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HomeMy WebLinkAboutBuilding Permit # 11/10/2015 T BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: WPORTANT: Applicant must complete all items on this page c ATI,O`N,� PROP Y"OWN b K;,�� ........ .. ..... ... 'A4C Hisf6d" 60,is IN TT, i'do. S TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential I New Building XOne family Ll Addition 11 Two or more family E Industrial 11 Alteration No. of units: 11 Commercial y'Repair, replacement 1,1 Assessory Bldg 11 Others: El Demolition 11 Other Veftnds,,,`-�, a El% E,1/8ept 16,, e Ro ate Se� Wa te r/ o/A 6e— L-1 I ry vvl"-ev 0 J�AAJ c2Ll b ok-A-r 6;4) '7-0 j- �L r rw(i 1bf LZ A-/-< Identification Please Type or Print Clearly) OWNER: Name: 90 r)'�5 .5"Y-0-f" Phone: TIL 6162 �J,503 j,�q A Address: (6vlr- V-1 N f, '-t- b R; N a m�e A` dies&-0,�', tio 'ns Nip 'Jeensw . .......... "t L Jcenw ............. ARCH ITECT/ENGI NEER— Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.VZOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ m000 FEE: $ Check No.: S�CA L� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to thef guarantyfynd 'Signature,of A ent/Owner Signature of coritractorz���� � N,QF2TH -w% dover Town of f E p R No. 5st- 201� .1Kt I IL o h , ver, Mass, coc-c"tWICK A0MATED S U BOARD OF HEALTH Food/Kitchen L D Septic System THIS CERTIFIES THAT ... ...TAC6... BUILDING INSPECTOR . has permission to erect ... ..................... buildings on ... ..-.. .......... .. �!�l............. ........ .. ., Foundation t ` Rough to be occupied as . .. ... �. .. .115..t... �. ... Chimney provided that the person ccepting this permit shall in every respct conform to the terms of the lIcation 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 16 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIOARTS Rough Service ...........L. .....,I.. 4s.,,.Yr.................... BUILDING INSPECTOR Final 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. SmokeDet. _ 430 f.� DQ� 59 JEVdEl�i. L RD,�,SHBURNN , 01 50&581-3798®FAx 505-519-5888®INFO@soLIDSTATECONSTRUCTION.CoM PROPOSAL Project: Nordstrom Windows&Siding 2015 Bid Date: 10.9.15 Attn: Doris&Robert Nordstrom Phone#: 978.689.4503 Work#: Company: Cell#: Address: 124 Penni Ln. Fax#: City,State,dip No over,Ma Email: renordy@aol-com Referred By: Shriner's Home Show PAyMNT TERMS &OPTIONS ✓ Base proposal total $ 40&600—.0-0 — • 0600.00✓ Alternate 1 total$ 443850-00 ✓ Marketing Cost Savings Plan 5%Discount$ 5 450.00 Total Job Amount Authorized: $ 80 000.00 ❑Ck X CC A non-refundable 1/3 deposit due upon authorization in the amount$:26 o Ck X CC of: ❑Ck X CC An additional payment due at job start $ 13.500.00 t completion of windows of: The balance due upon siding completion of$ —1-15-0000 plus any customer requested additions. ❑Ck X CC An additional payment due a above referenced amount(s)to the above referenced account(s)according to I authorize Solid State Construction to charge the the agreed Pon payment sched x Date Signature inform you of contract liens.Any contractor,supplier,or subcontractor may lien your real property if you or the general Disclosure: State taco requires us to contractor fails to pay for goods or services delivered de original lien lien release documents led at the work louation.Some meco anyonecwho provides saidmaterialori erviceleFiease call tftyouon similar to this notice. At your request,we will p g have any question regarding liens. Acceptance: The signature on this proposal reflects acceptance of the proposal as per the attached scope of work,authorizes commencement of the work,and hereby guarantees payment as outlined above. Any amounts not paid within thirty days of invoice are subject to service charges of 1'/1%per month r(J (18%APR)_ All costs of collection_including reasonable attorney fees are to be paid by the customer. #oractor igna re Date Customer Signature Date $1,000,000 Liability Insurance a Warranteed Work e MA CS License#96770®NIA HICK#179155 - _ 59 JEWELL HILL RD.ASHBURNHAM,MA 01430 508-581-3798 a FAX 508-519-5888 o INFO@SOLIDSTATECONSTRUCTION.COM JOB: NORDSTROM WINDOWS& SIDING 2015 SCOPE OF WORK: JOB SCHEDULED FOR WEED OF 11/9/15°APPROX 3 WORKING WEEKS. BASEPROPOSAL: The base proposal price includes the following: Supply building permits,labor,materials to: 1. Demolition-Remove 28 Primary vinyl double hung windows and 1 primary casement window.Full frame removal-all interior trim to be removed,all siding around windows to be removed. Entire window to be removed leaving rough frame only.Inspect rough frame and advise of condition.Remove and dispose of all primary windows. 2. Preparation-Clean RO.Install Vycor or equivalent ice and water shield tape to bottom of RO. 3. Windows-Install 29 Simonton Brickmold 600 series double hung,white interior and exterior,Double pane, Low-e coated glass with argon gas fill,approx.U factor.29.Jamb depth is 6 9/16" 4. Trim-Install factory made 5/4x 4 flat casing to exterior.Install 2.5"colonial casing to interior. 5. Siding-See alternate 1. 6. Full job site clean up and removal of all job related debris. 7. Interior finish to be completed at same pace with exterior. 5 year warranty on all craftsmanship.30 year non-prorated manufacturer's warranty on all JH materials. ALTERNATES: The options are available at additional cost: 1. Demolition:Remove all siding,door and garage door trim.Inspect underlying sheathing and advise. 2. Siding Underlayment:Install ice and water shield to sidewalls of shed dormer.Install James Hardie house wrap to all other siding areas. 3. Siding: Install James Hardie Cedarmill Lap siding(clapboard)to house,approximate Exposure to be 4"and color to be Light Mist.Install all appropriate flashing detail.All nails to be stainless steel ring shank siding nails. 4. Trim Detail- a. Corners-Install JH trim or cellular PVC 5/4x5 corners b. Windows-Windows will be new construction with built in trim as above. c. Fascia,soffit and Rake boards-Leave existing wrap intact.Customer understands that if any wraps are found to be substandard or if they need to be disturbed to complete siding work they will be replaced at a cost of$8 per LF with custom formed aluminum trim stock. d. Cheek wall-Install approx.2"cellular PVC trim to roof One. e. Skirt board-Install cellular PVC skirt as needed. f. Install all new JH light blocks and vent covers. g. Garage doors and patio doors-Case with Cellular PVC trim. h. All cellular PVC to be fastened with cortex screw and plug system.All Hardie trim to be installed with finish nails and touched up. MARKETING COST SAVINGS PLAN: To help defray SSC's marketing and sales costs,customer agrees to the following: 1. Contracting job at time of proposal 2. Writing and posting a member review of Solid State Construction on Angle's List.If customer is not already a member,this will require becoming a member. In consideration of participation in this program,customer will receive discount listed. EXCiLUSIONS: The following items are specifically excluded from the job: 1. Any rotted or sub-standard decking to be replaced at an additional cost of$45 per plywood sheet or$3.50 per linear foot.Any structural rot will be priced when seen. 2. Job includes above scope only. Any additions to the above scope will be priced when discussed. 3. Interior painting/prep. $1,000,000 Liability Insurance a Warranteed Work a MA CS License#96770 a MA HICR#179155 The Commonwealth of Massachusetts Department of lndustr'ialAccidents I Congress Street,Suite 100 < Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricrans/PIumbers. TO BE FILED WITH THE PERAUTTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Solid State Construction, LLC Address: 59 Jewell Hill Rd. City/State/Zip: Ashburnham, Ma 01430 Phone#: 508-581-3798 Are you an employer?Check the appropriate box: Type of project(I'equlred): 1.®I am a employer with 3 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ®Remodeling any capacity.[No workers'comp.insurance required.] In I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 10[(Buildinldi 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 S.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E]Roof repairs These sub-contractors have employees and have workers'comp,insurance? 6.Q 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. t Ilomeowners 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 I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Traveler's Policy#or Self-ins.Li,.#: UB-2E658587-15 Expiration Date: 1/15/16 Job Site Address: t�^� ����� /Zi/State Ci ty p: L�' iii r,-� �:�/' tart 1$1,4 � 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 WORD 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 DTA for insurance coverage verification. Ido hereby certify under'thepair ndpenalties ofperjury that the it fornrationprovidedabove is true and correct. ss nature: Date: 11/9/15 Phony#: 508-581-3798 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 Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 11/10/2015 12:44PM FAX 5087556412 THOMAS WOODS INSURANCE U0002/0002 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrrnY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THISCERTIFICATE 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 tho Certificate holdor Is an ADDITIONAI-INSURED,tho polioy(Ios)must be endorsed, If SUBROGATION IS WAIVED, vubJoct to the terms And conditions of tho policy,certain policies may roqulro an ondorsomont, A statomont on this certificate does IS confer rights to the cortificato holdor in lieu of such endorsement(s, PRODUCER THOMAS J. WOODS INSURANCE AGENCY, INC. "-A�� Lori BI clow -PHONE 508 755-5944 I fA/ —caw-rt), 508 C,No): -MAIL, - Ibi Blow woodsinsurance.com 20 PARK AVENUE —� �— --- LNCAI WORCESTER ,MA 01613 INsuRERA: TRAVELERS PROPERTY CAS CO OF AMINsuRED SOLID STATE CONSTRUCTIONLLCINaURHRe; INSURER D $9 JEWELL HILL RD INSLIaERE: ASHBURNHAM MA 01430 INSURBRr; COVERAGES CERTIFICATE NUMBER: 11365 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED TO THE INSURED N QMCD A80VE 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 SUBJCCT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR T TYPOOFINSURANCE 7N/A yGOMMERGIAL OENORAL LIADILITY LIMITS UCHOCCURRENCG $CLAIMS-MADG OCCURCCT(SP_ATEIT- - 3Ett�rC,v"1E0.OW--Rn;ar 91._ SMPO EXP(qr, one OaOn S PER:'ONAL R ADV INJURY S QBN'L AGQRECAT6 LIMIT APPLIES IES PER: GENPRAL AQCRECATF_ POLICY❑PRQ- ( -§ JECT C7 LOG PRODUCTS-COMP/OP A OTNPOC 5 .R AU1 OMOH140 LIABILITY § M LIMIT ANV AUTO (Fa nj=0110 S ALL OWNED SCHEDULED BODILY INJURY(Por Person) $ AUTOS AUTOS N/A N/A BODILY INJURY(Por aocldani) S - HIRED AUTOS AUTOS Ii0NF�5�DAMAZrt" (Per 0-Idantl S UMBROL AUA9 § OCCUR EAOHOCCl/RRENCE E CRCESSUAD CLAIMS-MADE N/A •• •- AGGREGATE § DFp R TGNTION WORxOR5COMPeNBAT10N S AND OMPLOYQRG'LIABILITY Y/N X U1T T ANVPROPRIe TOR/PARYN E(UGX ECUTI VG A OFFICEWMGMI3EREXCLUDED7 N!A N/A N/A 7PJUB2E65858715 01/15/2015 01/15/20113 F,L.EACNACCIDGNT S 100,000 (Mandatory In NH) Ifyyap,deaadb0lmdar E.L.OISU3E-PAGMIR --E § 100,000 DFQ RIPTION QF, bola y C.L.DISEASE.-POLICY LIMIT R $00,000 N/A DESCRIPTION OFOPCRATIONO/LOCATIONS lVONICLES(ACORD 101,AddlOonalRemark&3ghtdulo,may bea[tnohodifm Workers'Compensation benefits will be paid to M9aaachusetts employees only,Pursuant to Endorsement is 20 03 06 B,no authorization Is given to pay claims for benefits 10 omployoes in states other than Massachusetts if the Insured hires,or has hired those employees outside of Massachusetts, This Certificate of Insurance shows the policy In force on the date that this ceftl(Ieate was Issued(unless the expiration date on the above policy precedos the issue date of this certificate of Insurance). The status 0f this coverage can be monitored doily by accessing the Proof of Coverago-Coverage Verification Search tool at www,mass,gov/lwd/workers-Compenostlon/lnveatigation s/, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS, 1500 Osgood St AU,YMORIZED RCPRESBNTATIVE N Andover MA 01845 f` I I C, Danlos M.Crq rey,CPCU,VICo Presidont—Residual Market—WCRIBMA ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 1/10/2015 12:44PU FAX 5087556412 THOMAS WOODS INSURANCE 110001/0002 SOLID-1 OP ID:L6 r®���R�� CERTIFICATE OF LIABILITY INSURANCE 4111/10/2110/2 Y015 15 *�THISTIFICATE 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,tho pollcy(los) must be ondorsod. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,Certain policies may require an ondorsomont, A statomont On this cortlflcate does not confor rights to the certlflcato holder In lieu of such endorsement(s). PRODUCER CONTACT Thomas J Woods Insurance Agcy PHONE Jack Woods,CPCU Pax P.O.Box 2940 -(A/c;NO.Ext1:508-755-5944 LAIC.Nor 508.791-9841 Worcostor,MA 01613 A MAIL Jack Woods,CPCU — INSURER(S)AFFORDING COVERAGE NAIC p _ INSURERA.Atlantle Casualty Ina Co INSURBO Solid State Construction LLC INSURER n 59 Jewoll Hill Rd Ashburnham,MA 01430 INSURER C: _- IN$VRER D; INSURER E INBURQR!"; 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 [$SUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$ SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN$R -6L SUB LI Y Pocl'C T TYPE 0►IN'URANCE POLICY NUMBER MMI IYYv MMI /YYYY LIMIT$ A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1_,000,000 CLAIM&MADE U OCCUR L186000440 07/07/2015 07/07/2016414DCG6TO�tENTEO — 100,000 P13EM($,ES(Ep oc�ri n 3 X Deductible $1000 MED CXP(Any one porion) S 5,000 PI_RSONALSADVINJURY S 1,000,000 GEN'LAGGREGATE LIMITAPPLIESPCR: C'_NERALAGGREOATE r 2,000,000 X POLICY E1 PEO- F LOC PRODUCTS-COMP/OP AGO S 2,000,000 OTHER- $ — YM-61-N- LE LIMIT AUTOMOBILE LIABILITY a potldtnll S ANY AUTO BODILY INJURY(Por porzon) S ALL OWNED SCHCDUL[D 60DILY INJURY(Pel acgldcnr) $ H RT OSAUTOS NOAUTOS OWNED PROPERTY DAMAGIS S AUTOS Por o0ddanl) _- S UMBRELLA LIAR OCCUR EACH OCCURRENcI- EXCESS LIAR CLAIMS•MADC ACCREGATE S DED RETENTIONS $ WORKERS COMPENSATION S _TVTE R ANO EMPLOYERS'LIABILr Y YIN "-- ANY PROPRICTOR/PARTNER/EXECUTIVE C.L.GACH ACCIDENT S OPFICCRIMEMBER EXCLUDED? El N/A — (Mandatory In NH) E,L.DISEASE.Cit lZMPLOYEE S 11y00,deAorlDe under DESCRIPTION OF OPFRATIONS below 12. .DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Romark■SaAodule.may be attachod If moro space[%required) CERTIFICATE HOLDER CANCELLATION TOWNNAD SHOULD ANY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF NORTH ANDOVER THE EXPIRATION DATE THEREOF, NOTICE WILL BIT; DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPT. 978-688-9542 AUTHORIZED REPRESENTATIVE 1600 OSGOOD ST Jack Woods, CPCU NO.ANDOVER, MA 01845 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 4} Massachusetts Department of Pubirrr Safety Board of BuHdH ng Regulafions and Standards Conorurti(m Superro koa Lacense: CS-096770 ,JEFFREY R BROQkS 59 JEWELL HILL.RU IkiG r Ashburnham MA 014 r ExpBratSQrW Corn roissioner 02/07/2016 Office of Consumer Affairs&Business Itegulation License or registration valid for individul use only �pME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ,egistration: 179155 Type: Office of Consumer Affairs and Business Regulation xpiration: 6/27/2016 LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 SOLID STATE CONSTRUCTION LLC, BROOK JEFFREY —" 59 JEWELL HILL RD ASHBURNHAM,MA 01430 « _ Undersecretary N t valid without s nature