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HomeMy WebLinkAboutREPLACE BATHROOM FLOOR AND CEILING oRTH BUILDING PERMIT IF ,6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit Nay : Date Received AS US YED Date Issued: 4PORTANT: Applicant must complete all items on this page LOCATION " ,� Print PROPERTY OWNER ry , �� Prinf 100 Year Structure yDs5 no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village es no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition Ll Two or more family CI Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg _ ❑ Others: ❑ Demolition ❑ Other /rr, /,.../ i„/ ,. „rr / /./ r/ ✓/;rel ,.� / / �. DESCRIPTION OF WORK TO E PERFORMED: , , � - Ide flcation- Please Type or Print Clearly OWNER: Name: i r 14, 64 Phone s ' Address: r Contractor Name: _ Phone: m� ` - ” 296 Y p Email: Address: Supervisor's Construction License: ` �' E)b. Date: ✓ ~ '� Home Improvement License: l� Exp. Date: - r ARCHITECT/ENGINEER Ph-one: R. Address: Reg.,No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATEC QST BASED ON.'$125.00 PER S.F. Total Project Cost: $ �2 FEE: $ i Check No.: (,+3 Receipt N:a.: NOTE:E: Persons contracting with zs'zl^eg1 terecl cantFacta's c�® rZa�t have,access tt�.�f e guaran fund *6 zal> Sinaf�/rof Aa�n m 9-th W"Me% A"%L MF "er NORTI, UVVII U1 a uo'%' V O _ y; No. h ver, Mass, A- MK.( 1. A 7,9COCMIC lW 5 RTE �P D a���S in U BOARD OF HEALTH Food/Kitchen Rn E R IT T Septic System THIS CERTIFIES THAT l. ®. BUILDING INSPECTOR CO.... ..... has permission to erect.. 7U ......................... buildings on .... .... �. ..................... Foundation Rough to be occupied as ..... ��. ......f !!.. ... .... ...... ......... ................ .. �. ..0. .. Chimney provided that the person accepting this permit shall in every respect 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,ALIteration and Construction of Buildings in the Town of North Andover. 5U-W*4Q& Cb ® l PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT10 ARTS Rough `���'!" _7 � Service .......... ....... ............................................................ Final BUILDING INSPECTOR . GAS INSPECTOR Occupancy Permit Required to Occupy Puildinz 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. HEBERT • • Construction & Remodeling Inc. 102 Adams Ave. No. Andover Mass. 01845 (978) 686-0786 Phone / Fax Lic. #:058241 Reg. #:153811 DATE 5/5/16 Job: Trinitarian Congregational Church Elm St. North Andover Ma. 01845 Phone. 978-686-4445 PROJECT :Bathroom & Lounge I. PARTIES This contract (hereinafter referred to as 'Agreement") is made and entered into on this 4th day of May. by and between The Trinitarian Congregational Church (hereinafter referred to as "Owner"); and R.S.Hebert Construction & Remodeling Inc., (hereinafter referred to as "Contractor"). In consideration of the mutual promises contained herein, Contractor agrees to perform the following work, subject to the terms and conditions below: II. GENERAL SCOPE OF WORK DESCRIPTION 1. Remove hardwood floor from bathroom. 2. Install 3/4" plywood to floor area where hardwood was removed. 3. Install VCT floor tile. 4. Install new door unit to bathroom stall area. 5. Install new 2' x 2' suspended ceiling in lounge area 17' x 17' 6. Install 4 new sets of door hardware. 7. Box steam pipe riser in lounge area. 8. Install 1/4" birch plywood over the cork on wall in lounge. Contractor Owner Owner A. LUMP SUM PRICE FOR ALL WORK ABOVE* $ 6200.00 Sixty two hundred dollars. III. GENERAL CONDITIONS FOR THE AGREEMENT ABOVE 2. STANDARD EXCLUSIONS: Unless specifically included in the "General Scope of Work" section above, this Agreement does not include labor or materials for the following work: Plans, engineering fees, Testing, removal and disposal of any materials containing asbestos (or any other hazardous material as defined by the EPA). Custom milling of any wood for use in project. Moving Owner's property around the site. Labor or materials required to repair or replace any Owner-supplied materials. Final construction cleaning (Contractor will leave site in "broom swept" condition).,correction of existing out-of-plumb or out-of- level conditions in existing structure. Correction of concealed substandard framing. which may be discovered in the removal of walls or the cutting of openings in walls. Removal and replacement of existing rot or insect infestation. Failure of surrounding part of existing structure, despite Contractor's good faith efforts to minimize damage, such as plaster or drywall cracking and popped nails in adjacent rooms or blockage of pipes or plumbing fixtures caused by loosened rust within pipes. Exact matching of existing finishes. Cost of /testing/remediating mold/fungus/mildew and organic pathogens unless caused by the sole and active negligence of Contractor as a direct result of a construction defect that caused sudden and significant water infiltration into a part of the structure. B. DATE OF WORK COMMENCEMENT AND SUBSTANTIAL COMPLETION Commence work: on or about 5/5/16. Construction time through substantial completion: Approximately 5 days, not including delays and adjustments for delays caused by: holidays; inclement weather; accidents; shortage of materials; additional time required for Change Order and additional work; delays caused by Owner, Owner's design professionals, agents, and separate contractors; and other delays unavoidable or beyond the control of the Contractor. C. CHARGES FOR ADDITIONAL WORK: CONCEALED CONDITIONS, DEVIATION FROM SCOPE OF WORK, AND CHANGES IN THE WORK Contractor Owner Owner . CONCEALED CONDITIONS: This Agreement is based solely on the observations Contractor was able to make with the project in its condition at the time the work of this Agreement was bid. If additional concealed conditions are discovered once work has commenced or after this Agreement is executed which were not visible at the time this Agreement was bid, Contractor will point out these concealed conditions to Owner, and these concealed conditions will be treated as Additional Work under this Agreement. Contractor and.Owner may execute a Change Order for this Additional Work. Contractor is released, held harmless, and indemnified by Owner from all pre-existing mold, fungus, mildew, and organic pathogen problems and is not responsible for costs or damages associated with correcting, containing, testing, or remediating the same. • D. PAYMENT SCHEDULE AND PAYMENT TERMS 1. PAYMENT SCHEDULE: First payment when work starts. $3000.00 Final payment when work is complete. $3200.00 2. PAYMENT OF CHANGE ORDERS/ADDITIONAL WORK: Payment for Additional Work is due upon completion of either all or part of the Additional Work and submittal of invoice by Contractor. E. WARRANTY Thank you for choosing our company to perform this work for you. Your satisfaction with our work is a high priority for us, however, not all possible complaints are covered by our warranty. Contractor does provides a limited warranty against material defects on all Contractor- and subcontractor-supplied labor and materials used in this project for a period of one year following substantial completion of all work. This warranty covers normal usage only. You must contact the Contractor upon discovering an item in need of warranty service. Additionally, Owner's hiring of others or direct actions by Owner or Owner's separate contractors to repair a warranty item are not covered by this warranty and will not be reimbursed by Contractor. No warranty is provided by Contractor on any materials furnished by the Owner for installation. No warranty is provided on any existing materials that are moved and/or reinstalled by the /ate Contractor Owner Owner Contractor within the dwelling or the property (including any warranty that existing/used materials will not be damaged during the removal and reinstallation process). One year after substantial completion of the project, the Owner's sole remedy (for materials and labor) on all materials that are covered by a manufacturer's warranty is strictly with the manufacturer, not with the Contractor. Repair of the following items and related damages of every kind are specifically excluded from Contractor's warranty: problems caused by lack of Owner maintenance; problems caused by Owner abuse, Owner misuse, vandalism, Owner modification, or alteration; and ordinary wear and tear. Damages resulting from mold, fungus, and other organic pathogens are excluded from this warranty unless caused by the sole and active negligence of contractor as a direct result of a construction defect which caused sudden and significant amounts of water infiltration into a part of the structure. Deviations that arise such as the minor cracking of concrete, stucco, and plaster; minor stress fractures in drywall due to the curing of lumber; warping and deflection of wood; shrinking/cracking of grouts and caulking; fading of paints and finishes exposed to sunlight are all typical (not material) defects in construction, and are strictly excluded from Contractor's warranty. I have read and understood, and I agree to, all the terms and conditions contained in the Agreement above. DATE CONTRAC R'S SIGNATURE �i�Ilk DATE OWNER'S SIGNATURE CUSTOMER HAS THE RIGHT TO CANCEL CONTRACT THREE DAYS AFTER SIGNING. Contractor Owner Owner The Commonwealth gfMassachusetls s W Department of IndlastrialAccrdents a X Congress Sheet,Suite 100 Boston,H4 02114-2017 www.masseg'ov1d1a Wovkers'Compensation Insurance Affidavit:lBuiiders/Contractors/E Xectxiczans/T'1rzmberrs. TO BE P']ZETt WITH THE, PERMITTINGAUTHORITY.Applicant Information PXeas�,e Print Leg'tbly Name (Liiisiness/Organization/Xridividual): � � � � L�s�'�/�'� L012 2�'���'`�� Address: 1qAj",C City/State/Zip: e_*_6 4 a / S' Phone#: Areyou an employer?d ecictfi0 appropriate box: Type of ro�ect(�equir6d): 1. 1 am a employerwith • /! employees(full and/or part-time).* 7. 40W coxlUluotion 2,Q lam a sole proprietor or partnership and have no employees worldng forme in 8. 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,E]Electrical repairs or additions proprietors Witlrno employees. 12.Q)?1umbing repairs or additions 5.Fj I am a general contractor and I have hiied the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp,insurance t 13. Roof repairs 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 na.emplayees.[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 stib6it this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tConfractors that check this box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have eniployeas. If tho sub-contractors Dave employees,they tntist.provide their workers'comp.policy number. fl in an employer that ispra'vidirzg ivoi(leis'compensation insurancefor•my employees.'Pelow is thepoliey andyob site information. Tnsurance Company Name: 6717 22 % z loam Policy#or Self-ins,Lie.#:_ 4 C 2 °'� $� ® Expiration Date: fob Site Address: 7 ^tom" .. t1rt r 5�w-t�, )City/State/Zip: Attach a copy of the wormers' coxnpepsation 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. I do hereby certify u der°the pains and penalties ofpeijury Haat the information provided above's true and correct Si nature: - Date: Phone#: )40 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.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: RSHEB-1 OP ID:KM ACRS DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/0412016 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(les)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 endomemen s. PRODUCER N E"c` Lawrence R.Michaud,CIC Michaud,Rowe And Ruscak Ins. PHONE g78 688 8829 FAX P.O.Box 188 ac o c Nol:978 557 2130 North Andover,MA 01846 "AIS:lmichaud@mrrinsurance.com Lawrenoe R.Michaud,CIC INSURERS)AFFORDING COVERAGE NAIL INSURER A:Commerce Insurance Company 34754 INSURED R S Hebert Const 8r Remod,Inc. INSURER 8:NOrGuard 102 Adams Avenue INsuRER c:AmGuard N Andover,MA 01845 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. ILTR TYPE OF INSURANCE ADD Us POLICY NUMBER MM DD EFF MMN��°' umns C COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 CLAIMS-MAOE 1:1 OCCUR RSBP811273 05111/2016 05111/2017 pga ��ISEFonce $ 50,00 X Business Owners MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 2,000,00 POLICY❑JECT LOC PRODUCTS-OOMP/OP AGG $ 2,000,00 OTHER $ AUTOMOBILE LIABILITY OMBIINd D Si OLE LIMIT $ 1,000,00 (Ea aoci A ANY AUTO BBCM08 12!1912015 12H912016 BODILYINJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DA GE $ HIRED AUTOS AUTOS Peraccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONOTH- AND EMPLOYOW UABILITY — B ANY PROPRIETORIPARTNER/EXECUTIVE YIN RSWC759421 01/0112016 01101/2017 EL EACH ACCIDENT S 100,00 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.LDISEASE-EAEMPLOYE $ 100,00 ffes,describe under --" DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 5500,00 PROPERTY 5100 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,Trinitarian Congregational ACCORDANCE WITH THE POLICY PROVISIONS. WILL BE DELIVERED IN Church 72 Elm Street AUTHORIZEDREPRESENTATNE North Andover,MA 01545 41988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD z,, ;!✓fin, "�oaar�8at��eac�c�l�� a�;,,;��u�rrc�;�rrb���t Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR RegistratioExpiration: 8 on: 1/9/20171 Private Cor oratio R.8-.LHEBERT CO.&REMODELING INC. RONALD HEBERT 102 ADAMS AVE. NO ANDOVER, MA 01845 Undersecretary Mass ac h �s tf,s Department of Pubkc Safety Board of Budding R egul t-on s and SI arrraards I_A¢.ad.nse: CS-058241 CarrrsCruac[ion RONALD S HEBERT s '� 102 ADAMS AVE N ANDOVER MA 01845 r,sr,,:rinrri ironer 01108/2018