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HomeMy WebLinkAboutBuilding Permit #38 - 24 COVENTRY LANE 7/17/2007 BUILDING PERMIT pORTh q TOWN OF NORTH ANDOVER 0r APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ° ��SSACHUS�� Date Issued: 7S IMPORTANT Applicant must complete all items on this page LOCATIJN ; te 476V �y= _J F' nt Z P ZO E,RT. OWNER 7 tr w ly _ . �'P.�► CEL: : ZflM1VG�D�ST.R1�T ,HIH�tor�c Dlsti:ict. w 4. _. Machine Slp VaAage o 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 dellFJos�dplai'rJ, Wetlads laterslei �str�ct �71%ateSe rer T ,s. s DESCRIPTION OF WORK TO BE PREFORMED: Id ..fl ase'o ase Type or Print Clearly) OWNER: Name: Phone:9A� E Address: C 7C NaCQNTRTOR me _ Ptaorae Adbress �' - � , SupOrosnr s Construction Lacense _ :. Exp Date _ � Horne Improvement License `~ ... Ex Date. p - t 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. i Total Project Cost: $ ✓� FEE: $ Check No.: 16'2- � Receipt No.: �- �, NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund �igr�atureof�g;ent/Ov►rner.� _ ;�S�igna���e of cod#ra�tor.��� -�' Location d/ eyi--u► X73 No. Date :2-13 NORTH TOWN OF NORTH ANDOVER 3? � •BOOL 9 4 Certificate of Occupancy $ �'�s'••°�'��' Building/Frame Permit Fee $ s�CHU Foundation Permit Fee ' $ Other Permit Fee $ TOTAL �T Check #10 a� 20442 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 ` HEA_ LTH . ..f COMMENTS Zoning Board of Appeals:Variance, Petition No: ' ^-`Zdning Decision/receipt submitted yes PlanningBoa. . Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature &Date Driveway Permit Located at 384 Osgood Street _ I ;FIII�E.DE ' ►RTMEIc _ b'U1aapster o des` f no w located at 12 Nfa�n=Street * , �rt tre i'�epalrtrnen#,�h�natu�eZda�e> � �, � - �~ �� �� GY 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 ❑ 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 2.2007 ORTIy 0 of No. 0 y dover, Mass., T Q LAKE ^ T O� COCHICHEWICK V �AD/i'ATED CO BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ��~ BUILDING INSPECTOR THIS CERTIFIES THAT........ ..,�i.. ... .,........... ..... ........... ................................... ............... ......................... Foundation has permission to erect........................................ buildings and✓'�� . �� �......... Rough P 9 ...6.... . ......................... ........4 Nl.�7►do..W. ..�..��" .. Chimney to be occupied as.... ..... ............ ........................................................................................ 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 6�►" PERMIT EXPIRES IN _,AU N S ELECTRICAL INSPECTOR UNLESS CONSTRU4 110b1STP 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 Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Window Contract SOLD,FURNISHED&INSTALLED BY �rOMEC UB HomeClub Remodeling Inc. 1700 0 --� 113 Cedar Street•Unit S2•Milford,MA 01757 r SOLDTO l j6►L�n f�y'L� `� fti[' ISLj _ DATE '1 [b ADDRESS ✓"i` U eyyy- tom. LA. CITY W U it oto STATE ZIP PHONE HOME Fn) D -1 el 'A I C,to!nA WORKCc?) EM j 10B SITE ADDRESS(IF DIFFERENT) APPLIED VINYL WINDOW SYSTEMS General Description of Work at Above Address: Type of House: O Frame O Masonry Date which work is scheduled to begin: Date which work is scheduled to be substantially completed: • • APPROVED MATERIALS WILL BE FURNISHED AND IN STALLED TO THESE SPECIFICATIONS. Sped ications PLEASE READ CAREFULLY:ONLY ITEMS CHECKED"YES"ARE INCLUDED IN YOUR ORDER. YE NO YES 1. O REMOVE WINDOWS from openin where they now exist on: 22.0 SPECIAL ORDER Windows(in Addition to Above) 2. O FIRST LEVEL #Openings #New Window Units 3. ;O SECOND LEVEL #Openings-- #New Window Units - 4. O THIRD LEVEL #Openings #New Window Units 5. BASEMENT #Openings #New Window Units 6. O OTHER #Openings #New Window Units 23.Y O CLEAN UP All job related debris will be removed from property on completion of work;REMOVE AND DISPOSE of existing windows 7. O REMOVAL OF METAL or other units requiring modified installation 1 / and/or storm windows #Openings #of Units 24.rp O INSURANCE All workman's compensation and liability is maintained 8. 0 Install new PAINTABLE MOULDINGS 25.90 WARRANTY Mailed to customer upon completion&full payment is received Inside Stops #of Openings 26. PAYMENTS (On non-financed orders)is payable to installer on day Clamshell or Casing #of Openings of installation �J 9. OInstall new MASTER FRAME #of Openings 27.0 Additional Information 6n, '�. ��- 10.� New window units to have FUSION WELDED SASH# 11.0 0 New window units to have FUSION WELDED FRAME# ' !� "q � ` y 12.�O New window units include Double Insulated Glass 1"total thickness with the following INSULATED GLASS OPTIONS: O '12a.) Season ProHM Heat Mirror 88 with 28.0 ork Not to Be Done Double Low-E HP,R-9.62 Rating #of Units O 12b.) SolarProHM Heat Mirror 88 with f Low-E HP,R-6.25 Rating #of Units l C) 12c.) ProPlus Low E HP,R-3.76 Rating #of Units 04 12d.) Low Maintenance and Safety Pack Option, TUF Glass&Stajt-Clean. #of Units 13. O New window units to have CAM LOCK(s)or LATCH LOCK(s) `Y 14. O New window units to haveNIGHTNENTLATCHES(doubkhungunitsonly) 'fo a�,�Ia a rfCez ry 15. X New window units to have OBSCURED GLASS 0 Full 01/2 INDICATE FORM OF PAYMENi� w 16.)00 New window units to have HALF(1/2)5 REEN (full screen on casemenr Deposit Wlth Order ��- 33% $ type window) Paymenton 17. 0 Windows to have GRIDS Colonial Diamond fes/ All 01/2 Additional info f � Measure or Start 33% $ 18.90 O Install PVC COATED ALUMINUM to window frames Balance Due on <_ Color -& I Q dQ�' #of 0penings Substantial Completion 34% $ SG 19. O CAULK AND SEAL windows'with 3 point system Total Amount of q 20. 0 COLOR OF WINDOWS HITS O BEIGE O WHITE/CHERRY WOODGRAIN Balance to be Financed $ i , !- 0WHnE/U.OAK WOODGRAIN 0 WHITE/DK.OAK WOODGRAIN 0PAINTED COCOA/WHITE If financed, balance is payable in monthly installments of OOTHER approximately$ per month,payable by"Owner"to Contractor, 21.( JO Total#Double Hungs Total#Two Lite Sliders but if financed by Owner then Owner will pay said amount to the lending Total#Casements Total#Three Lite Sliders plus such interest and credit service charge of said lending mstltut rayable direct) to the lending institutionloanin such monies Total#Hoppers Total#Dead Lite/Pictures y g i aiscQumsssHave to"Owner"and will execute a Retail InstallmentBeen� 7IeBA Total#Awnings Total#Basement Sliders obligation and any documents required by suchneTerred#a restn-namue=�{ Standard or Equal lending institution in connection with said loan. ENE__�!'t€ yo1 Ism ME I S NOTRES�N511 �1Ff �• L _ ENfQ ES,® � YERTfCALW-BL(NDS,CURTAINS,D TAPES OR WINDOW MOUNT D=AIR CONDITIQ�IERSr PRIOI(TOTHE INST/1LLATII(N QFifIDf1R `NEW WINDOWS INSTALLERS ARE NOT RESPONSIBLE FOR THE ItE MOVAL OR�NSTAI.LATION OF HESE E1(PES QF ITEMS:: NOTICE:If financed,any holder of this Consumer Credit Contract is subject to all claims CONDENSATION INSIDE THE HOUSE DOES NOT INDICATE A WARRANTY and defenses which the debtor could assert against the seller of goods or services PROBLEM. obtained pursuant hereto or with the proceeds hereof. Recovery by the debtor shall not exceed amounts paid by debtor hereunder. SALESMAN HAS NO AUTHORITY TO CHANGE ANY ITEMS OR MAKE ANY "OWNER REPRESENTSTO HAVE READ AND RECEIVED A DUPLICATE ORIGI- REPRESENTATIONS OTHER THAN CONTAINED IN THIS AGREEMENT AND NAL OF THIS AGREEMENT AND TO BE THE AUTHORIZED AGENT OF ALL "OWNER"REPRESENTS THAT NONE HAVE BEEN MADETO OR RELIED UPON "OWNERS"OFTHIS PROPERTY UPON WHICHTHE WORK ORTHE MATERIALS BY"OWNER".YOU ARE ENTITLED TO A COMPLETELY FILLED IN DUPLICATE ARE TO BE SUPPLIED. NOTICE TO THE HOME OWNER(S),GUARANTOR(S), ORIGINAL OF THIS AGREEMENT. LESSEE(S),CO-SIGNER(S)." Contractor,at the expense of owner,shall procure all permits required by law. "YOU,THE BUYER,MAY CANCELTHIS TRANSACTION AT ANYTIME PRIORTO MIDNIGHT 1. Do not sign this Agreement before you read it or if it contains any blank spaces OFTHETHIRD BUSINESS DAY AFTERTHE DATE OF THIS TRANSACTION.SEE ATTACHED or if it does not contain everything agreed upon. NOTICE OF CANCELLATION FORM FORAN EXPLANATION OFTHIS RIGHT.ON ALLORDERS 2. Any person who shall have co-signed,guaranteed or signed any credit application CANCELED AFTER THE RECESSION PERIOD,CUSTOMERS WILL BE RESPONSIBLE FOR A or note relating to this Agreement hereby accepts to be bound by this Agreement. 45%ADMINISTRATIVE AND RESTOCKING FEE" 3. Owner(s)represents that the contents on the back of this Agreement is a true part SEE REVERSE SIDE FOR ADDITIONAL TERMS AND CONDITIONS.BY SIGNATURE hereof and has been read and accepted by Owner. BELOW,CUSTOMER AGREES TO THE TERMS OUTLINED ON THE REVERSE OF THIS 4. ALL INSTALLATION/LABOR GUARANTEED 1(ONE)YEAR. CONTRACT. DATE Io Contractor Accepted (Sig lure) Print / Salesman's Name (�l b�a Signature Salesman's (Customer5ign Here) License No. Signature 02007 HomeQub Remodeling Inc All Rights Reserved 0607 (Customer Sign Here) I Board of Building Regulations and Standards License or registration valid for individul use only = HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration. 155876 One Ashburton Place Rm 1301 Expiration. 5/16/2009 Boston,Ma.02108 Type:: Supplement Card iw , HOMECLUB REMODELING INC WALTER VOGEL ` A./ 113 CEDAR STREET SUJTE<;52 MILFORD,MA 01757 Administrator Not valid without signature I I � DATE(MMIDDIYYYY) AC ORD CERTIFICATE OF LIABILITY INSURANCE HOMEC 3H I 06/25/07 RDDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ICS Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 0.0. Box 220493 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR .1 Grace Avenue - Suite 300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4reat Neck NY 11022-0493 ?hone:516-466-6007 Fax:516-829-5857 INSURERS AFFORDING COVERAGE NAIC4 4SURED INSURERA: Hermitage Insurance Company 18376 INSURER B: The Hartford 22357 HomeClub Remodelin Inc INSURER C: 113 Cedar Street Ste S-2 INSURER D: Milford MA 01757 INSURER E: :OVERAGES 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. 15 -TR NS TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY DATE MMIDPOLICY EXP DIYY LIMITS EACH OCCURRENCE $1,000,000 GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY HGL528500-07 07/01/07 07/01/08 PREMISES(Ea occurence $50,000 CLAIMS MADE �OCCUR MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE s3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG -$2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 B X ANY AUTO 12UEND00235 07/01/07 07/01/08 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIREDAUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F]CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS X I ER B EMPLOYERS'LIABILITY 12WETS7397 07/01/07 07/01/08 E.L.EACH ACCIDENT $1000000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? E.L.DISEASE-EA EMPLOY $1000000 Myes,descdbeunder E.L.DISEASE-POLICY LIMIT $1000000 SPECIAL PROVISIONS below OTHER )ESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS :ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 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 Sue Hong t \CORD 25(2001108) ©ACORD CORPORATION 1988 { BOARD OF BUILDING REGULATIONS icense: CONSTRUCTION SUPERVISOR i Number::CS 079394 iirthdate OJlQ:911�57 �� Expires 0910912008 Tr.no: 2768.0 ' ' � ' •'� strict 00 WALTER VOGEL BOX 4 EV / EVERETT, MA 02149 Commissioner E E i I 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 Le ihly Name(Business/Organizationtbdivida#) b I Andress: CeAcLr City/State/Zip:M t JEe roll M A 01-79-7 Phone.#: (5b8 Are on an employer?Check the appropriate box: 4. I am a Type of project(required):. 1. I am a employer with � ❑ general contractor and I - _ �—* have hired the sub-contractors 6• ❑New construction employees(full and/or parttime)• , 2.❑ I am a sole proprietor or partner- listed on the-attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance co mp.insurance.t 9. [3 Building addition required] 5. ❑ We are a corporation and its ,10.❑Electrical repairs or additions •3.❑ I am a homeowner doingall,work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right-of exemption per MGL 12.E]Roof repairs insurance required.].t c . 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating•Brey are doing all work and then hint outside contractors must submits new affidavit indicating such:�' tconactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have • employees. If the sub-contractors have employees;:they:must provide their workers'camp.policy number. I am an employer that is providing workers'compensation insurance for information. my employees. Below is the policy:&nitjobsite' ` Insurance Company Name: Policy#or Self-ins.Lic.#:12' w ET.5 7 39.7 Expiration Date: 7 1 O$• Job Site Address: ----- .`ter d�- ,� City/StateMp: /01(/. Attach a copy of the workers'compensation Policy declaration axation a e (sho wmg the policy number and ezpirahon`date). Failure_to secure coverage as required under Section 25A of MGL c. 152 can lead to.the imposition of criminal penaltes.,of a fine tip 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$250.00 a day against the violator.;,Pe advised that copy-of this statement maybe forwarded to the Office:of . Investigations of the WA for insurance coverage verification. I do hereby ce u r pains•and penalties of perjury that the information provided above true d correct Si lure: Date: Phone#: 'SO$ —4,(. i Official use only. Do not write in this area,to be completed by city or town..offu:ial City or Town: Permit/License# Issuing Authority(circle one): .1.Board of Health 2,Building Department 3.City/Town Clerk 4.Electrical Insp 6. Other ector 5.Plumbing Inspector Contact Person: Phone#•