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Building Permit # 11/2/2016
txORTH BUILDINGTEAMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION —7— Y4 Permit No#: Received 12—--�24t) -7 Date Recei k-30 1 t Too -w"( CHU Date Issue, 0 �lT-Applicant must co m-nplete all items on this LOCATION V le!V Print PROPERTY OWNER_ fif Cp A,.rAo&o Print 100 Year Structure yes MAP PARCEL: ZONING DISTRICT:,,--Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential F1 New Building El One family 0 Addition 0 Two or more family 0 Industrial 0 eration No. of units: 11 Commercial epair, replacement 0 Assessory Bldg WOthers: Refr&V4y74-t- D-Derrolition —-------- QOther-- o 0 Septic F]Well 0 Floodplain 0 Wetlands n Watershed District El Water/Sewer ESCRIPTION OF WORK TO BE PERFORMED: r 4* t- 144firt(PA., Identification - :please Trpe or Print Clearly OWNER.- Name.- Phone. Address: A&A,906,J View /q, W,+L keo_ 14 ------------------------------ - ------- Contractor Name: I)AVIA, Vkk-g,"C4::�* Phone: JT– Email: r%4&gaP-,A-,veAj tEA * Address- .mA- 011!t d Supervisor's Construction License: 002.199. —Exp. Date: Home Improvement License.-.---1 Z V 7.7 Exp,. Date: 0 P/.f V/ 2-017 ARCH ITECUENG I NEER Phone: Address: P 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 CosIt. 00 -FEE- $ 7 74-- Receipt No.: Check No.: NOTE: Persons contraeting'A 5tere(1 qIctors do not have access to the guarantyfund -- ,Signab ire-Qf-A 0. nn gentlO. Sratoarontrac= L, AA ......................... . . . ...... ......... t%ORTh '4 own of � _ :�F 6 ndover 0 s� No. 446 - C% iO-qAoh ver, Mass, Z coc MACM�WICK Y �,Q °`��rF o ►`Y�`�,t5 � U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT r....C-04q-;*A0 BUILDING INSPECTOR has permission to erect .......................... buildings on .. .... ......._, Foundation 0/r Rough to be occupied as ...... . �. ....... .. . ....... .(s> c ..........,.......,.................. 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 CONS' ' 10 Rough Service ......; BUIL©ING. Final EC OR GAS INSPECTOR Occupancy Permit.Required to Occupy Buildinty 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. RIDGE PARTNERS LTD, INC. RIDGE PARTNERS LTD, INC. Estimate General Contractors 174 Forest Street 08119/2016 1169 Winchester, MA 01890 (781)721-0670 10/31/2016 ridgepartnersltd@verizon.net http://www.ridgepartnersltd.com IMM RMi Pat Corsaro Meadow View Condominium 12 Walker Road / Unit #10 North Andover, MA 01845 Andover, MA General • Proposed work to be performed: Meadow View 1 0.00 0.00 Description Condominium, 12 Walker Rd., Unit#10, North Andover, MA 01845 Based on site visit conducted on 08/17/15. We are providing pricing for the reptacment of four (4) double-hung windows and shalt include the following scope Et specifications as detailed below. Customer responsible to move any furniture from work area. Discard of all job related debris. Work to be performed during normal business hours. Exclusions: anything un-forseen, not detailed or unspecified within this proposal Continue to the next page Paee 2 of 3 Windows • Vinyl Replacement Windows - (4) total; 1 3,000.00 3,000.00 scope of work includes: materials, labor Et equipment to perform the following: Preliminary Scope of Work: *provide on site field measurements to formulate a window schedule to enable proper placement of window order with manuafacturer, Harvey Building Products; this phase of the job shall also include a deployment to remove at (east one (1) window to enable us to access the "actual" rough opening size of the existing window openings. We will then use these measurements so we can place the actual order with the window manufacturer. We witt attempt to re-install the existing window back or provide a blank panel to close off the opening until the new window order has been placed, received and ready for installation of new windows. There is typically a 2-3 week Lead time from the date of the order with manufacturer in which the new window order will be ready for pickup. Removal Et Installation Scope of Work for replacement of four (4) double-hung windows: *remove Et discard of existing ceramic the on window ndow sills as discussed. *remove four (4) existing double-hung windows, two located in I bedroom, one located in 2nd bedroom, one located in 3rd bedroom and discard of these windows. *install window insulation around perimeter of new vinyl replacement windows. *furnish Et install four (4) new fully welded white colored double-hung vinyl replacement windows by "Harvey Building Products" Classic style. To include double glazed 11/16"thick glass; Low-E glass Et Argon gas filled for all window ashes; Energy Star; double Locks; sash limit devices / night Latches; fiberglass mesh 1/2 screens for each new window. General carpentry allowance which shall include Continue to the next page Paee 3 of 3 this providing Interior window stops as related to um7 installation. providing interior window stops as related to this installation. *seal the interior perimeter of new vinyl replacement windows with interior paintable caulking sealant Et the exterior perimeter of new vinyl replacement windows with exterior caulking sealant. 'Discard of all job related debris. *Note: includes building permit Et fee with the North Andover, MA Building Dept. *Note: We will contact the Meadow View Condominium management company, Essex Managment Group prior to starting this job to make sure we follow their required procedures and protocol to perform work on this property. If it is determined that we are required to perform more duties to comply with their procedures beyond just applying and paying for a building permit, any additional costs we incur shall assessed accordingly. Exclusions: anything unforseen; anything not detailed in the scope of work above or on this proposal; any painting. . On behalf of Ridge Partners Ltd, Inc., thank you for the opportunity Total $3,00000 to bid on this project Accepted By Accepted Date i i Window Replacement Project Location Pat Corsaro Meadow View Condominum 12 Walker Road Unite#10 North Andover, MA 01845 Subcontractor: Soderquist Construction 83 Midland Street Lowell MA 01851 Attn: Derek Soderquist cp: 978-6044246 i NORTH ANDOVER BUILIDING DEPARTMENT Tel: 978-588-9545 DEBRIS DISPOSAL FORM 1n accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A, The debris will be disposed of in: �y tee l m C / (Locati n of Facility) GSI r G er� ✓1rj/�- G 1 P�u Z� C Signature of Permit Applicant Date ne Commonwealth ofMassachusetts r Department of industrlal.Aceldents " I Congress Street,Suite ZOh Boston,MA 02114-2017 .y{� www.rnass.gov1d1a Workers'Compensation Insurance Affidavit:Builders/Contractors/]J1eciaicians/Plumbexs. TO 10;�'II�D WITp[TM PER141UMG AUTHORITY. A Iicant Informationlease Print Le 'bX N�amo (Business/oxganizatiox>/Mdlvidual): ! -e• a ea-.r /,T29, J , ;r-4 C . Address: Y et 0 City/State/Zip: Phone#f: Are you an employer?Cheekt&appropriate box: Type gf[,project-(required): 1.n Tam aeraployerwith employees(fall and/or part-time).* 7. 0 New conshmotion 2,E]I am a sole proprietor or partnership and have no employees Working forme in 8. [!R. AOclhig any capacity.Wo workers'comp.insurance required.] q. Demolition 3.E]I am a homeowner doing all work myself Wo workers'comp.-insurance rcquired.j t 10 E]Building addition 4_Q 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 pro fetors with no employees. I.Z.0 Plumbing repairs or additions S. a general contraotor and I have hired the sub-contractors Listed on the attached sheet. ]. Roof repairs These sub cont[aetars have ojr ployees and workers'comp.insurance.# 14.[ ther k/F`100P 6.Q We aro a cerporattgn and ifs,officers havo exercisedtheirrigbt of exemption perMGL e. e— 1 Cr�r 152,§1(4),and wa haye ng e€npinyees.[leo workers'comp.insurance xegnixed.] - er:. *Any applicant that checks B&A must also fill out tho section below showing their workers'compensation policy information. t$omeowners who sfiblilif this of 5davit indicating they are doing all work and then hire outside contractors xhust s4bmlt a new affidavit indicating such. tContradma 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-cori6ci6rs Piave enaployaes,Jhey mu.;t pravido'their workers'comp,policy number. T am an employer that is providingsvorlcers'compensation insurance for•racy enployees.'velaw is thepolicy ararljab site information. >_ • Tnsuranoe Company Name: Policy#or Self-ins,Lie.#: S'�a� ,�` ` y y�y .�– ^ I Expix�tiort}dateOf/ 2-017 Job Site Address:_ 112- k4A1-e/t–/ti[ �d - -- City/State/Zip: Attach a copy off theworkers'compelxsation policy declaration page(showing the policynumber and expkatiou elate). Failure to secure coverage as required under MGL o. 152,§25A is a oximinal violation punishable by a face 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 flue 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 DIA for insurance coverage verification. X do hereby certify under•the pains and penalties ofper7ury that the inforinadon provided above is true and correct. Signature: Phone#: ( 72,t— Official i t 6 official use only. Do notwrite in this area,to be completed by city or•town official. City or Town: Peranit/Lxcense# Issuing Authority(circle one): x.Board of Iealth 2.Building Deparbn.eut 3.Citylxbwn Clerk 4.Hlectrical Inspector 5.Plumbing Inspector 6.Other Phone Contact Person: #: i i 1 a DATE(MMIDD1YYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE 5/19/2016 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. 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 EllenI7].N•S.Cdla .-. John A Pierce Insurance Agency PHONE _ (781)729-8770 AIC No:(781)729-0053 934 Main St. aDOR€SSS:edinicola@johnpierceinsurance.com INSURERNAIC q Winchester MA 01690-1994 INSURERAA.tain S ecialty Insurance Cc INSURED INSURER B:Safet Inde!Jj k 33618 Ridge Partners Limited Inc INSURER CAce American Insurance Company 174 Forest St INSUREto: INSURER E: _ Winchester MA 01890 INSURER F COVERAGES CERTIFICATE NUMBER-CLI61401173 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 AQDL Swvtl UER TEFF POLICY NUMBER MMIDDIYYYY MMID IYYYYY EXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMSMADE51 OCCUR PREAGE SET a occu D nce S 100,000- CIP269759 10/23/2015 10/23/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 % POLICY Ll JED LOC PRODUCTS-COMPIOP AGO $ 2,000,000 S OTHER: AUTOMOBILE LIABILITY Ea acccideDn151NGLELLMIT S 1,000,000 B ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED 6229085 6/12/2015 6/12/2016 BODILY INJURY(Per acridenl) $ AUTOS NUTOS ON-OWNED PROPERTY DAMAGE S X HIRED AUTOS $ AUTOS Wer accident) PIP-I9aslc $ 8,000 UMBRELLA LIAS OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAWS-MADE AGGREGATE - $-- DED I I RETENTION$ S WORKERS COMPENSATION x I STATUTE OR NIA H AND EMPLOYERS'LIABILITY ANY PROPRIETORIPAR7NERlEXECUTIVE YIN E.L.EACH ACCIDENT $ __59-01000 C FFICERIMEMBER NH)EXCLUDED? � 6S6203-4494P13-7-16 1/4/2016 1/4/2017 E.L.DISEASE-EA EMPLOYEE andatory - S 500 000 1(yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY OMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION (978)688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE North Andover, Town of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St ACCORDANCE WITH THE POLICY PROVISIONS. Bldg 20, Suite 2035 North Andover, MA 01.845 AUTYIORI2EQREPRESENTATIVE Kevin Pierce/En ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 owArm z Office of Consumer Affairs&Business Regulation License or registration valid for individul use only #[OIU[E IMPROVEMENT CONTRACTOR before the expiration date. If found return to: `Etegistratian_ 124731 Type. Office of Consumer Affairs and Business Regulation Expiration. 811412017 Individual 10 Park)plaza-Suite 5170 Boston,NIA 02116 Dana P,Marrocco Dana Marrocco 174 Forest Street Winchester,MA 01890 Undersecretary w Not valid without signature i i Massachusetts Department of Public Safety Board of Building Regulations and Standards License CS-0132199 % �„wOV�?�°�¢"gym �moV4 "..°:�tlRi.r.mi.^,ry&',:DN�. DANA P MARROCCO i Ir 174 FOREST ST WINCHESTER MA 01890 Expiration: Commissioner 08/01/2018