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HomeMy WebLinkAboutBuilding Permit #347 - 15 GREENWOOD EAST LANE 11/2/2007 t TOWN OF NORTH ANDOVER µcRTM APPLICATION FOR PLAN EXAMINATION 0f,t�•" •;'�o Ll s Permit NO: Date Received + Date Issued a-, �1SSACNUS IMPORTANT:Applicant must complete all items on this page LOCATIONw0&0 jifsr L� Print PROPERTY OWNER Z1�e4t-I E1Z L"eK Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building &One family ❑ Addition 0 Two or more family 0 Industrial. R Alteration No.of units: -Repair, replacement 0 Assessory Bldg 0 Commercial 0 Demolition ❑ Moving relocation 0 Other ❑ Others: 0 Foundation only DESCRIPT ON �OF WORK TO BE PREFORMED i i Identification Please Type or Print Clearly) OWNER: Name: )IIE4ME4 CZ42jI� Phone:(970 ti, Address: 6 4s r- ��✓ = CONTRACTOR Name: lei* 11/r*A - � o�f PhoneA97 7-4"Y Address: 11,15— APA,,�QZ- AeO 11�4kfftl ff lxf,4ori 3 Supervisor's Construction License: 4�94fff_5 J Exp. Date: /0`d-6 Home Improvement License: /.15 f 7 Y Exp. Date: ARCHITECT/ENGINEER Name: Phone: C - Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$11.00 PER$1000.00 OF THE TOTAL ESTIMAT � ST BASED ON$125.00 PER S.F. Total Project Cost :$ IS F_EE:$ i Check No.: ��� Rec e pt No.: Page 1 of 4 TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanning/Massage/Body Art ❑ Swimming Pools 11 Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED f HEALTH ❑ ❑ I COMMENTS f FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments i Water& Sewer Connection/Signature& Date Driveway Permit Building Setback(ft.) Front Yard Side Yard Rear Yard Re uiredProvided Required Provides Re uired 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 I I J - I I 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 i 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 I Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORMOS Page 4 of 4 Location / No. Date MORTM TOWN OF NOR17H ANDOVER O�,,60 ,x,40 3? O s ; ; Certificate of Occupancy $ lee NusEI Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL. $ Check # 20760 Building Inspector .N®RT#j TONM of over . o = lover, Mass., COCMICMEWICK ADRATED P? C7 5 BOARD OF HEALTH Food/Kitchen PERMIT T ' D Septic System BUILDING INSPECTOR This CERTIFIES THAT....... +.......... .. ..ir Foundation has permission to erect........................................ buildings on . 1c........ .......L.S.0......... Rough ......1 ' �. .w.I K4.IAS. i...�........................................................... t0 b8 OCCllpled as.... Chimney .......... . ....... ... ....... . ......... provided that the person accepting 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 I Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTI STARTS ELECTRICAL INSPECTOR Rough ............. P-1:10) Service B G INSPECTOR Final Occupancy Permit Required to 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. 11uC A� =- Contract Pella Windows&Doors,Inc. 43 FONDI RD HAVERHILL MA Phone: 978 373 2500 Fax: 978 373 7274 Ct%stom Pro eet%Shy o, f3r r DIADAMO CLARKE clark/wme/nandover Date 00/00/00 Quote No. CLARK 15 Greenwood East Lane 15 Greenwood East Lane Order No. Need Date 00/00/00 N ANDOVER, 01845 N ANDOVER, 01845 Sales Rep.Name Johnston,Andrea/WME ESSEX ESSEX Prepared by Payment Terms COD/WELLS Owner: heather Clark Architect Bus.Phone: ( ) - Bus.Phone: Jamb Depth Bus.Fax:( ) - Home Phone: (978)794-0820 P.O.No. Cellular: (978)886-0602 Branch Order No. Home Phone: (978)794-0820 Order Type Installed Sales Order Glazing Design 20.00 psf. Pressure Branch Name Pella Windows&Doors,Inc. Branch Address 43 FONDI RD Phone 978 373 2500 City HAVERHILL Fax 978 373 7274 State MA Comments: total project amount 15,650.86 inital deposit of$ $7825.43 paid by wells fargo upon substanial completion$7825.43 will be paid by wells fargo permit fee $220.00 All windows to be dove white For information regarding the finishing, maintenance, service, and warranty for all Pella products,visit the Pella Website at www.pella.com. Printed 08/27/07 Contract-Page 1 of 4 a Contract for Customer DIADAMO CLARKE Project: clark/wme/nandover Order No.: Outsi_ d_Vi`w Item No. oil_ Su�ma�ry D ti tion Item#IS UnitPri Extended Price Location: small trap Qty: I Fixed Casement,Frame:32-1/2 X 65 X 36:Architect Series,Clad, 2,538.22 2,538.22 f..... Shape 3Z Left Trapezoid,Model 1 , White, 5/8"InsulShld IG Glazing, I R.O: 2'9-1/4" X 5'5-314" Fins(single unit per design),Primed Interior Wa1lCond: 4-9/16" Value Added Items• Paint Window-Qty 1 Disposal per Unit-Qty I 2-Unit Composite Install-Qty I Notes: Outs*d� Item No- -- oty Item#20 Summary Descry ion Unite Extended Pri Qty: 1 Fixed Casement,Frame:32-1/2 X 98-1/2 X 69-1/2:Architect Series, 2,037.84 2,037.84 Location: lrg trap Clad, Shape 3Z Left Trapezoid,Model 1 , White, 5/8"InsulShld IG R.O:2'9-1/4" X 8'3-1/4" Glazing,Fins(single unit per design), WallCond:4-9/16" P gn),Primed Interior Value Added Items•Disposal per Unit-Qty 1 Paint Window-Qty 1 Full Wrap Windows or Doors-Qty 1 Notes: O& sid .Vi w Item No. Q Item#25Summary UnitPriceExtended Price Qty: 1 Fixed Casement,Frame:32-1/2 X 65 X 36: Architect Series, Clad, 2,538.22 2,538.22 Location: smaller trap Shape 2Z Right Trapezoid,Model 1 ,White 5/8"InsulShld R.O:2 9-1/4 X 5 5-3/4 Glazing,Fins(single unit per design),Primed Interior IG L ;' WallCond:4-9/16" Value Added Items:2-Unit Composite Install-Qty 1 Disposal per Unit-Qty 1 Paint Window-Qty I Notes: For information regarding the finishing, maintenance, service, and warranty for all Pella products,visit the Pella Website a www.eella.com. t Contract-Page 2 of 4 t Contract for Customer DIADAMO CLARKE Project: clark/wme/nandover Order No.: Outside View Item No. Oty. Summary Descr6p ion Unit Price Extended Price Item#30 Qty: 1 Fixed Casement,Frame:32-1/2 X 98-1/2 X 69-1/2: Architect Series, 2,037.84 2,037.84 FDLocation: lrg trap Clad, Shape 2Z Right Trapezoid,Model 1 , White, 5/8"InsulShld IG R.O:2'9-1/4" X 8'3-1/4" Glazing,Fins(single unit per design),Primed Interior WallCond:4-9/16" Value Added Items: Disposal per Unit-Qty 1 L....................- Paint Window-Qty 1 Full Wrap Windows or Doors-Qty 1 Notes: Outside View Item No. oty., Summary Description Unit Price Extended Price Item#36 Qty: 1 Right Hinge Casement,Frame:32-1/2 X 68:Architect Series,Clad, 1,539.53 1,539.53 Location: left casement Mode12,White,5/8"InsulShld IG Glazing, White Vivid View Screen, R.O: 2'9-1/4" X 5'8-3/4" White Hardware,Fins(single unit per design), Std Primed Interior WallCond:4-9/16" Value Added Items: Single Window Install-Qty 1 Disposal per Unit-Qty 1 Paint Window Linen White-Qty 1 Notes: Outside View Item No. Oty, Summary Description Unit Price Extended Price Item#40 Qty: 1 Left Hinge Casement,Frame:32-1/2 X 68:Architect Series,Clad, 1,539.53 1,539.53 Location:right casement Mode12,White, 5/8"InsulShld IG Glazing,White Vivid View Screen, R.O: 2'9-1/4" X 5'8-3/41' White Hardware,Fins(single unit per design), Std Primed Interior WallCond:4-9/16" Value Added Items:Disposal per Unit-Qty 1 Single Window Install-Qty 1 Paint Window Linen White-Qty 1 Notes: For information regarding the finishing, maintenance, service, and warranty for all Pella products,visit the Pella Website at www.pella.com. Contract-Page 3 of 4 Contract for Customer DIADAMO CLARKE Project: clark/wme/nandover Order No.: Outside View Item No. Oty. Summary Descri to ion Unit Price Extended Price Item#50 Qty: 2 Fixed Casement,Frame:32-1/2 X 68: Architect Series,Clad,Model 1,337.20 2,674.40 Location: 2 fixed casements 1 ,White, 5/8" InsulShld IG Glazing,Fins(single unit per design), Std PLO: 2'9-1/4" X 5'8-3/4" Primed Interior WallCond: 4-9/16" Value Added Items: Single Window Install-Qty 1 Paint Window Linen White-Qty 1 Disposal per Unit-Qty 1 Notes: Ila Products o Thank Yo :` r Purchasing Pella Taxable Subtotal $ 14,905.58 Cust er ignature Pella Sales epresenta ive Signature Sales Tax at 5.0000% 745.28 Non-taxable Subtotal 0.00 �eio %° �/ Total $ 15,650.86 Date Date r Deposit Received $ 0.00 P 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. 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.pella.com. Contract-Page 4 of 4 ' ✓1LC U/OOft/pLOOU!/Qq�R o�✓vGQ46a�cUdP,�6 Board of Building Regulations and Standards HOME IMPPOVEMENT CONTRACTOR Registr k 129774 /2/2009 Tr# 260785 PELLA WINDOVI SCOTT HOUSE 45 FONDI RD. HAVERHILL,NIA 01832 Administrator .—....-5. u-+�+xw� war-�.�,.w"- ..t' ;�Y sy,.� �.+{7+•�,� 'K - W$ PER ANN t J 2 I ATE ACO-RD, CERTIFICATE OF LIABILITY INSURANCE D11200709:56 Y) 07/11/2007 09:56 PRODUCER (800)225-1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lowell,MA 01851 800-225-1865 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Hanover Insurance Company Pella Windows&Doors,Inc. INSURER B: Twin City Fire Insurance Co. 45 Fondi Road Haverhill,MA 01832-1302 INSURERC: 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. INSR kDDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY DATE 1, EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Es N Ere ce $500,000 CLAIMS MADE I OCCUR MED EXP one rson $lO,000 A ZBN8161407 7/1/2007 7/1/2008 PERSONAL&ADV INJURY $1,�,� GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICYF—j PRO X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1000,000 (Ea accident) ANY AUTO X ALL OWNED AUTOS - BODILY INJURY $ (Per person) SCHEDULED AUTOS A ADN8162169 7/1/2007 7/1/2008 X HIRED AUTOS BODILY INJURY $ (Per accident)X NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ 9,OW,� X OCCUR FICLAIMS MADE AGGREGATE A UHN8167305 7/1/2007 7/1/2008 $ RX DEDUCTIBLE $RETENTION $ WC STATU- OTH- $ WORKERS COMPENSATION AND TORY LIMITS EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $500,000.00 B ANY PROPRIETOR/PARTNER/EXECUTIVE 08WBNL5742 7/1/2007 7/1/2008 OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000.00 If es,describe under E.L.DISEASE-POLICY LIMIT- $ 500,000.00 SPECIAL PROVISIONS bebw OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION Pella Windows&Doors,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION S FOndl Road DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN averhill,MA 01830 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) Client# 2960 Mst# 07-08 GL.Auto,WC& Cert# ©ACORD CORPORATION 1988 Umb 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 Legibly Name (Business/Organization/Individual): ?e I IC( W i�(��W,S QvA D-D0 rs (\C. Address: qPow\ ,'1 . City/State/Zip: 4ayP.t•' Vtll /�/� 01932 °'�Pb�l��a�#:;, � ���26,�•72SS Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 2 S .4. ❑ I am a general contractor and I 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-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 required.] officers have exercised their 10.❑ Electrical repairs or additions 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' comp. insurance required.] 13.0 Other Any applicant that checks box#1 must also fill out the section below showing t11ei ;Aor°kers'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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance formy employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Q$ W d N L 5-7A4 2 Expiration Date: 7 /2.00 g _ 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 imposition f criminal penalties of a g q tion 25A of MGL c. 152 can lead to the impos o fine up to$1,500.00 and/or one-year imprisonment, as wellas 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 dais:statement may be forwarded to the Office of Investigations of the DIA for insurance coverage-verification. I do hereby certify under the pains andpenalties of perjury that the information provided above is true and correct SignGt/•-r/Ci�� Date: —t> 7 re:atuq Phone#: ( 7�' 265•�Z SS Offu ial 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#: