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HomeMy WebLinkAboutBuilding Permit # 8/2/2016 05 7- �ORT►f '9 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ; Permit NO: Date Received ° °•°--�• "�r �9SSgcwu�Es�y Date Issued: IMPORTANT: em i . his a e om lete a �t� I A licant must c son e. w TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential f_: New Building One family II Addition [i Two or more family [:1 Industrial Ll Alteration No. of units: ❑ Commercial Repair, replacement i Assessory Bldg [] Others: Demolition I l Other u ° r :y y. ... mi NEW Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: . OJ0 I � 4 ARCH ITECTIENGINEER 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 Cost: $_ZY FEE: $ Check No.: I 1 �oReceipt No.:� 30101;16,:4_ NOTE: Persons contracting with unregistered contractors do not have access to the guaty fund t%ORTt Town of 4 _ AF 6 ndover O �� .Hr.X,w wry y 1 leo• T nO LAKE h ver, Mass, eg vzo ZED/ Ab [O[KI[HlwKK 1 CRATED S U BOARD OF HEALTH Food/Kitchen PERMIT D Septic System THIS CERTIFIES THAT ....., e............. .. �' ......................,.................. ...... BUILDING INSPECTOR has permission to erect .......................... buildings on .... .. . ,.� !� ,.,,,,, Foundation Rough t0 be occupied as �C., . ....oo..4tia.P0.0c............................................................................. 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS C®NST TION Rough Service ........... ........ Final BUILDING IN ECT GAS INSPECTOR ®ccupaLcy 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[let. i S N EXTERt�R ., R��1CC�1 �.... ; 25 Spaulding Rd • Suite 17-2 • Fremont, NH 03044 PH 603-895-0400 • Fax 603-895-0445 May 19, 2016 Gene Fay 1463 Great Pond Rd North Andover MA, 01845 Dear Gene, RE: Roof Replacement : Main home As per your request and our site visit to 1463 Great Pond Rd North Andover MA, we are pleased to provide pricing for the removal, disposal and installation of roofing at the address referenced above. Scope of work: • Install tarps to protect lawn and any plants and brick walkway • Remove & dispose of existing roof shingles &fiashing • Inspect sheathing and trim and siding for rot • Inspect roof and soffit to ensure balanced ventilation system • Supply and Install Owens Corning Tru Definition Duration shingles o Lifetime (50 YR)Architectural shingle o Color: To Be Determined from standard colors o Owens Corning Cap shingles at hips/ridge to match shingles • Supply and install 8"White Aluminum drip edge and to all eaves and rakes • Supply and Install Owens Corning Weather Lock Flex Ice and Water barrier for 6'of roof, all eves and valley's • Supply and Install Owens Corning Weather Lock Flex Ice and Water barrier for cheek wall, approximately 82'up minimum 24" • Supply and Install lead for chimney • Supply and Install Owens Corning Pro Armor synthetic underlayment(comparable to 15# • felt) • Supply and Install new roof boots as needed • Includes Permit and Dumpster for work above Pricing: Main House : $15,015.00 New lead for chimney: $350.00 Platinum Warranty, if wanted: $585.00 New Cedar Clap boards cheek walls: $2,865.00 Total job with Warranty, $18,815.00 Unit Prices: • Replace rotted sheathing-$60.00/sheet if needed. Warrantr. KTM Properties, LLC includes with their price a preferred contractor warranty through Owen's Corning. The preferred warranty includes 10 years Non-prorated workmanship and 20 years Non-prorated on Materials (Limited Lifetime warranty, proration period starts after year 20). Please find a copy of this warranty attached to bid. Warranty Upgrade: KTM Properties, LLC is a platinum contractor with Owens Corning and can offer a platinum warranty. The platinum warranty includes 20 years Non-prorated workmanship and 20 years Non-prorated on Materials (Limited Lifetime warranty, proration period starts after year 20). Please find a copy of this warranty attached to bid. Insurance: KTM holds the following insurance limits fillustration of Coverage Included • Commercial General Liability (CGL)with limits of Insurance of not less than $1,000,000 each occurrence and $1,000,000 Annual Aggregate. • Worker's Compensation and Employer's Liability with limits of Insurance of not less than $1,000,000 each occurrence. • Automobile Liability with limits of Insurance of not less than $1,000,000 combined single limit. • Umbrella Liability with limits of Insurance of not less than$5,000,000 each occurrence. • This quote is good for 60 Days If you have any questions, please feel free to contact me directly at 603-548 4085. Sincerely, Dave Brennick A4 6 J Accepted By: 44 G Date: t? Signature Date: �_ Print Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ApOicant Information Please Print Le ibl Name (Business/Organization/Individual): KTM Properties, LLC Address: 25 Spaulding Fid - Suite 17-2 City/State/Zip: Fremont, NH 03044 Phone #: 603-895-0400 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 25 4. ❑ I am a general contractor and 1 6 ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ .Building addition [No workers' camp,insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.© Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I must also till 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. $Contractors 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. If the sub-contractors have employees,they must provide their workers'comp,policy number, I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Insurance Company Company Name: Policy#or Self-ins. L.ic.M WCA5152316-10 Expiration Date: 6/16/2017 1463 Great Pond Rd N. Andover, MA Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: Date: 07/28/16 Phone M 603-895-0400 Official use only. Do not write in this area,to be completed by city or town offrciat City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other u Contact Person; Phone##: u d 9 s �..-� KTMPR-1 OP ID., BB DATE(MW0UN)-YY) �- CERTIFICATE OF LIABILITY INSURANCE 1 08162/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTWICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZEn REPNSSEN`I'ATIVE OR PRODUCER,AND THE CERTIFICATE;HOLDER, IMPORTANT: IF the certificate holder ie an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION Is WAIVED,subJect to tho tans and conditions of the policy,cartain policies may require an endorsement. A statement on this certificate does not confer rights to the CCrli tate hofdar in lieu of such endorsarnan s . TAODucER Phone:603-424-9901 CONTACT PHbNE Brown S.Drawn(IMerrlmack) Fax Bfi6-848-1223 FAX 309 baniol Webster Highway Merrimack NH 03054 Chris IMCRall INBVRER S AFFORGIHO coVEfifW4 MAIM* INsuRERA,Union Insurance Company 25844 INSURED KTM Properties LLC INSURERB I KTM Extartars&Recycling LLC INsuRERc: 25 Spaulding Road Fremont,NH 03044 INSURERD: IlusuaEa n: ' 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 PE f IOD INDICATED. NCfT!lUITHSTAN>5lNG ANS �F;NY, ! 9NpIT44N QF,AJVY.C,.SaNTRACT OR OTHER DOCUMENT WITH RESPECT To WHICH THIS CERTIFICATE MAY BE 135L1i D f lS F 11- �IH-,E r N3UF2q � P�1J�DE T,FF1l�� ROLICIES DESCRIBED HEREIN IS SUBJECT TO ALL YHE TgkM8, �CCI.VSIONS AND CONDITION5.OF..0 Q.J- .Q�I�Es t J( I Q ,•,M,4 }{ VE, .i�E9q E-D BY PAID OLAIM8. ILTRR TYPg OF INSDRANd@ '•�. .AgDt_eu�R'3 ,`;:':o'�,:Priircr�ut3M� �t9,•, ,n.�,)� t^ 'P(MINAP LIMITS OENERAL'IUIBILETY r .rr ,•..to a:egr.;_. i .,'u .r ;::, :. rc ...' EACH OCCURRENCE $ 1r600,000 .7 N 2Y A DAMAGE TO REN TED A COMMERCIAL C3G4BILITY-' {' tSarq� t J}6I76I2d IS OtiI1BI2Q17 pRPMIeE& Ea oanrtronm SOQr000 ENE s `A„_ .., _ ::�'"�� 1"'..,.�.i.. ti'', .+_.,._; - .�:.•., .. MED'EXP 'true alaan $ 5,000 r, L':foC:•tiA i irrt�_t .�.F:ri ei.• ;�•:<.:'e'v"., i>:hac:�:P •`I»r;'YN 4('` �;?.'r . , -PERSONAL INJURY S :: i : ..:.:. •: 11,00101,00 ..R. GENERALAGOREdATE $ 2.000,00rii'iti7.,e' 2,000,000 bI=N't-AmRE�AATE LIMIY APPLIES PER' %-'" i ,'>•S.' .. PRODUCTS-COMP/OP AGG S POLICY X ,'R'- LOG ^r'+'.. COA461hfE0 BINDLE LINI T A _ 1 600 00 LfrOMOSILELWSI&TY AW-AL : f , A ANY AUTO OPAS162308-12 0611612016;:,001101204'7;:aODIL'YIWURY(Par parson) $ ALL OWNEDSCHEDULED I I,aS',nZ:.,� 'l,„;;(:;•': I'?'i i” ::: ` ,$OUILyp4)URY(Par2cefdorrt) E AWOE AUTOS .. .,. tXA1HIRED AUTOS X AIOfIN43 ryD.-;i'' c':... Paraxldont S UMRHELLA LIAa X OCCUR EACH OCCURRENCE 8 5,400,OQ0 EXCESS OAA CLAIMS-MADE CUA'S1'S23114-12 ..:::sijF.r.ME1161$016 06/16/2017 AGGREGATE $ 5,000,000 DBD x o 1 . 00.RKERSCOMP9NSATION WCSTATU• OTH- ANoE'MPLOYERa'VABILMY. "yrN'," ER '-'•-' A ANY FROPRIETOROAKYNERJEX£CUTIVE .,.CA51521119.12' 0611612018 06/1612017 E,L,DACH ACCIDENT $ _11000,00 PFFIGERIMEMBEREXCLUDEO? .. :N'IR" s;l:^:;,• ,: (Mandatory in NH} �.. _ •• c ��:j�:.n,):it:'..4, :^' :..t t,• €.!„.DISEASE-EAEMPLOYEE $ 1,000,000 ligqea tlendbe under "''r 1 006 00Q DESLtRIPTIONOFOPRRATION^tb01 w ',r"t'`i�'"�i:y' ...�. I;.L.DISEASE-POUCYLIM[T S 7. 77 DESCREPTION Oi OPEfiA7IbN3I LOCATIONS 1 VEHICLES:(at(aah I)CGiio 101,Add-1 nai,ltpMnrk f SQ gqL la,rV'nco�o space la roqulratl) LD 0ANC9LL;A`1")(1N i4H9IJLD ANY OF THE ABOVE 13960RIBED POLICIES BE CANCELLED BEFORE Town of North Andover, rill "THE-'-EXPIRAT-ICIN•..DATE-'THEAKOF, NOTICE WILL. 6E DEL-fVER150 IN A Ai COOANCE WITH THE POLICY PROVISIONS. AUTKORRiZE13 REPRr139NNTA{TltlF(/(/�[J ®1988.2010 ACORO CORPORATION_ All lights resolved_ ACORD 25(2610105) Tho ACbI1 name and Idgo aro reoistared mark&of ACORD 100/100 'a 'ON XV9 Wd 90: 10 Efil/910NO/5 y Massachusetts Department of Public Safety `V Board of Building Regulations and Standards,' Affarr,r�urBusir Business License: CS-02A269 a Q ffice of consumer Affairs&Business Regulation Construction Supervisart [OME IMPROVEMENT CONTRACTOR Registration 'f60936 Type l ANTHONY R PETINO ;` Supplement Card 9 FIRST ST Expiration -612512. 0-, MEDFORD MA 02955 `l KTM PROPERTIES LLC ANTHONY PETINO 25 SPAULDING RD SUITE 97 2' ,= CA— Expiration: FREMONT,NH 03044 Undersecretary Commissioner 0511612018 li � � � �� �r i +� � a � � � � �9 ; � 1 "� ?[�f W � +� k' �� � � � �� �� � � r�. ������ ��i(���`"�d �� �- �a ��,� a � ,�� �, a ,,� �` � r F ' o' � � � � � � �i R�� � � � �� r .� ,: c 4 � �� �, z��,�' _ q �. ��� � , ^f > �,F� ..�°�� ,� - F ��� a �. s ,� ;r' a tr��'F„' �� y r "''�iN'� yfl S � "�'� yr/�K,T���`Yg.,�Y�",�^+:� �' F ,r. -, Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-020261 Construction Supervisor ANTHONY R PETINO 1 FIRST ST MEDFORD MA QV5� °-- j 4 ------ Expiration: 0611612018Commissioner ---------------— �.--- ------- The Commonwealth of Massachusetts = Department of Fire Services a` Office of the State Fere Marshal P.4.Box 1025 State RoadrrStow,MA 01775 PERMIT late: Permit No (W-of Town) (If Applicable) Dig safe Number In accordance with the provisions of M,�G.L/. Chapter l Pas provided in section 5 2 7 CMR 34. This Permit is granwd to: ✓// --7—O Start late Full amo of person,Firm or Corporation Permission to locate dumpst:er for construction/renovation/demolition of Structure Comments: dum ster be 25 ' from structure or covered with tarp or plywood Restrictions; at e n dd of workday at J V (Give location by street and no.,or describe in such manner as to provied adequate identification of location) Fee Paid$ �jc This Permitwi11 expire d�� �b (Sio antinanni ) i P�RRIIIT MI ICT AF rr]N_qPIf•1 iC71 rCl V POCT;=I] I IPt11lf TI-Ilr PR1=HIIICI~G