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HomeMy WebLinkAboutBuilding Permit #436 - 340 SUMMER STREET 11/30/2006 TOWN OF NORTH ANDOVER NORTF1 APPLICATION FOR PLAN EXAMINATION 3a 6..;: • 6 OL Permit NO: "I Date ReceivedIL—A- N - �o Date Issued: q�reo SAC HUS IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER /`t.Gyl LL� 1 J- Pridf MAP NO.: 110t-1-PARCEL: /6 1 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building �O.nefamily Y ❑Addition ❑ Two or more family ❑Industrial ❑Alteration No. of units: KRepair, replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED (2-e-to I entification Please Type or Print Clearly) OWNER: Name: � Phone: 79-fS_F�" SY67 Address: U �ii on 0 ,A✓ �. CONTRACTOR Name C= i t,� Ls-z,4 4,is'p, Phone: Address: Supervisor's Construction License: 0 F7 L�?S 7- Exp. Date: G-" t/7- y- Home Improvement License: 7:2 `7 Exp. Date: Jl Z�,— a 7 ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ FEE:$ lo q Check No.: Receipt No.: Page W4 f TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer ❑ ' Well Tobacco Sales El Food Packaging/Sales 11❑ Permanent Dumpster on Site ElPrivate(septic tank,etc. El Permanent Meter location to project NOTE: Persons contractin ith un istere contractors do not have access tCthguaran w Signature of Agent/ w e Signature of contrPlans Submitte ❑ aived ❑ Certified Plot Plan ❑ ped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS i DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED { HEALTH ❑ ❑ s COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS { 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 Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. q Total land area, sq. ft.: NOTES and DATA— For department use) 'I I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 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 Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan o 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) o Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) o Building Permit Application o_ Certified Proposed Plot Plan o 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 o Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stampthe decision from the Board of Appeals that the Pp 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:BPFORM05 Page 4 of 4 1 a Location y` r _3 No. Date NORTq TOWN OF NORTH ANDOVER F 9 ` Certificate of Occupancy $ ss�tMUSE�� Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ', Check # TUU 19840 `- Building Inspector �1ORTH Town of No. CN LA o dover, Mass., it COCHICMEWICK V Ids RATED 1 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ ... .l.G�w.r �" S.10-0p:40 """""""" Foundation ................. ............................................. has permission to erect........................................ buildings on.. ,6.......5&mowl.......rr.......... Rough to be occupied as...:... kill tChimney �1�1�! .. ......... 0W.4............................................................. y provided that the person accepting is 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 (Q 4(q,. PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRU ST S ELECTRICAL INSPECTOR 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 Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. „f Con tract Pella Windows&Doors,Inc. 45 FONDI ROAD a HAVERHILL MA 01832 Phone: 978-373-2500 Fax: 978-373-7274 Customer` Pro`est I Shy To Order NICOLE RICHARD LANLOISE langlois/wme/handover Date 00/00/00 340 SUMMER ST340 SUMMER ST Quote No. LANGLOIS Order No. NORTH ANDOVE MA 01845 Need Date . 00/00/00 NORTH ANDOVER,MA 01845 Sales Rep.Name Johnston,Andrea/WME ESSEX ESSEX Prepared by Payment Terms C.O.D. Owner: RICHARD LANGLOIS Architect Bus.Phone:( ) - Bus.Phone: Jamb Depth Bus.Fax:( ) - Home Phone:(781)588-8807 P.O.No. Cellular: Branch Order No. Home Phone:(781)588-8807 Order Type Installed Sales Order Glazing Design 20.00 psf Pressure Branch Name Pella Windows&Doors,Inc. Branch Address 45 FONDI ROAD Phone 978-373-2500 Fax Cit 978-373-7274 1 State MA 01832 Comments:All windows Dove White except for Kitchen window to be natural wood. Total project amount$8629.97. 50%DOWN PAYMENT RECEIVED OF $4314.98 PAID BY wells fargo UPON SUBSTANIAL COMPLETION THE REMAINING BALANCE OF 4314.99 WILL BE PAID BY WELLS FARGO PERMIT FEE CHQ COLLECTED IN THE AMOUNT OF $142.00. PELLA WILL PULL PERMIT ON BEHALF OF THE CUSTOMER For information regarding the finishing,maintenance,service, and warranty for all Pella products,visit the Pella Website at www.aelia.com. Printed . 11/01/06 Contract-Page 1 of 2 Contract for Customer NICOLE RICHARD LANLOISE Project: langloise/wme/nandover Order No.: Outside View Item No. Oty, Summary Description Unit Price Extended Price e—ll Item# 10 Qty: 1 Vent-DH Standard Jambliner Precision Fit Window,Make Location: MAIN BATH. Size:31-1/2 X 41-1/2: Architect Series,Clad,Model 3,White,Half R.O: 2'8" X 3'6" Vent/match Half Vent, 5/8"InsulShld Temp IG Glazing,Half Screen, Whit Lock l I W dee 04,Grille' Traditional L tesHig UpperSashi1Grille 021,Gril GrilleLites High Lower !i Sash=02), Std Primed Interior Value Added Items: Standard Pre-Fit Install-Qty 1 Disposal per Unit-Qty 1 Paint Window-Qty 1 Notes: Outside View Item No. Oty Summary Descrillfion Unit Price Extended Price Item# 15 Qty: 1 Vent-DH Standard Jambliner Precision Fit Window,Make �! Location: MASTERBATH BATH Size:31-1/2 X 41-1/2: Architect Series,Clad,Model 3, White, Half R.O:2'8" X 3'6" Vent/match Half Vent,5/8"InsulShld Temp IG Glazing,Half Screen, White Lock Only,3/4"REM Traditional Grille(Grille Lites ii Wide=04,Grille Lites High Upper Sash=02,Grille Lites High Lower L__SII Sash=02), Std Primed Interior Value Added Items: Standard Pre-Fit Install-Qty 1 Disposal per Unit-Qty I Paint Window-Qty I Notes: For information regarding the finishing, maintenance, service, and warranty for all Pella products,visit the Pella Website at www.pella.com. Contract-Page 2 of 2 Contract for Customer NICOLE RICHARD LANLOISE Project: langloise/wme/nandover Order No.: Outside View Item No. Oty. Summary Description Unit Price Extended Price -- --1I Item#20 Qty: 3 Vent-DH Standard Jambliner Precision Fit Window,Make Location: MASTERBED Size:31-3/4 X 62-1/4: Architect Series,Clad,Model 3, White, Half R.O:2'8-1/4" X 5'2-3/4" Vent/match Half Vent, 5/8"InsulShld IG Glazing,Half Screen,White Lock Only,3/4"REM Traditional Grille(Grille Lites Wide=04,Grille Lites High Upper Sash=03 Grille Lites High Lower Sash=03 g PP Std g ), Primed Interior Value Added Items: Standard Pre-Fit Install-Qty 1 Disposal per Unit-Qty 1 Paint Window-Qty 1 Notes: Outside View Item No. Oty., Su,mmary Description Unit Price Extended price Item#25 Qty: 1 Vent Large Awning,Frame:37-1/4 X 37-1/4: Architect Series,Clad, -- —'! Location: KITCHEN SINK Model 2, White, 1" InsulShld IG Glazing,Champagne Vivid View R.O: 3'2" X 3'2" Screen,Champagne Hardware,3/4"REM Traditional Grille(Grille Wa1lCond: 3-11/16" Lites Wide=03,Grille Lites High=03 ),Fins(single unit per design) �t Value Added Items: Single Window Install-Qty 1 Disposer Unit-Qty 1 PAINT Notes: For information regarding the finishing, maintenance, service, and warranty for all Pella products,visit the Pella Website at www.pella.com. Contract-Page 3 of 2 Contract for Customer NICOLE RICHARD LANLOISE Project: langloise/wme/nandover Order No.: Outside View Item No. My, Summary Descrilltion Unit Price Extended Price r_- Item#30 Qty: 1 Vent-DU Standard Jambliner Precision Fit Window,Make ,.Location: LIVING ROOM FRNT RIG Size:31-3/4 X 62-1/4:Architect Series,Clad,Model 3, White,Half iR.O: 2'8-1/4" X 5'2-3/4" Vent/match Half Vent,5/8"InsulShld IG Glazing,Half Screen, White Lock Only, 3/4"REM Traditional Grille(Grille Lites Wide=04,Grille Lites High Upper Sash=03,Grille Lites High Lower Sash=03 ) Std — N d-- Primed Interior Value Added Items: Standard Pre-Fit Install-Qty 1 Disposal per Unit-Qty 1 Paint Window-Qty 1 Notes: Thank o For Purchasing Pella Products Taxable Subtotal $ 8,219.02 Customer Signature Pella Sa epresentative Signature Sales Tax at 5.0000% 410.95 Non-taxable Subtotal 0.00 o i,�rt 3 c* a c. Total $ 8,629.97 Date Date Deposit Received $ 0.00 WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale. All applicable product warranties are incorporated into and become a part of this contract. Please see the warranties for complete details, taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system. Neither Pella Corporation nor Pella Windows&Doors,Inc. will be bound by any other warranty unless specifically set out in this contract. However, Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. For information regarding the finishing; maintenance, service, and warranty for all Pella products,visit the Pella Website at www.pella.com. Contract-Page 4 of 2 ACORD,. CERTIFICATE OF LIABILITY INSURANCE 07DATE07/05/2006 DIYYYY) /05/2006 13:54 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4]Wellman Street Connector Park HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell, an 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1 I INSURERS AFFORDING COVERAGE j NAIC# INSURED INSURER A: Hartford Insurance Company New England Window&Door Inc. INSURER e: Hanover Insurance Company 45 Fondi Road Haverhill,MA 01830 INSURER C: Mass Bav Insurance INSURER D: I 1 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. INSRLTR IADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION I LIMBS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 %{ I COMMERCIAL GENERAL LIABILITY DEMISEMAGE S TO Ea REoccurNTED $500.000 PA, CLAIMS MADE [x:1 OCCUR MED EXP(Any one person) S 10,000 B ZBN8161407 7/1/2006 7/1/2007 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG j S 2,000,000 JECT 17 POLICY n PRO- LOC AUTOMOBILE LIABILITY CGMBINED SINGLE LIMIT $ 1,000,000.()0 ANY AUTO (Ea accident) X ALL OWNED AUTOS BODILY INJURY S C SCHEDULED AUTOS ADN8162169 7/1/2006 7/1/2007 (Per person) IX HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE iS (Per accident) GARAGE LIABILITY I AUTO ONLY-EA ACCIDENT J$ ANY AUTO OTHER THAN EA ACC I$ AUTO ONLY: AGG I 5 EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 9,000.000 X OCCUR F—I CLAIMS MADE I AGGREGATE $ 9,000,000 B UHN8167305 7/1/2006 7/1/2007 $ DEDUCTIBLE j $ X RETENTION $ I I $ WORKERS COMPENSATION AND WC STATU- 10TH-I TORY IMI EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNERIEXECUTIVE 08WBNL5742 7/1/2006 7/1/2007 E.L.EACH ACCIDENT $500.000.00 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE;S 500,000.00 If yes.describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT!S =0000.00 OTHER Blanket Building&Contents B Property ZBN8161407 7/1/2006 7/1/2007 S5.540.000Deductible 51,000131anket Business Income$4,500.000 DESCRIPTION OF OPERATIONS I 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 New England Window&Door,Inc. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN dba Pella Windows&Doors,Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 45 Fondi Road, Haverhill,MA 01830 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) Client# 2960 Mst# 0607 all lines Cert# Evidence of]Nsurance ©ACORD CORPORATION 1988 t, The Commonwealth of Massachusetts r- Department of Industrial Accidents — Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r / y Please Print Legibly Name (Dusi�-less/Organization/Individual): Pe Address: /115- Foe, 41 . City/State,/Zip: ve4-4', ll Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction _ emplovees (full and/or part-time).* have hired the sub-contractors 2.U I am a'sole proprietor or partner- listed on the attached sheet $ ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.El I am a homeo�timer doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions myself [No workers' comp. c. 152, 31(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] Any appiicant that che6ri box::-1 must also fill out the section below showing their workers'compensation policy information T I-Iomeovmers who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy inforrnation. I am an emnlo}ver that is providing workers'compensation insurance for my employees. Below is the policy and job site informatiOIL Insurance Companv Name: 74ar4 �>r4 jnS ur-A,nCP_ 60!neao%�l Policy�or Self-ins. Lic. #t: d3V SAX 57 -/1 Expiration Date: Job Site Address: City/State/Zip: Attach a coPy of the workers" compensation policy declaration page(showing the policy number and expiration date). Faiiure �o 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 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Invesriaarions of the DIA for insurance coverage verification. 1 do hereby cerrify under the pains and penalties of perjury that the information provided above is true and correct. Si(ature: Date: Phone jOffjtcial 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 I I Contact Person: Phone#: a 5 au 3 ��3 r k� i k hzp4 i y iy y.}. „'4iw_4"M 4 h}t �,d�li ,rg'Yx 'y t ? `,- « '•.w{`�� " "e i S fir"'" tit iso + ' 7 i P.."I mo.... __.::..s+.. ..p_....-.... .e._..:_ .^, ..�8,71 .a. _ ��� ✓jze Larx7za�2��.a� a�✓��2a�zG�yuJ¢f�� BOARD OF BUILDING REGULATIONS 1 License: CONSTRUCTION SUPERVISOR - - -4 p.. Number:. -CS 089839 Birthdate: 06/19/1972 k Exprres. 06/19/2008 Tr no 89839 ° ` Restricted: 0-0 SCOTT P HOUSE 864 BROADWAY#1 c7 HAVERHILL, MA 01832 ; Commissioner 77 . ,. t:�'., ✓�e �Q-iiz»za�curva� a� j'lir.,;;cro`i,���,�a �,� \ \ Board of Building Regulations and Standards " HOME IMPROVEMENT CONTRACTOR :. Registration• 129774 "3 Expiration: 11/2/2007 Type: DBA PELLA WINDOWS AND DOORS • SCOTT HOUSE ` �? 45 FONDI RD. HAVERHILL,MA 01832 � � Administrator . - a.