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HomeMy WebLinkAboutBuilding Permit #120-15 - 53 GLENNCREST DRIVE 8/1/2014 L TOWN OF NORTH ANDOVER /APPLICATION FOR PLAN EXAMINATION tiQ ' Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION S3 - - Print. 4 PROPERTY OWNER G� `rod �c�--c:� u�✓sL<- Print 100 Year Old Structure yes 49 MAP NO:h�'�-PARCEL: ZONING DISTRICT: Historic District yes 0 Machine Shop Village yes o TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building IS One family El Addition ❑Two or more family El Industrial Iteration No. of units: ❑ Commercial fbRepair, replacement 0 Assessory Bldg 0 Others: ❑ Demolition ❑ Other _ ❑ Septic ❑Well 0 Floodplain ❑Wetlands ❑ Watershed District Water/Sewer !� DESCRIPTION OF WORK TO BE PERFORMED: 20 y, !D uV vI—S Identification Please Type or Print Clearly) r OWNER: Name: ''1� c.`�� Z�►; .rSNc` Phone:��1, _Q`-1 Address: CONTRACTOR Name: Phone: 3 Address: Supervisor's Construction License: Exp. Date: Home Improvement License: 0 k Exp. Date: b\,n !kkt ARCHITECT/ENGINEER tiv*-J-*,, Phone: . No. Address: Reg. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 14 SSb FEE: Check No.: Receipt No.:Da- �.d NOTE: Persons co ctin2inregistered contractors do not have access to the guarantyfund Signature_of Agerit/Ow —Sig nature of contractor Plans Submitted Plans Waived Certified Plot Plan ❑ Stamped Pla s Location No. Date t • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $. TOTAL $ } Check# 2784 $ ..i,. Building Inspector J - Plans Submitted ❑ : Plans-Waivede-: . ..-..Certified Plot Plan ❑ . Stamped Plans ❑ .,TYPE:OF-SEWERAGEDISROSAL-: ' Public Sewer ❑ Tanning/Massage/Body Art ❑. . ..Swimming Pools ❑ Well ❑ Tobacco.Sales ❑ •Food Packaging/Sales ❑ Private-:se tic tank etc. p ❑ ~ Permanent Wumpster on Site El -THE-FOLLOWING'SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM v.._-DATE REJECTED: DATEAPPR-OVED 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_ .. Planning Board Decision: Comments Conservation Decision: Comments !Nater& Sewer Conn ecti on/Sig nature& Date 'Driveway Permit DPW Tow,2 Engineer: Signature: Located 384 Osgocid Street FIRE DEPARTi IENT.--`Temp Dumpster onsite yes no Located'at 124.Mair;Street= Fire Departure►if signatu"re/date` - COMMENTS i�. I .-Dimension.- Number of Stories: Totals square feet of floor area based on Exterior dimensions. nsion s. .Total-land-area;sq. ft.: =ELECTRICAL: Movement of Meter I.ocat ari,mast-or service drop requires approval of ' ..Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL.Ch'apter-•166.Section 21A:=F and G min.$10041000,fine NOTES and DATA— For department use EI Notified for pickup - Date Doc.Building Permit Revised 2010 i r Building Department The fol,-3wing is.' -list of-the required:forms to be filled out#or.the-appropriate-permit to.be obtained. Roofing, Siding, Interior Rehabilitation Permits - ❑ Bailding pp Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/OrC.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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ��`_❑__ Engineering Affida_v_its 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 i ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract Li 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 M In all cas<s.if a variance or special permit was required the Town Clerks office must stamp tli'e decision from the Board of Appeals that the apn•,al 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.Bubding Permit Revised 2012 � �.10RT1i Town of 2 t... ndover No. ♦ , * y o a COCNI[ h ver, Mass, Mlwlc" 1' ��OO S V BOARD OF HEALTH Food/Kitchen PER T T D Septic System 00z .. Q �,. BUILDING INSPECTOR THIS CERTIFIES THAT ................ ..... I. .... .. ......... .. .............. ................. Foundation has permission to erect .......................... buildings on ...Ja....... ........ ....... .. ..,P . Rough to be occupied as ...........�01)..... . . ►11` .�...'.-�....((.�......a {�. ..! ..A..................... 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 3 PERMIT EXPIRES IN 6 M THS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO 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. DATE(MNI)LYYYYY) �'►�' CERTIFICATE OF LIABILITY INSURANCE 6/25/2014 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 POLICES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: Ifthe certificate holder is an ADDITIONAL INSURED,the policy(es)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 PONT A Sandi Munroe M P ROBERTS INS AGCY INC NE978 683-8073 FAx (978) 683-3147 1060 Osgood Street UL sancilomprobertsinsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# Nu R : MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURERB: GUARD INSURANCE 169 BOXFORD STREET i NORTH ANDOVER, MA 01845 INSURER D: N NS F' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: j THIS IS TO CERTIFY THAT TI-E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEROD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDMON 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 0 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY ErF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea ce $ 500,000 BOPI068945 11/22/1311/22/14 WD EXP one person) $ 15,000 A PERSONAL&ADV INJURY $ INCLUDED GEN'LAGGREGATE UMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY❑jEa []LOC PRODUCTS-COMPIOP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ r �,000 ANYAUTO MCA7013608 01/23/14 1/23/15 BODILY INJURY(Pel person) $ A AUTOSALLOWNED AUTOS SCHEDULED BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOSMAUTOS 'd t $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMS-MADE AGGREGATE $ / / CUP9145304 11/22/1311/22/14 DEDTW RETENTON WORKERS COMPENSATIONX PEAR U M- R EMPLOYERS'LIABILITY ANY PROPRIEfOR/PARTNERIEXECUTIVE Y ••• 500 000 B OFFICERIMEMBER EXCLUDED? N/A E.L.FAgi ACgDENi $ / (Mandatory in NH) KEWC527844 07/01/14)7/01/15 E.L.DISEASE-EA EMPLOYEE /uoo If es, escrbe dunder TIONSbelow Is DRI 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedue,may be attached if more space is requred) CERTIFICATE HOL R CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POL ICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 1 Y - � L 4 a T y� A y�y�hyr, 98 Forest Street K� Y in 1 q-U 1 �.J North Andover,MA 01845 1 • PH:978-688-6335 Building Contractor • FAX:978-688-7207 Proposal To: Dick&Pam Zengilowski 53 Glencrest Drive All Home improvement Contractors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma 01845 spea6cally exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the Commomveallh of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA02108.(617)-727 8598 CC: Date: 8/1/2014 Job: Windows/Doors/Repairs Date of plans: None Architect: None Location: Same Section 1—Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 6/15/14. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 8/15/14.The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11-Warranty The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup,the Contractor shall,at his own expense,forthwith remedy, repair correct, replace,or cause to be remedied,repaired,or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section 111-Scope of Work Page 1 of 4