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HomeMy WebLinkAboutBuilding Permit #814 - 425 JOHNSON STREET 6/17/2010Mar 26 10 03:01p Permit N0: NORTH ANDOVER 9786889542 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICAT.IQN FbA PLAN EXAMINATION Date 7/- )4� /6 Pont MAP 2 t D PARCEL:_ ZO-NING DISTRICT: �. Historic District des Machine :Shop Village yes_ TYPE OF IMPROVEMENT -'PROPOSED USE Residenf Non- Residential New 6uilding One family Two or more family Industrial Alteration No. of units: Assessory Bldg Commercial Repair, replacement Others: Demolition Other Septic ell Floodplain Wetlands Watershed District aterlSew DESGKIF I FUN Ul- VVUKr% I u ac rmarwrxirir=v. Identification Please Type or Print Clearly) OWNER: Name: L=&"W D Phone: Address: 1t- Me � i� ARCHITECT/ENGINEER 6I` -A rJ-0 Phone: 970 o ?v>a `/ % OL Reg. No. Address: FEE SCHEDULE: BULDING SIT: $92.00 R , 000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. - -�' .� Total Project Cost: $ FEE: $ r749; Check No.: Receipt No.: NOTE: Persons contracting with unreg�sto.gd contractors do not have access to the guar'iPh'-fund Signature of Ager;tOwney` �� Signature of contractor. i `J Permit NO: Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION • Date Received I IMPORTANT: Applicant must complete all items on this pate I LOCATION Print PROPERTY OWNER Print MAP 210 PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Villaqe yes no 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 Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: 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.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ti Signature of Agent'Owner. Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE WERAGE DISPOSAL f ublic 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 ' T , u COMMENTS HEALTH COMMENTS Reviewed on Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: Co servation Decision:_ Water & Sewer Co DPW Town Engineer: Signature: Zoning Decision/receipt submitted yes Comments CnmmPnts t_ocatea 364 us ooa street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Faire Department signatureldate a COMMENTS Dimension 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 - Date Doc.Building Permit Revised 2010 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 a Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o 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 o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o 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: Building Permit Revised 2008 Location y'?y U`/°`�Sd�1 S� we Date �/ L66) NpRTN TOWN OF NORTH ANDOVER L A Certificate of Occupancy $ Z� '�S'••°''<�'; Building/Frame /Frame Permit Fee $ J S cMust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 6_267 6 Building Inspector n0. C p 7 e z O Z. •tNR c.2 c O C arc. ��, Cl G y CL m 'O � 'r N �� y z CL.1- 09 E CL N N O H C O am M om c CIO O Cf C 'c N Co Z O 2 tz CD W! O O V V Z CD Q O y 0 C IO Cm C y 0 � O y O O �F m m CD G3 O �� O C O L cc O CL �a C Ca � c O O v J.O CL. O Co CO3C Z tsO v Co c C C C c LLI 0 W N It W 19 LLIW U) 0 U O , W- ►M w m% � y_. F � W Qj W >, 10 W (7 w o v C ; G N O �' mQ cit cn •tNR c.2 c O C arc. ��, Cl G y CL m 'O � 'r N �� y z CL.1- 09 E CL N N O H C O am M om c CIO O Cf C 'c N Co Z O 2 tz CD W! O O V V Z CD Q O y 0 C IO Cm C y 0 � O y O O �F m m CD G3 O �� O C O L cc O CL �a C Ca � c O O v J.O CL. O Co CO3C Z tsO v Co c C C C c LLI 0 W N It W 19 LLIW U) V% A CERTIFICATE OF, USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 814-2012 Date: DECEMBER 14, 2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON .425 JOHNSON_ STREET, North Andover, MA 01845 JOHN LAH(.00D MAY BE OCCUPIED AS SINGLE-FAMILY IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Fee: 100.00 PREVIOUSLY PAID Receipt: 23001 JOHN LAHOOD 425 JOHNSON STREET NORTH ANDOVER, MA 01845 Building Insp ctor w O n z m O Z. IM O \O ' 0 Q iCO "O LZci=oc ACmaCmmN Aoc mCc c� CL No y o ve3�vm WuAaMft W uj 19 W LLI ce LLIW W VII 0.4 JI, Q �# o cn co wi a a4 cn cn IM O \O ' 0 Q iCO "O LZci=oc ACmaCmmN Aoc mCc c� CL No y o ve3�vm WuAaMft W uj 19 W LLI ce LLIW W VttLED f6 <N 3•t ° h, 0. *6 0 40 APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION 9A ��SSacmus���� BUILDING PERMIT # ADDRESS/LOCATION OF PROPERTY: Z JOH 14 �j ST Map Parcel Lot Number SUBDIVISION: DATE REQUESTED FILED/READY FOR INSPECTION: CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A REINSPECTION FEE OF TWENTY DOLLARS ($20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. APPLICANT SIGNATURE Permit Issued to: Address: ROUTING TOWN ENGINEER, SITE PLAN — DRIVE -WAY REVIEW CONSERVATION PLANNING DPW -WATER METER SEWER CONNECTION DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW SIGNATURE File: Application for OC form revised Jan 2007/2011 c%hn 1.adnad eei�� 9��-s�7—�o7 1 4 0 • 0 z. O a o x u w° v t C/) 0 U w M Z O 0 w � to c aQ a 0 W a .� m2 a R N C O o: H W w w m� cn cn Q = F- CO.) LL F. C.3 COD _ ��0a4- x m O . a� M Z O o to c aQ o,cr .� m2 CC.,3 'Qc2c N C O o: L y m C c Z m.o �' O e+ 1-- 01 -- N m w,,, C cc ev 1 Z C O16 cr .0.� O •O �= o 2 CD , cm p ® � c p: m LO H.= E a m c o o. c m `i v CD = vQs a N cm g. �p c T N O Q = F- CO.) LL F. C.3 COD _ ��0a4- m O . a� = Z O to c aQ o,cr .� m2 CC.,3 'Qc2c a L y m C m m.o �' O e+ 1-- 01 -- N m w,,, C cc ev 1 Z •N O16 cr .0.� O •O c _ +' •d1 2 cm p ® � c d O� O� LO H.= J 0 O r, U O O v ►+r V 6 O CD cm CACD Q .� y O O �g m CD CD C.CD ~ � O � O 0 O � O Q C_ v�Q CO2 4— C cCc C I� .E O CD C Z s CL C-) y O C c — c CO)CL 0 LU LU U) 19 W LU 12 W CD Massachusetts - Department of Public Safeth Board of Building; Regulations and Standards Construction Supervisor License License: CS 96176 Restricted to: 00 RICHARD TEDESCO 11 SEARS ISLAND DR WORCESTER, MA 01606 ('ummissioner Restricted to: 00 00 - Unrestricted 1G -1 2 Family Homes Expiration: 1/12/2012 Tr#: 20812 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW. Mass.Gov/DPS 3 71. eomwnarawe� oeJ400ac/u"A Office of Consumer Affairs & Business Regulation t HOME IMPROVEMENT CONTRACTOR a Registration: 148935 Expiration: 11/8/2011 Tr# 290257 Type: Ltd Liability Corpor GOODFELLA'S CONSTRUCTION MANAGEMENT LLC. JOSEPH KUPSTAS 18 WAITE ST. go WORCESTER, MA 01604 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 of valid without sig ature t, . 4 CREScheck Software Version 4.3.1 NJ( Compliance Certificate Project Title: Lahood Residence Energy Code: 2007 IECC 38.0 0.0 Location: North Andover, Massachusetts 38.0 Construction Type: Single Family 1460 26.0 Building Orientation: Bldg. faces 45 deg. from North 387 Conditioned Floor Area: 2728 ft2 Orientation: Front Glazing Area Percentage: 13% Window 1: Vinyl Frame:Double Pane with Low -E 64 Heating Degree Days: 6322 SHGC: 0.28 Climate Zone: 5 Orientation: Front Construction Site: Owner/Agent: Designer/Contractor: 425 Johnson St 0.0 Richard Tedesco Gerry Bruno North Andover, MA 01845 GoodFellas Construction Management GJ Bruno Associates LLC Berekely Road 18 Waite St. North Andover, MA 01845 Worcester, MA 01604 336 26.0 0.0 508-363-1220 Rich@GoodFellasLLC.com 60 Compliance: 13.5% Better Than Code Maximum UA: 377 Your UA: 326 The % Better or Worse Than Code index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum -code home. Ceiling 1: Cathedral Ceiling (no attic) 1680 38.0 0.0 Ceiling 2: Flat Ceiling or Scissor Truss 200 38.0 0.0 Floor 1: All -Wood Joist/Truss:Over Unconditioned Space 1460 26.0 0.0 Wall 1: Wood Frame, 16" o.c. 387 26.0 0.0 Orientation: Front Window 1: Vinyl Frame:Double Pane with Low -E 64 SHGC: 0.28 Orientation: Front Wall 2: Wood Frame, 16" o.c. 90 26.0 0.0 Orientation: Front Door 1: Glass 18 SHGC: 0.35 Orientation: Front Wall 3: Wood Frame, 16" o.c. 336 26.0 0.0 Orientation: Front Window 2: Vinyl Frame:Double Pane with Low -E 60 SHGC: 0.28 Orientation: Front Door 2: Solid 40 Orientation: Front Door 3: Glass 20 SHGC: 0.35 Orientation: Front Wall 4: Wood Frame, 16" o.c. 270 26.0 0.0 Orientation: Left Side Door 4: Solid 18 Orientation: Left Side Wall 5: Wood Frame, 16" o.c. 240 26.0 0.0 Orientation: Left Side Wall 6: Wood Frame, 16" o.c. 378 26.0 0.0 45 6 54 17 0.290 19 4 0.350 6 11 0.290 17 0.160 6 0.350 7 0.160 13 3 12 15 Project Title: Lahood Residence Report date: 06/07/10 Data filename: C:\Documents and Settings\Maria Mazzocchi\My Documents\REScheck\Lahood.rck Page 1 of 5 Orientation: Back Window 3: Vinyl Frame:Double Pane with Low -E 48 0.290 14 SHGC: 0.28 Orientation: Back Door 5: Glass 40 0.290 12 SHGC: 0.28 Orientation: Back Wall 7: Wood Frame, 16" o.c. 336 26.0 0.0 15 Orientation: Back Window 4: Vinyl Frame:Double Pane with Low -E 50 0.290 14 SHGC: 0.28 Orientation: Back Wall 8: Wood Frame, 16" o.c. 270 26.0 0.0 13 Orientation: Right Side Window 5: Vinyl Frame:Double Pane with Low -E 16 0.290 5 SHGC: 0.28 Orientation: Right Side Wall 9: Wood Frame, 16" o.c. 240 26.0 0.0 11 Orientation: Right Side Window 6: Vinyl Frame:Double Pane with Low -E 25 0.290 7 SHGC: 0.28 Orientation: Right Side Furnace 1: Forced Hot Air 95 AFUE Air Conditioner 1: Electric Central Air 16 SEER Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2007 IECC requirements in REScheck Version 4.3.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name - Title Signature Date Project Title: Lahood Residence Report date: 06/07/10 Data filename: C:\Documents and Settings\Maria Mazzocchi\My Documents\REScheck\Lahood.rck Page 2 of 5 CREScheck Software Version 4.3.1 NJ( Inspection Checklist Ceilings: ❑ Ceiling 1: Cathedral Ceiling (no attic), R-38.0 cavity insulation Comments: ❑ Ceiling 2: Flat Ceiling or Scissor Truss, R-38.0 cavity insulation Comments: Above -Grade Walls: ❑ Wall 1: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 2: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 3: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 4: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 5: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 6: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 7: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 8: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: ❑ Wall 9: Wood Frame, 16" o.c., R-26.0 cavity insulation Comments: Windows: ❑ Window 1: Vinyl Frame:Double Pane with Low -E, U -factor: 0.290 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2: Vinyl Frame:Double Pane with Low -E, U -factor: 0.290 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 3: Vinyl Frame:Double Pane with Low -E, U -factor: 0.290 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 4: Vinyl Frame:Double Pane with Low -E, U -factor: 0.290 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Project Title: Lahood Residence Report date: 06/07/10 Data filename: C:\Documents and Settings\Maria Mazzocchi\My Documents\REScheck\Lahood. rck Page 3 of 5 ❑ Window 5: Vinyl Frame:Double Pane with Low -E, U -factor: 0.290 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 6: Vinyl Frame:Double Pane with Low -E, U -factor: 0.290 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Note: Up to 15 sq.ft. of glazed fenestration per dwelling is exempt from U -factor and SHGC requirements. Doors: ❑ Door 1: Glass, U -factor: 0.350 Comments: ❑ Door 2: Solid, U -factor: 0.160 Comments: ❑ Door 3: Glass, U -factor: 0.350 Comments: ❑ Door 4: Solid, U -factor: 0.160 Comments: ❑ Door 5: Glass, U -factor: 0.290 Comments: Floors: ❑ Floor 1: All -Wood Joist/Truss:Over Unconditioned Space, R-26.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Heating and Cooling Equipment: ❑ Furnace 1: Forced Hot Air: 95 AFUE or higher Make and Model Number: ❑ Air Conditioner 1: Electric Central Air: 16 SEER or higher Make and Model Number: Air Leakage: ❑ Joints, attic access openings, and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights in the building thermal envelope are 1) type IC rated and ASTM E283 labeled and 2) sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated (without insulation compression or damage) to at least the level of insulation on the surrounding surfaces. Where loose fill insulation exists, a baffle or retainer is installed to maintain insulation application. ❑ Wood -burning fireplaces have gasketed doors and outdoor combustion air. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U -factor of 0.50 and the maximum skylight U -factor of 0.75. New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: ❑ A minimum of Class II (1.0 perm) vapor retarder is installed on the interior side of above -grade framed walls or it has been determined that moisture or its freezing will not damage the materials. Exceptions: Class III (10 perm or less) vapor retarder is permitted for vented cladding over OSB, plywood, fiberboard, gypsum, or for sheathing over 2x4 framing having insulation of R-5 or better, or for sheathing over 2x6 framing having insulation of R-7.5 or better. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. ❑ Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R -value. Project Title: Lahood Residence Report date: 06/07/10 Data filename: C:\Documents and Settings\Maria Mazzocchi\My Documents\REScheck\Lahood.rck Page 4 of 5 ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. F1 Insulation R -values, glazing U -factors, and heating and cooling equipment efficiency are clearly marked on the building plans or specifications. Duct Insulation: ❑ Supply ducts in attics are insulated to a minimum of R-8. All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction: F1 Air handlers, filter boxes, and duct connections to flanges of air distribution system equipment or sheet metal fittings are sealed and mechanically fastened. ❑ All joints, seams, and connections are made substantially airtight with tapes, gasketing, mastics (adhesives) or other approved closure systems. Tapes and mastics are rated UL 181A or UL 181 B. Building framing cavities are not used as supply ducts. Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. F1 Additional requirements for tape sealing and metal duct crimping are included by an inspection for compliance with the International Mechanical Code. Temperature Controls: El Thermostats exist for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. Heating and Cooling Equipment Sizing: ❑ Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. F1 For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2006 IECC Commercial Building Mechanical and/or Service Water Heating (Sections 503 and 504). Circulating Service Hot Water Systems: F-1 Circulating service hot water pipes are insulated to R-2. ❑ Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-2. Certificate: ❑ A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R -values; window U -factors; type and efficiency of space -conditioning and water heating equipment. The certificate does not cover or obstruct the visibility of the circuit directory label, service disconnect label or other required labels. NOTES TO FIELD: (Building Department Use Only) Project Title: Lahood Residence Report date: 06/07/10 Data filename: C:\Documents and Settings\Maria Mazzocchi\My Documents\REScheck\Lahood.rck Page 5 of 5 2007 IECC Energy Efficiency Certificate Ceiling / Roof 38.00 Wall 26.00 Floor/ Foundation 26.00 Ductwork (unconditioned spaces): Glass & Door Rating U -Factor SHGC Window 0.29 0.28 Door 0.16 0.28 Forced Hot Air Furnace 95 AFUE Electric Central Air Conditioner 16 SEER Water Heater: Name: Date: Comments: The Commonwealth of Massachusetts Department of Industrial Accidents i ! Office of Investigations 600 Washington Street u. f Boston, MA 02111 �tt, s www.ntass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information f Please Print Legibly Name (Business/Organization/individual); �q 6©1' 5 n1AJcT1 Or J L— LC Address: I43 City/State/Zip: _WOVA,;? . OX 6,04 Phone #:. b -9 6, 3 JZZO Are you an employer? Check the appropriate box: LU I am a employer with `J 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet i ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required_] Type f project (required): 6. New construction 7. ❑ Remodeling 8. ❑ Demolition. 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks bo)t# l 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 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: eXLL A N -t Policy # or Self -ins. Lic. #: l.f jS3 3 q -71— U Expiration Date: 2� ` Job Site Address: L( ZS W �ISU>� -"�i City/State/Zip: • /►�� K O� 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 penalties of perjury that the information provided above is trueand correct Signature: �4MDate: -- 3 ! / O Phone #: 5645 3 C, ? 1226 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 #• A� V CERTIFICATE OF LIABILITY INSURANCE ATE 5D26(2010 PRODUCER Phone: 508-756-5159 Fax: 508-751-5747 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Herlihy Insurance Group 51 Pullman Street Worcester MA 01606 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. POLICY NUMBER INSURERS AFFORDING COVERAGE NAIC # INSURED Goodfella's Construction Management LLC 18 Waite St. _ INSURER A:Merchant s Insurance Group INSURERB:Safety Insurance Company INSURER c: Travelers C/O TPA Associates Worcester MA 01604 INSURER D: 4/22/2010 INSURER E: EACH OCCURRENCE $1,000,000 COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DDT POLICY NUMBER POLICY EFFECTIVE T MM DD POLICY EXPIRATION MM/DD/YYYY LIMITS A GENERAL LIABILITY CMP9150715 4/22/2010 4/22/2011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE IX -1 OCCUR DAMAGE ( RENTED PREMISES Ea occurrence) $ 100,000 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 JECLOC $ AUTOMOBILE LIABILITY ANY AUTO 6208072 10/31/2009 10/31/2010 COMBINED SINGLE LIMIT (Ea accident) S1,000, 000 BODILY INJURY (Per person) $ X rX ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per accident) X HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY CMP9150715 4/22/2010 4/22/2011 EACH OCCURRENCE $ OCCUR Ej CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N UB 3 3 9 7 t 5 6 410 2/3/2010 2/3/2011 // 3 2 011 X TNRYA IN LO ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT 1 $ 10 Q 000 OFFICERIMEMBER EXCLUDED? 1Y I E.L. DISEASE - EA EMPLOYEE $100, 000 (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT I $ S Q Q 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Corporate officers excluded, Joe Kupstas & Dale Shadbegian VCR I IrIVA I r- rIVLIJCR VAIYVCLLA I IVIY 111 Town Of North Andover 566 Main Street North Andover MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) fM,Cl,,GOODFELLAS CONSTRUCTION 18 Waite Street, Worcester, Ma 01604 Phone: 508-363-1220 HIC# 148935; CSL# 96176 John & Ileene Lahood AGREEMENT v8: New Home 16 Edgelawn Ave., North Andover, MA Primary Contact: John Phone: 978.387.4807 Secondary Contact: Phone: Note to Homeowner: Home Improvement Contractor / Subcontractor shall be registered, inquiries: Registration Division, Program Coordinator One Ashburton Place Room 1301 Boston, Ma. 02108 Tel:(617)727-3200 ext 25239 Dear Mr. & Mrs. Lahood, Thank you for working with GoodFellas Construction. We, "GF" have prepared this agreement for you, "the Customer" to better define our agreement, pricing, and scope of work. EMERGENCY CONTACT INFORMATION: Dale: (508) 207-2342 ; GF Office: (508) 363-1220 Project Developer/Phone: Rich (774)696-9789 General Project Notes 1. 30 yd Rubbish Container Location: Front Yard 2. An outdoor restroom will be provided on-site — least visible from street as possible. 3. GoodFellas Construction will maintain a clean and presentable job sign in front yard —to be removed when project is completed. 4. Access to home: A secured Realtor's lockbox will be placed on exterior door. 5. Homeowner will OK all finish products prior to installation. 6. Safe storage of materials: TBD 7. Worksite Message Center/Notebook: TBD 8. Weekly In-Person/Phone/Email on: TBD 9. Any planned parties or visitors? TBD 10. Project Timeline: 12-16 weeks Deadline for major construction: TBD Sincerely, Richard Tedesco, GoodFellas Construction Management, LLC N. 0 Lahood Residence -v8 425 Johnson St., North Andover, MA 05/07/2010 p1 of 29 PLEASE NOTE: Any work not stated in this agreement is not included in this proposal. ARCHITECTURAL PLANS & PERMITTING: • Owner to supply all required architectural drawings • GFC to obtain all required building, mechanical, disposal, and smoke permits JOB SETUP: GFC to supply portable toilet for duration of project GFC to supply dumpsters/rubbish removal for duration of project SITEWORK/UTILITIES: • GFC to notify dig -safe prior to excavation • GFC to supply all required excavation equipment and labor for proposed project's foundation per plan o Excavated material to be stockpiled on site for backfill o Excavation depth to be approximately 8' depth o GFC to backfill foundation with materials excavated from site o GFC to haul and dispose of excess fill materials • GFC to supply all excavation labor, equipment, and materials for water and sewer connections o NOTE: Water and sewer lines are assumed to be into lot o NOTE: Price does not include any bedroom or connection fees that maybe required by town • NOTE: GFC is not responsible for unforeseen circumstances (ie. ground water, ledge, etc.) FOUNDATION: • GFC to supply all labor, equipment, and materials for proposed projects foundation o Foundation to be 10" thick 3500# mix re -enforced with steel rebar —foundation wall to sit in keyway in 12"x24" footing o Pour to be approximately 9' o (4) Vinyl basement windows to be supplied & installed — Owner to approve size prior to installation GFC to supply all labor, equipment, and materials for proposed projects concrete floor o Floor base to be minimum 12" thick processed gravel compacted in layers o Floor to be minimum 4" thick 4000# concrete re -enforced with fiberglass o Garage floor to have slight pitch towards overhead doors o Relief cuts to be made @ appropriate locations • GFC to supply and install bulkhead with precast concrete steps PERIMETER DRAINS: GFC to supply and install perimeter drains o Drains to be 6" diameter SDR 35 pipe laid in 3/" crushed stone covered with filtration fabric with uprights at appropriate locations for gutter downspouts o Drains to connect to street surface drains Lahood Residence -v8 425 Johnson St., North Andover, MA 05/07/2010 p2 of 29 FRAMING MATERIALS & LABOR: GFC to supply all framing materials and labor per plan as follows: o Floor framing to be conventional as per framing plan o Floor sheathing to be %" Advantech ring -nailed and glued o Attic framing to be as noted on plan (NOTE: Attic to have subfloor installed) o Wall framing to be 2x6 (exterior walls) with 9' finished ceiling height o Wall sheathing to be 7/16" Advantech with taped seams o Roof framing to be 2x12 #2 & better KD SPF o Roof sheathing to be %2" Advantech with taped seams o All engineered lumber and fasteners to be installed per manufacturer's recommendations o All work to be done in accordance with MA State Building Code 7th Edition GFC to supply materials, labor and installation of wood chimney in center of roof (to be veneered) ROOFING: GF to supply and install 30 year architectural roofing shingles (See selection sheets for details) o Shingles to be installed on 30# saturated felt paper o Minimum 6' ice & water barrier to be installed @ all eaves, cheeks, and valleys o All appropriate flashings to be supplied and installed WINDOWS: GFC to supply and install Marvin Integrity Windows per plan (See selection sheets for details) o Front elevation windows to have wide flat exterior casing as follows: ■ 5/44 Azek Side & Head Casings • Historic Sill Nosing Crown Pediments on First Floor Front Elevation Windows .2 o All windows to have Internal Grids �� I( be. �fi'o�la ( 6 6i7 o All windows to have full screens a. u(V-9 5"-r o All sizes and light cuts per plan and window schedule (NOTE: First floor windows to be Cottage Style) EXTERIOR DOORS: GFC to supply and install exterior doors per plan (see selection sheet for specifications) GFC to supply and install exterior door locksets (see selection sheet for specifications) GFC to supply and install insulated overhead door w/opener and keyless entry (see selection sheet for specifications) SIDING & EXTERIOR TRIM: • GFC to supply and install 1/2x6 Primed Finger Joint Clear Vertical Grain Western Red Cedar Siding • GFC to supply and install 1x12 Azek Water Table w/Cap Lahood Residence -v8 425 Johnson St., North Andover, MA 05/07/2010 p3 of 29 • GFC to supply and install 1x10 Azek Frieze Under Eave Soffits (Pending Window Pediment Final Decision) • GFC to supply and install Azek Trim For Extended Rakes w/Frieze & Birds' Mouth Returns • GFC to supply and install 1x6 Azek for Corner Boards • GFC to supply and install aluminum gutters with downspouts tied into perimeter drains MASONRY WORK: • GFC to supply all masonry labor and materials for front & rear steps and landings as noted on plan (see selection sheets for details) • GFC to supply all masonry labor and materials to veneer false chimney (see selection sheets for details) EXTERIOR PAINTING: • GFC to supply all exterior painting labor and materials as follows: o Exterior doors — (see selection sheets for details) o Clapboard siding oil base primer w/2 top coats — (see selection sheets for details) HEATING/VENTING AND COOLING: • GFC to supply and install Forced Air Heating and Cooling System w/in-line humidifiers as follows: o Lennox Two Speed Natural Gas Furnaces w/Cooling Coils o Lennox AC Condensers o Lennox Filtration System o Lennox whole house Humidification o Central Air Exchanger • GFC to supply and install duct work for kitchen hood • GFC to supply and install all bath venting ROUGH PLUMBING: • GFC to supply all rough plumbing labor and materials per MA State Code as follows: o Kitchen (see selection sheets for details) • Supply and drain connections for sink, dishwasher, fridge • Gas connection for range • Venting for hood o Laundry ■ Supply and drain connections for washer • Supply gas connection for dryer o First Floor Bath (see selection sheets for details) • Supply and drain connections for shower, vanity, and toilet o Master Bath (see selection sheets for details) Lahood Residence -v8 425 Johnson St., North Andover, MA 05/07/2010 p4 of 29 • Supply and drain connections for Jacuzzi, shower, toilet, & double vanity o Common Bath (see selection sheets for details) • Supply and drain connections for Tub/Shower, toilet, & double vanity o Gas connection for fireplace o (2) Exterior faucets o Supply and install NG fired tank -less HWH (Rinnai or similar) o Supply and install NG fired fireplace (Fireplace allowance $1750.00) o Supply hot & cold water feeds to garage o Supply "Rough -In" only for Radon Mitigation — location TBD ROUGH ELECTRICAL: • GFC to supply all rough electrical labor and materials as follows per MA State Code & per plan (see electrical selection sheets for details) o Supply and install 200AMP overhead service o Plug and switch all rooms to code o Supply and install CATV & Cat -5 outlets as follows: ■ Living Room ■ Family Room ■ All Bedrooms o Supply and install up to 22 recessed lights o Install all customer supplied surface exterior surface fixtures o Install all customer supplied interior surface fixtures o Supply and install electrical conduit from panel to attic for future expansion o Supply and install up to 4 central vacuum outlets o Supply and install conduit to barn for future sub -panel o Supply and install 20 or 30amp outlet in garage (location per owner) 611� lj 6,W 1 T" `1Z> %e 17 l S W INSULATION: • GFC to supply and install closed cell spray foam insulation w/fiberglass batts as follows o Floor to be 2" foam (R-13.4) & R-13 Fiberglass Batt (R-13) o Walls to be 2" foam (R-13.4) & R-13 Fiberglass Batt (R-13) o Attic ceiling to be 3" foam (R-20.1) & R-19 Fiberglass Batt (R-19) o Garage walls to be R-19 Fiberglass insulation with vapor barrier FIRE STOPPING: • GFC to install ASTM -E136 Fire -stopping @ all penetrations Lahood Residence -v8 425 Johnson St., North Andover, MA 05/07/2010 p5 of 29 BLUEBOARD & PLASTER: • GFC to supply and install %2" blue board with smooth plaster skim coat for all wall and ceiling surfaces • GFC to supply and install %" blue board with textured plaster skim coat for all closet surfaces • GFC to supply and install 5/8" blue board with textured plaster skim coat for garage walls and ceiling INTERIOR FINISH: • To be completed by others KITCHEN, BATH, AND CUSTOM CABINETRY: • To be completed by others FINISH FLOORS: • GFC to supply and install tile flooring in following areas: o First floor bathroom $6.00/SF Allowance o Laundry Closet $6.00/SF Allowance o Mudroom $6.00/SF Allowance o Master Bathroom $6.00/SF Allowance o Common Bath $6.00/SF Allowance o All tile to be installed over %" cement board installed with mastic INTERIOR PAINTING: To be completed by others FINISH PLUMBING: • GFC to supply finish plumbing labor and materials as follows (see selection sheets for details) o First floor shower including valve & trim o Master shower including valve & trim o Jacuzzi o Second floor tub/shower including valve & trim o (3) Kohler Cimmaron toilets with soft close seats • GFC to supply finish plumbing labor for balance of customer supplied fixtures • GFC to supply and install (2) swinging shower doors - $1000.00 allowance FINISH ELECTRICAL: • GFC to install all customer supplied surface fixtures (see selection sheets for details) APPLIANCE INSTALLATION: • GFC to install all customer supplied appliances Lahood Residence -v8 425 Johnson St., North Andover, MA 05/07/2010 p6 of 29 CLOSET SHELVING: • To be completed by others LANDSCAPING: • GFC to grade entire yard to prepare for lawn installation • GFC to scrape existing loam on site and stock pile for re -use • GFC to rough in only irrigation system DRIVEWAY: • GFC to supply and install driveway as follows: o Supply and install processed gravel base for driveway (12" thick compacted in layers) o Supply and install asphalt base coat (based on approximately 1824 SF) CLEANING: • GFC to have home professionally cleaned upon completion MISC. NOTES Lahood Residence -v8 425 Johnson St., North Andover, MA "j, fd 05/07/2010 p7 of 29 The Customer and GoodFellas Construction Mgt, LLC agree to all of information stated in this contract: GoodFellas Construction Mgt, LLC Date 569�Ev 11 Date Lahood Residence -v8 425 Johnson St., North Andover, MA 05/07/2010 p29 of 29 ater — Cleanup & Restoration M - a Fire & W 978.663.9833 - SERVPRO of Bille688242 918..2rical7ewksbury 978.454-7577 688242 SERVPRO of Lawrence 603.893.9700 SERVPRO of Lowell 978.475.1199 SERVPIRO of SERVPRO of The Andovrersw Toll Free 800.535-6322 t l Owl r s Like it never even happened Inpendently Owned and operated