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Home My WebLink AboutBuilding Permit # 4/11/2016 %AORTFI BUILDING PERMIT6V + S TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION O D is Permit No#- Date Received Date Issued: tMPORTANT: Applicant must complete all items on this page I.......... TYPE OF IMPROVEMENT PROP9 §ED USE ResiqWntial Non- Residential 0 New Building ne family 11�ddition ri Two or more family Li Industrial VAlteration No. of units: 11 Commercial T1 ,L Repairreplacement 11 Assessory Bldg U1 Others: 11 Demolition 11 Other 0,F V611and S , 'Watershed lDistrict ,," Q—,lY,Y,,Pter/ ,ewer DESCRIPTION OF WORK TO BE PERFORMED: If VP Identification - Please Type or Print Clearly , OWNER: Name: r 14)"'l L-64 Phone: 7 .5 Address: z Contractor Name Vzl 0 'F MR eFIVIN11141 0///// ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 ERS.F. Total Project Cost: $ r Nrcy, FEE: Check No.: /9 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty.fund 8ignatur I e I of Agent/Owner ignature of contractor Th Town oll �. ', Andover 0 zi i 1�~ �"; No. -� - - o h ver, Mass, &41 K6 911 COC NICtl[WIC I[ y1' ��S RRtED r,Pa�,�S V BOARD OF HEALTH Food/Kitchen 17 E R T T L D Septic System THIS CERTIFIES THAT ............ BUILDING INSPECTOR ..... ...... .. . . .......... .................................................. has permission to erect......... ............... buildings on ... ...... .... a.. m ... . . #. .................. Foundation ® Rough tobe occupied as ........... ... ..... . ......+refbap....................................................................................... 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 LESS CONSTRUCTIONFARTS 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. Proposal AB Carnes Roofing,Inc. Page 1 of 1 30 Arrowhead farm Rd Boxford,Ma.01921 978.887.1431 MA.CS-000230 and HIC Reg.176928 Proposal Submitted To: CHRIS WELCH Date March 22,2016 202 ROSEMONT DR Project Name SAME NORTH ANDOVER,MA 01845 Address 978-918-1156 We propose to furnish material and labor-in accordance with the specifications below: Eleven Thousand Five Hundred Eighty Eight Dollars($11,588.00) Payment to be made as follows:$300.00 Deposit,Balance Upon Completion Notice:All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from registration by provisions of Chapter 142A of the General Laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and status should be made to the Mass.govllicenses website. ROOF PROPOSAL N STRIP ROOF OF ALL LAYERS OF ASPHALT SHINGLES.COVER ROOF DECK WITH THE UPGRADED RHINOROOF TITANIUM U20 HIGH PERFORMANCE SYNTHETIC UNDERLAYMENT MEMBRANE.COVER EXTERIOR WALLS AND FOLIAGE WITH TARPS TO HELP PREVENT DAMAGE. 0 ICE DAM PROTECTION:INSTALL CARLISLE HIGH PERFORMANCE ICE&WATER BARRIER OVER ALL HEATED AREAS SIX FEET WIDE AT THE LEADING EDGE OF ROOF AND THREE FEET IN ALL VALLEYS.WRAP THE CHIMNEY(S)AND SKYLIGHT CURBS WITH ICE AND WATER BARRIER. N COVER ALL PERIMETERS WITH EIGHT INCH PREFORMED ALUMINUM DRIP EDGE. N INSTALL GAF COBRA RIDGE VENT AND/OR NOR ROOF LOUVERS FOR ADDED ATTIC VENTILATION. 0 COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS AND FLANGE. ® REPLACE WALL FLASHING(S)AS NEEDED WITH ALUMINUM OR LEAD AT THE ADDITIONAL COST OF$25.00PLFT.WE MAY NEED TO REMOVE THE SIDING TO PERFORM THIS WORK AND YOU MAY NEED TO HAVE A CARPENTER REINSTALL OR REPLACE THE SIDING THAT WAS REMOVED. ❑ CHIMNEY FLASHING:REMOVE EXISTING FLASHING FROM .gWMNEY(S).CUT NEW REGLET INTO THE BRICK AND SECURE THE NEW LEAD WITH METALANCHORS AND SEAL. PLEASE ADD T%80VE PRICEti,(BLACK TAR USED BY OTHERS IS NOT FLASHING) 0 COVER ROOF SURFACE WITHCERTAINTEED LANDMARK 24 LB LIFETIME(WARRANTY DESIGNER SHINGLES. 0 REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH SIMILAF AT ANADDI IONAL COST OF$4.00PSQFT. ❑ COVER ROOF DECK WITH CDX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADDITIONAL COST OF N NAILING: SECURE SHINGLES WITH EIGHT IN TOTAL COATED ROOFING NAILS AS PER CERTAINTEED SPECIFICATIONS. .-N SKYLIGHTS:REPLACE EXISTING SKYLIGHTS WITH NEW VELUX OR WASCO UNITS.WE WILL PROVIDE THE SKYLIGHTS&FLASHING KITS AT OUR EXACT COST FROM OUR SUPPLIER.OUR LABOR CHARGE IS$90.00 EACH IF THEY ARE THE SAME SIZE.INTERIOR WORK IS EXCLUDED, ❑ REPLACE DEFECTIVE TRIM BOARDS WITH CUSTOMERS APPROVAL USING NO.2 PRIMED PINE,ADD$15.00PLFT TO THE ABOVE PROPOSAL. CLEAN ALL PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA. THE PROPERTY OWNER AUTHORIZES AB CARNES TO OBTAIN THE ROOFING PERMIT.WE CANNOT ACCEPT RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS. CUSTOMER SHOULD COVER VALUABLES. GREAT CARE WILL BE USED TO PROTECT THE STRUCTURE AND FOLIAGE.HOWEVER,SOME MARRING AND OR MINOR DAMAGE COULD OCCUR. IN ADDITION,WE CANNOT BE RESPONSIBLE FOR ITEMS FALLING FROM WALLS,SHELVES OR CEILINGS DURING THE ROOFING PROCESS. SPECIAL INSTRUCTIONS: THE ABOVE PROPOSAL INCLUDES ALL SHINGLED ROOF SECTIONS OF THE HOUSE. r SKYLIGHTS:WE RECOMMEND REPLACING SKYLIGHTS WITH THE NEW ROOF INSTALLATION. UPGRADE SHINGLES TO THE LANDMARK 300LB HIGH DEF PREMIUMS,ADD$1705.00 TO THE ABOVE PRICE.YES( )THIS IS OUR EXACT COST WARRANTY UPGRADE:T CERTAINTEED WIND WARRANTY WILL BE UPGRADED FROM 110 MPH TO 130 MPH WITH UPGRADE TO THE CERTAINTEED HIGH PERF MANCE HIP&RIDGE CAPS AND STARTER COURSE AT NO ADDITIONAL CHARGE.YES l ) EMAIL ADDRESS: r Warranty:All work warranted against installation defects for 5 years;this warranty is limited to the installed item(s)and its repair only.Material is warranted by the manufacturer against defects for 50 years;see the manufacturer's warranty for exact warranty performance. Cancellation:Customer has legal right under federal law to cancel this contract without penalty or obligation within three business days from the date of signing this agreement via Priority Mail Delivery Confirmation. Please see reverse side. Dispute Resolution:All partes agree that any and all disputes relating to this proposal shall be settled by arbitration as provided by the AAA.This forum is user friendly and does not r quire lawyers.Please see reverse side. Signing this Prop gral me ns,you have accepted all the terms as stated on the front and back of this agreement. Please see reverse side. *Date of Acceptanr� `Y` ` �t4 Signature *Signaturd ! l Signatur C `✓ ( , /t PLEASE SEE REVERSE SIDE TOWN OF NORTH ANDOVER WASTE AFFIDAVIT As a result of the provisions of MGL Ch.40-s54, I acknowledge that as a condition of building permit# all debris resulting from the construction activity governed by this building permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL Ch.111-sI50A. Waste Disposal or Solid Waste Facility: ALLIED WASTE Address: 300 FOREST ST Town/City, State, Zip: PEABODY, MA 01960 NAME OF HAULER: AB CARNES ROOFING, INC. DUMP TRUCKS DATE: 4-11-2016 SIGNATURE OF APPLICANT: I'Cle C'ottltilonweaith of 1llassachusetts " r Department of ffidustrial Accideuts 1 Concess Stt-eet,Suite.100 Boston,IVIG 02114-2017 �rr'�inurf w)vfP,i uass.gov/dia Wuhlters'Compensation Insurance Affidavit:Hail(lers/Contract0r$/EIcctricians/.Plumbers, TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Mune(Business/Organization/Individuui):AB CARNES ROOFING INC Address:30 ARROWHEAD FARM RD City/State/;Zip:BOXFORD, MA 01921 Phone#:978-887-1431 — --` Are you an employer?Check the appropriate bar: Type of project(required): I.[d I am a anployer with SamB..._.cunployces(Roil and/or port-tune).* 7. Cf New construction .2,01 aril it sole proprietor or partnership and have ao employees working for me it 8. Remodeling nay capacity.[No workers'comp,instnunce requirettl 3.Lj Ian a homeowner doing all wort.myself.[No workers'comp.insurtace required.] 9. El Demolition 4,[][am a hnrneowner and will be hiring conu7tcrottw to conduct all work onmy property. 1 will 10 n Building addition cneure flan all contractors either have workers'compensation iusuraoce or toe sole I L❑Electrical repairs or additions proprietors with no employees 12.Q Plumbing repairs or additions 5.0 1 am it general contractor and l have hired the sub-contactors listed on the aaachcd sheet. These sub-coutrnctor's have employees and have workers'comp,iusurance.t I 3•[-1 Roofropairs 6,[]We are a corporation mid its officers have exercised their tight of exemption tater MOL C. 14. Other 152,41(4),and we have oo cmployces,(No workers'comp,insurance required.] *Any applicant that checks box ill tmst also fill out the section below showing their workers'compensation policy inlbrnration. — -- t liontcowners who submit this affidavit indicating they are doing all work and then hire outside contractors must subndt to new aflidavit indiuutiog such, lCouttactors that check this box must attached an additional sheat showing the naun;ol'the sub-contactors and suite whutber•or not dose entities have employees. If the sub-contractors have omployecs,tltoy nrost provide their workers'uongt.policy oundter. X ant an employer that isproviding workers'coillpellsotXoil n1,Ya1(ince fon"my employees'. Below is the policy and fob site inji.01'nlation, Insurance Company Name: TRAVELERS INDEMNITY CO OF AMERICA F I olicy I/or yt,. CHUB-OG36156-6-15 - 13xpiration Date: 10/15/2016 i1 -tots. Ltc.il:...-- Job Site Address: . --__ City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing tiro policy number and expiration dame). Faiture to secure coverage as required under MGL c. 152,§25A.is a criminal violation punishable by a tine up to$1,500.00 andlor one-year imprisonment,as well as civil pcnatties in the form o`f a STOP'WORK ORDER and it tine of up to$250,00 a day against Iltc violator.A copy of thus statement may be forwarded to the Office oflnvestigations of the DIA for insura Lice coverage verification, C do/terehy certify m the pfffns hail jjel /tiev ofperfttry that the inflrrinatioitprovided]drove is true and correct. �. � St rta u�c978-887 1 31.. --- . ._- :m'1_ � _ ._._17ato: -- I',tturte it_._.. . Official use only. Do not tw'ite in this urea,to he contlVeted by city or town of ficiell, City 01-Town: ----—--------- Permit/License It Issuing Authority(circle one): --—�� 1.Board of fleulth 2.Building Department 3.City/Town Clerit 4.Electrical Inspector S.Plumbing Inspector. G.Other Contact l'crsou;__„- ----------.__-_- -- — Phorte#: i II 0 DATE(MMIDD/YYYY) ACCOREP CERTIFICATE OF LL 4/11/2016 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), PRODUCER CONTANAME: BRIAN L. PRESCOTT&SONS INS PHONE FAX A/C Nps__ 963 EASTERN AVE E-MAIL ---- - ADDRESS: MALDEN;MA 02148 INSURER(S)AFFORDING COVERAGE NAIC if s INSURER A: IN,' RED AB CARNES ROOFING INC h INSURER B: Travelers Indemnity Company Of America {I � , - --- 30 ARROWHEAD FARM RD INSURER c_. BOXFORD,MA 01921 INSURER D 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. ------- ---------- ITYPE OF INSURANCE ADDL SUBR LTR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYYMM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY - PREMISES Ea occurrence $ CLAIMS-MADE u OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY E O- LOC $ - -- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accldant $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR I F EACH OCCURRENCE $ EXCESS LIAB ,_�.,,. CLAIMS-MADE �, ,., .� -_ .. AGGREGATE --$----- DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN „ TORY_LIMITS___--_ ER B ANY PROPRIETOR/PARTNER/EXECUTIVE 6HUB-OG36156-6-15 10/15/2015 10/15/2016 E.L`FACHACCIDENT $�QQyQQQ OFFICE/MEMBER EXCLUDED? N;.: I A (Mandatory In NH) E.L/DISEASE-EA EMPLOYE $ 100,000 ---------- If yes,describe under DESCRIPTIQN OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $ 500,000 TF F DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ROOFING CONTRACTOR - CERTIFICATE,,HOLDER CANCELLATION *' TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 NO AUTHORIZED REPRESENTATIVE Brian N.Leary,PRESCOTT&SONS INS O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD NOTICE Z NOTICE TOM 0 TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS I Congress Street, Suite 100, Boston, Massachusetts 02114 — 2017 617-727-4900 — littp://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21,22 &30, this will give you 11()ticc that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P .O. BOX 1450 MIDDLEBORO, MA 02344-1450 ADDRESS OF INSURANCE COMPANY (CHUB-OG36156-G-15)�". 10-15-15 TO 10-15- 16 POLICY NUMBER EFFECTIVE DAT-ES PRESCOTT & SON INS 963 EASTERN AVE MALDEN MA 02148 NAME OF INSURANCE AGENT ADDRESS PHONE # , /AB CARNES ROOFING INC 30 ARROWHEAD FARM RD BOXFORD MA 01921 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDATMENT ICAL TRE The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the. First. Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, il' the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 000849 WMG15 TO BE POSTED BY EMPLOYER Aass achusetts Deprtment Of PubHr SatcAy Board of Bu0dmg Requhatwns and Stjn�mar"s Lo censeCS-000230 BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD MA 01921 5 1 03107/2018 .............. r J and B siness Regulation Office of Consumer Affairs u X 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 176928 Type: Corporation Expiration: 10/10/2017 Trit 269957 AB CARNES ROOFING, INC. BARRY CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 01921 Update Address and returii card.Mark reason for change. �;GA, Address Renewal Employment ' Lost Card