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HomeMy WebLinkAboutBuilding Permit #779-2017 - 70 ELM STREET 2/16/2017/AAW BUILDING PERMIT of TLSD ' TOWN OF NORTH ANDOVER �� h''• ,_,_6= APPLICATION FOR PLAN EXAMINATION. ` ,T P ermit No#: i 1 9 " a 0 f % Date Received a-0 7 DR,TED �SSACHus� Date issued: - EVRORTANT: Applicant must complete all items on this page LOCATION 7 9 �&_5z--- - _ ' Pnnt PROPEY-OWN ER�/_�_--- _-�- ��' � -/� � �_..�T_��-c _.._ _�. _ _._ __. P t._ _ qpD&YearStn c ure yes no MAP- PARCEL: !�' C�'` ZONING DISTRICTL- Htstortc bistnct yes no w� - - _ Machtne.Sh ilia 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 epair, ,replacement ❑ Assessory Bldg Others: ❑ Demolition ❑ Other Septic Q1 V1/e11 _ q Ffoodp(ain O VIIet[ands`w' " UVate shed Dis INater%Sewer' - _ -- - - Kiuitu: Identification - PIease Type or Print Clearly' OWNER: Name: ,none: Address: Contracfior Namej_,ePtioiie ... Address: Superv�so's.Consfiructiori License Exp: a.. _ - s Home Irnprovcmcnf- License:.. �5�3-5� . -. _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. _,T®tal Project Cost: $ FEE: $ Check No.: ` / $ C S Receipt No,,: 3 153 L/ DOTE: Persons contracting with unregistered contractors do not Piave: t g-uarl^anound f r, Plans Submitted ❑ Plans Waived ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ well ❑ Private (septic tank, etc. ❑ Certified Plot Plan ❑ Stamped Plans ❑ Tanniug/MassageBody Art ❑ Tobacco Sales ❑ Permanent Dempster on Site ❑ Swimming Pools ❑ Food Packaging/Sales ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature CONSERVATION Reviewed on Si nature COMMENTS HEALTH Reviewed on Signature COMMENTS 0 Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Com Conservation Decision: Comments Water & Sewer Con nection/Sinna¢vFrn A_ n_"_ DPW Town Engineer: (Signature: FILE nman r3Located �Ra - -- __ --1 lvlbii i i emp uumpster on site yes Located at 124 Main Street Fire Department signatureldate ��h nn nr'AITl� no Permit ood Street r" r Location r• �! I No. Check # t Date :1, . I +.., — 4, , 7 TOWN OF NORTH ANDOVER F Certificate of Occupancy $ Building/Frame Permit Fee $ .? " Foundation Permit Fee $, Other Permit Fee $ TOTAL $ 1 01 Building Inspector < 0 o ', O 2) 2 co < m fA CD C:Lo N 0 o:Q.o 3 m N Z C =.0 v► .a O o N Q. o. m '0 ocn N� N (D D • o a c� o O • Q � o� O n o S 0 °°(D t '- `D -0 C S. m -� 0 CD O� Z'fl � Z Qr�• rm (Q V! = f0 U C Z o M -p p rn � M U) o �* N D"� o CL O co <m� o Q �• c Cl)Q Q �o CD 03CD � Z 1, o CL CD It 0 N Cl)o o ` r. = WAN,-� Cl)co m o c_ C3 Z N CD z ^' Q D" Oz c� cn O m ,. 0. m CDO °' = �. CL m L/) 30 rD In ,-r m Z 0:3 07 T o Z -I 17 O N -0 T w z A O a m � zn n4 0 -n 7 m O � .O C �_ Z Ln rn 0 ° S 3 O C 0o O C a O 3 co C r z v, m O 70 'O �. rD 3 O Q S rD :3 W s D = E 1 R.S. HEBERT Construction & Remodeling Inc. 102 Adams Ave. No. Andover Mass. 01845 (978) 686-0786 Phone/ Fax Lic. #:058241 Reg. #:153811 DATE 1/21/17 Job: Trinitarian Congregational Church Elm St. North Andover Ma. 01845 Phone. 978-686-4445 PROJECT :office windows & paint I. PARTIES This contract (hereinafter referred to as "Agreement") is made and entered into on this 4th day of May. by and between The Trinitarian Congregational Church (hereinafter referred to as "Owner"); and R.S.Hebert Construction & Remodeling Inc., (hereinafter referred to as "Contractor"). In consideration of the mutual promises contained herein, Contractor agrees to perform the following work, subject to the terms and conditions below: II. GENERAL SCOPE OF WORK DESCRIPTION 1. Supply and install three Harvey classic windows ( grid pattern to match) 2. Paint ceiling two coats. 3. Paint walls two coats ( color by owner) 4. Paint trim one coat same as existing. 5. Remove windows and trash from site A. LUMP SUM PRICE FOR ALL WORK ABOVE* $ 5300.00 Contractor Owner Owner III. GENERAL CONDITIONS FOR THE AGREEMENT ABOVE 2. STANDARD EXCLUSIONS: Unless specifically included in the "General Scope of Work" section above, this Agreement does not include labor or materials for the following work: Plans, engineering fees, Testing, removal and disposal of any materials containing asbestos (or any other hazardous material as defined by the EPA). Custom milling of any wood for use in project. Moving Owner's property around the site. Labor or materials required to repair or replace any Owner -supplied materials. Final construction cleaning (Contractor will leave site in "broom swept" condition)., correction of existing out -of -plumb or out -of - level conditions in existing structure. Correction of concealed substandard framing. which may be discovered in the removal of walls or the cutting of openings in walls. Removal and replacement of existing rot or insect infestation. Failure of surrounding part of existing structure, despite Contractor's good faith efforts to minimize damage, such as plaster or drywall cracking and popped nails in adjacent rooms or blockage of pipes or plumbing fixtures caused by loosened rust within pipes. Exact matching of existing finishes. Cost of /testing/remediating mold/fungus/mildew and organic pathogens unless caused by the sole and active negligence of Contractor as a direct result of a construction defect that caused sudden and significant water infiltration into a part of the structure. B. DATE OF WORK COMMENCEMENT AND SUBSTANTIAL COMPLETION Commence work: on or about 5/5/16. Construction time through substantial completion: Approximately 5 days, not including delays and adjustments for delays caused by: holidays; inclement weather; accidents; shortage of materials; additional time required for Change Order and additional work; delays caused by Owner, Owner's design professionals, agents, and separate contractors; and other delays unavoidable or beyond the control of the Contractor. C. CHARGES FOR ADDITIONAL WORK: CONCEALED CONDITIONS, DEVIATION FROM SCOPE OF WORK, AND CHANGES IN THE WORK 1. CONCEALED CONDITIONS: This Agreement is based solely on the observations Contractor was able to make with the project in its condition at the time the work of this Agreement was bid. If additional concealed conditions are discovered once work has commenced or after Contractor Owner Owner this Agreement is executed which were not visible at the time this Agreement was bid, Contractor will point out these concealed conditions to Owner, and these concealed conditions will be treated as Additional Work under this Agreement. Contractor and Owner may execute a Change Order for this Additional Work. Contractor is released, held harmless, and indemnified by Owner from all pre-existing mold, fungus, mildew, and organic pathogen problems and is not responsible for costs or damages associated with correcting, containing, testing, or remediating the same. D. PAYMENT SCHEDULE AND PAYMENT TERMS 1. PAYMENT SCHEDULE: First payment when contract is signed $2650.00 Final payment when work is complete. $2650.00 2. PAYMENT OF CHANGE ORDERS/ADDITIONAL WORK: Payment for Additional Work is due upon completion of either all or part of the Additional Work and submittal of invoice by Contractor. E. WARRANTY Thank you for choosing our company to perform this work for you. Your satisfaction with our work is a high priority for us, however, not all possible complaints are covered by our warranty. Contractor does provides a limited warranty against material defects on all Contractor- and subcontractor -supplied labor and materials used in this project for a period of one year following substantial completion of all work. This warranty covers normal usage only. You must contact the Contractor upon discovering an item in need of warranty service. Additionally, Owner's hiring of others or direct actions by Owner or Owner's separate contractors to repair a warranty item are not covered by this warranty and will not be reimbursed by Contractor. No warranty is provided by Contractor on any materials furnished by the Owner for installation. No warranty is provided on any existing materials that are moved and/or reinstalled by the Contractor within the dwelling or the property (including any warranty that existing/used materials will not be damaged during the removal and reinstallation process). One year after substantial completion of the project, the Owner's sole remedy (for materials Contractor Owner Owner and labor) on all materials that are covered by a manufacturer's warranty is strictly with the manufacturer, not with the Contractor. Repair of the following items and related damages of every kind are specifically excluded from Contractor's warranty: problems caused by lack of Owner maintenance; problems caused by Owner abuse, Owner misuse, vandalism, Owner modification, or alteration; and ordinary wear and tear. Damages resulting from mold, fungus, and other organic pathogens are excluded from this warranty unless caused by the sole and active negligence of contractor as a direct result of a construction defect which caused sudden and significant amounts of water infiltration into a part of the structure. Deviations that arise such as the minor cracking of concrete, stucco, and plaster; minor stress fractures in drywall due to the curing of lumber; warping and deflection of wood; shrinking/cracking of grouts and caulking; fading of paints and finishes exposed to sunlight are all typical (not material) defects in construction, and are strictly excluded from Contractor's warranty. I have read and understood, and I agree to, all the terms and conditions contained in the Agreement above. 2 eel ? Zell -x AT// CONTRAC R'S SIGNATURE 2 608'110(7 DATE OWNER'S SIGNATURE CUSTOMER HAS THE RIGHT TO CANCEL CONTRACT THREE DAYS AFTER SIGNING. Contractor Owner Owner The Commonwealth of.Massaehusetts DeparMlent of IndustriaTAceidefats r X Congress Street, S5 to 100 M: T tl021X4 2017 - - Boston, MA • c a�M �'v`" WWw mass.gov/dza WarXers' CorapensationbsuranedA-0davit: ldens/CGAU1 tORi-Ericians/ Xmmbers. TOBE NEED WXT]aM:EM Print ] Name (Business/Oiganiza#onllndividual): Address: d City/Staielzip:. PhLano #: Arepou an emploper? G7? ecktlie appropriate box: 1• di am a employer with Zi employees (full and/or part time). 2.E] Jam a sole proprietor or pa' aershiP andhave no employees Working fozme in any capacity. [A0WOrkers' comp. insurance required.] 3.E1 I am ahomeowner doing allworkmyself. Egovorkere comp, fi=ancerequired] T 4.QI ahomeownerandwillbehiringcontractors toconduetall workonmyprope1ty Iv! ensure that all co�xactbts either have workers' compensation insurance or are sole proprietors vithno engloyess. 5_❑I am a general contractor and have hired the sub -contractors listed on the attached sheet These sub -contractors have employees and have workers' camp. insurance 6. F] We are a corporation. and ifs. offtcens have e=cisedtheirright of exemption per MGL c. have no employees- [No workers' comp. insurance required] T 1 /N G'CyG-d '761G Type ofproject ()regi ed)= 7. ❑ Ne `d6nstriiction S. El Remodeling 9. ❑ Demom?t L 10 ❑ Building adad'Dn 11.0 Electrical repairs or additions 12. [(.plumbing repairs or additions 13'.[]Roofrepair;; 14.M Other 152, §1(4), andvte - — - Auy applicautthat checksbbx#1mustalsofill outihe sectionbelow showingtheuw -workers, compensation poficyinformaiion i Homeowners wha Ant.this affidavit indicatingthey are doing ail. vork andthenhire outside contractors must submit a new affidavit i ant[48glh such ?Contractors that checkthis box must attached an additional sheet shoving the name of the sob -contractors and state whether or not�ose, entities have employees. Ifthe sub -co employees, they mustprosidetheir workers' comp. poIicymmiber. an ern Zo ei tliatisproviding rvor7ceNs' corrcpensation insu-rancefor my employees Be1o�v is t�iepolicy raridjo site X mn p 3' information. 'v 2 �J• insurance, CompanpName; PORGY # or Self ins. U0- #:. P C l t G ` � //� _ DTirationDate� ri cT Q ao a &IAA 4/ l City/state/Zip: CIS' Job Site Addxess: � � ' and, e�gpjratioR date). Attach a copy of the workers' compensation pokey declaxaixon page (sJ wmationpo,,,,,hesh bl by a fine up to $1500.00 Failure to secure coverage as required underMGL o-152, §25•A- is a cri mvs al -do axed a and/or one-year imprisomnent; as well as civil penalties in the form of a STOP WORK ORDER dine ofup to $250.00 a be forwarded to the Office of InvesiigatioxLs of the DIA. for insurance day against the violator. A copy of this statement may X do ]ieYe7�y cettzi der tlzepaii2s andpenafties ofper7ury tfiai the inforxnvtzonprom Phone #: Official us -,only. Do not t�rzte in tliis area, to lie corcpleted by city or town o ff cral • PermitlLicense # City or Town.' IssuiugAnthority (circle one):xzca ' ector 5. Plumbing l speetor J.. Board ofllealth 2. Buildingpepartment 3. CitylTown Clerk 4•. Rlectllnsp 6. Other Phone Contact Person RSHEB-1 OP ID: KM ACORO' CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATE NUMBER- 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 7(MMIDDNYYY) /12/2017 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. 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 endorsemen s . PRODUCER Michaud, Rowe And Ruscak Ins. P.O. Box 188 CONTACT Lawrence R. Michaud, CIC NAME:O AIC No EI. 978 688 8829 ac No : 978 557 2130 E-MAIL SS: lmichaud@mrrinsurance.com North Andover, MA 01845 Lawrence R. Michaud, CIC 05/11/2016 05/11/2017 INSURERS AFFORDING COVERAGE NAIC # INSURER A: AmGuard MED EXP (Any one person) $ INSURED R S Hebert Const & Remod, Inc. 102 Adams Avenue N Andover, MA 01845 INSURER B: Commerce Insurance Company 34754 INSURER c : NorGuard GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMPIOP AGG $ 2,000,00 INSURER D: INSURER E : AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X AUTOS SCHEDULEDAUTO X HIRED SAUTOS X NON -OWNED AUTOS INSURER F: COVERAGES CERTIFICATE NUMBER- 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRTYpE LTR OF INSURANCE A L IND ANUB VD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS-MADE F—I OCCUR X Business Owners RSBP736610 05/11/2016 05/11/2017 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTEIT-- PREMISES Ea occurrence $ 50,00 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMPIOP AGG $ 2,000,00 S B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X AUTOS SCHEDULEDAUTO X HIRED SAUTOS X NON -OWNED AUTOS BBCM08 12/19/2016 12/19/2017 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA A UAB EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F-1NIA (Mandatory in NH) If yes, describe under - DESCRIPTION OF OPERATIONS below RSWC836179 01/01/2017 01/01/2018 ERTH- STATUTE ER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 - E.L. DISEASE - POLICY LIMIT $ 500,00 PROPERTY 5,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION NORTHA9 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE culrn of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 16MOsgood Street North Andover, -MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD s=� Massach.asr,hs Department cf Public Safety BOard of Buildinn Re lat;ons end Stanaards License: CS -056241 Construction Supervisor RONALD S HEBERT 102 ADAMS AVE` N ANDOVER MA 0'!845 Commissioner Exp ration. m 01/08/2018 �. office of Consumer Affairs & Business Regulation i HOME IMPROVEMENT CONTRACTOR TYPE: Corporation e Registration Expiration 153811 01/08/2019 R.S. HEBERT CO. & REMODELING INC. RONALD HEBERT 102 Adams Ave. Vo No Andover, MA 01845 Undersecretary