HomeMy WebLinkAboutBuilding Permit # 12/13/2016 �AORTH
BUILDING PERMIT 0F4��Eo
TOWN OF NORTH ANDOVER
O yw '' v.-... "a OR
APPLICATION FOR PLAN EXAMINATION �:.
Permit No#: ���" Date Received �1
Za� •WCHt1`+E���
Date Issued:
IMPORTANT: Applicant must complete all items on this page
/
iririr„ /. r „/ire,///,,,,r/�: /i„�/ /,/ ,r r „,. i c, r „/ ,,I,/� / ,�✓,/�%r/ ///,/,�„v.,.. //,r r../r r .r/f///�r,rri;r//.✓i ,..
/.., /// /�.. r,; // //G%ii, r� �.^+ ,. r r�/�,, // air/.„ ,,,✓ - �i//,�i�,�r// �/�//� ���;riii:
///// /r////% %//!//r r%/ /..,��� /�;✓�i/// r,r/! ii / r rte/ i
:./ilii r, / .r// /
r
1,,,,,%, / i,�//l//„'r,,:/i/,,,r/�/r,iif-/, ,//,r/// ri„r ri..,,� /G!// %:: ,r„r ,/,,,,✓//ire ��_,_ r,.i/��%lc �,r,rh/�r��/„ r,,,, �/�'
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ne family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑1;Se tic;% „�'V'c1�eNN ;, `❑1 Flaodplain ;C VWetlands °/r�i 1NatershedrGstrict
DESCRIPTION OF WORK TO BE PERFORMED:
; ✓ . ' .
Identification- Please Ty e or Print Clearly
OWNER: dame: .. ' r ” . Phone:
a
Address: � �, .. ,�� p .
'Contracar Nanne r ��� rOle
:Phone
r ,,,,p. °, ,r, ,�J +,',;
Address , / rrr r ' ri
acSu0.11License
r.
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.
Total Project Cost: $ a ”
w M FEE: $
Check No.: V3 :26Receipt No.:_C
NOTE: Persons cant acting with Inregistered contractors do not have access to thq guaranty fund
: igniature`of Agent/Owner �� ' signature af�contractor; ”„ ,
................... ...I............ ............ .......... ...............................11.11,111.11111-,,,�,,,�,111,111,11.1-.,-,..',.I.,.--..-............
'T
NORTH
owe. o Andover .
0
No. & e JA ji
$(*6Ah ver,, Mass, Ise J41
LAKI
"IC:MEWICK
BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT .....i."4#4...j(.*oz.*.r**tjC... .....Awite*w. ..es BUILDING INSPECTOR
4 Foundation
has permission to erect.......................... buildings on 12...... aV� Im0000... .............................
Rough
to be 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 CONSTRUCT AN TAA Rough
Service
............................................. Final
BUILDING INSPECTOR GAS INSPECTOR
Occupancy Permit Required to Occupy Buildin 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.
I UNIONS; 1,11,;
LL UN12 R
301E a;
n I 7�7..C�
PChimnews Residential & Commercial Roofing All Types Of
Siding CHIMNEYS POINTED-REBUILT-CAPPED Expert Masonry Work
Licensed & Insured
ocally Own License#034200
Mass Toll Free '----�d&Oi;erateel�inva J 9 76
1-800-WAIT-4-US IKO (?,,zer 'Nozm cw qcha iwl We Work Year Round
(924-8481)
Proposal To: Kate Bargnesi Date 10/14/2016
Street: 17 Quail Run Rd. 617-877-7312
N. Andover, MA 01845
Replacement Window proposal Kate.bargnesi@gmail.com
1. Carefully remove and dispose of existing storm
windows. Total window cost: $ 11,9600.00
2. Carefully remove existing sashes and interior
tracks.
3. Prep and insulate all rough openings. Payment schedule:
4. Install (21) new white vinyl Paradigm premium Balance due upon completion
double hung Tapestry replacement windows. Low
E/Argon gas insulated Energy Star rated glass
package. 8 over 0 GBG's (grids between glass). Thank you!
Top sash only. Glass package will meet Mass
Save requirements.
5. Windows will be tilt-wash, have double locks and
full screens.
6. All windows will be sealed with paintable silicone
to code.
7. Removal of all work related debris.
8. No painting or staining included.
9. Limited Lifetime warranty direct from MFG.
(Paradigm)
10. Contractor workmanship warranty: 5 years
Acceptance of Proposal—The above prices, specifications and conditions are satisfactory and are herby
accepted. You are authorized to do the work as specific J. Payment wi I b ,ml)las ou 'ined above.n above.
Date of Acceptance:—L, Signatures
1%8 Cor monwea fth Of 71 wrsc c e
DIPP tment of b2dustrioilAceldeaft
1 C`ongf e-ss steeet,Suite 100
fA 02114-2 017 f
(:O pepsafilmfmstUaneeA-mda^vat:Bu rs/Caatrac ass/Lrxecfiezc st�'x n
TORE'T.{`MK.DWI''J.'.BIMPFCtW'1T1N •AT)`t'.E(OIt TY Please2xint
A
lira a Infara�ior�
per_._ tzr.�aI}iLatlaxcl)'nclta'zdua`l):
Name (13nsita ess/C7xg
dreg _
—Axe you an empioyex? ubeejtlfT e ap�ixepriafc box,
�'ype ax"pxo�ect{��er�:l:dj:
o <q 1irlland/orparEtiiivte).� 7.• 0Now t,azis[I'uc�aA
1.1Z am a employer Affi -__em tp Yee ..
Iamasole proprzetoroxpart'crshipand havenoeznplaycess�
- oslring ormeirr $. �Z �zrloCla lj;
any capacity j7o ws�rkors'comp.insurance regtzxed L Taerxio:Litior
L !Iarn al�omeowne xd ingall woxkzayse3h 1No wcazlccrs'comp_,insrrnaueprr�cpzb eci] 10 Fj Bullding acfri{(O
g YProperty-
-ElIamabosneownexaradwillbeliirin conixactorstooandnctaLl uvorkonm 7vva11 7 '� pec ca�xep�itSa :v 1[1 t7a 5
ensure that all.color m &ors either have-wo*-,rs'campensalion insurauec ox are sole Y
prdprietxua wit}iraeein loye?s. 12.:[].Plu biragxcpairsoxaddstiorlis
5.�I am agenexal contactor and?hayehireathe sub-contuactorslistea onthe attached sheat.
13: ]Roaf'iepaus
These sub-corrtracfor,l d;c aiployees auahave workers'camp.insurance ✓1
6.�We are a coxporat+nn y�na its peers have e cercised the right of'exempuonpex
152,§1(9),aadWPhraTncte ploye;s.J1Toworkers'comp.insazrannaxequired�
` yappLtcanttbrtchecT�sbrixlmustalsozlLouttheseconl�elovtshowJnthcSrwoz[cars'eompepsationpoTicyurioranationh
s davitindTca�ngtheyare doingall workanathenErc outsiaecoufractarsmustsibmitanc 'a `�iu P`
Iloxacavmers ratio sulfa ai y
?C;onfxactornthatchecktL-casF�as:pn�sc'atEacbeaanadditional Sheet slsowiztgthename oftheszxb contraotorsandstatev�bethezox}�otihoseenti�es �.vc ��
ala sorshave e m to ees;.�l?cymn- cvidethcir wort re romp.policyn=bor.
employees.'It:thc sub-co p Y
_ _ ___ ees.' eln zstAepoLicy cir�rl jai s ee
X ai r arc erti loYer t1z a�zs pi pvicii zg�t�o Ttea s'earn ansaticrrc insa�ancefo, 17Y LrazpZr}y
zrz,f a1TV0011.
TnSfL7xance Compamy Noma:_._
(,Dd.> r
.policy#ar S olf ins,
city/stato/zip:_
Tab Site A_ddxoss: - �_: _
At ttach.a copy€�f.-lh v o kexs' campoWa-txam�joRay dedax^atiaxxpag�;(s�o��g LJre�a7xcym�nabex axa�e�p�'afzam c��ta),
nd
Fazluxe to seeuxe COVerqgo as x egi3ixed an Civil enaltaPs t tho form o:f�`.I'OT'xWORK OPI.)�and-a fine ip to$256.0ll`t"
aad/o1 ane,.yetm. hnprx3 c)Icaaertt,as 1 p
day againsttbc�olat:Or.�,col?Y offs statomemtrnaybc farward.edtothe Of-e oo afTnvestigatloms Of oT IAT-bxit, amce
_
'age ° eaer
er refxcoyexifiatthirjbTW7ad0nPavid('daXoveus
" rarzexe yGeri/y saxpetazesq ct
VIA, bate -c
xca-
Q
Offidat%ase Onry. -DO not'W"'te in tries area,to be co,W?letecr by city 01't0N�n"ff'czal
city or Tots a., —
fss`usmg A atla.oxity (d]:de axze): '
:l,Board Of ffealtb.2..Roilciiaag T)epartmaeut 3.(,zfy/-own Oak 4.p;Xectr�cal Tmspeciox 5.p[ixzrabxmgTnsZ�ecto t
6.
111 axe
�.. _
i
AC(:?Rt> CERTIFICATE 4F LIABILITY INSURANCE °A1118 "�""'
1lroa120rznle
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 endorsement(s).
PRooticsA 02051-041 fiHRpAI_t.�_oT
Branch 20b1-i
Perry Insurance Agency LLC AIS o.Fxtl: 1978)685-7690 AlC.No., (918)681-0149
622 Chickering RdSss:
North Andover,MA 01845
A.I.M.INSURER(Si AFFORDING COVERAGE
Mutual Insurance Company
INSURED INSURE S:
All Under One Root
INSURER 0
C/O John Lanmafamo INSURER 0
30 Temple Drive
Methuen, MA 01844-0000 LN
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.
IDT TYPEOPINSURANCE V&IWOPOLICY NUMBER MMf00lY dolt YY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAI_LU4ILITYOAMAO (Ea oto irartc,
OR S
CLAIMS-MADE OCCUR MEO EXP(Any one person) S
PERSONAL d ADV INJURY S
GENERAL AGGREGATE S
EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO S
UCY 0- OC
AUTOMOBILE LIABILITY OMnN DSING iT S
(Ea Arrideat
ANYAUTO BODILY INJURY(Pao person) S
Al TOMEO AUCTOB LED BODILY INJURY(Par scaidontl S
HIRED AUTOS NON.OVYNED PRO ERTY DAMAG S
AUTOS
S
UMBRELLA LIAR OCCUR EACH OCCURRENCE S
_.
EXCESS LIAB CLAIMS MADE AGGREGATE ;
DEO RETENTION$ S
q(JDEA1pLLyYL�RSPP IABIL4TY Y! x TVAV�LIfYAI 9TIN
�i��(E ErO�Ip FOZfEClJ1IVE NIA AWC400.7008464-2016A 111912016 111912017 E L EACH ACCIDENT s1,000,00.0.00
A
I(Manda€ory In NH1 L
o��sCRIM&b1bPERATIONSWk. E.L.DISEASE-POLICY LIMIT S
DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required)
PROOF OF COVERAGE
The workers compensation policy does not provide coverage for John Lanzafame
CERTIFICATE HOLDER CANCELLATION
All Under One Roof
30 Temple Dr SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Methuen,MA 01844 THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01888-2010 ACORD CORPORATION.All rights reserved,
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
F
l
I
Msssachusotts-Departmeolt of pualla bits.
Board of Building Rogulatloslu ante SYarax-.:jr I
' Cettlitt'tlt:tiun Suprl-YINor
License:C848$120Iffla
0
JOHN W LANZE"
30TEMPLEDR .0- y
Oontmts:la:�v� 0410313017paw-
,
mbiz
Office of Consumer Affairs and Business Regulation
10 Park Plaza- Suite 5170
Boston,MassachYsOtts 02116
Rome Improvement
CoTractor Registration
Regle lWon: 137057
�•_ ;' TVPe: DBA
ALL UNDER ONE ROOF s ! - #_i ¢�::x•... Expiration: 10/212ols T0 291333
JON LANZAFAME . . =r" "" 4�t ` `•`y
166
6A N R{MACK ST '- " '•*� j
MA 01844
. _'` - update Address and return card.Mark reason for change.'
sone 4 sone•or�et �� []Address
❑ Renewal ❑ Employment ❑ Lost Card
r"� Nl+1i111lAllrCrl rtlf�r//r'l[frJJC7C�rrIJllY3
Otilee orCol>iueterAftrs BusiSess Regulation Reglstratlon valid for Individual use onl befo
1 HOME IMPROVEMENT CONTRACTOR expiration date- If found return to: Y re the
�gI°tratieq. 137087 Type. Office of Consumer Affairs and Busiaess Regulation
Expiration: 101272018 DBA 10 Park Plaza•Suite$170
ALL UNDER ONE ROOF Boston,MA 02116
JOHN i.AN7AFAME '
186 A MERRIMACK ST
METHEUN,MA 01&% ....
dersecretary Not valid without signatu e