Loading...
HomeMy WebLinkAboutBuilding Permit #434 - 54 BRADSTREET ROAD 11/30/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION p;t-fub° 1679tio O t 9 Permit NO: Date Received � �.9 A�RA70 SPP��y Date Issued: a- D SSACHU`�� IMPORTANT: Applicant must complete all items on this page LOCATION r�- Print PROPERTY OWNER �J G�'�✓� (3�-/�k--Av. Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building One family ❑Addition ❑Two or more family ❑Industrial ❑Alteration No. of units: ;repair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: �� ��-��L��vz w� Phone: Goa- Address: 5 �� J�✓ . ,�. .,� �' CONTRACTOR Name: PCILZ �•Jws � � f rT�' Phone: �'� Z6����a S j Address: L6 FC>Yr-S � �'t /�Z L9 '3 Z. Supervisor's Construction License: (fie`41 Exp. Date: Home Improvement License: ��`'� Exp. Date: l Z —Cl? ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ G( Z -'' FEE:$ Check No.: O Receipt No.: Page 1 of 4 Location 'y// l=� r� (( +s ,. ..--• . -a�, r. .-�.. - . .__ ,, f No. c( Date f f ` -50 r - i TOWN OF NORTH ANDOVER • Certificate of Occupancy SsACHUS Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Q�C� 19838 D 2 Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ F1Tanning/Massage/Body Art ❑ Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales El❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracti with u r i eyed contractors do not have acce?ract guaranty fun Signature f Agen Own r ignature of coor PlansSubmitted ❑ Plans Waived Certified Plot Plan amped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS a FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 I Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPPORM05 0 Bated JMC.Jan.2006 Building Department r 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks o Building Permit Application o 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) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan a Photo of H.I.C. And C.S.L. Licenses o 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 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 DEPARTMENTMITORM05 Page 4 of 4 ' Contract Pella Windows&Doors,Inc. Ort s 45 FONDI ROAD ® HAVERHILL MA 01832 Phone: 978-373-2500 Fax: 978-373-7274 CustomerPro'ect!Shi` To Order Quick Quote Project Date 00/00/00 Dr John Buchanan Quote No. QUICKQUOTE 54 Bradstreet rdN Andover Ma Order No. l Need Date -A4*WQA-- Sales Rep.Name Paul Johnston Prepared by 978 360 2070 Payment Terms Owner: Architect Bus.Phone: (603 )888-5577 Bus.Phone: Jamb Depth Bus.Fax: ( ) - Home Phone: P.O.No. Cellular: ( ) - Branch Order No. Home Phone: ( ) - Order Type Installed Sales Order Glazing Design 20.00 psf. Pressure Branch Name Pella Boston Pella Windows&Doors,Inc. Branch Address 45 FONDI ROAD Phone 978-373-2500 City HAVERHILL Fax 1 978-373-7274 State MA 01832 Comments: Cutomer to pay 50%now 50%when job is comp let All windows to be Painted Decorator White Permit fee is$125.00 paid for buy homeowner in seperart check. For information regarding the finishing, maintenance, service, and warranty for all Pella products,visit the Pella Website at www.pelia.com. Printed 10/05/06 Contract-Page 1 of 6 _.:c for Customer Project: Quick Quote Project Order No.: Outside View Item No. Otv^. Summary Description Unit Price Extended Price Item#30 Qty: 1 Vent-DH Standard Jambliner Double-Hung,Frame:30-1/2 X 56- Location:bath room 3/4:Architect Series,Clad,Model 3,White,Half Vent/match Half R.O:2'7-1/4" X 4'9-1/2" Vent,5/8"InsulShld IG Glazing,Half Screen,White Spoon Lock only WallCond: 3-11/16" Hardware,3/4"REM Traditional Grille(Grille Lites Wide=03,Grille Lites High Upper Sash=02,Grille Lites High Lower Sash=02),Fins (single unit per design), Std Primed Interior Value Added Items:Disposal per Unit-Qty 1 Single Window Install-Qty 1 Paint Window-Qty 1 Notes: Tha r Purchasing Pella Products Taxable Subtotal $ 8,754.94 Customer Signature Pella Sal s Re resentative Signature Sales Tax at 5.0000% 437.75 Non-taxable Subtotal 0.00 Total $9,192.69 Date Date Deposit Received $ 0.00 1 WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale. All applicable product'warranties are incorporated into and become a part of this contract. Please see the warranties for complete details, taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system. Neither Pella Corporation nor Pella Windows&Doors,Inc. will be bound by any other warranty unless specifically set out in this contract. However, Pella Corporation will not be liable for branch warranties which create_obligations in addition to or obligations which are inconsistent with Pella written warranties. For information regarding the finishing, maintenance, service, and warranty for all Pella products,visit the Pella Website at www.pella.com. t Contract-Page 4 of 6 t V40RTH Town of ' _ L Andover p A;..�. No. LA E dover, Mass., dalo • d �/ COCHICKEWICK V ADRATED PP���S H BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... ..p1�,A..........S...0-0.4.0%.41N ..........................:................................................... Foundation has permission to erect............. ........................ buildings on...,.5 I � .... ......i !I►. .................... Rough to be occupied as.........�j....... .. .. ......T............I! .!!1�d* ............................................................. Chimney 00 provided that the person accepting if 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 ® PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU N 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 RE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. IFSEE REVERSE SIDE Smoke Det. AC®RDrM CERTIFICATE OF LIABILITY INSURANCE 07/ 13:DATE 05/2006(0613:YYYY) 54 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 41 Wellman Street Connector Park HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Lowell.MA 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Insurance Company New England Window&Door Inc. INSURER B: Hanover Insurance Company 45 Fondi Road Haverhill,MA 01830 INSURER C: Mass Bay Insurance INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRDD' POLICY NUMBER POLICY EFFECTIVE I POLICY EXPIRATION DATE iMMIDDIYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurence $500,000 CLAIMS MADE 1 X I OCCUR MED EXP(Any one person) $ 10,000 B ZBN8161407 7/1/2006 7/1/2007 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY II JECT F71 PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000.00 ANY AUTO (Ea accident) X I ALL OWNED AUTOS BODILY INJURY $ C SCHEDULED AUTOS ADN8162169 7/1/2006 7/1/2007 (Per person) X11 HIRED AUTOS BODILY INJURY ! X NON-OWNED AUTOS (Per accident) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY ONLY-EA ACCIDENT $ H ANY AUTO EA ACC $ _r OTHER THAN AUTO ONLY: qGG $ EXCESSIUMBRELLA LIABILITY X OCCUR EACH OCCURRENCE $ 9,0070,000 F1 CLAIMS MADE AGGREGATE $ 9,000,000 B UHN8167305 7/1/2006 7/1/2007 $ DEDUCTIBLE X i RETENTION $ WORKERS COMPENSATION ANDWC STATU- OTH- EMPLOYERS'LIABILITY I A ANY PROPRIETOR/PARTNER/EXECUTIVE 08WBNL5742 7/1/2006 7/1/2007 E.L.EACH ACCIDENT $500,000.00 O /MEMBER EXCLUDED? yes,de If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000.00 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 OTHER Blanket Building&Contents B Property ZBN8161407 7/1/2006 7/1/2007 $5,540,000Deductible$1,000131anket Business Income$4,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION New England Window&Door,Inc. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN dba Pella Windows&Doors,Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 45 Fondi Road. Haverhill,MA 01830 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) Client# 2960 Mst# 0607 all lines Cert# Evidence of INsurance ©ACORD CORPORATION 1988 The Commonwealth of Massachusetts Department of Industrial Accidents -- - Office of Investigations 1 M1, '1"1 600 Washington Street -- Boston, 31A 02111 www.masSgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aoolieant Tnforrnation Please Print Legibly Flame 1Business/Organization/Individual): pe �`� l/V'1yL��„j S 4L Ad D�0s-s Address: City/State/Zip: u&41'+1 t Phone ±` Are you an emplover? Check the appropriate box: Type of project(required): 1. I am a employer with 2 S' 4. El am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. i ? El Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. 7 Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.F-1 Electrical repairs or additions required.] officers have exercised their 3. ❑ I am a homeo:vner doing all work right of exemption per MGL 11.7 Plumbing repairs or additions myself [into workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] `Am;appiia:nt that checkz box#1 must also fill out the section below showing their workers'compensation policy information: t riurreo%%mets who su=it this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tCuntractors that check this box must attached an additional sheet showing the name of the suircontractors and their workers'comp.policy information. I am an emplover that is providing workers'compensation insurance for my employees. Below is the policy and job site in tb M arlOIL Insurance Company Name: 44a4 "T d IPS urx, qce- 6wt^Q°%_1 Poiic_,_or Seif-ins. Lic. rO : R It.)SAIL S 7 -/1 Expiration Date: Job Site Address: City/State/Zip: Attica 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 S 1.=00.00 and/or one-year imprisonment. as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of InvesriEarions of the DIA for insurance coverage verification. I do hereby certi,6! larder the pains and penalties of perjury that the information provided above is true and correct Sl=ature: Date: Phone= O,jflcial use oniv. Do not write in this area,to be completed by city or town official Cite or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector S. Other Contact Person: Phone#: �y47 R r � aCA ' - .. ' '' .sv-��+�ms���✓f7� V07YCy�2007.LI/BCllIdL •✓ s jF - '#� BOARD OF BUILDING REGULATIONS License:-CONSTRUCTION SUPERVISOR + Number: CS 089839 } Birthdate-061.1-9/1 972 i Ex fres Ofi/1972008 Tr.noc 89839 �r p Restricted: 00 �# SCOTT P HOUSE - 854 BROADWAY#,I,, HAVERHILL, MA 01832 Commissioner ,.�� Jae {nanz�nar,.ulvalC� c�✓Tr'ay ac.�u�e�a �, _ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR + Registration: 129774 Expiration: , 1 1/ 2/2007 a . Type: DBA a PELLA WINDOWS AND DOORS SCOTT HOUSE <i. 45 FONDI RD. HAVERHILL, MA 01832 "-- Ad rt inistrator