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HomeMy WebLinkAboutBuilding Permit #194-15 - 265 BEAR HILL ROAD 8/25/2014 BUILDING-PERMIT "°nTij TOWN OF NORTH ANDOVERr APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ACHUS���� Date issued: I O TANT:Applicant must complete all items on this page _.:t'.' 7 S „ y, :Arn4 • te .tte'�t `5 -.51 • NON 't''�J•'�:r.. v �� =1'.x-�-s Fi �,��'- 9 .^,t n, ,. f1s,. -cJ4 y-3 �`�”' �"pa �� ",r. �'�� %Gr,�.�y..�'`"-6.�,.ei�a� "HI. 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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 - ,.Nf-xr�fi 1 IR EiuT` +try,r r `.>;tr' Y` -x"- ,....."v=n1"--, � � 3 lub ' .. .y, � ��y p�• -sr r_ X1-k�I-} { h ..n. K_.. YYY I*. "dr•:oF.tYs 1 .,"Fk.(g"Sf.<G ? =rit � ,cu, y. �.,YY yvr -,r.��4j7 f'•y �Gf ,}3�.,51j`j}:. .._t.....' .c�. .t'.,.,.}tet ,.,,J.,:;_:PJF'y-•1 M...x. 5..2:�-. �....1; ..s.. .. .::,u...r =�� DESCRIPTION OF WORK TO BE PREFORMED: -" 1 acndw�Az , Identification Please Type or Print Clearly) OWNER: Name: ne '(Cp'(CA. i- Phone:�1��� ia'�S -`—Tj Address: f€ __:Nva>,..y ,:r:udr_t....,Y,";.u>~'.. -'uaffi.:r•., � ,�' �'�-t�-�"• =„t,dx5��'1' ,r",�'.'V f �•' ate' 4i:�.s,-",tx�,. �.r�r��tas st �, mow• 3 • � a`�' .��tttlf'i5. ;,earl _.� � �-.'��'k - cr' ,iz`_e!S`e-..7 sxtC�-f�a�4. #r*' ���d�^;��•� 'e -"�'•�y� �r3: �f'��w'Y `z•.3 ' ... ����� �I�'aY��L' Fl vv�PIro xf �..� tx ry ��z --.`s ����'^���I a��,�"� 17�p�.-s..`-a✓,}, r•�t., -v"�, • �". �. 0-1Y. ,�,• x{ � ,N 1 y��u��� Yf r � J..` ,�H� °'��` `Y '—�;'�:a•��`_ �y�',�` ,''�, �y�a"��d r�� ?4�-� y �i ��++r � =• 7 ra �•c 'y 9n �f,Ly[�•1���'�., 3 9��T7''dRp��.�,�1Z� 1 _ � w9r , 7^ e •- .1n ,._ 't.L '� 'y.',9°3�IvF7'n'y�sN��.r<�lL1�L2-n'{,�j.>s-�C rG!"�RIN h err".� `;`;'' S 1 tl�s ,x+.13. 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'F !n� �skar a� -Ys �y �c+�ra �{�. �''•s„���Lam'^.3�_� e�� .�c.�� 't��'t �u t f �i y.y�.c5 �r,��a 1'� ,x�Y���xrr]���_'1'1T'3.'"^�r�}v��Y9sp o'�' 4 i--F•a� ,rt: ZS`,, y IasJ 3)1`,s,��'jig�( ��e^''Ar -e'.cy� �y.c�"^.���.xa" .ASH^��a,�v��' 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: $ 13; 014(0,00 FEE: $ A ) (D Check No.: 14 Receipt No.: � �3 NOTE: Persons contracting with unregistered contractors do not have access to the u aran tyfund s S i ra�Euiaf,/ 'en /,Oanern nature Yof co35 ctijr ' r L-Y The Commonwealth ofmassachusetts • - Department ofXndus 1a1 Accidents Office a,f TnvestigatioM . 600 Washington Street .Boston,MA 021.11 W4J ) wmmassgov/dia Worker>g'Compensation xn.murauce Affidavit:Soilders/Contractors/Electxlcians/Plumberg Ann :cant Information Please Pxint Le ibiy Name(Business/Organizzation/W:dividual): , MO�(t> L,S .J�nc.. arm N Q Address: a - C:ity/S#ate/Zxp: �Y1 phone#: 03_ Are ypu an employer?Check the appropriate box: die of project(required): 1.[i''Z am a employer with 4• ❑T am a general contractor and 1. 6, E]New onstruction r employees(ffiffl andlorpait lime)., have Hired the sub-contractors 2.❑ I am a sole proprietor orpartaer- listed on the attached shoot 7• EAemodeling ship and.have no employees These sub-contractors have 8. ❑Demolition working forme in any capacity, workers'comp.insurance. 9, 11 Building addition [No workers'comp.lalwMuce 5. ❑ Weare a corporation and its 10.�]Electrical repairs or additions required.] officers have exercised their 3,❑I am a homeowmr doing all work right of exemption per MOL 1 LQ Plumbing.repairs or additions myself.[No workers'comp. c.1:52,§1(4),audwehaveno. 12.QRoofrepairs insurance required.)t employees.[No workers' 13,n Other COMP.insurance required.] !Any applicant that chwksbox.#Imustalsofill outthesection below shafttheirworkereeompmsetionpolic h5namion. t Homeowners who submit this affidavit 3ndioating they ale doingall work and then hire outside contractors must submit anew afddavIt indicating suob. IODntractors that cbeckthis box must attached an additional sheet showingtheneme ofthesub-contractors andtheir workers'comp,pollcyinformation. Xyam an employer that isprovidtng workers'compensation insurance forrrry employees. Below is thepolicy mad fob site ir�ormatiora. Insurance Company Name% Exc6s,"Or S!\Ster�cv�c� Policy#or Self ins-Llo.#' W G S n3(430 5 Expiration Date: Job Site Address:_ �J• �1 City/State/Zip: - (YA 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 25A ofMGL o.152 can lead to the imposition of criminalpenalties of a fine up to$1,50 0.0 0 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 maybe forwarded to the Office of Investigations of the DTA for insurance coverage verification. Xr7012erebycertifyundae dpenaltiesofperj'urythattieinafayrmationprovtrtedJahoveistrue and'correct i e• Date: I�2114 Phone#' Official use only. Do not write in this area,to be completed by city or town official City or Town.: Permimicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.C41Town Clerk 4.Electrical inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: Location,�G No. Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ - Foundation Permit Fee $ �r Other Permit Fee $ TOTAL $ Check# -3jq IS 8 `t3Utl ing Inspector NORTH Town of E ndover No. * ti ver, Mass, cocmlcHew'cu 1101 7�S R�{7E0 PPP,�'�y U' BOARD OF HEALTH Food/Kitchen PER Septic System THIS CERTIFIES THAT . .l�11T ,....�. .-CA+r .................................... BUILDING INSPECTOR Foundation • has permission to erect.......................... buildings on .....0(ar.....8.0pr'.-KA • Rough to be occupied as ..........it.n y ............ . ....... �Il...... .......................................-- ......................... Chimne provided that the person accepting this permit shall in every respect conform to the terms of the 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 CONSTRUCTON RTS 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 No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. ti Owner's Namt .lob Address:_ Beatrice Cutler 978-685-5065 SIDING - WINDOWS - DOORS 265 Bear Hill Rd. f Phone:_ North Andover, MA 01845 — Family Owned And Operated I/we the owner(s)of the premises mentioned below hereby contract with and authorize you to furnish all necessary materials,labor and workmanship, to install,construct and place the improvements according to me following specifications,term and conditions,on premises below described; Brand: �prvt V (WINDOW)SPECIFICATIONS Quantity: Build Tie Into Low-E Metal PVC New Inside TOTAL$ Roof Overhang Argon Screens Grids Trim Trim Finish 1310 q ;CG Color: Yes No Yes No Yes No Yes No Yes No Yes I No Yes No Yeo No Double Hung XX X kX )( Picture •^ mac$ ,Soo Q CC Slider I Bow/Bay Gartlan `�()�,1 C.' Cas/Awn _ L NOTES: f— MATCs+y SOLO - airy ) ' mii��dty auinitCr15e»devi — f7 » e I I?p�elra/ vii—Pyl C,0 fe-t iiuL 4 I�e use +-ri v tr.►Yti / q6d' .S;fI 14, 'C X•nrr4, It 1 (SIDING)SPECIFICATIONS Apply over body area of house.Type of insulation Items not covered or installed: Yes No Yes No Yes Fief Strip off Existing Siding Vinyl Shutters Roof � t I Provide Container and remove all Window Mantels New Gutters debris Cover Fascia&Soffit Door Surrounds Gutter off&on Door Window Casing Ceiling Fluted Post 51/2 Vinyl Fixture Accessories if needed PVC Trim Traditional Post 5'/z 4"Corners i ON START OF ALL JOBS-HOMEOWNERS MUST REMOVE ALL ITEMS FROM WALLS&SHELVES Construction related permits:If the homeowner obtains his own construction-related permits for the work described under this agreement the homeowner is here by advised that in the event of dispute,judgment and nonpayment of the corrtractorthe homeowner will not be entitled to make a claim to or collect from the guaranty fund established by Chapter 142A,M.G.L. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from Reacts in materials and workmanship for a period of 1 Year following mrfpletion and shall comply with the requ'rements of this Agreement.In the event anydefect In workmanship or matterlals,of damage caused by the Cartractio is subcmtmctas,empbtees or agents,isd'scmeredwithinone yew aftereanple- tion of any Job.Inctuding cioarvrp.the Contractor shall,at his awn eiperse,fonhwifh remedy,repair,eoneet.repioce,or cause to be mmodied,repaired,or repaced,such damages or such defect in materials or workmanshq.The foregoing warranties shall survive any Inspection performed in connection with the agreed-upon Yak,No guarantee on gutter back W In roof,no guarantee on ice back up and no guarantee on facing of vN siting.BROOKS does not do any palming a staining. BROOKS Is not respor itrle for the conditions of circumstances beyond its control resulting from or due to pre-odsting conditions,BROOKS is riot respwtslble NK any rotten wood from any existing work.If retied wood is foundan additional charge will be incuned.BROOKS will charge for replacement pans.BROOKS Is not responsible for mold or mildew,All warranties or guarantees relate back to the manufacturer.Under such manufacturers'warranties,the Owner may be required to rog!ster or mail In a warranty card or other evidence of ownership and use of such equlpmem in order to activate such warranties.No money should be held back due to manufacturer's serote and repair.The Owner's fai:ure to mail in or register such documentation,which fa..".ure voids the manufacturer's warmmy,shall not create any respaisidt ty for the Contractor to warranty such equipment.MANUFACTURER GUAAANM LABOR AND MATFW.NOT BROOKS SIDING.A service charge of 2%of the unpaid balance par month W71 be added to balance irrwt paid according to farms orcontract on completion orcontract.Maximum hold hack l o%reminving balance or last payment whichever amount is less or the 2%service charge will be applied.Addilsirial charge for adding non-job site related materials into dumpstec TOTAL$ Brooks Vinyl Siding•Windows•Doors Name of Contractor/Designated Ragistram Payment to be made as follows: 1/3 ($ 1 Upon signing Contract; 254 N.Broadway-Breckenridge Mall street Address 1/3 is 1 Stan of Job Salem,NH 03079 (603)894-4488 www.brooksswd.com City/State Phone Moshe 1/3 IS 1 Balance upon completion 101682 99730 HIC a/Registration M CSLL e 1,12c If Cancelled After 3 Days, Int Ofe ant cori Balance Is Non-Refundable. 71��rX /1•Y yJ�,1 yf,r f�- Nohco:No agreement la Homo Improvement rnntracting work shall require a Gown paymam(aAanw „/ deposio of more than-50%-of the total contract price or the total amount of all deposits or payments Name or salesman which the contract or must make,in advance,to order and/or otherwise obtain delivery of special order 0/f _ materials and equlpmenl,whichover amount is oreater. Authorized Signature Acceptance of Proposal-I accept the pricas.spectucations and conditions stated.I understand that upon signing,this proposal becomes a binding contract.You are authorized to do the work as specified.Payment wig be made as outlined above.You,the Buyer may cancel this transaction at any time prior to midnight of the third business day atter the date of this transaction.Cancellation must be done M writing.We reserve the right to check your credit DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. IN WITNESS WHERW of thaparties hereunto hap signed�their names this day of l trL 20� Signed A service charge of2%of the unpaid balance per month will be adder/N balance irrwt Y t paid according to terms of conhact on completion of contract.Maximum hold back 10% l remaining balance or last payment whichever amount is less or me 2%service charge Signed will he app.': �q7r7M41horal Charge for adding non-Job site related materials Into dumpstec Yes.I am the Own !RNIB/ tr CERTIFICATE OF LIABILITY INSURANCE UAIt(MMIUUIY B/12/2©14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE: HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the po(icy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Linda Sogdanowicz Insurance Solutions Corporation PHONE (603)382-460Q FAX (603)382-2034 60 Westville Rd E-MAIL ADDRESS:lindab@isc—insurance.com INSURERS AFFORDING COVERAGE NAIC If Plaistow NH 03865 INSURERA:Peerless Indemnity Insurance 18333 INSURED INSURERB:EXCelBiOr Insurance 11045 Brooks Construction Co. of Lawrence Inc, DBA: INSURER C: 254 N. Broadway INSURER D: INSURER F: Salem NH 03079 INSURER F: COVERAGES CERTIFICATE NUMBER:CL145716377 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 WHICI I TI 113 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN5R ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER IMMIDDaYYYI (MMIDI)fVYYYILIMITS ocNcrul LIADIwrY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,000 A CLAIMS-MADE rX0 OCCUR BP8945793 /16/2014 /16/2015 MED EXP(Any one person) $ r 15,000 PERSONAL a.ADV INJURY $ 1,000.000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY JrCTPRO. LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS e accident) $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ ::4EXCESS LIAR CLAIMS MADE ACORCOATC $ DED I I RETENTION$ $ B WORKERS COMPENSATION I NC STATU• OTH- ANO EMPLOYERS'LIABILITY Y I NCRY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED, [KN] NIA E.L.EACH ACCIDENT $ 500,000 (Mandatory In NH) RCS836275 /16/2014 /16/2015 If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Beatrice Cutler ACCORDANCE WITH THE POLICY PROVISIONS. 265 Bear Hill Rd N. Andover, MA 01845 AUTHORIZED REPRESENTATIVE Keith Maglia/KLM ACORD 25(2010/05) T -_^^^ ©1988-2010 ACORD CORPORATION. All rights reserved. •Ay � �-�llr' f/r.»rltrf ulir'rt���r/r((ii�lrrrttn.rfr: , Z' Office of Consumer Affairs&Business Regulation 4 OME IMPROVEMENT CONTRACTOR ?Registration: 101682 Type Expiration: 6/29/2014 Supplement BROOKS CONST.CO., INC.OF LAW MARK DI PRIMA 254C N. BROADWAY STE 110 SALEM, NH 03079 Undersecretary Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen•isor Specialty License: CSSL-099730 MARK DIPRIMA 18 HAWK DRIVI SALEM NH 030' s� Expiration Commissioner 02/20/2016 l/ LL 94� °�� ° r ,/ tG,.;.;.,,/,%r16' r— Office of Consumer Affairs&Business Regulation tbME IMPROV EMENT CONTRACTOR e istration. 101682 Type- $F ype$ Expiration: 6/29/2016 Supplement 1 BROOKS CONST.CO:, INC.OF LAW MARK DI PRIMA 254C N. BROADWAY STE 110 SALEM,NH 03079 tindersecretary t Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-099730 x MARK DIPRIMA�= 18 HAWK DRIVE' SALEM NH 030' �,,ti;,, .11 • " "`.' - Expiration Commissioner 02/20/2016 7361 Date G�. !. .......... WORTH pF �.ao ,°1h0 o? TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION p9 �9SSgCMUSEt�y This certifies that . .4-.h�( f� . . . . . . . . . . . has permission for gas installation . . ri k�. r `� . . . . . . . . . . . in the buildings nof- . .� �^. . . . . . . . . . . . . . . . . . . . . . . . . . . . . at ..2 ?�. . . l�H. Li c. L / �! 1„ L North Andover, Mass. Fee. . 6.�. Lic. Noj-. .L.� . . �- .- . . . . . . . . INSPECTOR Check 4 ? L MASSACH SET)'S UNIFORM APPLICATION FO PERMIT TO DO GASFITTING / u ,Mass. Date f 20/0 Permit# _ Building Location Owner's Name C 13'eAk Type of Occupancy / New G— Renovation ❑ R lacement ❑ Plans Submitted: Yes❑ No❑ con E_ chi` w ¢ dao °off . Ww � w � ¢ � rxw �awHA �" rx a H > G 0H v SUB-BASEMENT BASEMENT FIRST 1 ST FLOOR SECOND 2ND FLOOR THIRD 3RD FLOOR. FOURTH 4TH FLOOR FIFTH 5TH FLOOR SLXTH(6TH)FLOOR SEVENTH TT FLOOR EIGHTH 8TH FLOOR Installing Company Name 171T-6 Address Check one: Certificate Q, 1A-�j b1,6-1 , /5A-C 9--Corporation 2!j_ Business Telephone wo 3 ❑ Partnership Name of Licensed Plumber or Gasfitte 14 V � ❑ Firm/Co. INSURANCE COVERAGE:. I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes D—' No❑ If you have checked y�s_please indicate the type of coverage by checking the appropriate box._ A liability insurance policy Fe Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the MGL,and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performe1 _d under the permit issued for this application will be in compliance with all pertinent provisions of the assachuse State Gas Code and Chapter 142 of the General Laws. By Type of Licmic:, ' / E7 Title B-Mumber [3-Master Si a r of Licensed Plumber/Gasfitter City/Town ❑ Gasfitter ❑ Joumeyman License Number APPROVED OFFICE USE ONLY