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HomeMy WebLinkAboutBuilding Permit # 8/6/2015 _ 7 r i' pF NoK rH q BUILDING PERMIT �� yt�1``p °•e"°0 TOWN OF NORTH ANDOVER � ° APPLICATION FOR PLAN EXAMINATION Permit NO: � Date Received � �.� ,`� 41 Date Issued: h sAcwusi�� IMPORTANT Applicant must complete all items on this page LUATI�N °,` "` r � � 77 PROPER;TY r � ✓,: , r t MA°P Nb ���� PARCC.., ��ZONING b�STI�ICTf� Historic D�str'ct �s no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential D New Building ❑ One family [ I-Addition Two or more family ❑ Indus ❑ Alteration No. of units: a ► ❑ C mercial Repair, replacement Fl Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ peptic WII ❑ �iopla�n �s�r �❑ wxrsfail'Des z r Ref--Acsce Ao r-5 0.......... FrA M `1 f)CY Identification Pl 7eTypeor Pl int Clearly) OWNER: Name: V / Phone; 9`789639 Cl Address: CQNT�AC `GI loam h Addres t4 $U( C til'I0r'��,� 4r1 �f1���1t��M��l ��� � ' � ; ; fY fn 1184 1� 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: $ FEE: Z , Check No.: Receipt No.: t ` NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fu d Signature;o Agent ern Signature of contractor t% RTH It F Town of ndover 0% No. h Z `, ^� CC e ® LAKE �e�9 �VVy COCAkkni CNEWICK IMF- BOARD OF HEALTH Food/Kitchen PL; n IT T LD Septic System THIS CERTIFIES THAT Otto BUILDING INSPECTOR ................ ............ .................................. .................... .... Foundation has permission to eLect .......................... buildings on ........................C .................... Rough to be occupied as ....... . .. ltt..... ... ....... .!'K.�1��'.! ... chimney provided that the person accepting this permit sha I 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 EXPIRESPERMIT IN 6 MONTHS ELECTRICAL INSPECTOR UNLESSI TRTS Rough Service ................ ... .................... ., BUILDING INSPECTOR Final g GAS INSPECTOR Occupancy Permit Required to Occupy ualdln Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be one FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. CONTRACT WORK SPECIFICATIONat ' �. Mass HIC# 177704 GAF Certified Roofer CE 18650 r a,�'X, xai>�l"'q'?z.-7ce of` 354'M orrimack St-.t(Entry C,Suite 500)•t.awranca,MA 01840 888-49AUDGET•Fox(978)299-0128•www.8udgct-Extcriar,.com Matt and Betsy Cote 4- 116 116 High Street North Andover, MA July 21, 2015 Proposed Window Renovation Project: 1. Remove existing doors and discard from 4 openings. 2. Prepare frames for instal lation of new doors per manufacturer specification. 3. Supply and install 2 custom self-storing storm doors. 4. Insulate perimeter of doors. S. Caulk and seal doors. 6. All interior and exterior finish carpentry provided.No paint or stain if needed. 7. Remove all work-related debris from job site upon completion. Broom clean. 8. Lifetime 100% transferable warrantee will be provided to homeowner. 9. Seven year workmanship warrantee provided by Budget Exteriors on windows. 10. Budget Exteriors is responsible for work related permits. 11. When on premises, work crews will act in a courteous and professional manner at all times. Front door style. Side door style: Total Proiect Cost Tax,Labor, Materials: Four Primary doors and two storm doors: $6,000 Accepted by: Homeowner � ni� � � `'7{ 4)- Datel - Budget Exteriotis ! n " Date /<r1 CONTRACT TERMS AND REQUIRED NOTICES Notice: All home improvement contractors and subcontractors engaged in home improvement Contracting,unless specifically exempt from registration by the provisions of Chapter 1 42A of the general laws,must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the director,Home Improvement Contractor / "� Registration,One Ashburton Place,Room 1301,Boston, MA 02108. Q/�/C!t'/�y eo 172are Qf)'#1#U f0/- less354 Merrimack Street(Entry C,Suite 500)•Lawrence,MA 01840 888-49BUDGET•Fax(978)299-0128•www.Budget-Exteriors.com I/We hereby agree and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the specifications,terms and conditions,on the premises below described which I/We represent that we have good record title in our own name. Owners Name:�� � •, i ;'{ (� Home Tel. No. %� "tt 'j-�f, Bus.Tel.No. e-mail Job Site Address City It/ 11,, ST Zip Massachusetts Contractor Registration# 161932 Work Specifications described attached on pages of Permits: The contractor agrees to apply for and obtain all construction related permits(building/electrical/plumbing)but shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting,or inspection agencies,authorities or individuals. Notice: The homeowner who secures his own permits will be excluded from the guarantee fund of MGL Chapter 142A. Price:The contractor agrees to do all work described by the contract for the total price of$ r, i'J Notice: No agreement for home improvement contracting work shall require a down paymen (advance deposit)of.no more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must,in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever is greater. Payment Terms: Advanced Deposit $ 1 ,€ (-'r Payable on signing of contract Interim Payment 1 $ Payable Final Balance $tee.—�-: Payable on completion unless otherwise specified. Work Schedule: The contractor will not begin work or order material before the third day following the signing of this agreement unless speed in writing. The contractor will begin work on or about 4l, 't S(date). Barring delays caused by circumstances beyond the contractor's control,the work will be substantially completed in_�_wee /days. The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the cont shall not be considered as violations of this agreement. The contractor shall not be liable for any delay or non-performance caused by strikes,accidents,weather or any other contingency beyond its control. Insurance: The contractor agrees to maintain workers compensation and comprehensive general liability insurance during the operation of this job to cover the acts of its employees and or agents. Warranties: The contractor warranties its workmanship for up to a period of "7 years and assigns the rights to any manufacturer's warranties to the homeowner after substantial completion and payment of the contract terms. You may cancel this agreement if it has not been consummated by a party thereto at a place other than an address of the contractor,which may be his main office or a branch thereof,provided you notify contractor in writing at his main office or branch by ordinary mail posted,by telegram sent or delivered,not later than Midnight of the third business day following the signing of this agreement. See the reverse side of this form for an explanation of this right. The instrument and any and all other documents attached hereto and signed by the parties set forth the entire contract between parties and may be modified only by written instrument executed by both parties. Receipt of a copy of this contract and duplicate notice of cancellation and explanation thereof is hereby acknowledged. Notice: Cancellation of this agreement after three business days will result in a restocking fee of up to 33%on custom products and 25%on non-custom order products. HOMEOWNER: Do not sign this contract if there are any blank spaces. IN WITNESS WHEREOF, the parties hereunto signed their names this r ! day of �� 201 Budget Exteriors, Inc. Representative ""z ��- " Homeowner Accepted Budget Exteriors, Inc. Homeowner-� Page 1 of The Commottivealth of Massachusetts Department of Ladtcstrial Accideitts Office of Investigations k1V 600 Washingtoii Street Boston, MA 02111 itninumass.gov/dia Workells' Compensation Insurance Affida0t: Builders/Contractors/Electricians/Pluwnbers Applica»tt Information Please Prhit Legibly Na1ne (Business/otganization/Individual): Budget Exteriors—C/O Lou Milano Address: 354 Merrimack Street( Entry C,Suite 500) City/State/Zip: Lawrence, MA 01840 Phone #: 860-753-0452 Are you an employer?Check the appropriate box: Type of project(required): IX I am a employer with 12— 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 Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10. Electrical repairs or additions 3.❑ 1 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.❑ Roof repa rs insurance required.] t employees.[No workers' 13.X Other 4 — G^ Wy� comp. insurance required.] "Any applicant that checks box#1 must also fill out the section below shoiving their workers'compensation policy information. I Horneownerswho submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new aYildavrt indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I ant an entplo�yet•thal is pt•Ovtld112g workers'contpensation insurance for my employees. Belma,is the policy and job site 1tt f01•tnation. Insurance Company Name: Atlantic Charter Insurance Co. / 781-593-1200 Policy#or Self-ins. Lie. #: WCV01161200 Expiration Date: 06/05/2016 O 1-11 Job Site Address: to, 1 City/State/Zip 0 1 g45� Attach a copy of the«porkers'compensati n 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 umposition of crnninal 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 ce y tiler the p ' sand penalties ofpe�ju���that the i�zformation provide l above is true aan`d correct. Sign {Bud et Exteriors Auth. Agent} Date: Jb Phone#: Home— Fax : 860-315-5266 / Cell: 860-753-0452 Oficial use only. Do not write in this area, to be eontpleted 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#: DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 08/03/2015 ACORDLY AND CONFE T, HIS CERTIFICATE IS ISSUED AS A MATTER OR INFORMATION 0 NEGATIVELY AMEND, XTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I :ERTIFICATE DOES NOT AFFIRMATIVELY IELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED 1EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, dorsed, if RE ,the policyes)mut 8 91 MPORTANT: If the certificate holder m an ApDloliOc esLmay rlequDre an endorse ent sA st tement on th sUe rtiif cat I does of con er rights ttoothe he terms and conditions of the policy, p ;ertificate holder in lieu of such endorsement(s). TACT - —_ "AME: — FAX 781 593.7260 ODUCER PHONE 781 593.1200 — —, AIc_N __'__—._-- uffy Insurance Agency, Inc• A/C No Exp — ---- — E-MAIL 17 Broadway ADDRESS:— NAILfF INSURER(S)AFFORDING COVERAGE ---- yoma Square — Endu_rance American Insurance C .ynn, MA 01904-2602 — — INsuRERA: — ----- — — _— INSURERS: Atlantic Charter Insurance Co. 0005 SURER Budget Exteriors ------ INSURER C: c/o Lou Milano INSURER D: ---- 354 Merrimack St Entry C S 500 — _ Lawrence, MA 01840 INSURERE: —_____-- ---- INSURER F REVISION NUMBER: ;OVERAGES INSURED CERTIFICATE NUMBER: 74 THIS IS TO CERTIFY THAT ND NG ANYI REQUIREMENT TERM OR COND)TIONVOF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To WHICHTHIS INDICATED. NOTWITHSTA CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,OF SUCH POLICIETHE S.LIMITS RSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.HEREIN IS SUBJECT TO ALL THE TERMS,--- EXCLUSIONS AND CONDI — LIMITS I yyVp POLICY NUMBER MM/DD/YYYY MMIDDIYYYY I GENERAL LIABILITY CBC2000001740 07/3112015 07/3112016 EACH�O�CCU RREENNCI3_ $ —--- 1,000 000 ,TR TYPE OF INSURANCE $_ 100,000 —, �I PREMISES(Ea occurrence S OOO I COMMERCIAL GENERAL LIABILITY I MED EXP(Any one person) 1$ ------�---- CLAIMS-MADE L J OCCUR i i PERSONAL 8 ADV INJURY $ 1,000,000 A I ---- --- ----- GENERAL AGGREGATE I $ 2,O )0,000 PRODUCTS-COMPIOP AGG $ _2.000,000 I GEN'L AGGREGATE LIMIT APPLIES PER'. $ �— r` PRO- LOC $ --- POLICY JECT Ea accident - AUTOMOBILE LIABILITY I BODILY INJURY(Per person) $ ANY AUTO I I I BODILY INJURY(Per accident) $ - -" ALL OWNED SCHEDULED I I I rPRO�ERTTDAM�� — $ _ AUTOS i I ��eraccident�—___-- — AUTOS 4 J NON-OWNED I, $ HIRED AUTOS 'i_ AUTOS $ EACH OCCURRENCE r—�UMBRELLA LIAR OCCUR I AGGREGATE $ -- EXCESS LIAB CLAIMS-MADE $ 1 I — r� DED RETENTION$ WC STAT - OT -' WCV01234100 06/05/2015 06/0512016 _ j TORY LIMITS_Ly—ER _ 1 WORKERS COMPENSATION i E.L EACH ACCIDENT —__ 500,000 AND EMPLOYERS'LIABILITY YIN ANY PROP RIETORIPARTNERIEXECUTIVFD NIA I E.L.DISEASE-EA EMPLOYEEI $ _500,000 B I OFFICERIMEMBER EXCLUDED? ( �_�� -- --T-- — 500,000 OOO I (Mandatory In NH) E.L.DISEASE-POLICY LIMIT $ If yes,describe under DESCRIPTION OF OPERATIONS below RD 101,Additional Remarks Schedule,if more space is required) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACO CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRE TATI�E Betsy Cote and Mary Windle TA 116 High St North Andover, MA 01845 '✓� f�� ©1988-2010 ACORD CORPORATION. All rights reserved n('nRD 25(2010/05) The ACOR0 name and logo are registered marks of ACORD ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/22/2015 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 NAME: _ Duffy Insurance Agency, Inc. PHONE 781,593.1200 FAx 781.593.7260 A/C No Ext): (AJC,N 317 Broadway E-MAIL _ — — — ADDRESS: Lynn, y ,oma Square __ INSURER(S)AFFORDING COVERAGE _ NAIC# NSURED Budget 01904- Lerii INSURER A: Endurance American Insurance C dget EXterlor$ INSURER B: Atlantic Charter Insurance Co. 0005 c/o Lou Milano ----— -- -- INSURER C 354 Merrimack St Entry C S 500 INSURER D: Lawrence, MA 01840 INSURER E: INSURER F: ._ ------- OVERAGES CERTIFICATE NUMBER: 71 REVISION 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. )SR TYPE OF INSURANCE PO CY­EXP — -"' INSR WVD+ POLICY NUMBER MM/OD/YYYY) MM/DD/YYYY LIMITS GENERAL LIABILITY CBC2000001]40 07/31/2014 07131!2015 EACH OCCURRENCE $ 1 r 000,000 COMMERCIAL GENERAL LIABILITY MI 6A1VTARENTEl7—" --' 1 PRESES�Ea occurrence) $ 100,000 j ) CLAIMS-MADE D OCCUR j MED EXP(Any one person) $ 5,000 A / PERSONAL&ADV INJURY $ 1,000 r 000 �J--- GENERAL AGGREGATE $ 2,000 000 G 111 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- �' JECT LOC $ AUTOMOBILE LIABILITY Ea accident) $ I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED ---- — "" -____.-_._ AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS AED AUTOS PREP R A E $ --- �"- I I Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR I CLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION TBQ 06/05/2015 I WC STATUOT - AND EMPLOYERS'LIABILITY Y/N 0 6/05/20161 - ANY PROPRIETOR/PARTNER/EXECUTIV —TORY LIMITS ER _ B OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 500,000 (Mandatory In NH) �— - --" — It yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 __-- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT J $ 500,000 i i ESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Budget Exteriors ACCORDANCE WITH THE POLICY PROVISIONS. c/o Lou Milano 354 Merrimack St AUTHORIZED REPRESENTATIVE,, Entry C S 500 fG La rence, MA 01840 �.- ©1988-2010 ACORD CORPORATION. All rights reserved. CORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CONTRACT T`FERNS AND REQUIRED NOTICE 21 Notice: Ail horric improvement contractors and subcontrae?ors engaged in io rEo improvement Contracting,unlfx^_,s specifically exempt from registration t y the provisions of C hapter 1 42A of the general law s,must be registered vith fhe C:OM MOOWealth Of Massachusetts. inquiries about registration and flus should he made to the director,Home Improvement Contrarctot ) Ro jistrution.One Ashburton Place,Room 1.301,Boswn,fS A 02108. f1/otlC1lff�jCl��GL� oil'#1vkej- f)! 854 Merrimack Street(En"C,Shite 500)<Uiwrence,MA 01846 888.49BUDGET®F-ax(978)290-0128+v.�ww,fludget-Exteriors.com i 3 (Office oftu,rzumcr, [f ire tlushrevs Nr{uG#Elan L,icenst or registration valid for individul list-.only {OME IMPROVEMENT CONTRACTOR before the eipii�tion tiatc. if found return to: i gistrationl 1 77704 Type: Office of t t>rtsumer Affairs and Business Regulation 7�� xpiratiow 112712016 DBA 10 Park Plaza-Suite 517ti Bos€on,wx 02116 BUDGET EXTERIORS LOUIS MILANO � �� 2 ✓� 3S4 MERRIMACK ST ENTRY L LAWRENCE,MA 01840 t ndcrscCretar}� � int S'alu1 w logit signature t i I 1 Massachusetts - Department of Public `safety Board of Building Regulations and Standards. Cokvr trutij,n tt(3c4 s i tsr # License: CS-097519 .3� LUBOS SVEC 827 THOMPSON ROAD" F Thompson CT 06277 _ rt Expiration Commissioner 08/31/2016 1 3 ,,,3(tJqe Exteriors celi - 1