HomeMy WebLinkAboutBuilding Permit # 10/8/2015 ,t%ORTH
BUILDING PERMIT 'O'Fo '!6"
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
Permit®: S CHUS
Date Issued:
ANT:Applicant must complete all items on this page
LOCATION -e
Pr Alvlov-er
PROPERTY OWNER r1YJt I
Print 100 Year Structure yes no
MAP PARCEL: �=ZONING DISTRICT:—Historic District ye no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
El New Building El One family El Industrial
El Addition El Two or more family [i Commercial
El Alteration No. of units:
')<Repair, replacement [I Assessory Bldg [I Others:
El Demolition [I Other
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TO BE PEFPRME
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Identification- Please Type or Print Cle A
OWNER: Name:q,WLO— Phone:
Address srSA La`-
5vvPContractor Name: A — hone
Email:
Address:
Supervisor's Construction License: M6
Exp. Date:
Home Improvement License: 13S 0-2 Exp. Date:
7
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ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 1-11 FEE: $
Check No.: Receipt No.:
NOTE: I'ersons contracting with unregistered contractors do not ha ae s to t
,he grran orad
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Town of
Andover
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11 BOARD OF HEALTH
Food/Kitchen
PERMIT �T LD Septic System
THIS CERTIFIES THAT ........ ...... ....... BUILDING INSPECTOR
. ...... . ................ ... ..............................
has permission to erect ..............®.......... buildings on .... .�::.....��. . . ........ . Foundation
R ugh
to be occupied as ...... ......... ...... ....D.&.1m ...... ,,,RA... ...If11.f 1��.. ... x,,. c coney
provided that the person accepting this permit shall in every respect canform to the s 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
PERMITI S IN 6 MONTHSELECTRICAL INSPECTOR
OM UNLESS CTS
RTS 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.
PRIME COMMERCIAL CONTRACT
I hi S roan Co I I I I)I ies\Vi III protessiona I slan(hirds in effec I J marary I-Decen I her 3 1,2010
Erinrm THIS CONTRACT'I'
ENTU"RED INT0
TI-I IS DATI":
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CA+01 First United Methodist Church of'North Andover-Paul Carlo(to is church representative
PI ION V
BI)VER/ V I Y STA HYZIP
OWNER (7 Peters Sit-cot North Andover MA 978994,3631
C I'I'Y STATIVIP 1111 ON I
N/A
L E N D E R: (11A rtl):
N/A
(Natiiiell.lrailL�li/A(I(Irk!ss ot'l ender)
We hereby propose to perl'orm tile 1*611mving Nvork:
See estimate dated September 28,"2015
We will begin oil or about October 12,2015
Work performed at. Church in N. Andover tat 57 Peters Street North Andover, MA
(Street Address And Legal Description
TIME FOR COMPLETION: The work to be perf6rnied by("ontractor pursuant to this Agreement shall be substantially completed
within ninety(90)(lays or approxillintely on 14-0-20)l 0,) ve,4ve^
INT-TERESOverdne piryments will bear fill I of I pet
PAYMENT- Contractora total price of- Seventeen Thousands, flour hundred filly three dollarsand thirty one
ceillsDollal ($17,453.31)
Down pay rnejlH�41mlylsk,)81.3 1 is tile down payment
with any payments to be made as follows: $5,236.00 after tile drywall is installed, l'ollowed by 3,236.00 alien painting is done,and
$2,000.00 is the 1111,11 payment after substantial comp etion.
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CONTRA(']09 SIGNA]I)160WNJ-1'1Z/BUY1AZ S16NA YURI: DA FV
o 2010 ABCAVorms
TERMS AND CONDITIONS
I. CHANGES IN THE WORK. Should the owner,construction of construction, theft, vandalism and malicious mischief
lender,or any public body or inspector direct any modification or endorsements attached,the insurance to be in a sum at least equal
addition to the work covered by this contract, the contract price to the contract price. The insurance shall name the Contractor and
shall be adjusted accordingly. any subcontractors as additional insured's, and will be written to
Modification or addition to the work shall be executed only protect owner,Contractor and subcontractors as their interests may
when both the Owner and the Contractor have signed a contract appear.
Change Order. The change ui the contract price caused by such Should Owner fail to procure such insurance,Contractor may do
contract Change Order shall be as agreed to in writing, or if the so at the expense of Owner,but is not required to do so. Owner
parties are not in agreement as to the change in contract price,the and Contactor waive rights of subrogation against each other to
Contractor's actual cost of all labor,equipment,subcontracts and the extent that any loss is covered by valid and collectible
materials, plus a Contractor's fee of 30% shall be the change in insurance. If the project is destroyed or damaged by accident,
contract price. The Change Order may also increase the time disaster, or calamity such as fire, storm, flood, landslide,
within which the contact is to be completed. subsidence or earthquake,owner as extra work shall pay for work
Contractor shall promptly notify the Owner of(a)latent physical done by Contactor in rebuilding or restoring the project.
conditions at the site differing materially fiom those indicated in
the contract, or (b) unknown physical conditions differing VII. RIGHT TO STOP WORK. Contactor shall have the right
materially fi•om those ordinarily encountered and generally to stop work if any payment shall not be made, when due, to
recognized as inherent in work of the character provided for in this Contactor under this Agreement;Contractor may keep the job idle
contact. Owner as added work shall pay for any expenses incurred until all payments due are received. Failure to make payment,
due to such conditions. within five (5) days of the due date, is a material breach of this
Agreement and shall entitle contactor to cease any further work.
11. OWNER'S RESPONSIBILITIES. Owner agrees to allow
and provide Contactor and his/her equipment access to the VIII. CLEAN UP. Contactor will remove from Owner's
property. property debris and surplus material created by the operation and
leave it in a neat and broom clean condition.
III. DELAYS. Contactor agrees to start and diligently pursue
work through to completion,but shall not be responsible for delays IX. COMPLIANCE WITH LAWS. In connection with the
for any of the following reasons: failure of the issuance of all performance by Contactor of duties pursuant to this Agreement,
necessary building permits within a reasonable length of time, Contactor shall obtain and pay for all permits and comply with all
funding of loans, disbursement of funds into funding control or federal,state,comity and local laws,ordinances and regulations.
escrow, acts of neglect or omission of Owner or Owner's
employees or Owner's agent, acts of God, stormy or inclement X. ARBITRATION, VALIDITY AND DAMAGES. Any
weather,strikes,lockouts,boycotts,or other labor union activities, controversy or claim arising out of or related to this contract,or the
extra work ordered by Owner,acts of public enemy,riots or civil breach thereof, shall be settled by arbitration in accordance with
commotion,inability to secure material through regular recognized the Construction Industry Arbitration Rules of the American
channels, imposition of Government priority or allocation of Arbitration Association,and j udgment upon the award rendered by
materials,failure of Owner to make payments when due,or delays the Arbitrator(s)may be entered in any court having jurisdiction
caused by inspection or changes ordered by the inspectors of thereof.
authorized governmental bodies, or for acts of independent
contractors, or holidays, or other causes beyond Contractor's XI. ASBESTOS AND HAZARDOUS WASTE. Unless the
reasonable control. contract specifically calls for the removal, disturbance, or
transportation of asbestos or other hazardous substances,the parties
IV. SUBCONTRACTS. The Contractor may subcontract acknowledge that such work requires special procedures,
portions of this work to property licensed and qualified precautions, and/or licenses. Therefore, unless the contact
subcontractors. specifically calls for same, if Contractor encounters such
substances,Contractor shall immediately stop work and allow the
V. TAXES AND ASSESMENTS. Owner will pay for taxes and Owner to obtain a duly qualified asbestos and/or hazardous
assessments of all descriptions. material contractor to perform the work or do the work at
contractor's option. Said work shall be treated as an extra under
VI. INSURANCE AND DEPOSITS. Contactor shall carry the contract.
Worker's Compensation Insurance for the protection of
Contractor's employees during the progress of the work. XII. ATTORNEY FEES. In the event legal action or arbitration
Contractor shall carry liability insurance to cover any damages to instituted for the enforcement of any term or condition of this
Owner's property resulting out of the acts of Contractor. Owner contract, the prevailing party shall be entitled to an award of
shall obtain and pay for insurance against injury to his own reasonable attorneys fees in said action or arbitration,in addition to
employees and persons under persons on the job site at Owner's costs and reasonable expenses incurred in the prosecution or
invitation. defense of said action or arbitration.
Owner shall also procure at own expense and before the
commencement of work hereunder"all-risk"insurance with course
The Commonwealth of Massachusetts
z Department of IndustrialAccidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTEIOPJTY-
Applicant Information Please Print Legib
' q .
Name ($usiness/Organizationadividual): z /Zhu C464
Address:
City/State/Zip: Wa V 3d—Phone#:
Are you an employer?Check the appropriate box: Type of project(required):
1. I am a employer with : employees(full and/or part-time).* 7. ❑New construction
I am a sole proprietor or partnership and have no employees working for me in $. Remodeling
any capacity.[No workers'comp.insurance required.]
9. El 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.F]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.)
'
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.F]Other
152,§1(4),and we have nca 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.
Homeowners who submif 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-co' traciors have employees,they'must provide their workers'comp.policy number.
I am an employer drat is providing ivorkers'compensation insurance for my employees.'Below is thepolicy and joh 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 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 certif r the pains an penalties of verjufy that the information provided ahove is true and correct.
Si afore: - Date:
Phone#:
Official use only. Do not write in this area,to he 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#:
Date Prepared: 03/10/15
COMMERCIAL LINES POLICY
BUSINESSOWNERS POLICY DECLARATIONS
Merchants Mutual Insurance Company
Buffalo, New York
Policy Number: BOP 1083845 Transaction Type: New Business
Previous Policy Number: Billing Type: DIRECT BILL
Your Agent: 40478/NER06/033
Named Insured and Mailing Address: Agent Name and Mailing Address:
RAMON ERINNA DBA M P ROBERTS INSURANCE AGY INC
ERINNA CONSTRUCTION SERVICES 1060 OSGOOD STREET
583 NORTH BROADWAY NORTH ANDOVER, MA 01845
HAVERHILL, MA 01832-1221 (978)683-8073
Policy Period: From 03/01/15 to 03/01116 12:01 a.m. Standard Time at location of designated premises.
Exceptions: 12:00 noon in Michigan.
The Named Insured is: INDIVIDUAL
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE
WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
Policy may be Subject to Audit
TOTAL POLICY PREMIUM: $ 1 ,001 .00
Includes Terrorism Risk Insurance Act Premium Of: $ 12.00
Policy Subject to $150.00 Minimum Retained Premium
Countersigned: Authorized Representative:
MU 8382 (09/07) THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, COVERAGE PART
FORM(S)AND FORMS AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF,COMPLETE THE ABOVE NUMBERED POLICY.
INSURED COPY
September, 2014
Dear Customer,
Below is a listing of our material rates and hours of operation. If you
have any questions please call our Administrative Office, Monday-
Friday 8am - Spm at (603) 894-9800.
Other Bulky Waste (OBW) $130.00 per ton
Shingles $128.00 per ton
CRT* $ 22.00 each
Propane tanks $ 11.00 each
Tires $ 6.00 each
CFC** $ 17.00 each
Fluorescent Bulbs $ 5.00 each
Mattress $ 10.50 each
* CRT includes computer monitors and all size Televisions.
**CFC includes air conditioners, refrigerators, freezers and
dehumidifiers.
Minimum charge of$75 for loads under 1200 pounds. All rates
subject to fuel surcharge based on the weekly US Department of
Energy Index. Prices subject to change
Scale Hours of Operation
Mon - Fri 7:30am - 4:30pm
Saturday 7:30am - 12:00pm
Sunday Closed
Thank you,
LL&S, Inc.
87 Lowell Road
Salem NH 03079
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Office
Consumer Atfaas& CTOR
MEIMPROVEMENT CONTRA Type
� gtration: 135503
is
DBA
I Xpiration: 41912016
yI SERVICES� ERINNA CONSTRUCT.ION
Igni 7 '�
i Ramon Erinna
583 NORTH BROADWAY �
MA 01832, Undersecretary
"- VERHILL, J
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
„_�._.____ • c____�-•___
�,1/II1L1 Ullll/ll JU�ICI�11111
License: CS-066182
RAMON M ERPU4
583 N BROAD
HAVERHILL 01'
`
Expiration
04/16/2017
II
Commissioner