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HomeMy WebLinkAboutBuilding Permit #053-2017 - 58 BEVERLY STREET 7/18/2016 NORTy BUILDING PERMIT Oft<.EO 6 TOWN OF NORTH ANDOVER 03� APPLICATION FOR PLAN EXAMINATION A� y Permit No#: t� Date Received a 7� hR1TED I•PPt.(5 SSACHUS� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 717 6(:'VFyLtf4JY ' �( PROPERTY OWNER ��Dtr fTV6 Z n Print Print 100 Year Structure yes MAP _PARCEL: �. ZONING DISTRICT: Historic District yes Ono Machine Shop Village ye TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑AI eration No. of units: ❑ Commercial El�epair, replacement - ❑Assessory Bldg ❑ Others: 0 Demolition ❑ Other . ;- I �o ala � : a �• �. DESCRIPTION OF ORS(TO BE PERFORMED: Iiyt779tt 2 � �ALCM&Wr 1 /�,�(i�c��t/� —�t/n .�Ty�y�7yn s¢'t C/-�)g6s� Identification- Please Type or Print Clearly OWNER: Name: JU1) t'T Phone: �17�•��z-�lei' Address: 5F f " . 7, Contractor Name: M 6h� ' Phone: W'W d Dlr Email: Address: j rlcLO, r• i� Supervisor's Construction License: �f 7 6 y1 _Exp. Date: 9 ` ! •(� I ��• p p _ . Home Improvement License: t' f Exp. Date- ARCH ITECT/ENGI NEER ate: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: $ 21 ' FEE: $ Check No.: ReceiptNo.: NOTE: Persons contracting with unregistered contractors do not have acc s to t e ua anty fund t. 4_ E=nq f 1,r, g NORT1� Town of No. 2,6 soh ver, Mass, coc �,9s RAtEO PP ,`,�5 U BOARD OF HEALTH Food/Kitchen Septic System THIS CERTIFIES THAT PERMIT Twa ,,...3 BUILDING INSPECTOR ............. .... ....................................................... Foundation has permission to erect .......................... buildings on . .... 1�. . .... ... ....� 0ef..........., Rough g to be occupied as ....ca...... Vthpiermit .....W.. 9.6.................................... Chimney provided that the person acce tn shall in eve ryrespect 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST CTION Rough "Ur 'JAhIll Service .. ...... a?4 ....... Final BUILDING I CT0 GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. about:blank r-- National Headquarters Judy Huard 2501 Seaport Drive,Chester,PA 19013 32-03309 888-736-6335 June 13,2016 " I WWW.POWERHRG.COM MA HU 10616 CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Buy"s),information and Description of the Property: Project Number:32-03309 June 13,2016 Judy Huard ) �d� (Home) 58 Bevorty St (978)682 6545(Ho North Andover,MA,01845 (978)767.0860(Roberts Cell) County:Essex IV_V/ VW Township: Buyer(s)listed above hereby jointly and severally agrees to purchase the goods and/or services of Power Home Remodeling Group and its vendors("Contractor")in accordance with the prices and terms described in this 5 page document and the Product Specifications,which are incorporated as part of the Agreement(collectively,this'Agreementl. This Agreement represents a cash sale of goods and services. Buyer(s)agrees to pay the cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyer(s)may seek for their purchase. pumme e: $ s- Dom Pt: Woo6 1� 6 weeks 844nom,owW) sf : iioat; ;; :�`f days of P .kt yr t: fii�4* i ar a . � C s)tweby M*n0WWfgqS tecelp,of a*0W of me po Sets C~Gu*t*ftW410 RO Bu (s)of(t*amential risk of load hazatd ex4x*asre from renovation adMy to be perfortrred s)'Property, wr tan ate.Bu rs)rooelved thas t on the date of Oft of mark. s t d fu&as fhe'entireagreement and wrdersandkV bobstam OW PWO", fmpWm any and all s rep s�nt�as , ,'; IV . No OW100104, Agraerneffl Shen or f u fk1 r both119) has r wairs AgreerneN and has MWVW and Of e�"f�Wms,on me date first a and 2)was 0(*WMWd su` )also and that O Man"a the WO&Wwoo, ``� �l mukw on espotate,dowmera,art WW trance dwoo, FUUO T1s trof oXvicable, 00 Wr TIN AGROWNT"fic Iowa .t. 001 is s� l v' fr: I nywwMm �� pw�^•^.�r�!,++«wwDz«wwr^ �rn i�^^"�kaa�mW.uu�rM�::��4 `� "u",.t..,t .,, :' o., 1, 1 of 1 7/6/2016 2:40 PM National Headquarters Judy Huard 2501 Seaport Drive,Chester,PA 19013 32-03309 888-736-6335 June 13,2016 WWW.POWERHRG.COM MA HIC#168616 PRODUCT SPECIFICATIONS Buyer(s)'Information and Description of the Property: Project Number: 32-03309 June 13,2016 Judy Huard Date of Agreement (978)682-6545(Home) 58 Beverly St North Andover,MA,01845 (978)767-0860(Robert's Cell) 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 Sat 6/18 between 1:30p and 2:30p. Windows-SL 2700 Inclusions: Includes metal reinforced meeting rails and nighttime safety locks on double hung windows only,welded corners,foam injected frames,Sashlite technology, Heatshield, Duraglass,exterior custom capping, installation,clean up and haul away of all job related debris. I I 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 have read and received each page of this 2 page agreement. Power Home Remodeling Group Buyer(s) /06/13/16 /06/13/16 Signature of Remodeling Consultant Signature Matthew Lynch Judy Huard 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. June 13,2016 11:40 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Page 1 of 2 National Headquarters Judy Huard 2501 Seaport Drive,Chester,PA 19013 32-03309 888-736-6335 June 13,2016 WWW.POWERHRG.COM MA HICii 168616 Project Specifications Windows: Kitchen 1 18.0"x38.0" WINDOWS: Models SL 2700 Styles Casement Types Single Configs None OPTIONS: Color White/White: Grid Pattern: Colonial: Contour I Removal Wood Additional Details None Windows: Living room 1 72.0"x50.0" WINDOWS: Models SL 2700 Styles Slider Types 3-Lite Configs 1/4-1/2-1/4 --_—_-- OPTIONS: Color White/White: Grid Pattern: All Lites: Colonial: Contour Removal Wood I Additional Details None , I June 13, 2016 11:40 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Page 2 of 2 rl ; ,n,. �� ��IhiYaVLrK t�SIC!%lzC7" SL2700 DOUBLE HUNG WINDOW t/ VINYL FRAME DOUBLE GLAZED FOAM,FILL GRIDS LOW E/ARGON I na g a s", NFFAC «» GRI 0010 7.21.Q 1 00488344/001 FELL .i ENERGY PERFORMANCE RATINGS 01, 07 0 m.26 f ADDITIONAL PERFORMANCE RATINGS Condensation Rcsistancc _ t 0.47m11��cMca rr �ativ eFx�pruta�a:tr rieua;rro�,a-.r wc.-4Ga 5t+'•t r yz�r rC�ttrrrt9 h�et.+c sr,s?Cnr�crK<:tsccrc,ocrfafAa- •sr<:Gr::a jntariu.. 7!,lr..c Esr.;i,an�nsx�,ve�3•,aU�*!��''4✓.Cr�.,c,�+oEr..n�ar.cer+.u.�Jic 1jt t E h q kC� i POWER-1 OP ID: EL . kw O CERTIFICATE OF LIABILITY INSURANCE DATE(MM/2015 ) `� 0911112015 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 Lacher&Associates Ins Agency PHONE FAX Lacher Insurance Group (AIC, A/C No Ell:215-723-4378 A/C No): 215-723-8604 632 E Broad St P 0 Box 64398 E-MAIL Souderton,PA 18964 ADDRESS: Chad Lacher INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Harleysville Preferred Ins.Co 35696 INSURED Power Home Remodeling Group, INSURER B:Harleysville Worcester Ins Co 26182 LLC INSURER C:Nationwide Mutual Ins Company 23787 2501 Seaport Drive Ste 8110 Chester, PA 19013 INSURER D:Pennsylvania Manufacturers 12262 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP YYLIMITS LTR POLICY NUMBER MM/DDIYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE � OCCUR MPA00000089793N 10/01/2015 10/01/2016 D MAG TOR NTED w 1,000,00( PREMISES Ea occurrence) $ MED EXP(Any one person) $ 15,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY JEC �LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccident $ 1,000,00 B X ANY AUTO BA 00000089796N 10/01/2015 10/01/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJUR AUTOS AUTOS Y(Per accident) $ NON-OWNED RP T DAMAGE $ HIRED AUTOS AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 C X EXCESS LIAB CLAIMS-MADE CMB00000089794N 10/01/2015 10/01/2016 AGGREGATE $ 5,000,00 DED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER D ANY PROPRIETOR/PARTNER/EXECUTIVE Ya NIA 201500-66-20-96-7 10/01/2015 10/01/2016 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,00 B Mass Auto BA OOOOOO18227P 10/01/2015 10/01/2016 Auto Liab 1,000,00 B NY Auto BA0000007484SR 10/01/2015 10/01/2016 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 1600 Osgood St AUTHORIZED REPRESENTATIVE North Andover,MA 01845 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD The Coyntnonwealth of Massacliusetts Departniem of Industrial Accidenats 1' ; I Congress Str•eel, Smite IOU Boston: MA 02114-2017 www.mass.gov/dia Zl orkers'Compensation insurance Affidavit: Builders/Contractors/Electricions/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Appli"ni inform ltion l'le.,ice Print l.,eoibly Name(Business/Oraani2ationrindividtrl):Folder Home Rerl;odelino Group Address:2501 Seaport Drive City/State/Zip:Chester PA 1913 Phone 4:508-280-0156 Are you an employer?Check the appropriate box: Type of project(required): 1.Q 1 am a employer wit, 15 employees(full andlor pan-r me).° 7. New construction 2-M I ams sok proprietor or partnership and have no employees wrrkirg forme in S. Remodeling anycapacily.[]voworktrs'tomp.;nsurance reauirtd.] 3.71 am a homeowner doing all work mysel:.[No workers'comp.insurance required.)r 9. ❑Demolition 4.71 am a homeowner and will behiring eeruractors to conduct all work on my proper ty. 1 will 10[)Building addition enure that all contrsstors either have wc?kers'compensation irstuxnce or are sole i 11.[]Electrical repairs or additions Proprietors with To employees. 12.[]Plumbing repairs or additions 5.❑1 am a general conaracior and I have hired the sub-contractors.fisted on the attached sheet 13.[:]Roof repairs These subcontractors,_have employees and have workers'comp.insurance.' 6.r_1 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[-]Other 152,§1(4),and we have no employees.[No workers'comp.inswance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. iContractors that check this box must attached an additional sheet sho-wing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number, I am an employer that is providing workers'compensadon insurance for my employees. Below is the policy and job site information. Insurance Company Name:Harleysville Worcester Insurance Company Policy 4 or Self-ins.Lic.#:201500-66-20-96-7 i Expiration Date:10111/2016 ,� //� Job Site Address: t SI City/State/Zip: Wr 1. 11 1 j"� Attach a copy of the workers'compensa' n 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 coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 7 ( Phone#:508-280-0156 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle Due): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Off+cc of Cons11Mer Affairs aS Business RtkUlstion License or registration valid for individul use only :ir=rh �-= OhiE IMPROVEMENT CONTRACTOR before the expiration date. if found return to: C ; ^J1 Office of Consumer Affairs and Business Regulation Registration: 168616 Typ{ Expiration: 3118/2L),,7 Siplemen4 :ard 10 Par•Plaza-Suite 5170 Bostgn, 4 116 POWER HOME REMODELING GROUP LLC. MARK MORDINI 2501 SEAPORT DRIVE STE 13110 A4PIvrafldwithout CHESTER,PA 19013Undersecretary signature Massachusetts Department of Public Safety ' Board of Building Regulations and Standards License:CS-057645 Construction Supervisor -, MARK E MORDINL ` 18 NEWELLGR `J N ATTLEii 0Z t�qA ,Al C ^ ��''�t�"^-'� v�--- Expiration: core Missioner 09/18/2017 DW .. o ve A. R AMMROUGN, 5 DD 09.22.1014 Re.07.1s709 `