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HomeMy WebLinkAboutBuilding Permit #408 - 15 ALCOTT WAY 11/30/2007 pORTF/ BUILDING PERMIT TOWN OF NORTH ANDOVER F p APPLICATION FOR PLAN EXAMINATION Permit N0: 4i6Date Received /�'�'� ' ? ��Ssgc►+us t Date Issued: IMPORTANT:Applicant must complete all items on this page k ,�"' OC,�T�OTaI r �3 f x k s . n .ROPERT -,OW,NER�0, � ��.: '.`{ k .: � !'� �•a ,�' t v'?�C a'�`.u3 r♦t:��� � � rC'r �i'��S,�a s ,,g .,r ' rt z � 1�7 JUI ►P1fl PAROELZflfiING�JSTRIOTs trF�sfonc��str�ct yes �� TYPE OF IMPROVEMENT PROPOSED USE 1-Residential Non- Residential New Building One family Addition Two or more family industrial Alteration No. of units: / Commercial Repair, replacement Assessory Bldg Others: Demolition Other r °Septic z Weil xloadplar l/aletlards #' Wa#ershe f3astr�t • '.i a = �. .7 # �.,;'� x s„x a .r r P .:..fes r -c z x DESCRIPTION OF WORK TO BE PREFORMED: I / AcE:m' eA.r re6mcd- aae Identification Please Type or Print Clearly) OWNER: Name: K94En/ 96047-f-s Phone:9Z -6r?r?&- Address: l5" 4L,Ce, rr WA,7' NIL' 1 rlS '* 3 v r^ t r`r w - �� h �, f¢+H�?i✓ ""' �- o€'a rC. r� � �".r� s�s t } CONTRACTOR i�arne , 4C ��t�one` 3 y A x,. ..? 1.>n. r `, te" � � �. w.9 .c, S� er lis&s Construtty License -,f= ,zt `a. ., '4 C � r�.�kxr'' '�. .� �+ .r y' � f i � ,r~ : �, � -. h• �,, 1orx�e lmproem�n ���ense .. :. . ARCHITECT/ENGINEER 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: $ -S-6d FEE: $ ' Check No.: 3-23 9 Receipt No.:--a � NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Si nature of A`ent/Owner 9 9 ��Una.... of contract . - WW4(-- 2/Jim s Location C G No. d Date �oRTh TOWN OF NORTH ANDOVER 41 . i Certificate of Occupancy $ 9 C Building/Frame/Frame Permit Fee $ s� sE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 20831 Building Inspector 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 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 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 Connectiontsignature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT '=Temp Duympster on site fires: no Located at 1:24=1Nain Streetlif Fire3eprtrnent�ignatureate i ,COMMENTS. 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.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 l ❑ Certified Proposed Plot Plan a 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 ` �pRT1-� T0VM of And 0 _ ©Y dower, Mass. o = A > > GOCHICHEWICK � AORATED S BOARD OF HEALTH Food/Kitchen PERMIT . T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........./ ,,.. 'C —� .... �..........✓.f�. �...................................... ...... ..... .................................. Foundation has permission to erect................. ...................... buildings on � Rough to be occupied as... f, .�.. .....✓....�.f' � g'L.....��.Cr�.C :. ...................................,.......... Chimney provided that the person accepting tit 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO ARTS Rough ................. ....... ................ ........................................ Service BUILD[I�fi6-14A PSt�ECTOR -'`,--� 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 Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. iS 1. Board of Building Regulations and Standards HONE IMPl�EMENT CONTRACTOR Royist 129774 EW— . .009Tr# PELLA WINDO 260785 r R KENNETH PAQU 45 FONDI RD. _ HAVERHILL,MA 01832 Administrator YT. _dx r 2 � �l M 3 �� In:.xj•1 '4� y t ', The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le2iblY Name (Business/Organization/Individual): �e l lC( W��(�l W S aid kc . Address: City/State/Zip: MA 01932 dPbil��s1#:; Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer J� 4. ❑ I am a general contractor and I P to Yer with . , 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I'am a sole proprietor or partner- listed on the'attached sheet.t 7• ❑Remodeling ship and have no employees These sub-contractots have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. ' q. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.[]Electrical repairs or additions 3.❑ I am a homeowner doing all.work right of exemption per MGL 11.0 Plumbing repairs or additions' myself. [No workers' comp. cl 152, §1(4),and'we have.no 12.0 Roof repairs insurance required f t employees:[No workers' 13.❑.Other comp. insurance required.] • y applicant that checks box 01 must also fill out the section below showing ilii'`�%oiSFers3 cCmpensation policy in I Homeowners who submit this affidavit indicating they aro doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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-nry employees. Below is the policy and job site information. Insurance Company Name: �t`'COI C�Vr•e,� Policy#or Self-ins.Lic.#: 0 05' d N L _7A4 2 Expiration Date::Ii2 bD 9 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 cNil 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 cop; -,>f'lai5`statement may be forwarded to the Office.of Investigations of the DIA for insurance coverage verification. I do herebyeerlify�under the pains and penalties of perjury that the infor"Wion provided above is.true and correct Signature fJ✓/I.'t-�''�%_. k— Date: I/ b s ID-7 Phone# ( 70' �6S•7�.S5 Offkial use only. Do not write.in this.area,to be conVileted by city or town offrciaL. City or Town: Permivl icense# Issuiog Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other OATS(MMMOf f" AGOIRM, CERTIFICATE OF LIABILITY INSURANCE 07/11(200709:56 PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Fred C.Church HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 41 Wellman Street *AL,TtKTHE COVERAGE AFFORDED BY THE POLICIES BELOW- Lowell,MA 01851 900-225-1865 S AFFORDING COVERAGE NAIC#I INSURED 1-oVet hluMTcompany Pella Windows&Doors,Inc.45 Fondi Road Iiaverhill,MA 01832-1302 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. TYPE OF tMURAKCL- POLICYNUMBER POLICY EFFECTIVE POLICY TION LIMITS EACHOCWRRENCE $1,000,000 GENERAL LIABILITY $500,000 X COMMERCIALGENERALLIABILITY CLAIMS MADE OCCUR MED EXP: om arson =10,000 A ZBN8161407 7/1/2007 7/108 PERSONAL a ADV INIURr 1 1,000,000 /20 GENERALAGGREGATE &2.000,000 PRODUCTS..COMPIOP AGG f 2,000,000 GEMLAGGREGATE LIMIT APPLIES PER:• POLICY X Loc AUTOMOBILE LIABILITY (Ea COMBBINESINGLE LIMIT $110001000 mccidANY AUTO X ALL OWNED AUTOS BODILY DAf Ips►Pel) A SCHEDULED ADN8162169 7/1/2007 7/1/2008 INj X HIRED AUTOS rE60C)emidr)r f X NON-OWNED AUTOS PR OPERTY P j AUTOOMIIY-EAACCIOENT S c.MAGELIABIUTY i EAACC S ANY AUTO THAN AUTO ONLY, AGG EACH OCCURRENCE. $9,000.000 EKCESSNMBRELLA LIABILITY $9.000,000 X OCCUR FICLAIMS MADE AGGREGATE S UMS167305 7/1/2007 7/1/2008 f A f DEDUCTIBLE f X RETENTION S WC STA = N• tORKRS COMPENSATION AND 500,000.00 R5'LIAEL EACH ALCIOENTSOPWETORIPARTNERIEXECUTIVE -98WBNL5742 7/1/2007 7/1/2008 OY S 500,000.00RIMEMSER EX UOEDT 300,900,00 yype , EL..tXSEASE-POLI�YLIMIT : SPEGI LaPROVISIONS Edow ` OTHER DESCRIPTXNA OF OPERATNHAS I LOCATIONS 7VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECUV-PROVISIONS CERTIFICATE'HOLDER CANCELLATION SHOULD ANY OF THE ABOVE Pella Windows&Doors,Inc. DESCRIBED POLICIES BE CANCELLED BEFORE nIEE�MRAT1oN Road • DATE THEREOF:THE ISSUTAG'WSURER WILL ENDEAVOR To"1.10 DAYS WRITTEN avet�ill,MA OIH3O NOTICE TO TH S la Windows E CERtIFICATE HOLDER NAMED TO THE LEFT,BUT fA1LlNiETo Do ao SHALL IMPOSE NO OBLIGATION OR LJAmufY OF ANY MOND UPON THE INSURER,ITS AGENTS OR ENTATNES_ .......... y�, ...... AVTHOMMREPRESENTATIVE .... :1 ®ACORD CORPORATION 1988 ACORD 25(2001/08) Cyd M 2960 Mst# 07-08 GL.Auto,WC& Cert# Contract . '71-0W0 73E 1 Pella Windows&Doors,Inc. 45 FONDI ROAD HAVERHILL MA 01832 Phone:978-373-2500 Fax: 978-373-7274 Customer Pro'ect/Ship-To Order Beats,Karen Beats wme North Andover Date 00/00/00 Quote No. BEATS 15 Alcott Way 15 Alcott Way Order No. Need Date 00/00/00 NORTH ANDOVER,MA 01845 NORTH ANDOVER,MA 01845 Sales Rep.Name Woodward,Stumt WME ESSEX ESSEX Prepared by SW Payment Terms Deposit/C.O.D. Owner: Karen Beats Architect Bus.Phone:( ) - Bus.Phone: Jamb Depth Bus.Fax:( ) _ Home Phone:(978)687-7620 P.O.No. Branch Order No. Cellular:( ) - Order Home Phone:(978)687-7620 Type Installed Sales Order Glazing Design 20.00 psf. Pressure Branch Name Pella Windows&Doors,Inc. Branch Address 45 FONDI ROAD Phone 978-373-2500 City HAVERHILL Fax 1 978-373-7274 1 State MA 01832 Comments: Customer has paid$1,781.22(50%of Contract Total) Customer has paid using a(Credit Card). The Remaining$1.781.22(Final 50%)will be paid upon Substantial Completion of Installation. Customer will be paying balance with a(Credit Card) For information regarding the finishing, maintenance,service,and warranty for all Pella products,visit the Pella Website at www.t)ella.com. Printed 10/16/07 Contract-Page 1 of 3 .. 4 Contract for Customer Beats,KarenProject: Beats wme North Andover Order No.: Outside View Item No. Otv. SummaLl SummaDescription Unit Price F.:tended Price Item#10 Qty: 1 7281 Fixed/Left FA In-Swing French Door,Frame:71-1/4 X 80- Location:Living Room 1/8:ProLine,Clad,Model I ,Poplar White(PR0047),3/4"InsulShid R.O:6'0" X 6'8-5/8" Temp IG w/Argon Glazing,Sliding Screen,Satin Nickel Handle,Fins WallCond:4-9/16" (single unit per design) Value Added Items:Disposal per Unit-Qty 1 2-Wide Hinge Door-Qty 1 Unfinished NO PAINT-Qty 2 Notes: Thank You For Purchasing Pelta Products i -- 0 Taxable Subtotal $3,392.80 Customer Signature Pella Sales Representative Signature Sales Tax at 5.0000% 169.64 Non-taxable Subtotal 0.00 Total $3,562.44 Date Date Deposit Received $ 1,781.22 Remaining Balance $ 1,781.22 WARRANTY:Pella products are covered by Pella's limited warranties in effect at thetime 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. 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. For information regarding the finishing,maintenance,service,and warranty for all Pella products,visit the Pella Website at www.yella.com. Contract-Page 2 of 3