The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 11 BEAR HILL ROAD 7/31/2015 %AORTH BUILDING PERMIT TOWN OF NORTH AIV VE 16VER APPLICATION FOR PLAN EXAMINATION 0 Perm!tNo#: Date Received 'y C U5 X Date Issued: 1AVORTANT: Applicant must complete all items on this page LOCATION. 'Yee'r- h"& Print PROPERTY OWNER ZPA4 Print 100 Year Structure yes n MA F PARCEL: ZONING DISTRICT: Historic District yes n Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building El One family [I Addition El Two or more family 11 Industrial El Alteration No. of units: El Commercial X Repair, replacement 0 Assessory Bldg 0 Others: El Demolition El Other DESCRIPTION OF WORK TO BE PERFORMED: -0/9 of oe Identification- Please Type or Print Clearly OWNER: Name: 7;4,q P11%ee c e 4 7- Phone: 9X7- 717 Address: // ,,*// A eZ Contractor Name: 4e,-,olow + Phone: f 7e- -el7fF- Email: Address: Zr -v'Aqo *12111dl Supervisor's Construction License: 0 Exp. Date: 7-P'- 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: $ ?7, foo FEE: $ .............. Check No.: Receipt No.: Ir L4 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fiend or" tk®RTH Town of Andover to T h ver, Mass, ki oLAK. COC NI CNE WICK V OAT S � BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ........... ... .�.�.�. BUILDING INSPECTOR .. .. ........... .G}� .� Foundation has permission to erect .......................... buildings on ....�. ..... ��... ...... ...�.1�........................... o Rough tobe occupied as ........... ....... .. ....... .. .... ..................................................................... Chimney provided that the person accepting this permit shall in everpspect 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 PERMIT EXPIRES IN 6 MG, THS ELECTRICAL INSPECTOR LESS CTIN Rough 91 �� iService ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy 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. N fil H11- �' 111BCL1t1k L�j d�ini, 8 L LED)'It N,G R 0. 8,ox 823 ?, IN a r d H!11, RAA 01835 MA Reg. # 118836 29 Arrowwood St. fy!Gthuen, MIA 0l 844, MA Lic# 016201 Date: 40 15 milt"V.1-1 Rech Corp.L-1 Z consultant: Ism 1,Klan`130-:_ 0 Qhd rt V1 6( 51� i o b Ad 61 res s:U& A' ' 5011(Xo��- t7f�cW �ILZJII i! CONTRACTOR agrees to start described work on/or about weeks after final fittings and complete descri be wo in about king days. i! �k 11�j b �A&kin CONTRACTOR shall not be held liable for delays due to causes beyond our control, Sic 1f11 The following work includes all labor and materials needed to complete your job in a w knial-iship like manner. FJOb Includes E]Combination Job-Siding With Other%,%Iotk Building and Elea Permit ❑ P.VC-Coated Alum Aluminum LAS .t ascia Trim Siding Removal i FasciEl Treatment if Soffit Trim Preparation Package Fascia ColorindoW Door Tirkin I Accessory Package Full Custom ❑Stitt ers In None LIZ Underlayment Ir-,:fin Sid ng Via W Gult cs ut Z-:Oiyit—U-eatrne L ownspouls emove Debris Lock.Elec.ropter Soffit Color —reparation IncludCenter vent es El Fully Vented ❑ ?,lon-Vented apiece Visible Rol —4 Location Venice as Needed i x ff F-1 Energy Savings I Bug Guard Starter Window And Door Casing If eaiment VWindow And Door Accessory act,age Includesti„ Formed J-Less ❑ Full Custom Form_ I Color.- eta V Blind Ste Capping UNone ii Vinylight Blocks L tiont Vinyl Dryer Blocks (JO Vmyl Electric;Outlet Blocks Vinyl Exhaust Vents Gutter a Do,;Afn'zzn—gf� Vil'91 Faucets BlocksVir Downspouts Color nyl Gable Vents P AVIAh Me. 'Itt V Underlayrnent Insuia Ion To Used0 ecial Notes 17 OS Hi-Tech 318 Other 11 Location _s�tC e Area To Be it Complete House it Garage I -1ding To U1114 OW 4A hi U Cofer 0 Pa n Ir Brand 1 Bank Financing F-1 Owner To Arrange Profile rl Ven Hi-Tech To Arrange L4n o ❑Cash Or Check ❑ khaster Card Corner Post To Be Used Corner Post Color: Total In I Or v estnient Insulated :93=�70c), oo E]'Aider ❑Wide Non-Insulated 1/3 Deposit 11 LJ Regular Insulated ❑Regular N-11-111,1-lated 1/3 Payment 11 1/3 Balance of Day Completion YOU May cancel this agreement if it has been signed by a paily thereto at a place other than the address of the seller,which be his main n office or branch thereto, provided you notify the seller in writing at his main office Or bre by ordinary mail pos by te(eql�alnrt M I ay sent,or by delivery,not later than midnight of the third business day following the signing of this agreement.See ed, 11 the attached notice of cancellation form for an explanation Of this right. iiAn interest charge Of 1.5%per month(18%per year)v411 be added to any amount unpaid after 30 days from invoice date. tl �.n Date of Acceptance -lo(()—lS an ellorney for Mart Of this order or any Part thereof and the account is fao cti.a.the Purchaser agrees to pay toago_bio ottoo,of,(0_ I/We give Fit-Tech permission to obtain all necessary permits. Signature ISignature Signatur f (1-fi-Tech The Commonwealth of Massachusetts F Department oflndustr^ialAceldents 1 Congress Street,Suite 100 Boston,MM 02114-2017 `. •4�t www.mass.gov/dia ,�. Workers'Compensation Insurance Affidavit:Builders/Contractors[FIectricians/Plumbers. TO BE FILED WITH THE PERAUT IENG AUTHORITY. Applicant Information ,e Please Print Legibly Name`(Business/Organization/Individual)- / ,%—/e-c44-m-4 Address: Of City/State/Zip: lqe�14,ver ,vt _�*W Phone#: g7k-41rrf . Areyou an employer?Check the appropriate box: Type of project(required): 1.�I am.a.employer with employees(fulland/orpart time).* 7. [❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required] • 9. E]Demolition 3.Q I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 D Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. ROOF repairs These sub-contractors have employees and have workers'comp.insurance.1 6.❑We are a corporation and its officers have exercised their tight of exemption per MGL C. 14.Z Other 10 152,§1(4),and we have nqp riployees.We workers'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 flus affidavit indicating they are doing all work and then hire outside contractors must s4bmit a new affidavit indicating such. TContractors that check this box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-conlraclors have employees,Viet'must provide their workers'comp.policy number. dam an employer that is providing workers'compensation insurance for my employees.'.Below is the policy and job site information. Insurance Company Name: XPfA /" V'' Policy#or Self-ins.Lie.#: " ✓ �Ire ��° Expiration Date: Job Site Address: 04IfA * `' #'V City/State/Zip: ' Attach a copy of the workers'campensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORD ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjuty that the information provided above is true and correct. Signature: Date: Phone 4: Official use only. Do not write in this area,to he completed by city or town official.. City or Town: Permit/License## Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 4: ii:06 `�f A;' h.i 1 1(;-tU(iE INS A 3T ((:J!1—G:) FE:C,I'I: j.U(11 I:1�—'i'r ,- P.,GE all; ril 1 /I 1 J�8 3�.�3360 y:`Tp: n o CERTI CATS E LIABILITY INSU NCE ' DATEw?6VD0(YYVYI THIS CERTIFICATE IS 15SUEb AS A MATTER OF IWFORh1ATION ONLY AND CONFERS ND RIGHTS UPON THE CERTIFICATE 1 /1/1012014 11 CERTIFICATE DOES NOT /IFFIRMA7(VELY OR NEGATIVELY AMEND, EXTEND OR ALTEE�. THE COVERAGE AFFORDED BY THE PO lITHIS I CIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. the terMS an If the ioncers nate holder;s an ADDITIONAL INSURED,the pDlicy(ies)must be endorsed. tF SUBROGATION IS WANER, subject to the terms and conditions of the policy,certain Policies may require an endorsement. A statement on this certK(cate does not conFerrignts`o the certifI 4tr;holder in lieu of such endorsements. PRODUCER BARRY J KITTREDGE INSURANCE CONTACT 81 S MAIN ST NAME: ! g BRADFORD, MA 01835 PRONE EMAIL IL-0 11• FAX t r INSURER 9 AFFORDING COVWcRAcar t1A1CB 3 INyUREO DISURERA= LM Insuranre Corporwon HI-TECH WINDOW a SIDING INSTALLATIONS INC33600 29 ARR.OWWOOD ST a1suRERe: ! METHUEN MA 01844— W$URER C: a,suReao, ( 9 QISURERE: ; THIS I ES CERTIFtCATE NUMBER; �SURERF: TNIS IS TG CNOTW6Y THAT THE POLICES OF INSURANCE LI5}ED BE OzWDHAVE BEEN I$$(lED To THE INSURED NAMED ABOVE FOR THE POLICY PER I00 REVISION NUMBER: INDICATED. NOT4V(THSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OP. OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED UR MAY PERTAIN THE INS()RANCI AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUcJECT TO ALL THE TERMS,. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LI'altl$SHOWN NAY HAVE BEEN THE POD BY PAID CLAIMS, iN$R LTR TYPE OF IN9uRANCE Sl.SUER COMMERCtAL6ENERALLiA$lLfTy INSD VIVO POLJCYNUMBER pJLICYEFF IpOun EXP nVn Uram i ll CLAIMS-MADE OCCUR EACH OCCURRENCE S ------------ i P 9AUETO' S l MED 59—(Any ana pomm) S )� C3EN L AGGRIaCATE LIMMAPPLIES PER; PERSONAL 8 ADV INJURY S ) POLICY[D-PRO- JECT LOC GENERAL AGGREGATE 5 OTHER. PRODUCTS-COMPIOPAGG 5 AUTOMOBILE UABILTTy ANYAtITO f aBJdnat b 1 S UTO-/NSD SCHEDULED BOOILYINJURY(PerQarean) 5 i Q AUTOS HIREDAL AUOTOS��CD BCDILYMURY(Pcacrideet) S ! PROPER TYDAMAGE ! ' uMSR1;Llq Leat; Pa, S ! EXCE9d 61-8 OCVJR CLAiMS•MADE I EACH OCCURRENCE S I IiFD RETENTIONS AGGREGATE S A woWERR COMPENSAIION S AND eStFLCYIE"'L ILITY WC5-31S-607R1d-(114 10/31/2014 10!31!2015 PER foVYPROPRIETOPLPARrNER/Ey.ECUTNF_ �YIN - v TATIIT �- �j _� OFFICE 0AIE(1'BERexCLUOED?N14) F N N/A 1 it aadalory'rn and EL EACH ACCIDENT 9 50Ut�'00 D a;,d�crba under DESCRIPTION OF OPERATIONS(!-lawI F-L-0IGEASE-EA EMPLOYE S 50O OO E.L.O(SEASE-POLICYLIMIT S I 5001TOD DERCRfPT*N OF OPERA"O"/LOCATIONS(VEN(CLES(-CURD 1Ut,Addivanol Ramirkr Schedule ., ,may beattachedifmoreapacelaraqu(red) ! Workers compensation insurance coverage applies only to the tivorlcers compensation taLva of fhe 51ate(s)of N H This certificate Lancets and supersedes alt previously Issued cefficates,only as they relate to vmrkem compensation coverage, i I - i CERTIFICATE HOLDER S CANCELLATION r SHOULD ANY OF THE ABOVE DESCRIBOp,ED POLICIES BE CANCELLED dEF014 I ACCORQANCEWIFHDT1AiEPpLNjCYPROVtS(ONNOTICE WILL BE DELIVEtiED 11 1 I ADYNORIZEn REPRFSENTAT(vE 41 — - Ltd Insurance Corporation ��1� ,,� AC-ORI?25(2014/01) 0'1988-2014 ACORD CORPORATION. All right&rssery cm— E6T ((G,: The ACORD name and(ago are registered marits of ACOftO 4:315259 i r'L:=`-CODE: 1017190 Otdi l9ncas !u/_ i . '1:5':57 A"A:1 (_J Fai¢1 oL L 1 I °I I V�e "V It, eveccle/a, I fice of Consumer � �JJccc/zare&j t' Affairs&Business Regulation — E IMPROVEMENT CONTRgC7OR — P egistration 118836 P n Ex iratid 9/26%2017 TYAe: HI TECH WINDOW&;SIDINGjj�STALL INC Supplement C�' TIM WICKS I 29 ARRO WVl/OOD ST � � METHUEN,MA 01844 Undersecretary Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-096516 TIMOMY W WI ks 3 ELLIS STv wrf r Methuen MA 01$44 �t . Expiration Commissioner 09/09/2016