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HomeMy WebLinkAboutBuilding Permit # 5/12/2016 � BUILDING PERMIT OORIF -1 TOWN OF NORTH ANDOVER 0 *,ruu^/mmrvxrL*mE^*m/mx/mm IdentificationPermitNo#. Date Received IMPORTAN,r:Applicant must complete all items onthisp�jge�--------------------------- Print PROPERTY OWNER_,4/// Pnn 100 Year Structure yes *n MAP—PARCEL —ZONING D STRICT:-—------------Historic District yes n Machine Shop Village yes Qn.9 Residential Non-Residential 0 New Building A One family 0 Addition [I Two or more family 0 Industrial 0 Alteration No.of units: 11 Commercial ,4 Repair,replacement 0 Assessory Bldg 0 Others: o Demolition 0 Other etlab DESCRIPTION OF WORK TO BE P _ Please Type Contractor Name: Phone:zze Email: It Supervisor's Construction License:c� Improvement License: /W1 �1_212 Exr). Date:- ARCH ITECTIENG I NEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED.GN$125.00 PER S,/=, Check No —Receipt No.:- ?xr NOTE: Persons contracting with unregistered.1-1tractors do not have access-to the guarantyfund Town of %A®RrH Andover t tI �al� ver,Mass, 0 4TED PPo-�RS 11 BOARD OF HEALTH Food/Kitchen PERM� Ili T ILD® Septic System THIS CERTIFIES THAT. IN" r*.*A ,.. a r�r BUILDING INSPECTOR ....... ..................... has permission to erect............. ....buildings on. ..1,1MV�{.,,,, a Foundation .... t Rough to be occupied as.............`�,�/� r (� .'• ......... .......AF......................................................... Chimney provided that the person accepting thi!permit shall in every respect conform to the terms of the application on file in this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Final 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 !�ASTS Rough Service ............................................................................... Final BUILDING INSPECTOR /� GAS INSPECTOR @I'CC,,Uancy Perliih Requir,-d tO t7CCu/17 Byi1din Rough Display in a Conspicuous Place on the Premises v 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. PageNo. of Pages Supervisor CS 068461 -' $ Fully Licensed&Insured Home nstruction Reg.#146722 i 00 "Keef V G•TJSETTd, Roof p� p� X711\ No Rea S iw�tt,i978-276-3043 1980 p e — C PROPOSAi.eu6lore —27 33 Cs J �esrls�e�zt� C. I ogre r MiTTE r r lrtair4feedC^I _� a!' r� r /' °.> Joe NA L - ------ � vnaN ST�EET CITU STATE ANC ZIPCaDE - f _......_ .__......� J JOB LOCATION �"-'- I We he eUy^submit spegif cat ans and estimates for: Reepmmended OpBlona (Included In price) (Not included in price)�f +,' Rip&Remove all shingle debris from roof&lob site: 9"1 layer, U 2 layers „U 3 layers or more Repair/or Replace any roof decking;not to exceed 50sq.ft. Install 8" + _ p- g 9 y nd skhrteor brawn P Install CEI&WATERuminum runderla/and mentalon ,ho along " p erlayment between roof deck and roofing shingles 1,,lights&chimneys , ) �L,,,y - 7 Install premium base sheet and rake-edgeg p Choice of milli w a ... .. ...... es 15 Ib.felt U 30#.felt _.... .. ,+ Install 25yr CertainTeed/GAF/IKO traditional�-tab roof.shingles U,30 year Install CertarnTee / roof shingles y,� Sf GAF/IKO architectural Lifetime "See manufacturer,warranty policy for more details _. Install new aluminum vent-pipe flange(s) �I n Cut&Install new lead flashing existing flashing - I Chimney(s) coup or flash and shin si n,hidden R� Ridge-vent/exhaust- - p ofle da- g by shingle vent with to off' U Soffitventilation U Roof louver-vents Seamless style aluminum gutters-custom,fabricated at,job site , C'u U downspouts YYY Other ... .. .. _ ... .... ... ... .. --''f ... I O.Keefe"oofer9 will properly,dispose of all roof debris in our own dump truck. "Please Note:.All items in,roof attic should be removed or covered due to falling roof particles at time of roof tear off Pace includes all items above that are checked only/others maybe priced separately upon request Or 1jropaxse hereby to furnish material and labor-complete In accordance with above specifications,for the sum of Total price not including options dollars($ Payment to be made as follows: .. ..... .... .-.. ::.:) P r)' ...... ,_..P Y completion. ... .. .... _ f� PI ase make aired upon dative of materials.Balance due m full u on da of ° P q I to out to Michael O Keefe 21 Francis St. No.Reading MA 01 86 4 tin outstanding bills due upon da of Authorized r Late charges proposal moans agreeing to the terms of the enclose y g p 9 p completion. d binder withdrawn bolus if nal L Signaturel� b �f contract. proposal may be y accepted within ''da s y Page No. I Pages Proposal Supervisor CS 068461 Home Construction Reg.#146722 jg6l" Fully Licensed&Insured 0" 'Kee 0 afe BBB Roof North ReadinS 978-276-3043 CertainTeedrd PROPOSAL SUMTTED TO PHONE - rSTAIET JVY-�t,6�- el Y DATE 5 JOB NME CITY STATE AND ZIP CODE --JOB_LOCATIC�N----------- .Zbl�y�S,,blit BID c1fi--ti-D.1d etimst.s for: Recommended Optional -—--------(-In-cl-Diced i-n-price) (Not includ-ed in-_price).,. Rip&Remove all shingle debris from root&job site: I layer Z)2 layers :13 layiers or more 7/-R pair/or Replace any roof decking;not to exceed 50sq.ft. I-._­­______................ .................. Install_8"aluminum drip-edge/and rake-edge along entire perimeter.Choice of mil,ohite&rbr�� -—----------—___ __ _w� - 1/I-nistall-ICE&WATER underlayment along horizontal eaves,valleys,sidewalls an c1sky-P ts&chimneys -------____- —-—--------— _qh I Este I I premi u in base sheet u rde rlayment between roof deck and roofi ng sh i ngles Sil/i 5 1 b.fe it LJ 30#.felt —------------- --------- ---------- Install 25yr CertainTeed/GAF/IKO traditional 3-tab roof shingles J 30 year ................ V�lnstal[_CertaI�GA /IKO architectural Lit/Life-time roof shingles —--------- —---------- ........... ---_-_-- See manufacturer warranty policy for more details -—--------------___------ -v"Install new aluminum vent-pipe flange(s) ...........—-------- —---------- --------------- ��_Chinrney(a)-counter-flash and re-step existing flashing —------------ .................. J Cut&Install new lead flashing T -----------­­­---------- ............._-------------- Ridge-vent/exhaust vent with low profile design,hidden by shingle caps ............ ............ LJ_Soffit-ventilation J Roof louver-vents —- -------- Seamless, Is aluminum gutters-custom fabricated at job site --------—-------- .....................___------------ downspouts -------—-—-------.......................—------------—--------- th r --------—-—----------------........ ........... .............. -------------- ..........—-------- ----------- ——-------- —--------- .................. -----------­_____.__­___—-------—-—-------- ...... ............. —-------—------............. —-—-__-_---------- --------—-------- ------—--—-----------......................... —--------- --------------------—--------- —--—-------—-------—--—----------- —------ .................................. ................... O'Keefe oofers will properly dispose of all roof debris in our own dump truck. - _111----------- 'Please Note:All items in roof attic should be removed or covered due to falling roof particles,at time of roof tear-off .......................—-----—--—---------------—---------- ——--—-------- 2rice includes all items above that are checked drily/aNn may priced sis rat upon request. We Propo sv hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: Total price not including options.dollars is ............J. Payment to be made as follows: -_30%deposit required u-pon--de-live-ry of ED-aterials.Balance due in fu 11 u pon day of completion, P I ease make al I payme nts o ut to M ichael O'Keefe,21 Francis St.,N o.Readi In g,MA 0 1864 .........—----------1--------......... -------- Late charges of$50 per week for all outstanding bills due upon day of Authorized S completion. Accepting proposal means agreeing to the terms of the enclosed binder Note:This proposal may be ithdrawn by us if not accepted within days w Rp® CERTIFICATE OF LIABILITY INSURANCE Dr/11/DOYYYYI s/11/zo16 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 C NTACT NAME: _.._.. 6 Fowler Insurance /PwHONE (g78)664-0366 ISTeI6sa-szos J{VG NOLLEdt/:_...._.....__......._. ............._. A/CiNol:- _.. 200 Park St. E-MAIL --------- ADDRESS: INSURERfS)AFFORDING COVERAGE NAICp North Reading NIA 01869 INSURER StWorld Insurance _ INSURED ..... --------_____..._— INSURER B ................—... _...—_...—.._ __........... _ O'Keefe St. LLC INSURER C21 : Francis is SSt. INSURER D: INSURER E: __..........__— North Reading DIA 01869 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1591110313 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 ._______....__------__......._ _ ......A LSUE�R�_........_.-........_--.________.—�—.. .......__�________.._--�......__ LTR TYPE OF INSURANCE POLICY NUMBER MMILID/YYYFY MM/DDl1'EVYY LIMITS X COMMERCIAL GENERAL LIABILITY – EACH OCCURRENCE S 1 000 000 A CLAIMS MApL ��OCCUR 6AMAl�,�i0 R-FNP€(7— $ 50,000 PREMISES lE 7 __... ...___ ILL 1 ......_... ..——.. NPP1404384 9/8/2015 9/8/2016 MCD EXP(Any one Person) $ 5,000 ---- - -- _BE_ ft AW INJURY $ 1 000 000 X POLICY ]PRO- r �S PFR GENERAL AGGREGATE_ $ 2 000 000 EN ETHER AGGREGATE JECT LIMIT APPLIE LOC PRODUCTS-COMP A3D S 1,000,000 AUTOMOBILE LIABILITY C MBINED SIN LE LIMIT $ Ea accidelit) AUTOMOBILE AUTO e001LY INJURY(P,,person) $ AU OS SCHEDULED ...._ ....._ AUTOS __.AUTOS BODILY INJURY(P citlent) $ NUN-OVVNEO HIRED AUTOS AUTOS I4PROPERTY DAMAGE $._ S UMBRELLA LIAB gCCUP EACH OCCURRENCE.. S EXCESS LAS CLAIMS MADE AGGREGATE $ DFD RETENTION$ $ ANBERSOOMPW D ENIPL YERS'LI A ILIT PER OTH- ANVD PRCPRI EEORIP RBTINER/EXECUTIVE �STAT<1TE...._ ER_ V/N Workers Compensation cert OFFICERIMEMBER EXCLUDE D? �'NlA E.1.EACH ACCIDENT $ (Mandatory in NH) '— to follow separately. E.L.DISEASE,EA EMPLOYE $ If Yes,describe under ._ _..._—_..........___.. DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Insurance verification - Please refer to actual policy for all other terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main St. ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 _ AUTHORIZED REPRESENTATIVE NScole Orlari—/NMO ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) A CERTIFICATE OF LIABILITY INSURANCE DATEIMIY MIDDYY) osn vzols 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 endomement(s). PRODUCER CONTACT NAME: Nicole QrlanZO BYETTE INSURANCE AGENCY INC. �"C,Ns€aft (978)851 6678 _- ,C N1 --- AIL _nooaE$$ nlcole�'la akfowlerms,com 200 Park St. INSURER(SLAFFORDINGCOyef E NAICN North Reading _ MA 01864 INsuRERA: AIM MUTUAL INS CO 33758 INSURED ._ _.... ....._. _.._..._._ INSURER B _ OKEEFE ROOFING LLC _ _INSURER C INSURER D 21 FRANCIS STREET INsuRERE NORTH READING MA 01664 INSURER F: COVERAGES CERTIFICATE NUMBER: 51968 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. LSR ADDLiSUeR (POLICY EFF POLICY E%P LIMITS TR TYPE OF INSURANCE POLICY NUMBER MMIDOIWW MMIDOMIYY COMMERCIAL GENERAL LIABILITY 1 r EACH OCCURRENCE CLAIMSMADE OUR OXWc ETOIR WED PREMISES,(E t S MED EXP(A y person) $ _-- N/A PERSONALBADVINJURY $ GENT.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE _ $ POLICY .._JECTPRO- I L. .PRODUCTS COMP/OP AG; $ _-- 07HER ......._._ —... $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ denlj ANY AUTO BODILY INJURY I p -) S _ ALL OS --- SCHEDULED cudenl) AUTOS - UT NIA aODILY INJURY(P 1 NON-DOWNED lP OPFRTY pAMAGC ---.,.$ HIRED AUTOS F $ (UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1 — ____— ....._.... ......... EXCESS LIAB CLAIM$-MADE N/A ,....ED__ _ _— AGGREGATE DED RETENTION$ �/I ry in NH) Y� ^4SIATUTE� F2�_ WORKERS COMPENSATION _ AND EMPLOYERS'LIABILITY ANY ROPRIETORIPARTNER/EXECUTIV[ FL EACH ACCIDENT $ 50001)0 A 'OFF CERIMEMeEREXCLUDEE NIA NIA NIA VW C10060178842015A 10/12/2015 10)12/2016 - --- - (M d to I E L DISEASE EA EMPLOYEE$ 500,000 It yes,dasci be under — -_.- DESCRIPTION OF OPERATIONS bel- IEL DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORO 101,Additional Remarks schedule,may In,attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status Of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main St. AUTHORIZED REPRESENTATIVE North Andover MA 01845 'J Daniel M.Croy,CPCU,Vice President-Residual Market-WCRIBMA CJ 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD The Commonwealth of,Massa chasetts - "-' Department ofIndustrial Accidents F I Office ofhnvestigations t% 600 Washington Street x Boston,MA 02111 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plurnbers A 1[]leant Information Please Print Legibly Narne i /7 ( ness/Or i iza�n/1 dividual).--. rJ --L'"�) �l�'e�"j� ga ;y c Address y/State/7rp. � -- - Phone 4: Arc,yen an employer?Checkthe appy ria[e box: Type of project(required). ].T p 1 amu;employer with �_ 4, ❑1 am a general contractor and I -� have hired the sub-contractors 6_ ❑New construction employt:es'(full and/or part-time).* 2.0 1 am a sole proprietor or partner- listed on the attached shect. 7. []Remodeling Ship and have nu em to ees These sib-contractors have P Y o. 'L]Demolino i working for me to any capacity employees and have workers' o i-]Biuldim additnm wart r[s'crnnp,utetuamce comp.insurance l I _ required-] S.�] We are a corporation and its 1011 Electrical repairs or additions 3.�_]I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself.(No workers'comp, right of exemption per MGL 12"tI Roof repairs insurance required.]t c.152,§1(4),and we have no `a employees.[No workers' 13.(]Other_ _—_ comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ' t Florneowners who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new aCfdavit indicating such. tC.an-tons that check this box must attached an additional sheet showing the name of the sub contractors and state whether ornot those entities have crnployres..If the subcontractorshave employees,they must provide their workers'comp.policy number_ 7 rim an employer that is providing workers'compensation insurance for my employees. Below is the policy andjoh site information- insurance Insurance Company Name:y,O . `, GC.ce-t- Policy fl or Selt urs.1,tc IJ ----- ✓G 6c'7C."yT_ L~ 7"/'E-_ Expiration Date ---�/ --�C. Job Site Ad Le,s:_.;-,✓? ^�/fitQ,+rc¢ ..� Attach a copy of the workers'compensation policy dechration page(showing the policy number and expiration date). Failure to secure coverage as required trader Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a Einc 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 a day against the violator. Be,advised that a ropy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. -- --------- ----- ---- ----------- t do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. m /� �✓" Date. -X/-AG Phone#: Official use only. Do not write in this area,to be completed by city or town official, City or Town:_ Perini rfLicense 4 Issuing Authority(circle.one.): I Board of Health 2 Building Department 3 City/Toon Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone tt: ._ Construction Supervisor License or registration valid for individul use only Restricted to: before the expiration date. if found return to; Unrestricted-Bu➢dings of any use group which contain Office of Consumer Affairs and Business Regulation less than 35,009 cubic feet(991 cubic meters)of 10 Park Plaza-Suite 5170 enclosed space. Boston.AIA 02116 NJvalid vi ut sign ore Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit:WWW.MASS.GOVIDPS 'Ap Massachusetts Department of Public Safety l/e -- W Board of.Building Regulations and Standards = Off of Consume tff rs&Bus��ss Regulauon License:;CS-068461 r�y30• ME IMPROVEMENT CONTRACTOR Construction Supervisor I Registration: 146722 Type: �'Expiration: .511112017 DBA MICHAEL J OKEEFE 'cl-, 21 FRANCIS STREET O'KF_EFE CONSTRUCTION NORTH READING MA 01864 MICHA=F O'KEEFE 21 FRANIGS STREET NORTH READING,MA 01864 - 3 Expiration: t. d rsecrewry Commissioner 02124;2018 4..r. I i