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Home My WebLink AboutBuilding Permit #155 - 148 MAIN STREET 8/29/2006 TOWN OF NORTH ANDOVER �� i,•` APPLICATION FOR PLAN EX:11IN:1TIUN 1� Date Received: Permit NO: Date Issued:—Ii�5-0 IMPORTANT: :Xpplicant. must complete all items on this page LOCATION � /l �n � ' Print PROPERTY OVI'NER ,C,p4 1%9,AP NO.: PARCEL:i �intZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building IVQne family ` Addition Two or more family Industrial Alteration No. of units: Assesso BldgCommercial Repair, replacement ------------ D lic Demolition Others: Moving relocation =Other Foundation only DESCRIPTION OF WORK TO BE pREFORIttED �"!t Cess e Identification Please Type or Print Clearly) Phone: �- �997 OV�'NER: Name: .Address: S4 CONTRACTOR Marne: S Address: Esc Date: �=��r� Super%isor's Construction LicenseP - Home [mpro%ement License: ��7 `� Exp. Date: 112 ARCHITECT. E,NGCvEER Namc: Phcne: kddress: Reg. No. FIE SCHEDLLE:BL LDIAG PERMIT.510.40 PER 51300.00 OF THE TUT IL ESTIMATED CAST BASED H,4 517 (A ER S- Total Project Cost :$__ �`� YI0.00=FEE:$�f�= CEeck N.(I.: a(�ds— Receipt No.: TYPE OF SEWARGE DISPOSAL Public Seer Tanning'%Iassage Body.Xrt S"imming Pools - _ Well -- Tobacco Sales Food Packaging Sales -- Permanent Dumpster on Site _ Private(septic tank,etc. _ Electric Meter location to project NOTE: Persons contrncti, with nnregi red co tractors do not have access to the i,►7pa Signature of Agent,Own r Signature of Contr ctor Plans Suhmitteds Wai��ed Certified Plot Plan THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ 'J []Water Shed Special Permit CSite Plan Special Permit El Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS 8 DATE REJECTED DATE APPROVED HEALTHh r- L C01I-),IENTS Luning Board of Appeals: k ariance. Petition No: Zonin- Decisiim,receipt submitted yes 1'!anning Flmrd [decision: Cutscr�;.tticn Decision: 'V:,trr& S n (x:crnection-i,�naturc&uatc f imp Dempster rn site -,,s no Fire Department si!matur- .late Building Permit Appro%cd and Issued by r: -v 2(r.t Building Setback 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 DAT, —(For department use) I. L,T ,',I5_5: EPhia•::TG7 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 VN'ork 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 Hydrau 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 kppenis 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 `uc:I�.tiPF.("1'1()\.\L.sl'.R\'I('L:i OF,P\R'L\IEti'�aP!OR`!IIS Location No. A-C~ Date NORT1� TOWN OF NORTH ANDOVER O � ►?41 •, •'NOA Certificate of Occupancy $ NUBuilding/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ " TOTAL $ �a Check # 19525 Building Inspector Contract Pella Windows&Doors,Inc. 45 FONDI ROAD ' HAVERHILL j MA 01832 i �^ 1 Phone: 978-373-2500 Fax: 978-373-7274 Customer Project/Ship-To Order -Quick-Quote-Project Date 00/00/00 Sandra Shamas 5�,.�s Quote No. QUICKQUOTE 148 Main st unit s 528 North Andover Ma 01845 � Order No. Need Date -66/00'/8@-t'M. � o 7 Sales Rep.Name P Johnston Prepared by 978 360-2079 Payment Terms Owner: Architect Bus.Phone:(978)688-7899- Bus.Phone: Jamb Depth Bus.Fax:( ) - Home Phone: P.O.No. Cellular:( ) - Branch Order No. Home Phone:( ) - Order Type Installed Sales Order Glazing Design 20.00 psf. Pressure Branch Name Pella Boston Pella Windows&Doors,Inc. Branch Address 45 FONDI ROAD Phone 781-373-2500 978-373-2500 City HAVERHILL Fax 978-373-7274 State MA 01832 Comments: 1 For information regarding the fmishing, maintenance, service, and warranty for all Pella products,visit the Pella Website at www.yella.com. Printed 07/26/06 Contract-Page 1 of 3 i I i -ontract for Customer Project: Quick Quote Project Order No.: i Taxable Subtotal $6,061.23 omn; Signa Pella Sales Representative Signature Sales Tax at 5.0000% 303.06 Non-taxable Subtotal 0.00 Total $6,364.29 Date Date De osit Received $ 0.00 WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale. All applicable product warranties are incorporated into and become a part of this contract. Please see the warranties for complete details,taking special note of the two important notice . sections regarding installation of Pella products and proper management of moisture within the wall system.Neither Pella Corporation nor Pella Windows&Doors,Inc. will be bound by any other warranty unless specifically set out in this contract. However, Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. i Clear opening (egress) information does not take into consideration the addition of a Rolscreen [or any other accessory] to the product. You should consult your local building code to ensure your Pella products meet local egress requirements. I Per the manufacturer's limited warranty, stainable exterior, wood windows and doors must be finished upon receipt and prior to installation. Stainable exterior, wood windows and doors must be refinished annually, thereafter. Variations in wood grain, color,texture or natural characteristics are not covered under the limited warranty. 1 i 1 I Contract-Page 3 of 3 NORTH O 2 it over oVM 0 o dover, Mass., ' o LA COCMICMEWICK �ADRATED '9S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System _ BUILDING INSPECTOR THIS CERTIFIES THAT.J.0.I1406.....J.4.10. J............................. .. ............................................. Foundation has permission to erect........................................ buildings on ./..yje......O.W*0 ....41%....0.................... Rough to be occupied as....� /... .. .. I.. ................................. Chimney provided that the person accepting this permit shall in every respect con or 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 tampPERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTT , TS_ Rough.... TOR Service UILD Final Occupancy Permit Required to Occupy Building r 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. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations s 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): pe l kW (��1$ a'1_` jDO(>T—_3 Address: ys Fy✓t 120 . - City/State/Zip: -+ ve447',It Phone#: 6 S-7 L SS Are you an employer? Check the appropriate box: Type of project(required): 1.Q� I am a employer with Z S 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors ,, � � 7. El Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees ees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation 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. lContractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 444r4or4 1KS ur0.rlCe. 60wteaAy -7/Policy#or Self-ins. Lic. #: 084J ISN .S 7y2 Expiration Date: D1 Lo 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$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 violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 97�- Z6s '72 S5� Oficial 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#: ACORDrM CERTIFICATE OF LIABILITY INSURANCE DAT20061D/YYYY) 07/05/2006 13:54 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street Connector Park HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell,MA 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Insurance Company New England Window&Door Inc. 45 Fondi Road INSURER e: Hanover Insurance Company Haverhill,MA 01830 INSURER C: Mass Bay Insurance INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRDD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE IMMIDDP(Y) LIMBS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE 0 RENTED $00,000 PREMISES Ea occurence $ CLAIMS MADE 7 OCCUR MED EXP(Any one person) $10,000 B ZBN8161407 7/1/2006 7/1/2007 PERSONAL&ADV INJURY $1,000,000 N GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY 1 PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea axident) $1,000,000.00 X ALL OWNED AUTOS BODILY INJURY $ C SCHEDULED AUTOS ADN8162169 7/l/2006 7/1/2007 (Per person) X HIRED AUTOS ' BODILYINJURY XI NON-OWNED AUTOS (Per accident) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 9,000,000 X OCCUR 71 CLAIMS MADE AGGREGATE $9,000,000 B UHN8167305 7/1/2006 7/1/2007 $ DEDUCTIBLE X I RETENTION $ $ WORKERS COMPENSATION ANDWC STATU- OTH- EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNERIEXECUTIVE 08WBNL5742 7/1/20067/1/2007 yes.de If yes,describe under E.L.EACH ACCIDENT $$00,000.00 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000.00 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 OTHER Blanket Building&Contents B Property ZBN8161407 7/1/2006 7/1/2007 $5,540,000Deductible$1,000Blanket Business Income$4,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION New England Window&Door,Inc. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN dba Pella Windows&Doors.Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 45 Fondi Road. Haverhill,MA 01830 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ^ ACORD 25(2001/08) I{/ CLent# 2960 Mst# 0607 all lines Cert# Evidence of INsurance ACORD CORPORATION 1988 r`;�ss-^^-;---z�� ✓/ie iiJom�i�noouuvactia o�✓!�(,addac�tecdef,�6 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 089839 Birthdate: 06/19/1972 Expires: 06/19/2008 Tr.no: 89839 ^4 Restricted: 00 SCOTT P HOUSE 854 BROADWAY#1 / HAVERHILL, MA 01832 Commissioner i :�tze toanr,��zar�uroczL�. o� �la��u.:etC lugBoard of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 129774 Expiration: 11/2/2007 Type: DBA PELLA WINDOWS AND DOORS SCOTT HOUSE 45 FONDI RD. HAVERHILL,MA 01832 Administrator