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Home My WebLink AboutBuilding Permit # 7/25/2016 . .. ............... ..... ` 10RTJ1 BUILDING-PPERMIT TOWN OF NORTH ANDOVER ��pp�� APPLICATION FOR PLAN EXAMINATION Permit NO:4 fiol Date Received � p cocw.ini wic. 1' 9�AAT@O I�`yej5 Date Issued: Ga' AC HUS IMPORTANT: Applicant must com lete all items on this page f k f f r ! F w r G r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑ Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ARepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other r Skc ce- �-o dlo Identification Please Type or Print Clearly) OWNER: Name: �-'�-� L Phone: �— c Address: L4 OaS � fr! ✓ / f f r f:.w f f y :f:, r n r �- � �,`, �� /z ^�r"z z_.: f f f f/ f y ! t ARCHITECT/ENGINEER Phone: Address: Reg. No. PEE SCHEDULE:BUDDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925,00 PER S.P. Total Project Cost: $ FEE- $ Check No.: Receipt No.- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty,fund NORTH own. of 2 . ndover Ivo. -,27 _ ..� o ( i _W ver MassO;;N*-. h � COC NIC KE WICK L �,,9sa'�wse a tga,�•(5 11 BOARD OF HEALTH Food/Kitchen PER T L D Septic System THIS CERTIFIES THAT .. ,,,,,, � „ BUILDING INSPECTOR has permission t0 erect .......................... buildings on ......,. . ....... ..�6...... A*W............... Foundation Rough 4 tobe occupied as .............. . r . .. ....... ... ..........................,.......,.................... chimney provided that the person accepting this p rmit shall in every respect conform to the terms of the application Find 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 Fina( PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TION Rough Service . .......... .. ..... Final MB61_131NI I PEC OR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin 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. 0 sax RXIVe, Craig LaCrosse-Owner CONTRACT PO Box 728,Tyngsboro MA 01879 June 21, 2016 978-580.7376 cralg@roofingi(ingltic.com Customer: Peter Longo Property Address: 41 Oakes Drive,North Andover MA Phone: 603-893-3631 Email:ploiigo@autouse.com Thank you for allowing Roofing King Inc.the opportunity to work with you, Please feel free to contact me with any questions at the number listed above, rr-SC PE OF WORK., Full Roof Replacement -1-louse will be covered with protective blankets to prevent any damage and for easy cleanup during removal process -Remove all shingles right down to existing wood and re-nail and prep before installation process begins(Est.It of layers_) -Install up to 96sq ft of rotted plywood(3 sheets 1/2 roof plywood)at no charge on any full roof replacement&$50 per additional sheet If needed -Install 6 ft of GAF Storm Guard Ice and Water along base of roof,snow load areas,valleys,chimneys and skylights for proper protection -Remove and re-install new plumbing flashing on soil pipes vented through the roof -Install Felt Buster on any exposed wood after Ice and water is applied to cover any exposed roof decking -Install new 8'" (White, Brown or Mill Finish)drip edge on all edges of roof for proper protection -Install GAF Pro Start starter strips around entire perimeter of the roof to create a 3/4 inch overhang for proper install -Install GAF Architectural Timberline HD LIFETIME[Ad.Shingles will be storm nailed with 6 nails per shingle 130 MPH resistance -Cut 1112 inch opening on peak of roof If it wasn't previously done for proper installation to meet building code(on full replacements) -Remove old lead around chimney and reinstall 12 inch lead and reseal joints(if applicable) -Install Snow Country exhaust vent on peak of roof to allow proper ventilation and meet building code -Hand nail Seal A. Ridge caps on peak of roof with 2 inch nails to complete installation. -Blow off entire roof,clean gutters,driveway and all walking surfaces and any loose nails with rolling magnets daily and on completion -Existing roof will be removed and recycled at Roof Top Recycling(Certified Green Roofer) _Weathei watch upgraded to Storm Guard Ice and Water Shield $0.00 Included -Remove skylight flashing kits to install ice and water on all 4 sides(reinstall existing kits) $0.00 Included -Deck Armor in place of Felt Buster $200.00 Not Included -Gutter work to be determined $TBD Not Included Warrant Roof corn es with 60 Year Weather Stopper System Plus LTD manufactures warranty Promotions $500 off Coupons(Act Fast Offer,Angles List, Horne Advisor and PAF$250 military rebate) I SHINGLE COI-OR:—ILI Initial:—L 1111''t, PAYMENT STRUCTURE: This price includes labor,material,trash removal,building permit(if required)and contract may act as signature for permit. _ALny.addition a I work will require separate pricing. Please make all checks a!able to aofi... Ing Inc. Total: $6,500.00 Deposit(due 1/3 $2,166,00 Payment(due hen material Is onsite): Final Payment(due upon job completion): 2/3 $4,334.00 ACCEPTANCE OF PROPOSAL.The included specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will he made as outlined above and accept all terms Included. All discounts on all work to be done must be presented to Roofing King Inc.representative before contract is accepted. If rotted wood Is discovered AFTER removing the existing roof,or It Could not be identified at the time of sale an additional charge of$50 per sheet. If this account is collected through legal actions,customer will be responsible for all attorney fees and court costs, Disclosure:Customer responsible to cover any valuable Items In the attic to protect from debris.Roofing Kirrg,,(�es not assume responsibility for acts of Mother Nature. Owner/Contractor Property Owner/RepresentrVe Craig LaCrosse Peter Longo (t'\ The Commonwealth ofMassachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 wwwmass.gov1dia Workers'compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. oplicant Information Please Print I.e [bl. Name(Business/OrganizationAndividual):Roofing King Inc Address:Po Box 728 City/State/Zip:Tyngsboro MA, 01879 Phone#: 978-580-7376 Are you an employer?Check the appropriate box: Type of project(required): 1.®i am a employer with employees(full and/or part-time).* 7. []New construction 2f]i am a sole proprietor or partnership and have no employees working for me in 8. []Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.®1 am a homeowner doing all work myself[No workers'comp.insurance required.]t 10®Building addition 4.F1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I Ln Electrical repairs or additions proprietors with no employees. 12.[:]Plumbing repairs or additions SQ I am a general contractor and I have hired the sub-contractors listed on the attached sheet. t3.R]Roof repairs These sub-contractors have employees and have workers'comp.insurance 14.rl Other 6,n We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContTactors that check this box must attached an additional sheet showing the name ofthe sub-contractors and state wbether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I atit ati ettililoyer that is providing ivorkers'conipensatiott insurance far Prey employees. Below is file policy mrd job site information. Insurance Company Name:Star Policy#or Self-ins.Lic.#:WC 07427..97 Expiration Date:08/20/16 Job Site Address: 141 0q1_(' DY, City/State/zip: No Attach a copy of the workers'compensation policy declaration page(showing tile policy number and expiration date). 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 the form of STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under tine e pains mid of perjury that the ilyorniationprovided above is trite ue and correct. Signature: 0� Date: Phone#:978-580-7376 Official use only. Do not write its this area,to be completed by city or town 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#: ACC) CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD,YYYY) 7/22/2016 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(tes)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: McSweeney& Ricci Insurance Agency, Inc. PHONE FA.781848-800QX 420 Washington Street E-MAIL IAIC,No Ext) - A1C 843-8807 No): - Braintree MA 02185 AoDRE55: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Berkley Regional Insurance Corn 9680 INSURED ROOFK-1 INSURER B Roofing King Inc INSURERC: Craig LaCrosse INSURER D: P.O. Box 728 Tyngsboro MA 01879 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:869719680 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. I TR TYPE OF INSURANCE INSA BURR POLICY NUMBER I��DY EFF POLICMMfDD EXP LIMITS A GENERAL LIABILITY N N CGLOO59562 12111/2015 12/11/2016 EACH OCCURRENCE $1,000,000 XDAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 CLAIMS-MADE [K]OCCUR MED EXP{Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 POLICY X PRO-jECI LOC INGLE LIMIT $ B AUTOMOBILE LIABILITY Y MIT5776F 8/2012015 8/20/2016 Ea axident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED x SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X AUTNOSEO P eOaoEcldenDAMAGE $ A UMBRELLA LIAR X OCCUR N N CU0071022 12/11/2015 12/11/2016 EACH OCCURRENCE $1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ C WORKERS COMPENSATION WC0742797 8/20/2015 8/20/2016 XWC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? N❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500,000 If yyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES{Attaoh ACORD 101,Additional Remarks Schedule,it more space la required) Roofing(Residential/Commerclai), Siding Installation and Carpentry 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 ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ivi cxa,�¢quvn rn.ra c.a �a .d+c�wcrqaouvxrnr wr wwauaaw a✓rxcc� I Beard of I3ttiIding Regulations and standards Licensee: CS A-101415 Construction Supervisor I & 2 Iw'AmiIy CRAIG A LACROSSE 18 HIGHLAND STREET TYNGSBORO MA 01879 C nlsSi oner 06/26/2018 r/�r`N orrrrrrrr>rerrrrrlf✓r rf fr�irrrar rffd Office of C'.ousunacrA,ffairs&Business Ilegniation u A 4 V 3rRr ✓ MCyME IMPROVEMENT CONTRACTOR a istration: 01 "' �J 17117 Type. : r� , r,�r 4 1 i x iratian: 9/4/2D16 p Private Corporat1w, ROOFING KING INC; ' p it CRAIG LACROSSE 12 MALVERN AVE. TYNGSBORO,MA 01879 � Undersecretary