 SECTION II CONTRACT PRICE AND TERMS Owner shall pay contractor for performance of the work described in Section I, payable as follows: 1. Yd Deposit upon execution of agreement, not to exceed one third (1/31) of the total contract price, or the cost of special order items, whichever is greater; 2. Remaining Balance on final completion of the work and settlement of all claims of laborers and material suppliers. If all specified work areas are not ready to receive insulation and another visit is necessary for completion, an additional fee will be charged for this additional site visit. *March and Martin accepts all major credit cards. If a credit card is used, a two percent (2%) service fee shall be charged and will be reflected in the contract price above. SECTION III CONTRACT TIME SECTION IV CANCELLATION PURSUANT TO MASSACHUSETTS GENERAL LAWS CH. 93 §48, CH. 140D §10, AND CH.2551) §14. This agreement may be cancelled by owner within three (3) business days following the date of the execution of this agreement by giving written notice of rescission to contractor at the address given in this agreement, in which event owner shall be entitled to a complete refund of the down payment given to contractor at the time of execution of this agreement. Notice of cancellation shall be given by owner by first class mail, email, facsimile, or sent by delivery no later than midnight of the third (31) business day following the execution of the agreement or a date a completed agreement is signed by the contractor is delivered to the owner, whichever is later. In the event of cancellation pursuant to this section, the contractor shall, within ten (10) business days of their receipt of any valid notice of cancellation: i. Refund any payments made, including any down payment made under this agreement; ii. Cancel and return any copies of the agreement and any negotiable instruments signed; and iii. Take action necessarily appropriate to terminate promptly any security interest created in connection with this agreement. After the period expressed in the first paragraph of this section, but before the actual commencement of work, the owner may cancel this agreement, in which event, owner shall forfeit to contractor the down payment given at the time of the execution of this agreement. In the event owner cancels this agreement after the contractor has commenced the work, owner shall forfeit the amount of the down payment given to the contractor at the time of the execution of this agreement and in addition, shall pay to the contractor, such proportion of the total contract price as the amount of labor and materials furnished bears to the total amount of labor and materials agreed upon to be furnished under this agreement, which amount is to be paid within 30 days from the date of such cancellation. In the event contractor is unable to complete the performance of its obligation under this agreement due to Acts of God, strikes, unavailability of supplies or materials, or any other unforeseeable condition or contingency beyond his control, owner may, at his option, cancel this agreement, in which event, owner shall only be liable to pay contractor the amount of labor and material already furnished. Such payment is to be made within 30 days after the date of such cancellation. In the even the owner's home is destroyed by fire, earthquake, tornado, hurricane, or other cause not attributable to owner, this agreement shall automatically be cancelled with the parties and owner shall only be liable to pay contractor the amount of labor and material already furnished. Such payment is to be made within 30 days after the date of such cancellation/event. SECTION V CONTRACT MODIFICATIONS Any alterations or modifications initiated by owner or contractor must be agreed upon between the parties and the price fixed by them before work on such alteration or modification shall commence. Payment for such alteration or modification shall be made at the time of the final completion of the work. Further, any alterations or change orders must be in writing and be in a form substantially similar to Exhibit "A". Any modification of this agreement or additional obligation assumed by either party in Page 2 of 4 connection with this agreement shall be binding only if evidenced in writing signed by each party or an authorized representative of each party. SECTION VI WARRANTY Contractor guarantees that the work will be constructed in accordance with accepted home improvement practices, and it will guarantee against defects in the quality of work and materials for a period of one (1) year from the date of its completion. This warranty does not cover damage or defects that are the result of characteristics common to the materials used, or conditions resulting from condensation, expansion, or contraction of such materials. SECTION VII ASSIGNMENT This contract cannot be assigned by contractor without the prior written consent of owner. SECTION VIII ENTIRE AGREEMENT This agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this agreement shall not be binding upon either party except to the extent incorporated in this agreement. SECTION IX GOVERNING LAW It is agreed that this agreement shall be governed by, construed, and enforced in accordance with the laws of the Commonwealth of Massachusetts. SECTION X WAIVER The failure of either party to this agreement to insist upon the performance of any of the terms and conditions of this agreement, or the waiver of any breach of any of the terms and conditions of this agreement, shall not be construed as thereafter waiving any such terms and conditions, but such terms and conditions shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. SECTION XI NOTICE PURSUANT TO M.G.L. c. 142A All contractors and subcontractors must be registered by the administrator and that any inquiries about a contractor or subcontractor relating to a registration should be directed to the administrator. SECTION XII BINDING ARBITRATION The contractor and the owner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in Massachusetts General Laws, chapter 142A. Page 3 of 4 Owner's Signature Contractor's Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not separately signed by the parties. SECTION XIII OWNER DEFAULT In the event that the Owner breaches this agreement, the Owner agrees to pay Contractor 18% annual interest on the unpaid balance and all costs of collection including reasonable attorney's fees. Do not sign this contract if there are any blank spaces. Owner Russ Loveland Contractor Dated December 22, 2015 Dated Rest of page intentionally left blank Page 4 of 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address: i U N i n I e r bob U AAA 61 Gi �1'' U Phone #: Are you an employer? Check the appropriate box: I am a employer with 4. ❑ I am a general contractor and I 1. 9 employees (full and/or part-time).* have hiredthe sub -contractors 2. ❑ TI a sole proprietor or partner- listed on fhe attached sheet. ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have employees and have workers' comp. insurance.1 . 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance L Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition - 9. ❑ Building addition 10. ❑ Electrical repairs or additions I I. E] Plumbing repairs or additions 12.❑ Roof repairs 13. Other *Any applicant that checks box #I must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. �i'6. 00 :t Insurance Company Name: AoL1VI- A T� i J Policy # or Self -ins. Lic. M \M C (Do 00 LAW-3 Expiration Date: OLJ i0i Job Site Address:0 3 I n (",� a&L± "� City/State/Zip: &(4h 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 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 for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct D 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. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: -0-11� A cc CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 112/22/2015 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. POLICYNUMBER 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 M P ROBERTS INS AGCY INC 1060 Osgood Street North Andover, MA 01845 CONTACT NA PHONE9']8 683-8073 F N,):(978)683-3147 L- RES Pall a mpr0 ertslnsurance. COm Pip INSURERS AFFORDING COVERAGE NAIC# INSu R:HANOVER INSURANCE COMPANY INSURED MARCH & MARTIN, INC. INSURER B: INSURER 16 WINTER STREET MED EXP An one erson $ 5,000 INSURER D: SAVERS PROPERTY & CASUALTY INS CO PEABODY, MA 01960 978-532-3224 INSURERE INSURER PERSONAL& ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 A COVERAGES CERTIFICATE NI)MRFR- RFVISION Nl1MRFR- 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 BYPAID CLAIMS. N RAUUL LTR TYPE OF INSURANCE INSINSID WOK WVD POLICYNUMBER POLICY EFF (MMIDD/YYYY)D POLICY EXP YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR lu It= PREMISES Ea occ r encel $ 300,000 MED EXP An one erson $ 5,000 PERSONAL& ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 A ZBN-A193542 01/01/1501/01/16 GEN'L AGGREGATE LIMITAPPLIES PER: RPOLICY a JET 1:1 LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ / / BODILY INJURY (Per person) $ ANYAUTO A ALLOWNED SCHEDULED AUTOS X AUTOS X HIRED AUTOS}( NON -OWNED AUTOS ABN -6555704 07/29/1507/29/16 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 PD EXCESS CLAIMS MADE, UHN-A193788 01/01/1501/01/16 AGGREGATE $ 2,000,0 D RETE TI 0 D WORKERSCOMPENSATIONX AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N (Mandatory In NH) If � describe DESCRIP ION OF rOPERATIONS below NIA WC0000443 04/01/1504/01/16 PEA UTE ETH 500,000 E.L. EACH ACCIDENT $ I E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE -POLIOIMIT 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached'rf more space is required) CFRTIFICATF Hni r1FR !`Akt(`CI I ATInn1 TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN .120 NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTA I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SCA 1 c; 20M-05111 v/ie �u7�v��carrcuca �f Y' Office of Consumer Affairs & Business Regulation _ ME IMPROVEMENT CONTRACTOR Type. egistration: 1'08405 Private Corporation xpiration: -: 811 8120 1 6 MARCH & MARTIN ING Raymond March 16 Winter Street - Peabody, MA 01960 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: ulation office of Consumer Affairs and Business Reg 10 Park Plaza - Suite 5170 Boston, MA 02116 Notav liwithout ithout signature Massachusetts - Department of Public Safety Board of Building Regulations and Standards I-orntruchoi-I Super -$ impr Specia"'k License: CSSL-102367 -1 Is RAYMOND P MAJ00 9 Flint Street Marblehead MA ;01 I 1•11 )I lit Expiration Commissioner 01119/2017 Restricted To: CSSWC- Insulation Contractor Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS