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HomeMy WebLinkAboutBuilding Permit #672 - 91 FULLER ROAD 4/19/2007Permit NO:(;, i -� Date Issued: Y �1l 6 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received iv -49-117 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family 0 Addition ❑ Two or more family 0 Industrial ❑ Alteration No. of units: ❑ Commercial WRepair, replacement ❑ Assessory Bldg ❑ Others: 0 Demolition ❑ Other 0 Septic 0 Well 01FIloodplain,j, 0 W6t6r ft .,=- 0 W tehsl edI Distract,,,. 0 Water/!Sewer x f DESCRIPTION Of WORK TO BE PREFORMED: INaimhc- SO ),o r OWNER: Name: Address: 7l �Gll� D�r/I CONTRACTOR Name: Supervisor's Ganstr�iction"License: Home Improvernent f.rcehse6: !�f ,Please Type or Print Clearly) %/Y V, «rV•-*ter �, - � • . p. Date` r r-, :0Z 1'7' 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: $ 2-0660 FEE: $ a 9le— Check No.: 1S162 Receipt No.: �2 o/z o' NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Sk Signature of contracto Location q/ R,/ NO. 6 -7,Z Date TOWN OF NORTH ANDOVER Certificate of occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 20 z 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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED DATE APPROVED 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 w"Tem Dum - ster on.s'ite' :. P p yes_ no . Located at 124 Main Street 'Fire department signature/date m F r _ e COMMENTS - M. G 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 0 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 CO) iii M M CO) CO) m = CA C � — d CA o Z y CL V. O � C CL = y n� � o m ."! CD o p CDCL o o• =r CD CCD o CD C CD CAS _. CD CL p y O C=D s` O 00 C Mrim a y :v N C MM .-► r z �a y -�OOO O a ? m �wa = m C o ao e ar mmm om CL IV* m m am _ c � d :� fIEA � O COO o C+ mo� H � O ry, � m .T N mm. a� C z 0 r CA v Cf) V1 o al :v � a r z n *Q 1 � a Z!t O C A, r� EXPERTS Full Worker's Compensation Coverage $2,000,000 Liability Insurance Coverage Warranteed work Excellent Financing Plans available United Home Experts & United Painting Co., Inc. 200 Butterfield Dr. Suite I Ashland, MA 01721. 508-881-8555 FAX 508-881-5584 www.unitedpainting.net MA HIC License # 130101 RI REG # 22948 PAGE 1 Project: Exterior siding Bid Date: 11-9-06 Attn: Gaylyn Reilly Phone #: 978-689-2453 Company: $1564 Work #: 978-609-6224 Address: 91 Fuller Rd. Fax #: Email: mereillygcomcast.net City, St. Zip: N. Andover, MA 01845 Heard of us by: Referral- Jackson lumber Base proposal as per attached scope of work:,, Q Siding and trim work as specified on page 2 $980 Painting work as specified on page 3 4 5.4t. ; H w. .1 3 sv. ' 4 $2070 3 �� y� ©. ` Option 1- Add additional trim replacement: all Window frames, soffits, and eaves (painting wouldn't be needed) $4651 Option 2- Add new seamless aluminum gutters and downspouts (white) $1564 Alternates: Any additional customer requested carpentry work will be billed at 48per hour + materials. Prices good for,30 days PAYMENT: A non-refundable deposit of 1/3 of the accepted proposal int m(s) _ amount is due upon authorization in the amount of $ A with 1/3 due upon half of completion in the amount of $_7S-00, and the balance due upon completion in the amount of $ %S' D, + any custorrler options DISCLOSURE: State law requires us to inform you of contract liens. Any contractor, supplier, or subcontractor may lien your real property if you or the general contractor fail to pay for goods or services delivered or installed at the work location. Some contractors and suppliers automatically send letters of notification similar to this notice. At your request, we will provide original lien release documents from anyone who provides said materials or service. Please call if you have any questions regarding liens. LJ 64; ACCEPTANCE: The signature on this proposal reflects acceptance of the proposal as per the attached scope of work, authorizes commencement of the work, arf'd hereby guarantees payment as outlined above. Any amounts not paid within thirty days of invoice are subject to service charges of 1 '/z % per month (18%APR). All costs of collection, including reasonable attorney fees are to be paid by the customer. �7 ysA =' Contractor signature Date Cust er i nature ate BBS DISC"YER Great People, Quality Service, Fair Prices, That's United! m U%0Z =HD-1 Dcm Z-Ir� Pm>= K�0� omZm N m ,o m C/) -� -i - m - n M m 0 � Ul N �N 0 7 CD CD 3 00 0) oUOD v3 N 7 n N C CL 0 CD �tz 0 0 C O n o " CD o CD � N 7a (=> . 00 Client#! 27859 1 1 NI ITC ACORD- CERTIFICATE OF LIABILITY INSURANCE (MM/D INSR 0DATE 4/17/ 4/17/07 7D/YYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Herlihy Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 65 Elm Street Worcester, MA 01609 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. GENERAL LIABILITY 508 756-5159 INSURERS AFFORDING COVERAGE NAIC # INSURED United Painting Company, Inc. 200 Butterfield Drive, Unit I Ashland, MA 01721 INSURER A: Acadia Insurance Company INSURER B: American International Group INSURER C: INSURER D: INSURER E: COVERAGES 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. LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE MM/DD/YY POLICY EXPIRATIONDATE DATE MM/DD/YY LIMITS A GENERAL LIABILITY CPA011338711 04/15/07 04/15/08 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAMAGE TO RENTED occurrence) s250,000 PREMISES (Ea MED EXP (Any one person) $5,000 PERSONAL 8 ADV INJURY $11,000,000 GENERAL AGGREGATE s2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY JEC LOC A AUTOMOBILE LIABILITY ANY AUTO MAA011338812 04/15/07 04/15/08 COMBINED SINGLE LIMIT 1,000 (Ea accident) $1,000,000 ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $NY OTHER THAN EA ACC $ A AUTO 1 AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY X OCCUR FICLAIMS MADE CUA011339112 04/15/07 04/15/08 EACH OCCURRENCE $11,000,000 AGGREGATE $11,000,000 DEDUCTIBLE RX $ RETENTION $ O $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC8960828 08115/06 08/15/07 OTH- WC STATU- IR RY IMI E.L. EACH ACCIDENT $100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Oyes, describe and EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $100,000 E.L. DISEASE - POLICY LIMIT 1 $500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS John Dudley 200 Butterfield Drivve Suite 1 Ashland, MA 01721 OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _20_ DAYS WRITTEN TICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 'OSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ZEPRESENTATIVES. AUTHORIZED REPRESENTATIVE U, 4 iF-51.0041 DAF O ACORD CORPORATION 1988