HomeMy WebLinkAboutBuilding Permit #925 - 16 DANA STREET 6/25/2012 BUILDING PERMITo�No DT b�ti
TOWN OF NORTH ANDOVER 3� ''- ' 4' '° °
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APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
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Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION,4C ZID <-/x
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not
PROPERTY OWNER
a Print
MAP NO: PARCEL: ZONING DISTRICT: Historic District yesno
!Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
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
Septic
W611 Floodplain Wetlands Watershed District
er/Se
DESCRIPTION OF WORK TO BE PREFORMED:
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Identificat'on Please Type or Print Clearly)
OWNER: Name: 6itJ,c/,g u/liL2A1J Phone•R»- Z 2 ,? 716
Address:_/6, f�/ox//4 5✓ c,
4
CONTRACTOR Name;//V -,� �� Phoneme—Oy
Address/57c -ro u. /C /eAAAR 10{
Supervisor's Construction License:—? (0 Exp. Date: a_ %-2CY 3
Home Improvement License: Exp. Date: -.2ol�
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: $PWg�eC76 FEE: $
� it Check No.: l Receipt No.: �J^ _
NOTE: Persons contra c ng wit unr i red Tactors do not have access to the guaran f nd
Signature of Agent/Ovv r ature of contractor
Location�(e / 'S
r ^ �No.!�29Date ' �.
• - TOWN OF NORTH ANDOVER
s •
Certificate of Occupancy $
Building/Frame Permit Fee
y�
V19,1
� Foundation Permit Fee
Other Permit Fee $
TOTAL $
c
Check#
25447 UBuilding 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
CONSERVATION Reviewed on 3S //,2, Si nature
COMMENTS
4�
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
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 2008
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
❑ 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
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
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I OORTH
Town of 2Andover
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No. T
P1111 W-
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BOARD OF HEALTH
PER Food/Kitchen
Septic System
THIS CERTIFIES THAT ................
........... �... .. BUILDING INSPECTOR
T LD
Foundation
has permission to erec .......................... buildings on ......I.�p........ �M�� !...... ..
Rough
to be occupied as .... ...........6 V 1.1 ............CID...U.....1Z........ chi
provided that the person accepting this permit shall in every respect confo m to the terms o e application Fin
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. PLU BING INSPECTOR
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
I UNLESS CO
NSTRUCTTAR Rough
Service
............... ........ .................................................
Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display-in a Conspicuous Place on the Premises — Do- Not Remove - - - Final t
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 _J
E
GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS, ADDRESS, AND PERMIT(COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps I
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec,etc.
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip- Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate.
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girls-solid brick or steel plate bearing at foundations
'/2"air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
` Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min. 22x30 w/3' headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
I Firecode S/R wood frame of"0"clearance fireplaces&stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8%of floor area.
of required glazing shall be openable.
Bedrooms required min.20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing-Smoke Chamber- Finish
Smooth parging, clean joints, 8"solid @ combust.
DECKS: Lag to house, provide flashing.
Rails min. 36" high, Baluster max space 4" on center.
Over 8'above grade, use 6x6 posts w/lateral bracing. I
Lag all posts and rails.
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete. I
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee- $30.00(Be Ready).
Certificate of occupancy required prior to occupying structure
9 14.1
The Commonwealth ofHassachusetts
Department oflndustrialAccidents
Office of Invesfigations
600 Washington Street
Boston,MA 02111
www.massgov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors ElectricianslPlumbers
Applicant Information Please Print LeAb
Name(Business/Organization/lndividual): e-�
Address: -
City/State/ZipZ L,�� o ( Phone#: So ^ -gig�
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a loyer with 4. El I am a general contractor and I
� have hired the sub-contractors 6. EJ New construction
e�loyees(full and/oxpart time)
2.[ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling
ship and'have no employees These sub-contractors have 8. ❑Demolition
working for mein any capacity. workers'comp.insurance. 9. ❑Building addition
[No workers'comp.insurance 5. ❑ We area corporation and its
required.] officers have exercised their l0.[]Electrical repairs or additions
3.[]x am a homeowner doing all work right of exemption per MGL I L]Plumbing repairs or additions
myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roof repairs
insurance required.]i employees.[No workers'
comp,insurance required.] 13.❑Other
!Any applicant that checks box must also fill out the section below showing their workers'compensation policy information.
T Homeowners who submit this affidavit indicating they tie doing all work and then hire outside contractors must submit anew 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 information.
X am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob site
information.
Insurance Company Name%
Policy#or S elf-ins.Lf c.#: 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 requiredunder Section 25A of MGL o.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 DTA.for insurance coverage verification.
Ido hereby cero and the gins an nalties ofperjury that the informationprovidedabove is true and correct
Si -
Date:
Phone If: t�'2
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: PermitUcense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.tither - -
Contact Person: Phone#:
i
Information and Instructions '
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract ofhire,•
express or implied,oral or written.,,
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a j oint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be,deemed to be,an employes."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license orpermit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced-acceptable evidence of compliance with the insurance coverage required"
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence ofcompliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)andphonenumber(s)alongwiththeir certifieate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are notrequired to carry workers'compensation insurance. I fan LLC or LLP does have
employees,a policy is required. B e advised that this affidavit maybe submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law orifyou are required to obtain a workers'
compensation policy,please call the Department at the number listed below. self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill.out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number, In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
Policy information(ifnecessary)and under"Job site Address"the applicant shouldwrite"all locations in (city or
town)".A,copy of the affidavit thathas been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
Year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture
a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone anal fax number:
Tho . ommonwealthof cssaohv.:setts -
Dop.aftent ofIndusirial Acoxd.oats
Office ofIuestigatxow
600Wuhb)gWa Sixeet
Boston,MA.02111
TO,#617-7274900 PA 406 or 1-877�MASS-FE
Revised 5-26-05 Fax#6M727?7749
--- ----- _ __ 'LRFTX7•S7F_1Yf o nn_rrntr�r�n n
NORT1i
Town of E 1,, Andover
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No. -
�oh ver, Mass,LAK
A- COC NICNlw"CM
7,�ADR�ITED ►`PP� 5
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BOARD OF HEALTH
Food/Kitchen
PERM T LD Septic System
•
THIS CERTIFIES THAT ................ �... .�kl.�wW.
. ......... . ..........................................................
. ........................
........... . BUILDING INSPECTOR
has permission to erec ........ buildings on . ... J WOMM� .........4. Foundation
• Rough
to be occupied as .... ...........4 vi.!JO(.........l..0...U.....1.1........ ... �.... ....5.��. Chimney
provided that the person accepting this permit shall in every respect confo m to the terms o e 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
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
�. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTTAR Rough
Service
.............r...... ................................................. Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required 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
Printing Property Page 1 of 1
Print
Ownerl SULLIVAN, DONNA H
Owner2
Address 16 DANA STREET
PropertyID 010.0-0017-0000.0
Lot Size 7405.2S
Fiscal Year 2010
Land Use Code 101
Last Sale Date 10/04/1993
Book/Page 3852
Total Valuation $269100
Building Type CP
Year Built 1939 1
Finished Area 1463 sq. ft.
Assessor Map NorthAndoverAssessorMaplO_26x36.pdf
More Info: Click here for Assessor website
http://mimap.mvpc.org/NorthAndovermimap/Identify.aspx?datatab=ParcelBasic&id=010.0-0017-0000.0 6/21/2012
Massachusetts Home Improvement Sample Contract
This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard
language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"a
Massachusetts consumer guide to home improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the
Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757.
Home 19fprmation a Cont act Info tion
Name amo
/6 tiN9 �� ��se
S eat Address(do not use a Post Office Box address) tor/Salesperson/Owner Name
G NrDa�P2 0 4S 9 6
City/Town State Zip Code usiness Address(must incl de a street address)
? ���? � I
Daytime Phone Evening Phone ityfrown State �( Zip Code
-11
Mailing Address(It different from above) Business Phone ederal Employer ID or S.S.Number ,. .
]awregn'¢es lhetmost home m�- . Home provemmt ContmctorReg.Nmaber Expiatimdate
pro—t coahnctma have a
a rcp tmfim a ba
The Contractor agrees to do the following work for the Homeo er:
(Describe �� ! ^ate�01
, ,agoaus ewC.
�]
ee7,t 4C3
Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will
and will be secured by the contractor as the homeowner's agent, be adhered to unless circumstances beyond the contractor's control arise
(Owners who secure their own permits will be �]
excluded from the Guaranty Fund provisions of �o/ Date when contractor will begin contracted work.
MGL chapter 142A.) � L
'Ll Date when contracted work will be substantially completed.
Total Contract Price and Payment Schedule
The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum ofc5� (*)
Payments will be made according to the following schedule:
� 20 �Upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater)
or upon completion of
srA� �~ / / or upon completion of
6 �pon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction)
The following material/equipment must be special $ to be paid for
ordered before the contracted work begins in order $ to be paid for
to meet the completion schedule-(**) .
NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may
not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
Express Warranty-Is an express warranty being provided by the contractor? No Yes fall terms of the warranter must be attached to the contractl
Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third
party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for
materials and labor under this agreement
Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the
contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices
carefully before signing this contract.
• Dont be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear.
• Make sure the contractor has a valid Home hnmrovement Contractor Registration. The law requires most home improvement contractors and
subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor
registration by writing to the Director at One Ashburton Place,Room 1301,Boston,MA 02108 or by calling 617-727-3200 or
1-800-223-0933.
• Does the contractor have insurance? Check to see that your contractor is properly insured.
• Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer
Guide to the Home Improvement Contractor Law.
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the
contractor' at his/her main offi or branch office by ordinary mail posted,by telegram seat or by delivery,not later than midnight of the
third bu' ess day fo owing the siguin of th' ment. See the attached notice of cancellation form for an explanation of this right.
D OT S T S O TRACT IF THERE ARE ANY BLANK SPACES!!!
Two id icalcopiesof tract completed and signed One copy should go to the homeowner.The other copy should be kept by the contractor.
`c
o s Signa Contractor's Signature
ate Date
Massachusetts- Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor License
License: CS 83616
MICHAEL C SMITH r
19 SCHOOLHOUSE LANE
ROWLEY, MA 01969
Expiration: 1/27/2013
Commissioner Tr#: 9908
- - CJ�ie�po�niaw�.zuseaC�a�C�aac�iccaelfl
paea;sorj ❑ ;u, C\ Office of Consumer Affairs&Business Regulation
•a2uey3.1o;uose ME IMPROVEMENT CONTRACTOR
gistration: 1$0931 Type:
xpiration: -5LSL2A(4._ Individual
MICHAEL C.SMITH:1'4 =
MICHAEL SMITH '
1?01?5ZZ #J. 19 SCHOOL HOUSE LN.,,.
ROWLEY,MA 01969 �� _ �Jr4.
--<` Undersecretary
Location /6'.
No. Date
HQRTM TOWN OF NORTH ANDOVER
op Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
JACMus
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $ 1--145
Building Insp
1 4-0t22J�9�13:10 25.00 PAID
� ( Div. Public Works
Location
No., Date
NORTN TOWN OF NORTH ANDOVER
�? `p Certificate of Occupancy $
x Building/Frame Permit Fee $
Foundation Permit Fee $
s�CHust
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector"
U
10/22/9813:10 25.00 PAID
Div. Public Works
PERMIT NO. 4D APPLICATION FOR PERMIT TO BUILD`** ****NOIZTII ANDOVER, MA
A111'NO. O b 1.01.NO. /�� 2. RECORUOFOWNERS1111' DATE BOOK PACE
V
Z(IM1E SltBB11'. LO"T NO.
LO( A I ION ,0 -otlf} 5-7-, PURPOSE IN B1)II DINGLZ
L f lDr
Ow*NER'S NAME F" A IV (J `IV l� t 11.� NO.OF S"FOR TES SIZE
O
)WNEiR'S ADDRE ESS �, I J BASEMEN OR SLAB
16 ST ND
r
AR(I III ECF'S NAME SIZE Of FLOOR TIMBERS I 2 3
BIM DER'S NAME w
�C`_ /' X9N P ��
nTSPAN
DISIANCETONEARESTBUILDING
cJ u G DIMENSIONS OF SILLS
DISI"ANCL FRCM1 S TREET DIMENSIONS Of POST S
DISTANCE FROM LOF LINES-SIDES REAR DIMENSIONS OF GIRDERS
AREA OF LOT FRONTAGE IIEIGI IT Of:FC)INDATION THICKNESS
IS BUILDING NEW SIZE OI I(X)TING X
15 BUILDING ADDITION MATERIAL-OF CI IIMNE-Y
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FIE LED LAND
1191.1.BUILDING CONFORM TO REQL IIREMENTS OF CODE IS BUILDING CONNECI'ED TO TOWN WATER
BOARD OF APPEALS AC-FION, IF ANY IS BUILDING CCNJNECI'ED TOI OWN SEWER
IS BUILDING CONNECI-ED TO NATURAL GAS LINE
INSTU('TIONS 3. PROPERTY INFORMATION LANDCOSF
ESI'. BLIXi.COS T
PAGE I FILL CN IT SECTIONS 1-3 EST. BLDG.C(bl"PER SQ. FT.
ESI. BLDG. COS I PER ROOM
EI FCTRIC N-1111 ERS MUST BE ON OUTSIDE OF BUILDING SEPI 1C PERMIT"NO.
AI-IACIIEDGARAGESLNUS'TC(1IFORM"TOSTATEFIRERE6111.Ano NNs J. APPROVED BY:
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR
DA l E 1:11 1:1) !b ( ��� OWNERS-1'ELa
C(NN"I'R.lEl.a
Co N IR.1.11'4
SI(.AlumOFOWNE OR AUIIk)RIZA)AGEN-l'
III:
I'I-Rh11T GRAN IIID
19
OCT-20-98 TUE 11 :07 AM BILRAY, ALUMINIUM FAX N0, P, 1
F.I.D.No,11.23204 ME Lie.No.DDI Be3
Job 1f-32via =/QI IL��1 NH Ur.Na. --
✓r'►1/17,fr`r+/ MA Lk.No,120466
SALES; opAA pp Now York Dept,of consumer
New��= SERVICL/REP1U11S HomeCentlal" Affairs Lie,No,0730586
800�8d2.6111 P ASE LLL Naaeeu Lie,No,M2704INDOO
�oston: IB •942.61L1 The Service Side of 5earl'- Sutton(LIO,N0,21194M
0p SEARS-31 SIDING Yonkers 1397
Hartford Area: Waatcheehar WCoe13•H87
800•SEARS-99 CONTRACT Now Jersey Lie.Ne.LOI1604
proVI�d¢8nee Area; Conn°ettevt D001,of Consumer
888.8EARS•51 Affairs Lia,NO,00532774
VT LIC.No.
SOLD TO__ Rhoda Island L10,No.13707EF
��� �n DATE
ADORESS_Al W . PHONF(Home) ATE
CITY—A j eta!r (_ �STATE( IP,Q PHONE(Work) ( )
JOB SITE ADDRESS(if different)
APPLIED VINYL & ALUMINUM SIDING y
Sold,Furnished a hlelaaedDy Bil•Rey Alurnlnhan Srding carp•M Ouoon,Inc.
or
WostDofm euah,MA 01561 ao termortt po amonrNSul NMI A. hionizadrr Cas
mer
13onor2l D000rlp(lon of Wortt 41 Abuve Adaress: Approx.Start Date: p /101146
Type of House; Frame O Masonry Approx.Completion Date:_�Z�Q I 5098
3PECIFlCAI7ONS
Stara spprovod materials will be"shed and Inetane4 to these specRbations;
YES NO PLEASE READ CAREFULLY:ONLY THE ITEMS CHECKED'YES,ARE INCLUDED IN YOUR ORDER.
1.LJ ,M-SOLID VINYL SIDING-cmro*Relwall Nem designated for wing,except those argue dssignaled bCIOW.3L.1
Color `Pattern package—,.��Custumaorner
1A.n If�SIDINO will be aDDlled to the following areas drill: polls color_
❑From Elevation 0 nigh Eleveboo 0 Endre DefaDs:
❑Roar Elevauon 0 Len Davauon 0 Partial(ME DEra1s1 •�
F)other ❑(slEoahuta
2.LJ INSULATION•coreF only flatwAll areas 4e3ipnaled ler siding Win ^
,•R �U=Sears 4/1/011011114 GALVAN12b0 STEEL SIARTER STRIP whore contract deems rrecessary.i�Ot bb with Name.)tion.
13 ,*S
1. iding to be applied Over existing tountgotin.
S.0 Pr--Us0 Sears approved PERMA TABS AND FINISH STRIP where CDmr4clor deems necasury in saint Calor as aiding.(Not available with Naifile)
6.0 r-WINDOW OPENINGS
0 Custom wrap with Sears apProyed vinyl clad aluminum as �Calor
❑Jump aver C455093 with Siding and'J'channel a_ Color�
OaChsnncl aSlsbng window only(cg.Andersen type or plCA0110 vhappod)d_Color
❑ CAULK-110 sills with Nbtrvrald eOlOr co•ordlnaled caulking
B.❑ DOORS•custom*tap with SEARS approved VINYL CLAD ALUMINUM.p of Doers
g• ❑ GARAGE DOOR FRAMES•custom*lap with SEARS approved VINYL CLAD ALUMINUM,Color Color
❑Single 0 Double Wuh Mug ❑Double No Mull
109 • n FASCIA.Custom wrapwilhSEARS approved VINYL CLAD ALUMINUM,Color
11. IJ 61!l1i.8OfFll- �.�) ~ �
TOVtd
lor-
12.n �ROTTEN(WOOD-I iN only be�caled or rep tedpwhere specfliedVINYL
n Una SOFFIT
27 RSlca below.Any ddl,lonal4rcasnding below.%vented.ar pairwillbe e5limagg upon
their distevery and Priced accordingly.(Does not Include wood studs,or 11xteriar sbea(hinq).
i2.C) 0mave existing natant on exterior of hours,
Virtyl ❑Aluminum 0 W006 ShinglC 0 Wool Siding EJ Other
Does nrx Include any Ulleslo3 removal,
14.❑ PORCH CEILINGS-covtf with SEARS approved SOLID VINYL CEILING MATERIAL In the following areas
L
16.Cl M—SEAMSICOLUMNS•wrap williSEARSepprovedVINYL CLAD ALUMINUM(NoCirculugrioundColumns).Color
16 C1 GUTTEASIEADERS-runiexistingand wllhnewcustOmsamlesggu8ersandleadert.Wbite_❑ SHUTfS•prOvideandlnstS
u
rown
1TlCM.Colora. n JX MASTERMOUNTSprovide Ind lnslalllpr pair SEARS approved polystyrene slot
t9.ffXvAARIF VrNTS.nrnvk1aend'nctsd —exterior light Mulls ody.Color
vtey.Ovbh a 1'•
20No drCOlar.Or Vangle rcnla20;< LT CLEAN UP PIODOny at cOmg4li0n of work
21.CK 0 INSURANCE-all requlre4 WORKMANS COMP,and LIABILITY Io tie maintained.
22.> C3 WARRANTY-mad to eu510rnar liner completlon and hill payment 12 received. All Di:counta Have aeon pDDllad•
23,El>9.PAYMENTS-On NON-MANCED Mull Insialrr it nuthrozeit to Collect progratelvo paymonto.
24.❑OW ALL DISCOUNTS APPLIED. —� DvIvred Paymcnr,Interest war Accrue.
25.0 LJ ADDITIONAL WORK•not bpv,•itbd tkuve.
Cash Sale Total S ' ss deposit 33%E Cash Balance S Other Payment(ll any)S
n CASH FINANCED$�3 dose not InGluda interest Dalaltea utt Subslantlal Completion i—_ sly
11 financed,balano payable in monlhry mstallmCgtl of 8paf0almalrly E
out a nneneif by Owner Ihot nwru0 win sof amount ntoAle —r S� —991 mpgun,paYshm by'nw,ar'to cunlrxclur
to Ino Ming institution boning such Dw at to'Owner'and wlBdasCute a IRelalil 11151 1ment'oblryauon and�y�doC,menls re runny!int such
l an i paYuble dion in
connecliOn with such loan. S by ouch lerldinp inslltuli0n or
26.X ❑ WORK NOT to tie done., --4114 ti
27X Cl Repair or replace The Iollowlng woods v
nOTKi a Nnanae,MY nese?a ea Ca,.ww.crest cow.g,"eel W p GLUM aro SALESMAN HAS NO AUTHORITY TO CHANGE ANY TEAMS
,klvnft.w,qp,Me d"b'""00 eeren 60"M en Pkr of good.h"e.nlcex 01i
"W"neem lir with too �
r, •hw.., ftwarr W ue eeewr yaw�wed On MAKE ANY REPRESENTATIONS OTHER THAN CON•
a.e er Che On*nhv.wsor. TAINED IN THIS AGREEMENT AND"OWNER"REPRESENTS
r "OWNER REPRESENTS TO HAVE READ AND THAT NONE HAVE BEEN MADE TO OR RELIED UPON BY
RECEIVED A DUPLICATE ORIGINAL OF THIS IN DU LICATEUOhIG NALI OFT TO A IS AGREEMENT. FILLED
AGREEMENT AND NE BE THE AUTHORIZED ^you,THE BUYER MAY CANCEL THIS TRANSACTION AT
AGENT OF ALL"OWNERS"OF THIS PROPERTY ANY TIME PFUQR TO MIDNIGHT OF THE THIRD BUSINESS
UPON WHICH THE WORK OR THE MATERIALS DAY AFTER THE DATE OF THIS TRANSACTION. SEE
ARE TO BE SUPPLIED, ATTACHED NOTICE OF CANCELLATION FORM FOR AN
NOTICE TO THE HOME OWNER($),GUARANTOR(S), EXPLANATION OF THIS RIGKr.ON ALL ORDERS CANCEL•
LESSEE($),CO-SIGNER($), LED AFTER THE RECISION PERIOD,CUSTOMERS WILL 6E
RESPONSIBLE FOR A 204E ADMINISTRATIVE AND RE•
Contractor,at the expense Of owner, Mall prectvs an Permhe STOCKING FEE.
requbed by law as follows: THE COMPANY WILL DEPOSIT ALL MONIES RECEIVED
II, owners who secure tMll ewe parrnits will ba dycluded from the FROM
guaranty fund Pravisigma of MSL Chapter 1026 IN AN ESCROWACCOUNTATCHASE MANHATTAN BANK
!' Ray P°ra0r who atoll h°'res co-skn�.9uatanlaed to atBnsd 1 IMI.062089, WITHIN FIVE BUSINESS OATS OF ITS
any credit ePpakadon or hop Totaling to this AOM*mem hereby RECEIPT.
accepts 10 be hound by this agreement,
s Ownerjs)represents 1181 the COMMA On the bark of this apes• Dale
Owrner3 a true part hereof and has hath nae and acappd by Do not alyn this agreement before you read It or It
It contains any blank space or If It does not Contain
a. ALL INSTALLATION LABOR GUARANTEED t(ONE)YEAR, everything g upon.
Print
Sareeman'3 Name
signal-
salesman's Mali Sign Here)
Lkanad No. Signature
HOME IMPROVEE��yyENT CONTRACTORS REG �y
;• Board or Bu11d1ng Regulations andl5tandarOds
One Ashburton Place - Room 1301
= Boston, Massachusetts 02108 - ----
_ _- HOME IMPROVEMENT CONTRACTOR
iS
Registration 120456 Expiration 01/01/99
Type - PRIVATE CORPORATION
BIL-RAY ALUM . SIDING CORP
JOHN O 'NEIL
123-10 ATLANTIC AVE
RICHMOND HILL NY 11415
3 ,
ACOR-. CERTIFICATE OF LIABILITY INSURANCEDATE(NMIDIDNY)
x8/05/98
MODUC6t TIS CERTIFIC/LTE IS ISSUED AS A MATTER OF INFORMATION
COUNTRY INN INSURANCE AGENCY, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
217 MERRICK ROAD ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
SUITE 212
AMITYVILL18_e NY 11701 NSURERS AFFORDING COVERAGE
INSU= BIL•—RAY .ALUMINUM SIDING CORP. INSURER ANHE I:gSURANCE CORPORATION OF NY
134-10 ATLANTIC AVENUE INSUREsts:CIGNA INSURANCE COMPANY
RICHMOND HILL, NEW YORK 11419 INsUaERCREALM INSURANCE COMPANY
INSURER DGUARD IAN INSURANCE COMPANY
jINSURER E
COVERAGES -- —_.— - —_4—
f THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE :OR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUffeAffiT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RO PECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
I MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS fl(CLrtyStbN3 Arrp CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INER TYPE OF INSUPAIIICE POLJCY NUMBER POLICY EFFECTIVE Pout Y DCPIRATION
UMI TS
OBNERAL LIAB7Lli Y EACH OCCURRENCE $11000 ,000
X COMMERCIAL GENET AI.LIABILITY RRE DAMAGE(Am one firs) S 50 ,000
CLAIMS MADE Fx—1 OCCUR
MED¢xP fAny one pmwQ $ 51000
A IGLOO6886 05/14/98 05/14/99 PERSONAL&AOV INJURY $1,000 , 000
GENERAL AGGREGATE $2 0 0 0 0 0 0
GEN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OP AGG $1 000 000
} POLICYED lRO Loc -
t AOTONIOsILE LIAIMLITY
�f4
ANY AUTO COMBINED SINGLE LIMIT
(Ea aeaidattt) S
ALL OWNED AUTOS
SCHEDULED AUTOS BODILY INJURY S
(Par panes)
HIRED AUTOS � " "--
NON•OWNEO AUTOS BODILY INJURY $
(Par accfder+U
PROPERTY DAMAGE S
(Par accident)
j I GARAGE LIAEIIITY AUTO ONLY.EA ACCIDENT $
t ANY AUTO
!!� OTHER THAN EA ACC 6
AUTO ONLY; AGG 6
EXCESS LIAMUTY
EACH OCCURRENCE s3, 000,000
OCCUR a CLAIMS NlAOE AGGREGATE s3,000,000
B BINDER # 05/14/98 05:/14/99 $
iDEDUCTIBLE C1151497 s
RETENnav s
• $
C.
WORKERS
'LIANL ITYT10N AND X -1ORY-IMIYB O R
BINDER # 05/14/98 O5'114/99 EL EACH ACCIDENT S500,000—
C1151498 E.L.DISEASE-EA EMPLOYEE s500,000
OTH9t E.L DISEASE-POLICY UMIT $500,000
D DISABILITY BINDER # 06/01/98 UNTIL
CI151499 CANCELED
DESCRIrDON OF OPIPATIONS WCATIONs/VEHCM$mxCwMMS ADDED BY=DORSWENTjm%mAL fRDVWUS
K
I
CERTIFICATE HOLDER AoasloNAL mumm;INSURER LErM: CANCELLATION
SHOULD ANY of THE iZOVE DESCRIBED POLICIES BE CAWCEILm BH;ORE THE EXRRAT)ON
DATE TM=r-.TW I DUNG INsurm WILL E NGELVOR TO MAUL 3 0 DAYS WRITTm
NOTICE TO THE Cern 9CATE HOWER NAMW YU THp U3Y.BUT FAnUatE TO 00 60 SHALL
1NPO3E NO OBLICATN'IN OR UAB(YTY OF ANY KIND UPON THE INSUML ITS AGENTS OR
RErRSSIENTATV
' AUTHOfUZM