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Building Permit #707-15 - 43 BRIGHTWOOD AVENUE 3/10/2015
BUILDING PERMIT o �TyED TOWN OF NORTH ANDOVER, y '`- APPLICATION FOR PLAN EXAMINATION` Permit No#: �� Date Received 7q DR^TED wpP SgA USf� Date Issue • k&6<7 PORTANT: Applicant must complete'all;items�on-this"page LOCATION y Br �LA1PD i) V ?i , Print ` PROPERTY OWNER IV 0_4 bi Print 100 Year Structure J MAP PARCEd ZONING DISTRICT: _ Historic District es n Y. _ Machine Shop Village yes _ no 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 El Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ _Watershed District: Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: YJ,r,eA11A,r 1610 G✓it �� C�1��l� .�� /� �7 / 1C-7"-' / '� Identification- Ple se Type or Print Clearly OWNER: Name: AA Ph Contractor Namew_orrf 070 Phone: Address:�/-�/�^�n, Supervisor's Construction License:–/ 0 1- 7 0 7 Exp, Date: Home Improvement License: !� Exp: Date:: /:0 ARCHITECT/ENGINEER Phone: Address: Reg. No. . FEE SCHEDULE: BOLDING PER IT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED...COST BASED ON $125.00 P6R _F=. Total Project Cost: $— FEE: $ Check No.: _ ) `i ,� Receipt,.Nd :__ NOTE: Persons contracting with unregistered contractors do not have: access to the guaranty f icnd r nature otico Location 4-�) `'tee, Y ` DOS '2W No."� (),_ 15 Date ,Z Check #� 2 5A W TOWN OF NORTH ANDOVER t Certificate of Occupancy $ Building/Frame Permit Fee $ ru- It Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector Plans Submitted ❑ Plans Waived ❑ ;S Certified Plot Plan ❑ Stamped Plans ❑ - TYPF F SEWERAGE DISPOSAL Pvblic Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Signature Reviewed on Signature Reviewed on Signature " 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 384 Usgood Street FIRE DEPARTMENT - Temp Dumpster on site yes -no - Located at 124 Main Street Fire Department signatureldate _ COMMENTS 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 a Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ 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 ❑ 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 a Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract a 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 2014 s04 0 TVT�l LV J W U. OQ m O L U \ LL ti Ln U Ln 0 d z Z O J m O O " 6 _0 LL L-0 mo 2' U1 C U LL U N Z Z m J d t to cr LL 0 � z U J W L K Uc Ln LL oc O a Z N Q t z WCC C a W G W LL N Z - (% N N Ln O cis c CL cm cca - o c 0 E Q im cn C ) = N 0— S. -0 f E ,CDO C 1 C to / O v L w. tn�cc � J d Cc > `c o m c � ��; � V _ ;Z: t c :a M Q E w- oo m z CL c — N O O c o H Q CL w w �cc y0+ (n C Of 2 cc c C = N Q d �� ~ O Nm � cc O v W '04- O O LU LL2 —co N C CLt O N = A- yI.- :a+ W E v .= O V 0-0 Q d N d > 4- C 2 m O OL C O I— t .r CLO V V. Z Z 0 U) J Z 2 ti �S. r., W O E L Z � 0 •- � Q •� W 0 ^ V O 0. CL a O •CL 0 4) � Z � O V N U) B Job Number 5146 Client address city / town contractor 1.WEATHERSTRIPPING/CAULKING QUANTITY Door Kits Q -Lon or Equiv. 4 Door Sweeps (Regular) Door Sweeps (Automatic) 3 Reglaze Windows /In.inch Window.Weathstr Schlegal per side Recessed light cover per SWS. Not a tenmat cover attic sealing 2 part foam attic sealing 1 part foam 2 basement and living space air sealing 1 part 1 SUBTOTALS 2A.INFILTRATION / INSULATION Domestic pipe Hot Water Tank 1st 6' Sill Two Part Foam w/ Fiberglass Batt 110 1" T-max only foam boardPerimeter per IECC& SWS sq. ft. 2" T-max only foam boardPerimeter per IECC& SWS sq. ft. Drape DOOR R-5 or T-max only Tape Joints (Aluma Grip only) per hr. Duct Ins w/ Tape sq. ft. R-5 conditioned space Duct Ins w/ Tape sq. ft. R-8 unconditioned crawl/garage/attic Hydronic pipe insulation to 1" R-5 120 Hydronic pipe ins. 1.25'!- 2" R-5 Steampipe Ins, 1.25"- 2" iron pipe R-5 Steampipe Ins. 2.5 "- 3" iron pipe R-5 Air Conditioner Meeting Rail Air Conditioner Cover Air Conditioner Cover Special Order SUBTOTALS 2B. INSULATION Open Unrestricted R 49 Open Unrestricted R 38 Open Unrestricted R 30 Open Unrestricted R 20 224 Open Unrestricted R 10 Restrict FUSloped R 38 694 Restrict FUSloped R 30 Restricted FUSloped R 20 Restrict FUSloped R 10 R-19 FGB open rafters/walls/kneewalls R-11 FGB open rafters/walls/kneewalls Attic Stairs(stairwell & common wall) Cover Pull Down Stairs Thermadome up to R49 per SWS Site built pull down stairs 2" foam box DATE 2!27/2015 ERIN NADEAU- 978-886-1713 43 BRIGHTWOOD AVE. N. ANDOVER,01845 TOTAL 204.00 0.00 78.00 0.00 0.00 0.00 0.00 140.00 70.00 492.00 0.00 270.60 0.00 0.00 0.00 0.00 0.00 0.00 458.40 0.00 0.00 0.00 0.00 0.00 0.00 729.00 0.00 0.00 0.00 322.56 0.00 1138.16 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 I AUDITOR NOTES I I AUDITOR NOTES COPPER AUDITOR NOTES slopes INSULATE ATTIC AND WALLS USING BLOWN CELLULOSE JOB TOTALS _ \(� Greater Lawrence Community Action Council, Inc. Weatherization Assistance Program 305 Essex Street ci-�k Z- Lawrence, MA 01840 z WORK PERMIT 1, A) �`► v Certify that I am the owner/authorized Agent for the property at: q,' (Address) 1 further certify that I have given my permission to allow work on the property listed above in accordance with the following provision: 1. Weatherization 2. Heating System Work and such other particulars as may be attached to this agreement. 61 s 13 N ATO P C - F- n ek�- sA-L-�K j e-2 Signed i Date:; /8 Owner/Authorized Agent ©MIE Ti INSULATION CO. 362 EASTERN AVE LYNN, MA o1 CO2 FLO �Ot� [ �C z✓ Are ym a mupiaW. Check the 1.0I=a=qiqywM1h__ y waddag s� aid ire as fees form imy - DID wad= =mp. 3- i atg abomeow= doing an want mysem N wadm s' Oamp. .} Pb=c f.. �. riambas: 4. 1 am a gwaW con-actm) aM I nave�� hod am the " These subcomnamom have cmpfqy=mdbave, comp=. 5— Weaea adia officas hmdwa afPorbim c 132,§1(4)6 and wbawno mvby=& DRO mss' MrAr-il Type of i % 6. New moa �Q &IIDemoDdo 9. BMI&9adftm 10.0 Or addirk 12.0 M=tbft rr 3th or ams 12.II Roafr�s 13-tIS s�Y 7�iiCsiSbos#I_�a�at � a�i�sestmos i�dows�veooder: �"' 5��'sb�s�t�asa�6oazi�sbow�;8�eacaf °S�O��aaara€�vsse�. es�io�s ffffieS�e.ti�.yms¢PaD�QeS�etegodors' �9a�a3�r�6cctmt�emmcs5�e cefora� Ideait*&pW%!yalydjab*c Job LI) o Oct -'0 Y-/ - �dw3.S va wvsaics� puarq �S1l9iix ESC fa r10 sca=measrequiud 25A afMQ. G iS2 cm badLO*ta(crimbalpa2kimof %e �3 tc SI,SDEiB(i i� c�o-year IDs, as wail as " Pumbimin the hm of a: TrOP WORK ORDEP a d a ofOR'Ds250-W adwi 2PbwThe YiDh=- Be uWiwdtbwa COW Of bis� smumum may be fmvaded to ft Ofte of 16 ?el i-rl k-? n *aite p a�reaa�d a�rr�rt tease a(;L ft wf wsae ifs *is =cc, m bca by g*&'—M a Offida My ar Tom ivmft Amdm* Odede as* L Bow efBaft 2. g iegarbecut 3. tbyrraim Ocrt 4. F :, pkmb5ag i t 6.01bw gc�ru of Building`ReIgulations and Standaidl Construction. Supen isor Spceialty i - License.' CSSL-102707 C 4 ALBERT W SOUZA 9 RANT'OUL ST UNIT 1 -BEVERLY MA. 01915", J,,`,, Jyc`, ++`a;' ` fxiiatiijn d Commissionc r ' 05J2512015 ` r122 office of Co nsumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor RqgistratiOrL DANETTI INSULATION CO. *EDWARD CHAMPIGNY 362 EASTERN AVE_ LYNN, MA 01902 XA 1 0 CONI-RACMR Type: 'A;z MA WEAS7'M,jAVE LYW VA 01902 A-1 TYPe- DBA EVk.&= &2=016 T14 250930 Upd2te Ade-Ulgaad reftm card- Mark remn for dang, Address .7 Rm'eww El ELast Card or rem v3M fw blaividW use � before the exph-afim dalp- Iftmd bra tD- Ofree . Of COSSWRa Affairs and Busiam RegWkdm 10 Park P12= - SVift $170 Boston, MA 02116 Not V-dho Without sigaw ACORD CERTIFICATE OF UABILITY INSURANCEDATE(MN90�' 06/25/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORFAATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR INEGATNYELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. THIS CERTIFICATE OF INSURANCE HOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER Iff9PORTANT. Nf the certificate hoiden is an ADDITIONAL INSURED, die pollcy(fes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policies may requare an endorsement A statement on this cerfificate does not confer rights to the certificate holder in lieu of such endorsonent(s). PRODUCER Duffy Insurance Agency, Inc. 317 Broadway Wyortla Scare Lynn, NA 01944-2602 NNME .(781)S93-1200 I N,•(781)593-7260 Ea REBS: INSURERS) ARORDOG COVERAGE NAIC 1!l A: Endurance American Insurance Co -- ;NsuREa Danetti Insulation C/o Edward Champigny 362 Eastern Avenue Lynn, MA 01902-1626 nes: Norfolk & Dedham Mutual Ins Co INSUI RC: AIN Mutual Insurance.Company IND: INSUREIt E : WSURER F: r-nu.E,:n I r , mal W- tHm eecv..�.. ». FVLJ a M. 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 REQUIREfuIENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUfA NT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUEUECT TO ALL THE TERMS. EXCLUSIONS AND CONDIi7ONS OF SUCH POLICIES. LUTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLWS. LTR TYPE OF INSURANCE @ISR iieMD I POLICY Will9m ! LfAC'rS Gt3N@iAl ttAMmJTY CBCIOW199400 0613212014:041122/2015 EACH OCCURRENCE S 1,0w,ow Xi COMMERCIAL GENERAL LLABILITY PRENtgSEs tEa oeaarerre) s 10O.Nd DANS RODE C OCCUR EXP t" ors person) is S1001 A 1 j I s PEIRSONAL a AM INJURY $ 1,000,00( I I GENERAL AaG6REGATE $ 2.000100( GENL AGGREGATE LIMIT APPLIES PER i PRODUCTS. COMPIOP AGG $ 2,000,00( X POLICY ^ LOC AvroaoeaE UASU TY 914607614 0710812014 07108120151 y s 1,000,0001 ANY AUTO GODX" ` INJUFrf (Per W" $ B ALL OWNED t SCHEDULEDBOQp.Y (AUTOS X :AUTOS WJURY(Peracd ent; 3 X HIRED AUTO$ € J( `�� 'EO e N UA03+RE L n L AIRI OCCUR EACH OCCURRENCES.._. ^^ E]CCESSWtB ! i i AGGREGATE 5 ' $ 1 RmENnoNs jDED woRa tscoaPecsATNON YWC-100-6018528-2014 "24120141o4r1 mis A xJOTH I TORY L>LtrTS i ER ! M EMPLOYERS' UA�IJI'9 A ANY PROPRFETORIPARTNER)EXECU Y 1 N I ---- i EL EACH ACCIDENT $ S00100( C OFFK2R&9DA8ERIXCL�. P OL;mdat-y NIAi 1 EL DISEASE- EAEhVLOYE£ S S00'00( X yas' describe under DESCRIPTION OF OPERATIONS bdos 1 I I EJ_ DISEASE - POLICY LIMIT $ 5001 I i DESORPTION OF OPBtATHM I LOCATIONS I VEHICLES OWtac ACORD tot. Addftonai Remarks S If mere space is n ID Corporate Services. LLC d/b/a National Grid d/b/a Boston Gas Co, d/b/a Colonial Gass Co, d/b/a Essex Gas Co, and Action Inc and Greatern Lawrence Community Action, NSTAR,ABCD, and Community Teamwork care -additional insured_ - FAX: 978.654.7919 AeolrE PaLwEs CANCELLIM BEFORE =ETrNo IN WH THE POL= PROVIS IOAM Community Teanwrk, Inc ATTN: Eve iMeegan, Accounting Techician 45 Kirk Street 2nd Floor Lov#eel l , MA 01452 ACORD 26 (2010105) The ACORD name and logo are regls rrediparks of ACORD