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Home My WebLink AboutBuilding Permit #Exception - 49 FERNWOOD STREET 10/22/2015BUILDING PERMIT IAORTH 0 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date Issued: I — I IMPORTANT: Applicant must complete all items on this page I 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 El New Building El One family 0 Addition 11 Two or more family 0 Industrial 0 Alteration No. of units: El Commercial 0 Repair, replacement 0 Assessory Bldg El Others: El Demolition El Other A--- - , , t.. 11 Sepfic 0 well I F`i - - - - - - - - � n 0 oodplain Q ia,' 0 Wate -OlDistrict n Wat(E�r/Sewqr DESCRIPTION OF WORK TO BE PERFORMED: Identification - Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Home Improvement License: ARCHITECT/ENGI NEER Exp. Date: Exp. Date: Phone: 91 Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $1Z00 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 JA- -I() Location �;� No. 1567-2o4 Date Check #-I � (.00 TOWN OF NORTH ANDOVER Certificate of Occupancy $- Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL % Building Inspector Plans Submitted Fl. PlansWaivedl] Certified Plot Plan Stamped Plans 11 TYPE OF SEWERAGE DISPOSAL Public Sewer Taming/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales 0 Private (septic tank, etc. Permanent Dumpster on Site 0 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature' CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: ___ --Zoning Decision/receipt submitted yes Planning Board Decision: Com Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: LOcateci M4 USgOOCI 6treet F,I R, EIDEPART tMENT, --,.T0`rn0 ipurnp�ter. n,,sit -)y 1--� .71� q -Fi j1p,0p d d4te.— M P1, PA '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.$100-$l 000 fine NOTES and DATA — (For department use U 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 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 IOTE: 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 . TE: 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 I Doe: Building Permit Revised 2014 0 0 cic z 0 LLI LLJ 0. LL z z 0 Q z z z u LLJ co 0 3 2 LU 0 rd w LU co E (U a) to LU to 0 CL E LE cu 0 w 0 o :E LL- U LL L.L Ln LL w LL co Ln 0 2 LU a- 0 CO E 0 .0 0 U) 0 Z CA CO M 0 a 0 I(. VA 0 0 u IC E S 4r :,2 0 S- 0- 0 E CD r_ m 0 LU 0 U) '2 W 0 0 > (D 0 > -0 0 0 e% 'a > Ci) 0 CL CL .0 LLJ A- cm E L.- m + 0 — I-- a z CL U) " C/) a 0 (1) C/) 0 (n 0 CD LU -i 0 0 o 4):5 CL 0- (n U) CD L- : 0) — 0 W a) -,s N -W 0 .2 (D co -I.- tt= :s r_ LU r- 'a— 0 0 0 4) M 0 c 0 Q -.a ;: 0 z CL umi Z3 ;_- U) C 0 0 LU E :3 — co 0 0- 0 0 CL 0 > NA710NAL HEADOUARTERS 2501 Seaport DO-, Chester. PA 19013 : POWEA 1088-REM013E aboutblank Henry Ucclard! 31-71947 October 08. 2015 MA "C# lamis CUSTOM REMODEUNG AND IMPROVEMENT AGREEMENT BUY*KSY kdommdm aw Deow"m Of the —Pmpwty: PMJW Nuffiber: 31:il �7 WOW 0% 2015 Henry Ucclardi =ftmmmm� 49 Fernwootj st (HOWY* c4m b" Al�, MA. 01845 foop C4"-. ESW Towrdhip; I � BUY908) Asted above hereby Jointly and "WelflY agrees to purchase the goods andfor SOMOSS of Power Horne Remodeling Group and Its vendors CCOntractor) in acciordat" vAth the 0096 and Wrns described In Us 5 page document and the Product SPOCIftations. which are 1000rporelad as part of the Agreernent (00901V*, ft 'Agreemenn. This Aqwnerd represents a cash sale of goods and servioes. Buyer(s) agrees 10 pay ft cost Of ft 0006S WW services purclutsed as described hersin, regarojess of "Ming Ot 8PPVM Of WW tm&ndng BUY0r(S) May 390k lot #Wr purdme. Purchase Price: Sol Down Pftlwlt- Pro bulaltation lnspwdon DOW: 10-19 j�Z WAD Balance Due on $13,=30 Wmated Pro)ed ftart. 3 to 4 weeks Substantial CompWon- Esdm*W Pr*isd COMPWUon: I to 2 do" Method of Pryrnent: OUW G14*%)*dMAAK*V*a a A 0*42b BUYWS) hereby SdWVM@dW reoW of a COPY 01 #* PWOOK wM LOWkSltle CWdW Guide to Renovate Filghr, wmWN BUYW(s) 01 ft MW" risk Of Wed t0lard WPOSUm ftm mmvftn &*My to be perfortned In at at Buysr(sy to($) nocelved 11116 PWnPW On " dM* of Oft AWmr*K before omvnencwnem of we*. address wrillen above Sul Prop", al #0 initiats. This Agreemorit constfUn ft atire W09"" WW WWWAnft bftw to WIN, mid M A0001111001 A008086 ony and alt prior negotiations, fe"mftftw. or agrgunwft ~ wrillen or orW. No arnendmnosK m0d"icstiOn Or w8KW of ft Agreemem OW be valild or effective unless In WMV Ond Signed by both pwom Buyr(&) h8r$bY SdUVW409ft Met BLW(S) 1) hm twd ft emrs AweemW and has received a cm*W, $IWWd. Ond d&W MW of ft AqrowneK IncluOng the two *cownpanying Noks Of C8f"WM WAS, on ft dais IIM ~ ebm mW 2) wft orally inliormed of hWw rWo to cenoW Us tmmwfion. Buyer($) OW Sgre" and undKftmWs #* N BUY006) *W)m Ift work with a V*dl)wV, On Wm 01 OW *WlOrq will be cOnWined on sopmft docurnents. kckAV any *wm omqk Future prornoilorm rot sppk" 00 NOT SIGN THIS AGREEMENT IF TKERE ARE ANY SLAW SPACEIL I hm Md NW me~ each pop of Vft 5 pop W"M" ftwer Mom RoModeft Group BUY044) Z��f/-10/08fls QW5 &Wma" of PA'modekng C4=ftt WM LkW" Y01.4 THE BUYEAft MAY CANM THIS TRAMIAMM AT ANY TIME PRICIR TO MIDNIGHT OF THE TWRD DISINESS QAY AFM THE WE OF THO TRANSACTION. SW THE ATUC4W NOTIM OF CANCEUATION FORM FOR AN WLANATION OF TW fmwl pop I ds �3, I of 1 10/20/2015 2:17 PM NATIONAL HEADQUARTERS 2501 Seaport Drive, Chester, PA 19013 888 -REMODEL PRODUCT SPECIFICATIONS Henry Licciardi 31-71947 October 08, 2015 MA HIC# 168616 Buyer(s)' Information and Description of the Property: Project Number: 31-71947 October 08, 2015 Henry Licciardi (978) 685-9609 (Henry's Celif) Date ofAgreement 49 Fernwood St North Andover, IVIA, 01845 County: Essex Township: Buyer(s) listed above hereby jointly and severally agrees to purchase the goods and/or services listed,on the accompanying specification sheets, in accordance with the prices and terms described in the Custom Remodeling and Improvement and the Product Specifications (collectively, this "Agreement"). Pre Installation Inspection Date: Your pre installation inspection is tentatively scheduled for Mon 10/19 between 1:00p and 2:00p. Roofing - GAF Inclusions: For steep slope roofs, the application includes Timberline Ultra HD Lifetime Shingles with 50 -year non prorated labor warranty Also includes removal of existing shingles, installation of F -style drip edge, Weather Watch ice and water shield, Deck Armor breathable roof deck protection, Pro Starter starter strip, Snow Country ridge vent exhaust, Timbertex premium ridge cap shingles, PowerVent intake ventilation, all flashing where needed and 6 nails per full shingle. All applications used only where applicable. Clean up and haul away of all job related debris. To protect our clients, Power HRG includes, at no additional cost, the removal and replacement of up to 300 square feet of soft or rotted roof decking if needed on steep slope applications. Any additional wood replacement needed, over and above the 300 square feet we provide will be done at a cost to the homeowner of $3.57 per square foot. (Buyer initials . For Example: After the shingles have been removed, if we find there is a need to replace 325 square feet of wood, Power HRG will pay for the first 300 square feet. It is the responsibility of the homeowner to pay for the cost of 25 square feet of replacement at $3.57 per square foot, which in this example is $89.25. For low slope roofs, which are roofs with a pitch below 2/12, the application includes a 15 -year non prorated labor and material warranty, removal of all existing roofing materials, new decking, TriBuilt base and cap sheet, drip edge and flashing, where applicable. Roofs with cedar shingle removal will include all new decking as part of the installation. Clean up and haul away of all job related debris. It is agreed and understood by and between the parties that the Product Specifications, along with the Custom Remodeling and Improvement Agreement, constitutes the entire understanding between the parties, and replace any and'all prior negotiations, representations, or agreements, either written or oral. The Product Specifications may not be changed, modified, or varied in any way unless such changes are in writing and signed by both Buyer(s) and Contractor. Buyer(s) hereby acknowledge that Buyer(s) has read the Product Specifications. I I have read and received each page of this 2 page agreement.. Power Home Remodeling Group Buyer(s) /10/08/15 /10/08/15 Signature of Remodeling Consultant Signature Michael Pappas Hen ry Licciandi 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 FORM FOR AN EXPLANATION OF THIS RIGHT. October 08, 2015 17:32 Page 1 of 2 NATIONAL HEADQUARTERS 71;0 1 r%P;annrt nri,to rhactor PA i Qn 1,4 Project Specifications Roofing: Whole House 1 1625.0'x1.0' ROOFING: Models GAF Styles Architectural Shingles Types None Configs None OPTIONS: Color Slate I Removal Standard Shingle I Installation Details None October 08, 2015 17:32 Henry Licciardi 31-71947 October 08, 2015 -J MA HIC# 168616 Page 2 of 2 POWER -1 CIP ID: EL '44C4C>REr 111%� CERTIFICATE OF LIABILITY INSURANCE ATE (MMIDDN" r TYPE OF INSURANCE 09/11/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT -NAME: Lacher & Associates Ins Agency Lacher Insurance Group HONE IC tFAX, (PA . No, E,I: 216-723-4378 AIC No): 216-723-8604 E-MAIL 632 E Broad St P 0 Box 64398 Souderton, PA 18964 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Chad Lacher INSURER A: Harleysville Preferred Ins. Co 35696 GENERAL AGGREGATE $ 2,000,00( INSURED Power Home Remodeling Group, INSURER B: Harleysville Worcester Ins Co 26182 LLC 2601 Seaport Drive Ste B1 10 INSURER C: Nationwide Mutual Ins Company 23787 INSURER D: Pennsylvania Manufacturers 12262 Chester, PA 19013 INSURER E: BA 00000089796N INSURER F; 10101/2016 COVERAGES CERTIFICATE NUMBER: REVISION NUMRFR- 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 REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL IRM SUBR WVD POUCYNUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 7MPAO0000089793N 10/01/2015 10/0112016 EACH OCCURRENCE $ 1,000,000 DAMAGE To RENTED PREMISES (Ea occurrence) $ 1,000,00( MED EXP (Any one person) $ 15,00( PERSONAL & ADV INJURY $ 1,000,00( GEN'L AGGREGATE LIMIT APPLIES PER POLICYF_X] PRO- —] LOC JECT F OTHER: GENERAL AGGREGATE $ 2,000,00( PRODUCTS - COMP/OP AGG $ 2,000,00( $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED S HE ULED AUTOS A TOS NON -OWNED HIREDAUTOS — AUTOS BA 00000089796N 10/01/2016 10101/2016 WMBINED SINGLE LIMIT .c.denl) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PR PER DAMAGE (Peor c.Z I) $ $ C UMBRELLA LIAB EXCESS LIA13 ---- --- I X IOCCUR CLAIMS -MADE CMB00000089794N 10/0112015 10/0112016 EACH OCCURRENCE $ 5,000,00C AGGREGATE $ 5,000,00C T_ DIED RETENTION $ I $ D WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNER(EXECUTIVE OFFICER/MEMBER EXCLUDED? F—Y] (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 201600-66-20-96-7 10/0112015 10/0112016 OTH- ER E.L. EACH ACCIDENT $ 1,000,00( LE. 00( — E.L. DISEASE - P01 ICY LIMIT S 1.000,00C B B Mass Auto NY Auto 1 BA00000018227P BA 0000007484SR 10/01/2016 10/0112016 10/0112016 1010112016 1 Auto Liab 1,000,00( DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom space is required) CERTIFICATE HOLDER tAKIf'=1 I ATIf%KI NANDOVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover AUTHORIZED REPRESENTATIVE 120 Main Street North Andover, MA 01846 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD .C\. The CammonweaM ofHassachusew DePartment ofIndustfialAceidents I Congress Street, Suite 100 Boston, MA 0,2114-2017 wwwmass.govldia Name IN"Orkers' Compensation insurance Affidavit: guilders/CoutractOrs/Electricians/Plumbers. TO BE FUED WrrH THE PERMMTNG AUIHORffy. Address:—CS'01 Jc-,,t�ppgZ "I'% - WAYMM An you an employer? Check the appropriate box: Phone#: 5V8-Z8t0-015'6 I.Slaimaemployerwith 15 —employee,(fillandf4part-tim).- 2.0 lama sdlepropietororpartmrshipimdha,,,OeWlyeesworkitkg forinein any capacity. [No workers'comp. ksuranze requirod.] 3Q lam a homeowner doing all work nryscif, [Nowoikers'comp.in=w"req1rirc&11 4.n I am a homeowner and will be hiring contractors to conduct all wcnk on 3my property. I will CuSin dull all contractors either have workers'compensation MSUnMCe Or are Sole Proprietors with no employees. 5. F1 I am a general contractor and I have hired the sub,,ntracto. listed on the attached sheet These sUb-COMIUctors have employees and have workers'coW. instirsnoc.: 6.[] We are . corporation and it. oflicers have ei,,.d their fight of eeuiption per MGL c. 152, § 1(4), and we have no employees. [No workers, comp. insurance required.] Type of project (required): 7. []New construction 8. Remodeling 9. Demolition 10 Building addition I I Electrical repairs or additions 12. Plumbing repairs or additions 13 1. Roof repairs 14. E] Other *Any applicant that checks box #1 must also fill out the section below shownig their workers'cotapeassfion policy inforinafion. t Homeowners who submit this affidavit inclicating they are doing al! work and then him outside contractors must submit a new affidavi . t indicating such. :Contractors that check this box must attached an additional sheet showing the name of the Mb-contractars and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers'comp. policy number. ,ram an employer that isprovhfing workers' compensation insurancefor my enployee& Below is ifiepoficy andiob site informadoiL hisurance Company Name.'— "AM f VIL L'17 /by C tzi 7-rn— /Z I ri 1 V A f ffo�v rM L-1 -qb-? Policy# or Self -ins. Lic. M ZCWjV#�� , _1) -1-2016 J EViration Date: Job Site Address: f A City/Statozip: N 4�410h Vr7t� �t, Attach a copy of the workers9 compensation policy declaration page (showing the policy number and expiration date). 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 I do hereby thepains andpenaliks ofperjury that the informallonPrOlWd aboll is fr-e and — ky I correct Sirmature: T%�4— 10 Phone M 6191, rr=1 — OjrwW use only. Do not mWte in this area, to he completed by city or town offkiaL — — — — — — City or Town: Issuing Authority (circle one): Permit/License # 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone M free of Consumer Affairs & Business Regulatiop License or registration valid for individul use only OME IMPROVEMENT CONTRACTCR before the eiipiration date. If found return to: Registration: IrO861r, Typ, Office of Consumer Affairs and Business Regulation Expiration 10 PRAFIaza - Suite 5170 .: 3/1�12.017 Supplerned ',ard Bo on, 116 POWER HOME REMODELING GROUP LLC. MARK MORDINI 2501 SEAPORT DRIVE STE Bi 10 11,(, (A CHESTER, PA 19013 U Undersecretary - w id without signature t Val Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -057645 Construction Supervisor MARK E MORDINI., F., 18 NEWELL DR N ATTLESORO �iA �-JZUZ- CA-- Expiration: Commissioner 0911812,017 4 n R1 FLrt" ....... . . . . . . . . 5 OD 094MDU PwOMS-M X. p