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Home My WebLink AboutBuilding Permit #240 - 11 WALKER ROAD 2/27/2006 tORT" X. ° p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION +r.° ,SSACHUSES Permit NO: O Date Received: Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION \� \ Print PROPERTY OWNER �)('7C1r�� (2 �• �� _ Print MAP NO.: PARCEL: 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: XRepair, place ❑ Assessoiy Bldg ❑ Commercial ❑ Demolitio ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED nn \ Identification Please Type or Print Clearly) OWNER: Name: \ J nG�� Phone: Address: CONTRACTOR Name: �r-)Nvp � Phone: -7� ` `�-7 c �o _ G4E:P0[)t11—WJ Address: �,1.(ri S—f" ► A fir,c� o��C�' Supervisor's Construction License: Exp. Date: Home Improvement License: r �(4�5�� Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PER T.$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST ASED ON$125.00 PER S.F. Total Project Cost :$ , UyU x10.00=FEE:$ Check No.: f `[ `� Receipt No.: Page Iof4 TYPE OF SEWARGE DISPOSAL i wmmn SiPools ❑ F1 Tobacco Art ❑ g Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ❑ ❑ Permanent Dumpster on Site Private(septic tank, etc. Electric Meter location to project— NOTE: roject_.NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of Contractor Plans Submitted ❑ Plans aived ❑ 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: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer connection signature&date Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 i i 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) Nage 3 of& Doc:INSPECTIONAL SERVICES DEPARTMENT:13PFORM05 Created JMC.hn.2006 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) i ❑ 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 Dor:INSPECTIONAL SERVICES DEPARTMENTMFORIN105 Page 4 of 4 //Location No. U Date r �oRT� TOWN OF NORTH ANDOVER • o:i...° •1�0 O? • • os F A 41 Certificate of Occupancy $ '- �'�s MUBuilding/Frame Permit Fee $ 4 zACs �— f Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 'vi 19620 Building Inspector MARSH � ` a CERTIFICATE OF]NSURANCE cERnFIQATE"UM�R = ATL-000915907-11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA,INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE ATTN:BRENDA BOOKER (404)995-2594 POLICY.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE MAYA MCCLURE(404)995-3206 OR AFFORDED BY THE POLICIES DESCRIBED HEREIN. TAMI ROUSE(404)995-3430 FAX(404)760-5663 COMPANIES AFFORDING COVERAGE 3475 PIEDMONT ROAD,SUITE 1200 ATLANTA,GA 30305 COMPANY 00492-IPUSA-GWA-03/04 A STEADFAST INSURANCE COMPANY INSURED COMPANY THD AT-HOME SERVICES INC. B ZURICH AMERICAN INSURANCE COMPANY DBA THE HOME DEPOT AT-HOME SERVICES,INC. HOME DEPOT USA,INC. COMPANY 2455 PACES FERRY ROAD NW C NEW HAMPSHIRE INS COMPANY BUILDING C-8 ATLANTA,GA 30339 COMPANY D AMERICAN HOME ASSURANCE COMPANY COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below. 3 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANYCONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MMIDD/YY) A GENERAL LIABILITY IPR 3757 608-01 03/01/06 03/01/07 GENERAL AGGREGATE $ 4.040.000 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' PRODUCTS-COMP/OP AGG $ 4.000.000 CLAIMS MADE OCCUR 'OF SIR:$1,000,000 PER OCC' PERSONALBADV INJURY $ 4•QOQ•� CWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE $ 4.000.000 FIRE DAMAGE(Any one fire) $ 1.000.000 MED EXP(Anyoneperson) $ EXCLUDED B AUTOMOBILE LIABILITY BAP 2938863-03 AOS 03/01106 03101/07 COMBINED SINGLE LIMB $ 1.000.000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ ( NON-CW NED AUTOS Per accident) ELF-INSURED AUTO HYSICAL DAMAGE PROPERTY DAMAGE $ X GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ G WORKERS COMPENSATION AND 661099$ AZ.ID.MD.VA WC STATU- O EMPLOYERS'LIABILITY ( ) 03/01/06 03/01/07 X I TORYLIMITS ER _ C 6610995(AOS) 03/01/06 03/01/07 EL EACH ACCIDENT $ 1.000.000 G THE PROPRIETOR/ X INCL 6611326(OR) 03/01/06 03/01/07 EL DISEASE-POLICY LIMIT $ 11000.000 PARTNERS/EXECUTIVE 6610999 NY,WI) 03/01/06 03/01/07 E OFFlCERSARE: IXCL ( EL DISEASE-EACH EMPLOYEE $ �•OOQ•� OTHFR WORKERS E COMPENSATION CONTINUED 6610997(FL) 03101/06 03/01107 D 16610996(CA) 03/01106 03101/07 DESCRIPTION OF OPERATIONS!LOCATIONSIVEHICLESISPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE ME EXPIRATION DATE THEREOF. THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO IML An DAYS WRITTEN NOTICE TO THE FOR INSURANCE PURPOSES ONLY 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 MMI(3102) VALID AS OF: 02/27/06 r NORTEy own o _ Andover No. zqo LA E dover, Mass., A- COCHICHEWICN 7� ORATED PP�� `S BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT. D4f0VP1V.......� ,!�/..� .......................................AV Foundation r buildings on . has permissiontoe a t........................................ `t!�. �.� ..... .............. Rough /...... to be occupied as.... �r Chimney provided that the p son acce ing this permit shall in every respect 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 Final 3b PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR " S RTS Rough . ..................41� ... ... Service UILDING INSPECTOR Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. m 1 m _ T n O Board of Building Regula 'ons and standards m - - One Ashburton Place - Room 1301 R N Boston. Massachusetts 0210E Home improvemed—,Contractor Registration Registration: 128893 YD pplement Card RXp[ration: 8'aQ(308 THE -tome Depot At-Home Se�it ps=� �=_�.��. ' �; ;a i-.'': ------ ----------------------- = a.�"L r.- BUNROEUN CHHOUY - -- ------- _—_. �„ 0 3200 COBS GALLERIA PKWY #24G`.r- ---- G.A 30339 4-�• •�;—�~ Update Address and return card.N12 rk resron for change. .� oPs-C-,ti ii sr osu&Pce44a L] Address (j ReneNval U EmploymentEj Lost Card *� /211esmr�aanunmz!<. ,.t' ;Evastellb VO He:rd o[Building itegulaCem and Standag ds License or registrstion valid Cor tndividul use only HO-ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Regiotratlan. 126893. Board of Unitding Regulations and Standards �! �°nom 9 .!2008 One Ashburton Place Rm 1301 +I:I =-- �: Boston,Ma.92108 'f �.T�e._:$wpOlementCard 0 THE Horne Dcplo- RAW Se[ViF l3IJNR{ltuls` G`HiiO�1X'a,�';r�_,_j I`[ 3Q200 CON GALLERIA I-CWrX rzu T XUAWA.GA 3D339 -- A..-------- AdmfnGstrat�r hot v54lid without signature W I i Monday,September 25,2006 7:55 AM Craig Smith 603-594-5973 p.04 HOME IMPROVEMENT CONTRACT .to Sold,FD At-ed and InstalledServices, Inc.. Branch Name: p ft Date: `f��l t� THD At-Home Services, n d/b/a The Home Depot At-Home Services 345A Greenwood Street,Worcester,MA 01607 Branch Number: Job#: %ost�'�3 Toll Free(800)657-5182; Fax:508-756-2859 e&ral IDA 75-2698460 ME Lic f C 02439 RI Cont.Licit 16427 (� Lic 4 565522; MA Home Improvement Contractor Reg.6126893 Installation Address: ( w a j-+k e r Q • Ali A n 1 n o e_X M4 a 1 g-tty— City State Zip Purchase s: Last 4 Digits or Driver's[Ac.N&Exp.Mo/Yr. Work Phone: Honte Phone: Home Address: (If different from Installation Add—rr City —T State Zip E-mail Address(to receive updates and promotions from The Home D:pot): Project Information: I/We/You("Purchaser"),the owners of the property located at the above installation address,offer to contract wit t Home Depot U-S.A.,Inc. Home De oxx") o furnish,deliver and arrange for the installation of all materials as described on the attached Spec Sheet#( a,4 6_7y� i icorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if,upon re-inspection 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 antllor credit approval.) CONTRACT AMOUNT $,;)y 31 apo t. Chec ashiem Cheek of US Postal Service Morey Order � / e playable to The Horten Depot). G*LESS DEPOSIT $ - V 2. Credit t:ard'and/or other payment options-Circle One Below Vis: MasterCard Discover American Express BALANCE DUE The Home Depot Horne Improvement Loan The Home Depot Credit Card ON COMPLETION AD 1 0� J New Acco mt n Existing Account (HIL&HDCC ONLY) "Minimum 25%of Contract Amount due upon Availalde Credit:S (HIL&HDCC ONLY) execution of this contract. AccW_ Exp.Date: Name as it all pears on card: Indicate Payment Method For -By my/ot.r signature below,I/We agree to allow Home Depot to BALANCE DUE ON COMPLETION: charge the above referenced credit card for the deposit indicated. Cardholder's Signature Date v HIL or HDCC Authorization Codes Deposit Final Payment # +iV— Purchaser agrees that,immediately upon completion of the work,Purcl.aser will execute a Completion Certificate and pay any balance due. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire Aereement:This agreement and its attachments,including art financing agreement,contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both patties. NOTICE TO PURCI-ASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign a Completion Certificate before this project is complete. Law prohibits home repair contractors from requesting or accepting a ::ompletiou Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. There hill be a service charge equal to 25%of the contract amount if the job is cancelled by Purchaser AFTER the third busin ass day. BY MY/OUR SIGNATURE BELOW, I/WE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. I/WE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT P ND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW,UWE UNDERSTAND THAT TELL AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND I(WE AUTHORIZE HOME DE'OT TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVE [SSI NS OR ERRORS. SUBMITTED.BY: Date: /.xa Cn t ACCEPTED BY: t/ Date: 2 Homeowner - Date: Homeowner 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-Customrr Pink-Sales Consultant