HomeMy WebLinkAboutBuilding Permit #633-2017 - 946 OSGOOD STREET 12/12/2016v i11111 -�J BUILDING PERMIT
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TOWN OF NORTH ANDOVER
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� AfAPPLICATION FOR PLAN EXAMINATION
Permit NO: —GA-v�/ Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
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PROPERTY OWNER° M
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TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
D One family
Addition
D Two or more family
i Industrial
Iteration
No. of units:
D Commercial
Repair, replacement
D Assessory Bldg
D Others:
Demolition
D Other
D Septic' D Well
D Floodplain D Wetlands
Watershed District
.1 Water/Sewer :d:
OWNER: Name:
Address: 1p
COVT, CTOR Name:
Addr s: r
Supera�visor's Constructi(
Improveme ;License
C,C ( 4,-dAA c
Identification Pleasee Type or Print Clearly)
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Exp. Date t
Exp. Date:.
f a �.
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: $ Z-10 4 FEE: $ :�'7 r0--
Check No.: Mc I Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have acces Ile ty and
_. .
Signature of Agant/Owner Signature of contractor ,
0�:;1.
Plans Submitted ❑
Plans Waived El Certified Plot Plan ❑ Stamped Plans ❑
TYPF-OF SEWERAGE 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
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
CONSERVATION
COMMENTS
Signature.
Reviewed on Signature
HEALTH Reviewed on Signature
.,COMMENTS
0
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Commen
Comm
Wafer & Sewer Con nection/Sictnature & Date Driveway Permit
DPW Town Engineer: Signature:
FeatFIRE DEPARTMENT - Temp Dumpster on site yes
ed at 124 Main Street
Fire Department signatureldate
COMMENTS
Locatea �M usgood street
no
-limension
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
Doc.Buildiug Permit Revised 2014
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
r '
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
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
a Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Cross Section/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)
o Building Permit Application
❑ Certified Proposed Plot Plan
• Photo of H.I.C. And C.S.L. Licenses
a Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ dopy o CCol Contract
❑ Mass check Energy Compliance Report
o Engineering Affidavits for Engineered products
40TE: 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 2014
Location /'7
No.
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $-
TOTAL $
Check #-�eO2-
Building Inspector
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ 20,935.00
m
$ -
$
251.22
Plumbing Fee
$
31.40
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
31.40
Total fees collected
$
414.03
946 Osgood Street
633-2017 on 12/12/2016
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NCS, Inc.
314 Clark.Street North Andover MA 01845
978-685-0568 / fax 794-3780
Siding Proposal
August 8, 2016
Proposal submitted to: China Blossom Address: 946 Osgood
Street, No. Andover, Mass.
SeR ire Adriress: Sam-,
� VIIG, IIIQII.
david@chinablossom.com V I
Salesman: Mark DelGreco Contact: David Yee
vve nereby submit specirications ana estimates, subject to all terms and conditions as follows:
Scope of work:
• On backside of restaurant, back half section of driveway side, and back quarter section on street
side. Strip all existing vinyl siding, leave in place all tile type siding. Fur out the area behind
condenser unit, replace the rotted soffit area with new pre -primed pine.
e Install new Tyvek house wrap and 3/8" foam insulation board on entire body of restaurant where
stripped.
• Install new white, vinyl vented soffit panels on all soffits. Cutting open wood soffit for venting if
needed.
• Wrap all existing facial, rake, shadow and window trim with new white .019 aluminum coil stock.
Install new Certainteed "Monogram .046", Double 4" clapboard style, vinyl siding on entire
specified wall areas, with standard
5" vinyl comers, and vinyl light/outlet blocks.
Thoroughly clean and magnet grounds and remove all job related debris from property on a daily
basis and at jobs completion.
• $70.50 Per Sheet Extra Cost to replace any rotted or damaged plywood wall sheathing (if needed).
• Entire jobs comes with NCS full 10 Year. installation warranty, and a lifetime warranty from
the manufacturer Certainteed on all materials.
Notes:
TOTAL PRICE: $20,935.00
All work to be done during normal business hours
Price good for 30 days
Work would need to be performed when warmer weather permits
Questions? Call us, write us and check out our website @ www.ncsne.com for more information on our other services.
TERMS & CONDITIONS
PAYMENTS AND DISBURSEMENTS: Customer is responsible for obtaining any financing he deems
necessary to comply with this Agreement. If Customer is obtaining financing form a third party, Customer agrees to
apply for such financing without delay and this Agreement is subject to Customer being approved for such financing. All
payments are due and payable as specified in the Proposal/Contract. Northeast Contracting Solutions reserves the
right to assess a $25.00 fee if Customer requests us to re -invoice them for any reason. Overdue payments will bear a
1.5% service charge. Failure by Customer to pay any invoice within five (5) days after payment is due per contract shall
constitute a material breach of this Agreement. All legal, court or otherwise collection cost incurred by Contractor are to
be paid by Customer.
LABOR AND MATERIALS: Contractor agrees to furnish the materials for the project and complete the work to be done
in a workmanlike manner. All materials furnished under this Agreement shall be construction grade and meet industry
standards. Where brand names have been specified, Contractor may at his option select substitutes when such
substitutions are due to unavailability or previously specified. Contractor shall pay all subcontractors, laborers, and
material suppliers, unless specified differently in writing.
SPECIAL CONSIDERATIONS: For those selections of materials requiring special considerations including, but not
limited to, cash deposits to insure their production, Contractor may at his option require Customer to pay such required
deposits directly to distributor or manufacturer rendering such services. It is understood that when matching existing
conditions such as color, size, planes and texture, Contractor will provide materials so as to match, as closely as
possible, the existing materials. However, Contractor does not guarantee materials will match existing conditions:
DISCLAIMED WORK: No soil testing, surveying, plan design or engineering are included in this Agreement unless
expressly specified. Contractors shall not be held responsible for any existing violations of applicable building
regulations or ordinances, whether cited by the appropriate authority or not. Contractor is not responsible for any
abnormal or unusual pre-existing conditions including, but not limited to, damage caused by termites or dry rot, filled
ground or ground of inadequate bearing capacity, rock and other material not removable by ordinary hand tools,
inadequate electrical wiring systems for the load imposed by the work under this Agreement, and plumbing, gas, waste
and waterlines not shown on documents or plans furnished by Customer. Correction of any such violations or abnormal
conditions by Contractor shall be considered additional work.
ADDITIONAL WORK: Contractor shall promptly notify Customer of any additional requirements necessary to facilitate
the project's completion. Any additional work required or ordered by Customer (or any regulatory agency having
jurisdiction over the project) shall be set forth in a signed change order, and the agreed price shall become due and
payable as agreed upon between Contractor and Customer, or within 30 days if not specified, payment is due in full.
Contractor, his employees, subcontractors and agents are unauthorized to perform any additional work or to enter into
any agreement to perform additional work unless agreed to in writing by Customer and Contractor through a properly
executed change order, which shall become an integral part of this Agreement.
PROPERTY RIGHTS AND RESTRICTIONS: Customer represents that he owns the property described as "property
address", or has authority to order and sign for work. Customer shall locate and point out the boundary lines of the
property to Contractor. Customer shall be solely responsible for accuracy of markers and boundary lines indicated to
Contractor and as detailed on plans and specifications approved by Customer. If a land survey is required for any
reason to confirm markers or boundary lines, Customer agrees to pay for such survey. Prior to the start of construction,
Customer shall give Contractor a copy of any restrictions, easements or rights of way relating to the property.
ACCESS AND FACILITIES: Customer agrees to provide free access to work areas for workers and vehicles, and to
provide areas to store materials and debris. Unless otherwise specified, all water, sewer, gas and electric utilities from
the servicing agency to the point of entry at Customer's property line (or to the metering device if such devices are
required) are the responsibility of the Customer. Customer agrees, at Customer's expense, to provide electricity at the
project site as may be required by Contractor to affect the work described herein in compliance with federal, state
and/or provincial law. Contractor shall not be held liable for minor damage to curbs, driveways, walks, patios, unless
caused by the gross negligent movement of workers, vehicles, equipment, materials or debris.
START. DELAY AND COMPLETION OF WORK: Contractor agrees to commence work and to continue to work in a
timely fashion so as to insure the project's consistent development and ultimate completion. Contractor is bound by the
terms and conditions regarding start of work imposed by any licensing or regulatory agency having jurisdiction over the
project. Contractor shall not be held responsible for project delays caused "acts of God," civil unrest, acts of Customer
or Customer's agent, inclement weather, strikes, labor disputes, material shortages, licensing or regulatory agency
inspections, or any other actions or causes beyond the Contractor's control.
CANCELLATION CLAUSE: Option of Customer to terminate contract in the event of Contractor's failure to complete
work. If the Contractor shall refuse to or fail to perform the work with such diligence and force as specified in this
contract, or shall fail to complete said work in a timely manner, or if Contractor does not perform the work in a
professional manner according to industry standards, Customer reserves the right to give written notice to the
Contractor of its intention to terminate this contract unless said violations of the specifications are corrected within
fifteen (15) working days after serving of said notice. If after fifteen (15) working days the violations have not been
corrected or satisfactory arrangements for the completion thereof made, this contract may, at the option of the
Customer, be terminated. In the event of termination, payment in full for all services performed to date by the
terminated Contractor shall be made immediately at the time of termination. Option of Contractor to terminate contract
in the event of Customers failure to make timely payments as specified or to abide by all terms and conditions as
outlined by this Agreement hereto, also, but not limited to any actions by the customer to circumvent, interrupt or
otherwise, any relationship with a subcontractor and the Company. Contractor's option to terminate will be immediate
and communicated In writing.
DAMAGE AND INSURANCE: Contractor agrees to carry worker's compensation and business liability insurance to
insure the Customer against damages or defects caused by Contractor, his employees, or any agents acting in his
behalf. A valid insurance certificate will be furnished upon request.
MISCELLANEOUS: Contractor may subcontract all or any portion of the work and may assign this Agreement to
another Contractor, provided such assignment shall not affect the rights and privileges of Customer under this
Agreement. In case one or more of the provisions of this Agreement or any application thereof shall be invalid,
unenforceable or illegal, the validity, enforceability and legality of the remaining provisions and any other application
thereof shall not in any way be impaired thereby. If any legal action shall be instituted to interpret or enforce this
Agreement, the prevailing party shall be entitled to recover all litigation costs, including reasonable attorneys' fees. It is
agreed that this Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of
Massachusetts.
CONTRACT ADJUSTMENTS: In the event of an unanticipated increase in the cost of fuel or materials used by
Northeast Contracting Solutions, Inc., reserves the right to pass through to the Customer such increases or, if the
Customer does not agree to pay any such increases, to terminate the contract.
LIMITED WARRANTY: Northeast Contracting Solutions guarantees workmanship, subject to the following conditions.
• Contractor warrants all labor and material for a period of thirty (30) days from the date of completion of work,
unless otherwise stated or an Extended Warranty is purchased. This limited standard warranty extends only to
Customer and is not transferable.
• Contractor will provide replacements as stated above on a one-time basis only at the request of the Customer,
at no charge to the Customer except for supportive materials deemed necessary and labor. Please note,
however, that Contractor is not liable under this limited standard warranty for actual of consequential damages
resulting from "acts of God," excessive weather conditions (extreme cold/drought, washouts, etc.), soil
conditions, abuse, vandalism, poor drainage, salt damage.
• Any warranties given by manufacturers pertaining to materials used by Contractor in with the project will be
passed through and inure to the benefit of the Customer.
• There is no implied warranty of merchantability or any implied warranty of fitness for any particular purpose.
There are no warranties either express or implied beyond the description within this section.
If you have any questions, call your salesperson for more information.
Payment Schedule -Third upon acceptance, 2nd third at initiation of job, and remainder due
upon completion. Change orders due upon completion of work.
Accepted: The signatures below indicate that the above prices, specifications and conditions are
satisfactory and hereby accepted. Payment will be made as outlined above.
Signature: r. Date: Z 12,V .
1 Client Initials
TRAVELERS J�
VDAC
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
TYPE AR INFORMATION PAGE WC 00 00 01 ( A)
POLICY NUMBER: (7PJUB-8D88464-9-16 )
.RENEWAL OF (7PJUB-8D88464-9-15)
INSURER: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
1.
INSURED:
NORTHEAST CONTRACTING
SOLUTIONS INC
314 CLARK STREET
NORTH ANDOVER MA 01845
NCCI CO CODE: 13879
PRODUCER:
MTM INS ASSOCIATES
1320 OSGOOD ST
NORTH ANDOVER MA 01845
Insured is A CORPORATION
Other work places and ' ratification -numbers are shote rrthe-sGhedule s) attac
2. The polic Eod is from 01 -07-16 to 01 -07-17 12:01 A.M. at the insured's
3(�MA
WORKERS COMPENSAT7777=77
Partto the Workers
Compensation Law of the s(� �,1
A rG-�' /Hid
v�
B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in
item 3.A. The limits of our liability under Part Two are:
Bodily Injury by Accident: 5 500000 Each Accident
Bodily Injury by Disease: $ 500000 policy Limit
Bodily Injury by Disease: S 500000 Each Employee
C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here:
COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06B
D. This policy includes these endorsements and schedules:
SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE
4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans. All required information is subject to verification and change by audit to be made ANNUALLY .
DATE OF ISSUE: 01 -11 -16 MEC ST ASSIGN: MA
OFFICE: DIRECT ASSIGNMENT 701
PRODUCER: MTM INS ASSOCIATES 7766P
002460
The Commonwealth of Massachusetts
u Department of Industrial Accidents
I Congress Street, Suite 100
c Boston, MA 02114-2017
www mass.gov/dia
Workers' Compensation Insurance Affidavit: General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
pplicant Information Please Print
Business/Organization Name: 1 \-Iu
Address:
City/State/Zip: I V • 41,111ry ,Va- at�`f) Phone #: %�_ p5� d
Are an employer? Check t appropriate box:
1. U I am a employer with employees (full and/
or part-time).*
2. ❑ I am a sole proprietor or partnership and have no
employees working for me in any capacity.
[No workers' comp. insurance required]
3. ❑ We are a corporation and its officers have exercised
their right of exemption per c. 152, § 1(4), and we have
no employees. [No workers' comp. insurance required]*
4. ❑ We are a non-profit organization, staffed by volunteers,
with no employees. [No workers' comp. insurance req.]
Business Type (required):
5. etail
6. Restaurant/Bar/Eating Establishment
7. ❑ Office and/or Sales (incl. real estate, auto, etc.)
8. ❑ Non-profit
9. ❑ Entertainment
1011 Manufacturing
11.❑ Health Care
12.❑ Other
*Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy information.
**If the corporate officers have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an
organization should check box # 1.
I am an employer that is providing worPrs' compensation insurance for my employees. Below is the policy information.
Insurance Company Name: w.vtlr\\ L'g-nix
Insurer's Address:
City/State/Zip:
Policy # or Self -ins. Lic. # �E'5 (ice �U9 (0Ll - �ib Expiration Date: 1
Attach a copy of the workers' compensation policy declaration page (showing the policy number and a piration 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 ce4ditft n*r IN pd#is akd penalties of perjury that the information provided above is/true and correct.
Sienature:I �-A h/ X �L Date: t Z-1 ' Z- / I (o
(
Phone #: -)-) - — (A -s - 0% g
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. Licensing Board 5. Selectmen's Office
6. Other
Contact Person
www.mass.gov/dia
Phone
3
blic
Massachusetts Department
of Pu Standards
ty
Board of Building Regulations
License: CS -104241
Construction Supervisor
MARK DELGRECO
2 FOX HOLLOW ROAD;.. j �I Vii+
DERRY NH 03038
1r�Z7,7 lam! Expiration:
Commissioner 08/18/2017
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvemen#'Contractor Registration
NORTHEAST CONTRACTING
SOLUTIONS INC.
314 Clark St
N. Andover, MA 01845
SCA 1 is 20M-05/11
Type: Corporation
Registration: 167900
Expiration: 11/16/2018
" Update Address and return card. Mark reason for change.
7 Address 01 Renevip! 7 1 nct Park{