Loading...
HomeMy WebLinkAboutBuilding Permit # 9/25/2015 FORTH BUILDING PERMIT o�'J'yEo , + TOWN OF NORTH ANDOVERoa ga APPLICATION FOR PLAN EXAMINATION t H Permit No#: w Date Received Sys RA7EDEPPa�(5 SHCHIJS� Date Issued: V11�1) IMPORTANT: Applicant must complete all items on this page x r' l.'.u r ?X i _rt �"f/' r r .r.. ,x' u; t �- .,/.�.z• '`r s, t t1 . 9 :Jr� t ":�' ✓x. t 1. r� a c,�,�xy / r ^`',.< ;, r, /' "� ,.:.�� r ,k"„�s rr r�'�°� �� S .f 1, r.<✓�'7. f x a"" ,,�'; r / u `r f ..rl,x., r r a': t ,r,t r.;x;.,`�`�/�yl-i asx i'fr,� �,.-'" f.,,"; f � a %r .r r�... r r r ."s" ,rr15�f,.. 1 rrgr�r�rrr;'.., �r'�,xr'��` .,+( ,t �l✓.l',+ / J - '4� 7 ff f r r .::�r..:iP e s r.;-<✓`tr,��''``""r -"f ' / "`r,�i,r r,c.:. J'"f is r r ,Y x r rr-a ,." fi �"- l d1'r �: r ,,r n "- ,r r .x ,s ar rr r ;✓1 .r r r t::� rf _.f r „Y x r ',r {`rr f� r rf f �,;..� a r:�� rr,,r f, �? .. f„°: ,�r1 r;a: rl- ✓ ,r "_� --? r z'- rrk ;i.�ti i 9 rr � <.rx t r`P� s`fi<,^:. � ;.',� �r fl.r. l6 u,^r;?" r� �r-.,,'���rr r .. .s4 kr�'.;. r u''r C .u:�'B"?,:" Jt � �,✓ r`i� F:r -Ff..l.'t. r,r.rk ,. ,>•rz.,f / I ,t. �1 X ,3 r i` ,;. .r .�d.e`E,'r ,,+'. rrrr l/r` r.,.,..t rf r -5,-;�� r✓.,vr',, ✓r r r, 1 .� T "r r.. ..� "i ,,r , � ... 1`"t,,�. �-� �" ��7..�k r �ax, d ,l,r f f rr �x ur...� rf„ ,.G^' 7>t r-xr✓,r <:z"x'� r �, fr r=.. # .�'� =" ,,.r.r' G,� rr'f.r.. fir .l J":; .r' s k,-..�„r � ,.�,' .>.l's)' ,. l ,r:u,r ,r5o Yr,+•J r. /�� Y,u r u':rf,v-f 'rl..!xr, 2.i(r,. f r.. E^`,:a%^.��,'�'c�i,,� ;',?�rt�r,rk�„ :,r r,.:^` r>,rr ,r,.i rr,,rJr;?%".r..:.rr f-,.,-, r' a�Y �r✓. .: '.,. r ".v�. t f 1 rf/ ..r;r..`."�` .3.r,f�.,�^.,i., y`�'S'�..;`k"-L`.,lel':.�` ,:.,,,;. r� .rsz a .r' F. r, ,.ry r.L� �' r, r r 7 rr'✓,r r'i .,, :,x ,;,;r y' r f'a;.rJ� ,fk/:r' �` �r`?^� :.,� r'.,r Ori SIX it r',, .fs�,,yt' .� r�2'r.^� .,,%". �� ":r ' ✓r: rr dH 3 s ":r r A f ,f.k rx ,u r r/- t G,<.�„+mr<�,fr �.'a+»Xur'.,"1Ir t"'�F`".-.�, .x r „re�., :--x'f5x �rrt -' r' d ✓ ,s r art �" t 1 r, r r' � ?X ff t P �rr"r°rsr5r'r rtr F'k�� �r MAP��rr�� � `� '�PARGEL � r, 'ZONING DISTRICT Hisforic�Disfrict' �� '� r��yes ���;�norz r l ,rrr 1' ;�r "r .x t' r r°r rf X. r r I �. r r �t�,✓rl it r;F r p� r�y�xl�r ,r?`r,t`,'r'�t�7 r y, ;. TYPE OF IMPROVEMENT PROPOSED USE ResicJAE5ntial Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Oeration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other p Septic q Well ❑ Floodplain ❑Wetlands ❑ Watershed Distract '<❑,Water/Sewer� f r r � '� °' 1 ', r DESCJR11'TAI0 OF TOB PERFORM Iden if'Cation- le se Type or Print Clearly OWNER: Name: Phone: Address: r -r,: r r Confracfor Name , Phone � f � � r Address; tr r rrr � ,r, rrr, f , �, g'7. �Su enirsor�s9C,onstruction Lacense�r r ���' r �fr � r r� Exp,Dater � �,� x�r ���11� �- ' r r r f�� �✓ 'x��'{ t�r�r ;�,. r,` �'� �, r >T'. rrr r%1 1%�r� .r .'rte+ r r.: ' ,� -i �i r�:at,z rr"' x.� r r:� ✓t r�"<".�y",w r r „r r 'r't f� '� `�'kr:w'� lr� / r X '' .f f rrrrt r ,.rrj �..r"'r' -✓xr" r r$x� r��p? a f r} f P -{t r✓' '^3 r fX r,?�, ' F` �1 t .y X f 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: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access the uaranty f nil Si nature of A pr !w Signature of contra tAORTH Town of ' 11117" ijidover ® - .:`.; 0 ° L,�� h ver, ass,0 I1� COC q� NICM@WICN * A0J�ATE® u BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT .....................A.(.`WrM........ ✓ . .... BUILDING INSPECTOR .. . . ... .® ., .' has permission to erect .......................... buildings on ....... ......... .. .. . . ..t�.. ........ ... Foundation Rough to be occupied as ........ ........ . . ..... .... ..... .......... ....®..... .. .: .................................................... 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR T Rough Service ................ ...... ..... .................................................. 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. MA Reg#146589 Contract# t CT Rag#4605216 Federal ID 9 20-2625129 RI Reg#26463 Hamelmproliellienf5olWons `-f Corporate Headquarttm,26 Cedar,9t,Woburn,,MA,(P)600-342-2211(F)761-833.0826,www rtewpro.00m THIS CONTRACT MADE THE day of U` _ 20__Z�E between G(Ii lrc�rg Mfxpky X79- 77I- 899/Cell &26/ r 1 PI-1 0r111 of 16- i�vN• Ado Wz (Add-4 rcrtrl la) - / the"Owner"Find NEWPRO Operating,LLC,"NEWPRO". (E-AfallJlbr proprietary use only NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,fumish all labor and material necessary to install the following described wo t the premises located at: e The job address Is a condominium. S (i n ?";:., •. t ?r M-1, MR `�v m(4 Grlds: YE$ NO U CONTOUR SOL. rEURO DIAMOND Y Window color QTY I Windowcolor QTY 0881i'MP:(t0cetvn/ ( TOP ❑60TTOM Int: Int: Uraens:(Exterior color Full Screen Standard) ❑HALF IMPULL Ext: Ext: Vent latches: DYES NO Capping Color: IOooF! }F i"c i`.`r;tili E r.-,iY TY.Pleese/a1Nal. PVC Lj Smooth Lj NOMar Lj No Cappn $l( Ir1g;GT#a jtY z O i MODE Color In: Out: Double Hung Activa: Left Center Right ruuomefurderalandsMtNEWPR06 2Lite Siider HDWR: SN y'BB BGE WH doesnotdoanypalntlryorstaning. 3 Lite Slider (V9,1O,1HI ntry;,, -his'i -` I (le:vfien rcmavfng or replacing lnladof 3 Lite Slider tfra,In,int lColor Im Out: stops or tdml.NEWPROXDIt not respo- Casement(Hinged Rlght) Fiberglass Steel nlbie for conditions orclrcumstanoes bay- Casement(Hinged Leri) HDWR: SN BB AGB AB ORB and itawntrot Including wndansetion resw Twin Casement 51il ll ,�' 'jB.i .tfR` IGngfrom orduelopre IsGngcondfllo '.. Stationary Casement Color In: Out; (cdcleoneg Triple Casement 1114,112,1141 D>'B 1 ?tStil CASH Triple Casement (tn,trIAM Color In: Oul: (3alsneep3 oompAeticn , PiaturoWindow HDWR: SN BB AGB AS Sash Only tali Hinge Right Hinge FINANCE Hopper O. ::MA-0..c `?a" Bank coWetlon roan signed at lWallatlon Awning Color In: out: Garden Window Fibarglaes Steel Bay WI(1d9W(RooN 9aRf) HDWR: SN' BB AGB AS URB r• R 11" 1` Bow Window(lioarysotfit) Other lColor In: Out Other HDWR: "• 1 ( j I�• � DESCRIBE WORK B PROMO 7I0NSAPPL1ED: Ell" sen [32- 0 2.-111-1 FSG Stat Dale: j,Vst.Cane.Date: Customer understands this Is an"estimated date" Owner has read and agrees to the terms and conditions on the front and the reverse of this Agreement. Owner specifically agrees to the(1)Total Cash Price;(2)work being performed;and(3)work not being performed. Owner understands that this Agreement and any attachments contain all of tha promises made by NEWPRO. Owner has been orally advised of his right to cancel this transaction at any time prior to midnight of the third business day after the date of this transaction and Owner was provided with two(2)copies of a cancellation form explaining this right. DO NOT SiGN TH18 CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhone Island Sales Only): Notice to buyer: (1)Do not sign this Agreement If any of the spaces intended for the agreed terms to the extent of then available Information are left blank. (2)You are entitled to a copy of this Agreement at the time you sign It. (3)You may at any time pay off the full unpaid balance due under this Agreement, and In so doing you may be entitled to receive a partial rebate of the finance and Insurance charges. (a)The seller has no right to unlawfully enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement. (6)You may cancel this Agreement if it has not been signed at the main office or branch office of the seller,provided you notify the seller at his or her main office or branch office shown In the Agreement by registered or certified mail,which shall be posted not later than midnight of the third calendar day after the day on which the buyer signs the Agreemant,excluding Sunday and any holiday on which regular mall deliveries are not made. See the accompanying notice of cancellation form for an explanation of buyer's rights. (Rhode Island Sales Only): Owner acknowledges receipt of required Contractor's Registration and Licensing Hoard consumer education materials. (Owner's initials) By awes +r EINN Signed: Productllst(PNatodN Owha _ BW Signed: gL NE O OpBrating,LLQ'8/gnaa/mi Owner 11C-1A WW1T9• Q--h r— VGI I FW- I—, D-V, moi,..!-n... 1!/11�• e......,...,/+...... erty�� The Commonwealth of Massachusetts Department of IndustrialAccidents office of Investigations I Congress Street,guile 100 Boston,lid 02114-2017 " mvip massagov/dia Workers'Compensation Insurance Affidavit: Bu lders/Contiactor-s/Electrieians/Plumbers 1 Applicant Information IDlease Print Letdbly Name(Business/Qrganization&dividual): �'� 1" 0 0 ���/'��iN Address: vim' C(2.c- 6t,-t-- 5� _ d City/State/Zap: /Wo U Phone 3 q4,,? Are you an employer?Check the appropriate box: Type of project(required): 1- ] I am a employer with SO 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- []Remodeling j ship and have no employees These sub-contractors have g, (1 Demolition t working for me in any capacity. employees and have workers' i coin insurance J 9- E]Building addition [No workers' comp.insurance P• required.] 5. 0 We axe a corporation and its 10.❑Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11. ]Plumbing repairs or additions myself [No workers' comp, right of exemption per MGL i insurance required.]t c. 152,§1(4),and we have no 12.❑ zepaks employees. [No workers' 13. Other j comp.insurance required.] I 'Any applicant thaz cheeks box NI mustalso fill outthe section below showing their workcrs'compensation policy information. i t Homeowners who submitthis affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating sucb_ tContraetors that cheek this box must attached an additional sbect showing the name ofthe sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'camp.policy number. I am an employer that is providing lvorkers'compensation insurance far my employees. Below is the policy and job site i information. Insurance Company Name: & �� ( � ��✓ i%r'j.�,nJ C_ s 1. J Policy#or Self-ins.Lie.It: J L' 37' tj (J Expiration Date: Job Site Address:_ I l _ City/State/Zip: 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,S00.00 andlor 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 certify under the p rr ar p alties o perjU Y that the information provided above is true and correct. Signature. Date: t Phone#: LOI i Official rise only. Do not write in this area to be completed by city or town official- City or Town: l'ermit/f icense# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ( pig ®g CERTIFICATE OF LIABILITYINS NCE DATE(f.% 5/1/2012015 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 endorsement(s)- jPRODUCER CONTACT Mel- Plug �hiackintiNAl,1E:re Insurance Agency Inc PHONE IA,C Nn 6 1 r 1(508)366-616I FAX AIC No:(508)366-520Z 11 West Main Street 'c-61AIL melissa ADDRESS: pemackintire.Com INSURERS AFFORDING COVERAGE NAIC!r P7estborough MA 01581-1931 INSURER A_Netherlands 124171 INSURED - INSURER B-L3-bert Mutual/Peerless 24198 ^teimro Operating LLC INsuRER c Acadia insurance Ca- 26 Cedar St. INSURER 0: �I I INSURER E: 1 Woburnba 01801 INSURER F: I COVERAGES CERTIFICATE-NUMBER:i, ster 14-15 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELONJ HAVE BEEN ISSUED TO THE 114SURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTNlITHSTANDING ANY REQUIREMENT. TERM OR CO`NDMI ON 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.LUOITS SHOVvid)s1AY HAVE BEEN REDUCED BY PAID CLAI1fS- INSR II ADaI(suBR LTR I TYPE OF INSURANCE ' I t POLICY EFF POLICY''! t POLICY NUIIBER ;It,,?.VDD i PY EXP ) tPOLIC I LIldTTS , :i CO7,1 h1EP,CIAL GENERAL LIABILITY I I t - r I I EACH OCCURRENCE (S I,000,000 P_ i r'LA11.5-ldADE ! X 1 OCCUR ; t f! I DAMAGE TO REQ ITED I S 100,000 t REMISES(Ea d_currence I I TCB? 8569577 I12i31/2010 2/31/2015 1 laEDEX.0 (Anycnep=rsnn) j S 5,000— i PERSONAL&ADV II•:JURY 1,000,000 GEa1'L AGGREGATE U.•-d;•T.a,P;:UES PER. v! c-O_C: I GENERAL ACGREGATE I5 2,000,060 FOUCY`_i J= LOC l j IPRODUCTS-COMPIOPAGGIS 2,000,000 I OTHER: AUTOlAOBILELIABILITY I I ! COMBINED SINGLE LIMIT 1s 1,000,000 n j ANYAUTO i j ;Ea amdenl) — ALL OV,?IED ` X (�I v ;SCHEDULED ULED (BODILY INJURY(Perperson) AUTOS y1 AUTOS ?' 352517; ?/311201Ei 12/31/2015!BODILY INJURY(Per accident)ON-O'tNED ' HIRED ALI,OS IL _ AUTOS ! i i (PROPERTY DAL!AGE 1 S ! ! !Iperacddent) -_ 111 I t ' Zi t),000 I r I UMBRELLA LIAB' �• � ' � - Uninsured mdlarist 8!split limil�S ��` !OCCUR I I I —1 EXCESS EACH OCCURRENCE (5 5.4Jv,000 LAR i 3 Ii CL41Lt5-GtAO_I I I AGGREGATE I S 5 000,OOU I OED i-.' RETENTlCN 5 101000: ' ,CU 8582578 }12/3!/2014112/31/20251 I 1VIORKERS COMPENSATION I i I I I PER I I OTH- I S AND EMPLOYERS'LIABILITY YIN t �STATUTc' EP. ANY PROPRIETOPJPAP.TNERlciCECUTIVE I I L, !OFr'ICERRJE�;6EP,EXCLUCED? �'N/A1 ( I=J-EACH ACCIDENT j5 5D0,DDD i(mandatory in PIH) —1 I WC-20-20-003506-02 i 5;1/2015 5/1/2016 I 11 yes,d-Scrbe u..^.der I f I t E.L.DISEP.SE-EA EMPLOYE.E�S 500,000 .0_SCRiPTION OF OPEkATIOr'S balb'•t I I.DISEASE-POLICY D0.5ST 4 S SDO,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,,nay be attached ilmonn space is required) :. CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE To Whom it May Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Timothy Moynagh/2,EL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 r�n+.+n+t Board of Building regulations and Standard: fi�r��strmrir,»Sul)e3�isrlr ,,,,;w Lfcense: CS-096093' J THOMAS E PEACOC !� P.O.Box 505 Seekonk M4< 0277i • v� . .Gy.dGe )l r.� Expirati Cornmissidher 04/08/20 Consumer Affairs ,1d Business Regulation . . Office of g 10'Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement.Contractor Registration Registration: 146589 Type: Supplement Card NEWPRO OPERATING, LLC. Expiration: 5i5l2017 TOM PEACOCK 26 CEDAR ST. WOBURN,'MA 01801' Update Address and return card.Mark reason for change: SCA1-t� 20M•05111 Address Ej Renewal [:] Employment [] Lost Card Met of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation + egistratlow, 146589 Type: 10 Park Plaza-Suite 5170 Expiration;.:,WSW..17' SupplementC:trd Boston,MA 02116 NEWPRO OPERATiNG,`LLC;, _ TOM PEACOCK -1 26 CEDAR ST. WOBURN,MA 01801' Undersecretary 1Vot valid without signature