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HomeMy WebLinkAboutBuilding Permit # 11/10/2015 %AORTH BUILDING PERMIT TOWN OF NORTH ANDOVER oma. APPLICATION FOR PLAN EXAMINATION �I — z mho °.� � SRA Permit No#: Date Received ��SSgcHus���� Date Issued: IMPORTANT: Applicant must complete all items on this page f LOCATION r `! �©gyprr c r fr r f l ' r { . J r ♦ r r f r s. I 1. r - r ' { {/ /PClflt ���YeBf StfUCtUf@ {r r yes (10 EMAP ` 'PARCEL ZONING DISTRICT Historic District yes no Y` f{ { / ,..z , ��` IVlachine Shop Village yds no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building AbOne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ,pcRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well [] Floodplain J 1Neflands ❑ Watershed District ❑WaterlSewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: d- VA le Phone: Address: C J Contractor Narne: l4cwte •t •,,; Phone.: ., �--- Ema"ih ` iAdd ress ' , r yr . ✓ . , l r r {r r Supe�risor's Construction License � ��� ��-� Ex �{Dafe ��t "'��-�� 'r r /r ,.Hofne Improvement License ! �b� ��� r Date � r,"`f,�-3 ''f ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92:00 PER$9000.00 OF THE TOTAL ESTIMATED COSSTBASED ON$125.00 PER S.F. Total Project Cost: $ (e 3�'5'®0 FEE: $- '-7&, Check No.: I �jIb Y Receipt No.: � c NOTE: Persons contracting with unregistered contractors do not have access to Me guaranty fund Sigriafure of Agent/Owrer Signature of contractor FORTH q Town ofT EAndover ® - 0 Yy Z h h Y' O ver, ass' COC LAKE KICNE WICK A04ATE 0 S U BOARD OF HEALTH PER D Food/Kitchen Septic System THIS CERTIFIES THAT ................... BUILDING INSPECTOR .. .. . ... . ..... ..... ..... has permission to erect .. buildings on Foundation ................... ... . ....... .. k w... .........4.. Rough to be occupied as .....16&..... ... .... ... ... 1.' ........0%....................................... Chimney provided that the person accepting t s 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 IN 6 MONTHS ELECTRICAL INSPECTOR LESS C CTIO RTS 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 Approved by the Building Inspector. Burner Street No. Smoke Det. Rene ajMAN, ��l MA Home Improve menC t ontractor License#170810(Expires 1 2123/2 0 1 5); byAndeCSen Renewal by Andersen Corporation Federal Tax ID#41-1918413; 'dWfp QOw flEPLA CEMENT .lv•.J .., 30 Forbes Rd. Northborough,MA 01532 (508)351-2200 Fax(508)•986-7072 CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT I I ;Buyer(s)Name Date: PATRICIA DALEY - SEPTEMBER 18, 2015 Buyer(s)Street Address City State Zip Code 45 HIGHWOOD WAY NORTH ANDOVER MA 01845 ;Email Address Home Telephone Number Work/Cell Telephone Number j DALEY45QCOMCAST.NET 9786820612 Muyer(s)hereby jointly and severalty 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. i Total Job Amount $ 6,365 Amount Financed S 0 Est.Start Date Method of Payment Deposit Received(3391.)$ 2,121.67 Deposit at signmg$ 0.00 ChecklCash 10-12 weeks Balance Start of Job(33%)$ 2,121.67 Chock# Balance on SubstantialEst.Install Time At Substantial ✓ Credit Card Completion of Job(33%)$ 2,121.67 Co Plea nn S 0,00 1-2 days It credit card is selected,please No final m-ti he demanded unto a4 aNea a<e sst,d see Credit Card Payment form Buyer(s)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 i .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. i Renewal by Andersen Corporation Buyer(s) Buyer(s) Signature of Signature Signature X DAVID BARRY PATRICIA DALEY Printed Nam of Consultant Printed Name Printed No i YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. -------------------------------------------------------------------------- NOTICE OF G.ANGE[.L\TION i NOTIGE OF CANCELLATION I Date of Transaction -1/18/h .lou may cauml alts 1 Date of•1'r nsaetion D/f I/L', You may cancel oris transaction,without any penalty or obligadoty within three busiorss days front the 1 transaction,without any penalty or obligation,within three business days front the ralwve date.lY you cancel,any property traded in,any payments made h}'you under above date tf you carrel,any property traded in,any payments made by}ou under ;the Contract of Sal¢,and any negotiahl¢instrwuent execut¢d by ytiu will lie I the Contract of Sale,and any negotIahle instrument¢xecuted by you will be ;returned within 10 days following receipt by the L'antrartor("Seller")or your 1 returned within 10 da}s lollnwtng receipt by the Contractor("Seller") of yvur icancelladou notice,and any security interest arising out of the transaction will be 1 cancellation notice.and any security interest arising out of the transaction will be canceled. If you cancel,you must mah avallable to the Seller at your residence,in I canceled. If you cancel,you must Drake available to the Seller at your residence,in %substantially 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 Sale/or you tray,if you wish,comply with the Instructions of the I this Contract or Sale, or you may,if you wish,comply with the instructions of the Sc.Ur regarding the return shipment of the goods at the Setter's expense and risk. I Seller regarding the return shipment of the goods at the Seller's expense and risk. 4f you do make the goods available to the Seller and the Seller does not pick them up 1 tf you do make the goods avallable to the Seller and the Seller does not pick theta up l.w4LhIn 20 days of the date of your Notice of Cancellation,lou ntay retain or dispose I within 20 days of the date of your Notice of Cancellation,you may retain or dispose f of the goods without any further obligation. !t you Earl to make the goods avallable 1 of the goods without any further obligation. if you fait to make the goods avallable to the Seller,or if you agree to return the goods to the Seller and fall to dose,then 1 to the Seller or if you agree to return the goods to the Seller and fall to do so,then ;you renialn liable for performance of all obligations under the Contract.To cancel you remain liable for performance of all obligations under the Contract.To cancel I this transaction,mall or deliver a signed and dated copy of this cancellation notice 1 this transaction,oudl or deliver a signed and dated copy of this cancellation notice or any other written notice,or send a telegram to Contractort Renewal by Andersen,1 or any other written notice,or send a.telegratu to Contractor: Renewal by Andersen, 40 Forbes Rd. Northborough,NIA 01532. 1 30 Forbes Rd.Northborough,MA 01532. {I I HEREBY CANCEL.THIS TRANSACTION. I I HEREBY CANCEL THIS TRANSACTION. 1 mf,esS+?s".u- Nn-,N,'-e e�a I eu ,'rsc ,-m N tNa-^ 0-t.. 1 Renewal Renewal by Andersen Corporation MA Home Improvement Contractor byAnderrsen. .q* 30 Forbes rd Northborough,MA 01532 License#170810 (Expires 12/23/2015) wtr000w nerraceateuT ,,,A,,..I.,,,,c..:..,.."'° (508)351.2200 Fax:(508)-986.7072 Federal ID#41.1918413 Window Specification Sheet Buyer's)Nano' [)etc of:\glccmmnt PATRICIA DALEY FRI, SEP 18, 2015 The buyvi-N listed above herebyjoindy and sevcrallyagrce to purchase rile goods;nut/or sel vices listed below,ill accordanec with the prices and ternis described �otl the Specification Shcel and the Grml and the reverse cif the.accompanying CUSTOM WINDOW AND DOOR REXIOd�LLING AGRE,ENIE\'T,of which the Specification Sheet is part. WINDOW&DOOR DETAILS -- App. App.FApps - - - ExteriorAnt0nor---Color Hardware Hardwvare -LowEd/ Gri&e GO. Glass - Room d ,a;d=.n he;ght WindowIDoor Style Detail Casings Cid,Int Color style Screens smartsun Grilles Sash 1/a Sash z Llt1s Cellons t.ivin 1111 l0 65 CS:R full frame InUExt MF 908 HANH White Standard FTS martsu Gee _ 4/6 X ----- Temper.- Dinin 102 10 65 105 CS:L full frame Int/Ext MF 908 WHAVH White Standard FTS sm3ritsur GBG 4/6 X Temper Total 2 BAY BOW&BUILD OUT DETAILS Style Detail/ Approx width/ Approx. Number Frame Window End Ceptor LmvE/ Roof/ Hardwans Roam Count Sty", Flankers hel ht C-41tis Ang!a Utos Interior Ex/tnt Color Griltes sashes sashes Screens Smartsun soffit Color SPECIAIXY WINDOW DETAILS Full/ Approx. tov,E/ Specialty BAY/BOW ADDITIONAL WORK NOTES Room Count Style Insert U.I. Smartsun Grilles Grillo STyIo F�d/int Color Curnm, a sar,d,.. id,b.,/Ir , rim„un M. ,>guile. ADDITIONAL WORK DETAILS: Middle gbS to be a hori ontal FDL to sunu/ate doubleluurq u,indoru I Yes Contractor will wrap exterior casirigs with coil stock color of White Owner is aware that Contractor does not do any paintinglstaining or removal/installation of alarm system or window treatments/hardware.!tis the responsibility of the homeowner to have the alarm system and window treatmentslhardware removed prior to installation. We make no guarantee as to whether alarms or window 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.We 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 Yes Contractor will insulate,caulk and seal windows with 3-point 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. I Yes Building Permit--Contractor will secure any and all necessary permits. The fee for the per nit(s)is included in the total contract price. Yes All discounts have been applied to this agreement. r, ✓ li°s No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance form(s). It k agreed and undarstrxxl by and bet,uc it tin•partic,dwt dtir Sleet,along t,ith ill,(:USTOM tVINDOIV ANI)DOOR REMODELING AGREEMENT,coustiiutes IIIc -wire uudcrslmtding bcttecen the pmuu"and then.in,-uo wd'al uuder.tmidiuga clwnldug oe naxliljhu;any ol"till let III,This Six'cilication Shcet may not be dLnu!;ad ur iia lc_ruu nuxlifird or variezl in :mc,sat uulcss nu,h l:tngci:;tr in tyri;inw wd t;;ntr1 hr both the Itutcrtsl and(:ouu:uvot. Iln,'nsl 6crchy ackno,elydg,�that Bul ,Sj ha,a°art dtis Spccilicatiou shcit. Renewal by Andersen Corporation liuyc(\']�st�^ llnu. xj Signature of Consultant Signature ` Signature DAVID BARRY PATRICIA DALEY Print Name of Consultant Print Name Print Name 9 Do not remove unN Uai code InspedUon. Save label forfuture reference, 1 I d) Caaad� � Y s000R-QOoa Q' maMmnr.:^^• NLI MEE=cu U E UA rCU. d c ��d� m [L i Renewal bAndersen ' NINCON X"LAC6NQNi "AndewtOmIM - ? ararrcc +r AND-N-102 .IldgCblpo; Wood/Vlnyl Compostte .........._._... Dual Argon . Low-E4, Product Type: Casement ENERGY PERFORMANCE RATINGS U-Factor Solar,Heat GEIn Coefficlent 0•.29 1 .65 0 .28. fV .SA-P Metrlc/SI ADDITIONAL PERFORMANCE RATINGS isible Transmittance 0 .48 • MamnewrcaCPutam Ont4raa raOrga NiYminb aFPlcama xFi+C W^aNaa Pr aafunktnq•nNa prodvz i AVm'^'^?•IrRiC radlga an dabmNredprtdaA aatmr+w emdrbry argaapeetle pmmtiaee. WAC dad rmtfamnmYld arty pmdaaal don r t""tIM au.bw R aril'P..Vlt Mr-1'WM-a, cwNrmannmlara llnaaae rtr odnrpodu�pamrrriaa lmmn.,- '.. . 'ir+armmro I WTAPIOM A,12 ersen Co ora on: A Casement now it ' leu r mrnannana. nq Standard Raring • xx�az o AAMA mnwcsA IOL1.63/M4"5 DP psr DP36 'k 41Aj% Thap aUCmam . ,ly smm Baan . At! / arMinmmanf mrtla p .It * tem—bh 1r Qae Inane and anh ugqjjjWp4 • - � 10D-ob513972-001 1.laan oraacida Ar�o..cac.4lr=cc.irn.u>mon reaurmwn rmrA+xuomrmvremrmQr>T,. '. d SQX The CommonweAuh u,f Massacklaeft - .Departowat of In4striad Aceidents 091ce of invesoal&ns 600 Washington Sired Boston,MA 02111 www.rnass govIdie Workers' t~ompetmation Insurance Affifavit:BuUders/Contractors/Eleetrkiens/Plumbers Anoka!a!L*Uns io _ 'lea -'_int ibft Name(Business/Organizaticnglndividual): RENEWAL BY ANDERSEN Address: 30 FORBES ROAD City/State/Zip: NORTHBORO,MA 01532 _ Phone#: 508-3511-2200 Arejou an employer?Check the appropriate box: Type of project(regwtred): Cg lion a anployer with 30 4. 1 am a general oontxat:tor and 1 b. ID.Now construction. employees(full and/or part-time).* have hired the q6-contractors2. 1 am a sole proprietor or partner- listed on the attached sheat.t 7. Remodeling ship and have no employees These sub-contractors have. 8. ❑Demolition working fbr mein any capacity. workers'comp,insurance. 9, � n Uttildirig addition [No workers'comp.insurance 5. We are a corporation and its 10.(]Electrical repairs or additions required.] offices have exercised their 3.® 1 am a homeo-amer doing all work right of oxemption pet MM I LEI Plumbing repairs or additions myself:[No workers'comp. c. 152,[il(41,and we have no 12.❑Roofrepairs insum.ce required.]t employees.[No workers' 13.E]Outer comp.insurance required.] - -My applicant d;at checks box 41 must aiso till out the section Maw showing dwir workers`compensation poti4y Wotmation. t Houcowrm who submit this affidavit indio"S they tine doing all work and then hire outs*eutlrftatDn meat submt!a MW affideMt hu i Aiq such +C;ontractom that cneA this box must awtA"an additional sheat showing the name of the sub-oonnotoo and their workers`oomp,policy ittk mation lam an eiVloyer that is providing workers'con"sad©n lnsrrrance fir rev ensployam Below is the poltcy dad job site informar%n. Insurance Company Name: OLD REPUBLIC INS. C07--- Policy O: _Policy#or Selfans.Lic.#l: M1jVC,30543700 Expiration Date:_10-01-166 Job Site Address, 45 HIGHWOOD WAY _r-_ City/StttrZip: NORTH ANDOVER, MA 01845 Attack it copy of the workers'compt:usation policy declaration page(showing the pulley number and expiration date). Failtwe 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$250.00 x day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ceMft under the pains and penalties of peyary that the Wormadon provided above is true and coma Phone.t 506-351-2200 offlelal we only. Do not write in this arca,to be ronpieled by cid.or town o,)1c1aL City or Town: PermittlAcense# Issuing Authority(circle one): 1.Board of Health 2,Saliding.Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Penson: Phone#: ANDECOR-01 YADAVYO CERTIFICATE F LIABILITY INSURANCE F �10/11201 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the polley(bes)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 Ileu of such endersement(s). PRODUCER NOAH.,CT Willis Certificate Center Willie of Minnesota Inc. PHONE 877 945-7378 FAx c/o 28 Century Blvd ) AIC Ne: 888)487-2378 P.O.Box,TN 37 BAWLAMRM Cerlifica llllsxom Nashville,7'N 37230-b191 INSU 8)AFFORDING COVERAGE N=# INSURER A.Old Republic Insurance Company 24147 INSURED INSURER e Renewal by Andersen LLC INSURER C: 30 Forbes Road INSURER D: Northborough,MA 01532 INSURERS: _ 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. NOTVNTHSTANDING 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. JCY EXP LTR TYPE OF INSURANCE POLICY NUMBER MAIM YY EFF MMN LIMITS A X COMMERCIAL GENERAL UABWTY EACH OCCURRENCE $ 1,0D0,000 CLAM484 ME Fil OCCUR MWZY 305440 10/01/2015 10/01/2016 PNMISEs(Fa ocxumerwe S 500,000 _ MED EXP one Person) $ 10,0 PERSONAL&ADV INJURY $ 1,000,00 GENL AGGREGATE LIMIT APPLIES PER; GENERA,AGGREGATE $ 4,000,00 X POLICY D JECT F LOC PRODUCTS-COMPIOP AGO S 4,000,00 OTHER $ AUTOMOBILE LIABILITYOMBI (SING MIT(EaS 5,000,00 A X ANY AUTO MWTB 305438 10/01/2015 10/01/2016 BODILY INJURY(Per Person) 3 ALL AUTOS OWNED LED BODILY INJURY(Per sooident) $ NON-OVMED AMAGE HIRED AUTOS AUTOS per eerldmt S S UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAMS-MADE AGGREGATE $ DEQ I I REfENTIONII g WMERS COMPENSATION AND EMPOYERIT LIABILITY Y/N X STATUTE R L A ANY PPR�EnTORIPAR BER u�7 ECUTiVE AlNIA 30643700 10/01/2015 10/01/2016 EL EACH ACCIDENT $ 11000,0 OFFIC(Mandatory in NH) E.L. SEASE-EAEMPLOYEE $ 1,0001000 Irye�de W ON under EL DISEASE-POLICY LMR f 1,000, DESCflIPT1OF OPERATIONS below DESCRIPTFON OF OPERATIONS I LOCATIONS/VEHICLES(ACORD It",Addrdonal Remarks Sahk e,maybe attached U 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 ACCORDANCE WRH THE POLICY PROVISIONS. AUTHORVED REPRESENTATIVE Evidence of Insurance ®1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD i Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor i License:CS-MI25 JAB"L MOBIN= 86 GARDMM ST. LYNN MA 0190 r wry '�'"�'a Expiration Commissioner 10108/2018 C-�i�e�'oAr�conu�ea�n�C-�aarac�uaell3 � AtiFiira#:Bardnersdilaen Suporni it81IV BY `N TItN JAIz r•M3 .' OMTt' OR©UG H,MA 01532 1Jfi+s►ecra ry . f