HomeMy WebLinkAboutBuilding Permit #151-2017 - 2 Village Green 8/17/2016 4v i NORTH
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BUILDING PERMIT 3r g 0�
TOWN OF NORTH ANDOVER ° : o
AI PhIAO FO PLAN EXAMINATION
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Permit NO: � � i � Received � °9 �•.•; ' '`
Date Issued: (l
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I PO ANT:Applicant must com Tete all items on this page
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LOCATION PIIIQe -&705'00) Z 201 'lq
Print
PROPERTY OWNER
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MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building D One family
E�Addition Ffw-o or more family ❑ 1 dustrial
F eration No. of units: Commercial
Repair, replacement 0 Assessory Bldg ❑ Others:
❑ Demolition F1 Other
i Septic Ll Well : Floodplain l Wetlands ❑ Watershed District
F]Water/Sewer
Identification Please Type or Print Clearly)
OWN R: Name: 4nPhon .
3
Addrs 1:15 !2 l
CONTRACTOR Name: hone: 2
Address:
17-91 M!t-q J
Supervisor's Construction Licens - Exp. ate:
Home Improvement License: j n Exp.. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULD/NG PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $p (^ _ FEE: $
Check No.: 2 ' Receipt No.:369 w3
NOTE: Persons contracting wit nreis d contractors do not have accessto1-7zol
anty fund ,
Signature of -gent/Owne Signature of contractor
1
Flans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art E] 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
PLANNING & DEVELOPMENT Reviewed On fil 7 Signature_
COMMENTS '5M k [ lL�Rck� O�o.� G� )A--
IQ
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed ori Signature
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/si nature&pate Drivewae
qy P rmit
DPW Town Engineer: Signature:
t oatd at�12;4tMainStreetem ® 4 Located_ no Osgood
Lpumpster on}site; eri;FIREeDEPARME �y9
�Ta • ; ,, , ;: .� •— -, -.
-�„-. .,.
,� �, t�
*FireDepartmentMs�gnature/;a e x { �• -
t - n,.,r s'.d-
COMMENTS
N, , 4 f*
e -< C-- ,� 'r
Dimension
I ti
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.$100-$1000 fine
NOTES and DATA— (For department use)
❑ Notified for pickup Call Email
Date Time Contact Name
Doo.Building Permit Revised 2014
pORT#j q
Town of 2 s ndover
O
No.
I � 2 h
h ver, Mass, �D
coc Mlc Nl WIC" yIt. -�
�d p�R�7E D PPP�,�S
1s �
BOARD OF HEALTH
Food/Kitchen
PER T Septic System
THIS CERTIFIES THAT C....... ,,,, „ ,n! .,,,, ,,, ,,PeN,
BUILDING INSPECTOR
..
has permission to erect .......................... buildings on .... ..I . ...�.. Foundation....�J
Rough
tobe occupied as .....�� .. ....�. .... ..... .................................................................... Chimney
provided that the person accepting this ermit 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
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONST CTIO Rough
Service
... . .. . ............. ........ ..........
Final
BUILDI INS CTOR
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.
G ORGOULIS ROOFING & CONSTRUCTION, INC. y J
Dracu�MA 01826
Al Greene—Director of Field Operations
1-978-653A212 O�.ice
1-978-98&1 70D Cell
ecomoulisl,4144aol.com
CONTRACT
Villager Green East Condo Assoc. 07/27/16
do Property Management of Andover
P.O.Box 488
Andover,MA
1-918-6$3-4101
lir€tda!o@pmandover.com Job:t.oeation:Village Green East Condo Assoc.N.Andover,MA
Scope of Work: (Roof Replacements)
Remove all layers of roofing down to plywood deck on entire shingled roofs of all buildings,as specified in bid Specs.,
careMly tarping the work areas to fully.protect the house bodies,decks,and landscaping.Re-nail plywood decking as needed.
Remove existing siding from all sides of cheek wall locations to accept new ice/water shield and aluminum step flashing.
Re€nave existing I x 3 shadow board from all eave lines,run ice/water shield onto fascia board 3",re-install I x 3 trim board.
bail Grace Select ice/water shield underlayment 9'across all roof eaves,4%z' in all valleys,Y up rakes at all
roof to wall locations,around all roof protrusions,and curbing up onto all face and sidewalls a minimum of 2'. Install new 6"
strip over the newly installed drip edge for proper and added water tightness.
lzoall new.019"aluminum step flashing at all roof to wall locations in conjunction with ice/water shield.Install new roll
fimbing at all horizontal face walls in conjunction with ice/water shield.
lil GAF Deck Armor synthetic underlayment over remaining exposed roof deck surfaces.
tmtail T'.025 gauge heavy duty brown aluminum drip edge on entire roof perimeters.
ball GAF Pro Start starter strips acros's.all eaves and up all rakes.
1zsWI GAF Timberline HD Lifetime Architectural shingles with Timbertex'Hip/Ridge caps on roof,cutting ridge
as necessary to ensure there is a 1 ''/s"opening on each side of ridge pole and extending the entire length of ridge.
new heavy duty stack pipe boots on all plumbing pipes.
l:-stall GAF Snow Country ridgevent on all main ridges.
Ustall new pre-primed cedar clapboards and/or cedar shakes on all roof to wall areas where.removed to properly flash and
root': Painting or staining to be done by others and is not included'in this contract.
i--ail new.032 gauge aluminum rain diverters to replace any rain diverters currently in place.
ill new lead flashing on al l.existing brick chimneys,properly mortar lead seam,seal all others seams for water tightness.
`roughly clean and magnet grounds,and remove all job related debris from property on a daily basis and at jobs
completion.
°Georgoulis Roofing,Inc,will comply with all OSHA,MA,and federal safety work practices.As a GAF Master Elite Certified
contractor we will comply with GAF's product specification and installation guidelines.
:00 Per Sheet Extra Cost to replace any rotted or damaged plywood decking(if needed).
ii7-iO Per Lineal Foot Extra Cost to replace any rotted or damaged fascia,rake or shadow trim boards(if needed).
Goerg.pialis Roofing,Inc.is a GAF Master Elite Certified Contractor
includes GAF's Systems Plus Warranty. First 40 Yrs.Is non-prorated,Cull labor and material coverage
fr GAF,against any material defect or installation cause,at no charge.
VYT PROPOSE hereby to furnish material and labor complete in accordance with above specifications,
F= sten of.
"tree Hundred Thirty Thousand Eight Hundred Thirty Dollars $330,830.00
PAYMENT TO RG MADEAS FOLLOWS:
INVOICING WILL OCCUR.l'ER BUILDING COMPLETION,EACH INVOICE TO BE PAID IN FULL
WITHIN S DAYS OF INVOICE SUBMISSION. IF A RE'TAINAGE OF 10%1S WITHHEIJ)AT CND OF
ENTIRE.108,THIS WILL BE PAID WITHIN 1.0 DAYS OF COMPLETION OF ANY PUNCH LIST ITEMS.
All material is guaranteed to be as specified.All work to be completed in a substantial workman like manner according_to specifications submitted
per standard practices.Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will
become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry
fire,tornado and other necessary insurance.Our workers are filly covered by workers compensation insurance.
Georgoulis Authorized Signature
This proposal may be withdrawn by us if not accepted within 30 days.
Acceptance of Proposal-The above prices,specifications are satisfactory and are hereby accepted. You are authorized to do the worts as specified.
Payment will be madras outlined ahov
t
Sign a Signature Date of acceptance
t9 /4
� .
The following is part of this contract.
Contractor Re istratian
All home improvement contractors must be"registered with the Commonwealth of Massachusetts. Contractor
Registration#117870 and Construction Supervisor License#058498. Inquires about registration should be made to-
Director,Home Improvement Contractor Registration,One Ashburton Place,Room 1301,Boston,MA 02108(6 t7)
727-8598.Better Business Bureau,Inc. Georgoulis Construction,Inc.member ID#35522.Contact the Better Business
Bureau(508)652-4888 or at nicniberservices .0117.
General
All outside work areas will be left rake clean.Roofing may result in dust or debris falling into the attic. This contract
dues not include clean up or protection of the contents in the attic.In the event a satellite dish should have to be
removed to complete project,Georgoulis Construction,Inc,will not be responsible for repositioning after re-
installation, should it be necessary.
NMents
The maximum down payment or advanced deposit allowed by Massachusetts law is limited to whichever is larger: (A)
One third of the total contract or(B)the entire cost of any special order materials.Final payment is not required until
the date of completion of the project.Payment must be made within seven days from completion date.All Credit
Card Sales over$1,000.00.are Subject to a 2.0%Convenience Fee.
Work Schedule
T>be owner agrees the scheduling date is approximate.The contractor agrees to show good faith in meeting deadlines
bL-Iarc not responsible for delays caused by weather. Suppliers,subcontractors,building officials. asbestos abatement,
Edden damages or conditions,accidents, acts of God or anything beyond our control.
Change Orders
TU owner is aware that the work may contain hidden damage,defects,or conditions such as decay,insect damage,or
mrd construction practices,that may require additional work not included in this contract. In this case,
Creargoutis Construction,Inc. will contact the owner and agree on an additional charge to the original contract price.In
esmt'the owner can not be contacted,and it is crucial that work continue to protect the residence from the
dents, (rain,snow,ect.)photographs)kill be taken to document the necessity of the additional work.The owner
Viands that any additional work will delay the completion of the project.
sC ,• .
W- arrggty
The contractor, Georgoulis Construction,Inc. agrees to correct any work that fails to conform with the contract or
workmanship that is defective with in TEN(10)years from the substantial completion date of the project at NO
CHARGE to the homeowner.The homeowner agrees to notify Georgoulis Construction,Inc.specifying the nature of
any workmanship defect,immediately.No warranty is provided for ordinary wear and tear,fading,abuse,neglect or
casualty,or minor cracking/shrinking of concrete or caulking.No warranty is provided for materials not directly
supplied by Georgoulis Construction,Inc.or for used,re-installed materials,(including skylights not installed by
Georgoulis Construction Inc)or work done by others.This warranty excluded consequential and incidental damages.
Contract Acceptance
Upon acceptance of the authorized parties at Georgoulis Construction,Inc.this contract and all work described herein
will constitute the entire agreement between Georgoulis Construction,Inc.and the Homeowner.
II
f
The Commonwealth of Massachusetts
z Department of Industrial Accidents
s 1 Congress Street,Suite 100
Boston,MA 02114-2017
www mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Anmlicant Information Please Print Leeibly
Name (Business/Organization/Individual):Georgoulis Construction, Inc.
Address:96 Arlington Av
City/State/Zip:Dracut, MA Phone#:9784534242
Are you an employer?Check the appropriate box:
Type of project(required):
1.Q✓ I am a employer with 10 employees(frill and/or part-time).* 7. ❑New construction
2.❑I am a sole proprietor or partnership and have no employees working for me in g. ❑Remodeling
any capacity.[No workers'comp.insurance required.]
3.M I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. El Demolition
10[]Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p
Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c.
14.[:]Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 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.
$Contractors 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.
Admiral Insurance Company
Insurance Company Name. P y
Policy#or Self-ins. Lic.#:WC009774283 Expiration Date:9/25/16
Job Site Address:Village Green East Condo City/State/Zip:N.Andover MA
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification. -
I do hereby certify u er the ai and penal ' s of perjury that the information provided above is true and correct.
Si nature: Date:
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.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
• l s DATE (MMIDDANM
ACORO CERTIFICATE OF LIABILITY INSURANCE
03/11/2016
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 INSURERS AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(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 Phone: (978)263-35M Fax (978)263-1438 CONTACT Gallant Insurance Agency,Inc.
GALLANT INSURANCE AGENCY,INC. NAME:PHONE 978 263-3500 F'X (978 263-1438
199 GREAT ROAD/P 0 BOX 975 MIL E e ( ) No: )
EMAIL
ACTON MA 01720 AD ESS:
PRODUCER36702
CUSTOMER
US O ER D'
INSURER(S)AFFORDING COVERAGE NAICtt
INSURED INSURER A James River Insurance Company
GEORGOULIS CONSTRUCTION INC.
CIO SCOTT GEORGOULIS INSURER B : Chartis Insurance Company
96 ARLINGTON AVENUE INSURER
DRACUT MA 01826 INSURER D:
INSURER E
.SURER F
COVERAGES CERTIFICATE NUMBER: 48658 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 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,
ONDITIONS OF SUCH P111 MITS SHOWN MAY HAVE BEEN RFDUCFD BY PAID CLAIMS
INSR TYPEOF INSURANCE ADD?. SUBR POLICY EFF POLICY EXP
LTR INSR WVD POLICY NUMBER LIMITS
A GENERAL LIABILITY 000706700 03/05116 03/05117 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 1 OO,000
PREMISES a occurence $
CLAIMS-MADE I7 OCCUR MED.EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY PRO lOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $
ANY AUTO (Ea accident)
BODILY INJURY(Per person) $
ALL OWNED AUTOS BODILY INJURY(Per accident)
$
SCHEDULED AUTOS PROPERTY DAMAGE
HIRED AUTOS (Per accident) $
NON-OWNED AUTOS $
$
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS UAB CLAIMS-MADE AGGREGATE $
DEDUCTIBLE
$ i
RETENTION $ $
B WORKERS COMPENSATION WC009774283 09/25/15 09/25/16 X I TD STATu- OTH
AND EMPLOYERS' LIABILITY YIN IMITSFIR
ANY PROPRIETORIPARTNERIEXECUTTVE E.L.EACH ACCIDENT100,000
OFFICERIMEMBER EXCLUDED? I� NIA $
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,U more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
I
AUTHORIZED REPRESENTATIVE
Attention:
�. a G�rr4ah
ACORD 25(2009/09) 0 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Q�Xll'- V fl
Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 517'0
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 117870
Type: Private Corporation
Expiration: 12112/2016 Tr# 260054
GEORGOULIS CONSTRUCTION, INC.
SCOTT GEORGOULIS
96 ARLINGTON AVE
DRACUT, MA 01826
Update Address and return card.Mark reason for change.
( ] Address Renewal Employment j Lost Card
SCA1 05 20M-05111
ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only
IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
ME
gistration
IMPR 117870 Type: Office of Consumer Affairs and Business Regulation
piration: 12112f2016 Private Corporatior. 10 park Plaza-Suite 5170
Boston,MA 12116
GEORGOVUS CONSTRUCTION,INC.
9
SCOTT GEORGOULIS
96 ARLINGTON AVE g�
DRACUT,MA 01826 Undersecretary Not valid without signature
� Massachusetts Department of Public Safety
VimBoard of Building Regulations and Standard
ISE11010-6955849 _ License: CS-058498
'`UCSattUiego Extension m' �n Construction Supervisor
INTERNATIONALSAFEtYEDUCAn6NINSnTUTF(t ) S✓"^"',^�*®�p7
SCOTT C GEORG.OUL{,`,,,t f 1` rr'•
This card certifies that: S N.. red
96 ARLINGTON AVENU� l
SCO'T'T MORGOULIS � DRACUT MA o1"sss'� ��
i
has com feted a 10-Hour OSHA Hazard Recognition Training
P 9 9 ,
for the Construction industry.
._ �k- 08/23/2013 ,� �:_ Expiration:
� Dir��---�--- 10!2112017
ector:Scott MacKay Trainer:TaytorSikes Grad.Date: Commissioner
II
i
'0� _
Location
No. Ygl(D —2117Date
. - TOWN OF NORTH ANDOVER
� Certificate of Occupancy $
Building/Frame Permit Fee $ 909 9
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check.# l�,��
Building Inspector j
X30, S6 CD ,6z