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HomeMy WebLinkAboutBuilding Permit # 8/13/2015 TOWN OF NORTH ANDOVER ® �l�R ff APPLICATION FOR PLAN EXAMINATION Permit NO: t Date Received Date Issued: U -/ �� IMPORTANT:Applicant must complete all items on this page _LOCATION Print PROPERTY OWNER tr;d Unit# Print MAP NO: 6 cL PARCEL: T�ZONING DISTRICT: Historic District es y no nit Machine Shop Village ye no 100 year-old structure ye 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 U Vy U0:11/Ut1VVti,A DESCRIPTION OF WORK TO BE PERFORMED: orGgIi Rl-�� v, /u)-Ild az qts-70 -4- (Identification Please'Type or Print Clearly) OWNER: Name: ba Phone: Address:_3k3 &� , CONTRACTOR Name: Eric W.Palm Phone: 7 3 Hilton Street Address: Salem MA 01970 Supervisor's Construction License: 7 7 Exp. Date: t?k 3 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 5 FEE: $ 5 Check No.: /I 16 7 Receipt No.: - - g g p g ry,,frond NOTE: Persons contractrn with unregistered contractors do not have access to the ua. ant r r Signature of_Agent/Owner " Signature of contractor � �� OTIC x own o �. :_..,. -Anclu ell 0 �I C, h Ver, Mass 0 -or�41��ff �. BOARD OF HEALTH PERMIT T %O LD Food/Kitchen Septic System THIS CERTIFIES THAT ................. BUILDING INSPECTOR has permission to erectg ...sQ.[-��. .. .. ..... Foundation .......................... buildings .. .... .... .. ...... w\ Rough to be occupied as .....1.. R!?........ p.L .. . .. . .. .. ....'.'�! ....... ...................................... 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 EXPIRESPERMIT IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough Service ................ lr .... .- - . .................................... Final BUILDING INSPECTOR GAS INSPECTOR ccupancV 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. e;; Ur, ntstazaxs,.�GSDilL�a t•it{�,�jb�.�(�:.v`t ^t s n m�0ftne.- b- m_o���c4? 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'anC.`_Ie7tg;;L�•,�C777 - =t2Qc7ut'-.-.api14..�W •`'�lE$OII CIttIC r:J7�-0� al���`r''��Eea:+••.:: Ccnh�c nt -t.:t -J mss; '-y:tsea;a7rS3•, G7�edr-e,-rrelt;svF.• [Fi?J not 7t?i•;-:..:T�"tltisdpCeii•rrT zsva vie_ - utearevzsc= Lt � C,?t c neo D;pterM. c r G'- nGa bineia� lI�-acatstt;ali��t N lt1a`uljS CvutruC?:Mmza "F7_•��. .-� 5'..J'itucLin^ria-1. as-}i_ L ca E4EeT1pi iD� ¢J"'a aca�iite C�(r M +•a 2ka•7p. ?b^ �irtrtrtprnsSa tD'to csz`sE rpt: Lh toi ttCita Ya4ec-liact tt Iccka;_ :SiJ?eCJIIt -S7Qi1tC7�.� tprt•?_ 'pwpr ' Yoa__DQ '`�� is z or:�.zi^R_ % i�,;� _r1rat 10 p:1 na• etc 3c--_ Q Leac - c3_uc�'—'`c^ ccc 4a L c,Ip;his' c on. �`3�?1Ea r $S ja-'&u-. n tot�r�c!p ipt; Ad Ul'i^:ip:hpj4L•7D�,au[iy9dillYFa'._C;:�e.7�i r+`.iL1pc^_StZIIIta':�ati+!'li S'kIttC'as�7si a3<9u' 7 j 37$7• p �vsrr: '• t t..^.F3tC4uu"7r G.prr.•.nO�uZE r'L•iL'lt, TpA 127e, Cfl`emm,ca.2�C or .t 1L1CCI cCEpi Ia 1i(t'ilrr c�'liicctFltn_.^.SD �.-�i:�^r fl :I't'''L"1•at7La C8Cp�tljrL,L•oarn^Cr t trGtz 4 r :20c $ F ULIAFa 'J•_�.t'i,v1p6I3�u C CC:Ti� rrh k s,A1T72:7fF :1@i`,p't 5=��+t-7gl)F n �:o,�i fku't tL•Sil r,-�i"e.'dr'tSIIAai s71c^,v�•r� E _I%t?-;?^.j'J r.7,�� `..x•ek%acr the- -`'r"t'•�.wralC--S,;. � :.i=-; -_�.�..�r��,�. _�L��,t•-,��: .r-� QA.u��.�:v7::,-�� '�ate:?rentorthe ` •�J�a-,,,�.� .-=`_.•�.Te'-u..._v iYr�> a __L`a' QfOtS �+-L8_ l���s.�sr� ���ivv J �,✓'3 +�w' �ti�iac : ri7iion T"iti__e.nelmp notautolnanc�?yaifordedioa rovement ConCactor I.ati�provides homeoc4zle�«nth the riehtto initiate an azbih-anon acLon as a� z ute:heishe has-with a hotneov�ner in court u.-zess alietitadve to court action}ii they have a iiispnte eFtiti L contmeto. 'Ltte same ogbt is-- contractilr:however_The contractorvrouldhave to resolve any rasp both parties axvae io the op=earn i clause pro�nded below.i m5 et3'me joule�ve'lbe cooLTacto:the s2sne stir to arbitration as is afforded to the homeotimerby ineIiotne improvement r ontiacto �a�v The contractor and the homeor�nerllerabymptuall;`awe cat advance mat in tae eveat the contractor has a dispute concerning this eolacL,tl2e coutictor %ay`sub�litttie dispute to a private aTbt_tratieh iirm Gvhica has been appl�ved b' rite Secratan=ofllieFaecutiye Qi�Teeonsumer �ai=�an¢justness Redilation and the consumer shad ae requirza -+ ' TO12e11In,JIasSacliusetS�7ehe21 Lci'-..� to submit to such ar"o`tra"Un p nL /\) .\ .. i Lt1'/.=3 r=te �lr•PA �� ly VM CoatTtlCtors Slmtatura }aorneovrtees Sien�i*SL t es to alternative dispute T -0.Sd�1:ne Signatures of the parties above apply only to 1te agnainent ei tae uarci resolution initiated bythe contractor_The hoomeOvIner may initiate aitarnative dispute;resolution even where this es- sectiones not.separately sled by ihepar`a 1=1ontoo-waze_'s 'ghs t 1L'_2A)and other consumer Ahomeov;•neesrghtsundertheHomeImprovement Contractor Lail., (itievenby;i��zemeni Ilo�vetzr,llomcovr_ers ter 93A na not be ivai ved in an, 'y_ , i yr protection lair(i.e LC-1 chap ): y �,he exciudedEhm.caaam.-dItS if tiie contracttll they choose is ri e,mieluded 1rom1gistel G la pr Ly"Fun d b,`vi . Honlew"Mers AD�ry�latroiNra bullct r La«a niingr gContractor�straspons?b oricomplean the work de;��ed:irl�s oI tine 1•lame L-nura be enti led to ober specme Iegtlei!t4 1€the con��cto- rmaly ar:d:o; tan,;- raallner Iromeovmzr may �uaralitees or pro-%.,e a�Przss l Jar aty for tivoii anship or-MIoials_In addition to antaes o ability and-fitness nd-fitn providedby file contiactor;all goods sole in-Massachusetts r�—=�'mPL*ed warranty of nteFehant1iiility a�Id fitness or puFntise A-t enwaer2tieno;othsrrnatter onrintcn itiehomeotynerand coat actorlm fiullf Uzi have be added to the tot ns oftae contract as long as they do notres�ct a hormoti.itez's basic consumer gttt?. '€yon have questions a terbout your constnnerthomeoxi>ier,"i ts,cont;cthe Coasuszeriz*orulation Ilotiine(lisled'pelov;. The conunctmust be executed to h �also ad�sedno to sign the document unff 211b lan and have been docomentshavebeen�'�ched-Pa. es _ nts is ED filled is or rn go as'an the arae I.7t uv thetco;ztia tm A-nt nodiaC on to theri-nal contract in rs ins be g4ven to thea e:ecuied copy of and armed to by both parties.Contracted�,orlt may notbe� both navam- s calved z 11I the contract.and he:tree dq}y rescciss=.oa naiad has expired_ in ca hem the acMad on-the aym r_ co- demand nomersel€abeefula�cialtyinse u n-in advance of the dr.teseer ininstanrotsl p a acontracto-deems hJimlYterseii eo_leon�er der~rs to aan"-nanelallt'I���:thecpn�cio�alayrztnurttha:tllebuall,aof;�d�nott,°et due bepIacadiaajomtesook: a be-fli aszprat_q itetaconYnuillg` econtracted�vor4 �rrhd-,.-o alt}`nmds saidaecou>?tivhuldrzquiretae S;Zaa_ures pi bots.Parties. o �Addiion$I n IfYou have amealquestions or=ad adtonaiTm "Oachuetis onstmerCuidetoaRorovemp"'- Bs consumer r=lits ori€you to obtain aREe eaTY contact: Consamer ImfoamaFanHu`une Q�ce of Consumer Affairs and Business Re-Matio3 .10 ParIcDIa?�Recs�5T70=SestoiLiaia 0211 i7.'�.Ia OtUT,UUU?��'�T�I OrvlStt`tit?QCT.�R1-ebs'ita ai hti3:(1ciR:ti`.tnass-=oiio-Orl II-loll vJuttto verity ilia re La'toiz of contractor orf you have questions ornead-ad idonal Worm,.don specl�cally about the Cao torrz rg9isu stnceinpoua toft the Home Improvement Co_�ctQrlsvr cpnmcti I}irLt loT(ifHome farovemn'tCor�ncrorRt�sWlt OP- OM=ciAffarConsumeranE BuSiMsslce�Jation 10 Part;?la?;;Room 5170,Boston;Ian 021-16 b17-�7�°u7u°7�aat�i=tv���T77 ory sit the ML ZF2bstP atliff li'11,:i1'.Ttla no\'loCabri Ga online io mewthe sm-s c=ii`don1e Ilnprov2uten Can c fir's Re s tiara litti�:iidb St3teamughome t OrovelllendlicerseeiisGasn rrlai mediation or "disputesortoggster�ormal:ompiain'`'mintabusi�Iess,call: For assistance-T-"u3in=o ,onsum- er complaint Sec_=on Ofiim Of the AU-0mey Cdner6tt 617 727_3400 - ANDi01R Betterbus'uess Bureau 5TG-652 Vgo_ =55? 1 `1344--3vcri0nMM_7010 ' =i '•r �� 9 4 / r r lei. Lam __ -i' - 0 Qualified 1 Air o Lik NFRC Bringurg quarfry m tight. VINYL DOUBLE HUNG NaUof>vl r-enastralion IMPERIAL LS Rat,n:7r,pin^am Double Glazing-Argon Fill.Low E.Grids SLL-A-29-OW -00002 -ENIERGY' PERF i�E TI U-Factor (U,S./I-P) Solar Heat Gain Coefcient 0. 28 M25 ADDITIONAL PERFORM NCE RATINGS Visible Transmittance Condensation R.Psistance-4 OAS Manufacturer stipulates that these raitings conform to applicable NFRC procedures f•)r da-lFln-1711)Y--hrje prrdu[t performance. NFRC raltings are determined for a Reed sar at f F•. �� .widitions and a specific product size. NFRC der,not N,omn!e!!rl any o;!d!rct I a:,u noes not warrant the suitability or any product for any;periric u;e.Consult manufattur er's Ilteratnre foi other product performance information. w•nsM1v.nfrc.o 1318555.060 ' e CQatzmony"eala,of rssr€aaz.Sets D,5 partrnene of Inas s Wal-liccldents J J 0011eress SIEeez sure I00 BOStoiis!z4 O2 L 7d 20 7 bQ WWW 1:MSSgov/dltr IN'orkers'Compensation Insurance oda vitak3uflders/Gonna actorslElectt icians/P!€tanl�eas. T©BE FILED WITpI THE I'EI MITTUNG AUTF�TORIT? T°I ILIABILITYI13/3/2015 DATE(MMIDD/YYYY) 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: Construction Eastern Insurance Group LLC PHONE (800)333-7234 ac e: 233 West Central St E-MAIL DDRESS: INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA Arbella Protection Ins. Co. 41,460 INSURED INSURER B�TantiluS Insurance Co Atlantic Weatherization INSURERC: 61 Rear Jefferson Avenue INSURER O: INSURER E: Salem MA 01970 INSURER F COVERAGES CERTIFICATE NUMBERNASTER 2015 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. ILTR TYPE OF INSURANCE INSR D SUER POLICY NUMBER —POLICY EFF MM/DDS LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO PREMISES Ea occu encs $ 50,000 A CLAIMS-MADE Fx—]OCCUR B500042816 /20/2015 /20/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY EO COMBINEDBBI� tSINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 020015871 /20/2015 /20/2016 BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOSED PROPERTY DAMAGE Per accident) $ PIP-Basic $ X UMBRELLA UAB�1� OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIABCLAIMS MADE AGGREGATE $ 1,000,000 DED RETE4600058654 /20/2015 /20/2016 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑Y/N E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in If under es,describe aunder E.L.DISEASE-EA EMPLOYE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B POLLUTION LIABILITY CPL200370613 0/1/2014 10/1/2015 GENERAL AGGREGATE $1,000,000 EA POLLUTION CONDITION $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. 1600 OSGOOD STREET NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE John Roegel/PMA ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25r9mnmmni Tho AlInpin nomo nnrl Innn nrA mnictororl marlrc of AtlnRni Rightfax N2-1 3/10/2015 10 : 11 :37 AM PAGE 7/013 rax z)t1rVV.E DATE ACCOR06 CERTIFICATE OF LIABILITY INSURANCE 03-10.2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE Cii3TIFICATE ALTER THE COVERAGE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND TAFFORDED BY THE HE ISSUING NSURER(S)CA THORIIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDERIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A . BETWEEN 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). CONTACT PRODUCER NAME: FAX EASTERN INS GROUP LLC PA(HGNE A/C No: C No Ezl 233 W CENTRAL STREET EMAIL NATICK,MA 01760 INSURER(S)AFFORDING COVERAGE NAIC V INSURER A:AMERICAN ZURICH INSURANCE COMPANY INSURED INSURER B: ATLANTIC WEATHERIZATION LLC INSURER C: 61 REAR JEFFERSON AVE INSURER D: SALEM, MA 01970 INSURER E INSURER F: OVE E T TE UMB V 0I I E 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. AWL SUB POLICY EFF POUCYEXP LIMITS INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MWDDIYYYY M DDIYYYY GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERALLIABILITY P DAMAGE TO RENTED S FIF.,SE E oce ne CLAIMS-MADE❑ OCCUR MED EXP(Anyone person) S PERSONAL 8 ADV INJURY S GENERALAGGREGATE $ GENL AGGREGATE LIMB APPLIES PER: PRODUCTS-COMPK�P AGG S PRO- LOC S POLICY JECT COMBINED SINGLE LIMIT S AUTOMOBILE LIABILITY Ea ecdent ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS OPERdY AMAGE S HIRED AUTOS NON-OWNED PER e AUTOS $ UMBRBLLALIAB OCCUR EACHOCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S S DED RETENTION$ X WORKERS COMPENSATION WGSTATU- DTH• TORY LIMITS1 I ER AND EMPLOYERS'LIABILITY ANY PROPRIETORMARTNER/EXECUTIV YIN N/A E.L.EACH ACCIDENT $500,000 OFFICERNEMBER EXCLUDED? 6ZZUB 03-20-2015 03.20-2016 E.L.DISEASE-EA EMPLOYEE $500,000 (Mandatory in NH) 58270121 II yes,describe under E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,R more space is required) CERTIFICATE OLDE CANCELLAXION TOWN OF NORTH ANDOVER SHOULD ANY OF THE A13OVE DESCRIBED POLICIES BE 1600 OSGOOD ST CANCELLED BEFORE THE EXPIRATION DATE THEREOF, N.ANDOVER,MA 01845 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of AGORD Board of Hui➢ding Regu9ai`ons arid- tmad<aa is Cmv�tru Clio 21 Sujwzl-N(�r License: CS-087977 ERIC W PALM 3 TON ST Salem MA 01970 4:gua t ai>:b: asa 04123/2016 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(99lu?)of enclosed space. la r Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS �'/�c�!'arunraurnerrlf�r��J 1°4crJJarlrr�r�/f.� .Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR _- gistration: 142089 Type= Expiration: 3112/2016 Ltd Liability Corpo" ATLANTIC WEATHERIZATION L.L.C. ERIC PALM 61R JEFFERSON AVE SALEM,MA 01970 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Paric Plaza-Suite 5170 Boston,MA 02116 10, 10 10 11011 Not valid without signature