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Home My WebLink AboutBuilding Permit #098-2017 - 61 WESLEY STREET 8/1/2016 �l V aORTh q BUILDING PERMIT TOWN OF NORTH ANDOVER ° QI APPLICATION FOR PLAN EXAMINATION 41a �* Permit NO: " J Date Received �9SS 4TaD Date Issued: I I ACHUs IMPORTANT: Applicant must complete all items on this page l OCATION :� ,P-RPERTY OWNER-r., Print MAP NO:,- PA� tCEL; ONINC DISTkICT Historic District } yes �•.no# ' atm k A Machine Shop ViNage N yes nog TYPE OF IMPROVEMENT PROPOSED USE Resid al Non- Residential ❑ New Building o6ne family ❑Additi ❑Two or more family ❑ Industrial ❑Al ation No. of units: 0 Commercial ❑fqepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other C°Septic: ❑.V1/el� O Floodplain. WetlandsWatershed tistnct QWater,/Sewer Identification Please Type or Print Clearly) OWNER: Name: I Phone: Address: CONTRAO CTRee .� NmPhone' Avol Supervisor's Coristructro License xp to Home-Improvement License „ Ex Date p ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ , Check No.: 1°7zL}y-"` Receipt No.: ?xQUW NOTE: Persons contracting with unregistered contractors do not have accesfito"the.gua my fund gnature of Age_naVOwne,r Signature,of contract BUILDING PERMIT �oRTh. w- o�'(q LLe� 16�'r0 TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION p ene..a..e... Permit No#: Date Received ATED ' Date Issued: IMPORTANT:Applicant must complete.all items on this page LOCATION. Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no I i TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family k ❑ Addition ❑Two or more family ❑ Industrial 0 Alteration No. of units: ❑ Commercial ❑ Repair, replacement - ❑Assessory Bldg ❑ Others: ❑ Demolitione ❑ Other ❑ Septic�;tl}❑xWell�. � ., ..� '� ' 'R;❑ Floodplain,, �,❑Wetlaritls:4, ,rt#'x`.C`r��.,+t�7 xit�3r�t"� <g f ,» i w� �� `e � ,-;a x'` o'""s I�.` �'y +`�•�x 4,��?' -}f i„,,�� lr.'�i.7" �- ,-+rr-a�+ -e:>.j•.�'�,A DESCRIPTION OF WORK TO BE PERFORMED: - i Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email Address: ; Supervisor's Construction License: Exp. Date: G Home Improvement License: Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund - - -- - - ---- --- - -- - -- -- -- -- - ---- ---- — ---- -------- Siang PrP of AaPnt/QUyr,er Sidn f re of contractor - �- T ^ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped flans ❑ 9 TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Taming/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food ales Packa in g g s ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFA' - U FORM PLANNING a DEVELOPMENT Reviewed On Signature_ { COMMENTS i i i CONSERVATION Reviewed on Signature 1 COMMENTS it HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes a Planning Board Decision: Comments r Conservation Decision: Comments. - Water& Sewer Connection/Signafiure ®afie Driveway Permifi )DP's Town]Engineer: Signature: Located 384 Osgood Street EIRE EPARTMENT - Temp Dumpster on:sife yes. no. . . . ,.., Located at U4 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.$100-$1000 fine NOTES and DATA— (For department ase) I, ® Notified for pickup Call Email Date Time Contact Name Doc.Buildinab eu P nit Revised 2 v 014 I 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 Affidavit- fnr Engineered products ®TE: 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 46 Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) iL Engineering Affidavits for Engineered products ®TE: 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) i Copy of Contract 4 2012 IECC Energy code 4 Engineering Affidavits for Engineered products OTE: 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 Revised 2014 Location Co e-C, i " e No.() n y J Date P • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee it Foundation Permit Fee $ Other Permit Fees $ TOTAL $ <_ i, Check#� -3< �' _ JsYL �,� ' z Building Inspector � f„7 t3 NORTH Town of 2 : _ L ndover O {n 098- 2oll yZh ver, Mass 4, �� I 1 T O COWICN LAN! A. NIC Nl V S U BOARD OF HEALTH Food/Kitchen PER 11 T D Septic System 0 4 THIS CERTIFIES THAT ........... ... Jm ... ..1..........�.►rBUILDING INSPECTOR .. .... . ... ....................... has permission to erect ...................Abildings on . Foundation 0 �. Rough to be occupied as ........ ....� . . ...... .0 SPA........ 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TI Rough Service .. .... .. . ........ ...... ................ Final BUIL G 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. Window rl of Boston, LLC MA HIC Registration Offices & Showrooms Number: 015A Cummings Park, LI 295 Old Oak Street 166025 Woburn, MA 01801 Pembroke, MA 02359 Federal ID# "Simply the Wiest fate L (781) 932-4805 (781) 826-6281 27-1481665 Y www.WindowWoddofBostoh.com Customer: 1 €V Q e-11 Phone(h) ? r install Address: Phone(w) City: L ",4 rf State:MA Zip0f�J-- .E-mall WINDOW WORLD GLASS OPTIONS 1000 Series Single-hung All-Weld $189 SolarZone Elite $99 ?cj� 2000 Series DH Mech/Welded Sash $195 Triple.Glazed TG2* $175 4000 Series DH All-Weld $205 (*Series 6000Only) 6000 Series DH All-Weld $240 WINDOW OPTIONS 2 Lite Slider $334 Breakage Warranty $15 INCLUDED 3 Lite Slider (1/3,1t3,1i3) (1/4,1J2,1i4) $525 112 Screens $91NCLUDED Picture/Fixed Lite $334 Insulation on Jambs and Head $11 INCLUDED. Awning $260L�� y'e Strength Glass $1;5 INCLUDED Casement $290 ouble Locks (> 26") $5,INCLUDED 2 Lite Casement $575 Full Screens $22 3 Lite Casement (w.1r3.w) (1/4,11Z 1/4) $860 Colonial Grids (Contoured/Flat) $45 Basement Hopper $334 + Prairie Grids $51 Bay Window-SoffitDiamond Grids $69.Mount/INS Seat $2660 Simulated Divided Lite $182 Bow Window-Sofa Mount/INS Seat$2785 Tempered DH Sash (BSO) (TSO) $65 Garden Window $1880 Obscure Glass (BSO) (TSO) $35 Specialty Window $ Oriel Style (40/60 or 60/40) $30 Beige/Almond $40 Foam Enhanced Frame $35 Wood Grain Interior(Serles 4000/6000 only)$100 PRE 1878 BUILT HOMES(Federal Lead Containment Law) (Light Oakl Dark Oakl Cherry/ Fox Wood 1-7- Lead Safe Practices Required $25 3 Rich Maple) MY HOME WAS BUILT IN THE YEAR Initial Brown Exterior(Arch.Bronze/American Terra)$100 Designer Color Exterior $155 MISCELLANEOUS Custom Exterior Aluminum Cladding s Window Color ct--� ( C1Textured Color Textured$75 Ism oth G-8 $75 $ r�� inside outside le Metal Window Removal $50 NON CUSTOM DOORS New Construction Vinyl Removal 175 Vinyl Rolling Patio Door 5ft,or 6ft. 5 � Vinyl Rolling Patio Door 8ft. $1095 Mull to Form Multi~Unit r FN $30 Add a price for Custom Rolling Patio oor$1150 _ Install Interior/Exterior Stops $50 1 b French Rai i ing Patio Door 5 r Eft. $1295 Install Interior Casing Starts At $95 French Rail Slidin do Doo $1395 Insulate Weight Boxes $20 French Rail Sliding Pati or 91t. $1495 Roof for Bay/Bow Windows $500 Custom Exterior Cladd' g $150 Existing New Const. Ext. Retro Fit $150 SolarZone Elite or Glass $175 Removal of Existing Bay/Bow $250 Grids Patio Door 129 Repair Sill,Jamb or replace sill nosing $50 Woodgrain Int ors $2 Full Sub-Sill (Single) replacement $150 Exterior De ' ner Colors $395 Interior C ing 21/2 31/2 $175 Mullion Removal $30 Bay/Bow Conversion Ext. Retro Fit $350 Handl et Options $ (New Siding Will Not Match) $ Building Permit $150 jS Door Color / @63,1ROUNDUP':FORHNDo ORLQ,OlARES inside Outside .St.Jade Children's Research Hospital . $ Customer declines exterior wrap and understands painting and or repair may be required Initial ----�— Customer declines grids on windows/doors Initial OISCLAIMER:Customer is responsible for the following in connection with this contract:Painting,Staining,Alarm System disconnecVreconnect Building Permitfeesin excess of$25.00,Homeowner and or Condo Association Approval,Historic District Approval.City of Boston parking&sidewalk Permit fees in connection with installation. No EXTRA WORK IF NOT IN wFIITINtal Customer agrees to the terms of payment as follows: Extra Labor&Materials $ Site Set Up, Disposal &Delivery Fee $ $195.00 Total Amount $ �'4> Custom Order Deposit 50 $ lS Ck# -f VZ- Balance Paid to installer upon Completion $ -_T— Amount Fin0-e e45 a rued $ ,.--�-- Window World of Boston anticipates starting this work on and being substantially completed in_days.Security Interest:Yes No Any deposit required in advance of the start of the work SHAI I NOT exceed 331/3%of the total contract price or the actual cost of any material or equipment of a special order or custom made nature,which must be ordered in advance of the start of the work to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of both parties: All home improvement contractors and subcontractors shall be registered and that any inquires about a contract or subcontractor relating to a registration should be directed to:Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170 Boston,MA 02116.Phone:(617)973-8700 No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract Window World of Boston under provision of Chapter 142A of the general laws is required to apply for and obtain all construction-related permits.Window World of Boston shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting agencies,authorities or individuals. Notice:if the PURCHASER(S)obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors, the PURCHASER(S)is hereby advised that in the event of a dispute,judgement and nonpayment,the PURCHASER(S)will not be entitled to make a claim or collection from the guaranty fund established by chapter 142A,M.G.L. You the buyer may cancel this transaction at anytime prior to midnight of the third business day after the date of this transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. t This Window World*Franchise is indeeendently owned and operated by Window World of Boston,LLC.under license from Window World,Inc. Owner:Do not sign If there are any blank spaces. Qat S :Do not sign if there a any blank spaces. -9e t slgrAf ther re any blank spaces. Boston 07-15 White Copy-Original Yellow Copy-File Pink Copy-C200,15ber Hayes Printing 888-667-1116 ,•�� ,w �vs,s„av,+,.s.uaas,. J <,�.xuuaea.,.reua.o.su Department of InduslWal Aecidents Office ofInveshagations 6011 Washington Street y M1 Boston, 02111 www.muss:govfdia Workers' Carlapensadou hamurance Affidavit: Buzlders/Coiafractors/E1eLlz-icians/Plunbers AppEcant litformation ` Please Print Leuibly Name (Business/Orpnizatibmgndividuel: Address: City/State/Zip: Phone Are yo employer?Check the-appropriate box: Type of project(required)_ i. am a employer with �_(7 4• ❑ I am a general contractor and I 6_ F-1 New construction employees (full and/or part-time.).* have hired the sub-contractor 7 2.❑ I am a sole proprietgx or partner- listed on the attached sheet t ElRenaode'r g ship and have no employees These sub-contractors have 8. ❑ Demolition working for me is any capacity. workers' comp_ insurance. 9_ ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10❑ Electrical repairs or additions required.] - officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL I 1_❑ PlumbiBg repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑Roo epairs insurance required.] f employees. [No workers' comp. insurance required.] 13. er *Any applicant that checks box#1 must also fill out the section below showing thea workers'compensation policy information: Horneowneis who submit this affidavit indicating they are doing all work and then hue outside contractors must subnat a new affidavit indicating such Contractors that check this box must attached an additional sheet showing the name of the sub-contrac`ors and their workers'annp.policy information. I am an employer that is providing workers,compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 1 �-�lJ Expiration Date: Job Site Address: ✓ City/State/Zip: Attach a copy of the workers' compensation polic declaration page (showing the policy number and expiration date). Failure to scoaare coverage as required under Section 25A of MGL c_ 152 can lead to the isposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civrl 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under par nd p aloes ofperfury that the information provided above is true and correct Si attire: Date: fs Phone#`.. Oficial use only. Do not write in this area,to be completed by city or town official. City 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 6.Other Contact Person: Phone#: WINDO-2 OP ID:HI CERTIFICATE OF LIABILITY INSURANCE DATE 07/1188//22016016Y) 07 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 NAME CT C.Timoth Ward,CPCU,CIC Senn Dunn-GSO PHONE 336-272-7161 FAX 3625 N.Elm St. A/c No Et): A%,No):336-346-1397 Greensboro,NC 27455 -ADDRESS:tward@senndunn.com C.Timothy Ward,CPCU,CIC INSURERS AFFORDING COVERAGE NAIC# INSURER A:Citizens Ins Co of America 31534 INSURED Window World of Boston,LLC INSURER B:Allmerica Financial Benefit 118 Shaver Street INSURER C:Hartford Fire Insurance Co. 19682 North Wilkesboro,NC 28659 INSURER D: 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. INTR TYPE OF INSURANCE 0=0LSUBR POLICY EFF POLICY EXP S POLICY NUMBER MM/DD MWDD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 CLAIMS MADE OCCUR 066790252707 04101/2016 04/01/2017 PREM SES Ea occurrenceDA S 500.00 Business Owners MED EXP(Any one person) S 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,00 POLICY PRO- JECT - 2,000,000 LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY EOa COMBINED D.denISINGLE LIMIT $ 1,000,00 B X ANY AUTO AW68757615 06116/2016 06/16/2017 BODILY INJURY(Per person) S ALLOWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident S S X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 1,000,00 A EXCESS LIAB CLAIMS-MADE OB6790252707 04101/2016 04/01/2017 AGGREGATE DED RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 22WECLJ2635 0112MO16 01/2712017 EL.EACH ACCIDENT S 500,000 OFFICER/MEMBER EXCLUDED? F_� N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE S 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,00 D DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St.Ste 2043 AUTHORIZED REPRESENTATIVE North Andover,MA 01845 r @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD `;I sacr;usatta 0_pa,?menr Ds pjmic jai?t'I Board o=8:�iiding fi=g�Iatiars and Standard's _c e rs e: CS-072772 - JEFF C STEELS 24 SHERWOOD AVE - - DANVERS MA 01923 Ccmrnissior,er ^ira.;Qn: 0W07/2012 f Consumer_ -,,.Office mer affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR —_ Registration: 166025 Type: Expiration: 4/12/2018 LLC WINDOW WORLD OF BOSTON,LLC. JEFF STEELE i 24 CUMMINGS PARK SUITE 15-A WOBURN;MA 01801 Undersecretary i i i Liregistration valid for injividual use only =: befo expiration date. If found return to: ti.V0of Consumer Affairs and But Regulation Plaza-Suite 5170 Boston,MA 02116 ll � s I ;:Not valid without signature i i