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HomeMy WebLinkAboutBuilding Permit # 10/22/2015 ®�R,*'CD BUILDING PERMIT TOWN OF NORTH ANDOVER - / APPLICATION FOR PLAN EXAMINATION - Permit NO: Date Received Date Issued: f SS A us IMPORTANT:A licant must com fete all items on this age I I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Buildingne family 11Addition i��Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Identification Please Type or Print Clearly) OWNER: Name: nry Lzl .fd l Phone: t 9 Address: , 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: $ a _ _ .� FEE: $h .— Check No.: (o Receipt No.: f C, NOTE: Persons contract ng ith up registere ntractors do not have access to the guaranty fund i F NORTi-r Town ofE. :...,, ndover 0 No. 5bl-20� �`y h ver, Mass, D4b6 22 2-o t5 T ULAK! CCC HIc He w1C K S u BOARD OF HEALTH Food/Kitchen PE ,RMIT T LD Septic System THIS CERTIFIES THAT .... ........� .................. . *,— ��1 Foundation BUILDING INSPECTOR has permission to erect .:........................ buildings on ...... ....... 11.h?�.?. ....5?1-:................ Rough tobe occupied as ..............6�j"'�. ...........................Q. .......................................................... chimney provided that the person accepting this permit shall in every res ct conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S Rough Service ......................... ....... ...... ................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. about:blank NA710NSA CMtve,CDOUARTERS HenryUcciardi r 2501 Sea 31.71947 October 08,2015 MA CUSTOM REMODELMG AND IMPROVEMENT AGREEMENTr,cr,e ,s Buye4s)'irMormation MW aerrcriptwn at the Pmperty: Project Number:31-71947 October 09,2015 Henry L fcciardi a 49 Fernwood$i MM)GW9e09(Henry's Colt) f�a� North Andover,MA,01045 _ County.ESM ownahip; Buyer(n)listed above hereby jointly and severally agrees to purchase the goads and/or services of Power Home Remodeling Group and Its vendors("Contractco in ac o danoe with the prfcas and terms descrlbod in this 5 page document and the Product Speclficatlons,which are Incorporated as part of tate Agreement(collectively,this"Agreement"►. This Agreement represents a cash $ale of goods and services. Buyer(s)agrees t0 pay ft Cost of ft goods and services purchased as described heroin,regardless of timing or approvai of any financing Buyers)may seek for their purchase, PurchasePrkar: $1 Pre Installation Inspection Dates: /0-/I D"n Payment: $0.00 Eatimsted Pro)eot Start:3 to 4 weeks Substan Duo ontlei f;ctrrq�etioh, tt1 .9i1 Esd11114W Project Compiationt 1 to 2 days Sabstan Method of Payment: Other �°r'4'rOoloo"0*a 00h%*Wd and MMW400 s 0NO We NOT 0 nor Ment,00" v apr�+troi nu MR9stlad M,caktuMratnq oma sea oalgArMutwm Buyers)horeby admowl roceil5t of a Copy of Cas paw,1N Lsad-Safe Certibed Culde to Rynovate Right",Informing Buyor(s)of the potential risk of lead hazard a from;r nWadon activity to,be al, ,rr W In or at I yer(s)'Property,at address written dbovea Buyers)rocelvedthis pa on date of�a 'sem nt befonr sistR7 rnr anent 0t work. This Agreement oonaanrfes trio erire agreernern and,tinderpufindinlg bWsen pts tl'la,Ament replaces any and sli *r ne ifatisane,re t eterlta r4s,ar avoerr4ents,el+W iii, cir oral, No tes> � onwalver of this A,gresrn9nt shall bavalbd un irl 6 may) s� Buyerjs)1)has road the Omni Agreement and ties 1e09ived a 06rapieted, ,grid date f ol,this tr�rfny the torn antiampanying Notit e of Cenrprrdlon on d pmt Web" 4' ma)/ �wt to ttgs rM, 61uY�'(s) a and Lin +h �t�(s)"� ►wok h a �t��:ol t tl►Ior►dng'wNlt be aantelirrad on ac4psrate dnc(riirl�e�s PutUre pna�s rapt sipk��m o � ��y+��p1/u.�II ; Y�r K1nlll 1� �� i1R"4AI1a1''A � AIA / i i/i / i/ % i //r r/��///r/r/J//l%�1✓�d�/�;,� r%f/ �,�1 /,/' ''i��/j r,o,/�� / i �ar���/�i/�!r% / ��//i i ,�/% 1 /l/ / IF j%M , 1 of 1 10/20/2015 2:17 PM NATIONAL HEADQUARTERS Henry Licciardi 2501 Seaport Drive,Chester,PA 19013 > 01X/ER 31-71947 _-- — u H—R<„waecngG. p-: October 08,2015 s3 f H MA HIC#168616 PRODUCT SPECIFICATIONS Buyer(s)'Information and Description of the Property: Project Number: 31-71947 October 08,2015 Henry LicciardlDateotAgreement (978)685-9609(Henry's Cell) 49 Fernwood St North Andover,MA,01845 County:Essex Township: Buyer(s)listed above hereby jointly and severally agrees to purchase the goods and/or services listed on the accompanying specification sheets, in accordance with the prices and terms described in the Custom Remodeling and Improvement and the Product Specifications (collectively,this"Agreement"). Pre Installation Inspection Date:Your pre installation inspection is tentatively scheduled for Mon 10/19 between 1:00p and 2:00p. Roofing-GAF Inclusions: For steep slope roofs,the application includes Timberline Ultra HD Lifetime Shingles with 50-year non prorated labor warranty. Also includes removal of existing shingles,installation of F-style drip edge,Weather Watch ice and water shield,Deck Armor breathable roof deck protection, Pro Starter starter strip, Snow Country ridge vent exhaust,Timbertex premium ridge cap shingles, PowerVent intake ventilation, all flashing where needed and 6 nails per full shingle.All applications used only where applicable.Clean up and haul away of all job related debris. To protect our clients,Power HRG includes,at no additional cost,the removal and replacement of up to 300 square feet of soft or rotted roof decking if needed on steep slope applications. Any additional wood replacement needed,over and above the 300 square feet we provide will be done at a cost to the homeowner of$3.57 per square foot. (Buyer initials ). For Example:After the shingles have been removed,if we find there is a need to replace 325 square feet of wood,Power HRG will pay for the first 300 square feet. It is the responsibility of the homeowner to pay for the cost of 25 square feet of replacement at$3.57 per square foot,which in this example is $89.25. For low slope roofs,which are roofs with a pitch below 2/12,the application includes a 15-year non prorated labor and material warranty, removal of all existing roofing materials, new decking,TriBuilt base and cap sheet,drip edge and flashing,where applicable. Roofs with cedar shingle removal will include all new decking as part of the installation. Clean up and haul away of all job related debris. It is agreed and understood by and between the parties that the Product Specifications,along with the Custom Remodeling and Improvement Agreement,constitutes the entire understanding between the parties,and replace any and all prior negotiations, representations, or agreements,either written or oral. The Product Specifications may not be changed, modified,or varied in any way unless such changes are in writing and signed by both Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read the Product Specifications. I have read and received each page of this 2 page agreement. Power Home Remodeling Group Buyer(s) /10/08/15 /10/08/15 Signature of Remodeling Consultant Signature Michael Pappas Henry Licciardi YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. October 08, 2015 17:32 IIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Page 1 of 2 NATIONAL HEADQUARTERS HenryLicciardl 2501 Seaport Drive,Chester,PA 19013 ®WER ,'= 31-71947 way October 08,2015 MA HIC#168616 Project Specifications Roofing: Whole House 1 1625.0'x1.0' ROOFING: Models GAF Styles Architectural Shingles Types None Configs None OPTIONS: ColorSlate Removal Standard Shingle Installation Details None J� {IIP mKff5VALS 0DRPORATION #lati I �t r �w �g MweS October 08, 2015 17:32 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Page 2 of 2 POWER-1 OP ID: EL ACORO@ DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/11/2015 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: Lacher 8r Associates Ins Agency PHONE FAX Lacher Insurance Group AIC No Ell:216-723-4378 A/c No): 215-723-8604 632 E Broad St P 0 Box 64398 E-MAIL Souderton,PA 18964 ADDRESS: Chad Lacher INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Harleysville Preferred Ins.Co 35696 INSURED Power Home Remodeling Group, INSURER B:Harleysville Worcester Ins CO 26182 LLC INSURER C:Nationwide Mutual Ins Company 23787 2501 Seaport Drive Ste 8110 Chester, PA 19013 INSURER D:Pennsylvania Manufacturers 12262 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 SUB POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 19000,00 �X MPA00000089793N 10/01/2015 10/01/2016 DAMAGE TO RENTED 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 15,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY[X]JEO--OLOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 Ea accident , , B X ANY AUTO BA 00000089796N 10/01/2015 10/01/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ r $ HIREDAUTOS AUTOS Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 C X EXCESS LIAB CLAIMS-MADE CMB00000089794N 10/01/2015 10/01/2016 AGGREGATE $ 5,000,00 '.. DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER D ANY PROPRIETOR/PARTNER/EXECUTIVE Y� NIA 201500-66-20-96-7 10/01/2015 10/01/2016 E.L.EACH ACCIDENT $ 1,000,00 D? OFFICERIMEMBER EXCLUDE (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,00 B Mass Auto BA 00000018227P 10/01/2015 10/01/2016 Auto Liab 1,000,00 B NY Auto BA 00000074849R 10/01/2015 10/01/2016 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION NANDOVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover 120 Main Street AUTHORIZED REPRESENTATIVE North Andover,MA 01845 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Yhe Commonwealth ofAfassachuserys DepaHment of Industrial I Congress Street,Suite 100 Boston,MA 02114-2017 www-mass.sovIdia Workers'Compensation insurance Affidavit:Builders/Contractors/El lectricians/riumbers. TO BE FMED WITH THE PE AUTHOF.ITV. Applicant Information Please Print Legibly Name(Business/Organization/ludividual):_ Ig me - b 11-1 L7- Address: #Z Sb U—i ut'T X21ve City/State/Zip: 6+0TGA ic q615- Phone 50 Z 86- 0 1 5't Are you an employer?Check the appropriate box: Type of project(required): I.M lam a employer with 15 -empioym(fun and/or paa-time).* 7. El New construction . 2.0 1 am a sole proprietor or partnership and have no employees working forme in Rem 8. F 0deling any capacity.[No workers'comp.insmanoe required.] _] 3-Ellamalromeovvnerdoing all work myself,[No Workers,comp.insrurance,req7uired.j 1 9. 0 Demolition 4.[:]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 E]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.F]Plumbing repairs or additions 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance) 13.E]Roof repairs 6.[:]We are a corporation and its officers have exercised their right of exemption per MGL c. 14*0 Other 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. I Homeowners who submit this affidavit indicating they an 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 am an employer that isproviding workers'compensation insurance for my employees. Below is thepolley andjob site information. Insurance Company Name: &"LVJL�JE L�fLC7TCM- Policy#or Self-ins.Lie.M 7,0WO ..y Expiration Date-_I()-I —2®l6 Job Site Address:- IM CitylState&ip:_W�, 41 )t?bVj7J,,,_, 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 60 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 DU for insurance coverage veril 3n/ I do hereby rti +d9Ft-A-eparns and penalties ofperjury that the informadonprovNed above is true and correct. SigLiature: Date: Phone M 61'7& 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 M (7, MCC Of Consumer Affairs Business Regulatiop License or registration valid for individul use only Rf PrtrjE IMPROVEMENT CONTRACTOR before the expiration date. If found return to, e.Registration: 168616 Typi Office of Consumer Affairs and Business Regulation 10 1320-�-Plan-Suite 5170 Expiration: 3/1'812017 Supplemeni 'ard 130 &,� A-q on ... POWER HOME REMODELING GROUP LLC. MARK MORDINI 2501 SEAPORT DRIVE STE B110 CHESTER,PA 19013 of valid without wou t signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License:CS-057645 MARK E MORDINI 18 NEWELL DR N ATTLEBORO MA _jZCK- CA-- Expiration: Commissioner 09/1812017 1WA o- UGHMA 0v, t w-m 5 DO D94-2014 R.07-154M J."