Loading...
HomeMy WebLinkAboutBuilding Permit # 5/31/2016 BUILDING PERMIT "ORT H RR4ED � TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit Noo 1 Date Received �paaa,E„ cus� Date Issued: IMPORTANT: Applicant must complete all items on this page r rr,i/�,///Ge,,/,./i,,rrrr,„,//,/,/t r�r%�//,/,////�o////ier.!,,rr,,„,,/,...�:.-:.!,/r r rrJ.///,,✓,i:%,///„/�./.r,„r,/rr,r/.//,//,,.,,,r,,.ir�.i:,,i../r,,r/i,i�/,✓ri%r�/,//r%//�/,::.�.rc�/ r/ /,I r r,,i.�./r/r,%r/,i,://,/i//,�,r/r,ii„iii%ir/t,r,,/,�,,ri�o%,:r.lr�r/i�rr,,/,rr//i.,r/,,r,,�/..P!/,,r-::.rfi.rfiic.l1.„ei,',.ro/r✓r/,ir iii„rr/ir.%,:%,r�r/,/�r///./r,./%//./r/�.:///�/%i%/J/ir/.i,/��r ,/ri/�i/.�aQ//sr/ri././.ur%�r..r/rfr///r.. .,frpilrU//,rrrGr¢„,..irrUr/rrr rrf,B/r�ir��///,,i,,,...;.,.;,.,..,./�/i,.,/.!.r./.rr/r/r rr,./,irr,.r,...2.a,r S r/%/r//,r/irrr!..,..,/...,..ir�./, , , .. TYPE OF IMPROVEMENT PROPOSED USE _ Res'dontial Non- Residential ❑ New Building r”One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Sep is �]Well C7 Floodplain, ❑Wetlands ❑ Watershed District ' q'1Nater/;Sewer:: DESCRIPTION OF WORK TO DE PERFORMED: Identification - Please Type or Print Clearly OWNER: Name: �n � „F� Phone: � :.�m�,w . Address: .�„ „,��:� .°'T . q C�antractor Name , ,� ,F one r Email, or / r , r r , ,/ �/oil/��i��r�i,�ii/��///��,�,-;.r,//i ,,,b.,..,,�r�//��� / ,,... r/ rrr../ 4h „/� ✓ r,i/i rr/ ,.;,,r/ ,/�, //��:�////„�, .,i� ;/! ;Homelm rouement License /��, , „ :, , %Ex p �L ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Coat: $ FEE: $ Check No.: Receipt No.: NOTE: ers VI coma eting with unregistered contractors do not have access to the guaranty fund Signator -f Ag r- ver Si nature of contractor IAC)RT#1 Town of L .A ndover- ® 0 h VerSSS 3 O LC"t COC MIC Kl w.CK ATED S ll BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ....... BUILDING INSPECTOR yl /`� �r . Foundation has permission to erect buildings on a.6 �..ls .......................... ................... ................................................ Rough to be occupied as ................ !./��.�er'mit . .. `... o®:....................................:..................................... chimney provided that the person accepting this 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 T Rough Service .............. ...... ............ ... ............I............ 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 r Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Proposal AB Carnes Roofing,Inc. Page I of 1 30 Arrowhead farm Rd Boxford,Ma.01921 978.887-1431 MA.CB-000230 and HIC Reg,176928 Proposal Submitted To: RORY MARTYN/CHRISTINE FRANCHI Date May 22,2016 216 FOREST ST Project Name SAME NORTH ANDOVER,MA 01845 Address 603-518-3219 We propose to furnish material and labor-in accordance with the specifications below: Five Thousand Six Hundred Seventy Dollars($5,670,00) Payment to be made as follows:$300.00 Deposit,Balance Upon Completion IiWce:All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from registration by provisions of Chapter 142A of the General Laws,must be registered with the Commonwealth Of MaS$aChUSOts. InqUidOS about registration and status should be made to the Mass.govIlicenses website, ROOF PROPOSAL. 0 STRIP ROOF OF UP 1`0 TWO 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 DAIA PROTM310W INSTALL CARLISLE HIGH PERFORMANCE ICE&WATER BARRIER OVERALL HEATED AREAS SAX 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, H COVER ALL PERIMETERS WITH EIGHT INCH PREFORMED ALUMINUM DRIP EDGE. 0 INSTALL GAF COBRA RIDGE VENT AND/OR El ROOF LOUVERS FOR ADDED ATTIC VENTILATION. [a COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS AND FLANGE, El REPLACE WALL FLASHING(S)AS NEEDED WITH ALUMINUM OR LEAD AT THE ADDITIONAL COST OF PLF1'.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. 01 CHIMWY FL,ASMNG;REMOVE EXISTING FLASHING FROM ONE CHIMNEY(S),CUT NEW REGLET INTO THE BRICK AND SECURE THE NEW LEAD WITH METAL ANCHORS AND SEAL. PLEASE ADD$400,00 TO ABOVE PRICE (BLACK TAR USED BY OTHERS IS NOT FLASHING) f2A COVER ROOF SURFACE WITHCERTAWTEED LANDMARK 240l.ti..IFETWE WAIARANTY DESIGNER SHINGLES, 0 REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH SWILAR AT AN ADDITIONAL COST OF$4.0()PsQF'i. 0 COVER ROOF DECK WITH COX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADDITIONAL COST OF 0 NA411.046. SECURE SHINGLES WITH ElGif"r IN TOTAL COATED ROOFING NAILS AS PER CERTAINTEED SPECIFICATIONS, El SA(YUGHft 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 EXCLUDE ED REPLACE DEFECTIVE TRIM BOARDS WITH CUSTOMERS APPROVAL USING NO.2 PRIMED PINE,ADD$15,00PLFTT0 THE ABOVE PROP ts�'w. CLEAN ALL PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA, THE PROPERTY OWNER AUTHORIZES AB CARNES"EO 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. UPGRADE SHINGLES TO THE LANDMARK 300LB HIGH DEF PREMIUMS,ADD$770.00 TO THE ABOVE PRICE.YES I I THIS IS OUR EXACT COST WARRANTY UPGRADE:THE CERTAINTEED WIND WARRANTY WILL BE UPGRADED FROM 110 MPH TO 130 MPH WITH A UPGRADE TOTME CERTAINTEED HIGH PEFORMANCE HIP&RIDGE CAPS AND STARTER COURSE AT NO ADDITIONAL CHARGE.YE EMAIL ADDRESS:, 0 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. Dls,,,,fe ResolullonAll parties agree that any and all dispute,relating to this proposal shall be settled by arbitration rovided b'y"the AAA.This forum is user friendly and does not relqbjre lawyers.Please see reverse side, P) Signing this Proposal mean you 7hna:,cap:teZdthe terms as stated on the front and back of I, agreement see, averse side. Date of Acceptance Signafufe *Signature Signature ?Nvner,Barry Carnes PLEASE SEE REVERSE SIDE Massachuseqts L)eparurwnt lw,wwatc,jty Boarci Of BUddk)g Regwanons ww s'Garw,,arf,ls t lk i e CS-000230 o n sr u r Prcw m u par r v I's u BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD MA 01921 03/07/2018 X j)(Y A/40'P/ Office of ConSUrner Affairs and BL isiness Regulation 10 Park Plaza - SLIii;e 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 enrd.Mark rellsor,for ellange. Address Renewal Employment Lost Ca rd 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 OFHAULER: AB CARNES ROOFING, INC. DUMP TRUCKS DATE: 5-31-2016 SIGNATURE OF APPLICANT: The C'011lln0niweafth oftlassachusetts a`r rz D-partinent o 'IndustrialAccidents 1 Congress Street,Suite 100 4 � Marian,MA 02114-20-17 www nlass,gov/dia \Vut•Iters' Coutpensation Insurance Affidavit:lit►itdc►'s/Coutracto►'s/Electi,icialls/PitiinbLxrs. TO BL''FILED WIT11 THE P[;t21VIlTTING AUTHORITY. AI?plicant.Informatior► �l Iease 1'ri►it I e ibw Na.nie(Biisitiess)Organization/lndiviclutal):AB CARNES ROOFING INC Address:30 ARROWHEAD FARM RD City/Stats;/Gip:BOXFORD, MA 01921 Phone It:978-857-1431 Are you an employer's~Chuck the appropriate box: Type of project(required): l j]I am a employer Mot some employees(full and/or earl-time),* 7. New construction 2,[:]1 am as sole proprietor or partnership and have no employees working forme to 8. Remodeling any capacity.(No workers'comp,insurance required.] 1(]1 cru a homeowner doing till wort:myself.[No workcrs'comp.insurance regmmod.] 9. El Deri'tolitiou 4,[:]l wu a homeownerand will be Pairing contractors to conduct all work ma nay property. (will 10E] Building addition ensure that all contractors either have workers'compensation irrsul'atmco or are sole I I,[:]Electricid repairs Or additions tmnpriuuars with rte employees, 12.❑Plumbing repairs or'additions I ain it general conm'actor and t have hired die sub-contractors listed(m die attached sheet. Those sub-crarnaotors have employees and bane workers'comp.insuranae,a 13.[,/]Roofrepairs b.El We are a corynomtion and its officers have excreised their tight of exemption per MGL C. 14. Otl'iei" 1.52,§I(4),sold Nye have no employees.[No workers'eosnp,uisurmnoe required] "Any applicant that checks box N I must also till out the section below showing their workers'ccamponsahon policy information. ----—�� t I lomcowners who submit this affidavit indicating they arc doing till work and then hire Outside contractors must subout at new affidavit indicating such, lContructors that check this box must attached an additional street showing the mime of then sub-contraetotj till([sono whether or not those entities have, employees. It'tile sub-coutracturs have csaapluycus,they must provide,their workcrs'cutup,policy number. t uni an employer that isprovidungr workers'competnsoli0o ntnstlrtttnce f01'ttny employees. Below is the policy widjob site atfur�uatr"uu. TRAVELERS INDEMNITY CO OF AMERICA Insurance Company pany Name Policy It or Self-itis. Lic ti 6HUB 0G36156-6-15 1ix1ration Date:: 10/15/2016 , Job Site Address:-- Attach ddress: _Attach a copy of the workers' compensation policy declaration,page(showing the policy lau suer acid expiration,date). Failure to secure coverage as required under MOL C. 152,§25A is a criminal violatiou punishable;by it tine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the tbrin al`a STOP WORK ORDER and m line of up to;6250.00 a day against the violator.A copy of dais staWniont inay be forwtarded to the Office of-Investigations of the DIA for insurance coverage verification. I do hereby certi/y ani t„t the pahis atut petitdttes of petyuty thut the htfurucutiuti pt-uvided above is trite nod correct. 4i 1_�Iltitt IV' ..__. '� .......,�""' '1 ''°` l.)atei Pholle lh 978-887 1 ;31 Official use only. Du not sprite in this area,to be completed by city or town of fic'iat City or Towil: _._ Perillit/f,icelise it Issuing Authority(circle enc): '— l.Board of Health 2.Building Department 3.City/I'owii Cleric 4.Electrical Inspector S.I'luud)iug lospector 6.Other Contact Person: Phone it: ACCOR" CERTIFICATE OF LIABILITY DATE(MM/DD/YYYY) —llh.� F 5/31/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BRIAN L. PRESCOTT&SONS INS PHONE -- �FAx (AIc No Extf:_�7�11)3222350_- __�_aic.Nor 963 EASTERN AVE E-MAIL ADDRESS: - -- -- -- -- -- ----- MALDEN, MA Q214$ INSURER(S)AFFORDING COVERAGE NAIC f! INSURERA: INSURE � AB CARNES ROOFING INC INSURER B: Travelers Indemnity Company of America 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. --- ---- ------ ----- ---- ----- ------ - ------ INSR TYPE 4F INSUR.ANCE ADDL SUER POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDIYYYY MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ RENTED ------- -- -- COMMERCIAL GENERAL LIABILITY DAtvfAGE T F.F PREMISES tEa occurrence) $ CLAIMS-MADE 1:1 OCCUR MED EXP(Any one person) $ ----- PERSONAL&ADV INJURY $ -__ ----- _ GENERAL AGGREGATE $ ------ - --- ---- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ PRO. ---- - ---- - POLICY E T LOC $ AUTOMOBILE LIABILITYKam. OMBINED SINGLE LIMIT (Ea accident) ANY AUTO _ BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident) ---- UMBRELLA LAB OCCUR FL.,F EACH OCCURRENCE CLAIMS-MADE $ EXCESS LIAB _... ------ ---$ ...... ---- _ AGGREGATE DED RETENTION$ $ WORKERS AND EMPLOYERS'LI BILOITY ( f Y/N `] WC STTU TH- ORY LIMITS OER_ ANY PROPRIETOR/PARTNER/EXECUTIVE B OFFICE/MEMBER EXCLUDED? NN NIA( 6HUB-OG36156-6-15 10/15/2015 10/15/2016 E.L EACH ACCIDENT $ 100,000..-- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under -- --- — --- nv-,(-.R1PT1nN OF OPERATIONS heIQW E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ROOFING CONTRACTOR CERTIFICATE,HOLDER CANCELLATION RORY MARTYN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 216 FOREST ST ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER,MA 018,A5 AUTHORIZED REPRESENTATIVE Brian N.Leary, PRESCOTT&SONS INS ©1988-2010 ACORD CORPORATION, All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD NOTICE z NOTICE TO >1 TO EMPLOYEES EMPLOYEES IV The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS I Congress Street, Suite 100, Boston, Massachusetts 02114 — 2017 617-727-4900 — littp://www.state.ina.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22&30, this will give you notice that I (we) have provided l*or 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 MIDDLEBORO344-1450 ADDRESS OF INSURANCE COMPANY (6HUB-OG361 56-6-1 5) , 10-15-15 TO 10-15-16 POLICY NUMBER EFFECTIVE DA`lC-S PRESCOTT & SON INS 963 EASTERN AVE MALDEN MA 02148 NAME OF INSURANCE AGENT ADDRESS PHONE # o AB CARNES ROOFING INC 30 ARROWHEAD FARM RD BOXFORD MA 01921 EMPLOYER ADDRESS 0 EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREAT 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 ol' the Workers' Coin pcnsa tion AcL A copy of the First Report ol' Injury must be given to the 0—1 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, it' llie 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 OFHOSPI"I'AL ADDRESS 000849 VV20P1G16 TO BE POSTED BY EMPLOYER