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HomeMy WebLinkAboutBuilding Permit #174-15 - 52 ESSEX STREET 8/19/2014 y VtORTH O�,I VD 16.9 tiO BUILDING PERMIT 3r s "•,'.6 0� TOWN OF NORTH ANDOVER ° ; o q�0 APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received '� 4 �9SSAC HUSEt�� Date Issued: iMP RTANT: Applicant must complete all items on this page LflCATIC3N '"!!k t rnl�+ 'Aft I rint PROPERTYONER Print MAP NO PARCELA4, ZflN'1NG DISTRICT: 1. Historic Districtes �.y Machine Shap Villager=yes no` TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building X One family I Addition Two or more family L Industrial Alteration No. of units: E Com cial Repair, replacement 7 Assessory Bldg E ers: Demolition Other rUi Z] Septic i Well m: ? _i'Floodplain C Wetlands ❑ Watershed;District Water/Sewer-S ()Q . S-fall Vinvi SiIdtl Act M 0 n CL te- Rxm" 41 IV Du)e I r)Ct 1-4 Aw�,rox , 0 Squares -- Identification Please Type or Print Clearly) 1 OWNER: Name: N Phone:3��"1 '*7013 Address: S2 ex t, NOr An ov e rN1GL o184S CONTRACTOR Narn ho ' Address- [ ddress Supervisoes'Construction°Lid nse, �' Exp. Date: ` Home Improvement License: y Exp. Date: ARCHITECT/ENGINEER 1U A Phone: Address: Reg. No. FEE SCHEDULE:BULDING PER/M�IT:QQ$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST B E ON$125.00 PER S.F. Total Project Cost: $ OTT7� FEE: $ Check No.: 241 Ll 7 Receipt No.: ` NOTE: Persons contr dc with unregi tered contractors do not have access to a ran fund Signature of Agent/Own e Signature of contract Location No. L ( Date Or_ . - TOWN OF NORTH ANDOVER • S��TLFD 16�6` • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# � - Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools I I Well ❑ Tobacco Sales ❑ Food Packaging/Sales I 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 ❑ ❑ COMENTS CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street FIRE DEPARTMENT Temp Dumpster on site yes,. no Located at 124 Main Street Fire Department signature/date 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.$10041000 fine NOTES and DATA— (For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2012 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 NA— ❑ Floor Plan Or Proposed Interior Work NA — ❑ 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 Applicatigp ❑ Certified Surveyed PI p� ❑ Workers Comp Affid ❑ Photo Copy of H. And C.S.L. Licenses ❑ Copy Of Co ct ❑ Floor/Cr section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hy ulic Calculations (If Applicable) ❑ ass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products NOT All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed I Ian ❑ Photo of H.I.C. A icenses ❑ Workers Comp A vit ❑ Two Sets of ding Plans (One To Be Returned) to Include Sprinkler Plan And Hydrauli alculations (If Applicable) El Cop f Contract ❑ ss check Energy Compliance Report Engineering Affidavits for Engineered products NOTE- II 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORiM07 Revised 2.2007 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluwnbers Applicant Information Please Print Legibly Name (Business/Orgaiiization/lndividual): Budget Exteriors—C/O Lou Milano Address: 354 Merrimack Street( Entry C,Suite 500) City/State/Zip: Lawrence, MA 01840 Phone #: 860-753-0452 Are you an employer?Check the appropriate box: Type of project(required): 1.DO I am a employer with 8 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. E]Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working forme in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof rcpai s insurance required.] t employees.[No workers' 13.® Other V 1 n 1 C� comp. insurance required.] J *Any applicant that checks box#1 must also fill out the section below showing theirworkers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew anidavit mdreatmg such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Atlantic Charter Insurance Co. / 781-593-1200 Policy#or Self-ins. Lic. #: WCV01161200 Expiration Date: 05/30/2015 Job Site Address: 52 Essex Street City/State/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby cer ' un r the pain nd penalties of perjury that the information provided above is true and correct. Signa (Bud et Exteriors Auth.A ent Date: _A/_x?&_5f_.aW 7T7_ Phone #: Home—Fax : 860-935-0346 / Cell: 860-753-0452 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Perin it/Lice nse# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: ACORQ. CERTIFICATE OF LIABILITY INSURANCE 01182°0" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. U RO ATi N 19 WANED,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). RODUCER _NAME.PHONE_ - - _.. }uffy Insurance Agency, Inc. ,CC781 593._.1200, FAX 791.S93.7260 317 Broadway -*AN,,IL .ADDRESe1._�L .__ C .�� - .- _ Alyoata Square _ INSURER(Ill)AFFORDING COVERAGE Lynn, 14A01904-2602 INSURER A; American Insurance�C �� - _ rsuaeo Budget Exteriors _ INSURER a: Atlantic Charter Insurance Co. 0005. c/o Lou Milano ulsllRERC; 3S4 Merrimack St Entry C S 500 -INSURER 0; INSI Lawrence, MA 01840 INSURER RE E INSURER F: ;,OVERAGES CERTIFICATE NUMBER:i5 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF 114SURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY t0 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 LTR rfPE OF INSURANCES ;me is~ T MM1DD PDI3CPFFF�-PaIDD Y 1NSR:WVO POLICY NUMBER ' MM/DO/YYYY 1 CIMrY'a GENERAL uAeIUTY I i CBCZOOOOO1740A 07,3912014 07131120151 EACH OCCURRENCE '# 1000 I COI^*RCWAL LIABILITY PREMISES GENERAL j I RMISEIOTiENfEI7' SLE , ?xcur-e!+cet : 100,Wd . I CLAIMS-NIADE L-?OCCUR MED EXP(Arty aye mean) A S 5, _ _. . _ PERSONAL&ADV INJURY # � 000, GENERAL AGGREGATE 1 S GEN'L AGGREGATE LIMB APPLIES PER I I PRODUCTS COMPIOP AGG S Z 000 __..._I ,..._ CT LOC I AUTOMOeKE LIAINUTY i E ! !(Ea acatlordj_................. S (ANY AUTO I rj BODILY INJURY(Per POW0 7 S AIL OWNED SCHEDULED ._..___�..- AUTOSAUTOS BODILY INJURY IP/T eomv" S _ 1 NON-OWNED 'PROPERTY DAMAGE � __. __._._. HIREOAUTO$ . �.1 AUTOS I Pet xa6ent)_._ !# I UMBRELLA UAB t I OCCUR I I EACH OCCURRENCE '# EXCESS U" ;CLAIMSaAADE I 1 �ACiGREGATE # DEC) ! RETENTION# ; WORKERS COMPENSATION WCV011b120005,13012014 06130120JS1 {AND EMPLOYERS LIABILITY Y f M i TORY lA104. - 11"(R - i ANY PRC)PHIETORWARTNERIEXECUT I EL EACNACCIDENT 100.No B IoFFICERJMEMBEREXCLUDEO1 iNIA .._... .. s.,.._...,mm,,.,_. 1QO, (Nen6elory M NH) f E L DISEASE. EA EMPLOYEE # i Myr 61urA)4 urv7er DESCRIPTION OF OPERATIONS below I 1 EL DISEASE-POLICY towt•# SOO 1 I i i OE#CR,PTION Of OPERATK)"r W"TK)Na I yENIGLE3 IARech ACORD"I.AddhwW RenwU Schadwks.N ew o two w ngWeM CERTIFICATE HOLDER CANCELLATION W WA D ANY OF INE AIME Ot$CRIMEa POugE3 at CAWtLLlg WOO" THE ELFWAT"DATE 1-"*OF,NOTICE MALL It OELNtfcEg W . A0C4aOfANc1*"%INE POLICY Pftoywo w I Drew Slobodjnak wTNOlutcn 3lMTAl 52 Essex St --- North Andover, MA 018454 J - -0 06111-2040 ACORD CORPORATION. All ngb*meer iod. ACORD 25(2010105) The ACORD name and logo are raylabrod tnerks of ACORD I CONTRACT TERMS AND REQUIRE} NOTICES Notice AIII home Improvement contractors and sutZwntractom engaged in 3 h r r�a verrent r canGacting,unless sWiF,cally exe,1 01 fr=regtstfwiun bY rr,r mw iot+:s of Chapter i 42A of the general laws,stns►be; €e:e,,etit S w€Eh the C rnmof wsealth of 1Massad)usetts. Inquiri-_s about req;stralion and t �; 31 etas shCu`d',tr ads to the director,Horne i-rrpruv rent Cohtrdetst Rc-q €F,nr,Cine A;hbue=Piave:Rocnt 130',Bars n. MA 02tr 3 ' c(` f d?fl'r f(7C Xec' f 3,'Merrimack Btroat(Faltry e.,SURD 00)�Lewrence,MA FJ1840 BROA9t3UDGET*lax(978)299-17128+� vw.t3uda e Exter ors.com O€fire+tt$,ti€Y G{3 tT?Cr: ttYtr3('w�{U51 CiC 5 NCnula tivrF L:£C�Er"e or registration valid for ifldivirdul use only tk` t3M�t7,4PRt3VEWNT CONTRACTOR izcf are the expiration date, [(found return to: ��F t pisiration: 177704 Type-. Mice cat Consumer affairs anti Husin"s Regalation 1177" 016 09A 10 Nrk Pia""-Suitt 5170 `, arriratAon: Rostoo,MA 02116 BUDGET EXTERIORS LOUIS MILANO 3.5k1 MERRIMACK 5T ENTPY C LAWRENCE,MA 0184 i ntfrratcrctary ( �sant valid evTfltrsttt signature A t �g 1 Massachusetts Department of ptjbI c Safety Board of Building Regu!aVofts and Stasda;,ds C„n�frui:ti:rra�€tlrri•1i�rar E Licenses CS-097519 LUBOSSVEC - f" 827 THOMPSON:ROAD _ € Thompson CT 06377 r expiraton Commissioner 08/3112016 � i 1 j rs -A C =uQ_ - ° 0 �- II�� CONTRACT TERMS AND REQUIRED NOTICES Notice: All home improvement contractors and subcontractors engaged in home improvement Contracting,unless specifically exempt from registration by the provisions of Chapter 1 42A of the general laws,must be registered with the Commonwealth of Massachusetts. Inquiries about registration and LIM status should be made to the director,Home Improvement Contractor "f 'J Registration,One Ashburton Place,Room 1301,Boston,MA 02108. Qal/ty am pwre Of/19/f�U f0/- legs 354 Merrimack Street(Entry C,Suite 500)•Lawrence,MA 01840 888-49BUDGET-Fax(978)299-0128•www.Budget-Exteriors.com I/We hereby agree and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the specifications,terms and1 conditions,on the premises below described which I/We represent that we have good record title in our own name. Owners Name: A-,#-IV In -, „t 14 1't� Home Tel. No. 3/0- N�7D(:J Bus.Tel.No. e-mail Job Site Address �a ev S 1-i ti,b City& STK x,, Zip Massachusetts Contractor Registration#161932 Work Specifications described attached on pages I ofa Permits: The contractor agrees to apply for and obtain all construction related permits(building/electrical/plumbing)but shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting,or inspection agencies,authorities or individuals. Notice: The homeowner who secures his own permits will be excluded from the guarantee fund of MGL Chapter 142A. ....� Price:The contractor agrees to do all work described by the contract for the total price of$ 94W Com, Notice: No agreement for home improvement contracting work shall require a down payment(advance deposit)of no more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must,in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever is greater. Payment Terms: Advanced Deposit $3 Jnr, Payable on signing of contract Interim Payment 1 $ Payable Final Balance $� _ Payable on completion unless otherwise specified. Work Schedule: The contractor will not bggin work or order material before the third day following the signing of this agreement unless specified in writing. The contractor will begin work oAorut,�f/3/date). Barring delays caused by circumstances beyond the contractor s control,the work will be substantially completed in ays. The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidablebyctor shall not be considered as violations of this agreement. The contractor shall not be liable for any delay or non-performance caused by strikes,accidents,weather or any other contingency beyond its control. Insurance: The contractor agrees to maintain workers compensation and comprehensive general liability insurance during the operation of this job to cover the acts of its employees and or agents. Warranties: The contractor warranties its workmanship for up to a period of years and assigns the rights to any manufacturer's warranties to the homeowner after substantial completion and payment of the contract terms. You may cancel this agreement if it has not been consummated by a party thereto at a place other than an address of the contractor,which may be his main office or a branch thereof,provided you notify contractor in writing at his main office or branch by ordinary mail posted,by telegram sent or delivered,not later than Midnight of the third business day following the signing of this agreement. See the reverse side of this form for an explanation of this right. The instrument and any and all other documents attached hereto and signed by the parties set forth the entire contract between parties and may be modified only by written instrument executed by both parties. Receipt of a copy of this contract and duplicate notice of cancellation and explanation thereof is hereby acknowledged. Notice: Cancellation of this agreement after three business days will result in a restocking fee of up to 33%on custom products and 25%on non-custom order products. HOMEOWNER: Do not sign this contract if there are any blank spaces. IN WITNESS WHEREOF, the parties hereunto signed their names this 1�__day of ..E , 201 . Budget Exteriors, Inc. Representa -- - •_,..kiomeowner c:/`' Accepted Budget Exteriors, Inc. ""„-- Homeowner Page of CONTRACT WORK SPECIFICATION ; - Mass HIC# 161932 GAF Authorized Roofer CE 18650 '.,�Hr>/if1, railll/'+,n.?:"�*r�i..r19•'%s.�F,>r/pti.�: 75il M."111—k SI—t(C try C.Suite.500)•Lwwrance.MAO 1840 AAO-4ABUDGE7-Fax(V7A)$93-0'12A•www.Ott4ACc- :t'crtor.,corn August 13, 2014 Drew and Karina Slobodnjak 52 Essex Street North Andover, MA 01845 Proposed Vinyl Siding and Trim Proiect for Property 1. Strip walls of existing siding and properly dispose from entire home. 2. Install Typar or equivalent home wrap. 3. Flash the bottom of each wall with color coded pvc aluminum. 4. Install Crane starter strip for installation of new vinyl siding. 5. Install Craneboard insulation backed siding to home. Color 6. Custom cover all rake boards and fascia with PVC covered aluminum coil. 7. Custom cover windows with pvc aluminum as necessary(excludes Andeson 200 windows.) 8 Replace all drip caps with white pvc covered coil bent on site. 9. Custom cover exterior door casings in same manner as windows where possible. 10. Add Craneboard vinyl light blocks to all exterior wall light fixtures for a more attractive appearance. 11. Remove all work related debris from job site upon completion. 12. When on premises,applicators will handle themselves in a professional manner at all times. 13. All manufacturer warrantees will be provided to homeowner. 14. Seven year quality workmanship warrantee provided by.Budget Exteriors. 15. Budget Exteriors is responsible for all necessary permits. Total Proiect Cost: Craneboard Insulated Siding: [.046 thickness] $9,480(Insulated Vinyl Clapboard) 100%1rfetime non-prorated transferable warrantee. Accepted by: Budget Exteriors Date !� Home Owner Date ! NORTH own of . ? E , Andover .�. - to No. - ,� ;n '*1ver, MaSS , A- COCNIC"t WIC" y1. 7.95 RAreD 0'*' L) BOARD OF HEALTH PERMI-T T LD Food/Kitchen St.b. Septic System THIS CERTIFIES THAT .......�1���........... .. .!1... .. �I .... BUILDING INSPECTOR has permission to erect...................... buildings on .....s•L...... •• •••••••••••• ......•• .. Foundation ......•••••• Rough �s�a ........ R .. ..l........ ............. Chimney to be occupied as ...... .�.�...... �. •' C• • •• •• y provided that the person accepting this perin every respect confol4� to o 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 MON_WS ELECTRICAL INSPECTOR UNLESS CONSTRUCT N S TS Rough Service ............ .. .. ..... ..... . .............................. 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.