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HomeMy WebLinkAboutBuilding Permit # 9/2/2015 IAORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received ATED �s$acwu5Ec Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION cw'orx', -s/-- "41LI-Pe'Kew Print PROPERTY OWNER LD11VVA1',9 6A&t6e_�4 Print 100 Year Structure yes no MAP ld7, 6 PARCEL: 00d�& ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building E�5ne family 11 Addition Li Two or more family El Industrial El Alteration No. of units: Li Commercial 44�pair, replacement El Assessory Bldg El Others: Li Demolition 11 Other fi 42 W .......... r,,, w..1�/��/,/// �,, � ��, � /� / /lig/, � � ///,/,f � �� i � DESCRIPTION OF WORK TO BE PERFORMED- /V Identification- Please Type or Print Clearly OWNER: Name: ,D114A,-iV1q (50tmde� Phone: -F75--Jz1 7t Address: CJq.5a1,,vqq4- cs*/ Contractor Name: _3A_/MP RIi Phone: 617 7e, /P — o ,-112-- Email: Address: Supervisor's Construction License: —Exp. Date: Home Improvement License: 7,0 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDINGPERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1? 7,21 &0 FEE: $ I Check No.: Receipt No.: 1q", NOTE: Persons contracting with unregistered contractors do not have access o tlt guaranty fund ........... ®RTH AL "lwn o A Go v ur - �. :..., ® - .:ti•. ® J. - 117 T h ver, ass, _ �?/"; cocNac"twicK �1• 11 BOARD OF HEALTH Food/Kitchen P E mR� 1=V= I T Septic System THIS CERTIFIES THAT .............� ..............l r�.�✓�r::.............�� .f ......... .................................................. BUILDING INSPECTOR . ,,�L Foundation has permission to erect ....... buildings on . .:(.. g �?�y° :�1.., ................... ...... .. . ........................... / Rough to be occupied as .................... . y ./.e� .....�. ............................................ 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 PERMITI I �+® T ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STA TS Rough ............. Service ............. ....... .. -.......... ................ ........ Final BUILDING INSPE OR GAS INSPECTOR Occupancy Permit Required t® Occuay Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final o Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedy the Building Inspector. Burner Street No. Smoke Det. Renewal MA Home Improvement Contractor byAndersen. Renewal b Andersen Corporation License;y decal (Expires 12/23/2015) �' � Federal Tax ID#41-1918413 WINDOW REPIACENIENT n Aixlcesen Coairan, 30 Forbes Rd. Northborough,MA 01532 (508)351-2200 Fax(508)-986-7072 CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name Date: DIANNA GAUDET - RICHARD GAUDET JULY 16, 2015 Buyer(s)Street Address City State Zip Code 835 CHESTNUT ST. NORTH ANDOVER MA 01847 Email Address Home Telephone Number Work/Cell Telephone Number D IAN NA.GAU DETQG M A 1 L.CO M 978-857-8532 978-273-8337 Buyer(s)hereby jointly and severally agrees to purchase the goods and/or services of Renewal by Andersen Corporation("Contractor"),in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Est.Start Date Method of Payment Total Job Amount $ 19,721 okmount Financad$ 12,721 Deposit Received(33%)$ 7,000.00 Deposit at signing$ 6,360.50 Check/Cash, 8-10 weeks Balance Start of Job(33%)$ 0.00 Chet Balance on SubstantialAl Substantial � i Est.Install Time Credit Card ` Completion of Job(33%)$ 0.00 Completion$ 6,360.50 1-2 days It credit card is selected,please No final Payment shah be demanded until all parties are aatisf*d I I see Credit Card Payment form Buyers)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings changing or modifying any of the terms of this Agreement. No alteration to or deviation from this Agreement will be valid without the signed,written consent of both Buyer(s)and Contractor. Buyer(s)hereby acknowledges that Buyer(s)1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyers right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Renewal byAndaman Corporation � Bu r( Buyer(s) B Signature of Consultant Signature Signature X BRUCE PECK DIANNA GAUDET RICHARD GAUDET Printed Name of Consultant Printed Name Printed Name YOU,THE BUYER(S),MAY CANCEL THOS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAYAFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. -----------------------------------r ------------------------------------ I NOTICE OF CANCELLATION I NOTICE OF CANCELLATION Date of Transaction 7/16/15 .You may cancel[hila II Date of Transaction 7/16/15 You may cancel this transaction,without any penalty or obligation,wltbta three business days from the i transaction,without any penalty or obligation,within three business days tram the above date.If you Cancel,any property traded In,any payments made by you under I &hove date.If you cancel,any property traded in,any payments made by you under the Contract of Sale,and any negotiable Instrument executed by you will he I the Contract of Sala and any negotiable instrument executed by you will be returned within 10 days following recelpt by the Contractor("Seller")of your I returned within 10 days following recelpt by the Contractor("Setter) of your cancellation notice,and any security Interest arising out of the tramacdon will be i cancellation notice,and any security interest arising out of the transaction will be canceled. If you cancel,you must make available to the Seller at your residence,In I canceled. It you cancel,you must make available to the Seller at your reaideace,In subgtantlally as good condition as when received,any goods delivered to you under I substantially as good condition as when received.,any goods delivered to you under this Contract or Salel or you may,If you wish,comply with the lastructioas of the I 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 expense and risk. I 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 mot park them up I H you do make the goods avellahle 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 I wlthin 20 days of the date of your Notice of Cancellation,you may retain or dispose of the goods without any further obligation. If you tail to make the goods available I of the goods without any further obligation. It you fail to make the goods available to the Seller,or if you agree to return the goods to the Seller and fan to do so,then I to the Seller,or It you agree to return the goods to the Seller and fall to do so,then you remain liable for performance of all obligations under the Contract.To cancel you remain liable for performance of all obligations under the Contract.To cancel this transaction,mall or deliver a signed and dated copy of this Cancellation notice I this transaction,mail or deliver a signed and dated copy of this Cancellation nOtke or any other written aetice,or send a telegram to Contraetorl lienewal by Andersen,I or any other written notice,or send a telegram to Contractor+ Renewal by Andersen, 30 Forbea Rd. Northborough INA 01532. I 30 Forbes ltd.Northborough,MA 01532. 1 HEREBY CANCEL THIS TRANSAMON. i I HEREBY CANCEL THIS TRANSACTION. 1 I auy*N SVW— Prim Norte (late I 6vymh Slenmre Print Nam Dew Renewal Renewal by Andersen Corporation MA Home Improvement Contractor byAndersen. 30 Forbes rd Northborough,MA 01532 License#170810 (Expires 12/23/2015) WINDOW REPLACEMENT n„n,,.t<,K„c.„,,,.,o, (508)351-2200 Fax:(508)-986.7072 Federal ID#41-1918413 Window Specification Sheet Buyer(s)Name Date of Agreement DIANNA GAUDET RICHARD GAUDET THU,JUL 16, 2015 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 the Specification Sheet and the front and the reverse of the accompanying CUSTOM WINDOW ANTD DOOR REMODELING AGREEMENT,of which the Specification Sheet is part. WINDOW&DOOR DETAILS App. APP. APM ExteriorAnterior Cola Hardware Hardware LawE4/ Grille Grille Glass Room M width height U.L Window/Door Style Detail casings Ext-Int Color style straens sma,fs,n Grilles Sash 1/3 Sash 2 Ufls Options Dining 101 32 60 92 DB sq rail equal insert sloped sill L-Trim NHiWH White standard HFG smartsur GaG 412 0 No Dining 102 32 60 92 DB sq rail equal insert sloped sill L-Trim NHNVH White Standard HFG artGBG 4/2 0 No Dining 103 32 60 92 DB sq raft equalinsert sloped sill L-Trim NHWH White Standard HFG smartsur Ger. 4/2 0 No Dining 104 32 60 1 92 DB sq rail equalinsert sloped sill L-Trim NHAVH White Standard HFG 3martsur GBG 4/2 o 1 No Kitchen 105 32 60 1 92 1 D13 q rail equalInsert sloped sill L-Trim FHEWH H White Standard HFG arts GBG 4/2 0 No Kitchen 106 32 60 92 DB rail ualInsert slo sill L-Trim H White standard HFG arts GBG 4/2 0 No —Laundry107 32 60 92 DB rail ualinsert slo sill L-TrimH White standard HFG arts GBG 4/2 0 No Bath 1 108 32 60 92 DB rail equal Insert sloped sill L-Trim H White Standard HFG arts GaG 0 0 No Family109 32 60 92 DB rail ualInsert slo sill L-Trim White Standard HFG 3marisur Gee 4/2 0 No Family 110 1 32 60 92 DB aqcal equal Insert sloped sill L-Trim NHMHI White Standard HFG arts Gee 4/2 0 No Living 111 32 60 1 92 1 DB sq rail equal insert sloped sill L-Trim NH1WH White Standard HFG ismartsur GBG 4/2 0 No LIVIncl 112 32 60 92 DB sqra l equal insert sloped sLi L-Trim NH1WH White Standard HFG smdsurl GaG 4/2 0 No Living 113 32 60 92 DB so rail equal insert sloped sill L-Trim NH1WH White Standard HFG smartsur GBG 4/2 0 No Total 13 BAY,BOW&BUILD OUT DETAILS x Style Detail/ Approx. Number Frame Window End Center LOWE/ Roof/ Hardware Room Cant style Flankers tmolit Casings Lites Interior Ext/Int Color Grilles sashes sashes Screens Smarlsun Soffit Color SPECIALTY WINDOW DETAILS FLtI/ Approx. LowE/ spedalty BAY/BOW ADDITIONAL WORK NOTES Room Count Style Insart U.I. Smartaun Grilles Grille Style ExtAnt Color Clot—u swam-that with m q/hmv windo wh&r 72 inrhw them wig hr i ifranr lose ADDITIONAL WORKDETAIISt Pack pockets I No Contractor will wrap exterior casings with coil stock color of Owner is aware that Contractor does not do any painting/staining or removallinstallation of alarm system or window treatments/hardware.It is the responsibility of the homeowner to have the alarm system and window treatments/hardware removed prior to installation. We make no guarantee as to whether alarms or window 2 treatments/hardware will fit after replacement. Customer is also aware in some cases there will be glass loss. If there is,the amount will be dependent on the type of existing windows,type of installation and window style.t4/e make no guarantee as to the amount of glass loss.Customer is aware and understands any and all unseen rot is not included in this contract.Should any rot be found there will be an additional charge for time and materials unless so stated In this contract. 3 Yes Contractor will insulate,caulk and seal windows With 3-pant system to prevent water and air infiltration.Removal and disposal of all job related debris, windows,doors,storm windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be issued. 4 Yes Building Permil--Contractor will secure any and all necessary permits. The fee for the permit(s)is included In the total contract price. 5 Yes All discounts have been applied to this agreement. 6 V, Yes i No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance form(s). It is agreed and undemoed by and between the parties that this Specification Sheet,along with the CUSTO\I 1VM01V AND DOOR REMODELING AGREENIFAN;romthulrs the cutin understanding Ixtween the parties,and them-am no%vital underslatxlings changing or nnxlifying any of the wrens.This Specification Shect limy not be chmiged or its tenn.modified or%cried in any way%tiles such changes arc in writing and signup 4 Wth the Buyvr(s)and Contractor. Buyet(s)hem4 acknolvied ,that Buyet(a)has read this Slieditration Sheet. Renewal by Andersen Corporation ' Bu}mr(s) er B,,C , Pec/G/ ,Gil_* L 9 Signature of Consultant t Signature Signature BRUCE PECK DIANNA GAUDET RICHARD GAUDET Print Name of Consultant Print Name Print Name Renewal byAndersem WINDOW REPLACEMENT anAndeTamCDupny WoodMrp+l Composite IF # � Dual Argon - Low E4 SmartSun Double Hung 100-00473518-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)A-P Solar Heat Gain Coefficient 0 :29 Oull' ' ADDITIONAL PERFORMANCE RATINGS Visible Transmittance OAA tdanutaetoraratipaLtattW tMaa nt'etpooMwm toappFeaDU 11FRC pweaesrosbr detamseiapwiap proAset ' pedasmsoe.NFRO rotinpsaw detarmixd lora fated an of amiont"%Woosdibm and aspearb ptedod eke. NFiIC dues na re�onMnad tayproduetand dwa sot twraM IM aviaDHYeIasY P�'t terMly Wks�• Coroul amsafaetunt'r Raruan IorotMr product patbrmanea iMotAratioa. , \/YI1N.11/IC91g . Tiis pwdeat treats Gman ' Searsanvsonnestal pip ..� w stsstlsrfl q*-mLl9anergy a� •y.;...,�, sir' � atG�sney,'Mary craters in ' 'e`tM Iratna aad mA - 4 eonsawtradaiaatoml h �•,► matetiett aa.ira .�r�� Q DESIGN PRESSURE(PSF) i H-LC25 RbA DB Sloped Sill DH IN TestaAttWSffitrMNMSCNA/CSAtitd39VteUAi ieribefrert CatormlrlseU tM etrdsrUs. de��aext:eeds M.E.C.C.E.C,6LEC.C.Air MlGlrstinn aquitamentaWCMAINamatk GnTiostinn R'aDrom• � The Commonwealth of Massachusetts Department of Industrial Accidents Office of In vestigadons UV I Congress Street,Suite 100 Boston,MA 02114-2017 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lesibly Name (Business/Organization/individual): RENEWAL BY ANDERSEN Address:30 FORBES ROAD City/State/Zip:NORTHBORO, MA 01532 Phone#:508-351-2200 Are you an employer? Check the appropriate box: Type of project(required): 1.UP I am a employer with 30 4. ❑ I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6• ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. FNI Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp. insurance.: g required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[]Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.0 Other employees. [No 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 this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors 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-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:OLD REPUBLIC INS. CO. Policy#or Self-ins. Lic. #:MWC 30293800 Expiration Date: 10/01/15 Job Site Address: 835 Chestnut St City/State/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation 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 imposition of criminal 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of th DIA for insurance coverage verification. I do hereby cerfy nder the pains and penalties ofperfury that the information provided above is true and correct Si ature; Date: Phone • 8-351-2200 Offrcial use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• ANDECOR-01 YADAVYO ACOR® DATE(MWDDl M) CERTIFICATE OF LIABILITY INSURANCE 10/1/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTANAME: cerlificafe$QwIllis.com Willis of Minnesota Inc. PHONE 877 945-7378 FAX do 28 Century BIQ AIC No Ezt:( } Arc No):(888)4$7-2378 P.O.Box 305191 ADDRESS: Nashville,TN 37230.5191 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B: Renewal by Andersen Corporation INSURER C: 30 Forbes Road INSURER D: Northborough,MA 01532 INSURER E, INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSRTYPE OF INSURANCE ADD POLICY NUMBER MwDorr CYEFY MMIR EXP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE X OCCUR MWZY302940 1010112014 1010112015 PREMISES Ea orcurrencel $ 50000 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 4,00000 X ET LOC PRODUCTS $ 4,000,00 POLICY❑J OTHER: $ AUTOMOBILE LIABILITY COEa accidentBINED SINGLEIT $ 5,000,00 A X ANY AUTO MWTB302575 10101/2014 1010112015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Par accident) $ AUTOS OS NON-OWNED PROPERTY DAMAGE $ HIREDAUr0S AUTOS Pera de t r 1 1 $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO I I RETENTIONS $ WORKERS COMPENSATION x PER AND EMPLOYERS'UABtLITYSTATUTE ER TH A ANY PROPRIETORMARTNERIEXECUTIVE YIN MWC30293800 10/0112014 1010112015 E.L.EACH ACCIDENT $ 1,00000 OFFICERIMEMBEREXCLUDED? FRI NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Sclwdule,maybe attached IF more apace Is required) 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 REPRESENTATIVE Evidence of Insurance 01 ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD a Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-ixor License:CS-090125 JAIM L MORIN 86 GARDINER ST LYNN MA 0190fIj: v. Expiration E Commissioner 10/00/2016 Rice of Consumer Affairs&Business Regulation id OME IMPROVEMENT CONTRACTOR Registration: RV17410 ExplraGon• Type 92/2312015 Supplement RENEWAL BY ANDERSQNCORPORATI%t JAIME MORIN 104 OTIS STREET NORTHBOROUGH,MA 01532 Undersecretary a t.