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Home My WebLink AboutBuilding Permit # 5/9/2016 BUILDING PERMIT OORT#q TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: �r,G Date Received �SACH 5 Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print, PROPERTY OWNER Z", Print 1 100 Year Structure MAP PARCEL: yes no ZONING DISTRICT: Historic District yes no Machine Shop Village yes ncd TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building 9 One family El Addition 11 Two or more family [I Industrial Li Alteration No. of units: El Commercial WRepair, replacement El Assessory Bldg El Others: 0 Demolition 0 Other ti C1 v kfffi,75r/ii W�"41,4""��g 1, J �7, ❑Welland fib fat rs k'e D DESCRIPTION OF WORK TO BE PERFORMED: Identi icrtion�—Pllrase Type Or Print Clearly OWNER: Name: Phone: 0C r 6 Address:_,> >I I'J c-: 71 T-j ( ( Contractor Name: cl Phone: 2 2�,`L Email: J Address: Supervisor's Construction License: 52-4(1 Exp. Date: Home Improvement License: 705-7 --Exp. Date.,- ARCHITECT/ENGINEER Phone Address: ",Reg. No- FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASEUGAN$125.00 PER S.F. Total Project Cost: $ (f)t(700, FEE,:, -7- Check No.: Recbipt,No.-.:, Oce, NOTE: Persons contracting with unregistered contractors do not liave.'access'.tio uara tyfitnd .......... 1141"All, NORT#y ® n o �vv, � L nuu v er O ` No. � i� - � O LANE h ver, ass, Q _q cocrAl LCMEWICK �1' A�RATEO P � _tS S U BOARD OF HEALTH Food/Kitchen PER.Mn LD Septic System 36 THIS CERTIFIES THAT0 BUILDING INSPECTOR ..... ... . ....... . has permission to erect g ..�5. ►..C. � . Foundation ....... ................. buildings .. ...... Rough tobe occupied as .......... ...... ....ire......................`................................................................... Chimney provided that the person accepting his 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 UNLESS CONSTRUCTION STARTS Rough p,,,� ... .......• Service ........ .. �'�.4r.!J'�f.' .. . ^............... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Islay 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. CID Roofing Vincent Colangelo 0 3 Hodgson St. Tewksbury,Ma 01876 CIL 978-656-8497 vincentcolongelo@sbcglobal.net HIC Llc# 170575 CSSL Lic# 105943 00 0 Customer: OWENS CORNING PREFERRED CONTRACTOR r . Description of work Performed: Pei Obtain required town permits& provide certificates of insurance&workers compensation Provide Dumpster set on planks *for contractors use only(materials all recycled) Attach Large Tarps to protect adjacent finishes, landscaping, and property. Strip-off existing layers of roofing on complete house& re-nail any loose decking Install 8inch u Aluminum Drip edging/Owens Corning Starter Shingles Install Owens Corning Ice &Water shield 6ft at eaves, 3ft in valleys, around all pene ations Install Synthetic felt paper to entire roof Install Owens Corning LifeTime warranty TruDefinition Duration shingles K Install new neoprene vent pipe flashings on all plumbing pipes 0, O Install Owens Corning VentSure ridge venting with moisture guard Install Owens Corning ProlEdge hip& ridge cap shingles Completely re-flash chimney with lead Owens Corning Preferred contractor installation with full wqrraqty q All work will be completed according to state and manufacturing codes and specification e day we will have e roof water tight, clean gutters, completely clean the job site, and use a magnet roller to collect scattere Additional work to be performed All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above specifications must be made in writing on an Add-ori/Modification of Contract form and may become an extra charge over and above the amount stated herein. This agreement is contingent upon delays beyond our control.Owners to carry fire,tornado and other necessary insurance.Our workers are fully covered by Worker's Compensation Insurance. Homeowner agrees to pay for all work as set forth below. If the homeowner defaults, homeowner agrees to pay all costs of collection, including reasonable attorneys fees,in addition to other damages incurred by contractor.Full Payment is due upon completion of work. We propose hereby to furnish material and labor - complete in accordance with the above specifications, for the sum of: dollars ($ Said amount shall be paid as follows: Note:This proposal may be withdrawn by us if not accepted within days. YOU, THE BUYER, 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 FOR AN EXPLANATION OF THIS RIGHT. THIS SALE IS SUBJECT TO THE PROVISIONS OF THE HOME SOLICITATION SALES ACT AND THE HOME IMPROVEMENT ACT THIS INSTRUMENT IS NOT NEGOTIABLE; Work will not begin until your right to cancel has expired and you have,paid a deposit of,// dollars ($ unless this agreement provides otherwise. Signature of Contractor or authorized representative':- *(I/We) have read the terms statedp er in,th ve been explained to(me/us),and([/We)find them to be satisfactory and hereby accept them. Signature of Homeowner(s): The Commonwealth of Massa.chuseas L W Department of'IndustrialAecidents w Xcongress Street,Suite 100 Boston,MA, 02114-2017 www.mass.gov/dia Workers,Compensation insurance Affidavit:Builders/Contractors/E lee,tricians/Plumbers. TO BE TILED WITH TIM PERMITTING AUTHORITY. Applicant Information Please Print Legib Name (Business/Organization/Iridividual): Address: ° ko City/State/Zip: i -`,, ., -A Phorie#: Areyon an employer?Clteclt. e appropriate box: Type of project(xegnired): 1.O 1 am a employer with employees(full and/or part-time).* 7. Q New constrttction 2.Q 1 am a sole proprietor or partnership and have no employees working forme in $. EJ Remodeling any capacity.[No workers'comp.insurance required.] ❑Demolition 3.❑I am a homeowner doing all work myself[No workers'comp,.insurance required,]t 10 E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my,property. 1 will ]1. Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12.F1 Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13 Roof repairs These sub-contractors have employees and have workers'comp,insurance,t , 1.4.F Other 6. We are a corporation and its,officers have exercised their right of'exemption per MGL C. 152,.§1(4),and we hays no,employees,[No workers'comp.in required.] t;. 'Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy infonnation, I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors rrrust submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. Ifthe sub-coritraet`ors have employees,they must provide their workers'comp.policy number.' rim are employer tfiat is pi dvidiizg workers'compensation insurance for-my employees.'Below is the policy andjob site I information. Insurance Company Name: ` d• ,. Expiration Date: Policy#or Self-ins,Lie.#: x f „ lob Site Address: 1' �. . um and expiration %4< fa ¢ , r . City/State/Zip: � '.a an date). Attach a copy'of the workers'compensation policy declaration page(showxug the policy n p ) Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500,00 and/or one-year imprisonment,as well as civil penalties in tha form of a STOP WORD.ORDER and a Eno of up to$250.00 a da against the viol y A„sky ot'ihis st tement may be forwarded to the Office oflnvestigations of the DIA.for insurance ylator covera y rific i p ofp j y f Provided w, and correct. I(to It re „ pe l`4 t�tz r ti el,tl� aznse z r�z ar Date: orad` salt' .� e r zzr• Haut the zra or°raaczt orea a Si nature: :.._� � Phone#: Official use only. Do not write in this area,to be completed by city or towra official,, City or Town: Permit/License# Issuing Authority(circle one): 1.Board.of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ® DATE(MM/D WYYYY) ACC?R" CERTIFICATE OF LIABILITY 4/13/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the police) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A Statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Angela Westen Insurance Agency PHONE (978) 735-4094 FAX No): (978) 735-4095 557 Central Street ADDRESS: angel a@awes ten.com Lowell, MA 01852 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A:ATLANTIC CASUALTY INSURANCE CO INSURED INSURER B:HARTFORD UNDERWRITERS INS COMP F 0 CONSTRUCTION CORPORATION INSURER C: A$TOI°i ST AP. 4A INSURER D: LOWELL, MA 01852 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. INSR AWL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD/Y MD/YYYY LIMITS A GENERAL LIABILITY L021008696-2 3/18/16 3/18/17 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TRE O RENTED a occurrence) $ 100,000 CLAIMS-MADE D OCCUR MED EXP(An/one person) $ Cj 000 PERSOML&ADVINJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 1 000 000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY C MBcc ED SINGLE LIMIT $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON OWNED PROPERTY DAMAGE $ HIREDAUTOS —AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 2E112068-16 3/30/16 3/30/17 WCSTATU-LlMfT ] OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE Y/N E.L.EACH ACCIDENT $ 100,000 OFFICE RIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 Ifyyes describe under DESdRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Rene rks Schedule,if more space is requi red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CD ROOFING ACCORDANCE WITH THE POLICY PROVISIONS. VINCENT COLANGELO 3 HODGSON ST AUTHORIZED REPRESENTATIVE TEWKSBURRY, MA 01876 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: (978) 656-8497 Fax: E-Mail: VINCENTCOLANGELO@SBCGLOBAL.NET ��e�aj�i��zauruea��n�C�l�Cav ac�ttJeltt , ' Office of CoPROVEMENT CONTmer Affairs& Rness ACTOR OR Inion _, OME IM Type: Registration: 170575 Expiration: 1111012017 DBA CD ROOFING VINCENT COLANGELO 4 3 HODGSON ST Undersecretary TEWKSBURY,MA 01876 • - Mass - --- achusetts De Board of Buildi,n partment of Public License: 9 Regulations Safety-- Co CSSL_105943 and Standards nstruction Supervisor.Specialty VINCENT COLANGELO 3 HODGSON ST TEtN►�SgU REET RY MA `01876 i i ICommissioner Expiration: 03/09/2018