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HomeMy WebLinkAboutBuilding Permit #366 - 27 FURBER AVENUE 12/1/2008 BUILDING PERMIT No oTII qti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: /C71- Date Received 4 ,� ��SSACHUS t Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION IQ t )5 Print PROPERTY OWNER_ 0 Vv1- A Print MAP NO: ( �? PARCEL: ZONING DISTRICT: Historic District yes no 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 Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: n L S dentification Please Type or Print Clearly) OWNER: Name. Phone: Address: It`, CONTRACTOR Name: '� Phone: CSS --g l Address: S - CyC GsP' a . 7 Supervisor's Construction License: Exp. Date: (o Home Improvement License: G( Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASE 9N$125.00 PER S.F. Total Project Cost: $ T`?��(Q . FEE: $ Check No.: 6 © Z/ Receipt No.:_ CQ �2a" NOTE: Persons contracting with unregistergd contractors do not have access to the gu ranty fund Signatur of.Age Own ����ature of contract _� f nq Location �� �� �= ✓� No. 3—� Date 'F NaRTh TOWN OF NORTH ANDOVER + • . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # d n �$uildmg 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 HEALTH COMMENTS r 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 Located at 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 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 ,tAORTIy Town of Andover No. (e Yw C,o == K E o dover, Mass., T_ • COCHICHE WICK �A0RATED 'QS BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......r ......... Foundation �� Rough . ...........has permission to erect........................................ buildings on .. ...... ...... .. ........ . ... � ........... to be occupied as............. 4.®. .KY�... ............................................................................................ Chimney 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 � ELECTRICAL INSPECTOR VFinal aW I'ER.MIFI' EXPIRES �� � MONTHS�,�!LESS ..COI V S 1 .i\V_ kSA,,,s Rough ................................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. 10/25/2008 03:30 0000000000007 MADDEN & ROBBINS PAGE 01 Window Agreement-Page 1 of 2 104 Otis Sit.,Northborough, Windows,Inc.,dlblahborouph,MA 01331 Wndemn. MA Homs Improvement Contractor (508)919-0900•Fax:(Sea)912-0903 Rewal License 0149601(Expires 112M2010f Customer Service ■ Federal Tax ID 023-0404201 Indiv.Licenses:John Ester(cs#74251), (600)573-7606 ry Kathleen Blanchard(#149601) wlNaow aaPLAOcr[ar a A-J. 1Un r, V Product Manager: Window A reement Contract Data: Homeowner "Owner")'s Name(s): Stroat Address: City o Smote Zip: Home Phone: i Work Phone: Job Site Address If dlfforant: remail Address: Materials to be provided and work to be performed by Renewal by Andersen("Contractor"): Contractor will furnish and install Renewal by Andersen-approved materials to the following specifications: 1. Date on which Work fe had to Begin: �_ Expected Date of Substantial Completlon(,�� 2 fontractor will Install a t a1 of windows in Owner's home,using the following individual quantities: Double Hung(DB) Equal sash ❑Cottage sash(113 top,213 bottom) ❑Oriel sash(213 top,1/3 bottom} _Casement(CW) ❑Hinge right ❑Hinge left(as viewed from exterior):❑Standard handle ❑Metro handle Double Casement(CDW) ❑Standard handle MMetro handle _Casement/Picture/Casement(CPW) ❑1:1:1 ar q 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(PW) Bay or Bow Window: 3. Ild'Yes ❑No #Windows to be Custom Fit Replacement: 4. ❑Yes S<o #of sills to be replaced by Contractor: 5. M Yes QW6 #Windows to be New Construction Full frame(includes new interior 8,exterior casings): Exterior casings: Pine 13 Maintenance-free material ❑Factory applied 900 Fibrex brickmold 6. Glazing to be:Qo'IghPel►'ormance ❑Other If other,please specify: 7. Exterior color to be: M47hite ❑Sand Cl Canvas ❑Terratone 8. Interior color t be: ite A Sand ❑Canvas ❑Terratone f�-V�od�(e -�. Note:intefior for can o be white,wood or same color as exterior. Wood into ors need to be fin,i�d by Owner. 9. Hardware: White Stone ❑Canvas❑Brass Double Hung: Install lifts? ❑Yes 10, 10. ❑Yes o Contractor will remove metal frames or grilles. #of Units: 11. C7 Yes o Contractor will install new paint-ready or stain-ready casings.Inside or outside stops#of openings: Interior casing#of openings: Exterior casings#of ❑Pine ❑Maintenance free material Owner Is aWe that Contractor does not do any painting ner initials 12. ❑Yes Mono Contractor will wrap exterior casings with a uminum coif stock of color. Note:Required with storm van w removal;removal of storm windows will leaves screw holes in casing. 13. New windows to have: %Mag or ❑Full screens Screens to be: efiberglass ❑Aluminum ❑Tru$cene 14. Windows to have grilles; JKes ❑No If Yes: ❑Grille Between Glass(GBG) Movable Interior Wood(INTW) ❑Full Divided Light(FDL) Grille patterns: #: #: #: #: #: #: #: L__�j P R El F� LLil DH DH DH DH CW/Picture Glider or GPW "use acdtttonal sheet if needed Owner approved(int L 15. VY s M No Contractor will insulate,caulk and seal windows with 3-point system to preven wa er and air infiltration. 16. s ❑No A limited warranty shall issue to Owner upon completion of the job and payment in full(see reverse side). 17. es ❑No Building P r{�mit-Contractor will secure any and all necessary permits.The feeor the arm'( )is not included in the Contract Pri and a separate c is required at the time of sale for this fee, l�{ Ota 16. Additional job deta�'Ils' y S �F 19. Vag ❑No Owner has Loviewe h A it ria Terms and Condition ov ming this Contract on the revs side-'F 20. Total Contract Price:$ Regular Reta'I Price:$ All suet ble dl un s appl'ed: e ❑No 21. Deposit(113):$ paid y❑Cash �.F�nance (Acro fit#: ) Second(1/3)$ to be paid by Cash at startof job on,. (Estimated start date). Final(1/3)$ f to be paid by Cash at completion of job on _ (Estimated completion date). 22.X-Ves ❑No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. No final payment shall be demanded until the contract is completed to the satisfaction of al/earties. NOTICE: All home Improvement contractors and subcontractors must be registered. Any inquiries about a contractor or subcontractor relating to a registration should be directed to: Registration Division,Program Coordinator,One Ashburton Place, Room 1301 Boston MA 021011,Tal: 617)727.3200,ext.25239. The parties hereby mutually agree In advance that should a dispute arise regarding this contract,Contractor may submit such dispute to a private arbitration service that has been approved by the Office of the Consumer Affairs 8 Business Regulation and Owner shallZMAW,2—wrierSignat d to submit to such arbitration s provided in MGL c.1420. Contractor Signature: NOTICE:The signatures of the parties ab ve apply only to their agreement to ernate dispute relution Initiated by Contractor.Owner may initiate alternate dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES J&L Win Ilnlv_s,Inc.d/ Ren wal by ndersen _-1 By: Prod ct snaggy ner nature � ���doAAA Product Manage (Print Name) Signature White—Renewal by Andersen Yellow—Installation Pink-Homeowner The Commonwealth ofMassachusetts Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 wwmasWorkers'Compensation Insurance Affid v t Bidis A licant Information ers/Contractors/Electricia.ns/Plumbers r Please,-Print Le ibl Mine(Business/orgmizadon/Indiddual): Address: •S L City/State/Zip:I&L G r ��� Phone#: ViaF) 7Armployer?Check theappropriate boa: Type of project(required): ployer with 4. ❑ I am a general contractor and Ies(foil and/or parttime).' have hired the sub-contractors 6• ❑New construction le proprietor or partner- listed on the attached sheet x �• �Remodeling have no employees These sub-contractors haveg, ❑for me in any capacity, workers'comp.insurance, Demolition .eqers'comp,insurance 5. ❑ We are a corporation and its 9• ❑Building addition required.] officers have exercised their 10.0 Electrical repairs or additions . 3.•❑ I am a homeowner doing all work myself right of exemption per MGL 11.[I Plumbing repairs or additions [No workers'comp, C.152,§1(4),and we have no insurance required.]t em to ees. 12.❑Roof repairs P y [No workers' comp.insurance required.] 13__J. .0 Other '�Y applicant that checks box. must also fill out the section below showing their worker;'compensation policy information. t Homeowners who submit this affidavit indicatingtheyworandffi _ #Conhactors that check this box mustattached an addih'onal she showing the name of the sub-contractors and their w�ers om�p policy information I am sn employer that is providing workers'compensation insurance for my employees Below is the oli � information. p cy and job site � Insurance Company Name: � �"/e�C�117� -, Policy#or Self-ins,Lic.#:_ j�J Expiration Date: �10 Job Site Address: City/State/Zip:_ �bcj Attach a copy of the workers'compensation policy declaration page(showing the Policynumber a ��my Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of c nriminap!rhon date). fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP W Of up to$250.00 a da as 1 penalties ndof i Y against the violator. Be advised-that a copy of this statement may be forwarded to the Office o f d a fine Investigations of the DIA for insurance coverage verification. Ido hereby c rtify under th pain and penalties orjury that the information provided above is true and c rrect Si ature: Phone#• \0 P (' 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 Inspector 5.Plumbing Ins i 6.Othe -------------- r g pector (i Contact Person: Phone#: I �-' Nl:msachusetts.- Department of Public Safety Board of Building Regulations and Standards - Construction Supervisor License s License: CS SSMS Restricted to: 00 SCOTT PHILLIPPI 58 0 STREET WHITINSVILLE,MA01588 Expiration: 6/7/2011 Co nuns sioner Tr#: 99256 Restricted to: 00 00-.Unrestricted LG-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: VVWW.1VI2ss-G0v/DPS . p ���utGw�utJe�d Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registca0on:, 149601 E5W,— E�a-M4/2010 ype 10 ilement Card RENEWAL BY ANDtSQf SCOTT PHILLIPP Al 104 OTIS STREET'1 NORTHBOROUGH, '0T532 Adjninistrator A�II '°°" ACORD- CERTIFICATE 4F LIABILITY INSURANCE ° PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Joseph MCKeone ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE JP McKeane Insurance Agency, OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9 CYC Inc.. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 333 Ann Arbor, MI 48106-0333 INSURERS AFFORDING COVERAGE NAIC 0 INSURED Renewal by Anderson INSURER A: Hartford Insu nce Company J&L Windows,Inc. INSURER B: Hermits- e 104 OUs St INSURER C: Northborough,MA 01532 INSURER Or INSURER E: COVERAGES 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. INSR D-LPOLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER LIMITS B GENERALLUIBIUff HCP 507 404 09/07/2008 09/07/2009EAcH=uuRRcNcE S 11.000.000 COMMERCIAL GENERAL LIABILITYZQ PREMISES Ea comroneal S 100,000 CLAIMS MADE ®OCCUR MED EXP(Arvy one person) PERSONAL&ADVINJURY S 1 000 O 0 GENERAL AGGREGATE f 2 M0,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO f 2 o0a ODa POLICY 17 PRO' LOC A A1t0°dOBiLE''O'L'TM 35 MCC XD 6390 10101/2007 10/01.2008 COMBINED SINGLE LIMIT ANYAUTO (Ea 0=401) S 1,000,000 X ALLOWNEDAUTOS BODILYINJURY ' S SC14EDULEDAUTOS , (Parparm) HIRED AUTOS BODILY INJURY NON-0 EDAUTOS IParoceidsnq S PROPERTY pAMAGE S (Por ao.dent) GARAGE ILIABIJITY AUTO ONLY-EA ACCIDENT S ANYAUTO H ' OTHER THAN EAACC S AUTO ONLY: AGO S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR D CLAIMS MADE AGGREGATE S S DEDUCTIBLE f RETENTION S S A WORKERS COMPENSATION AND 35 WEC PP 1444 02/17/2008 0211712009 we sTATu- SR EMPLOYERS'LIABILITY ELEACH ACCIDENT S ANY PROPRIETORIPARTHER/EXECUTN . . E 500,000 OFFICERiIiIEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S 500.000 If ra,dest7@e under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MALL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL 04POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108) f 4(,4/0 cACORD CORPORATION 1988 x re al :�Mj By ANDP.RSO, - woodNinyl composite Frame F#aCnal Ferecbatior Dual Argon. Low E Retlag:Canc�� Glider 'ENERGY PERFORMANCE RATINGS - U-Factor(U.S)/I-P Solar Heat Gain Coefficient t 0 3 4... 06'.30. . 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