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Home My WebLink AboutBuilding Permit #291-14 - 35 BONNY LANE 9/30/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION /504 A `!�-t ��rz" PROPERTY OWNER t/�CL� 7 e �� Unit# Print MAP NO: � PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure ye no TYPE OF IMPROVEMENT PROPOSED USE Residential - Non-Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alt ration No. of units: ❑ Commercial Kpi�epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 7777 Septic []Well' D Floodplain Wetlands` ❑,Waterslied District. - /J^ DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Print Clearly) OWNER: Name: Phone: 6Y3- Address: 3 Address: 7,:�,:� CONTRACTOR Name:��l!'7`7 Z�zt� Phone: '11�)lf Address: ( �Ae /l/la A'e-, Supervisor's Construction License: ^ 10 V9 Exp. Date: /4) _13 Home Improvement License: 7f 70 Exp. Date. �� - �� 1�7 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PEWT.-$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ �� FEE: $. e-2) -2- Check Check No.: , l f Receipt No.:. NOTE: Persons contracting with unregistered contractor, do nothave access to t#e guaranty fund -IM, of Aaet`it/Ovvner:` _ignatue of_contra or . Location ?:6nn ak!l No. 1 I Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee s2— Foundation 2Foundation Permit Fee $ Other Permit Fee $ TOTAL $ I Check# 1�1 t J ✓ 4: Building Inspector 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 D Private(septic tank,etc. ❑ ' Permanent Dumpster on Site ❑ a THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature 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 i Water & Sewer Connection/Signature&Dafe Driveway Permit F,-W 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 Dimension Total square feet of floor area, based on Exterior dimensions. Number of Sfiories:_______ Total land area, sq. ft.: ELECTRICAL: Movement of Meter lies ion, mast or service drop requires approval of Electrical Inspector ector No ®ANGER ZONE LIT ER) RE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ® Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi 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 o Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products MOTE: 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) i ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products ATE: All dumpster permits require.sign off from Fire Department prior to issuance of Bldg Permit i 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 a 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 productstmerior to issuance of Bldg .Permit )TE: All dumpster permits require sign off from Fire Depar p 311 cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals t the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording st be submitted with the building application Doc: Doc.Building Permit Revised 2008mi ,I r 1 NORrN . 1c . . ver 0 h , ver, Mass, coc»Ic„ewrcw ^TED JPa�,�S S V BOARD OF HEALTH Food/Kitchen PERMIT D Septic System ... . .... � �. ,... . .�........ .... BUILDING INSPECTOR THIS CERTIFIES THAT .............. ... ... � ��'� ..... .... r� ..................... has permission to erect g Foundation .......................... buildings .��..... ��......�.a�..�i�w............. Rough tobe occupied as ................... ..N;p.......... ................................. .:. .................................... Chimney provided that the person accepting this permit shall in every respect conform 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 CONSTRUCTST S Rough Service .............1 ....................................................... Final BUILDING INSPECTOR 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. SEE REVERSE SIDE GEORGOULIS CONSTRUCTION 9784589997 P. 1 .a►coRv CERTIFICATE OF LIABILITY INSURANCE �09123�120113 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 IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. It SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy,Dertaln policies may require an endorsement Astatement on thls eeRHicate does not confer rights to the certificate holder In lieu of such endoraemenga). PRODUCER Phone:(978)263 500 Fax (976)263-143a AOT Gallant Insurance Agency,Inc. GALLANT INSURANCE AGENCY,INC. P"O"E (978)263..3500 FAX . (978)263-1438 198 GREAT ROAD I P O BOX 975 E4MIL ACTON MA 01720 PROCUCER 36702 CUsro - INSURER(S)AFFORDING COVERAGE NAM 19 INSURED INSURER A Seneca Specialty Ins Co GEORGOULIS CONSTRUCTION INC. CIO SCOTT GEORGOULIS wsuReR 6 : Chartis Insurance Company 96 ARLINGTON AVENUE INSURER DRACUT MA 01826 INSURER D: WWRER E INSURERF COVERAGES CERTIFICATE NUMBER: 36324 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 P HAVE BEEN RFDUCFD BY PAID CLAIMS (NSR 7YPEOFINSURANCE AODiI6UBR POLICYNUMBER POUCYefF �� LIMITS LTR _._ A a[w-RAL LkmNJw I BAG4001034 03105/13 03/05/14 EACH OCCURRENCE a 1,000,000 X COMMERCIAL GENERAL LIABILITY DMRAOE To teF.NiEO S 100,000 PREMISES R NT10 ca CLAIMS-AWDE I7 OCCUR MED.EXP(Any one person) y 5,000 PERSONAL 8 ADV IrtJURY S 1.000,000 GENERAL AGGREGATE S 2,000,000 GEN'LAGGREGATE UMITAPPUESPER: PRODUCTS-COMPIOPAGG S 2,000,000 POLICY PRO LOC S IFCT AUTONKM345 UABI nY COMBINED SINGLE LIMIT $ (Fa accidenl) ANY AUTO BODILY INJURY(Per person) S ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per ecciderq) $ NOW-OWNED Ar1T0.5 1 i E i I a UMBRELLA LAS OCCUR EACH OCCURRENCE $ rxceas Das HCLAIMS-MADE AGGREGATE g DEDUCTIBLE S RETENTION S $ B woRKeRs cobroaATmN WC009TT4283 09/25113 0912W14 X TORY LI TS °iH s AND EMPLOYE"' LLAae.I7Y Y I N ANY PROPRETOMPARTNERJEXECUTWEE.L.EACH ACCIDENT s 100,000 OFFICERFMMORR EXCLUDW? E-1NIA IM-8 1-Y 1.NM E.L.DISEASE-EEA EMPLOYEE s 100,000 IF yes.desafte waw DESCRIPnoNOFOPERATIONab.1— IE.LDISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEla1XES(Attach ACORD 101,AdMonal Remarm Schedule,H mora 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 WrrH THE POLICY PROVISIONS. 120 Main Street Andover,MA 01845 AumoRlz® RFPRFSENTA7IYE Aftentfon_ Ray Gallant,President ACORD 25(2009109) G 1988-2009 AC D CORP. RATIO . All rights re3erved. The ACORD name and logo are registered marks of ACORD v GEORGOULIS ROOFING & CONSTRUCTION, INC. 1 96 Arlington Ave. t Dracut,MA 01826 Al Greene-Estimator 1-978-453-4242 Office 1-978-888-1700 Cell georgoulis 141 @aol.com CONTRACT Jeanne Contarino 09/16/13 35 Bonny Ln. N.Andover,MA 1-978-683-4138 jcontarino@comcast.net Job Location:35 Bonny Ln.N.Andover,MA Scope of Work: Remove all layers of roofing ofin down g to wood deck on entire shingled house,additions,porch,and garage roofs,protecting the. grounds and house body with heavy duty tarps as stripping is being done. Install 6'GAF Weatherwatch ice/water shield underlayment across all eaves,in all valleys,3'up all rakes at all roof to wall locations,and around all roof protrusions. Install GAF Shinglemate felt paper on remaining exposed ed roof deck surf ac es. Install 8".025 gauge heavy duty brown aluminum drip edge on entire roof perimeters. Install GAF Pro Start starter strips across all eaves and up all rakes. Install GAF Timberline HD Lifetime Architectural shingles with Timbertex hip/ridge caps on roof. Install new Coravent V400 ridge vent on main ridges. Install new stack pipe boots on existing plumbing pipes. CoA=-; Remove existing attic box vents,close in and roof over with scope. 1 Com` Jra` i I Inspect and seal all seams and joints on existing lead flashing of chimney. Thoroughly clean and magnet grounds and remove all job related debris from property on a daily basis and at jobs completion. $55.00 Per Sheet Extra Cost to replace any damaged plywood decking(if needed) Entire job includes GAF Systems Plus Warranty.First 50 yrs.Is non-prorated,full labor and material coverage from GAF,against any material defect cause. WE PROPOSE hereby to furnish material and labor complete in accordance with above specifications, for the sum of. Dc?. K4 9(.310.00 CRq In6(3 RI�fi3 Eighteen Thousand Three Hundred Seventy Dollars $18,370.00 PAYMENT TO BE MADE AS FOLLOWS: 0`►320.bb Sfi;3�PAID IN ADVANCE FOR MATERIAL COSTS. PAID IN FULL WHEN JOB IS COMPLETELY FINISHED ACCORDING TO THE ABOVE LISTED PROPOSAL 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 fully coved d b rkers compensation insurance. Georgoulis Authorized Signature This proposal may be withdrawn by/iyfnot/ccepted within 30 days. Acceptance of Proposal-The above _ p p prices,specifications are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payment will be made as outlined above. Signature ignature Date of accep O— r 2 The following is part of this contract: v Contractor Registration 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(617)727-8598.Better Business Bureau,Inc. Georgoulis Construction,Inc. member ID#35522.Contact the Better Business Bureau (508)652-4888 or at memberservices@bosbbb.org. General All outside work areas will be left rake clean. Roofing may result in dust or debris falling into the attic. This contract does 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. Pam 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 azOny 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$1,000.00 are Subject to a 2.0% Convenience Fee. Work Schedule The owner agrees the scheduling date is approximate-The contractor agrees to show good faith in meeting deadlines but are not responsible for delays caused by weather-Suppliers,subcontractors, building officials.asbestos abatement,hidden damages or conditions,accidents,acts of God or anything beyond our control. Change Orders The owner is aware that the work may contain hidden damage,defects;or conditions such as decay,insect damage,or substandard construction.practices,that may require additional work not included in this contract.In this case,Georgoulis Construction,Inc-will contact the owner and agree on an additional charge to the original contract price-In the event the owner can not be contacted,and it is crucial that work continue to pr ted the rhe fram the cleameft (ram,snow,ect)pbotognq6s will be tal--to document the necessity ofthe anal world-The owner understandsthat zny additiortal work will delay the completion of the project_ �atranfy The conbactor,Georgoulis Construction,Iw-agrees to correct any work:that fmils for con1brm with the caeftal orwadommbip the i%dcEwtiwwkbin (55yms&=th &tmcf tlr.- 2fNO C;Etmffic -lt= agscsto mon,Inc-specifying the nature ofmry workmanship defer immediately-No water is -pw*,zhd fnranE=ry w=;aA tom,fadiq&zhmr,vcpAnd tir ,+crrmro raac,3 Or caccZeft orramw=Wo Immanly isprum liw uA&mcdy. hmr-or for mod,reiotsballed mAmink f`mdni&g AybgW not mA3%d by Cam zp arm of dw, tulhw- Fa .;aGzUqWUL- —k—i --*lemid WM ibe cefur 99=C:===r beta==G0MP=5S Cb=5h=1iM3'Ire zmd t$e vGiQ�??%Y1�0/J2d�l>�CCTit%yG _ Office of Consumer Affairs and B siness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 117870 Type: Private Corporation Expiration: 12/12/2014 Tr# 234343 GEORGOULIS CONSTRUCTION, INC. SCOTT GEORGOULIS 96 ARLINGTON AVE DRACUT, MA 01826 Update Address and return card.Mark reason for change. Address E] Renewal F� Employment n Lost Card. SCA 1 A 2OM-05111 lia%*achusetts-Department(if Public Safety &t:trtl of 13uiltlim�Re,�ul:ttinns and ttstndard Construction Supervisor License License: CS 58498 SCOTT C GEORGOULIS 96 ARLINGTON AVE DRACUT, MA 01826 d- - ,.r.�.— Expiration: 10/21/2013 P (ummi,-sinner Tr#: 4384 The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigationg 600 Washington Street Boston,MA. 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: �p ` City/State/Zip: Mz—' phone FEIre an employer?Check the appropriate box: _ a employer with Ay 4. ❑ I am a general contractor and I Type of project(required):loyees(full and/or part-time).* have hired the sub-contractors6 ❑New construction a sole proprietor or partner- listed on the attached sheet. 7• ❑Remodelingand have no employees These sub-contractors have 8. ❑Demolitioning for me in any capacity. workers'comp,insurance.workers' comp.insurance 5. ❑ We are a corporation and its 9 ❑Building additionred.] officers have exercised their 10.❑ElectricaI repairs or additionsa homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additionslf. [No workers' comp. c. 152,§1(4),and we have no12.❑Roof repairsance required.]t employees.[No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie. n -- ? Expiration Date: 7_ '�d__S Job Site Address: City/State/Zip-j/, hlzil_ell� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required Wider Section 25A of MGL c. 152 can lead to the imposition of fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK O penalties of i Of u to$250.00 RK ORDER and a p a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of fine Investigations of the DIA for insurance coverage verification. I do I:ereby ce ify under thepains and enalties o p P fperjury that the information provided above is true and correct. Si nature: G Date: —a —� Phone 6 c� Official use only. Do not write in this area,to he completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,orad or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers',compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy;please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investi ations . g has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating curret Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city nor town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Cormuorweai- ofMassachnsetts Department of Industrial Accidents Office of Investigations. .600 Washington Street Boston;MA,02111 TO.B 61.7-727-4900 ext 4406 or 1.-877-MASSAFE Revised 5-26-05 Fax#61.7,727-7749 wwvv.mass.gov/dia