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Home My WebLink AboutBuilding Permit #318-14 - 43 MEADOW LANE 10/3/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page r LOCATION Print- PROPERTY OWNER �1 Print 100 Year Old Structure yes no MAP NO: 0� PARCEL�I NING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOS USE Resid ial Non- Residential ❑ New Building 26ne family ❑Additi ❑Two or more family ❑ Industrial ❑AI ation No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERF ED: 17/ Iden ' on Plea e or 4int Clearly) OWNER: Name: Phone: Address: �— CONTRACTOR Name: _T C r►x- Phone: q '�s2gu Address: Supervisor's Construction License: ("21,N Exp. Date: Home Improvement License: Exp. Date: 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.: a24a!5-- Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access a ua my Si and Si nature of A erit/Owner mature of contr_ o .._9__ 9 _ _ g ._ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ S amped Plans ❑ Plans Submitted-0 PlansWaived-❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OF°:SEW-ERAGEDiSPOSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑. . . 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 Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes �x Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Siqnature & Date Driveway Permit h DPW Tows Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT --Temp Dumpster on site yes no Located-at 124 Mair 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 - Date F Doc.Building Permit Revised 2010 Building Department The foliswing is-a-list of the required forms to be filled out for the appropriate.permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building pp 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 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) ❑ 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 orspecial permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building Permit Revised 2012 Location No. fir[ Date v r o - TOWN OF NORTH ANDOVER a ` LIKD c s o Certificate of Occupancy $ F Building/Frame Permit Fee $ � Foundation Permit Fee $ ' ' Other Permit Fee $ TOTAL $ Check#� ' Building.inspector v, -TIFICA-E 01"' L A83,111 "T LIF NCE IU" TAtS FER R 1 G T 1 C'. F ICAT E DOES is OTA FIR M-1 TTVE:Lf GR NEGATIVELY AM END, EXTEN-D OR ALTER THF C OVE R-4,G E P',F F 0'RD c,E.v T E",'-OiWcii E-E. 0'!w�V,TH I S----E-Rrj F i_0 A'I E:0 F IINS';�I P J-40 E ID 0 E S IN T C 0 -S U7 E A C 0 F LA.C T B�E 1-1 M E E T 7 S 1 C L7 0 CERMMATE a n kDu be if c:��7,65c;=-elhokder is TiGNIAL INSURE-Da the poficy(ies!rAu I S and- S 0,;h PC,(i�' Cer!2;Ti'Q-�lisie_s rn 3 F eq U; 71, rld•;r,=:ri rl'.A s e, r. C,7! c;ei-i" E: Cathy eco u-mgard 1; PHONE E_'d): 03,LA6K-2766 ADDRESS: 'B= -7.e N._--shua, NH 030E-4 60"! SZ2-2766 _ERs: ------------ .............. CFopai�L? s LLC I'VINMIG IrI5LIi`aT)CG'CO j.,,sup—P,c cio Mark& Freeman ShirleyI INSURER 1) n-- _------------iry Drive 333 RNS"UPFF,E Naz,hua,NUH 038952 L INSURIER F C0VEPJ,GFS CERTIFICATENIL120BER: 1',EVI 3 11 0 N N U'N'j B E P: THIS IS TO CERTIFY THAT THE POLICIES OF71(,R7054CE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE'.-,,10,r) INDICATED. NOTWITHSTANDING ANY REQUIREMEN'T, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAK THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLILIS IONS-AND CONDITIONS-OF-SUCH POLICIES..-LIMITS SHOWN MAY HAVE BEEN REDUCED-BY-PAID CLAII'VIS.- - 1:11,13F - ADD US EFF POLICY F-1� L TYPE OF INSURE !y!�Vp POUCYINUMBEER (WPIOLD3 I DDrnitily'$ I I I&! EACI-10 C(__WRR CNCE S 1,000,000 GE-41ERAL UABILF Y V N. lni21501385 12 0 i3 0411-A 120 %TI'()ncaDnce) $50,000 X IA l I COMERUP.1 GEjicrAL UABIUT`� SS CLAIMS-MADE ®OCCUR MED E),:P(Amy one person) $5,000 X B11PD Ded:500 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER., PRODUCTS-COMP/0P AGG $1,000,000 7 POLICY 7 PAR El LOC $ C; 1',1'NEO',SINGLE LIMIT AUTOMOBILE L1ABUrY 6:A0113773113773 6124,2013 0612412-014 ,j�I1,,1'3 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per a--bent) $ AUTOS AUTOS NON-OWNED PROPERTYIDAMAGE X HIREDAUTOS AUTOS Per accident) UMBRELLA LLAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION 0_TH- AND EMPLOYERS'LIA.B—BRY --- ogy I IMIT IER E; VVORKERS COWE-41SATION iq 0612M2013 06/2712014 F )K jC STATU-q I ANY PROPRIETORIPARTNERfEXECUTr%fEE.L EACH ACCIDENT $1001000 OFFICER/MEMBEREXCLUDED? F-Y] NIA (Mandatoryin NH) E.L DISEASE-EA EMPLOYEE $1*00 000 If yes,descnbe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF GPERAT;DNS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if rnorc,space isrequired) Workers Comp Information fi-lernbers ExClUded: Mark Freeman, Member, Shirley Freeman, h1ernber;Covg for NH. :CERTIFICATE HOLDER. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Alside Supply Canter THE EXPIRATION DATE THEREOF, NOTICE IMILL BE DELIVERED IN PO.BOX 2010 ACCORDANCE WITH THE POLICY PROVISIONS. Akron, OH 44-309 AUTHORUED RFPRESENTALTWE 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25.(201.0105) I of I The AGORD name and logo are registered marks of ACORD #54907'81M49077 CBX NORTH Town of ndover O / No. z _ h ver, >Mass ( z13 o COCHICM!WICK V^" 7�A�'OA TE O S V BOARD OF HEALTH Food/Kitchen PERNL T D II Septic System THIS CERTIFIES THAT l�.d4•. BUILDING INSPECTOR Ae � 1 Foundation has permission to erect ......... buildings on ....... a Rough M to be occupied as ......... ..... .... ... .!.K .......................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TARTS Rough Service ........... ..... .. . . r................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE COASTAL ROOFING CONTRACT Miassachusetts License#168446 WINDOWS BXI rlZI[3RSINC. DATE .a Job# tC S`tl 1�� 11 6 REPRESENTATIVE 100 Cu nmings Center,Suite 236-H•Beverly,MA 01915 978-304-0495 • 888-812-2783 ' Fa;::978-304-1928 SOURCE www.mycoasta twin dows.com CR GENERAL CONTRACTOR'S AGREEMENT I/We,the owner(s)of the premises described below,hereby authorize you as contractor to furnish all necessary materials,labor and workmanship to install,con- struct and place the improvements described herein according to the following specifications,terms and conditions on the premises described below. OWNER'S NAME t 1 COUNTY i;tel t �,k-�•� ::�;K i 'ia y ADDRESS '" CITY I� STATE ZIP ,y �� S 1��d�`irr' R r,��s,'` ?fit_ �.<,...f a. sz_� 1�� .��i -;� "a`➢ o CONSTRUCTION SITE CITY STATE Zip HOME PHONE WORK PHONE(7) ALTERNATE PHONEe E-MAIL SHINGLE COLOR QUANTITY DIAGRAM OF HOME # TIMBERLINE HD a; (1:31 �. a.-� TIMBERLINE ULTRA HD CAMELOT II _ CAMELOT ULTRA <-y TRUE SLATE a SKYLIGHTS �---a---T i — -- —k WORK TO BE DONE: ROOF TAKE OFF REQUIRED ROOFING MATERIAL:(squares= )Chimney q'OTEAR OFF ,�'� GUTTER MEAS:LF= Ends+ 90's= DS= R EPLACE SHEATHING IF DRY ROT IS PRESENT Skylights:2x2 2x4_ Custom ,�'� Satellite Dish? DumpsterAccess? C2'USE GAF WEATHER STOPPER SYSTEM(ACCESSORIES Delivery Access? ,--, ,� � Vents Type How Many Vents WANSTALL LIFETIME SHINGLES Current Roof type:Comp Cedar Tile Other- MX therQ REMOVE ALL JOB RELATED DEBRIS Pictures:Yes/No Questions:_ 1. Work requested:Replace Roof/Resheeting/Install New Skylights/Replace Old Skylights EI/JOBSIGN IN YARD Roof size_ Roof Pitch Layers of Roofing Stories 1/213!4 ❑ ADDITIONAL CONSTRUCTION(SEE ADDENDUM) Dryrot:Minor Major Massive EST.START DATE: EST.COMP.DATE: SECURITY INTEREST: YES❑ NO( 5' 7 PRICE $ ` [ _� DEPOSIT WITH ORDER Payment Method SALES TAX $ BALANCE TO BE PAID $ ^ CASH ON COMPLETION TOTAL DUE $ a{ BALANCE TO BE FINANCED' $ _ Financed By "This agreement is subject to financing which you must secure within thirty(30)days after the date of this Agreement If Financing acceptable to Coastal Windows&Exteriors is not obtained within 30 days,this Agreement may be cancelled by either party. All home improvement contractors and subcontractors must be registered by the Chief Administrator of the Massachusetts Board of Building Regulations and Standards.Any inquiries about a contractor or subcontractor relating to a registration should be directed to:Director of Home improvement Contractor Registration,One Ashburton place,Room 1301,Boston,MA 02180,(617)727-8598. The Contractor shall obtain and pay for the building permit and other permits and governmental fees,licenses and inspections necessary for proper execution and completion of the Work. If the Owner elects to obtain the foregoing permits,or to deal with unregistered contractors,the Owner will be excluded from the guaranty provisions of M.G.L.c.142A.The Owner shall obtain and pay for all other necessary approvals,easements,assessments and charges. The Contractor and the homeowner hereby mutually agree in advance that in the event the Contractor has a dispute concerning this Contract,the Contractor may submit the such arbitration as provided in Massachusetts General Laws,Chapter 142A. L "il�t1J r y t o HOMED ER'S SIGNATURE DATE c -` CONTRACTORS SIGNkfURE'- kms-- .,�` DATE 71 ' NOTICE:The signature of the parties above apply only to the Contract ofthe parties to alternative dispute resolution initiated by the Contractor.The homeowner may initiate alternative dispute resolution even whera thi,cwtinn k nor mnvor.J...:....,,a k1-__�:__ INSTALLATION PACKET Customer Info- Sale Info: Deborah Degalla Salesperson- Timothy Conlon 43 Meadow Lane Contract Date: 9!512013 North Andover, li A 01645 Total Contract: 13951.00 Horne Phone: (976) 697-1669 Balance Due: 9301.00 Work Phone: Payment Method: cash Cell Phone: Job Number: 0609 INSTALL DATE AND TIME Special Instructions Please email before and after pictures to upon completion. Product Timberline HD—COLOR TO BE DETERINED-21 sgso Work Order Notes Customer is calling in on Monday with the color, please schedule for measure regardless of this fact and I will provide it on Monday 09/0912013. Should you have any questions please email me. Thank you, Candace irl CS.06619A TklARK FRFEKAN ' 11 €3AYa 1�g" DRIVE t�sh�ia KH 03062 O(fire ul(atxutttrr.\if�un S ,tines>�tc�a ition HOltE.tldIPRGVEitAENT coNTRACTOR Type. RtigistratiOn: 1,53131 1 i0 LiabiNty Cursor Enpie�tibn: 10I30120'14, AJC Pito? RTIES DR. MARK FP.EEMAN. /1 DAYLILY DR. f`" '1 "— NASHUA.NH X3062 t'ndctsgcrct>•�:'