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Home My WebLink AboutBuilding Permit #284 - 15 WOODCHUCK LANE 10/11/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONNORT11 32 ae , +6 O L To A Permit NO: Date Received / y Jap � t 9 e" � /' A. . Date Issued: i' .� 4oq,*.o 9SSACHUS�� IMPORTANT:Applicant must complete all items on this page LOCATION PROPERTY OWNERnot �1 j l Print MAP NO.: 16 (0 ,C PARCEL: a 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: ❑Repair, replacement 0 Assessory Bldg ❑Demolition ❑ Commercial ❑Moving(relocation) ❑ Other ❑Foundation only ❑ Others: DESCRIPTION OF WORK TO BE PREFORMED ! �yl I� S d � Identification_Please Type or Print Clearly) OWNER: Name: Phone: Address: `� � CONTRACTOR Name: ►Y��. � Phone: Address:_ L( �-►- OI�1�6U��- , �� !"� �r- � Supervisor's Construction License: Exp. Date: N Home Improvement License:_ o� (� ��'(�j p• Date:Ex ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERM/T:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST EASED ON$125.00 PER S.F. Total Project Cost :$_�, �(o -1 FEE:$__ jU -yam - Check No.: Receipt No.: Page 1 of 4 F TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art ❑ Public Sewer ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ❑ Private(septic tank,etc. Permanent Dumpster on Site Electric Meter location to proj ect NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waive ❑ Certified Plot Plan ❑ Stamped Plan ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED r CONSERVATION ❑ ❑ COMMENTS I DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS 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 Water&Sewer connection/Signature&Date Driveway Permit 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 DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan2006 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) ❑ 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 �. . y© �- / Location/ «© No. Date TOWN OF NORTH ANDOVER 0 y< 1 Certificate of Occupancy $ R � �� Building/Frame Fe $ \. t' . . Foundation Prh Fee $ R Other Permit Fe $ �. TOTAL $ check * If (. ] 9676 § Q Building Inspector e q.�ORTly °9 Town of Andover 0 No. Z ffy KE O dover, Mass., 0 LA ��•�%� �► COCHICHEWICK ✓�AD4ATED p'P�` �y BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT....�..I.../. ..........G(................................................................................................................ Foundation has permission to erect........................................ buildings on ..� .... +. .. ..`.. ................ Rough a�r �� Chimney tobe occupied as Vllfflyz........ � ...:.....�,�................................................................................................................... provided that the person Mccepting 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 6 downPERMIT EXPIRES IN 6 MONTHS FinalELECTRICAL INSPECTOR UNLESS CONSTRLJ I TS Rough .. ....... ....... ........ .. ...... Service .. ... .. . .. . ...... ......... ... .. BUILDING 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 (Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. MARSH CERTIFICATE Q INSURANCE ATL-000915907--Il--I 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 MCCLU RE(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 100492-IPUSA-GWA-03/04 A STEADFAST INSURANCE COMPANY INSURED COMPANY THD AT-HOME SERVICES INC. B ZURICH AMERICAN INSURANCE COMPANY DBA THE HOME DEPOTAT-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 OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO 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 POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS A GENERAL LIABILITY IPR 3757 608-01 03/01/06 03/01107 GENERAL AGGREGATE $ 4.000,000 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' PRODUCTS-COMP/�AGG $ 4.000,OQO CLAIMS MADE OCCUR 'OF SIR:$1,000.000 PER OCC' PERSONAL&ADV INJURY $ 4,000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 4.000,000 FIRE DAMAGE(Any one file) $ 1,000,000 MED EXP(Anyoneperson) $ EXCLUDED B AUTOMOBILE LIABILITY BAR 2938863-03 AOS 03/01/06 03/01/07 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) X ELF-INSURED AUTO PROPERTY DAMAGE $ PHYSICAL DAMAGE 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 $ WORKERS COMPENSATION AND C Sr OTH C' EMPLOYERS'LIABILITY 6610998(AZ.ID,MD,VA) 03101106 Q3101/07 X TORY LIMITS ER C 6610995(AOS) 03/01106 03/01/07 EL EACH ACCIDENT $ 1.000.000 G THE PROPRIETOR/ X INCL 6611326(OR) 03101/06 03/01/07 EL DISEASE-POLICY LIMIT Is 1,000.000 PARTNERS/EXECUTIVE. - E OFFICERS ARE I I EXCL 6610999(NY.W I) 03/01/06 03/01107 EL DISEASE-EACH EMPLOYEE I$ 1.000.000 WORKERS E COMPENSATION CONTINUED (6610997(FL) 03/01/06 03/01/07 D 6610996(CA) 03/01/06 03/01107 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL_3Q.DAYS WRITTEN NOTICE TO THE FOR INSURANCE PURPOSES ONLY CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LLABLITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,RS AGENTS OR REPRESENTATIVES.OR THE ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Walter Gilstrapta i F* MM1(,3/02) VALID AS OF: 02/27/06 le AT-HOME installed Siding and Windows \' Board of Building Regulations anti Standards License or registration valid for individul use only l k,4-- HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: E; Board of Building Regulations and Standards Registration: 126893 g =s=' Expiration- 8/3/2008 One Ashburton Place Rm 1301 Type: Supplement Card Boston,Ma.02108 THE Home Depot At-Home Servic 9lJNROEUN CHHOUY 3200 COBB GALLERIA PKWY#20 ^� a�rA ` (Z AtIANTA,GA 30339 � h Administrator Not valid without signature r Proridly sold,furnished and installed by RMA Home Services,!nc.,a Home Depot authorized contractor. 345 Greenwood St.Unit 2•Worcester.MA 01607•508-756-6686•Fax 508-756-2859•Toll Free 800-657-5132 FROM : KIMBLY FAX NO. : 6033629679 Oct. 11 2006 01:3BAM P7 HOME 1MI'RO%'1':Mb:N'1CONTRACT '1 / p Sold,Famished and Installed by: Branch Name:„ N Date- - b THD At-Home Services,Inc. d/b/a The IIome Depot At•Homc Services Branch Number- Job# � 345A Greenwood Street,Worcester,MA 01607 013 �QG Toll Free(800)657.5182; Fax;508-756-2859 rcdmdl tV#75-26994(10 ME Lic#C 02439 RI Cont.t.ic#16427 CT Liv#565522; MA Hone Improvement Contrdcu>r Reg.#126993 Installation Address: Q City State Zip P re cr a: Laat 4,Wts of DrNer a Lia#&Exp.Mot Work Phone: Home Phone: Home Address: t� �0/ ;✓ C (Tfdiffereat from Installation Address) r City f to Zi E-mail Address(to receive updates and promotions from The IIome Depot); Po ect information: i/We/You('Turehascv"),the owners of the property located at the above installation address,offer to contract with Houle Depot U.S-A,,Inc.("home Depot')to furnish,deliver and arrange for the installation of all materials as described on the attached Spec Sheet# incorporated 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 performs 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 PAYMF,NT OPTIONS (Subject to fund verification and/or credit approval.) CONTRACT AMOUNT $_ 1. Check,Cashew Check ur'US Postal Service Muncy Order (Made payable to The Horne Depot). *LESS DEPOSIT $ 2. Credit Cards and/or other payrne-nt options-Circle One nelow Viw MastevCard lhscover Americantsxpn= BALANCE DUE �•� ON COMPLETION $ The Hnmc J /�O Dcpot home Improvement Loan The How Depot Credit Card tE?l�lew Amount •U Existing Account (FITC&HDCC ONLY) •Minimum 25°J°of Contract Amount due upon execution of this contract. AvaaabIeCCrvdit:S (HIT.&HDCC ONLY) .. Aoct �D 1� Date: -.. Na as it appears an card: /_/1Z Indicate Payment Method For -By my/our signature below,l/We agree to allow Home Depot to BALANCE DUE ON COMPLETION: charge the above referenced credit card for the deposit indicated 14•Y`/1 G hnldcr'a tgnalure nal R I L or HDCC_ Authorization Codes Deposit_ Final Payment # .. . R # 00 9 � Purchaser agrom that,immediately upon completion of the work,Punchascr will execute a Completion Certificate and pay any. ba�t 'ce due. Puruhaser also agrees to be jointly and severally ob W ated and liable hereunder. nt fir'' �� N0 ntir ment:This agreement and its ineTuding at(y`}'u tl�inggrbee it ebr_trrin'"Tt t�complete age�•m between 6e parties and can not be amendW or modifiedyulessinn writtinn inn a state agmemenli,/gned by both partte �90)e-ry t7E TO'P()RCIIASER (P IA'; /N�N vi yL-o 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 Completion Certificate signed by the owner prior to the actual completion of the work to he 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 capianation of this right. There will be a service change equal to 2.5%of the contract amount if the job is cancelled by Purchaser AFTER the third business day. By MY/OUR SIGNATURE BELOW,I/WE AGREE TO 13E BOUND BY.THE TERMS OF THIS.CONTRA(1_..r1WE .. ACKNOWLEDGIi'RECFlPT Ol,'A COPY Or THIS CONTRACT AND TWO COMPLE'T'ED COPIES OF TIIE NOTICE OF CANCI3LLATJON. BY MY/OUR SIGNATURE BELOW,I/W1i UNDERS'T'AND THAT THE AGREEMENT IS SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND UWE AUTHORIZE HOME DEPOT TO VERIFY AND REVIEW MY/OUR.CREDIT RECORD WITH AN INDEP•NDENT CREDIT REPORTTN(.AGENCY AND RELEASE.THEM PROM ALL LIABILITY INCURRED FROM INAO Ti OMI ! NS OR ERRORS. SUBMITTED BY Date; .— ACCI;P'fED BY; Homeowner - � ._ Homeowner Date: NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT 7.18-06 C-SC White-Branch File Yellow-Customer Pink-Sales Consultant