HomeMy WebLinkAboutBuilding Permit #782-2017 - 28 IRVING ROAD 2/16/2017I
i� �[,�;Q 'r✓ BUILDING PERMIT
TOWN .OF .NORTH ANDOVER
APPLICATION FOR. PLAN EXAMINATION.
Permit No#:.'7 - q Date Received
TYPE OF IMPROVEMENT _.
PROPOSED USE
Residential
Non- Residential
❑ New Building
DrOne family
❑ Addition
-❑-Two or more family
❑ Industrial
IWAlteration
No. of units:
❑ Commercial
Repair, replacement -
El Assessory Bldg
❑ Others:
— O Demolition
_0_TOther
F septic 1Nell
Floodplain "Weil' nds
'Watershed b"istrict
Y
t -
DESCRIPTION OF WORK TO BE PERFORMED:
Identification - Please Type or Print Clearly'
OWNER: Name: z w a„nd_jy/,e Cp0f v/ate Phone:
Address:
v,
Cdntmebr, Name ;: i9 , E:: Phone::..
Address: _d .s �d2T%O>�'�
Su pervisor�s:Const u tid L=ieense o. =�3QO/o?5�_ M . Exp> ®ate �
Home Implovement�Licen'se . .... ...�.�d� _Exp. Date
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
,Total Project Cost: $ 7So?o?, Dy FEE: $ �� a
Check No.:U 15al Receipt No,.
NOTE: Persons contracting i unregistered contractors do no ave: access to the guaranty fund
Sigriatute>of-Agen ,Owner Signatur of oritractor �
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
i
❑ 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/Cross Section/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
tract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
DOTE: 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: Building Permit Revised 2014
Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑
TWj_3 bF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/MassageBody 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
PLANNING & DEVELOPMENT _ Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
-t -
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning.Board Decision: Comments',
t
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer:. Signature:
Locatea Jb4 usgooa Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124. Main Street
Fire Department signature/date
COMMENTS
to
-
limension
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 jrequires approval of
Electrical Inspector Yes No •...
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
Doc.Building Permit Revised 2014 -
_,� rel
Location / f
No. W O�-7 " p?C 7 / Date v2//(r/
Check#
3153
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee$
Foundation Permit Fee $�
Other Permit Fee $
TOTAL
' Building Inspector
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Renewal Agreement Document and Payment Terms
Andersen. dba: Renewal by Andersen of Boston
Legal Name: Renewal by Andersen LLC
1112� HIC #170810
wiNoow EE IACEMEN. 30 Forbes Road I Northborough, MA 01532
Phone: 508-351-2200 1 Fax: (508) 986-7072 1 RbABoston0perations®AndersenCorp.com
Customer(s) Name: William Quinlan and Julie Quin,an
Customer(s) Street Address: 28 Irving Rd, North Andover, MA 01845
Primary Telephone Number: (978)821-4261
Primary Email: wjg42@comcast.net
William and Julie Quinlan
28 Irving Rd
North Andover, MA 01845
H:(978)821-4261
C:(978)682-8237
Contract Date: 02/04/17
Secondary Telephone Number: (978)682-8237
Secondary Email:
Buyer(s) hereby jointly and severally agrees to purchase the products and/or services of Renewal by Andersen LLC d/b/a Renewal by
Andersen of Boston("Contractor"), in accordance with the terms and conditions described in this Agreement Document and Payment
Terms, Notice of Cancellation, Itemized Order Receipt, Image, Warranty, Sales Cost Savings, MA Addendum, Terms and Conditions of
Sale, Waiver, Owner or Builder, Electronic Consent, and any other document attached to this Agreement Document, the terms of which
are all agreed to by the parties and incorporated herein by reference (collectively, this "Agreement"). Buyer(s) hereby agrees to sign a
completion certificate after Contractor has completed all work under this Agreement.
Total Job Amount:
Deposit Received:
Balance Due:
Amount Financed:
Method of Payment:
$7,522 By signing this agreement, you acknowledge that the Balance Due, and the Amount
Financed must be made by personal check, bank check, credit card, or cash.
$0
$7,522
$7,522
Financing
Notes:GS 2521 12 MONTN NO NO
INTEREST NO PAY
Estimated Start:
8-10 weeks
Estimated Completion:
1-2 days
We schedule installations based on the date of the signed contract and secondarily on
the date in which we complete the technical measurements. The installation date that
we are providing at this time is only an estimate. We will communicate an official date
and time at a later date. Rain and extreme weather are the most common causes for
delay.
Buyer(s) agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal
understanding changing or modifying any of the terms of this Agreement. No alterations to or deviations from this Agreement will be valid
without the signed, written consent of both the Buyer(s) and Contractor. Buyer(s) hereby acknowledges that Buyer(s) 1) has read this
Agreement, understands the terms of this Agreement, 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.
NOTICE TO OWNER: Do not sign this contract if blank. You are entitled to a copy of the contract at the time you sign.
YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT
OF 02/08/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION,
WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN
EXPLANATION OF THIS RIGHT.
Legal Name: Renewal by Andersen LLC Customer(s)
dba:Renew Wen Boston
Signature of Sales Person Signature Signature
Steve Dana William Quinian Julie Quinian
Print Name of Sales Person
Print Name
Print Name
02/04/17 Page 2 / 19
Renewal
Itemized Order Receipt
byAndemn.
dba: Renewal b Andersen of Boston
Y
William and Julie Quinlan
����
Legal Name: Renewal by Andersen LLC
28 Irving Rd
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HIC #170810
North Andover, MA 01845
WINDOW ae .......
30 Forbes Road I Northborough, MA 01532
H: (978)821-4261
Phone: 508-351-2200 1 Fax: (508) 986-7072 1 RbABoston0perations®AndersenCorp.com
C: (978)682-8237
ROOM: DETAILS:
101 Living Misc: 22 Deg Bay tie to soffit casement flankers FW center
1:2:1, White/White pre finished interior white exterior white
hardware tru scene screens
WINDOWS: 0 PATIO DOORS: 0 SPECIALTY. 0 MISC: 1 TOTAL $7,522
UPDATED: 02/04/17
(aRenewal by Andersen is committed to our customers'safety by
complyingwith the rules and lead -safe work practices specified by the EPA.
02/04/17
Page 4 / 19
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ANDECOR-01 DtIBEAA
CERTIFICATE OF LIABILITY INSURANCE
L
TY� INSURANCE
I°A'Ep"""°°116
9fZ9/201B
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), AUTHORED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the tenors 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 endorawnent(s).
PRODUCE
rwCONTiL: Walls Towers Watson Certificate Center
Willis of Minnesota Inc.
do 26 Ceny Bhr+�
P.O. Boon 305191
PHONE 8 943.7378 FAX
No : (N8) 487-2378
Nashville, TN 37230-5191
OIL : cem" nis.com
e o $ 508,00
PREMISES Emmri
MED EXP one Demon s 10.0
AFFORDING COVLRAeE NAIC S
eEURERA:01d Republic Insurance Com 24147
RMATE LIMRAPPUER: EB P
PRO -
POLICY ❑ JECT ❑ LOC
OTHER:
INSUREDIIEUIER
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IN SURERC :
Renewal by Anderson LLC
104 Otis Street
INSURER D:
Northborough, MA 01532
MWTB 308232
10/0112016
-INSURER E
INSURER F
ODDLY INJURY (Per SoMenq $
%.%JYCKAbC3 L mm it ;Ai NImmmms& t amna %u a111u0Go.
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 CONTRACTOR OTHER DOCUMENTWITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS,
EXCLUSIONS AND COMMONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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AVTHORZED REPRESENTATIVE
POLICY NUMBER
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101011=6
10/01/2017
EACHOCCURRETICE 61,008,80P
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PREMISES Emmri
MED EXP one Demon s 10.0
PERSCNALaADVRWRY 3 1,000,0
RMATE LIMRAPPUER: EB P
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POLICY ❑ JECT ❑ LOC
OTHER:
DENERALAeGREGATE $ 4,000,00
- S 4,000,00
- ` . $
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AUTOMOBILE LIABILITY
X ANYAtfro
ALL OS ® ASHEDULEDC AUTOS
NON-ONED
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MWTB 308232
10/0112016
10101/2017
COMBINED INOLE LIMIT $ 5100010 01
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E.L. DISEASE - POLICY UMTr S 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. AtIftonaR Re narks Sohadul% may Ae filed H more apaft is mqukwl
Evidence of Insurance.
ra IM -2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROYRSIONS.
Town of North Andover
AVTHORZED REPRESENTATIVE
120 Main Street
_ North Andover, MA 01845
ra IM -2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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