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HomeMy WebLinkAboutBuilding Permit # 12/18/2015 I m. � "i(1r W CY I ' "i'0..✓ BUILDING PERMIT TOWN OF NORTH ANDOVER • APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ru,araa "w'` J Date Issued: " CHU, IMPORTANT:Applicant must complete all items on this page LOCATI;C7N ,. , rirt PROPERTY QlNER` +� ,, �, , c l�r,nt I 'MIt CIITFftT His(anc�7�strit yep MAt' NCACEL . l - Ma+ehineSlitsil'a �y eh . 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 cipie 11N'e11 :; ": ❑ Floodplain ends � 111fa�ersh�d C?� tri+rtt � i uuetl b W atwer Identification Please Type or Print Clearly) OWNER: Name: epresco.4Vi iWe Con& ASSOG Phone: Address: Cif C+ T + �OR ► arrl CtM1 � � hohe„ „i t r 64Yuperlsbr°s Co rtru. �on Ller� eh Chat t li ARCHITECT/ENGINEER Phone: Address: Reg. No. � l FEE SCHEDULE:BULDING PERMIT:MOO PER$1000moo .00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ rr9- Check No.: 2 I 59B Receipt o.: NOTE: Persons contracting wit registered contractors do not have acre•s WA uaranty fund iglnfure o °Age, a Signature of contractor ... ,..... .. t$ORTH Andoverr9 Town of • 7,41— / _ _ soft -ja"f7h ver, Mass, COC MICKE wIC of y1. 7� u BOARD OF HEALTH Food/Kitchen PEM T Septic System 1 LD ,.,,. ... BUILDING INSPECTOR THIS CERTIFIES THAT ........ ... ... ............ ..... ..... ... ....®............. Foundation has permission to erect.......................... buildings on ... .. .. .. . ..j..2.0..... ...D410 ... .... Rough tobe occupied as .. .. ..... . .......A-14.... ........... ................ .... .............. ............................... Chimney provided that the person accepting this permit sh II 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT ELECTRICAL INSPECTOR UNLESS CONSTRUCT Rough Service ............ ...... ....... .. .................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required toOccupy Buildin Rough Display in s Conspicuous Place on the Premises — Do Not Remove Final No Lathing r Dry Wall To Be one FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Diamond Nill Builders, 1,1,C• uiwirifil� iMlf g8 Portsmouth Avenue, Stratham, NH 03885 (603) 580-5368 1W,d� me ndhi,l9bL,Ail eu;�wcorri Agreement Diamond Hill Builders offers complete building and remodeling services �r,�, including new construction, renovations, home and business improvement needs for individuals and businesses throughout the Seacoast NH area. We are fully insured and offer the highest quality workmanship available. In addition to new home construction and remodeling we specialize in home additions, garages, roofing, decks, windows, doors and siding.All of our work is guaranteed. Date: December 17 2015 Job ID: Great North Property Management: Prescott Village Repairs Customer Name: Great North Property Management c/oPrescott Village Customer Address: Stacey Ln North Andover, Ma • • Description • Unit 20,13 Remove and replace the window sash. Prime and paint as needed. • Unit 18 Remove the rotted windows and replace with new Harvey Vinyl Windows. (3 Windows) • Unit 9 Remove the rotted window and replace with new Harvey Vinyl Window unit. (1 Window) Price Breakdown Unit 20.13 Window Repairs $ 385.00 Unit 18 Window Replacement $ 2,/q 0®e®® Unit 9 Window Replacement 900.00 Total $ 3'985.00 Comments: Please note that this price is based on the work requested. Please note that any hidden damages are subject to a change order. Please note that this price includes materials, labor and dumpster. LINE# DESCRIPTION QTY UNIT PRICE Ex'1'E1vlir:v 10000-1 Welded Vinyl RW 2-Lite,Unit Size 62.5 x 47,RO 63 x 47.5 1 Full Screen,Fiberglass Mesh,Screen Shipping Separate=No Window Label=Harvey,Double Locks,Sash Limit Devices=None,Pin �— Exterior Sash=No Overall Glass Thickness= 11/16",Double Glazed,Low E,Argon Filled, Custom Annealed IG=No,IG MFG=HY 7 Unit 1:U-Factor=0.3, SHGC=0.3,VT=0.55,NFRC CPD Number= s- HII M 47 00003 00001,Custom/Call Size Option=Custom Size,New Construction,Reverse Sash Pattern=No 1 Unit 1 Left Glass, 1 Right Glass:NFRC CPD Number=HII M 47 00003 E, 00001 Base Color=Almond Energy Star Overall Rough Opening Width=63,Overall Rough Opening Height= 47.5 Integral L Fin Adaptor,Receiver Pocket 6 9/16",Primed,4 Side Factory Applied Room Location: None Assigned LINE# DESCRIPTION QTY UNIT PRICE EXTENDED 11000-1 Welded Vinyl RW 2-Lite,Unit Size 62.5 x 54.5,RO 63 x 55 1 Full Screen,Fiberglass Mesh,Screen Shipping Separate=No Window Label=Harvey,Double Locks,Sash Limit Devices=None,Pin i ------------- Exterior TExterior Sash=No Overall Glass Thickness=11/16",Double Glazed,Low E,Argon Filled, Custom Annealed IG=No,IG MFG=HY Unit 1:U-Factor=0.3,SHGC=0.3,VT=0.55,NFRC CPD Number= �� HII M 47 00003 00001,Custom/Call Size Option=Custom Size,New Construction,Reverse Sash Pattern=No Unit 1 Left Glass, 1 Right Glass:NFRC CPD Number=HII M 47 00003 62; 00001 Base Color=Almond Energy Star Overall Rough Opening Width=63,Overall Rough Opening Height=55 Integral L Fin Adaptor,Receiver Pocket 6 9/16",Primed,4 Side Factory Applied Room Location: None Assigned Last Update: 10/20/201 12:38 PM Page 1 Of 3 Printed:10/20/201 12:39 PM 5 5 LINE,# lll+LSCRIY HUN 12000-1 Vinyl Casement,Unit Size 27.75 x 65.5,RO 28.25 x 66 1 Fiberglass Mesh,Screen Shipping Separate=No i Window Label=Harvey,Sash Limit Devices=None,Standard Overall Glass Thickness= 11/16",Double Glazed,Low E,Argon Filled, �. DSB Custom Annealed IG=No,IG MFG=HY �. Unit 1:U-Factor=0.3,SHGC=0.27,VT=0.47,NFRC CPD Number= HII M 38 00925 00001,Custom/Call Size Option=Custom Size,New Construction,Hinge Right Unit 1 Glass:NFRC CPD Number=HII M 38 00925 00001 j Base Color=Almond - I Energy Star Overall Rough Opening Width=28.25,Overall Rough Opening Height= 66 Integral L Fin Adaptor,Receiver Pocket 6 9/16",Primed,4 Side Factory Applied Room Location: None Assigned KINE# DESCRIPTION QTV UNIT PRICE EXTENDED 13000-1 Vinyl Casement,Unit Size 68.75 x 44.25,RO 69.25 x 44.75 1 Fiberglass Mesh, Screen Shipping Separate=No Window Label=Harvey,Sash Limit Devices=None,Standard Overall Glass Thickness= 11/16",Double Glazed,Low E,Argon Filled, I Custom Annealed IG=No,IG MFG=HY Unit 1:U-Factor=0.3, SHGC=0.27,VT=0.48,NFRC CPD Number HII M 38 00925 00003,Custom/Call Size Option=Custom Size,New e Construction,Hinge Left,Venting Pattern Configuration=LR Unit I Glass,2 Glass:NFRC CPD Number=HII M 38 00925 00003 Unit 2:U-Factor=0.3,SHGC=0.27,VT=0.48,NFRC CPD Number HII M 38 00925 00003,Custom/Call Size Option=Custom Size,New Construction,Hinge Right,Venting Pattern Configuration=LR Base Color=Almond Energy Star Vertical Common Frame 0"thick,44.25"length Overall Rough Opening Width=69.25,Overall Rough Opening Height= 44.75 Integral L Fin Adaptor,Receiver Pocket 6 9/16",Primed,4 Side Factory Applied Room Location: None Assigned Last Update: 10/20/201 12:38 PM Page 2 Of 3 Printed:10/20/201 12:39 PM 5 5 The Commonwealth of'Hassc!chusetts Department of•IndustrialAce'dents z. 1 Congress Street,Suite 100 -Boston,MA 021Z�2017 a Vww.mass.gov1dia da workers'CompensationTus EraAc D WXTH�TJ3EP RMITxT�l`T��'UTHO�TY.txicianslPXumbexs. TO BE Please Print Le ibl Applicant Information ` LU. Namo (Business/Oxganization/Individttal): Cs .A.ddxess: •IBJ U3�8 � �®. City/State/Zip: 6 hone#: Are you an employer?Cheekthe appopriafe box: Type of project(requir i ed): em to ees full and/or part time)l' r. Now construction 1. I am a employer with P Y a sole ro riefor or pa ership and have no employees Working for me in 8. [�Remodeling 2.❑any P P any capacity.[Now orkers'comp.insurance required.] 9, El Demolition 3, I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 ❑Building addition 4. I am a homeowner and will be thing contractors to conduct all work on my property. I will 11.F1 Electrical repairs or additions Ole ensure that all contractors either have workers'compensation insurance or are s 12.i-1 Plumbing repairs or additions - prop,rietors withno employees. Ll 13.[�Roof repairs 5,E]I am a general contractor and T baye hired the sub-coirtractors listed on the attached sheet. �� ®t,) These sttb-contractors bade employees and have workers'comp.insurance 14. Other TvIGI c. 6.❑We are a corporation and ifs ofCgers have exercised their right o£exemption per 15%§1(4),and we have n4 employees.[No workerscomp.insurance required.] •r:. FAny applicantthat checks tiox#1 must also fill out the section below showing theirwozkers'compensationpoliey information. i Homeowners who t this box musk atta ed an additional she,dicating they are et showing h naameall work andth'a ofthe sub contractors and s ate whether or n�of hosindicating entitiesthave h• •Contractors that the employees. 7fthe sub contraefozs have employees,they must pro-Vide their workers'comp.policy number. X am an employer that is pi'ovidirzg-work�rs'compensation insurance for my employees.'Belortv is t/ie policy and jolt site information. /��,. ,n n n L��f Net! 0.. l.J� DLJ 1 HCl Ur�C(,a ►�� Insurance Company Name: ' � ?,Q,,�2—Q�®d s Expiration Date: Policy#i✓or Self-his,Lic.#: fACity/State/Zip: ' �ir V Job Site Address: Attach a copy of the workers' compe, ation policy eclaration page(showing the polio*rtumber and expiration d te). lat on punishable by a fine UP to$1,500-00 Failure to secure coverage as required under MGL penalties in§he form eriminal a STOPiW01RI ORDER and a ane of up to$250.00 a and/ox one-year imprisonment,as well p day against the violator.A copy of this statement may be forwarded to the Office of luvestigations of the DTA for insurance coverage verification. and T do hereby cert Y under traepair andpenalties ofperjury lint the informationprovided abo �Au� correct Date: 2 Si nature: Phone#: Off tial use only. Do not write in this area,to be completed by city Or tOiwn official.. Permit[License# City or Town: IssuingA.uthority(circle one): ' 1.Board of Health. 2.Building Department 3.City/Town Clerk. 4.ElectxicalInspector 5.PlumbingTnspector 6,Other Phone#• Contact PerSon: ® DATE(MM/DDIYYYY) ACCWBO CERTIFICATE OF LIABILITY INSURANCE 9/21/2015 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). NNT CT Jessica Hildreth, ACSR PRODUCER pA ' CROSS INSURANCE - LACONIA P"CN o Ext): (603)524-2425 FAC No:(603)524-3666 155 Court Street E-MAILss:]hildreth@crossagency.com INSURERS AFFORDING COVERAGE NAIC# Laconia NH 03246 INSURERA:Frankenmuth Mutual 13986 INSURED INSURER B:Continental Indemnity Company DIAMOND HILL BUILDERS LLC INSURER C: 98 PORTSMOUTH AVE INSURER D: INSURER E: STRATHAM NH 03885-2415 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1592150689 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 HEREINIS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADD SUBR POLICY EFF POLICY EXP I LIMITS LTR TYPE OF INSURANCE POLICY NUMBER (MMIDDNYYYI IMMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE To RENTED 300,000 A CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence S BOR6165548 9/19/2015 9/19/2016 MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY I JECT LOCPRODUCTS-COMP/OPAGG $ 2,000,000 S OTHER: AUTOMOBILE LIABILITY EOMS'NdeD SINGLE LIMIT S 1,000,000 ntl ANY AUTO BODILY INJURY(Per person) $ T A ALL OWNED SCHEDULED AUOS X AUTOS BA 6165596 9/19/2015 9/19/2016 BODILY INJURY(Per accident) S NON-OWNED PROPERTY DAMAGE S X HIRED AUTOS X AUTOS Per accident Uninsured Motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED I I RETENTIONS BOP6165548 9/19/2015 9/19/2016 $ WORKERS COMPENSATION X STATUTE OERH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? ❑y N I A B (Mandatory in NH) 46-843442-01-05 9/19/2015 9/19/2016 E.L DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 500,000 A EMPLOYMENT PRACTICES LIAB BOR6165548 9/19/2015 9/19/2016 EACHCLAIM $100,000 RETENTION: $5,000 AGGREGATE $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Christopher Howlett is excluded from Workers Compensation coverage. Where required by written contract, Great North Property Management, its officers, directors, and employees are listed as additional insured for ongoing operations with respect to liability arising out of work performed by or on behalf of Diamond Hill Builders LLC. CERTIFICATE HOLDER CANCELLATION (603)766-6295 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Great North Property Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3 Holland Way, Suite 201 ACCORDANCE WITH THE POLICY PROVISIONS. Exeter, NH 03833 AUTHORIZED REPRESENTATIVE J Hildreth, ACSR/JH5 ©9988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2094/09) The ACORD name and logo are registered marks of ACORD INS025 19014011 Massachusetts Depart rne int of PuWic Safety Board of Buflding IlRiugWabions ind Standards C'6pwalluthyni supel 6,ml [Jcensw! CS-059504 PAUL RABENIUS 134 MILL N HAMPTON NII,03;q Exp�natiicm 09/19/2016