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HomeMy WebLinkAboutBuilding Permit #162-14 - 8 WALKER ROAD 8/19/2013 r 1 BUILDING PERMIT of:•��`i�F.•'.`'.�o� TOWN OF NORTH ANDOVER p J+ APPLICATION FOR PLAN EXAMINATIO _ „ - Permit NO: Date Received '� + - ti• Date issued: as�c►w� IMPORTANT:Applicant must complete all items on this page LOCATION V- / PROPERTY OWNER V,t ' Pdnt MAP NO: 0 PARCEL U ONING DISTRICT: Historic District yes An Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential U New Building u One family U Addition u Two or more family U Industrial U Alteration No.of units: u Commercial Repair, replacement u Assessory Bldg u Others: u Demolition u Other Li Septic u Well u Floodplain u Wetlands u Watershed District U Water/Sewer Re-eta c e en U I�pd-entification Please Type or Print Clearly) OWNER: Name: lV ,`�'J V /SC.{.r" �"� Phone: Address: 1L �P� V" 6�lj-J 17L, M/I � CONTRACTOR Name: Phone: q,7&-_500– fi!.�7Q Address: 61 le,m TcrL,- , 7eu)k r, , Nle, 01(370/ Supervisor's Construction License: Ex . Date: Home Improvement License: 7 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No.. FEE SCHEDULE.8U 'PEWIT..'512.0 PER$4000.0 OF THE TOTAL ESMATED COST 8 SED ON$125.00 PER S.F. Total Project Cost: $ ds� /FEE: $ I — Check No.: Receipt No NOTE: Persons VniFakfih9 'h unrep.Wered contractors do not have accesso the guaranty fund Signature of Agent/Owner Signature of contractor dGo� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Old Structure yes no MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 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 Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE-OFSEWERAGE DISPOSAL Public 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 F1 El 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 Water & Semler Connection/Signature& Date Driveway Permit DPW Toed;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Mair, Street Fire Department signature/date COMMENTS_ i 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 LI Notified for pickup - Date E t t Doc.Building Permit Revised 2010 Building Department The fol owing is-a list of the required forms to be filled out for the appropriate permit to be obtained. Roofivg, Siding, Interior Rehabilitation Permits ❑ Building Permit Application o Workers Comp Affidavit o 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 o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o 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) o 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) a Building Permit Application o 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 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 apo%-al 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: Doc.Building Permit Revised 2012 2 � � �7 Location q No. kD — ' ;. Date ( t • - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ D Building/Frame Permit Fee $� ? Foundation Permit Fee $ Other Permit Fee $ 'r TOTAL $ Check# Building Inspector i Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 259481 .00 m $ - $ 305.77 Plumbing Fee $ 38.22 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 38.22 Total fees collected $ 482.22 8 Walker Road #7 162-14 on 8/19/2013 reno Bathroom replace kitchen cabinets F_ , NORTH _ t E : " ver o to *� h , ver, Mass, 1 M0 LAKI 01. A-P, ��� C0[NIC"1WIC« %' �1,9504Areo ►Pa,��(5 U BOARD OF HEALTH PEr Food/Kitchen JAIT LD Septic System THIS CERTIFIES THAT .1. .� .�� �+►r BUILDING INSPECTOR ....... . ....�... .a�. ............ ......-1 ... ..... .......... has permission to erect ....... buildings on . .I.`� Foundation . ....k Rough to be occupied as . ... ��... \A!t�. ..�Qlr�...64. vb&m. ...... Chimney provided that the person accepting this permit 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 CONSTRUC T S Rough Service ................................................................................ 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 J ` Matthew Bradley Construction 1 61 Term Terrace,Tewksbury,Ma 01876 Contractor Agreement This Agreement: made the day of August, 2013 by and between Matthew Bradley Construction, hereinafter called the Contractor and , Vince C. Burton hereinafter called the Owner. Witnesseth, that the Contractor and the Owner for considerations named agree as follows: Article 1: Scope of Work The Contractor shall furnish all of the materials and perform all of the work associated with the description set forth on Estimate #1568 attached. Article 2: Time of completion The work to be performed under this contract shall be substantially completed in 3-6 weeks from the work start date. Time is of the essence. The following constitutes substantial completion of work pursuant to this proposal and contract: All aspects of work are completed with the possible exception of minor interior touch-ups. Article 3: The Contract Price The Owner shall pay the Contractor for the material and labor to be performed under the contract sum of twenty five thousand four hundred eighty one dollars ($25,481.44), Subject to the additions and deductions pursuant to authorized change orders. Article 4: Progress Payments Payments of The Contract Price shall be paid in the manner following: 1000 At Time of contract acceptance $ ptance for permit fees 30 At Demolition ($7,344.00) 40% At Completion of plaster ($9,793.00) 30% At Completion of Project ($7,344.00) f Matthew Bradley Construction 12 61 Term Terrace,Tewksbury,Ma 01876 ` Article 5: General Provisions Any Alteration or deviation from the above specifications, including but not limited to any such alterations involving additional material and/or labor costs, will be executed only upon written order for such alteration or deviation, the additional charge will be added to the contract price of this contract. If payment is not made when due, Contractor may suspend work on the job until such time as all payment due have been made. A failure to make payment for a period in excess of thirty (30) days from the due date of the payment shall be deemed a material breach of this contract. In addition, the following general provisions apply: 1. All work shall be completed in a workman-like manner and in compliance with all building codes and other applicable laws. 2. To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 3. Contractor may at its discretion engage subcontractors to perform work hereunder, provided Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this contract. 4. Contractor shall furnish owner appropriate releases or waiver of lien for all work performed or materials provided at the time the next periodic payment shall be due. 5. All change orders shall be in writing and signed by both Contractor and Owner, and shall be incorporated in, and become part of the Contract. 6. Contactor shall obtain all permits necessary for work to be performed. 7. Contractor agrees to remove all debris and leave premises in broom clean condition. Matthew Bradley Construction 13 M;61 Term Terrace,Tewksbury,M 01$76 8. In the event Owner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. 9. All disputes hereunder shall be resolved by binding arbitration in accordance with the rules of the American Arbitration Association. 10. Contractor shall not be liable for any delay due to circumstances beyond its control including, strikes, casualty, or general unavailability of materials. 11. Contractor warrants a.11 work for a period of twenty four (24) months following completion of work. Article 6: Indemnification To the fullest extent permitted by law, the contractor shall indemnify, defend, and hold harmless Vince C. Burton from and against claims, damages, losses, and expenses, including but not limited to attorney's fees, arising out of or resulting from performance of work providing of materials to the extent caused in whole or in part by negligent or wrongful acts or omissions of or a breach of this agreement by them or anyone whose acts they are, legally responsible. Article 7: Insurance The Contractor represents that it has purchased and agrees that it will keep in force for the duration of the performance of the work or for such longer term as may be required by this agreement, in a company or companies lawfully authorized to do business in the State of Massachusetts, such insurance as will protect Vince C. Burton from claims for loss or injury which might arise out of or result from the Contractor's operations under this project, whether such operations be by the Contractor or by a subcontractor or its subcontractors. The Contractor represents and agrees that said insurance is written for and shall be maintained in an amount not less than the limits of the liability specified below or required by law, whichever coverage is greater. The Contractor certifies that the coverage written on a "claims made" form will be Matthew Bradley Construction 14 61 Term Terrace,Tewksbury,Ma 01876 i maintained without interruption from the commencement of work until the expiration of all applicable statutes of limitation. (See Certificate Enclosed) The Contractor shall file Certificates of insurance, naming the owner/ person hiring the contractor as additional insured, in duplicate, acceptable to all parties prior to the commencement of work which shall contain a provision that coverage under the policies shall not be cancelled or allowed to expire or permit material changes until at least thirty (30) days written notice has been given to additional insured. Signed this day of A ' 2013 Signed in the presence of: Witness Witness Matthew Bradley .Name of Owner Name of Contractor ignature Signature CS 105023 Street Address Contractor's State License No. bji, Alt City/State/Zi zog Telephone No. Matthew Bradley Estimate 1568 Construction 978-500-4572 DATE:AUGUST 14,2013 Vincent C. Burton Work At: 19 Roosevelt Rd North Andover Condo Wilmington,MA 01887 DESCRIPTION TOTAL Install new owner supplied kitchen cabinets. Repair watt where backsptash tile was.Install new Back splash file($8 Sq Ft Allowance).Price indudes tabor to bring electrical and plumbing up to code in kitchen. Install new owner provided bathroom vent.install new insulation up to code. $4,870.00 Provide and install new blue board on ceilings and watt and plaster smooth; Install new shower base and tile watts($8 Sq Ft Altowanoe).Install new lite on bathroom floor($8 Sq Ft Allowance). Install new owner supplied vanity and install new trim. Price inctudes-tabor to bring electrical and plumbing up to code. $11,224.00 Signature ptance Property Owner Date Z 43 Contractor U-14 Date SUBTOTAL PERMIT FEE T"AL $16,094.00 C ��e PI��� C/' '3g �` cl a J i 3111 --------- ----- -- ------=-------- -- -3- 23 ch89--;------ _._-.�;---- .----- --- - - - = .- FM1230 W3012 W2130R - N N U ��-._.- o Q 1---• i t 1 I N a M- h30-GAS-RANGE1__B78/4k�LL21 R I I RW3312 p = LL `c a 1 - —- -- - 1 `n - - 'a. CO CY) (C) I j N_ • i (h J N COj + I N m 1, --i ---i I I _t( dinle�isi ns l�—_ d' - - - A o a, e-desT�ial;ions 2r'"� t This is an original design and must Designed: 8/6/2013 given are subject to verifi4i' non TeGHVVNOLOGIESFN not be released or copied unless Printed: 8/7/2013 job site and adjus Iment to�fitjob applicable fee has been paid or job condition.'-12 .–. 16-2L' order placed. The Commonwealth of Massachusetts Department of IndustrialAccWnts Office of Investigations 600 Washington Street Boston,MA.02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly 1 Name(Business/Organization/Individual): rl �fJ�Go r'� Address: 1-f-C e City/State/Zip: lem✓k5 l _ A16, Gl*�6 Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2I am a sole proprietor or partner- listed on the attached sheet.1 7• ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition workers'comp. ' 5. ❑ We are a corporation and its �0 insurance�'�' p >_u 10.0 Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they ire doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: ! r l v J 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#: ACC>R" CERTIFICATE OF LIABILITY INSURANCE73/20/13 MM/DD/YYYY) 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(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 CONTACT NAME: M.P. Roberts Insurance Agency PHONE FAx 1060 Osgood Street EMAIL • (978) 683-8073 A/ No: (978) 683-3147 ADDRESS: North Andover, MA 01845 INSURE S AFFORDING COVERAGE NAIC# INSURER A:MERCHANTS MUTUAL INSURANCE INSURED MATTHEW BRADLEY INSURER B:Merchants Mutual Insurance Co I NSURER C DBA MATTHEW BRADLEY CONSTURCTI INSURERD: 61 TERM TERRACE INSURER E: TEWKSBURY, MA 01876 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. INSR ADDL SUBR POLICY EFF POUCY EXP -- LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD/YYYY) (MMIDDIYYYYII LIMITS B GENERAL LIABILITY BOPI064228 3/2/13 3/2/14 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED R E occure e $ 500,000 CLAIMS-MADE F OCCUR MED EXP(Anyore person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENTAGGREGATE LIMITAPPLIES PER PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY JE LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIREDAUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION$ $ VWRKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N I ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED7 NIA E.L.EACHACGDENf $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is regui red) I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Office o onsumer airs smess e u a ion License or registration.valid forindividul use only HOME IMPROVEMENT CONTRACTOR. ' before the expiration date. If found return to: Registration: 171249 Type: Office of Consumer.Affairs acid Business Regulation - :`.Expiration: '3'/.1/2014 DBA 10 Park Plaza-Suite 5170, Boston,MA 02116 EW BRADLEY CONSTRUCTION MATTHEW'.BRADCEY A1:T.E.RM. ERRACE, '3EMKSIA.URY, MA 61 76 _' Undersecretary. Not valid without signature r t Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-105023 MATTHEW K BRADLEY _ T 61 TERM TERRACE - TEWKSBURY NfA 01876 , r ✓.�.� _0'1_&t!�w " "' Expiration Commissioner 03/12/2015