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Home My WebLink AboutBuilding Permit #Exception - 37 GLENNCREST DRIVE 2/17/2016Permit No#: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IAORTfi Date Issued: I IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building [I One family 0 Addition El Two or more family 11 Industrial El Alteration No. of units: El Commercial El Repair, replacement El Assessory Bldg El Others: 0 Demolition El Other U-Sqptis F-1 Vvell. El Floddolairl, owetlan,-.d5 Ei Watorsh 04.0igrita DESCRIPTION OF WORK TO BE PERFORMED: Identification - Please Type or Print Clearly OWNER: Name: Phone: A d d rp.q -, - Contractor Name: Email: I Address: I Supervisor's Construction License: I Home Improvement License: ARCH ITECT/ENGI NEER Phone: Exp. Date: Exp. Date: 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: $_ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Location 3-1 No. Date Check #1�,3�3 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee TOTAL Building Inspector x Plans Sul�rnittQdll Plans Waived Certified Plot Plan F1 Stamped Plans TYPE OF SEWERAGE DISPOSAL F Public Sewer Taming/Massage/Body Art Swhmling Pools El well Tobacco Sales Food Packaging/Sales 0 Private (septic tank, etc. Pennanent Durapster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature'. CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comm Conservation Decision: Comments Water & Sewer Connection y Permit DPW Town Fngineer: Signature: Located 384 Osgood Street Ft -I- Ri )—` "' � ''I'll 7-3 - IM E N F 9EP uAR m P--`S� te r, 6n s ite,%,� ytes �q M 1 X16 V" Lrocate �,4 % Rdhaturefflate- % C 6 M M E N TS, 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 rnin.$100-$1000 fine NOTES and DATA — (For department use) L) Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 No 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 4� Copy of Contract 4� Floor Plan Or Proposed Interior Work -;L Engineering Affidavits for Engineered products 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/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 10TE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products 10TE: 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: Building Permit Revised 2014 ;014 N LU x LL 0 0 co u ±� -a 0 0 Lj- Ln .Lj CL Ln 0 u CL tn z z co 0 r_ 0 U- -C bf 0 >� 0) c E 0 0 LLI 0. (A z z 0. bD 0 CC — U- 0 u LU CL IA ui I = txo 0 cr — U > w V) U- 0 I W 0 w LL z LLI LLI LU LIC :3 co 0 z 0) cu V) -Nd 0 E V) 7M77 LU CL t5 CL tm r 0 (D > -0 0 0 r.L cn U) 0 21) > 0 rL 4) CL 4) CD 0 0 m 0 0 r cc rL 4) 'm LU -0— 0 0 CL= :E .2 LU E (J a c-) 0-0 CL 4) *5 = U) U) M o %- c m o " a 0 m CL 0 C.) 0- ikii 55 0 E 0 z 0 lw L.: 0 00 - L- 0 CL CL 0) < C 0 z CL AW C =D 0 uj CL U) Z Z CO co Cl) 0: Z;� 0 Cl) U) LLI 0 U) x 0 UJ CD LLI uj -j CL Z 0 '45 4- 0 z 0 0 5: 0- ikii 55 0 E 0 z 0 lw L.: 0 00 - L- 0 CL CL 0) < C 0 z CL AW C =D E.B. Window and Siding Co. 756 Western Ave Rt 107 Lynn MA 0 1905 Bill To Susan Maderios 37 Glemicrest dr North Andover Ma Invoice Date Invoice # 1/7/2016 52213 Phone 4 P.O. No. Terms Project 781-592-9747 781-592-9746 ebwindow@insn.coni Description Qty Rate Amount Vinyl Siding Installed, Color: Charter Oak Premium .46 siding 1 22,500.00 0.00 22.500.00 1 0.00T Strip and dispose existing vinyl siding, leave wood shingle underlayrnent 1 1,00().()0 Scope of Work: Strip existing vinyl siding Insulate building with .38 Airlock double foil 'Platinum' insulation Cover fascia and rake boards in custom bent aluminum, COLOR: 0.00 0.00 0.00 0.00 0.00,17 0.004, 0.001, 0.004, Cover windows with aluminum Install siding Install 5 pair shutters Furnish and install .032 Seamless aluminum gutters. All gutters to be installed using hex screw hanging system. 0.00 0.00 0.00 0.00 0.001, 0.00,17 0.00T 0.00 Dispose of alljob debris! Any building permit required to complete prqject to be included. 0.00 0.00 0.001, 0.00 Subtotal Sales Tax Total Payments/Credits Balance Due Phone 4 Fax 4 E-mail Web Site 781-592-9747 781-592-9746 ebwindow@insn.coni www.ebwindow.com �J E.B. Window and Siding Co. 756 Western Ave Rt 107 Lynn MA 01905 Bill To Susan Maderios 37 Glenticrest dr North Andover Ma Invoice Date Invoice # 1/7/2016 52213 Mone # P.O. No. Terms Project 781-592-9747 781-592-9746 ebwindoNvgrnsn.corn Oe cription Qty Rate Amount acceptance of proposal "I authorized signature 0.00 0.00T Subtotal $23,500.00 Sales Tax $0.00 Total $23,500.00 Payments/Credits -$7,500.00 Balance Due $16,000.00 Mone # Fax # E-niail Web Site 781-592-9747 781-592-9746 ebwindoNvgrnsn.corn wwwebwindowcorn The Commonwealth of Massachusetts Department ofIndustrialAceidents I Congress Street, Suite 100 Boston, MA 02H4-2017 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNUTTING AUTHORITY. Name (Business/Organization/Individual): Address:- �Ifs�_c City/State/Zip: Are you an employer? Check the appropriate box: Phone#: —4-q A - :so( -.�_ - �A I.JR I am a employer with ( C) mployces (full and/or part-time).* 2.FJ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] In I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4.F] I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.n I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.t 6.FJ We are a corporation and its officers have exercised their right of"exemption per MGL C. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. n New construction 8. E] Remodeling 9. El Demolition 10 E] Building addition ll.FJ Electrical repairs or additions 12.E] Plumbing repairs or additions 13.Fl Roof repairs 14�40therN�_,",A\ '!�\CLY, 113 *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation policy 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. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number, Iaiiiaizeniployet-tliatisprovidiiig)voi*ers'conipeyisationiiisui-aiicefoi-niyeniployees. Beloiv is thepolicy andjob site information. Insurance Company Name Policy # or Self -ins. Lic. Y: Expiration Date: Job Site Address City/State/Z ip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expir londate). Failure to secure coverage as required under MGL c, 152, §25A is a criminal violation punishable by a fine up to $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 $250.00 a day against the violator. 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 thepains andp!�nalties ofpeijuiy that the information provided above is trite and correct. Official use only. Do riot write iffthis area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): i 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone FEB -18-2016 03:06 From:E B Winow CO. 781592 9746 To:19786889542 CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITION L INSURED, the Pollcy(ies) must be endo rsod, If SUBROGA' the terms and conditions of the policy, certain Policies may require an endorsement. A statement on this certificate i certificate holder in lieu of such endorsoment(s). PRODUCER CONTACT NAM ; Co ercial Lineg A&airal Inaurance Agency,tnc, PHONE 70 Munroe Street (A/p,No_Ext: 781)t�9-2000* E-MAIL ) - Suite D ADDRESS:— Lynn 14A 01901 INSURRRIS) AFFORDING COVERAGE INSVRER A:Providen INSURED Cie Mutual IFire Ii INSUR Re -Guard Insurance EDMUND DRA BYRNE ED BYRNE WINDOW COMPANY INSURER C: 756 Western Avenue Pap:2/2 Dil%ITE —(MMIDDfYYYY) RTIFICATE ilOLDER. THIS )RDED B H POLICIES qSURER(S), AUTHORIZED ON IS VVAIV(!D, subject to )es not confl ir rights to the -ff-M (Atg_ Co _RNAIC p 15040 LYNN MA 01905 IN6URER E: I INSURER F: COVERAGES CERTIFICATE NUMBER:CL1561720927 THIS IS TO CERTIFY THA REVISIO NU BER; I FHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE IOR THE INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIII-H RESPECT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS q'IpIIF:CT TO EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �3 R _TR TYPE Of INSURANCE ADDLSU X I COMMERCIAL GENERAL LIABILITY _J p w"n POLICY NUM ER POLICYF_PF I _r. A CLAIM'5-MADE EACH OC JD I X.1 OCCUR kll,;AMAGE_;��r NEF6 BOP0063101 GEN'L AGGRFmGA'I'E LIMIT APPI.0j:j PER: i POLICY r7 PRO- !1OTHER: JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED t" UCHEDULrD AUTO5 AUTOS HIRED AUTO$ NON -OWNED AUTOS UMBRELLA LIA; OcrVR EXcESS LIAB B WORK6111, COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PHOPRIETORIPARTNER/EXECUTIVE TEDWC643855 OFFICERIMEMBER FXCLUDED? N/A (MAndafory in N14) If yes, d—rriw under 6/21/2015 1 6/21/2OL6 LMEDE�P(Any-40-1__ - .— _Z1.7s PROOUCTS - COMprowAGG FLI _fc�_ IMBI Al �bINGLE Lf IT GOVILY IN JURY (R)r p4reofl) BODILY INJURY (Peraccider,i) 0AOf5E_RTYDAMAG�-- (r,cr acricirnt) AGGREC-ATE 12113Y2015 12/13/2016 _E.L. EACH AGQDE E -I - IASEASE - EA E.L. DIGGASF - po DESCRIPTION OF OPERATIONS I LOCATION5 I VEHICLES (ACORD 101, AddItIonal Remarks 81hedUle. maY ba OtWelled if more APSCO Iti required) No.rth Andover In5pector 1600 Osgood Street Bldg 20 Ste 2035 North Andover, mA 01845 ACORD 26 (2014/01) INS02r, 3HOULD ANY OF THE ABOVE DESCRIBEo POLICJ I ES BE CANC THR EXPIRATION DATE THEREOF, NOTICE WILL BE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRF15ENTATIVE JJ F. Scholnick/SSRS IZ) 1988-2014 ACORD CO The ACORD name and logo are registered marks of ACORD LICY PERIOD WHICH THIS THE TERMS, 1,000,000 5,000 1,000,000 2,000,000 2,000,000 50,000 1,000, Do 1,000,000 11000,000 BEFORE RED IN All rig(,'pts reserved. W9rkSr',s CoLnpensation and EMRloygr'g Liabilit BERKSHIRE HATHAWAY y Policy —GUAVft Oft', INSURANCE NorGUARD Insurance Company - A Stock Company KL)COMPANIES Policy Number EDWC643855 Renewal of NEW NCCI No. (25844] Policy Information Page [I]Named Insured and Mailing Address Edmund Byrne 756 Weston Ave Lynn, MA 01905 Federal Employer's ID 20-1160335 Additional Names of insured (N2) Ed Byrne Window Company Agency ADMIRAL INSURANCE AGENCY 70 Munroe Street Lynn, MA 01903 Agency Code: MAHARR12 Insured is Individual [2] Policy Period From December 13, 2015 to December 13, 2016, 12:01 AM, standard time at the insured's mailing address. [31 Coverage A. Workers' Compensation Insurance -Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident - each accident $1,000,000 Bodily Injury by Disease - each employee $1,000,000 Bodily Injury by Disease - policy limit $1,000,000 C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, and Wyoming. D� This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms (41 Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium $ 10,055 Total Surcharges/Assessments $ 545.00 Total Estimated Cost $ 10,600.00 INIERNAL_U� Page - 1 - Information Page MGA EDWC643855 WC 000001A Date 11/04/20'15 MANOTE Issuing Office: P.O. Box A -H, i(i S. River Street, Wilkes-Barre, PA 18703-0020 # www.guard.com in, r7" ERWINDOW AND SIDING CO. 756 Western Avenue * Lynn, MA 01905 4 Phone 781-592-9747 To Whom It May Concern, 1, Edmund Byrne, allow Jayme Byrne to apply for permits on my behalf. If you have any questions and/or concerns please call our office at 781-592- 9747. Respectfully Yours, 0" ,,, 111"WN I/ Office ofConsumer tVfTRirs & Business Regulation -HOME IMPROVEMENT CONTRACTOR 4Registration: 128634 Type: Expiration: 5r212017 V, OBA 1111.%'� ED BYRNE WINDOW Co EDWUND BYRNE 756 WESTERN AVE LYNN, MA 01902 Undersecretary Massachusetts - Department of Public Safety Board Of Building Regulations and Standards Ut tio.ij %n," it License: m4 iom EDhfUNDjBYRN % 18 Woodrow Terrice j�(a_ LYnn MA 01NM 7 f I J Expiration COrYMSSIoner 07M=17