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HomeMy WebLinkAboutBuilding Permit # 12/2/2016 of ORTI-1, BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PL..,AN EXAMINATION Date ReGeived ___,__ rev Permit No#: AC 5 Date Issued: ued .......­­­---------- 4VORTANT: Applicantrnust coinplete all items on LOCATION 11n K e.r, P, ,J Prir�, PROPERTY OWNER– 41 Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes y n)o Machine Shop Village yess 0 no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑FNew Building El One family F1 Addition LJ Two or more family 0 Industrial o Alteration No. of units: ❑ Commercial Aep2ir, replacement n Assessory Bldg 0 Others: [I Demolition 0 Other Wetla USeptib E1W&II ❑ 000dPlain Q nds ',,,0,,,Watbrshbd District DESCRIPTION OF WORK TO BE PERFORMED: ldenfificationP[ se Type or Print Clearly OWNER: Name: Phone: 73 - Is;,I Address- Contractor Name: P COkzr4=. PL C,e_ Oil Vile,11�hone: "k Email: Address: CQ, ,Ov I-kMr L42) 7 �i_ Supervisor's Construction License: 9 _,__Exp. Date: 4 Home Improvement License: Exp. Date.— ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDINGPERMIT. $12.00 PER$1000,00 OF THE TOTAL ESTIMATED COST BASED ON$125.00PER S.F. FEE: $ LC Total Project Cost: $ (r, Check No.: Receipt No.: NOTE: PersqiContra , If,, i,tg , -wti,eoivtere(,Icoiitractois clo not have access to the guarantyfund is 4, .............................. ... ........ ....... ........ � �ypRTly , 'T own of And 0 0 h ver, Mass QA 0 LAIi � 60C MH N[WICM y1' U BOARD OF HEALTH Food/Kitchen PER A I D Septic System THIS CERTIFIES THAT BU&DING INSPECTOR ......... .1�4! ......... .... .J .. .............. has permission to erect buildings on Ix. . o e,. .. ,,, .�^, Foundation � Rough to be occupied as .... . .,.... �.0 ,.61t,4 .. � Chimne.... ... . . . .... y provided that the person acceptiVng t is 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 CONSTRUY'. TART Rough ....... .......... ..... ........................ Service Final BUILDING INSPECTOR GAS INSPECTOR Dccu anc Permit die uired to OccupLBuilding Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final YY No Lathing or Dry all To Be Done ' FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No, Smoke Dei. p "4 i A AT-HOME Job if 67"684 To whom it may concern, Re: address: 11 Walker Rd#6 North Andover Ma 01845 Concerning the above location, We give the Home Depot approval to install Number of windows—4 Style ( Double Hung/Casement, name type) DH___..m,_._ Color White Manufacturer Andersen American Craftsman Exterior finish as agreed to be PVC(wrap trim)? Yes color White We agree to the grid or lack of grid configuration ______Y 8/8 Are grids between the panes of glass? Y As staged these proposed windows do meet with the Condo Management approval and will match exactly to what's there now. i Signed Lq- Date: R I x Home Depot Contractor License Numbers: MA Home Improvement Contractor Reg. # 126893 Salesperson Name and Registration Number: Leonard Racite : R-1-073-14-00023 Home Improvement Agreement THD AT- HOME SERVICES, INC ("Home Depot") or Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. Customer Information: Mark Stewart Boston North 9676842 First Name Last Name Branch Name Lead# ........... —— 11 Wa..Ike I r­R"d #..6--------- ------I [�_�RTH ANDOVER MA.... .......1 �01845 Customer Address city State Zip ......... (978) 973-1361 Home Phone# Work Phone# Cell Phone# ........... ------------ �markste rt2l53@yahoo.com ----------- Customer E-mail Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address City State Zip or Email Cu stomerCancellation North East@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A different CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR PROFESSIONAL, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE CONTRACTOR GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL, PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN, ORAL AND WRIlTI,z"N NOTICE-0;1= YOI,JR RIGHT TO CANCEL. Acknowla d n�j i5y" ft 11/0912016 X Customer's SiOj,/ture 7", Date Distribution: White - Home Depot Yellow-Customer Copy Contract Price gknd-Paynjent-Schedule: Payment of the Contract Price is due upon completion unless a different payment schedule is specified in the State Supplement. 5631.00 Includes all applicable discounts, rebates, and , taxes. Contract Price $ Excludes finance charges.* Minimum %deposit$ Due Immediately Remaining balance $ Due upon completion Finance Charges *Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which The Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payment(s) made payable to The Home Depot. Insurance proceeds will will not / be used to pay some or all of the total amount of sale. Descriotion of Work to be Performed: Installation of Windows A more detailed description of the work to be performed is included in the section entitled Scope of Work which appears on page 3 of this Agreement. Anticipated Delivery Date / Installation Schedule Approximate Start Date: 01/04/2017 Approximate Finish Date: 02/01/2017 All dates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. Electronic Records Authorization: You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and written communications related to this agreement. By contacting your Service Provider, you may update your email address,withdraw your consent, or obtain a paper copy of the Agreement or related documents at go charge. By providing your consent and verifying your email address above, you confirm that you havlo access to a computer that can receive and open emails and PDF documents. By, ihiti�afing this paragraph, I consent to receive only electronic records related to this transaction. ,AccQpAa�jice and Authorization: By signing below, you authorize Home Depot to (a) arrange for Service Provider to perform Installation and/or(b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's/permitting information may need to be provided to You later.) By signing, you acknowledge,that you have read, understand, and accept this Agreement in its entirety, including th'e ener l Terms and Conditions and State Supplement, if any. You further acknowledge receiving a cp m Ibtof this Agreement. Keep it to protect your legal rights. P �j co,p Fil/09/2016 Customer's Signature Date X..............­--------------- ---------------- ............------------------------- ------............................. Co-Signer(if applicable) Date X 11/09/2016------ Sales Consultant's Signature Date 2 Distribution: White - Home Depot Yellow-Customer Copy License number(s) held by or on behalf of the Home Depot: MA Home Improvement Contractor Reg. # 126893 License numbers are subject to change in accordance with local or state government processes. For the most current listing of license numbers held by or on behalf of the Home Depot, please visit ww ,hmed9j) 0. licensellUrnbers. Scope of Work Job M (Internal Reference) Products: Spec Sheet(s)M Project Amount ❑-'Roofing L] Siding , Windows Insulation 9676842 ❑ Gutters/Covers [] Entry Doors 9676842 $5631.00 —Siding-'-L"--]------:---dows insulation L] Roofing - Win L] Gutters/Covers F] Entry Doors E]0 $ [TRoofing Siding [] Windows [] Insulation $ E] Gutters/Covers E] Entry Doors [I[--- ❑ ring L] Siding Windows [] Insulation Gutters/Covers ❑ Entry Doors ❑ $ ------------- SubTotal $5631.00 .......------- Sales Tax $0.00 Total Contract Amount $5631,00 Warranty-.. The warranty on the work identified above is listed in the General Terms and Conditions, or if applicable, specified in the following documents: VantagePointe 6500-6100-6060 Warranty , VantagePointe 6500-6100-6060 Warranty Warranty , VantagePointe 6500-6100-6060 Warranty , VantagePointe Name(s): 6500-6100-6060 Warranty ——--—------------ 3 Distribution: White- Home Depot Yellow-Customer Copy AT-HOME S&I E."I"RI VICE 5 Job#_9676842_ To whom it may concern, Re: address: 11 Walker Rd#6 North Andover Ma 01845 Concerning the above location, We give the Home Depot approval to install Number of windows 4 Style ( Double Hung/Casement, name typed DH Color White Manufacturer Andersen American Craftsman Exterior finish as agreed to be PVC(wrap trim)? Yes color White We agree to the grid or lack of grid configuration Y 8/8 Are grids between the panes of glass?-Y As stated these proposed windows do meet with the Condo Management approval and will match exactly to what's there now. Name: tL�5zPyL Title: . .✓7.---w f Date: // /LI- oil 1ffiiido,,vs 7a a a ti-7-75 DH I CPD.sBp-A-44-21042-0=2 ENERGY PERFORMANCE RATINGS EVALUACION BE RENOtNI[ENTO ENERGETIC0 SolarHeat UR Coeff�'P-Rt 2, 0,29 1 .55 0.24 ADDITIONAL PERFORMANCE RATINGS EVALUACM SUPLEMENTARIA BE RENDIMIENTO ---------- 0.45 v r I;9F9 .)! 1�r YY -nir Wr Unit qualiflas for EiN ERGY STARG regi=(5):1\10rt.em. morth Central:South Central, Southern, STC:29 1�iD: Rain 000ass pro3olar/H-1-025 DP:+25/-25 Testad Rize:48"x 90" Por"da Product Appovai: Appicable Tast Standard(s): ANSIANAA]VAIINDA 1101A.S.2-97,AANAAANDMAIC-SA JOIJ13,21A440-105,AAtvjAjVVDMA;CSA 101A.S.2JA440-08, A440SI-09 Cana 4!an SUPPI 64GOOMA Hs Howard ----------- pl! Coil, Office suite P) Co it, 4-20 7 Oro v1dia www,MaS" Comp(!rj,,a tj4)a fj,3[Iraav, Buldars,1,C 0 atrac to rs/Ele ctTicians/T uers Wo rice rs please Matlmb Len- blv -A pplicant IgLbrma�io /00 ,,inesgioT�uiizatio[)i-�ndi,iidual'j' -C\ - Nv-—OL ame, (BU, 0 5— > Phone cif,J/State/z Type of project(required): A-re you an employer'! Check the a' ropriate box: 4. a general contractor and I onstmotion 6. New G iatV -d 1� Ci'J"t�t e n employer? Check the a 4 0 em 11 a 0, you I r rs the listed on These sub-contractors I.LI IMri.a employer with lixfe hired the sub-contractO employees (full and/or part-ditto),* 7. C]Remodeling listed on the attached sheet, tor P 2,10 1 am a 9010 proprietor Or partner- These gub-contractors haMe 9, Demolition ship and have no employees employees and hav,,workzr3' 9. 0Building addition Workin, for me in any capacity. 0 COMP,insurance.G to,F-�Electrical.repairs or additions .To workers, camp. insurance We are a corporation and!t3 repair-,or additions r�,�d-] oviner doing an woec officers have exercised their I LQ Ptumbina= 3.0 1 MI I hO me right of ax-,mptjon per NIGL 12-El oof t--pMT3 alyS_-L% [`jOWOrkdrs' COMP- e. 152, `a 1(4),and we have no Other required.] PmPLoyee3. DW -M o oric ' U, A � comp.insur:3nce required.] ;ornspensat�un ioLcy informalOn t�Jo must also Ell out the section�c(ow 5bowing didir worl(dr3' ew:lLbda,�it indicar:nl.MIL Contractors that ctlack this o.�.iy Ip9ij,.aactha thcn bLirt outside�ofl=tors Enust aubmit a a aieovmm who submit this iffidwAt indicatiog diuY a--doiag all INUr-k iud 0 Mta U b I , -dox must altauLed midditional beet showing he name of thr�,ub-Quu=tOfs and 3taw*whthvr or Dot kbos i av employees,they must pTovide their comp.pol icy arrrrtber, employees. If the sub contractors have C for my emploYeds- Below is the policy afIdJ0b IrlL rain an employer titat is pro-vtdiv-workers'compensation lmwrance infor7nation. insurance Company Name: Policy 0 or Self-ins.Lic, C, 05-1 1 4E Expiration Date. City/state/zip: mar Job Site Address: Ka attach a copy of the workers' compensation policy declaration page(showing the Policy number and ex:plration date) A on 2A of LVOL c 152 can lead to the iinPOsifiOn Of criminal Penalb"of a Failure quirod under Sectip WO R-K ORDER and a fine F to secure coverage as re sonment,asses ll as civU penalties in the form of a STO fine up to$j,soo.00 and/or one-year ImPri statement may be forwarded to the Office Of of up to$250,00 a day against the violator. Be advised that a copy of this stat verification. investigations of the DU ur for insance coverage ofperjury that the hifonnation provided above is true mid correct.I do hereby cerci rider the palm andpena#jes Si attire: Phone -1PI PbLono 9: D — official use only. Do not write in this area, to be completed by city or folvit offleiat Permit/License City or Town: issuing Authority(circle One)-, t 3. City/Toyvu Clerk 4. Electrical Inspector 5.plumbing inspector1, Board of Health Z. BufldiulP.,Departaten 6.Other Phone Contact Person:— ACC)R" CERTIFICATE OF LIABILITY INSURANCE D02n4a016D1YYYY) 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). PRODUCER CONTACT MARSH USA,INC. NAME: TWO ALLIANCE CENTER PHONE FAX No: 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA,GA 30326 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# 100492-HomeD-GAW"-16-17 INSURER A:Steadfast Insurance Company 26387 INSURED INSURER B:Zurich Amedcan Insurance Co 16535 THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. INSURER C:New Hampshire Iris Co 23841 2455 PACES FERRY ROAD,NW INSURER D:Illinois National Insurance Company 23817 BUILDING C-20 ATLANTA,GA 30339 ANSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003741310-08 REVISION NUMBER:O 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 CONDIT10N 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. INSRTYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR POLICYNUMBER MMIDDNYYY MMIDDIYYYY A X COMMERCIAL GENERAL,LIABILITY CL048877i4-06 0310112016 0310112017 EACH OCCURRENCE $ 9,000,000 DAMAGE TO RENTE CLAIMS-MADE F1 OCCUR PREMISES(Fa occur ence) $ 1,000,000 UMTS OF POLICY XS MED EXP(Any one person) $ EXCLUDED OF SIR:$1 M PER OCC PERSONAL S ADV INJURY $ 9,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 9,000,000 X POLICY PRO- JECT [—]LOG PRODUCTS-COMP/OP AGG S 9,000,000 OTHER: $ B AUTOMOBILE LIABILITY BAP 293886313 03/01!2016 03101/2017 COMBINED SINGLE LIM€T $ Ea accident 1,000,000 X ANY AUTO BODILY SNJURY(Per person) $ ALL OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ UMeRELLALIAB OCCVR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENT#ON$ $ C WORKERS COMPENSATION W0015519215(AOS) 03101!2016 03101/2017 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER C YIN WC015519217 AK,KY,NH,NJ,VT 0310112016 03101!2017 E L EACH ACCIDENT $ ANY PFRIM ETORIPXCLUDEIEXECUTIVE " NIA ( ) 1,000,000 D QI=FICERlMEMBER EXCLUDED? (Mandatory In NH) W0015519216(FL) 03101!2016 0310112017 E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under Continued on Additional Pae 1,000,000 DESCRIPTION OF OPERATIONS below 9 E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600OSGOODST. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER,MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ] Coate aoc� tt.a -s c ©'1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD � ry. 7 r7 li )�I ? �J. !• !,f� )- 1'-l.l'lr••s�.•}k7._i7}�L t f t,lc-� (�.•l and Business usiness�Re�Cgr i u.Jrl'Ca.'�ti�on IN, ,• Office oConsumer 10 Park Plaza - quite 5170 Boston, Massachusetts 02.1.16 Home Improvement Contractor Registration Registration: 126893 Type: Supplement Card Expiration: 8/3/2018 THD AT HOME SERVICES, INC. MARK NIADNA ----- 2455 PACES FERRY ROAD, HSC C-11 __-__�-_.--.--- ATIANTA, GA 30339 Update Address and return card.1Vlark reason for change. Address F1 Renewal [J mplovueat Lust Card /�r ��rUJr�n r,lNr'i'r�rl/!1• rf'7 '�i a,urriNL:r'(/1 Office of Coosumcr Affairs&Business f found return to: Regulation License or registration valid for individual use only before the expiration date. I s . v"f.HOME IMPROVEMENT CONTRACTOR puce of Cunstuner Affairs lousiness Regulation Registration: 126893 Type: lU Park Plaza-Smite 5174 Explratlon: a/-3/2018 Supplement Card Sostou,14i4 03-116 THD AT HOME SERVICES,INC. THE HOME DEPOT AT HOME SERVICES MARK NIADNA G`��. � s� 2455 PACES FERRY ROAD,HSC Nut validwithout srgnatexre AT'[ANTA,GA 30339 UjidersecretarY 9 CSSL-099699 4 6 tl ROBERT poCZOBUT 172 WHALERS LANE SALEM MA 01970 0210812018