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HomeMy WebLinkAboutBuilding Permit #088 - 85 HILLSIDE ROAD 8/1/2008 BUILDING PERMIT o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �4SSgCHUS�t� Date Issued: A / Af— IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER . +' .._ Pdn * " MAP.NO: , PARCEL: ZONING DISTRICT. Historic District, a yes° no Machine Shop Village -yes 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 Woiershed°District Water/Sewer - DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name:r�r)K IA.l Phone: qP? Address: CONTRACTOR 'Name: � f. Phone C fC.1 , Address: e./, "0- Supervisor's Construction,License: Exp." Dated!, Home ImprovementLicense: Yq 60_C}( Ex . Date: p. 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: $ (� , 7(.on LCIO FEE: $ 2 3 J Check No.: &077 b Receipt No.: o�2/3�7 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature ofAgent/Owner' .Signature of confractor - - m 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 f Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED f PLANNING & DEVELOPMENT I COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH -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 Located at 384 Osgood Street FIRE DEPARTMENT -Temp'Dumpsteron site yep no : Located at°124'Main Street=' M Fire Department signature/date 77, 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 2 1 A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 ❑ 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 DEPARTMENT:BPFORM07 Revised 2.2007 Location No. 19cy Date �oRTM TOWN OF NORTH ANDOVER 0 M Certificate of Occupancy $ 'ss+cwust< BuIldinglFrame. Permit Fee Foundation Permit Fee $ Other Permit Fee $ j; TOTAL $ Check # x 211 384 B ilding Inspector Window Agreement-Page 1 of 2 J&L Windows,Inc.,d/b/a 104 Otis St.,Northborough,MA 01532 Renewal MA Home Improvement Contractor (508)919-0900•Fax:(508)919-0903 License#149601(Expires 1/24/2010) Customer Service:(8001573-7606 byAndersen. Federal Tax ID#83-0404201 WINDOW REPLACEMENT a And rsmComp; y ,0 t� Product Manager: �F,LIs Window Agreement Contract Date: Homeowner(°Owner")'s Name(s): A M Street Address: _?ciNnCity/Town:A, tr State:{)1, ip: 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:4pExpected Date of Substantial Completion: 2. Contractor will Install a total of_windows in Owner's home,using the following individual quantities: Double Hung(DB) yd'5qual 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) Picture Window(PW) B or Bow Window: 3. es ❑No #Windows to be Custom Fit Replacement: 4. WKes ❑No #of sills to be replaced by Contractor: r � 5. ❑Yes PITO #Windows to be New Construction Full frame(includes new interior&exterior casings): Exterior casings: ❑Pine ❑Maintenance-free material ❑Factory applied 908 Fibrex brickmold 6. Glazing to be: ll?trigh Performance ❑Other If other,please specify: 7. Exterior color to be: ll7bhite ❑Sand ❑Canvas ❑Terratone 8. Interior color to be: 0 White ❑Sand ❑Canvas.❑Terratone "ood Note:Interior color can only be white,wood or same color as exterior. Wood interiors need to be finished by Owner. 9. Hardware:-0AVhite 11'Sfone ❑Canvas❑Brass Double Hung: Install lifts? ❑Yes Fd'IQ'o 10. ❑Yes ZHgoo' Contractor will remove metal frames or grilles. #of Units: 11. ❑Yes (. Wo 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 aware that Contractor does not do any painting. Owner initials 12. ❑Yes RIC Contractor will wrap exterior casings with aluminum coil stock of color. Note:Required with stormwin ow removal;removal of storm windows will leave screw holes in casing. 13. New windows to have: Oalf or ❑Full screens Screens to be: ❑Fiberglass 14 Aluminum 14. Windows to have grilles: M'Pes ❑No If Yes: ❑Grille Between Glass(GBG) C#'fl'emovable Interior Wood(INTW) ❑Full Divided Light(FDL) Grille patterns: #: #: #: #: #: #: #: 7 DH DH DH DH CW/Picture Glider CPW or GPW .use ad�'iional sheet if needed Owner approved(initials): 15. V'Yes ❑No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. 16. Ples 0 No A limited warranty shall issue to Owner upon completion of the job and payment in full(see reverse side). 17. R?Yes ❑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:. � � jll�1ZL,.x�f 19. Ves ❑No Owner has reviewed the Additional Terms and Conditions governing this Contract on the reverse side, including Owner's Three-Day Cancellation Rights pursuant to MGL c.93§48,c.140D§10 or c.255D§14(See Section 25). 20. Total Contract Price:$ 1 6,1 qL Regular Retail Price:$ All available discounts applied:C1Yes I-]No 21. Deposit(1/3): Q2paid by❑Cash ❑Finance (Account#: ) Second(1/3)$ lvk; c to be paid by Cash at start of job on (Estimated start date). Finn I(1/3)$ 1®fc,- i;—to be paid by Cash at completion of job on (Estimated completion date). 22. Q Yes ❑No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. No final pavment 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,Website:hftp://www.mass.gov/dps 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,and Owner shall be required to submit to such arbitration as provided in MGL c.142A. Contractor Signature: Owner Signature: NOTICE:The signatures 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 Windows,Inc.d/b/a Renewal by Andersen By: Produc M aiow' ne�SVlnature AIq 4,9A iw� Product Manager(Print Name) Owner Signature White-Renewal by Andersen Yellow-Installation Pink-Homeowner The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizadon/Individual): r' Address: City/State/Zip: Alii r1A p 61't1 l AJ 6'JSJ-)_ Phone#: CV�a t J �/`'�9 D 6 Are you an employer?Check the appropriate box: Type of project(required): 1.f&I am a employer with0 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. t 7• ,�Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g. ❑Building addition [No workers'comp.insurance S. ❑ 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. 0,152, §1(4),and we have no 12.❑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 isproviding workers'compensation insurance for my employees Below is the policy and job site. information. Insurance Company Name: ['�ep�� Policy#or Self-ins.Lic.#: ,j;� W� � r y1N Expiration Date:��o�_ Job Site Address: `) r((Si D R0&1) City/State/Zip:AI- /✓DOcJF_/Z.. 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. I do hereby c rnyy under the pains and penalties o rjury that the information provided above is true and correct Signature: Date: Phone#: Al - (' 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other `( Contact Person: Phone#: I i NIiGssachusetts- Department of Public Safety Board of Building Reg-ulations and Standards - Construction Supervisor License License: CS 98256 Restricted to: 00 SCOTT PHILLIPPI 58 0 STREET WHIMS.VILLE, MA01568. Expiration: 6/712011 Commissioner Tr#: 99256 Restricted to: 00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachasetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS ✓/ze -Pa�rrmzonu�ea�,l`/ o�./�aaaac�zuael;ya--1� ' Board of Building Regulations and Standards 1 HOME IMFAOVEMENT CONTRACTOR Regi.straRori:. 149601 E�tp�rafioi c EY2412010 Type_._Supplement Card ' =-' RENEWAL BY AN- DERSON = 4 : SCOTT PHILLIPP,G =--_ 104 OTIS STREET`.:��•��---�..;�,:' NORTHBOROUGH, MA 01532 Administrator ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDrYYYYI PRODUCER - 02/13/2008 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Joseph MCKeOne ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE JP McKeone Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 333 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ann Arbor, MI 48106-0333 INSURERS AFFORDING COVERAGE INSURED Renewal by Anderson NAIL# INSURER A: a. o sura ce C an ;v ; J&L Windows,Inc. INSURER e: Hermitage 104 Otls St C: Northborough,MA 01532 INSURER INSURER d: COVERAGES INSURER E: 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. [NSR=nLI POLICY NUMBER• POLICYATF EFFECTIVE POLICY EXPIRATION B LIMITS GENERAL HCP 607 404 09/07/2007 09/07/2008 EACH OCCURRENCE s COMMERCIAL GENERAL LIABILITY 1 00 OOO 7FAS 140 0 0CLAIMS MADE ©OCCUR person) S 5 000 INJURYS1 O000GATE S 2 000 ODOGENL AGGREGATE LIMIT APPLIES PER( � PJOPAGG S 2 000 000 POLICY PRO- I I LOC A AU MOBILE WABILITY 36 MCC XD 6390 10/01/2007 10/01.2008 COMBINED SINGLE LIMB ANYAuro (EA ecoldeny I S 1,000,000 X ALL OWNED AUTOS SCHEDULEDAUTOS BODILY INJURY S (Per per"' HIREDAUTOS NON.DWNED AUTOS BODILY INJURY (ParaeStlem) S PRO�eNtDAMUAGE S ) GARAGE uABILAY AUTO ONLY•EA ACCIDENT S 3::L OTHER THAN EA ACC S AUTOONLY: AGG $ EXCESSIUMBRELLII LIABILITY . EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S t S DEDUCTIBLE RETENTION S S A WORKERS COMPBNSATION AND 36 WEC PP 1444 we srgru- oTH. S EMPLOYERS'LJaeiLITlr 02/17/2008 02/17/2009 ANY PROPRIETORIPARTNERlEXECUTLVE E.L.EACH ACCIDENT S 5OO OOO OFFICERIMEMBER EXCLUDED9 tty�•describe untler E.L.DISEASE•EA EMPLOYEE S �jQQ QQQ SPECIAL PROVISIONS below OTHER E.L.DISEASE.POLICY LIMIT S 5QQ 000 DESCIIIPTION OF OPERATIONS r LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEp 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 DO SD SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE acaRo is(ZoouoB) G ACORD CORPORATION 1988 ' WtbrieiF rissh�cr, WoodNlnyI Composite Frane :ftiigC �d;L'� Dual. Argon law E Double Rung EXERGY'PERFORMANCE RATINGS • - ° U-Factor(U.S)/I-P Sotar Heat Gain Coefftient `' •A '.:.0 3 3' ADOMONAL-PERfORM-A'NCE RATINGS _ ••..._ '. t. . -.Visi•ble Transrni�tanc..e'• • � - ' : . • •.. M••rZ�elup.■YIwI.V•�Yrl4ui!•/inp.e.Mnnnb.�pl{c.OIe NFACpw.4in•f•e�.Me1i*iy.RI•I.�rdwr • ° ' p:i}iTrn••.N�ACirU•yrml(•l.!�hdF�r7Ar./�•e.l•Inhnm•�rl.�eaiMf.41�..M1(ap1•�r�Jh• -. - hf11G 1••.Mtga•ern•••it.••y prNael4njLan•I"9l ♦f•At/e�Mr11i•.�..Ir+iR-w�_ _ - • ,. .C•neuhnrMflieWnr`•AwnM•hf•Ih.rRr.dwly..l.p.l•no.eNn•n�•1,• •• • • • ' wv . - • DgslcN PR.ESt6RE•(PSF) , H - L C 2 .• . 1,00-00270239.012 , AW%'An 4i%. .-N.,V10 initX,Ir1NISUZ .+f..�wr• Viyw.6nw..c.Wlt. iM ..i..► - ' %4WOoftwobM•f.C'C.EC,AJAX.p•A4UOL1%900M-Th-V%kvYMWA4a1Mk6�.�I�r•.i• �N 0VA TH 4- over And ® d.®ver, Mass., $� o LA �. COCHICHEWICK ORATED PPS` �C7 BOARD OF HEALTH Food/Kitchen Septic System PE�. R MIT T _ D BUILDING .INSPECTOR THIS CERTIFIES THAT... �a ` ........ ....... �...... ..,.... Foundation has permission to erect.....................................:.. buildings on ...... ..t7..�.1. ./.S/ .....G4��r� .......................... Rough Chimney p �!• �•• .� �� ��:. �Z'....... . .. � ...... to be occupied as......... ........../� ... . . 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST'RUCTI S Rough Service BUILDING INSPECTOR .1 Final Occupancy Permit Required t0 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 SEE REVERSE SIDE Smoke Det.