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HomeMy WebLinkAboutBuilding Permit # 3/1/2017 %AORTH BUILDING PERMIT 4. A"G. ""0 ......... TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATI Permit NO:1ji22L7 Date Received Date Is SACHU IMP ge LOCATION Print PROPERTY OWNER LL&t Print MAP NO: PARCEL: �? ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building ffbne family 0 Addition 0 Two or more family 0 Industrial Gl AI ration No. of units: 0 Commercial I..................... epair, replacement 0 Assessory Bldg 0 Others: 0 Demolition 0 Other 0 Septic 0 Well 0 Floodplain 0 Wetlands 0 Watershed District 11 Water/Sewer 114 Identification PleaseTypeor PrintClearly) OWNER: Name- C It j,7 Phone: 'I Address: CONTRACTOR Name.- Phone: Address,- -7 Supervisor's Construction License: V 7 Exp. Date: Home Irnprovement License: Exp. Date: 1? ARCH ITECT/ENG I NEER 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: $ FEE: $ Check No.: 07. Receipt No.: 3 1 S 7 NOTE: T;e�rsons contract wi tinr gist red contractors do not have access to the guaranty fund -'P- Signature ofE;e>A caner -4 Signature of contractor 1%0 Tfhj own ® °1 ,�.��., SAS ® • er V h ver, Mass,9 . O COCN�C NL�MHCN y 4�R4rko ,pa,C,�� s u BOARD OF HEALTH Food/Kitchen 'PERMIT T D Septic System • THIS CERTIFIES THAT....t�'1!kk.......I.O.A.W N.`............................................................ BUILDING INSPECTOR has permission to erect ......... buildings on ! 0�. .. s A�.tow....... ,r Foundation ................. ....,,.... .,,.... n.... .... ..�....... Rough to be occupied as ..+r. ,... rR. . .....SR.A.01........11... 00. 1.�.. ,V, s 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- LESS C SR T T Rough Service ....L.. . ...... ................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. about:blank k r r ti 1 Y$hz$ t;0'w"'33t t d r at tkE ,1 hrrSW,PA W-611 0"•x°6325.., SilW9att�Yt'FNHgt3,C�t4t a�R at6 4 Sl.,,k CUSTOM.REMODELING AND IMPROVEM]wPIT AGREEMENT 941"g14),infrtrmseors 9nd r?rRa srlrttzir#vi the apto*tya Project Humber,�ti4B ranusrir 2tf�tl17 ruck(Wiittaar (ti7b}00-093{NcW90 quo Millar af�9)4 w�alra3a�I Yvwn�hip; B"Yer(B)in,100 above hereby Jointly and swarally agroos,1d purcha m the gderls nowor sorvlce6101 power Home H6Mpd61ttg Gr+nrp and its vendorta("C.anlract+r',}in a ocordane with the pkos ghd tettrtrd descrlW in this 6 page docomol and the PrOdWi. ,1>acifinratmrit€.v�hiah aro 1hrtNperraled as paari bf thg.At�repmattt Itk3lla@t iflglgty,ftais"AgrearnanY"), Thio AgrahHt &t tapr stints w It a uala of goods and somoet Wyurfs)agreas to Nay ilio 004 01 thrt Ot lS ori f,&eittiit es putotttrae,d gs da3ser d ftareinp rt gaf�dtt� s Uming or(approval di any financing 13pyrar(ie)racy seek fat-their purdhitaa. ;4 ,.arctaf,sa Hoe: TchKk fareUcrwn PriytnenteuE�lone�pu0 onItti�iCa±nPM1aa9f3odratpayiaerat: 1t1g1tt�lfrfltfrai�ndIsun�iasaar�aetitl#t�ifa� aaae .kRrr?t eoafrro9 ra�rird�at taa, tcsa sg Gnie trrtm�: tb�ayhlr�t;txr�ai r ota�isitaMk k3uyer.( }haret�y,nckhowMddgog toce pt of s copy of the pamphlet, lte trartd a9fe rpt it tf uldasft3 Actibv is I hl,;inlprrr+tts 13uyogs)of the„potential risk bf lead hazato expaeure from rettga+sW.h'.0cg+1!tb fag rfanrlcd Iil;pt 1FY �# ' Ai iit8 address Who..rtfaove. uYot(s)tecsiva�t this pomphit>t oh,thg d6l tff trtla3 Agrgemant,bgfotg t3lftigrt mtattf dl i tl< �Yer(al'lnittals. :, This AgroeMen conslitutos iho ooltto apreernonf and ur er fi I/s i n the ftert y ttd tt>1� tdetei ttt reple a er►9 n pflor,ttagotintlons,represenlettans of agra6monliis,bf1hO wlitoA t iifel fyo 0tnotldmpnt,rtt idlJt tfptt cr F bi thI$Agr m t1�3 9hala l 9 v� Or elfgctN+e unless In yriting and signed by-tx6fb pgrll s n yi�r g)hgro�f! fadgg �f. �s� hag tg entire Agiedrr+eni and hes€thceivad 6 cotnploted,signed,an dale Gepy of dila A+�iecment inttlu�lttp tlfe of+: r 01Ia114n forma,on(h9 date t)rbt written-ebrno and 2}Wga ifr )h trndd al hl It.9'.. Iri.Car t t� t4a x ti fuya3r{Sl of arress antl undeahrlri Char Iduyer�s}frni}'incd ihaa;'Ntdrit+Mttt%a ttfitd par ty tftd lrirta3 cf Itt1 IlsrrofPr + fri canto red.nn ar parata dr>cutn lit Including BAY litaece c?}afgg W a � �4tQ SlaifV fftlS pQf> 1iIfitVT°IF THieFiE�p AfVYt Atilt 9I'At`ra8 _ ' ;>�`, r , _ y , a I haw reed and wp31I0tsd dalfl p at!rT p>fw t 01Nt3 'Nome 13e 0 t roup f uy 3 yyy ( A , )ttljT + 11iTt gnatrx�l3f efrtod"a11ho.Cdhsultent e A?�IOW Pgpas X13,lrltt~f u�+ l �to F frAttot& 0 A ON A A �tR p till � Ar�7R Tii E Jif �9fx Cf MI 'I At#SA1N7Ptt� t I JII A(€HfiGl tSf� 1� G� 2n12017 3:12 ] of I Rick and Sue Miiler National Headquarters 32-31648 2501 Seaport Drive,Chester,PA 19013 January 21,2017 888.736-6335 WWW.POWERHRG.COM MA HIC#166616 PRODUCT SPECIFICATIONS ExoeF.,. January 21,2017 Buyer(s)'Information and Description of the Property: Project Number: 32-31648 Date otAgraement Rick Miller (978)6864593(Nome) Sue Miller 1094 Salem St North Andover,MA,01845 County:E=ssex Township: Buyer(s)listed above hereby jointly and severally agrees to purchase the goods andlor services listed on the accompanying specification sheets,in accordance with the prices and terms described in the Custom Remodeling and Improvement and the Product Specifications (collectively,this"Agreement'). Pre Installation Inspection date:Your pre installation inspection Is tentatively scheduled for Tue 1/31 between 9:00a and 10:00a. rop Underlayment,PowerWall form-fit adhered insulation Siding/Trim-Cedar Tech Wall System Inclusions; includes Raind ,all J-channel, starter strip,inside and outside corner posts where applicable,Installation,clean up and haul away of all job related debris. To protect our clients, Power HRO includes at no additional cost,the removal and replacement of up to 300 square feet of soft or rotted plywood if needed.Any additional wood replacement needed,over and above the 300sg1ft we provide,will be done at a cost to the homeowner of$3.57 per sq/ft.(Buyer initials ) Windows-SL 2700 inclusions; Includes metal reinforced meeting rails and nighttime safety locks on double u leanng s up and haul away of corners,foam injected frames,Sashlite technology, Heatshield,Duragla ss,exterior custom capping, ns all job related debris. It is agreed and understood by and between the parties that the product Specifications,along with the Custom Remodeling and Improvement Agreement,constitutes the entire understanding between the parties,and replace any and all prior negotiations, representations,or agreements,either written or oral. The ProdUCt specifications may not be changed,modified,or varied in any way unless such changes are in writing and signed by both Buyer(s)and Contraotor. Buyer(s)hereby acknowledge that Buyer(s)has read the Product Specifications. I have read and received each page of this 4 page agreement. Buyer(s) Buyer(s) Power Home Remodeling Group 10112111 lSignature /01121/17 101121117 Signature of Remodeling Consultant Signature Michael Pappas Rick Miller Sue Miller YOU,THE,BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. January 21,2017 14:38 II ll II jj II II II III��I Page 1 of 4 National Headquarters Rick and Sue Miller 2501 Seaport Drive,Chester,PA 19013 32-31648 888-736.6335 January 21,2017 WWW.POWERHRG.COM MA HIC#166616 Project Specifications Siding/Trim: Siding 1 2450.0'x1.0' SIDINGITRIM: Models Cedar Tech Wall System Styles Straight Types Triple 6"Configs None OPTIONS: Siding Color Greystone I Corner Post Color Aspen White I Removal Vinyl I Installation Details None SidingiTrim: Fascia 1 250.0'x1.0' SIDINGITRIM: Models Trim&Accessories Styles Fascia!Eaves 1 Rakes Types Standard Configs None OPTIONS: Color White I Removal None I Installation Details None SldingfTrim, Soffit 1 180.0'x1.0' SIDINGITRIM: Models Trim&Accessories Styles Soffit Types Standard Configs None OPTIONS: Color Aspen White I Removal None I Installation Details None SidingfTrim: Capping 18 1.0'x1.0' SIDINGITRIM: Models Trim&Accessories Styles Capping Types Windowa Configs Standard OPTIONS: Color White I Installation Details None SidingfTrlm: Door capping 7 1.0'x1.0' SIDINGITRIM: Models Trim&Accessories Styles Capping Types Doors Configs Entry Doors OPTIONS: Color White I Installation Details None January 21, 2017 14:38 II�I�I�II�lII��II�II�III�IIIIiI �lll�lll�ll�lll�l Page 2 of 4 National Headquarters Rick and Sue Milker 2501 Seaport Drive,Chester,PA 49013 32-31648 888-736-6335 January 21,2017 b WWW.POWERHRG.COM MA HIC#168616 Project Specifications Gutters: Gutters 1 180.0'x1.0' GUTTERS: Models Gutters Styles Gutters Types 6t(Seamless Configs None options Color: White I Installation Details None Gutters: Downspouts 1 120.0'x1.0' GUTTERS: Models Gutters Styles Gutters Types 3x4 Downspouts Conflgs None OPTIONS: Color White i Installation Details None i w k i I E if January 21,2017 14:38 �Il�ll���l�ll��ll�lll�ll�ll��lll�l�l��ll���ll�� Page 3 of 4 National Headquarters Mick and Sue Miller 2501 Seaport Drive,Chester,PA 19013 32-31648 888-736.6335 January 21,2017 ® WWW.POWrzRHRG.COM MA HIC#168616 Project Specifications Windows: Windows 7 31.0"x54.0" WINDOWS: Models S[_2700 Styles Double Hung Types None Conflgs None OPTIONS: Color White!White: Grid Pattern: None j Removal Wood Additional Details None f 6 p p January 21,2017 14:38 IIII I I I!t i l IIII II I I SII 111 I I II I II I I I III II 1 1 Ili I I II I Page 4 of 4 KuliX�Ir1gC,�V'✓�c�'Sle�lnt7,- It c SL2700 DOUBLE HUNG WINDOW V114YL PRAME - DOUBLE GLAZED FOAMFILL GRIDS LOVVEIARC-ON nE(iC CREm:-J@R-K•t:.�p41 6-CfiGS� Notional WEstW10 Rating OukV 107,21.01 00486344/001 CR100 ENERGY PERFORMANCE RATINGS AM I ADDITIONAL PERFORMANCE RATINGS 011 . 7 �Pl a:3^ at,a ca�Y(A{€l1 tr:s tic( .c t:r�ial.�iP sp,,Rrif Tct tcFc[rr .c. G[i 15C ter.,Ir[tIQ S. b a'' The Colninorovealtlt of Massachitsetts &/ DelrarttnetttofindustrialAc'cidents 7 Cott cess street,Suite 100 4 F Bostott, MA 02111-2017 �,�.�>�.-ir tt�rs�furrtas's,,�otr/dia WorkelY Compensation lnsurance Affidavit: Buildcrs/C..ontractorsiElectriciaas/PI uill bers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Inforttlation Please Print I etjiliv Name(BusinesslOrgani�atienllndividual);Power Home.Remodeling Group Address:2501 Seaport Drive city/state/Zip:Chester PA 19013 Phone# 610.874-5000 ext 2509 Arc you un employer?Check rhe appropriate box: Type of project(required): I'MI am a employer wiill^2p____wnploycer(full and/or parwime)." 7. Q New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in $. Q Remodeling any capacity.[No workers'cornp.insurance required,] 9. Q Demolition 3.E]ram a homeowner doing all work myself.(No workers'comp,insurance rcgaired.J 10 n Building addition 4,©I am a homeowner and will be hiring cuntractors to conduct all work on my property. I will ensure thus all contractors either have workers'compensation insurance(a,are sole I I.Q Electrical repairs or additions proprieiors with no employees. 12,Q Plumbing repairs or additions 50 1 am a general contractor and I]rove hired the sub-contractors listed on cite auacltcd sheet. 13.01toof cepa irs rltcse subcontractors have employees and 1mve workers'comp.insurance.l 6.F We are a corporatirnt and its officers have exercised their right of exemption per MGI.c. 14.M/ Other_ 152.§1(4),and Nve liuve no employces.[No n orkers'comp.insurance required] Any applicant that checks box 41 roust also fill out the section below showing thoir worker. cocipcnsation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractor;must submit a new affidavit indicating such. :Contractors that check this box must anached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees, If the sub-comtractors luo-sc cmployvvs,they muss prosidv their workers'Comp.policy number. 1 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Harleysville Worcester Insurance Company Policy#or Self-ins.Lie.# 201600 6620967 10/1/2017 P�� q Expiration t7ate:_-_—__...._—_._-�._._ .. Attach as copy the workers'compensationn _ — _---City/State/Zip: A,,,, I r�.4 e�. ,.,_\ « p policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MOL c, 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment 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 vii is r.A op of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verif ation. 1 do hereby c ra'fj,r tiler the his andpena/ties ofpei junta thin,the itrfornnation provided above is true and correct. Phone#:610-874.5000 ext 2509 Official use only. Do not write in this area,to be completer!by My or town official. City or Town; .._ ------___.Permit/License 4-- Issuing Authority(circle one): 1.Board of l-lealth 2.Building Department 3,City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6.Other _..._.._ Contact Person: __. __._...�...�_._ _ Phone POWERCL-01 ELISEL AcoRo' CERTIFICATE OF LIABILITY INSURANCE DATE 91281o0rr 009!28120166 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 INSURERI AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, holder is an ADDITIONAL INSURED,the policy(ies}must be endorsed. If SUBROGATION 13 WAIVED,subject to IMPORTANT: If the certificate 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). CONTACT PRODUCER NAME: --- _ _ _._ Lacher&Associates Ins A y Inc. -PHONE FAX (215 723-8604 g 215 723-4378 A c,sfo�_..1 Lacher Insurance Group,LLC E-MAILNo Ext. _ } _ -.-. E-MLacher lacherinsurance.com 632 East Broad Street ADORss: @ ..... �. _ -... _. Souderton;PA 18984 INSURERS)AFFORDING COVERAGE _ ., NAIC N E INSURER A:Harleysville Preferred Ins.Co 36696. INSURED - INSURERS Harleysville Worcester Ins Co 26182 INSURERC;Naticnal Union Fire Insurance Company of Pittsburgh 19446 Power Home Remodeling Group,LLC — 2501 Seaport Drive,Suite 8110 INSURER D_:_Pennsylvania Manufacturers 12262 Chester,PA 19013 NSURER E: _ IINSURER __ _.P: 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. e IN$ft - AD �_ P6�LICY EF —POLICY—'EXP LIMITS LTR TYPE OF INSURANCE EINSD NND' POLICY NUMBER MMIDDlWYY MM1DDfYYYY X `COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE __$ 2,D0D,DOD DAA�/�TO-RENTED 1,000,000 CLAIMS MADE rrX OCCUR MPAD0000089793N 1010112016 1010112017 pREMIS�S Ea occurrence] _ $ E 10 000 MED EXP(Any one.person) _ 5 i PERSONAL&ADV INJURY 5 2,000,000 --APPLIES PER: 4,000,000 G_EN'L AGGREGATE iGENERAL AGGREGATE $ _ 4,000,000 PRO- POLICY[1 JECT LOC ll I PRODUCTS-COMPIOPAGG S- -._ EJ - S OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY �' (EeaccJdens�._, .,,$ 1,000,000 B X,ANY AUTO BAOD000089796N 10!0112016 10101/2017 BODILY INJURY{Per person} E .', ALL OWNED r-_....1 SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED - PROP€ 4bAMAGE-... 5 HIREDAUTOS I_ AUTOS PEl7 axldent) _„ _.. -- 5 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ - S,000,flOO EXCESS LIAR CLAIMS-MADE BE 067941520 10/0112016 10101/2017 AGGREGATE 5,OD0,00o C _ _ X DED RETENTION$ 10,000 OT S WORKERS COMPENSATION '' STAt' -_ER AND EMPLOYERS'LIABILITY YIN 201600 6620967 10101/2016 1010112017 E.L.EACH ACCIDENT $ _ 1,000,000 D ANY PROPRIETORIPARTNERIEXECUTIVE ❑�N 1 A OFFICERIMEMBER EXCLUDED? E.L.DISEASE EA EMPLOYEE $ 1,000,000 (Mandatory In i 1,000,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below B Mass Auto ;00000074849R 00000098227P 10/0112016 1010112017 Auto Liab 1,00,00013 �NY Auto 10101/2016 10101/2017 Auto Liability 1,0011,000 DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES(ACORD 184,Additional Remarks Schutllllo,may be attached If more space Is 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 Town Of North Andover 1600 Osgood St North Andover MA 01845 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Oflice ur(:uusuuor Affoh's 0K,Husinesk Reg ktiNliim License or registration valid for individul use only I €,+ t OME 1MPROVEME14T C014TFZACTOR before the expiration date. If found return to: > Office of Consumer Affairs and Business Regulation Registration. 168616 TYP' 10 110uPlaza-Suite$170 ^" Expiration: 511812617 Supplement :ard I30769M 116 POWER HOME REMODELING GROUP LLC, MARK MORDINl 2501 SEAPORT DRIVE STE^13110 CHE$TcR,PA 19013 �tu��erccrrr �y��-- 1t"1V t valid without signature _ ...,,,.__ _..._.... ure 6 a Massachusetts Department of public Safety Board of Building Regulations and Standards License:C"57645 CL'1',T�St'rl-7 G`t ion € MARK E MORDiNI 10 NEWELL DR NATTLEBOROMA D�� Expiration: 7rr1tnissioner t)811812017