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HomeMy WebLinkAboutBuilding Permit #299 - 27 SAWYER ROAD 10/14/2009 BUILDING PERMIT NORTF� O�tt�Ec 16, A'40 TOWN OF NORTH ANDOVER O APPLICATION FOR PLAN EXAMINATION �o 1. Permit NO: Date Received A7Eo'PP,�<`� Date Issued: ,b IMPORTANT: Applicant must complete all items on this page 01, yy 'F£M6� ./ylltfp�} Z�l , �. C}1STR[CTT RICTye no MAPiQ.;';� y PACEf 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 Seip# D lttilell P1 ZZ Wtl ds ! aterhdst a Il 1�1lateS��rVery ,. • a, DESCRIPTION OF WORK TO BE PREFORMED: tI1SfC�11 l tr ep ( Cc e�mev�+ W wbe-)LOL (and Onn-e (JWW , n� � x�Sjl�� Pen �1�� Identification Please Type or Print Clearly) OWNER: Name: N1 Ca C �o- C zUQ�-u 0 Phone: Address: a`l sow -er Uel ev 'tel. "z`3i �'�E �� � �b $ .£ x •�,e�' � �YX F Y' CC3.NFCTR Narrte �f '>��` hoie 7: � �� � 3 � � TY•ii 9 b C » ,-f ,p °�'' ,d �'9T,'S�Y E �ag�¢ar., 4fxy"A^3 �'➢.% __ Addre�S: _ F Su iery or's onstructr6n 1 s ry ,f �ro - - 44 Home Ian rovete, t (�[t ipp ARCH ITECT/ENGINEER IV)Ume s PCX O►'1 Phone: -- L ( a 3 a k 3(YJ Address: a(o C2-dC�- St \N0b(JV(-" 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 a'1 -C30 FEE: $ CZ Check No.: & -t Y Receipt No.: 22 572' NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contrac orf Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 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 ❑ 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 ©EPARTMENT Temp Dumpst'r on site yes no a Located at 124 Mdirt Street % Fire depA' en#signa#"i re/date N COMMENTS ¢,. f 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 i I i ❑ 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan a 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) o Copy of Contract o Mass check Energy Compliance Report a 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 I Location if t1 No. Date �oRTh TOWN OF NORTH ANDOVER Of ` c ,ti0 f D ♦ i i Certificate of Occupancy $ CNUS Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ r TOTAL $ Check # 22' 52E Building Inspector MA Re #146589 from Our Home to Yours... 9 Federal ID#20-2625129 CT Reg#0605216Lwpffi WNWA9058574 RI Reg#26463 Windows,Siding and More k Corporate Headquarters,26 C ar St,Woburn,MA,(P)800-342-2211 (F)781-933-9626,www.newpro.com THIS CONTACT MADE THE day of 20V9' between 0 (Home Owners) (Home Phone) Phone) (Bu a (Address) (City) (state) (zip) the"Owner"and NEWPRO Operating, LLC, "NEWPRO". The job address is a condominium. NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,fumish all labor and material necessary to install the following described work at the premises located at 5h7ln (Job Address) ` (E-Mail for proprietary use only TOTAL Additional Model TOTAL Windows Purchased NEWPIROZZMWork Number Qty CASH Window Color In: Ou V;j,&�&;2'Sliding Glass Door PRICE Capping Color Steel Securitypoor &e Door Color In-. Out: DEPOSIT Model Name Model Number(s) Qty Sidelites WITH Double Hung New Construction Unit ORDER Picture Window Storm Door BALANCE Casement Obscure Glass TOP BOTTOM DUE AT 2 Lite 13 Lite Slider Screens HALFF INSTALL Bay/Bow Frame Please Initial: Roof. ❑ soffit: ❑ Customer understands that NEWPRO®does not CASH Garden Window do any painting or staining. (ie:when removing Balance er at installation Awning or replacing interior stops or trim) Hopper NEWPRO®is not responsible for conditions or Shaped circumstances beyond its control including con- FINANCE Other densation resulting from or due to pre-existing Bank completion form signed at installation GRIDS 7MI Colonial I SDL ro conditions. DESC IBE WORK: > vGPlyE r7,, Est.Start Date: ustomer understands this is an"estimated date" Est.Comp. Date: 47 `-naia s Initials 1-1 Customer understands all steel security doors will have a 3/4"aluminum threshold installed over existing threshold. It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the Owner's Agent. The Owners who secure their own construction-related permits,or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC,142A. All Home Improvement Contractors and Subcontractors shall be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration,One Ashburton PI,Room 1301,Boston,MA 02108,(617)727-8598. If the Owner is obtaining financing by way of a Retail Installment Sales Agreement,such Agreement shall include a time schedule of payments to be made under said contract and the amount of each payment stated in.dollars,including all finance charges. The Retail Installment Sales Agreement shall be incorporated herein by reference. If the Owner is obtaining a revolving credit line to pay,in whole or in part,for the contract amount herein,the terms of the revolving line of credit including interest rate and payment terms,shall be clearly set out on the credit application. The portion of the credit application referencing- a time schedule of payment,to be made under this contract,and the amount of each payment stated in dollars,including all finance charges,shall be incorporated herein by reference. NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$100,000-$300,000. If the Owner refuses to permit NEWPRO to proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason whatsoever shall cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agreed to be paid,as fixed, liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage. NEWPRO shall not be held liable in damages for delays in the performance of this contract due to causes beyond its reasonable control. Owner warrants that he is the owner of the property on which the work is to be performed or that he is otherwise authorized on behalf of the owners to enter into this agreement. This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and NEWPRO. You are entitled to a copy of the Contract at the time you sign. Keep it to protect your legal rights. We,the aforesaid owners, certify that immediately after the signing of the aforesaid agreement, a copy was furnished to us. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office,or branch thereof, provided you notify seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. (Saturday is a legal business day). See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. he owner as seen"sample' wa anties that will be provided by NEWPRO uponinst Sample warranties provided to Owner. IN WITN S W EREOF,th parti have hereunto signed their names this / day of - 20 # Signed ' Marketing Represen ive rinted Name J Owne Accepted: NEW 0 erati C By L" L Signed � Owner CORPORATE OFFICE SHREWSBURY BRANCH OFFICE WARWICK BRANCH OFFICE 26 Cedar St 151-153 Memorial Drive Business Pk 24 Minnesota Ave Woburn,MA 01801 Suite B-C Warwick,RI 02888 (P)800-242-9974(From NE) Shrewsbury,MA 01545 (P)800-356-3312(From NE) (F)781-933-0717 (P)800-456-0555(From NE) (F)401-732-1371 (F)508-842-9248 WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy US-15 R0508 i ����® Wrrtlal�slDaa,�s"1n ; akr JOB# THE REPLACEMENT WINDOW PEOPLE t ��� � / fI Page—of r•3: tw yx xsx, CUSTOMER E-MAIL ADDRESS Q HOME PHONE_?2 DATE LIVOR LL PHONE (Circle one) T ADDRESS EST DAY TO INSTALL: M T W TFI F CITY,STAT O/ — (Please circle one) PRODUCT SPECIALIST G BRANCH: ESTIMATED START DATE =' TOTAL#OF #OF DOORS WINDOW COLOR WINDOWS #OF BOW/BAY/GARDEN Storm, feel, atio -Inside/Outside CAP COLOR OPENING SIZE STOPS NO. STYLE W x H U.;. LOCATION GRIDS IN OUT ADDITIONS OPENING CUT )-4 !`/el X/7 Ile-) i x x .44L V 9l 6X/2 9101 •► x x x x x x Qv ,f,J 7 x x x x x x x x x x x x x x x x x x x x x x Measureman: FA. i Initials Date Crew Size Needed Time Frame to complete job Capping Typ ---- Special Installation Instructions: Directions to site: Revised 1/01 NQRT#j Town of Andover0 . k No. 49Y 9 4 oA K E - lover, Mass., N T 1 COC MIC K WICK y�. 7� ORATED `s BOARD OF HEALTH PERMIT T D Food/Kitchen i Septic System 1M � BUILDING INSPECTOR THIS CERTIFIES THAT....►.'.` V...............................C.;z ..V.�..'.r.... .�................................................................. Foundation has permission to erect.......... g �' g buildings on ... ............ .... ........................................ Rough F 1� 1 tit I� OW1 Chimney to be occupied as I..�. . ayt�.--.................................. provided that the person accepting this permit shall in every respect con orm 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 5 Z- PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU STARTS 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 BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. - -The--Co mmonwealth of 11Massac usetts- ----- Department of Industrial Accidents Office of Investigations lra 600 Washington Street �\ ;, Boston, MA 02111 `-' wwn,.mass.gov/dia Workers' Compensation Insurance AffidaAt: Builders/Contractors/Electricians/Plumbers Applicant Information . Please Print Legibly Name (Business/Ormnizatiori'Individual): /V W P A 0 Address: 2b C EbAP. Sr City/State.-Zip: W0/3UP-d NW 01901 Phone r: 781 93,�4300 EXT -;L5 Are you an employer' Check the appropriate box: Type of project(required): 1.( I am a employer xith 50'l' 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors M r - ,- listedrn the attached sheet. Remodeling tJ a 3 1 a Sole prop—C-- o partaer- ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its - required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeo Amer doing all work right of exemption per MGL 11-El Plumbing repairs or additicrs Myself [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t 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 police information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.police information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Hackin+ire insurance AQencU _ Policy=.or Self-ins.Lic. =: W G 2- to y 5 9 n L Expiration Date: 5- ( "2-C) 10 Job Site Address: SCt wJ jI -_r 2 c� City/State/Zip: An d W C4/_ 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 of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provided above is true and correct Siznature: P0 P, N - Date: Phone=- "] $ i-q 5 3- Oficial use only. Do not write in this area, to be completed by city or town official. 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 Inspector 6. Other Contact Person: Phone#: