HomeMy WebLinkAboutBuilding Permit #93 - 300 WEBSTER WOODS 8/5/2008Permit NO:
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
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
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Identification Please Type or Print Clearly)
OWNER: Name: Phone:
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ARCHITEC] Lq��5Lpt
Phone: 9q�;
Address:5, '�ff —Reg. No.
N'�bULE�,B&�VDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
FEE SCHF
Total Project Cost: $ FEE: $ 5z
Check No.: Receipt No.: MA
NOTE: Persons contracting with unregistered contractors do not haveSsca4 t�q gArantyfund
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
Ei Building Permit Application
u Workers Comp Affidavit
E3 Photo Copy Of H.I.C. And/Or C.S.L. Licenses
u Copy of Contract
o Floor Plan Or Proposed Interior Work
j Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
Zabilding Permit Application
��Certified Surveyed Plot Plan
u Workers Comp Affidavit
o �Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
Ej Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Mass check Energy Compliance Report (if Applicable)
u Engineering Affidavits for Engineef6d products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
u Building Permit Application
u Certified Proposed Plot Plan
u Photo of H.I.C. And C.S.L. Licenses
u Workers Comp Affidavit
u Two. Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Copy of Contract
u Mass check Energy Compliance Report
u 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 DEPARTAHNT:BPFORM07
Revised 2.2008
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 DATEAPPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on 7
Signature V -Z
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
-fl,
Zoning Board of Appeals: Variance, Petition No: -Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/signature & Date Drivewav P(r Z7�_�-'
DPW Town Engineer: Signature:
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
MGL Chapter 166 Section 21A –F and G min.$100-$16-0ofine
Nu i tz) ana UA I A — u- or ciepartment use
El Notified for pickup - Date
Doc.Building Permit Revised 2008
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
Ei Building Permit Application
u Workers Comp Affidavit
Ei Photo Copy Of H.I.C. And/Or C.S.L. Licenses
13 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
ZaUilding Permit Application
ertified Surveyed Plot Plan
a Workers Comp Affidavit
u Photo Copy of H.I.C. And C.S.L. Licenses
.V" Copy Of Contract
a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Mass check Energy Compliance Report (If Applicable)
Li Engineering Affidavits for Engineef efid products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance. of Bldg Permit
New Construction (Single and Two Family)
u Building Permit Application
o Certified Proposed Plot Plan
Li 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
Li 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
Doe: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
_r_
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
One family
Addition
Two or more family
Industrial
Alteration
No. of units:
Commercial
Others:
Repair, replacement
Assessory Bldg
Demolition
Other
IN
41,
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OWNER: Name: Identification Please Type or Print Clearly) . Phone-,
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ARCHITECI
Phone: 9 q�;, 1-2131
IL9 2E�z 'C�,
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FEE SCHEDULE. -BOLDING PERMIT. $12-00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ FE E: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not haveqLca4 i�q gA*,antyfund
Location J4,
No. Date
Check # 6- 5-
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Buildi ng/Frame Permit Fee $ 6, Y
Foundation Permit Fee $
Other Permit Fee $
TOTAL
2,- 389 Building Inspe ctor
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Date: 7/24/2008 Time: 2:30 PM To: Triad Associates e 1-978- 373-8051
esideO Page: 001-002
Lak
ACCRA CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDff"
07/24/2008_
PRODUCER (603)432-3666 FAX (603)432-6076
Lakeside Insurance Agency, Inc.
One Wall Street
Windham, NH 03087
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED Triad Associates Inc
100 Downing Ave
Haverhill, MA 01830-2661
INSURER A: Central Insurance Companies 20230
INSURER B:
INSURER C
INSURER D:
INSURER E:
rnx1IZPArZr-Q
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
LTR
ADD'L
INSRE
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE (MMlDD1YYl
POLICY EXPIRATION
DATE IMMIDONY)
LIMITS
North Andover, MA 01845
I
GENERAL LIABILITY
CLP7994721
03/29/2008
03/29/2009
EACH OCCURRENCE $ 1,000,000
DA'MMIGE NTED $ 300,000
FIR 'c prence)
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX] OCCUR
MED EXP (Any one l erson) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
A
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP/OP AGG $ 2,000,000
I—] POLICY R pjE'Cf F-] LOC
AUTOMOBILE
LIABILITY
BAP8123977–NH
03/29/2008
03/29/2009
COMBINED SINGLE LIMIT
ANY AUTO
BA 8611348 – MA
03/29/2008
03/29/2009
(Ea accident) $ 1,000,000
ALL OWNED AUTOS
BODILY INJURY $
X
SCHEDULED AUTOS
(Per person)
A
—
BODILY INJURY
X
HIRED AUTOS
X
N09OWNED AUTOS
(Per accident)
PROPERTY DAMAGE $
(Peraccident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
ANY AUTO
AUTO ONLY AGG $
EXCESSIUMBRELLA LIABILITY
CXS7995051
03/29/2008
03/29/2009
EACH OCCURRENCE $ 1,000,000
–j�] OCCUR 7CLAIMS MADE
AGGREGATE $ 1,000,000
A
$
$
RDEDUCTIBLE
X RETENTION $ 0
$
WORKERS COMPENSATION AND
WC799480403
03/29/2008
03/29/2009
X I TO`RySTL,`M,LS I JOTK
ER
EMPLOYERS'LIABILITY
E.L. EACH ACCIDENT $ 1,000,000
A
ANY PROPRIETORIPARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
OFFICERIMEMBER EXCLUDED?
ff ps, describe under
S E
ECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT $ 1,000,000
OTHER
CLP7994721
03/29/2008
03/29/2009
Lease or Rented Equipment
Equipment
A
�Contractors
L
Limit $100,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Covering Work Performed by the Insured during the policy period at JOB RE: 300 Webster Woods,
North Andover, MA 01845
e�C0TICIf'ATC Uf)l nIZO fAMI'llZI I ATInKI
ACORD 25 (200.1/08)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
A
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Town of North Andover
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
UTHORIZED RE:PRESENTATIVE
[Joseph
North Andover, MA 01845
I
Rossetti/PROPA
ACORD 25 (200.1/08)
@ACORD CORPORATION 1988
A
@ACORD CORPORATION 1988
9 P' -
<L Ite -Commowumald e
Qml�n i
Board of Building Reg-ula?ions and Standards
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvemenj�,CQ actor Registration
TRIAD ASSOCIATE, INC.
JOHN MERCK
100 Downing Ave.
HAVERHILL, MA 01830
DPS-CA1 0 5OM-05/06-PC8490
Board of Building Regulations and Standards
HOME IMP
ROVEMENT CONTRACTOR
Reg'�t "D,23299
to
"�,22J2009 Tr# 126661
�.T qikAte Corporation
R
TRIADASSOCI
JOHN MERCK
100 Downing Ave.
C
HAVFRHILI-- MA 01830 Ati—Wet—t—
Registration: 123299
Type: Private Corporation
Expiration: 1/22/2009 Tr# 126661
late Address and return card. Mark reason for change.
[:] Address [:] Renewal 0 Employment [j Lost Card
License or registration valid for individul use only
before the expiration date. If found return to:
Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Boston, Ma. 02108
Not valid without sidature
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rig Salisbury, MA 01952-1738
L ALI r Phone 978.465.6436 (Fax 5160)
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qELINA5 STRUJOITURAL ENMA/60FERINq L__LO__
Daniel L. Gelinas, P.E.
579A North End Blvd.
Salisbury, MA 01952-1738
Phone 978.465.6436 (Fax 5160)
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LEAD StURCE: 'I
CONTRACTOR:-_ WALL PAVER CONTRACT
ASSOCIAyES,
1jyC.
100 DOWNING AVENUE, HAVERHILL, MAO 1830
Name 71,_,
MA ONLY 800-464-8833
(978) 373-4223 - FAX: (978) 373-8(
Wvvw. triadassociatesinc. com
MA Reg. # 123 299
DATE _llld:,
Address- ��b
city State_
IIorne Phone Zip code
TRIAD ASSOCIATES, INC., hereinafter called the E3us. Phone Cell Phone
Contractor, proposes to furnish all material and labor necessary t
No. 0 complete the project according to job plan for work at:
F_ Street city State- 7in rnci�
"AL)HY113
DIVING BOARD SUPPORT
PAVERS:
TYPE:
ROTUNDO KIT
BLOCK TYPE:
zz�
LENGTH
RISER =TREAD 99
WATERFALL NAME & SIZE
SCOPE
WORI<
Any rna�erial and lAhnr
KA :LL: IF _0
OTING
ERS & CUPS
COLOR
gDRAINAGE
P fGRAVEL
PER2FLF
ASSIST ILS IISfTABILIZER SANDT STONE DUST
YES
SO. FT.
COLOR A CCENT STRIP
COLOR
# OF STAIRS
QUARTZ
YES NO
*4
Z: ILI _�,
LF.
SO. FT.
TYPE
COLOR
PERIMETER
COLOR
CAP TYPE
COLOR
BOULDERS
NEPTUNE
BORDER
COLOR CAP
CAP
QUARTZ
I- I - YES NO
4
POURED CAP
COLOR
LINEAR FT, OF CAP
LINEAR FT. OF STEP
COLOR
- - 1 t, - P, uiect unless stated above will be additional ie: machine time, Plumbing, electrical, and drainage.
THE UNDERSIGNED AGREES TO PAY, THE SUM OF $ Z3
13 5 -?6 (30%) AT DELIVERY OF RAW
(30%) ON 75% COMPLETION OF JOB, THE SUM
MATERIALS, THE SUM OF $ /3 (30%) DOWN, THE SUM OF $
rOTAL JOB COST $ - OF, $
_Z/s 4L07)
2 (10%) @ COMPLETION OF JOB.
-HIS CONTRACT CONTAINS THE FULL AGREEMENT BETWEEN PARTIES AND NO REPRESENTATION BY ANY AGENT SHALL BE BINDING UNLESS SPECIFICALLY INCORPORATED HEREIN. YOU MAY
,ANCEL THIS CONTRACT BY A WRITTEN NOTICE DIRECTED TO THE SELLER AT THIS M A -IN OFFICE BY ORDINARY MAIL POSTED, BY TELEGRAPH OR BY DELIVERY, NOT LATER THAN MIDNIGHT OF
*HE THIRD BUSINESS DAY FOLLOWING THE SIGNING OF THIS AGREEMENT.
I
Owner shall Provide reasonable access to the site, and all utilities to complete the Project, fire, unusual delay in deliveries, dela in delivery of, or inability to obtain,
work to be performed by Contractor. All dirt shall remain on the job site unless ys
otherwise specified herein. the raw materials, adverse weather conditions, any other condition beyond Triad's
reasonable control, or by any act or neglect of the Customer or his/her/their agents
The Contractor shall not be responsible for damage to the premises (including but or representatives.
riot limited to grass, shrubs, sidewalks, sprinkler systems, cu bs, driveways, patios 9. In the even of default by Owner of any Provisions of this contract, Owner agrees to
and other improvernents) resulting from the reasonable perfor
work. rmance of Contractor's pay all collection fees, interest from date of default and reasonable attorney's fees.
The Contractor is not responsible for sinking or s . ettling due to excessive movement 10. Dis . claimer — Customer understands and accepts that due to the natural
Of soil, generally caused by water migration, nor is contractor responsible for plow variance of the raw material used, all aggregates and dye products will vary up
damage. It installation fault is determined to be the contractors, the contractor will to 15% from samples to actual product.
replace the area i . n question only for up to a period of one year. 11. Contractor is responsible for all placements of expansion and control joints (saw
Upon Substantial completion the balance of the Price shall be due and payable in full cuts) unless the Owner provides a placement plan.
without offset or reduction. Contractor shall not be obligated to clean up or to correct 12. Consequential Damages: The Customer and Triad waive claims against each
anyideficiencies in his work until the end amount due for work performed has been other for consequential damages arising Out of or relating to performance or
paid by the customer.
nonperformance of the Contract Documents.
during access and construction, Owner agrees to be responsible for any damages 13. Customer's Responsibilities: In addition to any other responsibilities required in the
-In the event Owner authorizes the use of neighbor's Property for Contractor's use
Contract Documents�, the Customer shall:
Incurred. Contractor agrees to exercise reasonable care. a. Obtain any and all necessary construction related permits
Customer acknowledges receipt of Triad's Construction Guide and that the guide b. Keep all children and pets away from the construction area
.has been fully explained. Customer Initials c. Remove all valuables and personal property from the construction area prior
Contractor shall not -be responsible for incorrect property drainage caused by owner/ to Project Commencement date.
,architect landscaper during landscape procedures. Note: all ground water is to be
dive(ted from pool and Pool deck areas. d. Provide Triad with all utilities necessary for the execution of the Project
Delays: Notwithstanding the foregoing, Triad shall not be responsible for any e. Promptly communicate any questions or Problems to Triad's Project Manager
I [OF/ f. Not interfere with Triad's execution of the Project and not give instructions or
delays in the perform ce of the- esulting from changes ordered in the
7j�
t7WZt resulting from ch
6pted orders to any employees, subcontractor, vendor or supplier of Triad.
�TOMER
Date TRIAD ASSOCIATES, INC.
:�TOIVIER ------ Date
�51