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HomeMy WebLinkAboutBuilding Permit #422 - 770 FOREST STREET 12/1/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: tIW ORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER. 'r J C.!1JC,� Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village ye no 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 PERFORMED: dentifcation Please Type or Print Clearly) OWNER: Name: 4Phone: — 03� Address: CONTRACTOR Name:& �q %� ti�� Sc,-J Phone: S"67 Address: l � Supervisor's Construction License: S76 Exp. Date: Home Improvement License: /66/ Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PEOR$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ C.� ��� �G FEE: $ Check No.: �9 XL 5s-- Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner, ,�'�` -wE Signature of contractor Location No. Date NORTH TOWN OF NORTH ANDOVER O + ; : Certificate of Occupancy $ cwuEck' Building/Frame Permit Fee $ s� s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # i 2 ` GG f Building Inspector r 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 Siqnature 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: Siinature: 11 .11M • 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 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 ❑ 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 zi 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: Doc.Building Permit Revised 2008 NORTiy i of _ .IAndover TONM No. 44 ZZ = i ? L 0 9' o dover, Mass., LA COCMICMEWICK 7,9 AERATED P �C� `S E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........�A. .0.. ....... . . .. ..................................................................................................... Foundation has permission to erect........................................ buildings on .... .........P�....&.rJ19ST..................................... Rough oW to be occupied as.... ....... ......... ......... ......Z...........w�... .. i chimney . ........................................................................................ provided that the person accepting t is 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 n PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU '.NST,,AIRTS- 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. SEE REVERSE SIDE J1 Smoke Det. Oct 29 2009 11 : 05PM MIKE SIDMAN 6039345514 p. 1 RENEWAL BY ANDERSEN �C license tt14 601 Federal Tax spir®3PO404 201 Renewal Federal7a><1D#83-0404201 by dellen. tnsos ccncarsair m .c.rorm OF GREATER INIWSACHUSETTS AND NEW HAMPSHIRE 104 Otis Street-Northborough,MA 01532 Phone 508.919.0900•Fax 508.919.0903 CUSTOIy1 WINDOW AND DOOR REMODELING AGREEMENT Suyerlsl Name Data of Agreeme C'A 111.1 a Suyer(s)Slrret Add ss,Ci $ ,and Zip:Ccde D r f /v f�,�ds f,:- 0 Eavtail dress Home Uschone Numb.r Work Telephone Number Buyer's)bereby,jointl and severally agrees to purchase the products and/or services of J&L Windows,Inc.dba Renewal by Anderse (3r t Maw chvsetts and N eve Hanpshirc("Contractor"),in accordance with the terms and conditions described on the front and the reverse or thiE agreement and on tl.c attached specification sheets)(collectively,this Agreement").Buyer(s)hereby agrees to sign completion certificate after Conti wor has tour Icted all work under this Agreement. Method of Pymnt O Cosh heck ❑Mastercard a VISA Totalb Amount- Estimated m ng Data: O Discover D Financed,App#: Deposit Rea ived P3%4,1_L_ Name on Credit Card: Bc lance at Stott Job(33%):%J? Estimated ompl ' n Date; Credlt Card If: Balance or Substantial �L Q Completion Job(339)L' .__ I I r — CC Exp.Dote: CC Security Code: By initialing here,you acknowledge that the Balance at.Start of Job and the Balance on Substantial Completion AV B r Initials �'� ofjob cannot be made b credit card Rnd roust be made b ,] y y personal check,bank check,or cash. Buyer(s)agrees a rid understands that this Agreement constitutes the entire understanding between the parties, and that there are no verbg I understandings changing or modifying any of the terrors of this Agreement.No Alteration to or deviation frons this Agreen ent will be valid without the signed,written consent of both Buyer(s) and Contractor. Buyer(s) hereb) aclusowled8es thi t Buyer(sy 1) has read this Agreement,understands the terms of this Agreements and has received a con feted,signe ,and dat$d copy of this Agreement,including the two attached Notices of Cancellation,on the date firs, written above an 2)was orptW informed of Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT 11 THE RE ARE ANY BLANK S11ACES. Renewal byAnde2sen of Greater MA and NH Buyer(s) Buyer(s) By: ?0,z!A- Nh4� , Signatuf ?rodYct Mapager SignatureSigtiatu Print Name of Product Manager Print Name V Print I ame YOU THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY A17ERTHE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORME FOR AN EXPLAN kTION OF THIS RIGHT. 5t— — — — — — — — — —j— — — — —X- — — — — — — — — — — — — — •X— — — — — — — — — — — — — — — [yOTICF jg�t Date of Tionsacti n J .You may tante) I Date of Tronsaclion d .! 'F , You may tante this nsoetion thou a p a hr ar obligotion,within I this kwnsotdion without sty na ty or Obligation,wfthir, three business 40 5ftomthbabove dat&IFyou cancel,any t three business days from the above daft.lfyoucancel,any pro traded i ,airy payments made by you under the property traded In,any payments made by you under the Cont of Sale, nal any nnee��tsfiable instrvmtsnt executed I Contract of Salo,and arty negotiable instrument executes by v will be turned wdttin 10 days following recti t by you will be returned within 10 days following receipt V y a Seller of ur cancellation notice,and any securi I by a Seller of your cancellation notice,and any seturlty, In st arising of thej transaction will be cancele 1 interest arising Out of the transaction will be canceled. IF y cancel,y must mm��ooke available to the Seller at I H you cancel,you must make available to the Seller of YOU residence, in subs icily as good condition as your residence, in substantial as goad condklon as whe received, ny good+t delivered to you under this 1 when received, any goods dell?Vwed to you under this Cont ct or sale; you may,ifyou wish,compf�r vvitfi the t Contract or Sale-or you may,if wish,cotttply with#m instr ctions of th Seller regarding the return shipment of itlshuctions of tie Seller regar ing the retum shipment 01 males.,x....the. s•crtMte3eller'F t flood -expense anti risk.lf You do make pick thorn avails Is to the:Seller and the Se ler tit»s not the goods available to the Seller and the Seller does nal pick hem tip wi in 20 days of the date of your Notice I pick them up within 20 days of the date of our Notice of C mcellation, may retain or dispose of the goods I of Cancellation, you ma retain or dispose o{the goods with ut anyy fu er obligt titnt. If you fail to maks the I without any further ob atitut. R you fail to make the go s avaRable the Seller,or if you agree to return the t goods""fable.to the Seller,or If you agree t6 return the g s to the Sell and fail to do so,then you remain liable I s to the Seller and fail to do so,then you remain liable fir erforFnance of all ohiligations under the Contract. I Crfoperformance of all obligations under the Contract. To c noel this t nsaetion,;moil or deliver a signed and To cancel this transaction, mail or deliver a signed ane date copy of t"N wncello#ion notice or any other written I dated copy of this cancellation notice or any other wriMer: notic , or send o telegram to Renewal by Andersen I notice, or send a telegram to Renewal by Anderser. of In Mas achusetts and New Hampshire, 104 1 of Greater Mass husetts and New Hampshire, 104 Otis Witt Nort b IVIA 015132,NOT LATER THAN ( Otis Street, North ra MA 01332,NOT LATER THM MI I v OF .(Date) MIDNIGHT OF ! (pate) 1 HE BY LANCE T l5 NSACTION, K 1 HEREBY CANC IST NSACTION. I Conw er'e Slonciftuu Dart 1 ComwocrS slpnattw0 Dart Oct 29 2009 11 : 05PM MIKE SIDMAN 6039345514 p. 2 pire;1/24/100) Re i I RENEWAL SY ANDERSEN MA HtG LnSe�496al ax ID# 85.0404201 byAnc ersen. OF GREATER MASSACHUSMS MD NEW HAMPSHIRE WI■eew ■�++owe■r ne a Comvnr 104 Otis Street.Narthborough,Massachusetts 01532 Phone 508.919.0900•Fax 508.919.0903 SPECIFICATION SHEET Buyer( Name Date of Agreement 0 Jd 14 D rr TheBuyer(s)listeJi bove hereby jointly anis severally agree to purchase the goods and/or services listed below,in accordance with the prices and s describe on the specification sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR FEM DELING AGR MMENT.of which this S ecification Sheet is apart. WINDOW DETAILS 1. C ntractor will I astall a total of windows in Owner's home,using the following individual quantities: Double H ung(DB) ❑ Equal sash ❑Cottage sash(113 top,2/3 bottom) ❑Oriel sash(2/3 top.I/3 bottom) Casemen (CW) ❑ Hinge right❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle Double C ascment(CDW) ❑ Standard handle❑ Metro handle Casemen /Picture/Casement(CPW) '1:1:1 or❑ 1:2:1 ❑ Standard handle ❑ Metro handle 2 lite Gli Jing Window(GW) Glider/ lure/Glidcr(GPW) ❑ 1:1:1 or ❑ 1:2:1 Awning indow(AW) Picture\1 7indow(I'W) Bay or&w Window Patio Do rs(see separate Door Specification Sheet) Z. ELYes [• No Qty of Windows to be Custom fit Replacement: S. 7 Yes❑ No Qty of Sills to be replaced by Contractor: 4. Yes ❑ No Qty of Windows to be New Construction Full frame(includes new interior&exterior casings) Exterior c inns: Cj Pine❑Maintenance•free material X Factory applied 908 Fibrex brickmold S. Glazing to bc:6 1 HP Low-EV SmartSunTm (TsxC-e&tEl{ole) Other if other,please specify: 6. E xterior color to be:k!�White❑ Sand❑ Canvas ']'rerratone 0 Cocoa Bean 7. 1 itehor color to be: ❑ White❑ Sand ❑Canvas ❑Terratone❑ Pine ❑ Maple jK Oak Note: Inte rior color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner. 8. Hardware: ❑ While DZStbne ❑ Canvas ❑ Brass Daubleliung: 9. Yes❑ No nstall.lifts with Double Hung Windows 10. Screens: windows to have::❑ Half or 6LFull screens Screens to Fiberglass ❑ Aluminum ❑ Trascene Ca=DETAILS 11. Windows have ules: ❑ Yes K No if yes:❑ Grille Between Glass(6scd❑ Rctnovable Interior Wood nHsw)❑ Full Divided Light omn Qty: Qtr Qh^ Qty Qty• QtyQty DH OR DH DH CWIPiqure Glides CPW o•D Dr grille patters above 'Use aMlional sheet if needed Owner appmved(Initials): ADDITIONAL WORK DECAILS 12. Yes No Contractor will remove metal frames of windows. Qty of Units: 13. Yes❑ No Contractor will install new paint-ready or stain-ready casings. Interior ca sing qty of openings: tk Exterior casings qty of openings: ❑Fine�&Maintenance-free material 14. Yes ❑ No Contractor will install new pains-ready or stain-ready inside or outside stops qty of openings: Interiors ps qty of openings:. Extertor stop3 Y gf gper Ings: ❑ Pirie Rl Maintenance-free material �+I S. Owner is awaj e that Contractor does not do any painting. rC( L!1G�► Owner Initials t1�_ G. YesNo Contractor will wrap exterior casings with aluminum coil stock of color. Na�Wr ipping may be required with storm window removal;removal of storm windows will leave screw holes In casing. 174Yes ❑ No Contractor will insulate,caulk and.seal windows witl:3-point system to prevent water and air infiltration, 18. Yes ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 19. Yes ❑ No BAft (---Contractor will secure any and all nccessaty permits. The fee for the permit(s)is not included'a the Contnict Price and a separate check is required at the time of sale for this fee. 20. Additional jobdetails: 21. Yes ❑ N Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. No Ina:psvm ot shall be demanded until the contmct is completed to the satisfaction ofe prudes. It i i agreed and t ridarstwd by and betwccn the parties that this Spoc&atiott Sheet,atong with the CUSTOM WINDOW AND DOOR REr DE MG AG MW4T,constitutes the entiro understanding between the parties,and there are no verbal underst uidhtgs changing or r11D 0jilig any of terms. This Specification Sheet may not be charged or its tes:ru modified or varied in any way unless such changes aro in ting and a' by both the Buyer(s)and Contractor.Buyer(s)hereby adanowiedge that Buyer(s)has mad this specification Sheet. Rel al by of G MA and NH )3try 9uykr(s) By: � 1 8;,gnatum f Product Manages S*natttre S Print Name f Product DManeger Print Name Print Name t The Comntonwealth of Massachusetts Departntent of Industrial Accidents Office of Investigations 600 Washington Street ` Boston,MA 02111 www.mass.gov/dia Workers' Compensation insurance Affidavit: Builders/Colttractors/Electriciatis/Plumbers Applicant information Please Print Legibly Name(Business/Organization/Individual): !)eheL)a 7 V gndC'Y-'s e Yl Address: /0 q 0 �` 5 &Yew City/State/Zip: ,�0�� &,-, , / oJc2— Phone.#:— coop) I��y v/�00 Are you an employer?Check the appropriate box: Type of project: (required): L&I am a employer with 30 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ emodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers' comp.insurance. 9• ❑Building addition [No workers' comp.insurance 5. El We are a corporation and its required.] officers have exercised their 10.❑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 12.0 Roof repairs `insurance required.]t employees. [No workers' 13.❑Other comp.insurance 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, $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.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: J Policy#or.Self-ins.Lie..#: ��/ U(/ � � I`�'-} Expiration Date: Job Site Address: 2� � f�� City/State/Zip: /� AA ,0!2� /vG — Attach 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$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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby cer under the pains and penalteies.of perjury that the information provided above is true and correct Si anature Date Phone#: // t�U %��- 0 z o Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permtt/Lr,icense# • Issuing kutho ' , rct� (circle one): 1.Board of Health 2.Building,Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f , • ! '�' �.�ti '��J 'CJS lL•09����•K��i�o�V'!'{/'..�J�"LC�'.�4 j l ! I •. yoard konx and .epdsrds ' ! � �+v155ii:dCt10i1•SUp�R"�I`ii�I�Er:_�•.. .5' ,"•. .. . j i�thc ='_'91311962 i uration�_93?b90 Tr' 95707 1 BRIAN PEWSON.3% 8o CRES7 CIRCL ' VVORC=STcr�.',1>lA OioD.i' CoMmssiane ' 1 REKE SAL 3Y ANI!DE,<SCIN SR(AN.,OEN.11SON 10" OTOS STREET •NOR T HBOROUCH, MA.0 l532 . :)?=CA7 ea BDIV,L u", CB420 oard'oiEuildirQ 1?eaulatiocs and Standards r HOITe 1IN7nOVE11ENT CONTPACTOR� '`N�g�r•-�1 R_gist��iaa__q��o0i '. ! = _~d12 •_•'—=TYP_=_lioplan_nt Card R=N-VVALBY A5? O 3RII;N DEM 164 OTIC `NORTH50R000H,Wi X1532 Administrator R b f f � f • r p n.--nom eke, !L'C�4"2� � ate_3a � d '' 4 is.moi :a 7 ra Ll�a 0 �l i7''m°a - �.v i7+ 9`I 0 _ ,^." ! '� I dAr�o C iCO...�r✓yril'•..Y'..;'� 1 lid'/0r,/�ri�a • . !...� E S`::PS 'r'-''� �.�. 1mSVED Aid A 0SLY AND SON._ S i�G ._'JO^�Z Uc"7Ow9 TH� ,Amn�, �;3:�R! a• HOLAEE.R,. s 6s '•r,.L:4l3'l� ;~ JGE� :3�'" y 11Plwt=:7'- MEPZ'Z LJ= Cot 3v r:��. �y 1 1'�rtVl r Iq x 333 � �d�. �•.- _�.=OE D ..a `,n! "UtdOrr. Ml 48105-0333. I!!~'SLI?E?S wi=- 0 t.- - l"" E s-vl OCG I mkic" Parra Pal by Anderson zi I IrEu�ERS �arfnrd Insurance orn=,!v windows, Inc. Nci hbor"Ugh, WIA 01532 1NSUFER D: COV vAG I IINSUif- V L E POLICIES OF IN-Ur-AidCE STEJ?=LOW '- Y.F ' LI - ::AVE SEEN!SSUED 70 THE INSUPED I ED a• etc ? -Pr` =OLSP. =NT i-Rkll GR COTd(h i 10N OF NCO ? ._ CU I'_J Aro- "O. Tr:� r ^ I'.sICATED..NC i Ihll'f AN k i ACT OR OT=crt 00 MEQ s WIT•r, rc_SPEC i TO WHICH THIS CErc i 1rICAT-e fRGy I STr,�IDIFIv i .N r=RTA1Fl,THE SivSURANC:ArFOP,DED S?Y T i_PPOLICIES rc- -�-I Ic aU- 1 - BE !-SUED OrLICIES, ._aC 1=ED H_..e.P! 1ECT 70 Ad. ,F!E TEE FhZ,EXCLUSIOfa�AND CONDITONS br'SUCH AGG?=• ATE L Ifdr.S-HOWN W IV FlkV_8_=" -9UCED 3 ec r Ili:sR act ---q R_ Y?AID CIh�. t-�lu;aol - - 'F ef'P NC POUCYp LMS R POL'~Wno Cl^r I`•E.:1G1'''tFl 010] �s,., • ,-an"ralr,�n«n L11ti.'I'S r P 507 40; 02/07/2009 11V0'/20111) I sacx D=PpEncs I 1 OrJn pOn � CCtfSi,S RCIALGENERAL LL';�'L,T; j Draw a . 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