HomeMy WebLinkAboutBuilding Permit #280 - 47 WOODCREST DRIVE 10/6/2009 TOWN OF NORTH ANDOVER
p APPLICATION FOR PLAN EXAMINATION
Permit NO: a b Date Received
Date Issued: 6 760)
IMPORTANT:Applicant must complete all items on this page
LOCATION -
- Print
PROPERTY OWNER_
` .. Print _
MAP NO; PARCEL: (o ZONING•DISTRICT: Historic District yes no,
n . a Machine Shop Village 'yes �no T
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
Septics Well Floodplain Wetlands NatershedDistrict
Water/ ewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: 1 Lam, F f?,Y\jAPhone: ���` �a-�6(07
Address:
CONTRACTOR 'Name: t� +,J. isa.! _Phone:
Address: k -
/ L
Supervisor's Construction 'License: ` O`7 Exp. Date: i t a 4
1-lome'lmprovement License _
jq 'Coat Exp. Date; t t F
ARCHITECT/ENGINEER 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: $ j� FEE: $ Q/G'
Check No.: ffa2(�o Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to he guaranty fund
�3 --5
ignature of AgentlOwner Signature of contractofl` „
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales`
e
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
Planirrt7g Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT Temp Dumpsteron site yes
Located.a �t!24�Main;Stree
Fire Department-sigiiature/date .,
` L5
r
.:COMMENTS
a
i
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
i
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2008
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
o Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
o Floor Plan Or Proposed Interior Work
Li Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
Li 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
Li 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
o Mass check Energy Compliance Report
o 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: Doc.Building Permit Revised 2008
Location
No. �� 'Date �� q
NORTH TOWN OF NORTH ANDOVER
O��•. o ,�1q.0 .
F - p
Certificate of Occupancy $
s�CNUs<� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # (� r
3
22505 Al/
Building Inspector
� �.10RTI-�
TO" of Andover
over, Mass., %zle ,04
D LAKE T�
I� COCMICMEWICK
%d ADRATED PY
`S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
• L /l BUILDING INSPECTOR
THIS CERTIFIES THAT / i..y1 E....//� �1(.z.�......................
....................... ..... ............................................... Foundation
has permission to erect........................................ buildings on .... .'? V.P ....Cr,ro,".,................................. Rough
to be occupied as p�(�/,y,,,,,d 4.)r......... Chimney
provided that the person accepting this 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
Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS 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.
Sep 27 2009 12:51 HP LASERJET FAX p.8
R�nfwal MA FIIC Lleenw#doral T leDO 8 1/24/101
t l rr RENEWAL BY ANDERSEN Federal Tax DO 83Ad04201
ersen.
WINDOW REPLACEMENT OF GREA'T'ER MASSACHUSETTS AND NEW HAMPSHIRE
.n And.�aCw.r•n}
104 Otis St-cet-Northborough,MA 01592
Phone 508.919.0900 r Fax 508,919.0908
CUSTOM WINDOW AND DOOR REMODELING AGREEMENT
Bu (s1 Nome Date of A regiment
Ar i z l G Q
B rJsJ Street Address,Clry,State,and 7ip Code
143 Dtr OoAw"r, MA Of ' VIS"
E-Mail Ad....a Home Teleohnne Number Work Teleahone Nvmber
►^111LQ Vv7N A,N 2 C.E:dp.CAJ iH. A ells' 7 6 va
Buycr(s)hereby jointly and seer 11y agrees to purchase the products and/or services of J&L Windows,Inc.dba Renewal by Andersen of Greater
Massachusetts and New Hampshire("Contractor"),in accordance with die terms And conditions described on the front and the reverse of this
agreement and on the attached specification sheet(s)(collectively,this"Agreement").Buyer(&)hereby agrees to sign a completion certificate after
Contractor has completed all work under this Agreement.
Method of Pymnt•.❑Cash o Check ❑Mastercard O VISA
Total Job Amount; Estimated Starling Date: (�(biacover d Financed,App#:
Depoait Received ops): 7 P1 L ��a�-xL
Name on Credit Cord:
Balance of Start of Job(3=1: 4
Estimated Completion Do*: Credit Card 9,
Balance on Substantial7—/q i%.- 20.. G�
Completio o,.p%): ► CC Exp.Oar . CC Security Coda:
Byinicialing here,you acknowledge that the Balance at Start of Jab and the Balance on Substantial Completion
Buyer Iui ale of Job cannot be made by credit card and must be made by personal check,bank check,or cash.
Buyer(s) agrc� .-ttnd_imderstands that this Agreement constitutes the entire understanding between the parties,and that
there are no verbal understanding changing or modlPying any of the terms of this Agreement.No alteration to or deviation
from thle Agreement will be valid without the signed,written consent of both Buyer(s)and Contractor. Buyer(s)hereby
acknowledges that Buyer(s) 1) has read thin Agree> ent, understands the terms of this Agreement, and has received a
completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first
written above and 2)was orally informed of Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF
THERE AR BLANK SPACES.
Ren by d en of Greater MA and NH Buyer(a) Buyer(s)
A
13y:
lgnature of Product Manager Signature 16/ Signature
Print Nam of Product Manager Print Name Print Name
YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD
BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS
FOR AN EXPLANATION OF THIS RIGHT.
91c— - - — — — — — — — — — — — —x- — — — — — - — — — — — — — -�<- - - — - — - - - — - — -- - -�
N NI NOTICE OF CANCELLATION
Date of Transaction . You may cancel Date of Transaction . You may cancel
this transactiowith any pena Fy or obligation,within this transaction without any pone�i or obligation,within
three business days from the above late.If you cancel,any ' three business gays from the above date.If you ca noel,any
�roperty traded in,any payments mode by you under the I property trddod in,any payments made by you under the
ontrocr of Sole,and any negotiable Instrument executed I Cantro of Sale,and any nectlable instrument executed
by you will be returned within 10 days following recall t I by you will be returned within 10 days following recall t
by fhe Seller of your cancellation notice,and any secud I by rhe Seller of your Cancellation notice,and any securl
interest arising out of the transaction will be canceled. I interest arising out of the transaction will be canceled.
If you cancel, you must make available to the Seller at If you cancel, you must make available to the Seller at
your residence, In substantially as good condition as your residence, In substantially as good condition as
when received, any goods delivered to you under this when receive , any goods delivered to you under this
Contract or Sale,or.you may,if yyoou wish,comply with the I Contract or Sol or you may,if you wish,comply with the
Instruct Igm of.t�ie.Sellsr regarding.the.. um shlpment.of instructions of tKa Seller regarding the return shipment of
the goods at the Seller's expense and risk.If you do make x the goods at the Seller'is expense and risk.If you do make
the geode available to the Seller and the Seller does not the goods available to the Wier and the Seller does not
pick them up within 20 days of the date of your Notice I pick them up within 20 days of the date of your Notice
of Concellatlon,you may retain or dispose of the goods I of Cancellation,yyopu may retain or dispose of the goods
without an( further obligation. If you fail to make the I without any furfher obll9atlon. If you Fail to moke the
goods oval able to the Seller,or if you agree to return the I goods available to the Seller,or If you agree to return the
goods to the Seller and fail to do so,then you remain liable I goods to fhe Seller and fail to do to,then you remain liable
fpr performance of all obligations under the Contract. for performance of all obligations under the Contract.
To cancel this transaction, mail or deliver a signed and I To cancel this transaction, mail or deliver a signed and
dated copy of this cancellation notice or any other written dated copy of this cancellation noticeor any other written
notice, or send a telegram to Renewal by Andersen notice, or send a telegram to Renewal by Andersen
of Greater Massachusetts and-,Now Hampshire, 104 of Greater Massachusetts and New Hampshire, 104
Otis Street,Nort ro h;:MA'01$32, NOT LATER THAN I Otis Street,North ,MA 01302,NOT LATER THAN
MIDNIGHT OF (Date) MIDNIGHT OF 5r C.(Dare)
1 HEREBY CANOE THI TRANSACTION. I HEREBY CANCEL THI TRANSACTION.
I
Censurrser'ssignature DaM Coesurnerts slgnolure Deb
RbA Copy- White Customer Copy-Yellow Customer Copy-Pink
Sep 27 2009 12:50 HP LASERJET FAX p.7
Rtnewal RENEWAL BY ANDERSEN MAHICLtcense#149601(expires 1/24/10)
dersen. Federal Tax ID# 83-0404201
wyA II[�LAU[e .�/rae. OF GREATER MASSACHUSETTS AND NEW HAMPSHIRE
mom, 104 Otis Street•Northborough,Massachusetts 01532
Phone 508.919.0900-Fax 508.919.0903
SPECIFICATION SHELT
Buyers)Name Date of meat
V5WA 14 Z.
The Buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed below;in accordance with the prices
and terms described on the Specification Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR
REMODELING AGREEMENT,of which this Specification Sheet is a part.
W=OW D9TAILS
1. CAntractor will Install a total of windows in Owner's home,using the following individual quantities:
Double Hung(DB) XEqual sash 0 Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom)
Casement(CW) ❑ Hinge right ❑ Hinge left(as viewed fmm exterior); ❑ Standard handle ❑Metro handle
Double Casement(CDW) ❑ Standard handle ❑ Metro handle
Casement/Picture/Casernent(CPW) ❑ I:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle
2 Lite Ghding Window(GW)
Glider/Picture/Glider(GPW) ❑ 1:1:1 or ❑ 1:2:1
AwninS Window(AW)
Picture Window(PW)
Bay or Bow Window
Patio Doors(see separate Door Specification Sheet)
2. Yes ❑ Na Qty of Windows to be Custom Fit Replacement:
3. ❑ Yes No Qty of$ills to be replaced by Contractor:
4. ❑ Yes No Qty d Windows to be New Construction Vull frame(includes new interior&exterior casings)
Exterior casings: ❑ Pini ❑ Maintetlance-free material IV Factory applied 908 Fibrex brickmold
5. Glazing to be: ❑ IAF Loty-M SmartSunTM (Tex Ch ditZVgihb) ❑ Other If other,please specify;
6. Exterior color to be: White ❑ Sand ❑ Canvas ❑ Terratcne ❑ Cocoa Bean
7. Interior color to be: ❑ White ❑ Sand ❑ Canvas ❑Terratone Fine ❑ Maple ❑ Oak
Note: Interior color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner.
8. Hardware: ❑ White;f"Stone ❑ Canvas ❑ Brass Double Hung:
9. ❑ Yes k No Install Lifts with Double Hu Windows
l0. Screens: windows to have: ❑ Half or Full screens Screens to be: Fiberglass E]Aluminum r7TruScene
GRILLE DETAILS
11.Windows have grilles: ❑ Yes o If yes:❑ Grille Between Glass(GEC)❑ Removable interior Wood(mmvl❑ I1dl Divided Light brou
Q1Y Qty. Qt>r Qiy Q Qty*
01A
DN DH DH DH CWiPIeWro Glider PW 97G
Draw grille patterns above 'Use additional sheet if needed Owner approved ); '
AD MONAL WORK D13TAUS
12.❑ Yes 2fNo Contractor will remove metal frames of windows. Qty of Units:
13.❑ Yes X No Contractor will install new paint-ready or stain-r_eady.xMings. ti
Interior Casing qty of openings: Exterior cashigsqty of o ❑ Pine ❑Ma nanoe-free material
14. Yes ❑ No Contractor will instal]new paint-ready far stain-ready inside d. tside stops qty of openings:
Interior stops qty of openings: h3xberW stops o ❑ Pine ❑ Maintenance-fhec material
15. Owner is aware that Contractor does not do arty p tftlg• l` Own Initials
7 G.❑ Yes .No Contractor will wrap exterior cas16� ng with aluminum coil stock o -color.
Nott. Wrapping Aping ma y be required with storm 314ow removal;remavm storm windows will leave screw holes In casing.
17. Yes ❑ No Contractor will insulate,caulk and seal windows tivilti-3= int system to vent water and air infiltration.
po Ys pre
18. Yes ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full.
19. Yes ❑ No will secure any and all necessary permits. The fee for the permit(s)is not
included in the Contract Price and a separate cheek is required at the lime of sale for this fes 4
20. Additional job details: � 2�•'
� L7"ah t�A-$ .A lj E� esti(l�Y' S(r5 H 4 1
21. Yes ❑ No Owner agrees to be present on the final day of installation for ffnal inspection and to deliver final payment.
No final paym7c27t shall f e demanded until the contract is completed to the satisfacticw of all parties
It is agreed and understood by and between the parties that this Speoifi4aion Sheet,along with the CUSTOM WINDOW AND DOOR
Ii6IvIOD GR91 MEN'T,constitutes the entire understanding between the paths,and them ate no verba(underat endings changng or
modffylf>g y o the terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless suoh changes are
In wri s ed fry both rho Buyers)and Contractor. Bt yer(s)hereby aolotowtodge that Buyer(a)hw read this SpeofficatUm Sheat.
Renew sen of Greater MA and NH Bt{yer(s) B r(e) -.
By:
Signature Ofoduct Manager Siglufum gt
v t4tr
Print N=1 of Product Manager Print Name Print Mune
RbA Copy- White Customet Copy-Yellow
I
a 1'Ite Corn[Eionweakii of Jfa-ssachuse tts
��� D'spar•trnent of Irzdust�•ial�ccide nts
+
14� Office of Iitvestig tions
-' 600 TFashington Street
Boston,M4 02111
--`' Wl1rmmass.gavIdia <
Workers' Compensation Insurance A l avie,: Builders/Coni ractors/Electriciar--s/Planll)ers
-�DDlicant Infor>ilationPlease print Legibly
�TarIle(Business/Or_anization/Indit•idua � � '
Address:
i l 5 L1TY�.�i
City/S tate/Zi
I�•. IL)�,, r�o)'0 �� C�1�3:� Phone
ze'you an employer?Check the appropriate boy: Type of project required);
1.1�'I-zm a employer with +j p 4. ❑ I am a general contractor and I
emplo s Hill andlor part-time).m o: New construction
5'ee (" haYe hired the sub-contractors
I am a sole proprietor area pier- listed on`she attached sheet. 7:ti.�-i'.�model?.mg
ship and have no employees These sub-contractors have S. J�]Demolition
working forme in any capacity. workers' comp.insurance:' 9. Building addition
[No workers comp.insurance d. dire are a col-Doraion and its
required.] ouicers have e;:ercised�tlieir 10.�Electrical repairs or additions
+ 3• I am a homeowner dDing all work right'of exemption per 1\,i'GL 11.E PlnmbLi- repairs or additions`
myself. [No workers' Comp. C. 102, x.1(4),and we have no 12.❑RD0f repairs
insurance r.-quired.]t employees.[No workers'
comp,insurance re it=d. D. Other
`p ny applicant that check box fl must also fill out the section below showing the r wore ars'compensation policy in:o.�a*ion.
Homeowner who submit this ainda�'it indicating they a_e doing allworl;and then hire outside contactors must submit a raw affi i.indica ing such:
$Contactor that check this box mutt attached an additional sheet shoiring the name of the sub-contactors and their wori;e:s'comp.policy information.
I altl"alY,e7�pZO��eY that ES�TJYOVidiPte 1VOr l erS�cOtrper:sa 0?E r.SE:Ya?fC°JOY Fry erppZOyeeS. OZOl{'.:s he poZicy aj-dIoh Site
i12.JOY IY�t1011e
Insurancs.Company Name
Policy r or Self-ins.Lic. j
Expiration Date:
Job Site Add ass:
ttCC;t a C0ny ofthe NR'o Iner$'CO enSat£ort oo tcy 'L°Clara i4T!:7$Se�S114i%trE?g the policy number and e-p�e"tiLa'1
Failure to s�oure co rerage as required under Section 25 of MGL c. 152 can lead to the imposition of criminal penalties of a.
f me up" 5.1:500.00 and/or one-year imprisoiLment,as v,7-.Eas civil penalties in the form of a STOP WORK ORDER and a-Ene
of up to$2d0.00 a day against the violator. Be advised that a copy.of this statement may be fDrwardsd to e OL-ce of
Investigations of the DLk for insurance coverage verincation.
Ido hereby ter,tJ n)er the pains and penaltics,of pe;ji:,ry that the jrj 0:'naaii0n pYavidcd�b�'e is n ue wnd c�rrec
Si mature \� ;''r!� t
Data• V( l9
Phone T:
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only. Do rotY;ifs n ibis area, to be eairpleted by cry or town orTicial.
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WORC=S T=?;I�iA 0i S0'3 '. Commissions
'NEW}A�L BY nI\!D'=ISON
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104.OTIS STREEET
NIOR T HSIOROUGH, MA-01532 .
L?�-CAl ba �7tJ•L�lui•?�P4?0 • .
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Board of Building Regniaaons<nd S LLndards
HOME ri- CWTMENTCONTF`-CTO
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J _liopisn=_nt Card
PENEWAL BY
BRIAN
104 OTiS BTR=- i`` -
`NORTHBOROUGH,iJi�01S32 zdministrator
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