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HomeMy WebLinkAboutBuilding Permit #370 - 56 MAGNOLIA DRIVE 12/2/2008 BUILDING PERMIT *"°oT"gtio TOWN OF NORTH ANDOVER c� 6, - °�, APPLICATION FOR PLAN EXAMINATION Permit NO3 Date Received 3q"°q,TE, SI ellsACHUS��. Date Issued: - —� IMPORTANT:Applicant must complete all items on this page LOCATION i" f PROPERTY OWNER . Print MAP NO: 6-PARCEL: Z. NI DISTRICT: Historic District yes no Machine Shop Village -yes no _ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building XDne family "Addition Two or more family Industrial Alteration No. of units: Commercial ,, Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION O WORK gT0fERREF0JMJ1D: Idenation,Plase Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: Address: V4 Supervisor's Construction License: Exp. Bate: Home Improvement License: Exp."'Date: 1!;4)) 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: $_ 1���� FEE: $ J� Check No.: IrT Receipt No.: NOTE: Persons contracting wW4 unre istered contractors do not have access to,1he uar my fund ature of:Agent/Owner`m � Signature of contractor 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 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 ❑ 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 ❑ 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 ❑ 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 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:Building Permit Application Revised 2.2008 I 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 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 h 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE'DEPARTMENT -Temp Dumpster on'zste yes no I Located at 1.24 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 ' P 4 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Location:tom ' No. U Date ��° NOR�q, TOWN OF NORTH ANDOVER Os ' Certificate of Occupancy - $" Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check # 21726 _ Building Inspector s , TAORT Iq Town of Andover No. 37o �O ;+ LAKE O` L�7!( dower, ass.' ' d� COCMIC..".CK �� T ORATED P? C .a r- IT BOARD OF HEALTH w _ PEI. Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT................ ....... � +............ A6..... ....... .. ....... . . .... ...... - ♦ ' ' ' Foundation has permission to erect........... buildings on .....1.. ........ 4 + Rough g to be occupied as................... . ..... .... S.O... ........ ............................................ 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 PERMrF EXPIRES IN. b MONT iS ELECTRICAL INSPECTOR LJNLESS CONSTRLJ T Rough ftawa ............................. ........................ Service BUILDIN R Final Occupancy Permit .Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises ® Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. =1=SEE REVERSE SIDE Smoke Det. ACORD.H CERTIFICATE OF LIABILITY INSURANCE 02/26/0aY'fy' PRODUCER 1-404-995-3000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTE=ND Oil homedepoL.certrequest@marsh.cem ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOIJV. 3475 Piedmont Rd NE, Suite 1200 Atlanta, GA 30305 Fax (212) 948-0902 INSURERS AFFOROING COVERA GE NAIC# !INSURED INSURER A:Steadfast Ins Co 25387 Home Deoot U.S.A., Inc. -------------- The Home DeDot, Inc. INSURER B:Zurich American Ins Co 16535 2455 Paces Ferry Road Illinois Nati Ins Co INSURER C: 2 3 817 Building C-B — --------.... Atlanta, GA 30339 ---- INSURER D:American Home Assur Co 193RD INSURERE:New Hampshire Ins Co 2384.1 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWI riiS rm i iOdG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED UH MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF Sl.GH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. /NSR ADDI POLICYEFFECTIVE POLICY EXPIRATION TR INSRC TYPE FINSURANCE POLICY NUMBER OATEIMMIDDIYYI DATE M D YY LIMITS A GENERAL LIABILITY IPR 3757 608-02 03/01/08 03/01/09 EACH OCCURRENCE $4,000,00!) X COMMERCIAL GENERAL LIABILITY LIMITS OF POLICY ARE EXC SS DAMAGE ORENTED 1,000,000 PREMISES Ea occurence $__ __ I. CLAIMSMAD� X I OCCUR "OF SIR: $1,000,000 PER CC" MED EXP(Anyone person) $EXCLUDED_- -PERSONAL BADV INJURY $ 4,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OPAGG $4,000,000 POLICY • LOC --------- X )ECPROT _ B AUTOMOBILE LIABILITY BAP 2938863-05 03/01/08 03/01/09 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Eaaccident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) X SELF INSURED AUTO + PROPERTY DAMAGE $ PHYSICAL DAMAGE (Per accident) _— GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: - AGG $ _ A EXCESS/UMBRELLALIABILITY IPR 3757 608-02 03/01/08 03/01/09 EACH OCCURRENCE $5,000,000 X OCCUR EICLAIMSMADE AGGREGATE $ 5,000, $ DEDUCTIBLE $ RETENTION $ $ C WORKER'S COMPENSATION AND 1928757 (FL) 03/01/08 03/01/09 X WCSTATU- OTH- TMIT ORY EMPLOYERS'LIABILITY -'_"--- D 1928756 (CA) ANY PROPRIETOR/PARTNER/EXECUTIVE 03/01/08 03/01/09 E.L.EACH ACCIDENT $1,000,000-- - E OFFICER/MEMBEREXCLUDED7 192B755(AOS) 03/01/08 03/01/09 E.L.DISEASE-EA EMPLOYEE $1,000,1300 Ilyes.describe under SPECIALPROVISIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER 1 F TX Employers Excess TNS-C45197967 (TX) 03/01/08 03/01/09 Occurrence/SIR 25M/2M D Workers Compensation 1928759 (QSI) 03/01/08 03/01/09 E Workers Compensation 1928758 (KY, MO, NY, WI) 03/01/OB 03/01/09 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ,FOR EVIDENCE ONLY :ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORE THE EXPIRATION ' 'HE HOME DEPOT, INC. GATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTLR NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 455 PACES FERRY RD. N.W. BUILDING C-8 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR , REPRESENTATIVES. TLANTA, GA 30339 AUTHORIZED REPRESENTATIVE yip USA kCORD 25(2001/08)datkinson ©ACO RD CORPORATION 1988 821-3215 GS3-A-173 43-41 DK tlin.i I .Vinilo V11%tita da 610b-!z gulll0t�tta A.egoa!?ro?,�La_ I AaqS�t;?:o3alar plellondFsneeOYtfen 3/32" Cia99 12.38 3m Vidrio _ No Laminatad C1aa9 I SLA vldrLO laa+lnas0 ® No Crid2 sin rajllias ENERGY PERFORMANCE RATINGS Vactor Sciark atGain6effident , r� to�nocGasa<ula�Erbs9b�� 0 . 29 1. 32 ADDITIONAL PERFORMANCE RATINGS p UWU.ff ENVMDe R Cffi0WM MsibieT ansmittance • TnrdmWondaLiaVkbW 0 . 52 . Ihsrdlc�r�p�liOeetNt(heM��+toplplGbU(�FRCptouduslbrdvbnnti�0�p�p � .� " ' �sredetern�nedtOral�adeetdawYatnroralaoar�tloirandas�Ecp�ad�dstre.I�RlCdoeerotieamnendnl►Prodw.` .. • • �ddaeenotwrhntlh�bmll�>nf►OR��� ue.Can�te�uw's��lhralMrproduetp�rhrnrna" • rdbsnadas,www�oar0 ��y�p�—.�•�.�y�������y�.�r.��y� .. .. . .. .. • •. •tibslrade eBputtqur�eoevetasevanplmoon kop I --M"w ds Mppimd.��y11.1.*wdm1YpJftb ddd pnsdlado. ����a�a's Impa o•r"6466" iliM01M•.•x{nt�diplYM•i7r. ' :«peoleoa,�ro mm��ada�0��Yro D�4w d p�wio�tlemado.p�aun up e�pxllkn Osnu�oattl.: . Wa dd i l 1pnM pn d u�o tpopYdo dB podu�b.www a0 •' 'Unit gtsaLULAS Zoe SNEPM 9TAEt • region(s): td0ethprn. .iVosth • '' CeAtaal, SoAg Contral, seoatharA. ME 7AR La YA,Ldad Oa1LZiaa,pafa late), ragien(ee) WIRGY.STAM.Norte. Nota Central, 94A= Cantral_ sac.. 46 IND: Rain WILLS! 3/32"1N—R4s � ' • �* ' TaStud Sisaq 36 x 63" iND: RaZaQe:o Oa/VLdria 2.3:8 =111-443 I?P :+4 5 /-45 Tmana psobado: 91.4 ca x 16a IG773. NS Hoii>aan 293112C. Kup des bWfmPUS FNW STAR'mbdLTo Ivanm nmwwwMo tapov. faarde ah I"pa p&urklm ENO Stole Pmo mnaetadt aBto s�o,vldh www aurylishcpa: h �'. Board or Building Reguladonsi and Standards . HOMEIMPROVEMENTCONTRACTOR Regists� , 126893 ' t um� � !2010 ement Card i ' 1 Home Oepo _� fi�e RICHARD FALLON, � ` zinn rnaa rami i Cr}tAA6TE�rf�t✓inn FROM : Panasonic TAD/FAX PHONE NO. : +872 9599 Jun. 23 1998 08:19RM P03 HOME 1MPROVEMiENT CONTRACT PLEASE READ THIS SOM,Furnished and lnstalledby: T1iD At-Home Services,Inc. L" Branch Name: Boston Date: I I d/b/a 'Me Home Depot At-Home Services 345A Greenwood �trl�tli ,MA 01607 Brauch Number: Toll .18 Oj 657-518 ,,((�Qi�1 X56-8823 North 33 (South 31 pderal 1D#75-269 , 3�1. Info#16411 . � � I CT lie#565522;MA Home ImprovtxDetttCotttraCtotr Reg.#176993 :AAAInstallation Address: =t t �.ry tate I zip Werk Phone:— llome Phone: _Cell Phone:.— iY - Home Address:..—...--.—.—_ ———— City — — — $tate Zip (if different from installation Address) E-mail Address(to receive project eemtinunications and Home Depot updates):_. —. .__. ..—. -- —•— — 1 DO NOT wish to receive any marketing entails from The Home Depot to lou Protect 1Rformatiq: Undersigned("Customer'),the owners o he prop deliver and located t the aboverange for tbe�nsttion add es s agrees re s to b of and TIID At-Home Services,Inc.('The Home DepoY� Stces all materials described on the below and on the referenced Spec Sheet(s),all of which are incorporated into this Contract by this reference,along with any applicable State Su p)cment and ayment Summary t ebed hereto-apd any('range Ordeal(atlleetively, „Contract"): 1-2 `�P.s d"' S Sheets #: Pro ed Amount cc, .—i_- ---— pxooAng 5{ding Windo Q Insulation — �^,�© K5" $ t/ [Gutters/Coverskms"' Ol?ntry_CFIMnrs oofittg Siding Windows ❑insulation $ 0(,,1111ers/covers [D;ntryr Doors Roofuy; Siding —ariudnws Insulation []Guuers/Covers [JFntry Doors Roofiag Siding �Wi�nws []lnsuletion $ [](1ut1m/(`.overs 1]FntryDoors Memnon 2594 Depotdt of Contra(Amount due upon escuard"Orthta mntmet. ,total Contract Amount $ Matas Purchasers may not deposit mom than ono adrd ur the ContnetAmrnnt. Customer agrees that,immediately upon c nVietitm of the work for each Product,(:ustomer will execute a Completion Certificate (one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. lite Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Products(s)included herein,at t or its authorized service provider determines that it cannot.perform its obligations due to a structural 'rim if The Home is discretion. � pmbhun with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing errors nr because work rcsluitedto complete the job was not included in the Contract. Payment Sunirtrarv: The Payment Summary#--. ,„ , included as part of this Contract, acts forth the total contract amount and payments reWircd for the deposits and final payments by Product(as applicable). N(MICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. no not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Shuts)before work on that Product Is complete. la the event of termination of this Contract,Customer agrees to pa l'he llome Depot the eoso Of materials,labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth In this Agreement or allowed under applicable law. THE HOME.DEPOTMAY WITHHOLD AM61INTS OW).,D TO THE HOMY DEPOT FROM THE DEPOSIT PAYMENT OR O'i'IiE.R PAYMENTS MADE, WITHOUT LIM1T'ING THE 1IOME DEPOT'S O'1'11ER REMIiDIES FOR RECOVERY OF SUCH AMOUNTS. Asceotanee and Authoti tt�+' t: (boomer agrees and understands that this Agreement is the entire agreement between Cxtstolner anon The Home Depot wilb regard to the Products and installation servion and superseles all prior discussions and agreements,either oral or written,relating to said Products and Installation,This Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depot.Customer acknowledges and agrees that Cuswmcr has toad,understands,voluntarily accepts the terms of and has received a copy of this Agreement. Apted Sub ted by: e X x 4c2-L, - Cmer's Signature Date Salta pant ore Date X Telephone No. U,11, ` Customer's Signature Date Sales Consultant License No. CAN ELLATION: CUSTOMER MAY CANCEL THIS taerM�Pl'mb>CI AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY "rER SIGNING '11115 A(.REEMF.NT. THE STATES SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STA'r'E. NOTICK:ADDITIONAL TKKMS AND CONDITIONS ARE ti rATKD ON 711115 REVERSE SIDLK AND Attu PAkT OF THIS WWRAM' White-8raneh Fite Yellow-Customer PIN*-Salps Consultant