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Home My WebLink AboutBuilding Permit # 1/13/2016 RTfj BUILDINGBT � t% TOWN OF NORTH ANDOVER k" APPLICATION FOR FLAN EXAMINATION Permit N � � Date Received�� _ °'VAT Date Issued: J" SORT Applicant must colnplcte all items on this pa c 77, LAT� C KL rlrrt" PROPER ""O � v , Is Lstit kgs ra � ► ""Mao, TYPE OF IMPROVEMENT PROPOSED USE Residential Non® Residential ❑ New Building t-One family ❑Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial Repair, replacement i i Assessory Bldg I i Others: ❑ Demolition ❑ Other ❑� 1 : Cc; lb rfloodpl it tl, nd t 1 t l i ript n t �/herr uc. csAll S;�1�cT_�P�,�S� C��,� b s 5� ;/✓C . Identification Please Type or Print Clearly) OWNER: Name: �t Phone: A DB 3 '7 C u1i ��/ c� ys Address. 2a 4 ; T , S ' w s � r �io Fo ela r rr tLon � afo ARCH ITEOT/ENGINEER Phone: Address: Reg. No. PEE SCHEDULE,L3ULDILNG PERMIT.$1 ,00 PER$1000.00 OF THE TOTAL E TTML,AT"ED COST BASED ON$925.00 PER S.F. Total Project Cot: � � I � � FEE: Check No.: Receipt No.: OTE: e ffso-4kacting with-—unregistered contractors do not have ac: s�t t ae ran fiend i Haat r of Anent/ ner Signature of contrat r -Town of Andover O M ® — 0 . LANE h ver, �.SS' (410 COC MICMEMCK 1" �A �V °R',rE® Pfa��S S tl BOARD OF HEALTH PERMIT L Food/Kitchen Septic System .,, . , , ., .' BUILDING INSPECTOR THIS CERTIFIES THAT ......... ... ...... . ........... ......... ...... ................... .............. has permission to erect ........ buildings on .. _6 Foundation //®A FA 10Na Rough to be occupied as .!�. ........... .`fA�. ... ....................................... Chimney ................... .... ............. provided that the person accepting this permit shall in every Upect 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 IT I I 6 MONTH ELECTRICAL INSPECTOR UNLESS CONSTRUCST Rough Service ........... .... ...... ........ ............... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy.Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final ® •Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Bid Date: 12/28/2015 united Homo Expertx Full Worker's Compensation Coverage $4,000,000+Liability Ins.Coverage Owner: Dennis Duffy &United Painting Co.,Inc. Industry leading Warranties Company: 60 Pleasant St.Suite 1 Flexible Payment Plans available Street Address: 63 Crossbow Ln Ashland,MA 01721 Family Owned and Operated City,St.Zip: North Adover,MA 01845 508-881-8555 FAX 508-881-5584 MA HIC License#157108 Phone#; 508-335-9181 www.UnitedHomeExperts.com MA Constr.Supervisors License Phone#: RI REG#22948 RRP License#NAT-28008-1 Fed 1D#04-3541521 Qty Siding-Replacement Brand(if applicable): Everlast Composite Siding Door Replacement Install new door(s)with proper flashing,sealants,and insulation 2 where needed.Dispose of old door(s). Brand(if applicable): Integrity by Marvin Total Cost of Labor and Materials: $33,150 PAYMENT TERMS: A non-refundable deposit of 1/3 of ALL ACCEPTED PROJECTS is due upon contract authorization with 1/3 of EACH PROJECT due upon half of completion of EACH PROJECT,and the balance of EACH PROJECT due upon completion of EACH PROJECT along with any additional work requested by customer. LIENS DISCLOSURE: State law requires us to inform the property owner of contract liens.A lien or security interest has NOT been placed on the residence.Any contractor,supplier,or subcontractor may lien the real property if the property owner or the general contractor fail to pay for goods or services delivered or installed at the work location. Some contractors and suppliers automatically send letters of notification similar to this notice. At the owner's request,we will provide original lien release documents from anyone who provides said materials or service. NOTICE OF CANCELLATION: The property owner may cancel this transaction at any time prior to midnight of the third business day after the date of the contract without any penalty or obligation and has been notified in writing of such. NOTICE: All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to; Registration Division,Program Coordinator,One Ashburton Place Room 1301,Boston,Ma 02108 Tel:(617)727-3200 ext.25239 PERMIT: A building permit is required for work being done on the property listed above.The owner has authorized United Home Experts to obtain such permits as the owner's agent for any work requiring a permit.Owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. SCHEDULE: The following schedule will be adhered to unless circumstances beyond the contractor's control arise. Proposed Work Start Date 1/19/2016 Proposed Completion Date 3/4/2016 lug- 0t131313 f _ ... ContractojSiat�ure Date f Au zed Agerl Date The Commonwealth of f A(assac*usetts Depar6neiet of lndus&W Acddews Office of Investigations 4 I Congress Street, Suue 100 Boston, AL402114-2017 www mamgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Elecniel ns/Plumbera ARolicagl Information li Please nt L ` hT Name (Business/OrPaiz3nomb&vidua1): I /// ./ Address:_ '�O ('ClSG+'�T ClTV►�L . C itrr/S ;, 1'r Phone#: Alpf as empigw,C6ee!{the sooropeiate wy, Typo ofprgject l gHired): 4. Q I am a general contractor and l 1. i an,4 emplu e; .;�' a have hired ti�a'siil5-contcactors Li Naw cogstruciion 2. E '�crparmer listed on the attached sheet t, ttcmodeling ❑ These sub6c tit Tuve 8. Demolition ship and have Ito empla'ees employees,and have workers' t� . wig fb"r 3pie in " n:' t 9. ❑ Bung addition (No worS m' bOxInct comp. utsurance. ` 1, Cl we ars a and its 10,[] Electrical repairs o additions Vons eoQvner of€tcers have their 11.[�P1�ih*M tepaus or additions 3.❑ 1 am a ho Ong all work t t f �iCrL o ! p nih. ¢ Pdr 12.[� Roof mpairs myself i '132 1`(4�,anti we have no r F.: 13.0 Other insurance t eanp(aYeas. No w rhers' „ )ZT urwCQ. -,A*3PPt bd�t l mmt afsn t�014 be secnan below ii�owma a t�txas ca !rQ.a;l��!uy t Ftoeteoanxri tihw si�ib 'I f> "� tt►ey lire do tll wa�c ted ttka tugs Ougidt'e�ptrar�brs must tubtmit+ww atti4w t kdepa"such. rCanaactars t6et ctie tltei herr meted ll tiairal tit st i tliettaemp a sa6=gi4tt and maw mer or mot dww anotia/lave anployam 1t'dte `hex# ft9 aft*Mvwido*P& 004",%No PO&TM01ber, �r.•i r r t ern sr� onployer Ax m prav�� rte'6°�P�°�a:b�sraanrt jor�y ls�lojt els 'Betoip•bahe po�4y tzndJab_VU Insurance Company Name: — - _--- Policy #or Self-ins. Lie, #: � Expiration Date: 0� �. sr City/state/zip:, 4AY Job Site A odrass.. - . tl date n tYioneclaratne(song tRe pultcX q�nmber pid ezpir Qq ). F it 04 r �,: polky F of a r v' Section 2S of 14iGY,c. T$2 jan eatd to'ffle mtposttlon ofenip we s9 vii peaslTiei m the 6tXm bf sft]P VliOitI � ,sQd a lane stateumt m be fotytrarded ' i.. ,1 a of f may to tha ce taf ,„> coSlea�e va '00a I d0' w pei irry"d6ir ilse brJorF doi7 pruafded aLlwe B bait correct offieW we ou1J'. Ao aof wr& arca;to be cmWicad y e>dry or m+�o�tdot Clty or Town: Pernit/Lieease # Inning Asthority(circle nee): 1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6,tither Contact Pen• Phone rso OP ID: KG fAD ) �cvR® CERTIFICATE F LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A METYEOR NEGAT VELYLDER. THIS IOAMEND,N ONLY EXTEND OR ALTER D CONFERS NO TIHE COVERAGE AFFORDEDON THE GHTS UPABYTE SCERTIFICATE DOES NOT AFFIRMATIVBELOW. THIS CERTIFICED ATE OF INS D THE CDOTFSCAOOT HOSTI UTE A CONTRACTBETWEEN THE ISSUING INSURER(Sto REPRESENTATIVE OR PRODUCER,ANcertificate holder ic to rtanDPolcoesAmay SegRED, the uire an endorsement A statement(ies) must be rondthis ceBficOaGe does not vconfernghtstothe the terms and conditions of the policy. certificate holder in lieu of such endorsement s . CONTACT NAME FAX PRODUCER PHONE IAIC Noy East Douglas Insurance Agency (Ale,No,Ext): PO Box 1370 EMAIL ADDRESS: Douglas, MA 01516 PRODUCER UNITE51 Marc Larocque CUSTOMER ID!k NA;C INSURER(S)AFFORDING COVERAGE INSURED United Painting Company, Inc INSURER Essex Insurance Company 34754 dba United Home Experts INSURER B Commerce Insurance Company 60 Pleasant St. Ste 1 INSURER c Essex Insurance Company Ashland, MA 01721 INSURER 0:AEIC INSURER E: INSURER F REVISION NUMBER: THE COVERAGES CERTIFICATE NUMBER: 4E INSURED NAMED ABOVE FOR THIS IS TO CERTIFY THAT THE PONYIREQUIREMENNT. TERM OR CONDIES OF INSURANCE LISTED TION OFHAVE BANY CONTRACT EEN IESODESCRBEDR OTHER OHE HEREIN ISCUMENT WSUBJECITH T TOTALLL THE TEROIjCY O WHICH MS. !NDICATEC NOT'NITHSTANDING CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLI EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED L CY EFF P Pouf EIXPS LIMITS ADDL SUBR POLICY NUMBER (Mm MMIDDIYYYY 1,000 000 ;IN SR TYPE OF INSURANCE I EACH OCCURRENCE LTR 100,00 GENERAL LIABILITY DAMAGE TO RENTED 2CU3629 04/15/2015 04/15/2016 PREMISES ilia occurrence ' 5,000 A X COMNIER(aAL GENERAL LIABILITY MED EXP;Any one oersonl CLAIMS-MADE X OCCUR1,000,00 PERSONAL 8 ADV INJUR� - S GENERAL AGGREGATE 2,000,00 PRODUCTS-COMP OP AGG 3 2,000,00 GEN'L AGGREGATE LIMN APPLIES PER. 5 POLICY PRO LOC CONIBINED SINGLE LIMIT 1,000,00 iEa acaaenl) AUTOMOBILE LIABILITY 04/15/2015 04/15/2016 BDGTQN BODILY INJURY;Per Gerson S B ANY AUTO BODILY INJURY IPer acnaen( ALL OWNED AUTOS PROPERTY DAMAGE X SCHEDULED.AUTOS ;PER ACCIDENT) 5 X MIRED AUTOS 5 X NON-OWNED AUTOS EACH OCCURRENCE 3 4,000,00 UMBRELLA LIAB X OCCUR4,000,00 AGGREGATE X EXCESS UAB CLAIMS-MADE 10105017 04115/2015 04/15/2016 s C 3 DEDUC t IBLL RET EN I ION fORY �I RY LIMITS ER 500,00 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN wCC5010274012014 08115/2015 08!1512016 E.L EACH ACCIDENT S 500,00 D JN1,PROPRIETCRbPARTNER.EXECU7IVE , N I A E.L DISEASE-EA EMPLOYEE 5 f*I1r:hR MtMBLR L:u:LUDED' 500,00 (Mandatory in NH) E.L.DISEASE-POLICY LIMIT 5 n yes-descnoe under DESCRIPTION OF OPERATIONS berow All corporate officers are covered under the workman's compensation policy DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule.if more space is required) � CANCELLATION CERTIFICATE HOLDER LAwrmoRCMMED OULD ANY OF THE ABOVE DESCRIBED POLICIES B=CANCELLED E EXPIRATIONDATE THEREOF, NOTICE WIL CORDANCE WITH THE POLICY PROVISIONS. I REPRE Marc Larocq .11,4" - 001988-2009 ACORD CORPORATION. All rights reserved. -#ecnRn I�, >u� �``'+rr' �'�� ,.nus Fv{{:��'� '� +��,tlt�s,•�l't�.S� E�1`. 77 '. p�• C I� � k�4mmf � � LJ SGP �Fyl�2�?'GIl�Z Y� QJ�t7�'GC!/�l�l� c� Office of ConsumerA.tt'a rs a B d usmess Regulation 10 Park Plaza - Suite 5170 Boston, Ma ,. achusetts 02116 Home Improvem� -; ntractor Registration Registration: 157108 -L_ Type: Supplement Card UNITED HOME EXPERTS ` Expiration: 9/5/2017 MICHAEL DUDLEY = - 60 PLEASANT ST STE1 ASHLAND, MA 01721 Update Address and return card. Mark reason fog'change. SCS t 0 20M•06/11 Address [] Renewal F] Employment Lost Card n�,G C(1017L1I1P?t.Illr�lR o��/iCCIdJ2C/IG.JP,�r1 '' ice of Consumer Affairs&Business Regulation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ' Office of Consumer Affairs and Business Regulation gistration 1QgType: 10 Park Plaza-Suite 5170 Ex (ration - P F-l51 �;;;, Supplement Carl Boston,MA 02116 UNITED HOME EXP�1 ' MICHAEL DUDLEY 60 PLEASANT ST STE ASHLAND, MA 01721 Undersecretary Not valid without signature i 1