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HomeMy WebLinkAboutBuilding Permit # 5/12/2016 ,F t%O R TH gy m° BUILDING PERMIT �� TOWN OF NORTH ANDOVER 0 o„ APPLICATION FOR PLAN EXAMINATION :, Permit No#oo°, Date Received Date Issued: 'j CHUS IM ORTANT: Applicant must complete all items on this page r,,, r 0r ar /rill r / ✓ ri, r, r r / „�., , rr r r r • � r r r i ri r r ,,,,ur'9"o ,;r „ rr r r/ ii r r / / /, / / r r rrr / r r r ,»ri ri r r „i ��,�. ii / r „. // � f ./ //�r/„�1Q0 Ye r sir cture r Pry r u ,. � r //M/ Z/O,, Nr�,,,I�N/i%Gr c,,„,�,,;D„,✓�ISTr ,,R,,,,/I,,C., T H✓ir�/s,r� ///r o; %i//r/�%rpo ii�r /rrii r ri/ r y yr /r,,r,+ r ri rii %a/ ,,,„,.. ,%„v// ,,,rii/i �,,,r r rr,,,i/ /G,�//,,,/,,, �,,,/O!r„�//,�,,,✓% r // rr a,,,rii r, �Ilage„ a TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building X9ne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Sep ❑UUrll ❑ Floodplain ❑'Wetlands ❑ Watershed Distract r//r r�❑„1Nater/Sewee, � ,i ,, ,; r DESCRIPTION OF WORK TO DE PERFORMED: dentificati7 - Please Type or print Clearly OWNER: Name: :��° :: Phone: Address: /ontractor/Name � 7 Phone r //rrr%/ / t 0 / /.//,/r////r/'�rr,/HrS/i/�1„r,/”/.r�r�au/ro,?/r�r//�,�m/�/,,/�.�re/,rrr/er„/l r,////,/�//�r,//l„,/ra//r-m/,„1,rr�.%r/,r ror//ir„;o�./,/�r/.rrr��r/./.r/fi�a//�/r%//r,%//,i//r"Cr/i/r,l/r r/„�//.r//o�.//,ir/,/r,./.r//./r/!/nr//„//./G/s/,//////tr„/r/ri/tr�i/ru�/,..,.„...„./rc/Z,i.,i,tr/.larrr//rrn/./�,/,/,ri,,/r.,.L,¢,..,rr,,.c,,,r,/i,cc,r//„ir�e/,�./r//n/�r,,„s/ir,,rn.,.eyL.;>.„,//!/!///r/orrf,,,r,,i/,ir,i,irrrr,..,r,,.rrio..,/�/ir.r/ri�r/„/r/i//r//,.,//..,...,?/°i"e,ri,ri,�.„„.r/aci,,,.,,.....,r..,.,,////r///i///,/,..r,,/6/✓r/r/l l,,ar,r,r//i//rr rrrr/C,//.,/te///i//r//..�/r/,,r.,/..�/.i.,..Earri,,i,rrxr.�/,,/�.,i.�r/r///,r/,////.rr.�r.r-irter//c,�/,"::...:rrDi��ii.rr,/r//r/ � r ////rr/,./.vo/r.lri,%✓.rr ,r 0m , / r/ � , ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDINO PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925,00 PER S.F. Fr Total Project Cost: $ � �� FEE $ w I Check No.: Receipt No.: NOTE: Persons contra -fifli iregistered contractors do not have aeces to tl�e guar anty�und Signature sof Agent/Owner � � � �Jgnature of contractor t%OR'T H Town ofAR Andover 1,, 0 y. " 0 ® 11 aA C' v�/ O . LAK! 1 9 Mass, COC HICHE WICH � U BOARD OF HEALTH Food/Kitchen P E T %j D• Septic System i THIS CERTIFIES THAT ............ BUILDING INSPECTOR ....................... .......... .......... .......... .......................... . Foundation has permission to erect .......................... buildings on ...... .... �,� ..... ...: .........:: ® Rough rt ruf tobe occupied as ........... .. ... ... ....... .............................................................................................. 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR CONSTRUCTIONUNLESS STARTS Rough Service ................. ... .N ..IG�G�................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy BuRough 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. ........................................ .......................... Proposal AB Carnes Roofing,Inc. Page I of 30 Arrowhead farm Rd Boxford,Ma.01921 978-887.1431 MA.CS-000230 and HIC Reg.176928 Proposal Submitted To: JOHN&BEVERLY MAE LONGUEIL Date April 24,2016 926 FOREST ST Project Name NORTH ANDOVER,MA 011845 Address 603-512-2197 We propose to fumish material and labor-in accordance with the specifications below: Seventeen Thousand Nine Hundred Dollars($17,900.00) Payment to be made as follows:$300.00 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.gov/licenses website. ROOF PROPOSAL. C/D STRIP ROOF OF UPTOTWO LAYERS OF ASPHALT SHINGLES,COVER ROOF DECK WITH THE UPGRAWED RHINOROOF TITANIUM U20 HIGH PERFORMANCE SYNTHETIC UNDERLAYMENT MEMBRANE.COVER EXTERIOR WALLS AND FOLIAGE WITH TARPS TO HELP PREVENT DAMAGE 11�12 LM K'E DAM PROTECTIOW INSTALL CARLISLE HIGH PERFORMANCE ICE&WATER BARRIER OVERALL HEATED AREAS IFEETWIDE AT TH� LEADING EDGE OF ROOF AND THREE FEET IN ALL VALLEYS.WRAP THE CHIMNEY(S)AND SKYLIGHT CURBS WITH 11 r6WATER BARRIER. N COVER ALL PERIMETERS WITH EIGHT INCH PREFORMED ALUMINUM DRIP EDGE. bA INSTALL GAF COBRA RIDGE VENT AND/OR 0 ROOF LOUVERS FOR ADDED ATTIC VENTILATION, 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$25,00PLIFT.WE MAY NEED TO REMOVE Lr THE SIDING TO PERFORM THIS WORK AND YOU MAY NEED TO HAVE A CARPENTER REINSTALL OR REPLACE THE SIDING THAT WAS REMOVED. CHIMNEY FLASIONG;REMOVE EXISTING FLASHING FROM X-CHIMNEY(S).CUT NEW REGLET INTO THE BRICK AND SECURE THE NEwe6-(z LEAD WITH METAL ANCHORS AND SEAL, PLEASE ADD$,500.00 Tp ABO PAIC0(BLACK TAR USED BY OTHERS IS NOT FLASHING) 121 COVER ROOF SURFACE WITHCERTAINTEED LANDMARK 24(�Q Lfl.jIMF-,,WARRAWrY DESIGNER SHINGLES, Z REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH SIMILAR AT AN ADDITIONAL COST OF$4,wPs'QF-r/PLFT, F] COVER ROOF DECK WITH COX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADDITIONAL COST OF 011 [5D NAILING; SECURE SHINGLES WITH EIG14T IN TOTAL COATED ROOFING NAILS AS PER CERTAINTEED SPECIFICATIONS. 0 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, E] REPLACE DEFECTIVE TRIM BOARDS WITH CUSTOMERS APPROVAL USING NO.2 PRIMED PINE,ADD$15.00PLFT'TO THE ABOVE PROPOS�11-1""' CLEAN ALL PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA, THE PROPERTY OWNER AU'rHORVES 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 IWRUCTION& THE ABOVE PROPOSAL INCLUDES SHINGLED ROOF SECTIONS OF THE HOUSE,BARN AND CABANA. 0 UPGRADE SHINGLES TO THE LANDMARK 300LB HIGH DEF PREMIUMS,ADD$2945.00 TOTHE ABOVE PRICE.YES( )THIS IS OUR EXACT COST WARRANTY UPGRADE:THE CERTAINTEED WIND WARRANTY WILL BE UPGRADED FROM 110 MPH TO 130 MPH WITH AN UPGRADE TO THE CERTAINTEED HIGH PERFORMANCE HIP&RIDGE CAPS AND STARTER COURSE AT NO ADDITIONAL CHARGE.YES,'"') EMAIL ADDRESS 'AnIv -S ys 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 Linder 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 parties 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 require lawyers.Please see reverse side. Signing this Proposal mean you have accepted all the terms as stated on the front and back of this agreement. Please see reverse side. Date of Acceptant Signall.11 -z Signatui" Signature 01"er,Barry Cames 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.111-0.50A. 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: 5-12-2016 SIGNATURE OF APPLICANT: Mass ach usetts Depanrnen,iu prod Puws,atrmy Board of BwGdmg fkequ6,Wons and Standards License: CS-000230 C(HIStrUCt�W1 ",W�)WViSw BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD MA 01921 C) rl Ml I S S 0 rr e 03/07/2018 )"JJY/Jill/0114W(W �A -0 ice of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 176928 Type: Corporation Expiration: 10/10/2017 Tr# 269957 AB CARNES ROOFING, INC. BARRY CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 01921 Update Address and return card.Marti reason for change. C�n Address Renewal Employment Lost Card The Commonwealth of'/V. assachusetts a � ,department of bidustr°l`al AccNeuts `w .. I Congress Street,Suite 100 x Boston,MA 02114-2017 nQi'a pttAl/er� � foop. uss.gov/dia 1k'urker's' Compensation Insurance Affidavit:Builders/Contrtrdors/Electricians/Plumbers, TO BE FILED WI'T'H THE PERMIrrING AUTHORITY. ApplicautInforimition, _ PleasePrirlt Le ibly Name(Business/Organizatiori/individuiil):AB CARNES ROOFING INC Address:30 ARROWHEAD FARM RD --- City/State/Zip:BOXFORD, MA 01921 Phone:8:978-887-1431 Are you au employer'!Check the appropriate box: --- Typo of ilx•of ect(realuix t.d): all,a eel llo ea win, some cut io cos lull alae,,nlrt-Lhnic).r � i 1 y"' __. P y'° ( I 7. El New construction 2 I am it sole proprietor or pmtrtersbip and(rave no employees working lot-are al 8, Remodeling troy capacity,[No workers'camp.insurance required.] [). 3,1..r—..j t aro a Imiueowucr doing all work myself,[No workers'comp.insurance required.]Y Demolition 4.r_j I our a hauurwner amid will be hiring contractors to conduct till work on my property. 1 will 10 E] Building addition ensure that all contractors either have workers'couil msation insurance or tire sole 11,[]Electrical repairs or additions proprietors with no emplayaes 12.❑Plumbing repairs or additions 5. j;till a general contractor and I have hired Lie sub-contractors listed on tie aaached sheat. 13.[,:/] I1 oof repairs 'These sub-cunuawau ])live ave employees and have workers'comp.insurance. O.E]We are it corporation and its officers have exercised their right of exemption per MOL,c. 14. Other 152,§l(4),laid Nye have no employees.[No workers'comp,insurance required,) "Any applicant that checks box 111 must also till out the section below showing their workers'compensation policy information, l I-lonicowners wile submit this affidavit indicating they live doing all work and then hit outside contractors must submit it new atfidavil indicating snack, IControclors thin check tlms box must attached all additional sheet showing the mine of Lyne sub-cont ractois and shite whctlrei'or not those citifies have employees. Write sub-cootiacams have employees,they must provide their workers'cunip.policy number, I aur an employer that is phoviding workehs'compensation insurance far ttry employees. Below is the policy and job site injimivatioxn, Insurance Company Nauru: TRAVELERS INDEMNITY CO O1=AMERICA . Policy It or Sell n{s.Lic.It:6HUB OG36156-6-15 _. ..__-. E'xl)irntion Date: 10/15/2016 .lob Site Address Attach a copy of fake workers'eon1pC(1s.16011 policy(ICCIlWati011 I)al,'�e(showing tike policy number axed expxr litloxl(1ate). Failure to secure coverage as required folder MG],c. 152,§§'25A is a criminal violation punishable by it tune up to$1,500.00 and/or oat:-year imprisonment,as well its civil penalties ill the torn)of it STOP WORT(ORDER.and a tine of up to;6250,00 a day against the violator.A copy of this statement may be forwarded to the.Office ot'Investigations of the DIA Por insurance coverage verification. —fir da hereby certify on t„t thep'ithrs` ar ul pGnitltacs aj'pe)Juts Ibot the itxfornurlian provideduliove is thane earl carrxs<a. 97e 8871 31 Phone ti. _ _ Ojftcial use only. leo riot Ivrite in this ares,lobe completed by city or toms official. City 01-Town:'_ Ilerruit/License it Issuing eii,uthority(circle one): 1. Board of Ileallh 2,Building Department 3.City/Town C:lerlc 4.Electrical inspector S.P111u1bing 111spector b.Other Contact Person: Phone it: Accwbr CERTIFICATEI ILIT i INSURANCE P ATE(MMIDD/YYYY) 04/11/2016 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(les) 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 c0 TACT NAME: FBUSYO Pina ACE INSURANCE SERVICES INC PHONE . (508)584-5900FAX AIc Not: E-MAIL aceinsuranceservices@yahoo.com ADDRESS: @Y 675 WARREN AVE INSURER(S)AFFORDING COVERAGE _ NAIC# BROCKTON ----- MA 02301 INSURERA: AMERICAN ZURICH INSURANCE COMPANY 40142 ---------- ------- -------- INSURED INSURER 8: APC CONSTRUCTION INC INSURER C: INSURER D: 51 FORD STREET UNIT 1 INSURER E: BROCKTON MA 02301 INSURER F: COVERAGES CERTIFICATE NUMBER: 43555 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. ---------------- NSR -4 POLDICY EXP TYPE OF INSURANCE IN SUBR POLICY NUMBER POLICY EFF MWDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $_ DAMAGE TO RENTED CLAIMS-MADE D OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ -------- -- ------- GE_N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- ---ll ------ --- POLICY JECT EJ LOC PRODUCTS-COMP/OP AGG $ — ------ --- ------ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED ----- AUTOS L AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS Peracent AUTOS cid----- $---- UMBRELLA LIAB OCCUR _... - •---- - M,,, EACH OCCURRENCE $ ._----EXCESS LIAB CLAIMS•MA[�E..., ... N/A ".AGGREGATE $ DED RETENTION$ '�• 1,/ $ WORKERS COMPENSATION �% /\ STATUTE EORH AND EMPLOYERS'LIABILITY {4 Y/N ___ - ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACNACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? N/A NIA N/A 6ZZUB9F53382616 03/08/2016 03/08/2017 ---E - ----- (Mandatory in NH) E.L.DISEASE---EA EMPLOYEE $ 1,000,000 If yes,describe under ---- ----- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe 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.gov/lwd/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 AB CARNES ROOFING INC ACCORDANCE WITH THE POLICY PROVISIONS. 30 ARROWHEAD FARM RD AUTHORIZED REPRESENTATIVE BOXFORD MA 10921 Daniel M.Crq ey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD NOTICE f z NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS t 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 notice 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 (GHUB-OG36156-6-15) "' POLICY NUMBER 10-15-15 TO 10-15-1 G EFFECTIVE DATES PRESCOTT & SON INS 963 EASTERN AVE MALDEN MA 02148 NAME OF INSURANCE AGENT ADDRESS PHONE# o 0.-=,�'AB CARNES ROOFING INC 30 ARROWHEAD FARM RD BOXFORD MA 01921 L-,MPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TRE AT ENT 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 file Workers' Compensation AcL A copy ol' 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 W20NG16 TO BE POSTED BY EMPLOYE, R