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Home My WebLink AboutBuilding Permit #79-11 - 37 WAVERLY ROAD 7/21/2010BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: " 0 Date Received 16t Iv�� o. a 9 4� 0 Date Issued: � IMPORTANT: Applicant must compJete all items on this page LOCATION —Z 7 R t i 77 PROPER ��®1I11NER_ 1 _- `- 77=M7 ' ""Pnrit ;P-21tr PARCEL„ -C� Z®N1NGrD1STRICT Histoti`c ®istnct yesr4 no ViII5§91 YeS�. r no TYPE OF IMPROVEMENT PROPOS D USE esi ential I Non- Residential New Building One fa ily Addition r more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic LlNell "`` Floodpla n Wetlands UVatersh"edDistnet F -t DESCRIPTION qF WO K TO BEP F RMED:j0�D� uY ii15idl1 01J9 C)XI cUyw-19 'e Identification OWNER: Name: 4 vim. Dc Address: Type or Print Clearly) C.ONTRAC�TQR' Narne Adtlress C6 t6 h1.C'GR g Super's;Construct�oA visorL°icense ° Exp _ 1-lriinc�lmnrn�iAmarif=aslranca '. Fxn, i"flata ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING 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.: GL NOTE: Persons contracting with unregistered contractors do not have access to the guaranty f cnd Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 DPW Town Engineer: Signature: Located 364 Usgood Street FIRE` DEPARTMENT' eeTemp Dempster on t ryn es - L'ocated at 1°24�iVlain,Strt � z ° � .:. - .z �a`rtrnent sr = nature/dated COMMENTS - - ` r - 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 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 ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of K.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) ❑ 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 ❑ Mass check Energy Compliance Report ❑ 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: Building Permit Revised 2008 Location ✓ No. -^1/ Date MORTM TOWN OF NORTH ANDOVER �?O�,"•o ,•,MOL N Certificate Occupancy $ of sACHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # lo 0 +-- Building Inspector 18� Z60ZOL :44 tauu��uwo -- ZLOZ/SZ/8 :uoitejydx3`�� 6MO VIN VOR131118 d! , GLI (MOONOO Z£ `_ MINIM 30f i 00 :ol patoulsam Z60ZOL SO :asuaoi- asuaoll JoslnJadnS uoI}ona;suoo �p.nlnn'aS pur. suniar.Ict,�� ;�uipltn8 ,;t? p.nu►g N IV ��.�t'S �tl�Ittd J�� luitul.trd� � �sny�rsst�lt! -�_d G � { O '4 R I � •y � � � �.� ;�� foo . ;� CpZj 1 �4-Gf y0{ E Z W >* 'o:S !I .0 ?' o c p in 'Q c _z _Z a 3 0 p LLLu CL p CO, U O p _ U OPOO�co, V �O LIQ A `Sl�lNG GUY INCORPORATEID kali: 978__.- 62,1 _- 0729 _ SubmitteTo: & All home improvement contractors 'and subcontractors engaged in home improvement contracting, unless specifi- cally exempt from registration by Provisions of Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registra- tion and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108 (617) 727-4598 . vv r0774 -t! WORK SCHEDULE Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified herein. Contractor will begin the work on or about (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by (date). The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including, but not limited to strikes, Acts of God, shortages of materi- als,accidents, and all other delays beyond its control, shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that therwork furnished hereunder shall be free from defects in materials and workmanship for a period of following completion and shall compiy with the requirements of this Agreement In the event any defect in workmanship or materials, or damage caused by the Contractor, its subcontractors, employees or agents, is discovered after completion of any job, including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace. or cause to be remedied, repaired or replaced, such dam- age or such defect in materials and workmanship. The foregoing warranties shall survive aro inspection performed In connection with the agreed-upon work. We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the. sum of: dollars ($ ). Pay ent to be made as follows: %( upon Signing contract, THE SIDING GUY INC. / ($ ? upon completion of 181 CONCORD ROAD ($ 1 upon completion of ($ f hall be made forthwith upon completion of work under this contract Notice: No agreement for home improvement contracting work shall require a down _payment (advance deposit) of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make, in advance, to order and/or otherwise obtain delivery of special order materials and equipment, whichever amount is Greater. CHELMSFORD, MA 01824 Registration No. Name of Salesman Authorized Signature Acceptance of Pf'OpOSal I have read both sides of this document and accept the prices, specifications and conditions stated, l un ers a signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. 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 the 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. Please refer to the Notice of Cancellation that accompanies this contract; con- tents of which are referred to above and incorporated herein by reference. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature Date Signature Data 07/09/2010 13:32 9788514840 SULLIVAN INS PAGE 01/01 .PRODUCER CERTIFICATE OF LIJ PR JAMS SULLIVAN INSURANCE AGENCY 885 Main Street Tewksbury, MA 01876 (978)851-9600 INSURED The Siding Guy Inc. CERTIFICATE R/'IN �//►� A' OATE(MWDDIYYYY) BILITY IIOi$U10 THIS �E ISSUED A3 A M' TIER OF INFORMATION ONLY AND CONFERS NO BIGHTS fy PON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOEST AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED THE POLICIES BELOW. 181 Concord Road Billerica, MA 01821 j COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN I$$UEC ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT ( MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DE: POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED INSR.. Ljlt A,C. INSRD ......�—._ TYPE QF INSURANCE POLICY NUMB LIMITS GENERAL LIABILITY 03/22/11 EACH OCCU RENCE $ 1 000 , 000 NTEDr PREMISES E ocCuf9t Ce $ 50,000 X COMMERCIAL GENERAL LIABILITY PERSONAL&, VINJURY $ 1,000 000 4ENERAI, A URM3ATE $ 2,000,000 PRODUCTS- OMP/OPAGG $ 2,000,000 I I 2 I 09/21/09 09/21/10 CLAIMSMADE E X OCCUR BODILYINJU (Per person) $ A PROPERTY DAMAGE $ 100,000 (Pa aoaideflt) CLS -1198503 AUTO ONLY -�AACCIPENT $ OTHERTHAN1 EAACC $ AUTOONLY: j AG G $ i GEN'L AGGREGATE LIMIT APPLIES PER: EACH OCCU RENCE $ AGGREGATE C POLICY PROS LOC , $ $ i j AUTOMOBILELIABILITY 04/10/11 x TSI WCSTAIU OTH- Y IER E.L. EACHACQIDENT $ 100,000 E.L. DISEASE EA EMPLOY $ 100,0 0 E.L DISEASE• POLICY LIMIT $ 500,000 ANYAUTO i i i �NDORSf=m8NTJ SPECIAL PROVISIONS ,.s compensation policy. i ALL OWNED AUTOS X SCHEDULEDAUTOS C HIRED AUTOS PGC100096640 NON-OWNEDAUTOS GARAGE LIABILITY ANYAUTO EXCESSJUMBRELLA LIABILITY OCCUR CI CLAIMSMADE DEDUCTIBLE RETENTION $ WORKERS COMP ENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOFLPARTNEP/EXECUTIVE OTC 895-88-3 8 OFFICERIMEMBER EXCLUDED? If es.dewibeunder SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS l LOCATIONS /VEHICLES /EXCLUSIONS ADDED E I Joseph Wink is covered by the workel. I CERTIFICATE HOLDER j I Joseph Wink 181 Concord Road Billerica, MA 01821 ACORD25(2001!08) INSURERS AFFORDING COVERAGE NAIC# INSURER A: COttBddle Inau�dilClE! G Vany INSURER B: AIG Insurance Company INSURER C: Pi grim Insurance Deny INSURER D: 0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN ICATEP, NOTWITHSTANDING OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY RE ISSUED OR RIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PAID CLAIMS, iPOLICYM EFFECTIVE DATE MEXPIRATIONDATF( LIMITS 03/22/10 03/22/11 EACH OCCU RENCE $ 1 000 , 000 NTEDr PREMISES E ocCuf9t Ce $ 50,000 MEDEXPOny neperson) $ 000 PERSONAL&, VINJURY $ 1,000 000 4ENERAI, A URM3ATE $ 2,000,000 PRODUCTS- OMP/OPAGG $ 2,000,000 I I 2 I 09/21/09 09/21/10 COMBINEDSINGLELIMIT $1,000,000 (Ea accident) BODILYINJU (Per person) $ BODILYINJU $ (PefeccWenl) PROPERTY DAMAGE $ 100,000 (Pa aoaideflt) AUTO ONLY -�AACCIPENT $ OTHERTHAN1 EAACC $ AUTOONLY: j AG G $ i EACH OCCU RENCE $ AGGREGATE C $ , $ $ i j 04/10/10 04/10/11 x TSI WCSTAIU OTH- Y IER E.L. EACHACQIDENT $ 100,000 E.L. DISEASE EA EMPLOY $ 100,0 0 E.L DISEASE• POLICY LIMIT $ 500,000 i i i �NDORSf=m8NTJ SPECIAL PROVISIONS ,.s compensation policy. i Y . 41 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES to CANCELLED BEFORE THE E)'PIRATION DATE THEREOF, THE ISSUING INSURER WILL END�AVOR TO MAO _ DAYS WRITTEN NOTICE TO THE CERTIFICATE'HOLDER NAMED TO TI s LEFT, BUT FAILURE TO DO SO"SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIN UPON THE INSURER, ITS AGENTS OR 'ANTATIVFSFDR�F "a A CORDCORPORAT ,. 1988 bid U. ^V \I z C CD CD Z CD, CD O _ _ O c a m 0 O Vl CD = =_ Cy �.m H CO) So ®n m C7 mndC- m co) ?= ca Im H -n CD = .m m N 0 -� H O 0 Vl• n� m . �• �_ R: CL o Com. � CD y ow �oo$ CL m H c y . W SIN O. �mC = m 0 col = m . C o =r c CD 0: co, �a CO _c a� =Ncc : d c� C 0 0; co) O � = CD rD n z o v tv d _ ' y 4 • b C d � 1� � r CA n G7 yr ti CD c') z y �Iy� d hi 0 � • 0 6 r ca m �• CL c m �• y mCD X o. o (A Q 1 s =r m "cd CD y CCD o CD v m C CCD y. 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