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HomeMy WebLinkAboutBuilding Permit #483-16 - 109 LYMAN ROAD 10/15/2015 5 F NORTFf q BUILDING PERMIT TOWN OF NORTH ANDOVER ° /�� APPLICATION FOR PLAN EXAMINATION • Permit N0: Date Received wreo Date Issued: -- ACHU IMPORTANT:Applicant must complete all items on this page LOCATION . t PROPERTY OWNER r MAP NO �PARCEL ' ZONING DISTRICT: Historic.District yesno Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resi ntial Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑ffteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer, K)``�r� �� Identification Please Type or Print Clearly) OWNER: Name: V, VP Phone: 05 Address: ` CONTRACTOR Name: —Phone: Address: Q1 11'53 Supervisors Construction License: Exp. Date: l/tel Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ �— Check No.: Receipt No.: NOTE: Persons contracting wit un gistered contractors do not have access to th guaran nd ignature of Agent/Owner Signature of contractor r1 NORTOI - : W' ' � E : �A,. . .c . : ve" 'o No. r _ 2.,b ver Mass, 1 COCNKMtw.CK �. U BOARD OF HEALTH Food/Kitchen PERMITrrppm� L D Septic System THIS CERTIFIES THAT .►.�.`.f.. �, BUILDING INSPECTOR !� ' ....... ... ............................... ..... ................ ............................ . Foundation has permission to erect ......... buildings on ... �. �I ................. .... ................ ............ ... ......l........ , . . Rough tobe occupied as ..... .......... ... .... ........... ................................ Chimney provided that the perso accepting this lMrmit 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 M THS ELECTRICAL INSPECTOR ° UNLESS CONSTRUCTIO R Rough Service .................. ....... ... ..............................:............ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. De pr rierrt afIridust WAC-dden& Of ee of finves4anow 1 Congr�ss>stre4SzteI00 Bastion,M 02114-2017 I W .ma=gavldia I. Worl-IM'Compensation InswrimeeAffidavit..B ' illitlClS��flII�1'aCf'flrSQ(1]CetlT � A i c><ans/Flumbers li I>aformation Please ID nv Leat'b� Name mnsfim /otgacti.&,,,/l &,jdttel}- Address: City/State/ ' : W.AVP �r 8 P Arean ou employer?emp per? Check#he'appropriate box: 1-�I am a employer with 'r' . �.I am a general conteactor and I TYPO of project req ; employees(fall and/or part ime)* have.hired the spb-co racbMs '6. F1 New construction 2.0 I am a sole prop3detor or partner_ listed Dies the aftched sheet 7. Remodeling ship and have no employees Then snb=coa�trac oisjjaye i 8. ]Demolition ; woddag for me in any capacity. employcess and have worloers' [Nowoks comp.insmance Camp- nsrane2 9_ ❑Bud addition s ed .. 5. a ... T�4� 7 ❑ W me a oratio corp n and its 10.�Electrical azrs.or rep additions 3.❑I am a homeowner ' . officeas domes all work have exercrsed tlteh' 11. ❑plumbing ropairsor addrtioibr myself[Nowork=j comp. right of exemption per MGL of � iustrrance required.]I r:.152,§1(4),and we have no 12,❑ �� employees.[No workers' 13 ! connp.insurance required.] f ' YaPPlicantrhazdboxAlm�almlineafescibonbdoivsb dUir t wotkas' Hottteownets who sobmittttis at6da4tt mdt o�wg ootnPensatioa Po�cY iafptmatioq.. - e shay aze dbntgab Mc and 6ten hke outsFdc tis MUStsnbMk anaw affidavit i kjdngsa& tConfractotsihatdtecktLisba�m�tabacbedmmadd,�"o�tsheetsLovvingilunamaofl�sob, �dstatemhetherornotffioseentities}>ave - MPloyees- If thesuh-wntMd=haveoapltiyus;theymastproe deifuv:suorlaos•,oup,pol;apam bet f am an employer iliatfsPVVi irtg!Pdrkets'COMPMOoft vesrermrce or infonmtfon f enyeployees» Belol>s'as the policy rneaFjob site Insurance Congm r Name: Policy#orSelf-fns.Lic.#:_ 003 SOL--0;;t S"— FxpiraatioaDate: Job Site Address: / �. Attach a copy of the workers'tom peiisa on policy d tion page(showing the policy number and expiration date). Fa�ae to secQre coverage as recNitred Under Section 25A.of MGL a 152 can lead to the mrpOsrtroaOf ci�al fine'up to$1,500.00 gadlor one-year imprisonment;as well as civ0 penalties of a of to$250.00 a Fit lathe fomes of a STOP WORK ORDER and a fine ❑p dap against the vrolafor. Be advised That a copy oflbis.statement may be forwa¢ded to the Office of Investigations of the DIA for insurance coverage Ver fica6 m. Ido hereby certil'.wtAT. aba p .ofperjury that flee utfonnation provided aboue is true and correct Si Date. i Fa Only: De ltaf trite in this area,fob, feted i lt}' or n: rermitll fceuse## hority(circle one): Health Z Btulding Department 3.City)Towa Clerk 4:Electrical.Iivspector. S plumbing Xnspectnr �! rson: Phone#. - _A Mq K09 iF'14ti5tfi! Uontract 8 CT Reg"f P05216 mime Federal 10#20-2825129 ki Reg#26463 Home ltrprdpgrnam SolFtloiu a Corporate Headquarters,26 Cedar SL Woburn,MA,(P)8,0,U2-2211(F)781-933-9628,wwwnewpro.com THIS CONTRACT MADE THE day of 2D-!� between (Horns 0»ners/ (H apnens� � �� of 7 4— -'C�V'!�/ (Addrassf i'MY) t ri T— 00) -- the"Owner'and NEWPRO Operating,LLC,"NEWPRO'. (E-61a//Jforp�i jrrie/aryuse only NEWPRO herabyagrees that it All For the oonsideratIm hereinafter mentiDned,furnish all latorand material necessary to install Ihefoffowing described work at the premises located at: The Joh address is a condominium. (JobAdr/iesr ■ 1,'if'CAIS��-c. :� NEi(l+lt�Q I _ I: ..,�•:'r�x:••�'e,.�::=;. - ,::::.; _ _ N 1�1i1( ;:t.' InRi ✓ Clrlds: YES Lj CONTOUR LJSDL UEURO UDIAMOND r WIndow War QTY Window color CITY 0881TMP:gwrtfdm) QTCP ❑BOTTOM lot; lnl: Screens:(Exterior dolor Full Screen Standard) ALF Q FULL Ext LLJExt: Vent latches: Q YES Ca in Color. �_OOR °;;a,; ; :s ?tIl4D L`:'':. ' `:'.Q P(gp,W/n/ltah. PVC month NoMarLj k'.i.:.'Im. iilOYf 6f-,.;.,�;+. _.:,.,,,r,,vim-0.tii9: 1,a:: CoEoro litaa In- s;., ,Out-. DoubteHung _ :)i4... Acthre: Left Center Rigfit customoundersmndsth NE99 . 2LiteSlider HDWR:- SN BB BGE WH domnoldaarypainingerstannhg. 3 Lile Slider -'>z.11�dP�re.1(r�1.5,.ir:._ (ie:when remvring a rapiacing lidedm 3 Us Slider (113.us,im Color In: Out: #toys or trite.REWWPRODdrnA respo• Casement(HingsdRigm) Fiberglass Steel nalbleloroorWdronsorcnwrrrstsnow bey- Odsement(Hhgadlaft) HDWR: SN BB AGB Aft ORB and Rsmnbolrrd udmg eondelraatien naso• Twin Casement tSld4)i ',S"la;; :.;E:` nngfrom ordue to re-exatueoendroms Stationary Casement Color Ire Out: (~eory TripleCsserrent (umair4) Y pASif""''�-:p,,r`%, CASH TripleCasemerd (tceva,rnr Color In: O T. Balancepaif a erateomptetlon Pict re Window HDWR: SN BB jkGB AB Sash Only Left Hinas Right Hinge FINANiCE Hopper Batik m"%n torn signed et Melellellon Awning Color In: Out: Garden Wtldow Flbergla4 Steel >r Bay Window(Red?sofit) HOVE: SN 0A AGB AB ORB v (l BOW Window(Rdoflsclbll 'e' p Other Color Irr Out: Other HI)VYR: DESC171BEWQR &PR0M0Tt0NSA 11 : ��77 f Est.SbID-1 Est Comp.data - ' `3 Customer understands this is an"estimated date' Owner has read and agrees to the terms and conditions on the front aod�the reverse of this Agreement. 4ner specifically agrees to the(1)Total Cash Prlco;(2)work being perform4d;and(3)work not being performed Owner understands that this Agreement and any attachments contain all of the promises made by NEWPRO. Owner has been orally advised of his right to cancel this transaction at any time prior to Midnight of the third busirress day after the data of this transaction and Owner was provided with two(2)copies of a cancellation form explaining this right. OO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode Island gales Only): Notica to buyer: (1)Do not sign thfs Agreement if any of the spaces Intended for the agreed terms to the extent of then available Information art left blank. (2)You are entitled to a copy of this Agreement at the time you sign it. (3)You may at any time payoff the full unpaid balance due under this Agreement, and in so doing you maybe entified to receive a partial rebate of the finance and Insurance charges. (4)The sellar has no right to Unlawfuily enter your premises or commit any breach of the peace to repossess goods purchased underthis Agreement. (5)You may cancel this Agreement If It has not been signed atthe main office or branch office of the seller,provided you notify,the seller at his or her main office or branch office shown in the Agreemerd by registered or certified mall,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 not made. See the accompanying notice of cancellation form for an expionation of buyer's rights. (Rhode Island Sales Only): Owner acknowledges receipt of required Contractor's Reglatration and Licensing Board consumer education materials. (Owner's Initials) BY `---- Product 8peciallaf PdnradNearsJ Owner UZ 0 ey: Signed: 4 r s NEWPRO rating,L1,QOt(gOrh/riJ Owner us-Is WHITE:Branch Copy YELLOW:Customer's Copy PINK:File Copy GOLD:Finance Copy R0714 I A ® CERTIFICATE OF LIABILITY INSURANCE =_SS/1/2OQ15 THIS cERTiFICATE-tS ISSUED.As A ATTER.OF INFORMATION ONLY AND CONMM NO'RIGHTS UPON THE CERTIFICATE-HOLDER THIS CERTIFICATE.DOES NOT AFFIRMATPVELY OR NE AT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A,CONTRACT*BETWEEN THE ISSUING ORDER BY AE POLICIES REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER tM terms n conn ions Fcefe hotder'Ls an ADDITIONAL INSU9ED.the poli (Ids)must be:endorsed.-if SUBROGATION IS W4W,.SUbject to the terms and conditions policy,Certain policies may require an.endorsement A statement on this ceitifigte does not confer rights to the certificate holder in lieu ofsuch endorsernent(s). PRODUCER ACT Mackintire Insurance Agency 3:ne RAW= Melissa Pflug: PHONE_ ,35fi-6151 FAX 11 West Main Street E tvtAa I No.t$08)366T5202 D�:me7a.§sapLmackintire.com Westborough MA INSURER AFFORDINGCOVERAC,E. NAIC# flI 581-3 992. INSUREDLands 2A1 71 Newpro Operating LLC INSURER a-1-ib Mutual/Peerless24198 26 Cedar St. INSURER C 1Acadi.a Insurance Co_ INSURERV: WOburn t? INSURER-E:01803 -! COVERAGESI uRER CERTIFlCA1E NUMBERilaster 14-15 REVISION NUMBER THIS A TO CERTIFY THAT THE POLICIES UI INSURANCE LISTED BELOV►'H,4VE BEEPS ISSUED TO THE-INSURED NAMED.A80VE FOR.THE-P(3UCy PERIOD CERTIFICATE NOAY se ISSUED AN MAY PE IREMENT,TERM OR CONDITION'OF ANY CONTRACTOR OTHER DOCUMENT-VM- RESPECT TO 1AHCH THIS CERTIFICATE FRAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN JS SUBJECT TO.ALL THE-TERMS, ECCLUSIONS AND CONDITIONS OF SUCH°OUC1l S.LIMITS SHOVM MAY HAVE BEEN REDi ICED°81f'2AiD CLAIMS. INSR I jA00 aRI ?'YP£aFOYSURANCE 1 �:POU EFF. PC CYEXP. 1 POUCYNUMBER._ l AMIOD Idt LIMITS- 1 X j COMMMMAL GENERAL UAaiLTrY } ( I . p r�l ' ' II EACt' =—.000URREN ....�5 1,000,.000 I CLAIMS tSAI — OCCUR I DAMAG, c 1G0 I I F Y--tEa S. ,000 I� 85695?7 122/311/2014 32131/2035.Mw 0p IAOy mle person) S. .. 5;000 ' I GE, ACGPEGAT:USS?TrP�ttenP i { { tQERSONALBADVh1�lE1RY I_. 1,0flD,D00 X I PaucrJEC-9 ' { GENERALAC-oREOATE .. 5 2,.ODO,000 I ` OTHER: PRODUCTS-COASPIDPAGG S 2,000,000 3 i r I -!a ,{AUTOMOBILE LIABILITY sx+a Ea 60M81NEDSw6tELlM(r t . t S 1.._000 OOO A mt - I ANY AUTO I ` l I ALL SCFEDIF.ri BODILY INJURY Per Pew)' .S AUTOS ice"!t AUTOS .93E:17; i2J3i120_2?t 32/ /20131 80DILY I-llU.Tf POr l X HIP,EiI AUTOS (� TJQN•DIOIED i PRQP-R'fY OJihiAuE2� ) _ AUTOS I I S ` t ao6dent X I UMBRELLA UAB 3a' OCCUR " �� I w. 5 a':X3,000 .._f S i EXCESS UAB ` ; } c11CH OrCUM NCE S . ._5.Siy6 000 3 >� ! ,rtnrsnSati;Dc6 ` ;5 5'.0OO.ODO ACGr�eGATE I 0EO 4'e I REiENT100S 10,000. t CO 8.582576 12/31/2014�12/3t/2025 �.S WORKERS COMPENSATION . AND EMPLOYERS'LIABILITY I g PER { OTB• Ak'Y C I{ Y!N jIPROPMUOR19AP.TICASMDMVE 1OMCew&xHERvMUwE[" I l!!!!! . ({ NIA) E-ESATAH?UATC_- 1 EW(Martdatory in NFU c-R I 500,000 8C-20-20-003506-02 5/_/2015 5/1/2026 F-L DISEASE-.EA bPort s00ia001aieeSsCRPu770beNWOOF �OP`PATIONSbetoa - I ' EL DISEASE.Poury Lints b. .. 500 DOD' OESCwtmON oc es+sRArror s LOCATIons i vErttcLFs�rii oRo m,,Aam4onaS ae+nansI . _ Sehedutq m!4 he attaNieA iFinote 3paceis re4ai++ed} . GERTIFICATE HOLDER CANCELLATION SHOULD ANYOFTHE ABOVE flESCRiBED POUr.IES-8E CANCELLED.BEFORE To Whom It May Concern THE EXPIRATION DATE .THEREOF,.NOTICE WILL BE DELIVERED IN ACCORDANCE WETH THE POLICY PROVISIONS. AUTHORIZED REPRFSENTATM Timothy tAoynagh/MEI, ©19.88 2014ACORD cORPORATiON.All rlo%reserved. ACORD 25(2014101) The ACORD name and logo-are registered marks.afi ACORD INS025mrami Hoard of Suilding Regulations and Standards ' t'iii,tructtia� Sul>rn•icor • .,..�: License: CS-096093 I THOMAS E PEACOC s P.O.Hoz 505 ` r7 . Seekonk M4 02771 - �.. .. .11�vet+ �� •� ExPiratic C:ommissidner 04/08120` ak %• � ,� Office of Consumer Affairs ld:Business Regulation 10'Park'Plaza - Suite .5170Boston, Massachusetts 02116 Home Improvement;Contractor Registration Registration: 146589 Type: Supplement Card Expiration:- 5/5/2017 NEWPRO OPERATING, LLC. TOM PEACOCK ' 26 CEDAR ST. WOBURN, MA 01801 Update Address and return card.Mark reason for change.. SCA I 20M-a5/I1 0 Address E.Renewal E] Employment C] Lost Cacti . '�%rr'�'�rriirilNlrivvirf�i '� ��n.�.i!!r•�!!Jr•/% • . ^ ftice of-Consumer Affairs&Business Regulation RLicense or registration valid for individui use only Ilk ME IMPROVEMENT CONTRACTOR before the expiration date. If found.return to: Office of Consumer Affairs and Business Regulation registration 1465$9 Type- 10 park Plaza-:Suite 5170 Expiration .•5/5/20'!7Supplement C:+rd Boston,A,"02116 NEWPRO OPERATING LLC: TOM PEACOCK 26 CEDAR ST. ��:, WOBURN,MA 01801 undersecretary Not valid vithout signature Locationjo ! ' No. Aep Date/ . - TOWN OF NORTH ANDOVER ~ ` Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ �'' TOTAL Check#° 14 5 3,0- Building Inspector