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Home My WebLink AboutBuilding Permit #264 - 11 FERNWOOD STREET 10/5/2006 TOWN OF NORTH ANDOVER pORT►l APPLICATION FOR PLAN EXAMINATION OF,«•' Ibgtio ' o 32 a..:'• a L o Permit NO: cp(o 7 Date Received /U�5��(P Date Issued: iCS1U IMPORTANT: Applicant must complete all items on this page LOCATION � h OV60cl— J-/-- c Print PROPERTY OWNER ! ,lam 54" Ah d P6'So/1 Print MAP NO.: PARCEL: �j ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑Commercial ❑ Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED Ste/! -/- Pe •zv l U Identification Please Type or Print Clearly) OWNER: Name: itC51Rvq- .14I1 cizr-,50 Phone: Address: _ �� -6 j; CONTRACTOR Name: A/0,,v"r- Phone: Address: 1�-7d SZ S- 576� Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: F— ARCHITECT;ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 4l S / x12.00=17EE:$ Check No.: G�Sh Receipt No.: Page- I of 4 Location �� - No. Date AU is-ez� TOWN OF NORTH ANDOVER Certificate of Occupancy $ s' ° tBuildin /Frame Permit Fee $ s�CHU Building /Frame Permit Fee $ Other Permit Fee $ _ TOTAL $ Check # 19656 �.... Building Inspector, i TYPE OF SEWERAGE DISPOSAL n Swimming Pools ❑ ❑ Tanning/Massage/Body Art �I g Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales C ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner `� Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance,Petition No: r, Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature&Date Driveway Permit Temp Dumpster on site yes-4no_ Fire Department signature/date l Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) I i Page 3 of 4 Dac:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 created JMc.an.2006 r f Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) : ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENTMFORN105 I Nor 4 nf-4 WORTH own . of RAndover o� .......... CO i== LA dover, Mass., O 40 COC NIC NE WICK ORATED S BOARD OF HEALTH i Food/Kitchen PERMIT T D I Septic System THIS CERTIFIES THAT...... �.N r1......... 1i1................I 1!1 BUILDING INSPECTOR fFoundation has permission to erect........................................ bu' rags on ..'.r....... ...... !1�N fN..a.�.OI................................. Rough • to be occupied as .�.pii ,..."1',,,,,,�,,,, �� Chimney provided that the person accepting tpermit shall,in every re c conform to the terms of the application on file in Final 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRU "?I,,,l 'j'S ELECTRICAL INSPECTOR Rough ................................................................................................. Service BUILDING INSPECTOR l Final Occupancy Permit .Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER PRODUCER ATL-000915907-11 MARSH USA,INC. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MAR BRENDA BOOKER (404)995-2594 NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE MAYA BMCC RENDA E(404)9 R (406 OR POLICY.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE TAMI ROUSE(404)995-3430 FAX(404)760-5663 AFFORDED BY THE POLICIES DESCRIBED HEREIN. 3475 PIEDMONT ROAD,SUITE 1200 COMPANIES AFFORDING COVERAGE ATLANTA.GA 30305 100492-IPUSA-GWA-03/04 COMPANY INSURED A STEADFAST INSURANCE COMPANY THD AT-HOME SERVICES INC. COMPANY DBA THE HOME DEPOT AT-HOME SERVICES.INC. B ZURICH AMERICAN INSURANCE COMPANY HOME DEPOT USA,INC. COMPANY 2455 PACES FERRY ROAD NW BUILDING C-8 C NEW HAMPSHIRE INS COMPANY ATLANTA.GA 30339 COMPANY D AMERICAN HOME ASSURANCE COMPANY COVERAGES This certificate supersedes and replaces any previously issued noted below. 3 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TOTHE INSURED NA ED tHEREIN FORpolicyeriod THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THE CERTIFICATE MAY BE PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICISSUED OR MAY IES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I T TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DDNY) LIMITS A GENERAL LIABILITY IPR 3757 608-01 03/01106 03/01107 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' GENERAL AGGREGATE $ 4,000,000 CLAIMS MADE X PRODUCTS-COMP/OP AGG $ 4.000,000 ❑occuR 'OF SIR:$1,000.000 PER OCC' PERSONAL 8 ADV INJURY $ 4.000.000 OWNER'S 8 CONTRACTORS PROT EACH OCCURRENCE $ 4,000,000 FIRE DAMAGE(Any one fire) $ 1.000,000 B AUTOMOBILE LIABILITY BAP 2938863-03 AOS MED EYP(Anyone person) $ EXCLUDED o3r01/as 03/01107 COMBINED SINGLE LIMIT $ 1.000.000 X ANYAUTO ALL OWNED AUTOS SCHEDULEDAUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per accident) $ X ELF-INSURED AUTO HYSICAL DAMAGE PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO !DISEASE-EACH LY-EA ACCIDENT $ AN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ URRENCE $ UMBRELLA FORM TE $ OTHER THAN UMBRELLA FORM G WORKERS COMPENSATION AND 6610998(AZ,ID,MD,VA $ EMPLOYERS LIABILITY ) 03/01/06 03101!07 C 6610995(AOS) LIMITS OER G THE PROPRIETOR/ X 03/01/06 03/01/07 CCIDENT $ 1.000,000 PARTNERS/EXECUTIVE INCL 6611326(OR) 03/01/06 03/01/07 E-POLICY LIMIT $ 1.000.000 E OFFICERS ARE EXCL 6610999(NY,WQ 03!01!06 03/01107 WORKERS EACH EMPLOYEE $ 1.000.000 E COMPENSATION CONTINUED 6610997(FL) 03/01/06 03/01/07 D 6610996(CA) 03/01/06 03/01/07 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, FOR INSURANCE PURPOSES ONLY THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAL_ 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Walter Gilstrap li �aK: aLp�, MM7(3/02) VALID AS OF: 02/27/06 AT-HOME anstaooed Siding and Windows 1N s�, :Jlf+� �ai>rn�evrrus<arrtC� e�/: ��x.7.3err:��r:SP,l� Board of Building Regulations and Standards License or registration valid for individul use only f" HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: -'i Registration: 126893 Board of Building Regulations and Standards Expiration: 8/3/2008 One Ashburton Place Rm 13.01 Type: Supplement Card Boston,Ma.02108 THE Home Depot At-Home Servic AT1NROEUN CHHOUY 3200 COBB GALLERIA PKWY#20 NtIANTA,GA 30339 ------ '~ Administrator Not valid without signature Proudly sold,furnished and installed by RMA Home Services,Inc.,a Home Depot authorized contractor. 345 Greenwood St.Unit 2•Worcester,MA 01607•508-756-6686•Fax 508-756-2859•Toll Free 800-657-5182 Oct 03 06 06:55a tim saari 16038863430 p.6 HOME IMPROVEMENT CONTRACT �U Lllo / Sold.Furnished and Installed by: Branch t\ame: Date:C lv THDAt-Home Services,Inc. d/b/a The Home Depot At-Home Services / �Sr— 345A Greenwood Street,Worcester,VLA 01607 Branch Number. Job#: ! TolI Free (800) 657-5182; Fax:508-756-2859 Federal ID#75-2698460 ME Lic#C 02439 RI Cont.Lic#16427 CT Lic 1565522; MA Home Improvement Contractor Reg.#126893 Installation Address: ",no CD10A�r City Stat Zip Ppr+reser s: Last 4 DI its of Driver's Lic.#&Exp.Isfo/Yr: Work Phone: Home Pboue: Home Address: �24"52?! (If different from Installation Address) Citv State Zip E-mail Address(to receive updates and promotions from The Home Depot): Proiect Information: MVe/You ("Purchaser").the owners of the property located at the above installation address,offer to contract with Home-Depot U.S.A., Inc. (` m� deliver and arrange for the installation of all materials as described on the attached Spec Sheet# ` 7 incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if, upon reinspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with the home,pricing errors or because work required to complete the job was not included in the Spec Sheet or Contract. DEPOSIT PAYMENT OPTIONS (Subject to fund verification andlor credit approval-) CONTRACT AMOUNT S ��Q�—�� 1. Check,Cashiers Check or US Postal Service Money Order (Made payable to The Home Depot). *LESS DEPOSIT $ L 2 Credit Card`andlor other payment options-Circk One Below Visa MasterCard Discover American Exp. BALANCE DUE The Home De of Home I ON COMPLETION P mprovement Loan T Home Depot Credit C 7 New Account C Existing Account (HIL&HDCC ONLY) *Minimum 25%of Contract Amount due upon S execution of this contract Available Credit: (HIL&�HDCC ONLY) r- Acct#: g 'Daste ["i Dame as Et appears on ca �.! � Indicate Payment Method For "By my/our signature below,ItWe agree to allow Home Depot to BALANCE DUE ON COMPLETION: charge the above re renced credit card for the deposit indicated. „ r older's Signature Date HIL or HDCC Authorization Codes C� Deposit Final Payment SUBMITTED BY: Date: Sates Consultant ACCEPTED SY rG/,tGZs� ` Ka_ waIdG� tte: lam"1-4(�• Homeoemer Homeowner Date: NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT 4-07-06 C-SC White—Branch File Yellow—Customer Pink—Sales Consultant