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HomeMy WebLinkAboutBuilding Permit #364 - 62 GRANVILLE LANE 12/1/2008 BUILDING PERMIT o* pORT11 ttt.90 ,6�ti TOWN OF NORTH ANDOVER 3� �` '' `-� '° APPLICATION FOR PLAN EXAMINATION ° � Permit NO: C! Date Received 7 ��AArgo ropy h gSSACHUs�� Date Issued l,0 IMPORTANT:Applicant must complete all items on this page LOCATION UO, rt.. Print PROPERTY OWNER__ _ Print MAP NO ,PARCEL: ZONING DISTRICT: Historic District yes (' n0o o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One 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 OF WORK TO BE REFORMED: l Act 03 Identifigation Please Type or Print Clearly) OWNER: Name: (Y\AG-i N MA r-0 Phone: :2(Q Fr— Address: .� CONTRACTOR Name: S ��� M1 Phone: ' Oi�` 1 ., Address: � - l I j Supervisor's Construction License: &6t/' z,—Exp. Date )i5j 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: $ / ��� aO FEE: $ ?23 Check No.: Sov D Receipt No.: dA NOTE: Persons contracting with u re istered contractors do not have access to the guaranty fund Signatur of Ag Owne Signature of contractor s �z Location t" e.,w" No. 3L,, Date /C?;.Of ' NORTh TOWN OF NORTH ANDOVER � w a Certificate of Occupancy $ Building/Frame Permit Fee $ r Foundation Permit Fee $ Other Permit Fee $ .. TOTAL $ Check # 2 174' 0 ?0 v Building Inspector 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 I 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 Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 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 use ❑ Notified for pickup - Date ........................._.............---._...........................-....----._.......-_...........---....__...._............_._.............---......................__....___....................._......_.....----.......................................--------..........................----......... Doc.Building Permit Revised 2008 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 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 o 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 ConstructionSin le and Two Family) � g Y) ❑ 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:INSPECTIONAL SERVICES DEPARTMENTMFORM07 Revised 2.2008 OIL'own olIAORTH ti Andover , 0 -1 No. a, �� - �AKE oL dower, Mass.,/Q- Z. e� -;-OCMICMEWICK L ADRATED PPS\ �S E� BOARD OF HEALTH PERM -11 I U Food/Kitchen Septic System BUILDING INSPECTOR /mow �, d............... .4� T THIS CERTIFIES THAT...:............................ . .. .............................:.............. ................................................... Foundation has permission to erect........................................ buildings on ...........( ... ....... ..................... .'........ .... . .......V Rough f0 b8 occupied aS....�.... 4 .!! ..�^!'"......................................................................... Chimney e provided that the person ecce ing 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 33 ®. Final UNLESS �/EXPI�ES IN 6 MONTHS ELECTRICAL INSPECTOR �..J 1 a1 LESS '�a.+�Jl'�1 S 1 C�. _ 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. IL�SLEE REVERSE SODS Smoke Det. Window Agreement-Page 1 of 2 J&L Windows,Inc.,d/b/a 1(5 Otis St.,Northborough, 19 01532 L...Home Improvement Contractor (506)919-0900•Fax:(508)919-0903 ^�^��� License#149601(Expires 1124/2010) Customer Service Renewal ��. Federal Tax ID#83-0404201 (800)573-7606 Andersen, Indiv.Licenses:John Esler(CS#74251), WINDOW REPLACEMENT anAnd—C. pay Kathleen Blanchard(#149601) Product Manager: T, FV,4� Window Agreerrlen Contract Date: f�' J*b Cr Homeowner("Owner")'s Name(s): - Street Address: IL City/Town: V eZ State• Zip: 0 Home Phone: Work Phone: - Job Site Address(if different): E-mail Address: Materials to be provided and work to be performed by Renewal.by Andersen("Contractor"): Contractor will furnish and install Renewal by Andersen-approved materials to the following specifications: 1. Date on which Work is Scheduled to Begin:_��xpected Date of Substantial Completion] OJJ/V C _�"' 2. Contractor will Install a total of_windows in Owner's home,using the following individual quantities: _Double Hung(DB) ❑Equal sash ❑Cottage sash(1/3 top,2/3 bottom) ❑Oriel sash(2/3 top,1/3 bottom) Casement(CW) ❑Hinge right ❑Hinge left(as viewed from exterior):❑Standard handle ❑Metro handle Double Casement(CDW) ❑Standard handle ❑Metro handle _Casement/Picture/Casement(CPW) ❑1:1:1 or ❑1:2:1 ❑Standard handle ❑Metro handle 2 Lite Gliding Window(GW) _ Glider/Picture/Glider(GPW) ❑ 1:1:1 or ❑1:2:1 Awning Window(AW) f Picture Window(PW) Bay or Bow Window: 3._qa Yes ❑No #Windows to be Custom Fit Replacement:_(_ 4. ❑Yes ®"lq—o #of sills to be replaced by Contractor: 5. ❑Yes ❑No #Windows to be New Construction Full frame(includes new interior&exterior casings): Exterior casings: ❑Pirle ❑Maintenance-free material ❑Factory applied 908 Fibrex brickmold 6. Glazing to be: I!r�kgh Performance ❑Other If other,please specify: 7. Exterior color to be: ''pe ❑Sand ❑Canvas ❑Terratone 8. Interior color to be: A-White ❑Sand ❑Canvas ❑Terratone ❑Wood Note:Interiorco!9P can only be white,wood or same color as exterior. Wood interiors need to be finished by Owner. 9. Hardware: EYWhite ❑.Stone ❑Canvas❑Brass Double Hung: Install lifts? ❑Yes ❑No 10. ❑Yes � Contractor will remove metal frames or grilles. #of Units: 11. ❑Yes fg'1�10 Contractor will install new paint-ready or stain-ready casings.Inside or outside stops#of openings: Interior casing#of openings: Exterior casings#of openings:_ ❑Pine ❑Maintenance free material ? Owner is awXe that Contractor does not do any painting. Owner initials 12. ❑Yes 1YNo Contractor will wrap exterior casings with aluminum coil stock of color. Note:Required with storm window removal;removal of storm windows will leave screw holes in casing. 13. New windows to have: ❑Half ❑Full screens.- Sc ens to be: ❑Fiberglass ❑Aluminum ❑TruScene 14. Windows to have grilles: G- es ❑No If Yes: dlle Between Glass(GBG) ❑Removable Imre for Wood(INTW ❑Full Divided Light(FDL) Grille patterns:�jgT7 n/ 70 ,6,;rV i B 4 B DH DH DH DH CW/Picture Glider CPW or GPW use�ad 'rional sheet if needed Owner approved(initials): 15. ETYe ❑No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. 16. es ❑No A limited warranty shall issue to Owner upon completion of the job and payment in full(see reverse side). 17. ❑No Building Permit-Contractor will secure any and all necessary permits.The fee for the permit(s)is not included in the Contract Price and a separate check is required at the time of sale for this fee. 18. Additional job details: 19. MYes ❑No Owner has revie a the Additional Terms and Conditi n verning this Contract on the reverse side. 20. Total Contract Price:$ . 7 Regular Retail Price:$ All available discounts applied:❑Yes ❑No 21. Deposit(1/3):$ q paid by❑Cash ❑Finance (Account#: ) Second(1/3)$ to be paid by Cash at start ofjob on (Estimated start date). Fin 1/3)$ /1Y to be paid by Cash at completion of job on (Estimated completion date). 22. es ❑No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. NOTICE: All home improvement contractors and subcontractors must be registered. Any inquiries about a contractor or subcontractor relating to a registration should be directed to: Registration Division, Program Coordinator,One Ashburton Place, Room 1301,Boston,MA 02108,Tel: 617 727-3200,ext.25239. The parties hereby mutually agree in advance that should a dispute arise regarding this contract,Contractor may submit such dispute to a private arbitration service that has been approved by the Office of the Consumer Affairs &Business Regulation,a / h quired to submit to such arbitrations as prPV in Contractor Signa t p•-L Owner Signature: /J/ /- NOTICE:Th ' na ures of the parties above apply only to their agreement to alternate dispute resolution initiated by Contractor.Owner may initiate alternate dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES J&L WI c. Renewal by Andersen B . // /. k_ odb ana er ' Owner Signature Product Manager(Print Name) A Owner Signature White-Renewal by Andersen Yellow-Installation Pink-Homeowner / The Commonwealth of Massachusetts DepartinentofIndustrialAccidents. Office of Investigations 600 Washington Street Boston;MA 02111 Wminass.govIdia Workers' Compensation Insurance Affidavit: Buildes/Contractors/Electrici A licant Information ans/Plumbers " Please Print le ibI M Me(Business/Organization/Individual): Address: L , City/State/Zip A Phone#: �d .6 � F2.011 employer?Check the appropriate box: employer with 4, Type of project(required): employees I a general contractor and I (full and/orpart time).* have hired the sub-contractors 6. 0 New construction sole proprietor or partner- listed on the attached sheet x �• , ]Remodeling d have no employees These sub-contractors have g forme is any capacity, workers'com . 8 ❑Demolition rkers'com . ' P insurance. 9• Buildinp insurance 5. [] We are a corporation and itsg addition d] officers have exercised their 10.0 Electrical repairs or additions . 3.•❑ I am a homeowner doing all work right of exemption per MGL 11.[]Plumbing repairs or additions myself.[No workers'comp, c.152, §1(4),and we have no insurance re uired t 12. Roof repairs q � employees.[No workers' - comp,insurance required.] 13.0 Other `Ho Homeowners that checks box a 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 xConhactors that check this box must attached an additional sheat showing the name of the sub-contractors and their workers'comp, o1i info vrt indicating such. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob information. _ P cy job site Insurance Company Name: Ce. lee0�� Policy#or self-ins.Lic•#: rl y �j/ C Expiration Date: � A Job Site Address:_ — Attach a copy of the workers'( g /r} ` City/State/Zip: 4 /� /JIj compensation policy declaration page(showing the policy number and ' Failure to secure covers a as rec. expic'ation date). impo fine up to$1,500.00 and/or one-year imprisonment as$w well as�civil penalti152 es in the formlead to e of a STOP sitiOn of criminal,penalties of a Of up to$250.00 a day against the violator. Be advised that a copy of this the maybe forwarded to the OfWQRK fice nand a fine Investigations of the DIA for insurance coverage verification Ido hereby c rtify under th pain andpenalties o rjury that the information provided above is true and correct Si ature: / Date: l l Phone#: 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 one): I.Board of Health 2.Building Department 3.City/Town Clerk 4•Electrical Inspector 5.Plumbing Ins i 6.Other g pector Ii Contact Person: ! Phone#: I �-' h'Iassachusetts•- Department of Public SafetN Board of Building Re-ulations and Standards Construction Supervisor License 4 License: CS 99256 Restricted to: 00 { SCOTT PHILLIPPI 58 0 STREET WHITINSVILLE,MA 01588 } Expiration: 6/7/2011 (•n nlrttisAmer Tr#: 99256 Restricted to: 00 00..Unrestricted 1G-1 2 Family Homes Failure to Possess a current edition of the Massachusetts State Building Cade is cause for revocation of this license. Refer to: WWW-Mess-Gov/DFS ' �/�ie•�o�nmzanu�ealt�i a�,�uaaac�uiaelte Board of Building Regaiations and Standards HOME IMPROVEMENT CONTRACTOR RegistrAora:ti 149601 E_rpfcati6i4��2412010 � ype; ppiement Card RENEWAL BY SCOTT PHILLIPP = ;� 104 OTIS STIR E NORTHBOROUGH,MA Of632 Administrator ACORD-. CERTIFICATE OF LIABILITY INSURANCE "ATE'MMIDD/YYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Joseph MCKeone ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. DOES OR JP MCKeone Insurance Agency, Inc. ALTER THEHIS COVERAGECATE AFFORDED BYOTHEMENPOLICI STENBE�W P.O.Box 333 Ann Arbor, MI 48106-0333 INSURERS AFFORDING COVERAGE NAIC 0 INSURM Renewal by Anderson INSURER a Hartford Insurance Company JBL Windows,Inc. INSURER e: Hermitage 104 OtIS St INSURER C: Northborough,MA 01532 INSURER a. I I INSURER E:' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT.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. DISR MOL POLICY EFFECTIVE POLICY EXPIRATION LTR INqPM POLICY NUMBER LIMITS B GENERAL LIABILITY HCP 507 404 09/07/2008 09/0712009 EACH OCCURRENCE 11 1000000 COMMERCIAL GENERAL L(l3ILITY PREMISES Ea oaacarr S 100,000 CLAIMS MADE ®OCCUR MED EXP(Any one person) S 5,000_ PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GENL AGGREGATE LIMIT APPLIES Kit- PRODUCTS-COMRIOPAGO 5 2,000,00D POLICY PRO LOC A AutoLloeu LIABILITY 35 MCC XD 6390 10/01/2007 10101.2008 COMBINED SINGLE LIMIT f 1,000,000 ANY AUTO (Es aeddmo X ALL OWNED AUTOS • BODILY INJURY ' S SCHEDULED AUTOS , (Per Prson) HIRED AUTOS BODILY INJURY NON•OWNEDAUTOS (Paraeddon)) f PROPERTY DAMAG£ (Peraoddenl) S GARAOELIABILM AUTO ONLY-EA ACCIDENT S ANYAUTO OTHER THAN EAACC f AUTO ONLY:. AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR D CLAIMS MADE AGGREGATE f ' S DEDUCTIBLE S RETENTION i S WCSTATU. OTH- A WORKERS iCOMPENsATloH AND 35 WEC PP 1444 02/17/2008 02/17/2009 EIAPLOYERS'LIABAJTY ANY PROPRIETOR/PARTNERAiXECUTNE E.L.EACH ACCIDENT S 500,000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S 50b,000 K o0.deavibe under. SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL DIPOSE NO OBLIGATION OR UABILJTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE ACORD 25(2001108) I 4(,4/©cACORD CORPORATION 1989 NkC WoodNipyl Cotepositi Frame i4t CatretiltD OUai Amon low E Picture . 'ENERGY PERFORMANCE-RATINGS U-Factor(U-S)/I.-P . Solar Meat Gain Coefficient H.. . -0 : 3.2.1 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance hlMahelw...yyVlu w�1 M�•.hwR unhiniHM►,WM!1a110N�•NMMM�flhln�wl�+t•fAMt .. ., . .. , ' rTrr�M��.-NMC MMR.h hl•�.1 M.At.r t.1 N MYkMr��M•NNA��•A•�•fu1M/i�!�r•(•k., Nf�clw•rr�IgtgnrnrnlN+l�IweN11«tp.lwlwnllA.wAN1Pi/r�YM/w�tirN�yquMgra. i . ' . . '0•�►uM T.nv�•oMh Mnlue hr NH•f fr/vel►!A�01wLrbMAM�fi. . . .DESIGN PFIESSURE(PSF) '' F C50 4- ki 4,AM hf. M••u��•�.q1•M.f.O,,0,EC.411. 0.A10100M w•n r.�WrP•11k WONA.N•M�k CwMluirp fnp+m .. - .