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HomeMy WebLinkAboutBuilding Permit # 11/22/2016 I S �z,'s BUILDING PERMIT C4, TOWN OF NORTH ANDOVER �^� " b oz. APPLICATION FOR PLAN EXAMINATION pcoc.i� x ry` Date Received ww � f 2y �a�r�o Permit No##• �. .. X46 1 �S�ATED t Date Issued:, - � all iterras on t 1sae IM[PC1RTA1"rTT'F: �'�ppizcant must completep � i c / / / ✓ / � ,r /iii / /„ /.. / ,.,,,. ✓ ,� i„ � ,pori � i / / �/.. ,. v... /i of.. / .,�,..// /. l.. c., r ,. ,..... r �,. ,,, /,. r, �✓.�� r/ /, �„ / ,,. /fie„ ✓�/o.,,. .. ,� / / �� .l�i r/ / ��,�/ii�� // /.. ��,,�cir///iii%i,,,.,.�/.. ,//// ..//ii,:. Vii:;. // ,%i .� /a//a / / .�, i, „a ,./r ,,,. ,l/,.../� r,,,i ,///��/..o./i. // „�,,., „., i pile � rr,. /i/,✓ / � TYPE OF IMPROVEMENT PROPOSED USE _ — Residential Non- Residential_________, E New B Iding Li One family ❑Ad ' ion ❑ Two or more family 11 Industrial 0 eration No. of units: ❑ Commercial -- epair, replacement C7 Assessory Bldg ❑ Others: CJElOther DemolitNon 77 l Se tic CI'�lVell U floodplain ❑,Wetlands ,❑ Watershed Dastr�oft,,/; / if i/%//i DESCRIPTION OF WORK TO &E PERFORMED: UJ �Idea�ti�eon lea y�a �in��1'l�' Phone: OWNER: Name: Address. 6J~ T ",Con r ctor Nahae Phone ET71a91 Address �� � T / it M4, ,,,,, a✓i ,/„%fro i/ ,;/�„/!„ /!,,, ur ser Construction License ii �� ///%/ r/a / r �„ r ✓�// i / % /%��f//� �/ii / /i /���/ p/%/r�i�ii ii/�/ Hcarneilmprnurrnt License _.. 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. c„ Total Project Coast: � _ _�+ 0 �.� / FEE: $ 0, C-, "m Check No.: 1 0 F7 7 Receipt No.: °” 1 ,A,,>' NOTE: Persons contracting with unregistered contractors a n,.a, t lt av acre to the guarantyfund�t Signature of Agent/OwnerSignature f contr for FORTH own of 0 : . : h ver, Mass T0 4KE COC MIC 10.2 H!WICM 4°Rareo A�a,cr(5 S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT LV. 'N ,.. .... .. Ix ..,... �. �4. �.. ........ BUILDING INSPECTOR . Foundation has permission to erect.......................... buildings on .......Iz.v V.,....,+ ..�'.N..!Q.......F..�..... Rough to be occupied as .........Y........kref cc s .r........w f/1l . ................... 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 CONSTRUCT N STARTS Rough ...,.. .�....�..�....................... ...,.,..... Service Final BUILDING INSPECTOR g�uildinRough GAS INSPECTOR � Occupancy Permit Required to Occupy .0,,,.,,_------ 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. +,IA Peg:146589 q r Contract if OT Reg#0605216 ! ! Federai 0 f 2c}2625129 PI Reg#26453 Home 1rnpraYernersc50IU80[1$ 70628 Cctocta:e HaarJgrcanars,26 Cedar 9t,WoSum,1%IA,JP)WO-✓12-221 1(F)81.4 -3 -x62rs,xtvlf.rsew7',ro.ram THIS CONTRACT MADE TH day flt v. 29 � between ;Ferro Owners ;FemeYhonnj� (B;s/Ce,lPr+ne Is late) frp) the"C weer"and NEW?RO Operating,LLC,'MEW PRO'- (E-Mail) for proprietary uSe only NEWPRO hereby agrees chat I-Mli for the ccnsidera!ion hereinaf7e;ment aned,furnish all lebor and material necessary`:o irsfall the fdlraxing described work at the Premises located at: The Job address is a rx):ndominium- (Joc Address) OJALiP - tiEtikRd YdIN€30Vl:OPT[CNB LIItJ©0115` SERI $11`. ��`-' Grids:U YES O CONTOUR l•JS€L LJEURG L_j DIAMOND Window color QTf windowcalarl. QTY OBSJTh1Pt(t.too) EITCP 60 Tcl, Int: InL' �.� Screens: (E Ieriorcolor;u#1 iween Sland3rd) &ALF UFULL E Ext; Vent latches; D YES .10 CapptngCol r: Af 4y . OOOR5 ,, K{pIIOQEI .- GtTY-;Ptease{nirar: PVC Smooth Lj Na ar LNo Capping Slid€6g0lass;Dogi: ?) I+AOtIE-S:NAiNE P11E3DEL## i c QTY color In: O A: Drub€e Hung ) Attire: Leis Center Right CwJaarruad2 ataras W IMP as 2 Like 81IdeF Ht11aR: SN Ba BGc V1F} coos rot do cry pa r9 g or 713iti a. 3LUeSl!der wma-or,*; e— Eht(y.,Doo S,l lq;ti}.=s (+a:rrt nro rigarmp(acnniwdor 3LileSlider I+rs,irs,rst Galan ?17k. CUL a:apsaut }.NE4V?Rb�isnal res Caserrw_nt(Hinged RlgM) Fiherglas5 Steel nsibec4,r c,,Njdcmor CGr msma sbey- Casernent(H!ngedLeft) I HbWR; SH Bt3 AGS AB ORB nns rs cziL lirc[udingcanderumor,F u- Tvrin Casement Sidal€fe's:Scyle'`= IGap Gor crdeapre•=_ris irg careafon� StationaryCasernent Color in Oul: (lreraana): "rripieCasement l+u.vr-++as AS i Triple CasRMRFt Color In OWL aawrce Fald, - nr al c.mplerior Picture Window HDWR. SN 95 AGB AB S7shOnly Left H€r a Right Hinge FINANCE Hopper niry0oor;Sty) ahnr.WAIDKt:cafeenManed atio:lac�rrs Avining Color In: QUI: GardenW€ndow F:be lass $l68€ TOTAL Bay4Vhldaw(RaouSarst) HDVYR 514 BS AGa AP ORB YCASLJ I-P t vvv 9o;v'N€ntiawlaacrlsol:itJ Otherl7oot:$tyle:-,'=`+� E,, Olfter Color rn: we DEPOS)'L� y� Other HDWK: }hJE(J DESCRIBE WORK x PROMOTIONS APPLIED: s TDT a C� �r : -V ` 7 sy(S,TAL3z' Est.Start Oa1e Est Camp.f3afe: Custcmef fundefretandsbis!s an°estimated dale" Owner has read and agrees to the terms and conditions on the front and the reverse of this Agreement. Owner specifically agrees to the(1)Total Cash Price;(2)work being performed;and(3)irrork not being performed. Owner understands that this Agreement and any attachments contain all of the promises made by NEVtlPRO. Owner has been orally advised of his right to cancel this transaction at any time prior to midnight of the third business day after the date of this transaction and owner was provided with two(2)copies of a cancellation form explaining this right. DO NOT SIGN THIS CONTRACT IV THERE ARE ANY BLANK SPACES. (Rhode Island Sales Only): Notice to buyer: (1)Do not sign this Agreement If any of the spaces fntended for the agreed terms to the extent of then available information are left blank= (2)You are entitled to a copy of this Agreement at the lime you sign it. (3)You may at any time payoff the full unpaid balance due under this Agreement, and in so doing you maybe entitled to recg€ve a partial rebate of the finance and insurance charges, (4)The seller has no right to uniawfully enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement- (S)You may cancel this Agreement if it has not been signed at the main office or branch office of the seller,provided you notify the seller at his ur her main office or branch office shown in the Agreement by registered or certified mail,which shall be posted not later than midnight of the third calendar day after the day on which the buyer signs the Agreement,excluding Sunday and any holiday on which regular mail deliveries are nut made. See the accompany€ng notice of cancellation form for an explanation of buyer's rights. (Rhode Island Sales Only): Owner acknowledges receipt of required Contractor's Registration and Licensing Board consumer education materials. (Owner's Initials) BY,! EIP:;) 5igred: Pry t 5pna€a[€st{Frrnted dame) Y - 8WPR pant€ ,LL f8rgnaium)� Ownar 1 I - Ci Weinman NE PRO MANUFACTURING ivn>�c SERIES 0 ME&RO 2000 — DaUBi E•NUIdQ Cellular PVC frame,Triple glazed, NeuonnlFanetlretlnn Lown E orating(e=0.427,52 gatl�fyunoila Kryptonlair flIlied,Dividers 09V-K,27-00321,00001 9NERGY PERFORMANCE RATINGS U-Factor(U,S,A-P) Solar Meat Gain Goefficlent ADDITIONAL PERFORMANCE RATINGS Visible Transm[Rance Ail Leakage(U.S,lI-P) 0w35 011 Condensation Resistance 70i lAenuflscdnat ufda��I�e�erel4rd olnrmioep�[ eHFRCP�ure94ordafernstn�Ulsrhole . rodunty�orris�ca RPl(Oretlng�ote�e�emitnedtotusa olarn�tanmanloice0tllifon� da �p�fnop�gdunix Gdaa�rpttawmmandMy uci daetnatw�anit0e�uibhl aten3t WCG44tf0IP�lY�eai�uAG.>�7SlOARfAAnufuCU11N'i�r(�nfoT4dllOrFlod�'olPetlor�cehdarrtutlGol, - l — i I' The Cammonweallit of lgassachusetts Department of IndusirialAccidenty l Of ce of Investigatiarts 6 1 Congress Street, Suite 100 7 Easton, M4 02114-2017 �s1 www.mnss.gov/dia davit: Builders/ContractorslEleP�ase pri>att�Le eb� Workers' Camp emadon Iusarance�f'i v AppticaixIormatiioa 'Bina (Pcsiuess(CrgxnizatioolIucii`»dual): Address: !b t✓E,PA P- City State/Zi �D�,lRN O F D 1 Phone#: CY / Are you an employer`' Check the appropriate box: 'Type of project(required): 4. ❑ I am a general contractoTa=nd l 6 ❑Newconstrnctian 1.91 am a employer with �0 * have hired the sub-contr employees (full.and/or part-tine). listed on the attached sheet 7. ❑Remodeling 2.❑ 1 am a sole proprietor or partner- ship and have no employees These sub-contractors have g, L]Demolition employees and have workers' worming for me in any capacity. 9. ❑Building addition insurance. [\To workers' comp.in=ancomp. e I0.❑Electrical repairs or additions regttixed] 5. ❑ We are a corporation and its 3.❑ I am a,home owner doing all work o2l=s have exercised their II.Xother s repairs or additions right of exemption per MGL 12. pairs myself. R(o workers' camp. c. 152, §I(4),and we have no f insurance,required] i 13. s � employees. �o workers' ;. comp. insurance required] r A d m,, S i "tiny applicant that ihccks box 41 must also fill out the seci'son below showing theirworkers'compensation policy information. i (3vmeowners who submit this affidavit indicating they are doing all work acrd thea hire outside conu=tcrs must subutit a new allidavit indicating snit tcontractors that chock this box must amcbed an additional sbeet showing the name of he sub cot><ractors Sud state whether of not those entities have employees. If the;ub•cor&actors have employers,they must provide their workers'comp.policy number. i Tans an employer dint is-Providing workers'compensation insurance far my employees. Below is the policy and job site Information. lnsnr�ce Company Name: I : jP yr Gt,r1 . Expiration fob Policy#or Self-ins.Lic.#: tr i"��'-d 035"06 - ©� _ Exp Date: AlSite Address: r�Ll� s ..S o 0i r City/Statelzip: /u `/�� I �J wQ all- Attach a copy of the workers' compensatio policy declaration page(showing the policy number and expiration sof a Failure to secure coverage as required trader Section 25A of MOL e. 152 can lead to the imposition of criminal p fine up to$1,500,00 and/or one-year unprisou ent, 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. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DFA for insurance coverage verification. I do hereby cer*under the pains and penalties of perjury that the information provided above is true and correct 7— /6 Dat e: l Si azure: ` Phone#: i r ffictal use only. Do not write in this area, to he completed by city or town official. Permit(License #ity or Town:suing Authority(circle one): 1, Board of Heatth 2. Building Department 3. CitylTowu Clerk 4. Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phare#: ';y i i ''k DATE(MM)1)DIYYYY) ACCW" CERTIFICATE OF LIABILITY INSURANCE 9/9/2016 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. It SUBROGATION 1S 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 CONT CT Melissa Pflug g M3C3C].ntl.re Insurance Agency Inc PHONE (5Q8)366-6161 FAX No,(SOB)366-5202 11 West Main Street E-MAIL ADDRESS:mel iss ap@ mackinti re.com INSURERS AFFORDING COVERAGE NAIC 0 Westborough MA 01581-1931 INSURER A Netherlands 24171 INSURED INSURERB:Libert Mutual/Peerless 24198 NeWpro Operating LLC INSURER c Acadia insurance Co. 26 Cedar St. INSURER D: INSURER E: Woburn MA 01801 INSURER F: COVERAGES CERTIFICATE NUMBERMaster 15-16 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. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE 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. INSRPOLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE O POLICY NUMBER MMI0 YYW mmfoolYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TOR NTED S 100,000 A (;IAIMS-MADE [50 OCCUR PREMISES Ea occurrence CBROSS9577 12/31/2015 12/31/2016 MED EXP(Any one person) 5 5,000 PERSONAL BAQVINJURY 5 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 X POLICY PRO LOG PRODUCTS-COMPIOP AGG S 2,000,000 JECT S OTHER'. AUTOMOBILE LIABILITY EOa accident)cDSINGLE LIMIT S 1,0G0,000 BODILY INJURY(Par person) S A ANY AUTO ALL OWNED X SCHEDULED BA 8584174 12/31/2015 12/31/2016 BODILY INJURY(Par accident} S AUTOS AUTOWNED PROPERTY DAMAGE X HIRED AUTOS x AUTOS Per accident Uninsured motorist Blsplit rmd S 250,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5 00,000 E1 EXCESS LIAR CLAIMS-MADE AGGREGATE S 5,00-0- 000 DEDX RETENTION5 10,000 CU 8582578 12/31/2015 12/31/2016 $ WORKERS COMPENSATION X PER OTW- STATUTE £R AND EMPLOYERS`LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT 5 500 000 OFFICER)MEMBER EXCLUDED? N f A C (Mandatory In NH) 410-20-20-003506-02 5/1/2016 5/1/2017 E,L,DISEASE-EA EMPLOYEE S 500,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached df more space Is required) Excluded Officer: Nicholas Cogliani CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood Si~ ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01835 AUTHORIZED REPRESENTATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. I i ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD f , ii! i Office"zc Consumer Affair 0 Pgrk'-Plaza - Suite.517 Bostom-Mp; �husetts C2i 16 Home im.provonaltAontractorRegistration ,. -- --- Ra�latrallon: 1486Ei9 Type: Supplement Card IPA Expftatfori: 5/5/2017 NEVVPRO OPERATING, LLC. THOMAS FOXON 26 CEDAR ST. WOBURN, MA 01$01 h, sa�4 UValateA,ddre5s aad retarn card Marc reason for change. SCAT 15 eamW/fr [4 Addrsss ReaMd Employment Q Last Card de4�7vIt34fC[lfBaLf�A oJatrta8 flee afConsamer,imirs&$usiaess Regulation License or regiatratian valid for individaf use only VEKPfMt NE IMPROVE ELiT CONTRACTOR before the expiration date, If Found return to: Office of Cansamer Affairs aM Business Regulation - eg[slratfo _- Tyw- IaPark ijaxa-sui#e$170 , Supplemertl CaN Boston,NA 62116 NEINPROOPEf THOMAS FOXC3N 26 CEDAR ST V/08UM,MA 41801 Underaeeretary+ f Not valid withovtslgnature l Fw :`class-ch"usetts Department of Public 3,-t{ 1301td of Building Regulations and Sla<ndards Liconsa: CS-029090 THOMAS PAUL TOXON 230 WALNUT ST r` READING MA 04867 rornmi.�,:onQr 11119/2017 A