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HomeMy WebLinkAboutBuilding Permit #274 - 162 BRADFORD STREET 10/6/2009 NORTF/ BUILDING PERMIT 0.1 V&OR H TOWN OF NORTH ANDOVERZ. o� o� o APPLICATION FOR PLAN EXAMINATION Permit NO: 7 Date Received ��SSACHUS Date Issued: ® 07 IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER \ L Prin MAP NO: G-t 0 PARCELS-ZONING DIS ICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family L,---- Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: N CJC —S Nc) c rw b\r-,M dentification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: cel^ P t Phone: Address: t Supervisor's Construction License: Exp. Date: ill(--, ` Home Improvement Licenser C4 1�01 Exp. Date: I bq 0 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: $ " �((, FEE: $ Check No.: 6�S"�Z� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner t' _�. Signature of contract Location No. �/ Date /d NORTy TOWN OF NORTH ANDOVER C? • O� ' p Certificate of Occupancy $ sACM�s�� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #OP5 q! 2-- s 72 2' 1 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 t 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 Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes f" 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 i --- ---.._......._........._._..._......... —_._....._....._........................................_.........._ ---------- Doc.Building Permit Revised 2008 'V 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 Li Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And f 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 K: NORTH ® of 4Andover 7�1 LAK E dover, Mass., COC HICHEwICK ORATED 7 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT ��E'vE �a/dings BUILDING INSPECTOR .............. ....... ........................................................................................................ Foundation /� d has permission to erect................................... bu on ..,64r ....46640 . a ....................... Rough ..... .......... to be occupied as w0w......GE ��¢^��... 1..�1./o.a S ......./fit..................... Chimney p 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough • ............ ..........................:.. Service BUIL� GINSPECTOR 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. Renewal RENEWAL BY ANDERSEN �UcenseFedera01 (expires 1/24201 Federal Tox ID#t33-0.404201 byAndersem L mi -v REPLACEMENT coAodttsmGoPVm? OF GREATER MASSACHUSETTS ANn NEw HAMPSHIRE 104 Otis Strcct•Northborough,MA 01532 s fyh e-) '4'��fiy Phone 508.919.0900•fax 508.919.0903 91f-' (Ir-007,C CUSTOM WINDOW AND DOOR REMODELING AGREEMENT 17,Z AV;je vQ, e'[A Buye(s)Name Dote of Agreement ' V �; Bu r(sl Street Address,City,State,and X Code E-Mail Address Home Telephone Number Work Telephone Number 17 - 7T��A3-7-0/3c? Buycr(s)hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.dba Renewal by Andersen of Greater Massachusetts and New Hampshire("Contractor"),in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this`A grecrncnt").Iiuycr(s)hereby agrees to sign a completion certificate after Contractor has completed a.0 work under this Agreement. Method of Pymnt:❑Cash 0 Check)Iemastercard El VISA Totoi Job Amount: Estimated Starting Date: p Discover Xinanced,App#: Deposit Received Name on Credit Card,.S � Balance at Start of Job o:_._._._.._- Estimated Completion pate: r� Credit Card#:,.5-Y66 Balance on Substanti Completion of Job(33° CC Exp. Date �� CC Security Code: By initialing here,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion Buyer Initial of Jvb c;wurut be ritadC by crcclil t;acxl and inusL be made by pci-sonal cheep,bank clxcck,or cash. Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the panties, and that there ante no verbal understandings changing or modifying any of the terms of this Agreement.No alteration to or deviation from this Agreement will be valid without the signed, written consent of both Buyer(s) and Contractox: Buyer(s) hereby acknowledges that Ruyeir(s) 1) has read this Agreement, understands the terms of this Agi*ement, and has received a completed,signed,, and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Renew bye3 em o£Greater MA and NH Buyers Buyers) L V Ey �. S"n re of Product Managcr Sigxaature Signature M4,b t Cie)wt Print Namt6kroduct Managcr Print 1N ame Print Name YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO WDNIGFIT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION Of THIS RIGHT. 7 ---- - -- - - - - — - - - - - - — - - 1;K— - - - - — - - - - - - — — - N ELATION TICS A ELLATION Date of Transaction Q . You may cancel I Date of Transaction . You may cancel this transaction witho an pe a ty or obligation,within I this transaction with* an pe arty or obligation,within three business days from the above date.If you cancel,any three business days from the above date.If you cancel,any property traded in,any payments made by you under the ' property traded in,any payments made by you under the Contract of Sale,and any negotiable instrument executed I Contract of Sale,and any negotiable instrument executed by you will be returned within 10 days following receipt I by you will be returned within 10 days following receippt by the Seller of your cancellation notice,and any security I by the Seller of your cancellation notice,and any securriy interest arising out of the transaction will be canceled I interest arising out of the transaction will be canceledd If you cancel, you must make available to the Seller at I If you cancel, you must make available to the Seller at your residence, in substantially as good condition as ur residence, in substantial as good, condition as when received, arty 4db�3 8911YANd 16 you under (1115 I I�U1 n resolved, any pudli dellyered to yuu under lhilt Contract or Sale,or you may,if You wish,comply with the I Contract or Sale•or you may,if you wish,comply with the instructions of;Ke Seller regarding the return shipment of instructions of tfte Seller regarding the return shipment of the goods at the Seller's expense and risk.If you do make X the goods at the Seller's expense and risk.If you do make the goods available to the Seller and the Seller does not I the goods available to the Seiler and the Seller does not pick them up within 20 days of the date of ur Notice pick them up within 20 days of the date of our Notice of Cancellation, you maayy retain or dispose o the goods I of Cancellation, you mal retain or dispose of the goods without any further obligation..If you fail to make the I without any further Arivation..if you fail to make the Renewal RENEWAL BY ANDERSEN MA license#34MO1(expires(/24/10) byAndeC$en ( DCA T. Lrt T fTC AND 1 LTi HAMPSHIRE n c nn Federal Tax ID# 83-0404201 w-W REPLACEMENT .n.�n&rzm Cmny.rtT OF�aREA1LK MASSACHUSEI AJ A1�V 1YLW'^,n,�vAPJHlRL 104 Otis Street•Northborough,Massachusetts 01532 Phone 508.919.0900•Fax 508.919.0903 SPECIFICATION SHEET Buycr(s)Name Date of Agreemen The Buyer(s)listed above hereby ointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and tends described on the Specifi(;ation Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT of which this Specification Sheet is a part. WINDOW DETAILS I.. Ce tractor will Install a total of windows in Owner's home,using the following individual quantities: Double Hung(DB)X Equal Sash ❑ Cottagc sash(1/3 top,Z/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) Casement(C1) ❑ Hmge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle Double Casement(CDW) ❑ Standard handle ❑ Metro handle Casement/Picture/Casement(CPW) ❑ 1:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle 2 lite Gliding Window(GW) Glider/Picture/Glider(GPW) ❑ 1;1:1 or [] 1:2:1 Awning Window(AW) Picture Window(FW) Bay or Bow Window _Patio Doors(see separate Door Specification Sheet) 2. Yes ❑ No Qty of windows to be Custom Fit Replacement: 3. Yes E/No Qty of Sills to be replaced by Contractor: 4. Yes KNo Qty of Windows to be.New Construction Full frame(includes new interior&exterior casings) ] Exterior casings: ❑ Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: ( "HP Low-EGP SmartSunTM (Tax Cre&tE7(Silile) ❑ Other If other,please specify: 6. Exterior color to be: ❑ white ❑ Sand kf Canvas ❑ Terratone ❑ Cocoa Bean 7. Interior color to be: ❑ White [] Sand Canvas ❑Tcrratonc ❑ Pine ❑ Maple ❑ Oak Note: Interior color can only be white,wood or same color as exterior. Wood interiors need to Finished by Owner. 8 Ha ware: ❑ White ❑ Stone Canvas ❑ Brass Double Hung: 9. Yes�No Install Lifts with Double Hung Windows 1 tens: windows to have: ❑ Half or Full screens Screens to be: X Fiberglass M.Aluminum ❑ '1'ruSeene GRILLE DEPAIIS 11.Windows have grilles: ❑ Yes No If yes:❑ Grille Betwccn Glass((;rsG)❑ Removable Interior Wood omw)❑ Full Divided Light(tDu 2t1': Qty: Qty: Qty: Qty: Qty: Qty: l DH DH DH DH CWlpidvvD.1 �CPW or G "IMM209-� Draw grille patterns above "Use additional sheet if needed Owner approved(initials):( ) ADDITIONAL,WORK DETAILS I Z.❑ Yes No Contractor will remove metal frames of windows. Qty of Units: /p(r e 13.❑ Yes No Contractor will install new paint-ready or stain-ready casings. Inte,�r' easitlg qty of openings; Exterior casings qty of openings: '❑ Pine ❑,Maintenance-free material 14.❑ Yes A No Contractor will Mist 11 w paint-ready or stain-ready inside Or Outside stops qty of openings: I ferto�,stops qty of openings: Exterior stoKiu.'mlink.. p ings: Z ❑ Pine Maintenance-free material 15. Owner is ware that Contractor does n any painting. Owner 'tials /A 16.0 Yes No Contractor will wrap exterior casings with stock o' color. No rapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17. 1 cs ❑ No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. 18. Yes ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 19. Yes ❑ No B ' ' 't•--Contractor will secure any and all necessary permits. The fee for the perm :s not included in the Contr .t P 'ce a d a separate cL=y is r aired at the J6ne ole or ee. Zo io I job etails: r9dd ocr .� kr 21 1 es,❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. AN firtsl payment shs11 be detmwded until the contract is wm plcted to the satisfaction of all parties. it is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW ANA DOOR REMOU)MING AGREEMENT,constitutes the entire understandingbetween the parties,,and there are no verbal understandings changing or ntodifv,W any of the terms. 'nus Specification Sheet tnay not be changed or its terms modified or varied in any way unless such changes are in wri' and signed by both the Buyer(s)and Contractor. Buye s)h acknowledge that Buyer(s)has read this Specification sheet. Re rsen of Greater MA and an Buyers) Buyers) By: _ x of l vd t signs Signature cPd�,v Print Name 44luct Manager Print Name Print Name The Commonwealth of Massachusetts .department of Industrial AecidentS 4 —' �Jfice oflnvestigatiorzs ' 600 TEashingfoll Street , Boston,JL4 02111 " YIY) .mass:3ovIdia e Workers' Compensation£nszrra>�ce:�=rdavFi: � ,� dens/Ca�tractors/�iectricia�s/g'F��hers nDIiC2rft Inform atio please Print Lesibly. Nalne(3usiness/Organization/Individual): i lc�l�aJ 1. �,�. wry r,lo j-S e .Address: l D•y �i S L�TYa�i City/State/Zip:_Al,, f1><i bo i'a , /,l 4 1,)e/K))- Phone•=`: CSU ) F,'Lgree'you an employer?Check the appropr€ate bo : Type of project required): I.am a employer with tj p 4. ❑ I am a general conuactor and I6. D New construction employees(full and/or part-time).* have hired the sub-contractors • �I am a sole proprietor Or Da•-tner_ listed on the attached sheet� 7.�F_�_, ,emodeling ship and have no employes These sub-contractors have o. Demolition working for mem any capacity, worl.ers'comp.insurance:;..:; g. (]3uilding addition [No workers' comp.insurance �• 7Te are a co�ara on and its required.] ofiic�rs have e;ercised their 10.❑Electrical repairs or additions 3. 1-am a homeov,,ner doing all work right of e,.emption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c.152 I '),and we h � � have no 12.❑Roof r-pairs insurance required.]t employees.[No workers' comp,insurance:required.] I'D.❑Other `Any znplicant that checks box r1 must also fill out the se:tion below showin,their workers'compensation poli,-3,in:o-rnation. Homeowners who submit this affidavit indicating they are doing all work gad thea hire ou+side contractors must submit a new am-davit indicating such . $Contractor that cheek this box mwt attached an additional sheet 31101,;iag the name of the sub-contractors and thei worke.ss'coma.]oiiq information. I am all.er°rployer that'S vrovidZnP worl:ErSl� p` '1 cnnl el-saTiOn T,PEUrance or nY e p Yea' it In s. info;maiinn. o� A pal 1 end jab sit Insurance_Company Name: {1 C�•�r�/7 C Policy f or Self-ins.Lic?_ SID Expiration Date: Job Site Address: (�A'D` �icity/StFlip: -1 -/ ° ate/_ p erZJ,Ltacia Cop QfreNvorher&9 Comena`On rQ1LC .dC cFpgOpyS2 : raa0n date). Failure to secure coverage as required under Section 25AL of_MGL c, 152 can lead to the imposition of Criminal penalties of a. Tine up to$.1;500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WOPa ORDER and a fine of up.to$250.00 a day against the violator. Be advised Lr at a copy,of this statement may be for warded to he Office of Investigations of the DLA for insurance coverage ve�tcat on. Ido Ixreby cer iV u der the pains and peraLies of perju,y that the irformationp;avided above 7z, it ue and correctsSignaturet , 1Date 0 o Phone ;'A/ 1) Official use oni, Do not ivr e in this e r e carr 1 i �" on!y, )"rite s cr...-, .n b peed oY city or Iai4�n OifeC£al , Gl ' L_f PCS^Se TOELu,'_s zre;,lt Q n,7� (C_ale on): Dog-rd o-f--Eeall Lh 2.35`-Ir— i-De_zr nneritCT1 C?er1; 4.L1eC_"incl Ln-Sperm 0' S.P1urnrio Fh^ t 5 sB��:Qr o.O ren r t 11 Contact?erson: Phone 1, 1 / I :I ,•' � ':. �Z�r..�ry.'nonc:;�.,�.�i�a�✓/�2ar..c�iuJ�.,;,u: I � Q a pDE.^d OI iuil•3in6Fe4nlat ans s sd S,tanan ds I. �_ Cat uac:icn`uat5iscr .icsr• �..:_,; '• axe.' . .. ':a • 1 :.�.::- '� '' �ic�:;se; C+r. '95707 nl3120t1 0 Tr# 27107 .�= -�j.;. . . BRIAN DENNIS __-_ I 85 Ci',EST CiRvL -- wo A 1503" Commission- 11 + RLV1(�"-,L I Y A �DEPSON BRIAN.,DENfISON Dh O IS S1RCit NOR E HSOROi.JCH, MA.01 532 G?S•�A7 ea �61v:•Dilui-?:.24?D 1.,ea=1 D-z t Board bI yIIlldinc egrL`Iflt10n5 2nd�`^itnIldards - - © , ! HOME 1N _. OuEMEttT CONT r 4CTQ Lt mW_: _gist- io. :: 149501 r1241201 0 —'M-1— p Mem_nt Card MENEWAL BY DcNNISOl1--= '104 OTIS STREH 'NORTN30R000H,Iii, 01532 ' idministrntar a ! / e 6 �2 -AES-111 iMsui Pp=Ul.Z% HS 'HIPC IS IS .43 A:ILA 77—Z—F-7--77 -n 1 2 0 3 �M. Or Pin W!c K a-On a 'CONFEFS-HO FUCH73, F!!- E. Do=-B MOT ij=-7� 7�19: — -FAG= A�F=' OR By =S E Al n A%,-Lb 0 1 4O a n5.-0 F Bn-eWal by And-ersonj I Hl s uR E R A: r-lsm'crd Insurance Comnartv JZZLk.Alm-dows, Inc. S; .04 Ou St NU li1DOrCL oh, W,A 01,533 IPSURBR D: C VVI E Fr,A,G 'NSUFANCE LISTED BELOWHAVE===N!zQ^UED 70TH=INSUF= A 'IS-,Am IN Ny REQUIPEMENT TL-RIVI OR CONDI-1 ION OF AINY :��'�CT OR C7H=_-m Doculvil-=11-11 Kl- o G n �-, - WH'ICH THIS CERMiFICATE fAY, B- f6ky FEFZT'�IPJ,-IHE hl'ibFANCE AF--OPr,= By POLICIES H-=R-=!N S SUEZ= aL6cJ OR —7 70 ALL THE TERM-3,�XCLLISIOW'S ANL-CONDITION PiOUCEDBYPAIC CLAUZ. ucx Ns OF s �CBREPLAL LIABILITY, -H(CP 507 404 0, 01071�) K, C C", n1c) C� 'AMER�.IAL CENERAL LlkPJLriY CLAIW.SMAI c- x OCCUR LME:)EXP(Any Cns De=n) :=PS.0f4AL.ADV ltj.JLJPY GENERAL A(1-3RECAT= coo'Doo GardL APPL!ES PER: =2 COMP y?AGO � cOm T PCLICY I PRODUCY PR-'T 10^j 01 G SINIZI—E LIMIT LCC nos A -u-'c=-3r-E"m n I L:—, APP,'AUT,0 ALL AUTOS SOCILY IMIJURY lJL-- AUTOS (Pe:;a:=-I) VIFE:�AUTCS =COIL YINJUVY ('Pcrz:a=np U- 7-707ERTY {Per atisenp CE L'zp AUTO ONLY,EA A=O=HT Ll ANY ALJTO ;-7H==THAV EA AC: 5 UT.56N1.Y: AGO =UP CLAl*W.S 1`4ACE I-EACH A=-REGA7E 0Z:UC-, lBL-- PE—'=;+mON A 4' 01 17 2 D 0;':: '02117/1,010 PF I A NlY PROP R S4H A=:E?,]7 0'cFiCERPMEWEEF QF 11 vee. un6er I ----i - s EC POLICY LIMIT 10 111.0 03 rrul E..�`UeiC 5 By -E-LLsD -,.HE axpmkmc.N.i Z31 E D Cl F Vi U4UFF-' EH:EA.'--R 7D MAIL II +v :o Tw nZ E�;-. ne Tc' VIP ?OR[ S tk ol