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Building Permit #227-13 - 137 SUTTON HILL ROAD 9/20/2012
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: � Date Received I Date Issued: - L IMPORTANT:Applicant must complete all items on this page I LOCATION 131 JV`-l\, CJ I ti S- Print PROPERTY OWNER_g s g- l�LN�A e_ C o\f�r`,) Unit# Print MAP N0: b�� PARCEL(�7 ZONING DISTRICT:{�` Historic District yes j Machine Shop Village yes o 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑AI tion No. of units: ❑ Commercial 21�epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p c) Welly`. F od�'ids I in O Wetlan � i Watershed Dis nct ' t s ®Water/Sewer, DESCRIPTION OF11 WORK TO BE PERFORMED: I R� �rr � �` l,J�•.. GUw S— (10 S i(` i r T�1 �. \ C� �1�c�,c -. (Identificon Please Type or Print Clearly) OWNER: Name:3v ruflr-b Phone: Addressd 3� &,�-",n `-4A0-c� ��� r ✓moo. dl� F CONTRACTOR Name: J(` n bC18A�,!, � Phone:gLY-�-3,7�-�c)u 4 Address: b 1LA C) S i �rj (S-3 Supervisor's Construction License: 5 Exp. Date: I Home Improvement License: 1d g l Exp. Date: ARCHITECT/ENGINEER_ Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �� ,�,� FEE: $_(3�.u6 Check No.:--C��60�1 Receipt No.:_��'�- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signa#ure ofA` ent/®vvner� ;.. _ - - �g. .. } Si gnatu`reoftcontraetor.� _ r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ 1 COMMENTS nature CONSERVATION Reviewed onSi g � COMMENTS e HEALTH Reviewed on Signature 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 Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date L Doc:.Building Permit Revised 2011 June/mi 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks ❑ Building Permit Application ❑ Certified 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit 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 Doe: Doc.Building Permit Revised 2008mi Location ' �42 11, No. \ Date q • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Fee Building/Frame Permit Foundation Permit Fee $ Other Permit Fee $ TOTAL $ s Check# U 25733 Building Inspector � NORT1� own -oft : Andover 0 No. - VL h 0 h ver, Mass C7 ` Y O LAKE COC KI CKl WICK �d A0RATEO S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System � ,�'►� J BUILDING INSPECTOR THIS CERTIFIES THAT ...... .... ...... ......:................ .................... ............. ..i. .................... A... Foundation has permission to erect .......................... buildings on ....`.� ....... ..... ........... Rough to be occupied as ..........(ce ..�. .............. .......... ...............?............. `1 ..�:................ Chimney provided that the personpti 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. - , Final PERMIT EXPIRES. IN. ONE S ELECTRICAL INSPECTOR UNLESS CONSTRTLIA S TS Rough Service .................. ...... ................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired 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. SEE REVERSE SIDE Rene�r � �r; byAndersene WINDOW REPLACEMENT atiAndet aviCompany ,ffo?: Wood�nyi Composite IF Etu rgi✓�rr.kc9,� Dual Argon Low E4 SmartSun .k 1W. Double Hung 100-00473618-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)/1-PSolar Heat Gain coefficient ' 2■ A ADDITIONAL PERFORMANCE RATINGS Visible Transmittance ® 4 2 Manufacturer stoubtes that tbaee"ting-conform m apPksbg NFRC procedures for dtletmhiAg Whole product Performance,NFRC rating-ere determined for a Poked aet olanvironmenMleondikxrs arM a specific product sce. NFRC does not recommend any product and does not Wamnt the eubatifty of any product for any specSre use, Consul"matlufacluMr's Memiure For other product per(cM)Uce IIt(dmta110n. WWW.n1M.0r0 The product meats Green ! Seafs environmental csneb .;x .1—darnsm' a Y"•�t l aificianey;haat''malaI3In ��r+"jr•;•••.V, Y�• +pr,�r Al the IMAM and sash ff" lftattfK packhgMq.and ' Y'•.yr consumereducalkmal r Y `rs mater(ats 11S.r R,0. fr t'`"!e%irp"5 DESIGN PRESSURE(PSS s�plss�t H 'g �(�'+ "%.�t-114 RbA DB Sloped Sill DH IN Tts1WB1WS920r04M•NMIdfSh1011151M*pK MXUU&g or Omates Onllfotmanpa to 4lga SGBCIa spMafQt, daets or exceeds M.E.C.,C.E.C,61.EC.C.Ah inn rwion requirements VVphtA HaW nelk CenWioatioo program. ' I I Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS-095707 BRIAN D DENNISON 7 LAMBS POND PIRG Charlton MA 015b7 Expiration Commissioner 09/08/2014 ✓� �dr�maruuea�� g E office of Consumer Affairs&B siness Re uladon HOME IMPROVEMENT CONTRACTOR Type. i Registration: .t 170810 Corporation Expiration: 7 2312013 € ORATION R WAL BY ANDERSEN C(3Rf' "v. E BRIAN DENNISON } 104 OTIS ST. NORTHBOROUGH,MA 01332. Undersecretary r 4 r i 1 �j f M. Q ee ��++pp ��FF ® � DATE(I1IMRID/YY t NGE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS ND RIGHTS UPON THE CERTIRC:4TE HOLDER- THIS CEKTIHCATE DOES NOT-AFFIRMATIVELY OR NEGKTTVELY AMEND, EXTEND-OR ALTER THE'COVERAGE AFFORDED BY THE POLIGIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT C0h5T TUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESEArT,kMFE•OR PRODUCER,AND THE CERTIFICATE HOLDER,. IMPORTANT: If the Certificate holderls an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGA.TIDN IS WAIVED, subject tD the tenns and conditions af.the policy,Certain policies may require an endorsement. A statement on this certificate does not confer rights to the trfilficate holder in Rev Of such endorsemengsi). PRODUCER 1-E12-333-33 Z3 COACT Jaaelle Hargrove or Xa.tie Psi=S Hays COmpaaiee PHONE'CL 612-333-3323 (FAIAG,No; 612-373-727D BD South Bth 6t>`eet pDDREM. RwLte .7DD PRODUCER . hfinneapolis, ME.554132 ID INSURER AF-FDR13IND COVERAr.E NAIL 9 INSURED MSURERA; OLD Alemmr.rc ffi6 CD 24147 &enawal By AnAI qea C.CILpC=atiari INsuREt fl: RBTIOHAL TIILSOH rm iNS CO OF FLITS L9d45 LDA Otis Street INSURER C: Flartkibarangh, •ffi Q1532 INSURER D: INSLRERE; ' INSURER F: . ' COVERAGES CERTIFICATE NUMBER: 25114297 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LJ=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 TD WHICH THIS CERTIFICATE MAY BE.ISSUED-OR MAY PERTAIN, THE NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN'IS SUBJmT TO ALL THE TERMS, EXCLUSIONS AND CONDIYIONS-OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN R:mUCED'BY PAID CL41MS. INSR A13DLSUBR POUCYEFF POLICY EXP LIMR6 LTR TYPE OF INSURANCE g POLICY NUMBER D MMIDD . A GENERALLL43L rY XWEY 55313 EAC•LD Q1 LD/Ql/12 OCCURRENCE b L,DDD,DDD / / H % COCIIIL GENERAL LIA91LrrY PREMISESDAMAG rs ou nes b 5 D D,D D D CLAIMS-MADE M OCCUR MED EXP'Any one pw=n) PERSONAL&ADV INJURY b 14",D D,DDD GENERAL-AGGREGATE $ A,D D D,D D D GEhII-AGGRE GkTE LIMr.APPI ES PET.—PRODUCTS-COMPlOP AGG % POLICY 7 PRO LOC _ A AUTOMOBILEUASDITY XKM Z2_377 LD/OL/ LD/OL/12 COMBINEDSINGLEUMIT ;•3,DDD,ODD . (Ea acddoo ANY.AUTO BODILY.INJURY(ParpersoN j ' ALL owNED Athos BODILY INJURY IF erncddant) b SCHEDULED AUTOS PROFLSCTY DAMAGE b HRED AUTOS fparacdd-1) b % NON-OWNED AUTOS B X . UMBRElLALJAS % .00CUR 25D3D5L9 LD./QL! 1D/QL/12 EACH'OCCURRENCE b 25,DDD,DDD E=ES'6.LIAB CL-AIM5 MADE AGGREGATE b 25,D DO O D D b DEDU=BL.E % RETENTION b25,DDD b We STkTLI K_ OT A WDRKEP.SCDWENSkTION XWC 117LdD DD LD/Q1/ LD/Q1/Lz % ANDEMPLOYERrUABILJTY 7•IN EL.EACHACCIDEIJT $ I.,ODD,ODD ANrFROPRIETOR/PAR7NER/EXECLMVE NIA DFFEER/MEMBEREXCLuDED7 (Narmbdory in NH) EL DISEASE-EA EMPLOYEE,.F L,DDD,DOD R yec,dm=fte underL,D D D,DOD DESCRIPTION OF OPERATIONS balrn9 EL DISEASE-POLICY UMrr b DESCRIPTION OF ON MAMM I LOCATIONS/VEHICLE (AltaoAACORD 1 Dt,Addmonal P.emads Schedule,*znv opac it tequimc) Ev�_d=n.ce of Sa=•,,-.+„tee., . CEkTIFICATE:HOLIER CANCELLATION I tia of r,;.n.�—TcM SHOULD ANY OF THE ABOVE DESCRIBED POliCD3-BE CANCEIJFD'BEFORE THE .EY,PIii',A-nOW DATE THEREOF, NOTICE 'WILL BE- DELIVERED IN ACCORDANCE WTM7HE POUCY PRDVGIONS AUTHORRED REPRESEUMME - OW - v4i= ®-4S38-Z0R9 ACDRD CORPDRA.TION. All rights reserved :rrsrrr D rannnrnaL "ri,A Ar_-aRD.Rame'and'iOOD are mc0stared maim of ACORD The Cummaxwealth of Idassachcs.a is Departmee.©f I?id stial A6.gidzni r Office of Ewpestigaions 600 Waikington,breed Gaston;M4 k111 www.man.-goldia Workers 'Compensation Insurance A-Mdavit: $ceders/Co�tzaefors/ eetr ei zs/P��mbers A>v►,plirmnt Information Piene Priat Ledbl EIM (Bu6iness/0Tm izadondndh6dueij. c'\P uArk \ V)LJ Address: �•d y �'�s ST . . - - CitylSt�te/Zip: i`Jrx-_�A �Lw`o, Phone Are you an employer.? Check the appropriate'bar, Type of project(req red): 1, I am a Mz loyor with '3 C� 4. ❑ I em a general contisctor and I 6. ❑New construction employees (fall and/orpart-time), ��hired the sub-contractors listed on the attached sheat# 7 2,El am a sole proprietor orpartner- ' ship and bane no employees These mn_cort mc=have 8. E]Demolition WOr}�rS' inMnrgnCe, addition . w in r 8G Cep 9. +� far me zty, ❑ ar1� ffiy rap e are a c oration and its 5• ❑ W Corporation [No workers comp, msmance 10.❑Eloatrical repairs or additions �gui�] officers have a Braised their . 3,❑ I am a homeowner doing aE work right of exemption per MGL 11.❑Plumbing repairs or additions myself [No wod=T,.comp. c. 152, §1(4), and we hgve no 12.7 Roof repairs inmramb mmTired.] t employees. [No workers' 13.❑ Other ppmp,insnrs+nce Mquired.] =Any applicant bast ch=ks box#1 mist also ffi out the section be1Dw showing their wwl=s compensation pofiop iatimaation t Homeowners who submit this of davit indicating they as dung all wort and then hit:outride cmtact=most m*,dt a new affidavit mdicatmg such. lC� ,tMn-twat chest bail box must aHached an additional shut showing tae Mame Df the'sab-ceuiract=s and tact wadmrs'camp policy iafazmazim I am an.empltrper that is providing work..ers'compezc aduit insurance for rry empiapees. Below is the pa5cy and jab she Insurance Company Name:_ L' C�C��\ C r1 S a Policy W or Self-ins, Lic, #- FiTiration Bata: Iab Site Address: I�� -•��-n,n ��,\� -\`� City/.State/Tip: Iy' �✓���►r_�`, tl�n 0��`��� umber.arid ir-adon dzte), anon aiic declaration •a: a eta the policy n � .A.tta.ch a copy of the workers campers policy Page( � Failure to¢ecure coverage as regrured-under-Section 25A ofMGL c• 152 can lead to the imposition of crbnir al penalties of a fine up to �1,500.00 and/or one-year imprisonmmat,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to X250.00 a flay against the violator. Be.advised-that a copy aft3us statement maybe forwarded.tu the Dfrice of kwsfigadom of the.DLk for mmrunm coverage verification. n _ .1 do hereby.cer-45j r :the p penakia af.Pe rj)tart 6ze infarrrra6im provided above is Erre =arid correct. bats, Phone# - gff=al use only. Do not wri&in tkis.rareg tv be cvznpLetsd-by city or wwn..rrficcaL {may nr Tave;•x permit/Lacetxse# �ss»g Auffiority{eirr3e.one): • -1. RD;ard of Heal& 2,Smldnag Department .3. Citg/'I'awn Clerk 4;Eaectical hyspedw S.Plgmbh9°�pectar :L-per. Contact-arsaw: Phone '' RenewalMA Home Improvement Contractor • -- License#170810(Expires ]2/23/20]3) byMdersen. WINDOW REPLACEMENT an Andersen Company Renewal by Andersen Corporation Federal Tax ID#41-1918413 104 Otis St.,Northborough,MA 01532 (508)351-2200•Fax:(651)351-4810 CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name ii Date of Agreement d " t1i U Fav Buyer(s)Street Address,City,state,and Z Code E-Mail Address Home Tele hone Number Work Telephone Number Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Renewal by Andersen Corporation ("Contractor"),in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s) (collectively,this"Agreement").Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. G Total Job Amount: Estimated Starting Dater Method of Payment: Deposit Received(33% ) d � u ❑Check ❑Cash ❑Fin anted Balance at Start of Job(33%): /d�_ a/MC ❑Discover ❑AMEX Estimated Completion Date: Balance on Substantial If credit card is selected,please see Credit Card — Payment Form. Completion of Job(33%):—/0-0-7 Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties, and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alteration to or deviation from this Agreement will be valid without the signed,written consent of both Buyer(s) and Contractor. Buyer(s) hereby acknowledges that Buyer(s) 1) has read this Agreement, understands the terms of this Agreement, and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Renewal by Andersen Corporation Buyer(s) Buyer(s) By: Ju Signature of Product Manager Signature Signature Oc Kt fI� Print ame of P oduct Manager rint Name Print Name 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 FORMS FOR AN EXPLANATION OF THIS RIGHT. — — — — — — — — — — — — — — —�,c- — — — — — — --- — — — — — — -91<— — — — - -- — — — — — — — — — NOTICE NCELLATION X NOTICE OF CANCELLATION Date of Transaction `Ii. You may cancel Date of Transaction . You m cancel this transaction,with o an penalty or obligation,within this transaction,without any penalty or obligation within three business days from the above date.If you cancel,any I three business days from the above date.If you cancel,any property traded in,any payments made by you under the I property traded in,any payments made by you under the Contract of Sole,and any negotiable instrument executed I Contract of Sale,and any negotiable instrument executed by you will be returned within 10 days following receipt I by you will be returned within 10 days following receipt by the Contractor ("Seller") of your cancellation notice, by the Contractor ("Seller") of your cancellation notice, and any security interest arisingout of the transaction will and d an security I y ty interest arising out of the transaction will be canceled.If you cancel,you must make available to the be canceled.If you cancel,you must make available to the Seller at your residence,in substantially as good condition Seller at your residence,in substantially as good condition as when received, any goods delivered to you under I as when received,any goods delivered to you under this this Contract or Sale; oryou may, if you wish, comply I Contract or Sale;or you may,if You wish,comply with the with the instructions of the Seller regarding the return instructions of the Seller regarding the return shipment of shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk.if you do make If fou do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not Seller does not pick them up within 20 days of the date I pick them up within 20 days of the date of your Notice of your Notice of Cancellation,you may retain or dispose I of Cancellation,you may retain or dispose of the goods of the goods without any further obligation.If you fail to without any further obPgation. If you fail to make the make the goods available to the Seller, or if ou agree I goods available to the Seller,or if you agree to return the to return the goods to the Seller and fail to do so, then I oods to the Seller and fail to do so,then You remain liable you remain liable for performance of all obligations under I for performance of all obligations under the Contract. the Contract.To cancel this transaction, mail or deliver a I To cancel this transaction, mail or deliver a signed and signed and dated copy of this cancellation notice or any I dated copy of this cancellation notice or any other written other written notice,or send a telegram to Contractor: notice,or send a telegram to Contractor: Renewal by Andersen Corporation, 104 OtisI Renewal by Andersen Corporation, 104 Otis Street, Street, Northborou h, MA 01532, BY NOT LATER THAN Northborough,MA 01532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF - - .(Date) OF ,(pate) I HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature Print Nama Date I Buyer's Signature Print Name Dale RbA CoDv- White Buyer Conv-Yellow Buyer Com-Pink (lRll P9nn9 RRA-Ph MANH Renewal % ,_,newal by Andersen Corporatic MA Home Improvement Contractor bYAnderSene 104 Otis St.,Northborough,MA p 1532 License#170810(Expires 12/23/2013) byAndersent WINDOW REPLACEMENT an Andersen Company (508)351-2200•Fax:(651)351-4810 Federal Tax ID#41-1918413 WINDOW SPECIFICATION SHEET Buyer(s)Name Date of Agreement f- �, Y � The Buyers)listed above ereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on the Specific tion Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT, of which this Specification Sheet is a part. WINDOW DETAI S l. ttractor will Install a total of windows in Owner's home,using the following individual quantities: Double Hung(DB) ual sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) Casement(CW) ❑ Hinge right ❑ Hin e left(as viewed from exterior): ❑ Standard handle ❑ Metro handle Double Casement(CDW) ❑ Standard handle ❑ Metro handle Casement/Picture/Casement(CFW) ❑ 1:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle 2 Lite Gliding Window(GW) Glider/Picture/Glider(GPW) ❑ 1:1:1 or ❑ 1:2:1 Awning Window(AW) Picture Window(PW) $ay or Bow Window Patio Doors(see se79r to Doo Specification Sheet) 2. Lr.1/Yes ❑ No ty of Windows to be Custom Fit Replacement: - /� 3. ❑ Yes ty of Sills to be replaced by Contractor: 4. ❑ Yes No Qty of Windows to be New Construction Full frame(includes new interior&exterior casings)and actual Exterior casings: Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: P Low-E-4 TM ❑ Other If other,please specify: 6. Exterior color to be: V94 ite ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean 7. Interior color to be: hite F] Sand ❑ Canvas ❑ Terratone ❑ Pine ❑ Maple ❑ Oak Note: Inter' color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner. 8. Hardware: PrWhite ElStone E] Canvas [IBrass ElEstate Hardware: Style: 9. © Yes ❑ No Install Lifts with Double Hung Windows 10. Screens: windows to have: Half or ❑ Full screens Screens to be: Fiberglass ❑ Aluminum ❑ TruScene GRILLE DETAILS 11.Windows have grilles: ❑ Yes VNO If yes:❑ Grille Between Glass(GBG)❑ Removable Interior Wood(Itrlw)❑ Full Divided Light(PDL) Qty' Qty Qty: Qty' Qty Qty: Qty: �H DH OH DH CWIPicture Glider CPW or Draw grille patterns above Use additional sheet if needed Owner approved(initials): ADDITIONAL WORK DETAILS 12.❑ Yes [� o Contractor will remove metal frames of windows. Qty of Units: 13.❑ Yes [_No Contractor will install new paint-ready or stain-ready casings. Interior c ng qty of openings: Exterior cas®read , ngs: ❑ Pine [I Maintenance-free material 14.❑ Yes �No Contractor will install new paint-ready or sr outside stops qty of openings: Interior stops qty of openings: Exterior stop ❑ Pine ❑ Maintenance-free material 15. Owner is a that Contractor does not do any painting. wner Initials 16.❑ Yes No Contractor will wrap exterior casings with ak of color. /Note: Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17.Res ❑ No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. 18VOesNo Cleanup all job related debris including old windows will be removed.Vacuum nightly. 19No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 20No Building Permit--Contractor will secure any and all necessary permits. The fee for the permit(s)is not iDcluded in the Contract Price and a separate check is required at the time of sale for this fee. 21. es ❑No All discounts have beenapplied t th',agreynen r• e. 22. Additional job details: / / �. 23. es ❑ No Owner agrees to be present on the final day of installation for firial inspection and to deliver final payment. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. It is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet. Renewal by Andersen Corpo•ation Buye� ' � �J"`J" r(s) By: '_ , Signature of Product ager Signature Signature Z � Prin Name of Product Manager Print Name Print Name Date...... 4, TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ...................&........................ has permission to perform ............ .................... ........ ... ..... wiring in the building of.97...................... ..... ... ..................................... ... at......./.3........7 ...................... Al) ....z" .. ........gNorth Andover,Mass. Fee..,9.e........... Lic.No.,,;;K.? 7. ........... . . . ...... ...... .. ....... ELECTRICAL INSPECTOR Check # 7995 Jif♦�j r�r Commonwealth of Massachusetts official Use only Permit No. Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS�VjOccupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: —e� City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) -Z� /It / A6 Owner or Tenant OSe ILcN far/-v Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ElNo (Check Appropriate Box) Purpose of Building S t4,L,—-e Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: f — 74 Completion of the ollowing table may be waived by the Inspector of Wires. No,of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No,of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No,of Luminaires Swimming Pool AboveElIn- ❑ o.o mergency Lighting nd. nd. Bette Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No of Zones No.of Switches No.of Gas Burners f' No.of Detection and InitiatinLy Devices No,of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers .Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mumcipal ❑ Other Connection No.of Dryers Heating Appliances , Security Systems:* No.of Devices or E No.of Water N .of o.of uivalent No t Heaters KW Si s Ballasts . Data Wiring: No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring. OTHER: No,of Devices or Equivalent ` Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the s ape aloes of perjury hat the information o his application is true and complete. FIRM N i r fie! d�l�u� LIC.NO.: Licensee: r 5 / ✓n�t.v Signa e t LIC.NO.:Z�9a7;� (If applicable, enter"exem ' in the license number line.) Bus.Tel.No7r�C —��3J Address: fJ - �C 115 /191 • bDUeF Yl t� O! ,/S Alt.Tel.No.W:5&—7r-951 *Per M.G.L c s. 7-61,security work requires Department of Public Safety"S"License: Lic.No. D� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally SS required by law. By my signature below,I hereby waive this requirement. I am the(check one) F-1 owner ❑owner's agent. Owner/Agent ' S� Signature Telephone No. PERMIT FEE:$ The Commonwealth of Massachusetts k ! Department of Industrial Accidents Office of Investigations VIM600 Washington Street i1 Boston, MA 02111 i { www.ntass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Leaibl G ' Name(Business/Organization/Individual Address: P. C)- City/State/Zip: Xa• A- 4X - ktt'f Phone g Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 aro a employer with 4. ❑ I am a general contractor and I 6. ❑New construction ployees{full and/or part-time).* have hired the sub-contractors 2. I am e.sole proprietor or partner- listed on the attached sheet t 7. El Remodeling ship and have no employees These sub-contractors have 8. Q Demolition working for mein any capacity, workers' comp. insurance. g Building addition 1 [No workers'comp.insurance 5. ❑ We are a corporation and its 10 Electrical repairs or additions required.] officers have exercised their 3.❑ I ani a homeowner doing all work right of exemption per MGL I I.Q Plumbing repairs or additions myself.[No-workers'comp. c. 152, §1(4),'and we have no 12.0 Roof repairs insurance required.]t .employees. [No workers' comp. insurance required.] 11M Other *Any applicant that checks bo-I#l must also fill out the section below showing their workers'i:ompensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy infonnation. I am an employer that is providing workers'compensation insurance for►try employees: Below isthe policy and job site information. Insurance Company Name: ' Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$4500.00 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 violator. Be advised that a copy of this statement may be forwarded to the Office of : Investigations of the DIA for insurance coverage verificati n. I do here cert undert d p attic f rjury that the information provided above is true and correct. Siena e: Date: Phone#: / ��—G� 9p2-,? 7 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Date Al. .�,�4)G . ... .. .. ,&ORTp r pF ��:o ,° O I �,t + �` TOWN Of NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION �,SSACHUSES This certifies that . . . /(v. . . . . . . . . has permission for gas installation . rG!? �-. !. . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . 1. .?. . St. /.` - .�7: �. .�.��., North Andover, Mass. Fee. .?9. ... . Lic. No. ,�1. .l !.t . . . � ,. . . . . . . . GASINSPECTORO r Check# 6321 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: 4Z1y)wk-71 MA. Date: 44-16K Permit# e IV , Z/ Building Location: / 3� SVTTeL di d R b Owners Name: Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential❑� New: ❑ Alteration: ❑ Renovation:❑ Replacement: Plans Submitted: Yes❑ No ❑ FIXTURES C6 W W Y = fn IX Q W W O N U1 m = 0 J v I ~ cop m w x QZ5 Lu z N W W W m 00 Q tl. H W 0 W X tY N V Z C9 W N O Q = u_ W Q W W W Z 9 N = W ~ W Z w d' > U W Z O J H F O Z J O W = W I.- W W Z W } N Q Q m w O z 0 V o o LL 0 0 s i g O CL > > > 3 O SUB BSMT. BASEMENT - 1 FLOOR 413 2 FLOOR r` FLOOR 4 TH FLOOR 5 TH FLOOR 6 FLOOR 7 FLOOR 8 FLOOR Check One Only Certificate# Installing Company Name: C/�LL I�/J-/y /�-� l�f/ ��40 Corporation Address: 9/ 11 Ll50/LT gr City/Town: &- AA/&(//-17 State: Partnership Business Tel: C/),Y ( Fax: ❑Firm/Company Name of Licensed Plumber/Gas Fitter. L/=/' v INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes$--No❑ If you have checked Yes.please indicate the type of coverage by checking the appropriate box below. A liability insurance policy [�r Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:1 am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner E] Agent ❑ Signature of Owner or Owner's Agent By checking this box ;I hereby certify that all of the details and information 1 have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of license: By ❑Plumber Title ❑Gas Fitter Sig t r of Licensed Plumber/Gas Fitter ®Master City/Town []Journeyman License Number: APPROVED OFFICE USE ONLY) ❑LP Installer