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HomeMy WebLinkAboutBuilding Permit # 6/2/2016 OORT y BUILDING PERMIT _e fid' g�r•_ °oma TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: " 0 Date Received Date Issued: I �9SS�cnuS���� IA4 PORTANT: A22licant must complete all items on this page LOCATION 'B-EAR ,SILL "ROALl ItTORTFT ANDO�l`ER,MA ; 0185 PROPERTY OU'INER LISA BERNARD„ Prinf Pnnf (1lAP It'd 0 `t 0 P4RGEL0062 ZCINING DISTRI,GT `;' Ff�storrc I�� fr�t yes . ,io lu(ackineSho Villa a es n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Sepf�c Well' Ci Floodplain 1Netlands ;= [] ltllatershedDistrtct »WifeSewer rl REPLACE 5 WINDOWS - NO STRUCTURAL CHANGE Identification Please Type or Print Clearly) OWNER: Name: LISA BERNARD Phone: 978-686-6603 Address: 10 BEAR HILL ROAD NORTH ANDOVER, MA 01845 CONTRIAG,TOI Name"77 , PhQrle 508 351 2214 RENEWAL BY ANDERSEN: ,. Address 3>U FORB`ES ROA© NQRTI=IBOROCJGH, MA 0132 %sero sor's tons,U'd ion License Date: Up 90125 10 QG 16 "` rn Improuement License` �° : ,,Exp Date ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED C�T BASED ON$125.00 PER S.F. Total Project Cost: $ 7, 250 . 00 FEE: $ Check No.: (X®1 2, Receipt No.:— 'N45-0 NOTE: Persons cont acting with unregistered contractors do not have access o the uaranty fund Signature of Agent/OWner ''� Signature of contractor r ' th®RTH AndoverTown of :..'.�,, s �1 ver Mass, aSSy O 0 LAKE COC MIC K@WICK A04ATE® � u BOARD OF HEALTH L D Food/Kitchen PEIiMIT T Septic System THIS CERTIFIES THATft BUILDING INSPECTOR .............L. . ......... ................... ... ................... ... . ............... WAL has permission to erect ......... ......... buildings on .. Foundation Rough tobe occupied as ............. ............. .. .. .. .. . ..... ..� .. ....... ................................. 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, 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 l S1' S Rough Service �` .............. ...... .... ..........................:......... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin Rough Displayin a Conspicuous Place on the Premises — Do Not Remove Final No Lathing r Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. EVAN&I Agreem ent Document and Payment Terms 10ITS . 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SII , littvw-Ait by Atu1aveli,of Iiww-:ars ozti,�� urra�ni i, '� Lr l l)r �S�', i �r, t P ill Jill � �zg:r a��itieztpsEnr _! ..r�i ljr, flJ.t,i.r, t.. -,i� •�-v��l lai �f 5,!_,!Q r.'�>' '� w'e i� fN Ill�r,. .- F- i ��� �5�91�i1°;Ilil['l ;'�ii[s�irar� IRrrni,=� , ' 1� ;'n• ' 1� 4'� (� 1'i(ni ,(r`�� rl��,I� i�r � f PI I; t:�l 'a°•��� .- .,,mss. i .'`'.El' WINDOWS:",S PATFO 0001M.,0 SPECIALTY:0 MISC 1 e , r ri rl r.Y k�EY �:sa, :+��`1 u,L� �r nl✓i ,�t�a } �n*.;'Y r'1i"i'f a�n r , a a r91sr�•r .f• , a`1r 11tt,;lnmtulin4°iai i"aliat"Pltati°WI is 0 ll c CCs"f4),%1 NVINI)t7W AND DOOR h£.1WPUII` ; At.;RMCNIENC by .'t1i,7c,y'.c'rl c1 �a"�tlw•r ii,�r4:��'I4�1a�^4ta,�it,<I =tiny li;ilgAth4 MM 13"WY( 1;7iKUI 9i>tCcI y ,o ca111n1i1 stir'l�ti�'�:r`;lac1''=�'1'�"�,Pwc Sc3 arm:r!J aaYcl lm"dicy tltc N,W"Wni .c. hili atact 900W citlirr own W alXON;tlY uMMI Mao A Elan•gnus and conch m"s 4 IW a{ru•ttteaii MH NMWH in aw RMT MA coct, t l.i>srai4ti luau"sst,fs MW WAW W Onus and COasdatacxats M OWit rkownt. t"lic ILI]lc will",Satlthl lons.Atcraaioen,or,dclefions to IIIc`l3rodnc(s and 5.,r•vtccs I}rt�'�'i tsl.,i�!<ac,e ili l7�sir� ❑-ladc_ i -i t i ff 4 j" k� u i s t t i As a rt u1t uF tf►4 c C431,901,t}u fativu,in Wm_of Ole ar «tie►it:uc;alp ch;c►s i►► tit 14►er is ncx:c}►sxra c,:c►rntei�►tiriil bc'9eChb9xnk�r antarkui ris'.1.rA'; itacti��atiat tt►ret rt��3ta►t;�a:irt`+�lirs: e #ia#s1 jcf :rrxrcxzt►t° lv°cx�t #a#ti►i,►ttcc tmutrt►t, a�`wtt"es#innic4l:slni i ttatc; -- Nc>a cte}xxasil rcceivt rt. ✓ 1F5u►►t<c aiupesii, ir+ali�tilul,cc+inF51c#iii`auli: i�ew taali►►rec at=�ire+at"�'� .= ,. ,. - a4tu#ht1 pit y��►at1►> x►t" � "" hqck.Ttg>slt tc ;haCa►te "a#stYEast�ntizil,� `� � �'c +�1►aflr�i�►fat►�c;<tt ;�`� Crtil,ii+.�rit. m#?ls tu►1+f�- ib: Su3istzurti xt; ►r�iltcn` cit jub, JQ t i "frs d,t±nLI►m'dc '160b,"; Renewal Mic; byAndersen. WINDOW- REPLACEMENT anArdetaent ompmy .at.lrr3.ETr#c'a"1; 'ct. WoodNinyl Composite IF Dual Argon Low E4 SmanSun Double Hung 100-00473618-010 ENERGY PERFORMANCE RATINGS 1-1-Factor(U.S)/I-P Solar Heat Gain Coefficient 0 u29 0m19 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance manufacturarstlputates that these ratings con form to appGah%NPAC procedures for datarn)Wng who%product padormanca.NFAC ratin9sara datamtined fora feed-101 aWfOnn'anialcoadillonsand aspecik product sea. NFAC does not recommand any product and doas not warrant the auhahTey of any product for any apacdn usa. Consult manufaoturar's hiaraturo forothor product pedomtanca Information. YAYW.nllc.oy »y n 9} sir 0r pp, "' >� Thin product moots Of.. Vr L�r.•rr searaenvitonlnental ��erp� •�� 3 standards vafnin ener " °r°;, r �y;, • a efr'ai3ncy,heavy matak in '•`the frame and cash .ntatarel packaging,and 'E_t/ 'yarf consumer adutatbnal }- materials. us.rpq J, Qs v d jt y. j rhrM,ru}.rr P .. Orrrlr,w•Mrnr+J.,. DESIGN PRESSURE(PSF) ( "d _ } w aewandaor runuhou�rc are.., RbA DB Sloped Sill DH IN TWO 1019802crM.061 VANA.'CS•1101,S}A4400i htandaohrtr aliputalos o0niontnum w M s CCank sta}wuas. '.. seats or exceeds h1,E.C.,C.E.C,&I.E.C.C.Air Inikh ration requirements W hIA Halmark CartQuaiinn Proarmn. 0 } The Comlownwafth of Massrarhiaaw& _�, �rraetaa t�'lredrsly7at�.1'�cc:d�na'r Offs a of rmudgadow r ,s r TUU �y'ariairrgran sa:eer .8ast©n,AM 0«1X1 Wog`: sl C tlmpelnsnfl n I 68W.VaRCt:1, iti:a`�f€: �Il(♦lt;='9� Ul th�C$tJ" taaCCtr fiat $tis'3�1 tC 9 81riC thusiress/i�r a .:atiuvM i��dad��; RENEWAL BY ANDERSEN Address: 30 FORBES ROAD City/Stttj�_--17.ip'_NORTHBORO,MA 01532 508-351-2200 Are on an employt-r"'Check the appropriate but, 'lope of pr*,rt I:required)* 1 �_t 1 am a atnpleyer with 30�M t. Q I am a�aerxl►�ntractoT and I 6" ®'waw c;onstrwwtion employees(full and,'or past-time:) have hired the iub-comravors 1 am a sole proprietor or patuaer- listed on the attached.cht�t.y Remodelin strip and have ne employ"s `lc a sub-,xwitravtors have S. Demolithm working. for we in any capacityworkers'comp-insurance. o, Building addition [No workets'comp.inslrmnce 5. 0 We are a eorporawn and it- IO.F Flectr cal repairs or additions required officers have caem*iwd their a.LJ I.cru a homes mner doing all work tight of e>4.�toon per�G1, 11 E Pturnbin�+coca s or additions z*self jNo worker'comp. c. 15.1,41011 arid w,e:have no 12.3 Roof repaim insurance requu-J- J'' etrtployees (No workers' 13 0 Other comp,inswance mqutre3.l {aa1 app;�e�tn�the i lw i E+et a roust ata till wi the 4hoe%,n their wvrk,-n" "ICY&;bM&w. t lotne!ajtsro,n%ho a4kwt thu afftuavit Wkwumc Lhr a::doing ail cork wtd then tett+ +runt auhma a wu ai/davil tndwatiatt rich t,'uhed wrs 1.w cne:.t th+-1 lx r-.utast tilwo o an add?tt 4ve.,4twt-,rt-*ma the wma,of tree ntb-:onlmix r,and thsrr esorKw iomp pnhey tnlou"Wn l am an empiover thnt is providing workers'cotnptnsutlore lltsuta+'tc'd ftlr tele employs. helot,h tke policy and juh she infornruitlo� tnaumoe Compaty Name-, OLD REPUBLIC INS. CO. Policy 4,oa$eli-in�. 1.i+�. ; MW 4 7Q0.._ __. _— Expiration 1Jatc 10-01-16 Job SiteAddzess: 10 BEAR HILL ROAD �� - _ �y .;Si ;NORTH ANDOVER,MA01845 Attach a copy of the worleers'compensetion policy deciarntion;rage(shame the poNq number and rtplratlon Failure to secure wveia$e as required undo: Saction 25A tri'11Gi c: 151,can toad to the Lntpco,ttion of crimWil pertain•-i of tine up to$1,1100.00 andior ane°•J ear.tmprisotunent,as well as ch renalhe in the form of a STOP WORK ORDER and a fare of up to$250 00 a day against the vlolator. A4 advised that a copy of dais statement may be forwardad to the Office of Invesagattons of the IMA for insurance cow-rage vztificahon !dd/rare esti 3 ander Wpains and penakies of pert url that the Witr tx dim prsurhkd a&i e A tate and camtit Phone.. Dam- 51-2200 ef3ffirial Tuve anly. too not wtite u1 this ureq,lobe conViesed by clot or town ojAW City or own: PermitrLiet we# Issuing Authority°(circle one): 1.Board of Health 2.Building-Department 3. C t).Town Clerk 4.Electrical Inspector.S.Plumbing i»sperbr 6.Other Contact Person; l'hon"e#S ANDECOR-01 YADAVYO .� Da (MYY) CERTIFICATE OF LIABILITY INSURANCE 101112015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NCAME CT Willis Certificate Center Willis of Minnesota,Inc. PHONN Ext,(877)945-7378 IV N.):(888)467-2378 c/o 26 Century Blvd EMAIL C P.O.Box 30591 ADDREss: ertificates willis.com Nashville,TN 37230.5191 INSURER($)AFFORDING COVERAGE NAIC# INSURER A-Old Republic Insurance Company 24147 INSURED INSURER 0: Renewal by Andersen LLC INSURER C: 30 Forbes Road INSURER D: Northborough,MA 01532 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. TN­SR TYPE OF INSURANCE POLICYNUMBER MMIDOmYY MWDD� LIMrrs LTR INSD WVD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 LD CLAIMS�fADE T OCCUR MWZY 305440 10/0112015 10/01/2018 PREMISES DAMAGE Ee DOc-NIunence $ 500,000 MED EXP Any one person $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,00 PRO- PRODUCTS-COMP/OP AGG $ 4,000,00} NX POLICY aJECT 1-1LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 6,000,000 Ea accident A X ANY AUTO MWTB 305438 10/01/2015 1010112016 BODILY INJURY(Per person) $ LL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NUTOS WED PROPERTYDAMAGE $ HIREDAUTOS AUTOS Pereocldenl $ UMBRELLA UA13 OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS MADE AGGREGATE $ DED RETENTION$ PER $ WORKERS COMPENSATION X I STATUTE ER AND EMPLOYERS'LIABILITY MWC30543700 10/0112015 10/0112015 A ANY PROPRIETORIPARTNERIEXECUTIVE Y® NIA E.L EACH ACCIDENT $ 1,000,000 _ OFFICERIMEMBER EXCLUDED? 1 000,0 (Mandatory In NH) EA-DISEASE•EA EMPLOYE $ , It yes describe under E.L.DISEASE-POLICY LIMIT $ 11000,000 DESdRiPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space[a required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Evidence of Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD M =ja huoette-Depnriment of Public Safety Board of Building Regulalono and Standards Construction Supenisor CIO SAALMIM id ti Expiration 4 Vfirs :mzorzr��P.a.�o�r'�aaaac�use�a � ue of Consumer Affairs&Business Regulation MEkl". t:5 IMPROVEMENT CONTRACTOR Reglstratian::,f7b$ 0 Type: Explratigii '} it7 Supplement Card RENEWAL BY AND�ft E)t -L lq JAIME MORIN 30 FORBES RD NORTHBOROUGH,MA 01532 Undersecretary i