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HomeMy WebLinkAboutBuilding Permit # 6/17/2015 F N1 q BUILDING PERMIT 0� L� TOWN OF NORTHANDOVER APPLICATION FOR PLAN EXAMINATION * - - � Z n 4 Permit NO: �� � � Date Received � q°� <°R.gTe T,F 7 A o Date Issued:41 I PORTANT: Applicant must complete all items on this page / ;„„„ .,,"✓ r � ./,( ✓i/, ^» ,:.. ,��r,:. r, /,"; Gi. �r /r';i 6r/ r r r L,„,r/// ,,, ,,. /ir rii. //1/r r I r i /,/� r f 1, r r //✓ r J i / r/I rr// ✓ l / 6 sir„j / ) r r ,. r/ r / ✓�, / r.. /rr%rr rr r/// ,.r/lr rrf”/r� ti//er; '�% / r/l/l/ !i /l/ r / / r ', r p �%° r � // r/ ✓;/ 1/r /rr l�, r!,iii ,ir rlr .,.r rrOr/...'n 1,%,.:./! r „w /i/i;.c�, ,ir ,,.,r „ ,,, :/ r ” I ,,, !r%/ r,rr/i/„!�. /J%�//J/ in,//rr ri.,,., l/ '%✓. rY r /% �� // �.. r r � ;�,.,,I r/ of ;,,.., I/ /i � .rfi r rr,. r 1. „ „ „� r U,,,/r r /, ✓ ,,,, � /r/ /r1%/i rf r� :-./i r r ✓ ✓;,rr>,r,�e�„ / ,<„�,r.✓, j ,�',.> r/f ;/r f/- PRCOPE rrr rrirr r i � r r r r j. l / ri r r .✓ r ,.,. rr ///r / rG r// ,i% r f{/ r /f /r / r-, , 1 / ✓/f� rr// ri / l� /r/ r / rrr / �r�/ / r bl/%rr r r M h�n�i����p%;V��lage y�i.�l. �!!�Q fl U l': aC TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential \4 ❑ New Building [v ne family 11 Addition 11 Two or more family [I Industrial VAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well Elf loodplain/ We and sh rtl s ed r r ❑ t � ❑ a r. 0;W016 �s r P .. l (� +L , l/' / 1 d I'f�e C.k tyl1.%°s"..i., /a i K CIG-AJ c Identification Please Type or Print Clearly) OWNER: Name: �rt i r dPhone: Address —1 )C e � , K,,4/ Ale,,, e,� do v ee,, 11114- 1 / r//r r rr% Tw✓ r/ .r � , r� / r �r/%l/�r r / r r r r / 1 r ^*” r � 'uervisor's Construction License Date p ✓ r r l ;r / '� / f,: 1 ,r r r r /1I ,,; ,,,,%r/rri /�l/% ,r :,;i /i ,r/ /r r,,. r /. / ✓ r -:r r. / a r Hoene ern ARCHITECT/ENGINEER Phone: Address: Reg. No. p\ FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. a Total Project Cost: $ < 0 FEE: $ n ” Check No.: , ' Receipt No,: .4 ' 2. NOTE: Persons contracting with unregistered contractors do not have access to e uaranty fund Signafiure°of'Agent/Owner Signature of contractor tkORTH -rown of ndover WNW W No. _ Y ` �O LAKE ver, Mass 2 COC NI C NE WIC K' RATE' t1 BOARD OF HEALTH ijE MIT T D Food/Kitchen Septic System THIS CERTIFIES THAT ........ . ...r.: ':.'.... isc��.......................... ................................................ BUILDING INSPECTOR bd /',-// f,, n4— Foundation has permission to erect .......................... buildings on .2........................................................................ ��J Rough to be occupied as e � F /�G d- G" find% 7SCc�5............................................ 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 PERMITIES IN MONTHS ELECTRICAL INSPECTOR UNLESS C S CT N TARTS Rough Service ........ . .. .......AGN...................... Final BUILDING INSPECTOR GAS INSPECTOR ccupancV Permit Required t® OccupV 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. ,, /� �+��pp`' //11u�+ A & A SERVICES, INC. A&A SUNICES 115 NORTH STREET, SALEM, MA 01970 Telephone:(978) 741-0424 Fax: (978) 741-2012 Contractor Registration No. 101609 Construction Supervisor No.CS057733 Federal EIN: 04-3090162 CUSTOM REMODELING AND IMPROVEMENT AGREEMENT Buyer(s) Name Date of Contract )3 f Buyer(s) Street Address,City,Slate and Zip Code Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address 2 9:x-,36-3(b The Buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed on the accompanying specification sheets,in accordance with the prices and terms described on the front and the reverse of this agreement and any specification sheets(this"Agreement"),and Buyer(s)have requested that such goods or services be installed or provided at Buyer's address listed above.A&A Services,Inc.("Contractor"),hereby agrees to install or cause to be installed the products or services listed in this Agreement at the Buyer(s)address written above.This Agreement represents a cash safe of goods and services.The Buyer(s) agree to pay in cash the cost of the goods and services purchased as described herein,regardless of timing or approval of any financing Buyer(s)may seek for their purchase. Purchase Price: 0 Est.Starting Date: Down Payment: (5�r� l� c�7 A Est.Completion Dale: 1 Cash IT Amount Due on Start of Job: (,( 0,Check Credit Card Amount Due on of Completion: No. Amount Due on of Completion: Expiration Date: Balance Due on Upon Completion: CVC Code: It is agreed and understood by and between the parties that this Agreement, front and back and any addendum, constitute the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms of this Agreement.Buyer(s) hereby acknowledge that Buyer(s)has read the front and the reverse of this agreement and has received a completed,signed and dated copy of this Agreement,including the two attached Notice of Cancellation forms,on the date first written above.Buyer(s)also(t)acknowledge that they were orally informed of their right to cancel this transaction;and(it)request that they be contacted via their telephone numbers or email,as listed above,in the event Contractor believes Buyer(s)would be interested in any additional quality products or services of Contractor.DO NOT SIGN THIS CONTRACT IF IT '.. CONTAINS ANY BLANK SPACES. '.. A&A Servi. s,Inc. Buyers By: ti� 2/Signature �LJ� C/ Signature Print Name U c� eL /Z%ti ✓ ��SC/ft!� Print Nam Signature Print Name You,the Buyer(s), may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the following Notice of Cancellation form for an explanation of this right. ARBITRATION:The contractor and the homeowner hereby mutually agree in advance that in the event either party has a dispute conceming this contract,either parry nay submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs/and Business Regulations and the other party shall be required to submit to such arbitration as proved in M.G.L c.142A. cnmmanr imbia B.)&.,Initial,:Da tc: Datc:----��4� NOTICE.1 CANCELLATION NOTICE OF CANCELLATrON Dale of Transaction o� You may cancel this transaction,without any penalty or Date of Transacfiw r .You may cancel this transaction,without any penalty or obligation,vrithin three bu ness ays from the above date.If you cancel,any property traded in. obligation,vhthin three b Ines days from the above date.If you cancel,any property traded in, any payments made by on under the Contract or Sale,and any negotiable instrument executed any payments made by ou untler the Contract or Sale,and any negotiable instrument executed by you will be returned within 10 days following receipt by the Seller of your cancellation notice, by you will be returned within 10 days following receipt by the Seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled.if you cancel,you must and any security interest arising out of the transaction will be cancelled.If you cancel,you must make available to the Seller at your residence,and substantially in as good condition as when make available to the Seller at your residence,ana substantially in as good condition as when received,any goods delivered to you under this Contract or Sale;or you may,if you wish,comply received,any goods delivered to you under this Contract or Sale;or you may,if you wish,comply with the instructions of the Seller regarding the return shipment of the goods at the Seller's with the instructions of the Seller regarding the return shipment of the goods at the Seller's expense and risk.If you do make the goods available to the Seller and the Seller does not pick expense and ns�.If you do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice of Cancellation,you may retain or dispose of the them up within 20 days of the date of your Notice of Cancellation,you may retain or dispose of goons vAthout any further obligation.If you fail to make the goods available to the Seller,or if you the goods without any further obligation.If you fail to make the goods available to the Seller,or fi agree to return the goods to the Seller and fail to do so,then you remain liable for perform—of you agree to return the goods to the Seller and fail to do so,then you remain liable for performance all obligations under the Conuact.To cancel this transaction,mail or deliver a signed and dated of all obligations under the Contract.To cancel this transaction,mail or deliver a signed and dated copy of the cancellation notice or any other written notice,or send a telegram,a ASA erices, copy of the cancellation notice or any other wotlen-"or send a telegr to A Services, 115 North Street,Satem MA 01970,NOT LATER THAN MIDNIGHT OF r 115 North Street,Salem MA 01970,NOT LATER THAN MIDNIGHT OF j �'-- tot ! I 1 I HEREBY CANCELTHIS TRANSAC iON 1 HEREBY CANCELTHIS TRANSACTION Consumer's Signature Date: Consumer's S linatwe Date: AGrade �J 16r Above A & A SERVICES, INC. Siixe 1982 115 NORTH STREET,SALEM,MA 01970 Telephone:(978)741-0424 Fax:(978)741-2012 Contractor Registration No. 101609 Federal EIN:04-3090162 Construction Supervisor No.CS057733 WINDOWS AND STORM PRODUCT SPECIFICATION SHEET Buyer(s)Name Date of Contract Buyer(s)Street Address,City,State and Zip Code 7 c bw -<A, kul Daytime Telephone Number Evening Telephone Number Mobile Telephone Number E-Mail Address t 19' 6873 11-3h�d -F I The Buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on this Specification sheet and the front and the reverse of the accompanying CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,of which this Specification Sheet is a part. WINDOW REPLACEMENT _ S�ri�s, lf (-'SRemove and dispose of# ;(V� existing windows. � �` � ' ��5 � Install # "I-Wp-l U>✓ new S i()9 rf Sc-- windows:Ginyl t Wood (Manufacturer) Options: Style Vr��thle _ r�.r�u1� Grid pattern Color Interior W k J Color Exterior V11�t � GtJ2 Glass Type. O 'r _ Wrap exterior trim with aluminum: Style Color Ktj LDv�F 1� �AII windows will be installed according to the installation procedures in the portfolio. ��(c� `�C` Caulk all interior and exterior edges. 7 �vel—, CCC ��sc r revs r hE rC��s_7 Si �,�,j Insulate where possible around new units. T Insulate window weight pockets if exist,and around new window units where possible. Included in this proposal are set up,clean up,Hepa vacuum and cleaning windows inside and out. wilding permit included. BAY/BOWS/CASEMENT UNITS/ANY FULL CONSTRUCTION WINDOWS t Create new window opening by cutting through existing home and framing in opening. T Remove and dispose of existing unit(s)in its entirety. Note:Electric and plumbing may exist in wall and will require additional costs to customer if need to be dealt with. T Install window(s)into opening(s). Note: If Bay or Bow installation to include cable support system,new roof system(matching color as close as possible) or tie into existing soffit system. T Bay `t`Bow t Casement t Other window(s)to include new interior style trim and new exterior style trim and head flashing as needed. Note: Painting and staining not included. STORM PRODUCTS I Remove and dispose of# existing storm window(s). T Install new storm windows# Manufacturer Style Color Option t Remove and dispose of# existing storm door(s). t Install new storm doors# Manufacturer Style Color Type: h Aluminum *Solid Core SPECIAL INSTRUCTIONS: QA) Cl T j 1 GT 9 t� —r h[/as>n Cc2(/i/C�v'�N//u /��Su_ f�� It is agreed and understood by,and between the parties that this Specification Sheet,along with CUSTOM REMODELING AND IMPROVEMENT AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms.This contract may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and the Contractor. Buyer(s)hereby acknowledge that Buyer(s) has read this Specification.Sheet. Contractor Initials: L Date: S /71 Buver's Initials:--- Date: r✓/S The Common wealth of Massachusetts 40 Department of Industrial Accidents Office of Investigations 600 TVashhigton Street, 7`t'Floor Boston plass. 02111 4' Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors Applicant information: Please PRINT let=_ibly /,,�1`�tn�,���bC' �G`I���• address: // 57 / VO tTtA city f5a t-e m 11 /� state: /M A zip: 6/7-70 phone#vyt/ AJ "7 VI—e work site location(fitll address): 1(�� Ell' �!d/ ' 7 C�t�1 /Z /Via f l/1 cloV'�Q!Y'`� !'(iq o ❑ I am a homeowner performing all work myself. Pro.ject Type: ❑New Construction❑Remodel ❑ I am a sole proprietor and have no one working in any capacity. ❑Building Addition R1 I am an employer providing workers' compensation for my employees working on this job. company name: A -f— A— k trV f address:C ( I •5^ A V C3 �1n — �i city: /, (�", 'Y t phone#: �Ot� !�'� Lf Lr°. insurance co. �-a V 'S poliev# � ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city: phone#: insurance co. nolicv# company name: address: city: phone#: insurance co. policy# Attach additional sheet if necessary Failure to secure coverage as required under Section 25A of.IGL 152 can lead to the imposition of criminal penalties of a rine up to SI,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the ffice of Investigations of the DIA for coverage verification. 1 do hereby certify tori e th'Painv and p naltiev of perjury that the information provider/above is true and correct. Signature// -66Date C�` _ Print name C, I V- f Lo Phone# f -7 0 —7 7 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone H; ❑Other (revised Sept.2007) Jun 101511;18a The Insurance Advisory 781-449-3511 P.1 A� CERTIFICATE OF LIABILITY INSURANCE DATE(MM9/2 014 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 CONTACT NAME: The John M.Sullivan FnsuranceAgen PHONE 781-449-9330 FAX 787-449-3511 P.O. Box 920047 E-MAIL ss: sullivan.insadv@verizon.net /vc No Needham,MA 02492 INSURERS AFFORDING COVERAGE NATC# INSURER A:The Travelers Indemnity Co 11347 INSURED INSURER B: A&A Services,Inc INSURER C: 115 North Street INSURER D: Salem, MA 01970 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2,403REVISION 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- 1 T R TYPE OF INSURANCE AODL SUkffi ER POLICY NUMBER MMIDD�Y MM/LDI DIYYW Llhirrs EYP LTR GENERALLIABIUTY EACH OCCURRENCE $ COMMERCIAL PREMISESRCIAL GENERAL LIABILITY DAMAGE O RENT D 'Ea000urrence $ I CLAIMS-MADE OCCUR MED EXP(Any one person) $ i _ PERSONAL&AOV INJURY S GENERAL AGGREGATE $ G Nl_AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG S POLICY ` PRO- LOC 5 AUTOMOBILE LIABJUTY COMBINED SINGLE LIMIT a eccdectl $ ANYAUTO BODILY INJURY(Por person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per 5 I HIRED AUTOS NON-OWNED i I PROPERTYDAMAGE $ AUTOS Per acc!dent I $ I UMBRELLA LIAR 1 OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-NIADE r AGGREGATE S DED RETENTION S g WORKERS COMPENSATION ( AND EMPLOYERS'LIABILITY YIN 9/13/2014! WC STA i OTH- ANY PROPRIETORIPARTNERJEXECUTE 9/13/2015 NE.L.EACH ACCIDENT $ 5501}000 A OFFICERIMEMBER EXCLUDED? N/A 6KUB-0243M81-5-14 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 5 500000 If yes,describe under DESCRI.DTION CF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I S I I DESCRIPTION OF OPERA71ONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 Osgood Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 1N 9 ACCORDANCE WITH THE POLICY PROVISIONS. Building 20,Suite 2035 North Andover, MA 01845 AUT14ORIZEDREPRESENTAME ©1988-21110 ACORD CORPORATION. All rights reserved. ACO RD 25(201D105) The ACORD name and logo are registered marks of ACORD Cer 1at2 IND A043006 _- TFCE COMMOW" EALTH OF MASSACHUSETTS MQUIN - E'\- (_Ti'> OFFP=E(-)F L_\_; AV) W;C � EL (:.FORCE D�- C> .(, ;T - �= DEPARTMEfNT OF LABOR STANDARDS 19 ST NIDDRD STUFT, SoSrO\, I\,I-aSSA,-F(USETTS 02114 DELEADER CONTRACTOR LICEitiSE A & A SERVICES, tNC. 115 NORTH STREET SALEM{ iMA 01970 LICENSE: DC000440 EXPIRES: Sunday-,June 07, 2015 [N ACCORDANCE V,'ITH tMLG.L.. CH. I 11, § 197B(b) AND 454 Cl%JR 33.03,THIS LICENSE IS ISSUED BY THE FL)EP,`.DTEN'T 0:= LABOR STA'(D.�RDS TO THE CO\ITF ACTOR,ABOVE FOE THE PUP-PO SEE OF ENTERING INTO OR ENGAGING CN DELEADINIG WOR-K. THIS LICENSE IS VALID FOR A PERJOD OF ONE YEAR. TF[TS L[CE'+`SF `.[UT BE MA1v'TAf',;FD BY THE CONTR-ACTOR V'HEN ENGAGED Fyi DELEADIy"G WORK IN ACCORDANCE WITH tMLG.L. CH. I I 1 § 197B(b)(3) AND 454 CMR 33.03. HFATHea E. Rrw;T, DIRECT�:-R�- OfC00311mer. Mors& Bu;inas;R ;;l:;ca,i -HOME IMPROV=prtENTCODITR,ICT7R >> CS-057733 https://elieense.chs.state.ma.us/eGov/�Veb/PaymentResult.aspx?anstw. Application Submitted Your application has been submitted and all fees have been applied to your cred t card. Please print this page as your proof of submission and receipt of payment. Application Information 'Date Submitted: Wednesday, May 06, 2015 Applicant Name: CHRISTOPHER ZORZY License Number: CS-057733 !Agency: MADPS !Process: Renew License process Pavment Information Authorization Code: 126001 Received Date: 5/6/2015 9:26:33 AM Received Amount: $100.00 MAY 0 5' 2015 of I 5/6/20t5 9:26 AD