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HomeMy WebLinkAboutBuilding Permit # 7/31/2015 Ii UIL UI U F' K I I T TANDOVERa r APPLICATION FOR PLAN EXAMINATION r -+ Permit NO: I * Date Received °� CHUS Date Issued: tm-POIRTANT: A licant must complete all items on this page { t1 �'1 ) f r/ ! +r t - , r .r r✓r) , + r r ! I i r ! It / r r ✓ r r r y r'fr y+� } ��yyC('`�nr ✓r to p a t e r r r y r I- r 16, .).n / f i ?( r'r �t%i1� rr e�r I a j' 0 y r/ fr! y fie - r ✓�y W�,, r !tr' N t l)rtr rr r { r r n/, ryarr ilr rtr "(nt! dry✓�/ rrrr d4xr� r r r r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 91 Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ���,r'�I ,,❑UVe1l r��I�oc� 1 Irk ❑�1Vef rr�a ` , ` ❑ u�C�t�r, he� �i��rlt 7 Y � rr r f .+�; ✓ r r u, ✓ r Roofing related trim and siding replacement. Identification Please Type or Print Clearly) OWNER: Name: AlcottVillage Condominium Trust/C/O MSG Management phone: 603-235-9188 Address: 231 Hampstead St. Methuen, Ma 01844 r P fir r r R i G J ! r s r tr r/ l r µ i52» `tAJ Yrr + a ��yly� ,tn r fl i rr t r fi try ri r( 1 rf , IIr �M� i +,a+ '��:ykkc l lr r .:rr rn r:r r'/ �' !/ ✓,;�1 � :,/,1+r r..r r r I 'n+ rf ty s "v '�r r rr. r' ra r( i r :ar / 7v ,r r,Cc r rr ,,rf�lr�r�(t'Cxl`Il�l" 1 ,� r `'!t r � i yl-. k r r I I r l'.A if r r1 SI j r I r + ✓ t r , ! +yrr r rsi 7) r � r r�" r{{ r r ✓+{"r 1 r !P ry% �r xl�wlP�� I Jr r ,"4 r .r 1 ff I (rrt!r r r r9 / �� '�r y f r .k r r r i z ✓ a t r s 1t,r ),. rrrr '; ,Zr ✓ l /r�7,: lr Crr t r � 1r e r { "er n/. f rf {✓ a - f' rY v ; , t 7(�/ -µ �y Icy {� �y �g 6� r f r r It r 1 ,�.ar1 f ✓la rF r< iY l r {f y r-Ic�� , '* �} �7n#�IY�4 �� 'yd�r "�+{? p�X v 17 , f rr fr (r its+ i r r f ' rr'lY f r4++ �r+ �� r/ ✓r.9 f r yr f r r r r r ;h 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 Coit: $ a-� ��.� FEE: $ QwC5' "� "ti) Check No.: L Receipt No.: 2w NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fiend Sgr� ture of Awettt/ ntrle ',� Sigr� tur� cif contractor` , u _� «, SAH ' fown of ItFORTH And over to AIL o SAKE h ver, Mass, 447� COCHICNl WICK �• �.9 ORATED P`P��,�S U BOARD OF HEALTH Food/Kitchen LD Septic System THIS CERTIFIES THATPERML71 .... T , „ e,,, O .. .. BUILDING INSPECTOR �... . . . . . Foundation has permission to ere _........................... b 'Idings on ............ .... 1*M ........... ® • Rough to be occupied as .. �.T • � . .. ` ft..&i e.. Chimney provided that the person accepting this permit sin every respect conform to the terms of thea application pp 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 c Final PERMIT EXPIRES I 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTION S TS Rough Service ... .... .... ... .... Final BUILDING INSPECTOR l GAS INSPECTOR Occupancy .Permit Required to Occupy Building Rough Islay 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. TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: Roofing related trim and siding Est. Cost b Address of Work S­0� Alcott Way, North Andover Owner Name: Alcott Village Condominium Trust Date of Permit Application: 7/31/15 1 hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Permit No. Job under $1,000 Date Building not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND UNER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: 7/31/15 Primetouch Services 155685 Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name Proposal for Pre and Post roof Carpentry Work of Alcott Village Condominium Complex North Andover,MA Property Manager: Brian Oulette MGS Management LLC 40 Alcott Way North Andover,MA 01845 603-235-9188 MGS.management4�verizon.iret General Description of work to be performed: Carpentry replacement to rakes and fascias prior o roofing and above roof corners and siding after roofing work to exterior stained and painted surfaces of buildings A, B, C, D, E, F and G located at Alcott Village Condominiums, Alcott Way,North Andover,MA. Specific Description: Areas Included: Above roof clapboard siding, corner boards and rake boards,fascia boards. Areas Excluded: Window sash,inner window sills, door jambs, entry doors,decks,railings, stairways,items listed under unit resident responsibilities;any porch enclosures; any other area not specifically included. Unit Resident Responsibilities: Removal and replacement of personal property from deck, parking cars well away from building during production, unlocking windows, removal & replacement of storm windows, removal and replacement of window screens & slider screens and providing timely access to entry doors. Non-cooperation will result in exclusion of these surfaces. Prime Touch shall not be liable for any property that is not removed by the Unit Resident. Production Process: Timing: The job will be completed in the 2015 painting season (April to October, 2015 weather permitting). The crew will remain on the job site from start to finish of the project. Prime Touch will not leave the job site prior to completion. Each building will be completed in a continuous fashion to minimize the disruption of the unit owners. Communication: Prime Touch will designate a Project Manager. The trustees are requested to designate one Property Manager and one Board Member to be the project contacts for unit owners to communicate questions, issues and problems. Clear controlled communication and swift remedy will provide all parties with a positive experience. Prime Touch will utilize two way door hangers for the unit owners or tenants to communicate actions required to facilitate the painting of their unit. PRIMEtouch 6 Huron Drive Natick,MA 01760 S E R v t r e s 800-767-8910 Alcott Village 2015 Exterior Carpentry Proposal 06/12/15 Page 1 of 6 The Fine Print Deposit: A 10%deposit and the return of a signed proposal is required to secure a position in the production schedule.20%payment is required upon start of the project. Payment Schedule: Prime Touch will submit invoices on a section-by-section basis. Invoices are due and payable seven (7) days from date of submission. Prime Touch and the Property Manager/Condominium Association Representative will agree upon the submission procedure prior to the start of the project. Past due amounts are subject to a service charge of 1.5%per month,which is an annual rate of 18%. Utilities: Pricing is based on the Condominium Association providing free and clear access on a unit-by-unit basis to water and electricity required to perform the proposed service. Unit Resident Responsibilities/Water Infiltration: Removal and replacement of personal property from deck, parking cars well away from building during production, unlocking windows, removal & replacement of storm windows, removal and replacement of window screens & slider screens and providing timely access to entry doors.Non-cooperation will result in exclusion of these surfaces. Prime Touch shall not be liable for any property that is not removed by the Unit Resident. Prime Touch shall not be held responsible for water infiltrating any double pane window or door seal during power washing. Sign Off Procedure: Prime Touch requests and the Property Manager/Condominium Association Representative agree that each building or section of a building will be signed off after an inspection by the Prime Touch Project Manager and either the Property Manager/Condominium Association Representative. These inspections will be completed in a prompt manner not exceeding forty-eight(48)hours from notification. Proposal Validity: This proposal expires thirty (30) days from the date found on Page 1. Due to ongoing requests for painting service, acceptance of this proposal for production by Prime Touch is subject to the sole discretion of Prime Touch based on available production capacity. Once accepted by Prime Touch,the project will be completed within the season. Acceptance: Alcott Village Condominium Association having met on � �agree to request that the above- described work be accepted for completion for the above price. Signed z! : 1a !July auth ritedd,Representative of Alcott Village Condominium Association Of Signed' U Property MAnager,Duly authorized Agent of Alcott Village Condominium Association. Ch6 Huron Drive CZ Natick,MA 01760 S E R V r c E S 800-767-8910 Alcott Village 2015 Exterior Carpentry Proposal 06/12/15 Page 6 of 6 The Commonwealth of Massachusetts Department of IndustrialAecidents X Congress Street, Suite 100 Boston,MA 02119-2017 •' www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/E lectricians/PIumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Primetouch Services Address: 6 Huron Dr. City/State/Zip: Natick, MA 01767 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.®I am a employer with 60 employees(full and/or part-time).* 7. F1 New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, El Remodeling any capacity.[No workers'cotnp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp,insurance required.]t 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11. Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 14.®Other Tri m/Siding 6.Q We area corporation and its officers have exercised their right of exemption per MGL C. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 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, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I ant an employer tltat is providing lvorlrers'compensation ithsnrauce for trhy employees. Beloly is the policy and job site information. Insurance Company Name:Star insurance Co. Policy#or Self-ins.Lic.#:WC0452496 Expiration Date:4/1/2016 Job Site Address: Alcott Way, City/State/Zip:North Andover, MA Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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�thepains and penalties of petjuty that the information provided above is true and correct. Sig ature• Z4/�'� � > Date:7/31/15 Phone#: 508-652-9170 Official use only. Do not hvrite in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: PKIMt-7 UP ID: 5UK CERTIFICATE OF LIABILITY INSURANCE IDATE(MMIDDIYYYY) /30/2015 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: Loretta Brown FBinsure,LLC PHONE FAX DBA FBinsure (AIM,E,):508-824-8666 A/C No): 508-880-0142 PO Box 509 ADORess: loretta fbinsure.com Taunton,MA 02780 Tom Rogers,CIC,CRM,CWCA INSURERS AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Group 39926 INSURED Prime Touch Services Inc INSURER B:Star Insurance Company 18023 Attn: Mr. North INSURER C: 6 Huron Dr Natick, MA 01760 INSURER D: INSURER E: 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 TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP LIMITS LTR D D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE � PRE OCCUR S1916323 10/15/2014 10/15/2015 DAMAGEES S(Ea RENTED 500,000 MISoccurrence $ X Blkt Add'I Ins MED EXP(Any one person) $ 10,000 X Blkt Waiver PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY� jE E] LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: IPD Ded $ 250 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 Ea accident > > A ANY AUTO A9092598 10/15/2014 10/15/2015 BODILY INJURY(Per person) $ ALL OWNED X SCAUTOS HEDULED AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE S1916323 10/15/2014 10/15/2015 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 0 $ WORKERS COMPENSATION X PER 0TH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC0462496 04/01/2015 04/01/2016 E.L.EACH ACCIDENT $ 1,000,000 D? OFFICER/MEMBER EXCLUDE [ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Equipment Floater S1916323 10/15/2014 10/15/2015 Lsd Equip 100,000 ACV/Special Form Ded 500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Painting and Carpentry Contractor. CERTIFICATE HOLDER CANCELLATION ALCOTT1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Alcott Village ACCORDANCE WITH THE POLICY PROVISIONS. C/O MGS Management LLC 40 Alcott Way AUTHORIZED REPRESENTATIVE Andover, MA 01845 Tom Rogers, CIC, CRM, CWCA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD tt -Cat, Pub- Board , ftp bons andel Standards Constru'M(a. '-Ure, g ,e License: Cs-068992 MATTHEW T 13 Dana park a�pedale 01 47 corr"F €� 09M3120116 Office Consumer ffairs and �us>ness Regulaticin 10 Park Plaza - Suite 5170 Boston, assac setts 02116 Home Improvement C otor Registration Registration: 155685 Type: Private Corporation z Expiration: 5/112017 Tr# 268024 PRIME TOUCH SERVICES INC WILLIAM NORTH 6 HURON DRIVE A � -+• ATICK, MA 01 1760 Update Address and return card.Mark reason for change. SCA 9 85 20Pd-03!'!1 address r� Renewal 0 Employment Last Card j Office of Consumer Affhirs&Bos ness Regulation License or registration valid for individul use only WExplmtion CE S ROV ENT CONTRACTOR before the expiration date. If found return to: Int 85 Type: Office of Consumer Affairs and Business Regulation Prk+ate Corporation 10 Park Plan-Suite 5170 I Boston,MA 02216 PRIME TOUCH SE I .- i� _j W1VILUAM PNt)6 HURON DR RTH NATICK,MA 01760 Undersecretary Not valid without signature