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HomeMy WebLinkAboutBuilding Permit # 8/30/2016 BUILDING PERMIT tkORrH ��.�4aa 6r NO TOWN OF NORTH ANDOVER o= APPLICATION FOR PLAN EXAMINATION � e Permit No#: Date Received 2igsSRCHU5���5 Date Issued: PORTANT:Applicant must complete all items on this page LOCATION -7-` Print PROPERTY OWNER Z Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential Li New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alt tion No. of units: ❑ Commercial epair, replacement ❑A, essory Bldg LlOthers: F1 Demolition =they w� ', x� �:s ';�,�� sm,c-"5 S B r am c UES IPTION OF WORK TO BE PERFORMED: Ident' kation- Please ype or Print Clearly OWNER: Name: �?!�' - �' 7, Phone: ,7- /3 I Iollll Address: , Contractor Name: Phone: Ernail: Address: Are Supervisor's Construction License: Exp: `Date:. Home Improvement License Exp: Date' 12 ol ARCHITECTIENGINEER I-S --- Phone: Address: Reg. No, FEE SCHEDULE:BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ �D " FEE: $ Check No.-,— ,- Receipt No.: NOTE: Persons contracting with unregistered contractors t have access to the guaranty fund t%ORTFI q f Town ....1,. 6 ndover O % L,Ka h ver, Mass, ik !)as 2ei 0 COCNICNQWICII AERATED 0a��5 S U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT 41t.4111:1 r.. N '. , BUILDING INSPECTOR has permission to erect.......................... buildings on . Foundation . A'• 4 . ... Rough to be occupied as ..... ...... .............................................................. Chimney provided that the person accepting phis permit shall in every respect conform to the terms of thea application pp 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 p� MONTHS Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS CTI® T Rough Service ..... . ........... ....... ...... Final BUILDING SPEC OR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough r 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. i Proposal HIC#174377 Damphousse RoofelngLLP Jim A trusted name since 1938 Roofing *Siding m Windows � 67 Belmont Street a North Andover, MA 01$45 P: 978-683-4588 F: 973-635-7446 e I NAME OF OWNER AIR( ADRESS OF JOB TEL. !!7 DATE: We will remove all roof shingles off total roof area, layer, Replace' any boards or sheathing at additional cost. A new 8" white aluminum drip edge applied on all edges. Approx. Eft of ice and water membrane applied on eaves, aft in valleys, strips around skylights, along chimney flashing and sidewall junctions. Existing step flashings to remain. A new base sheet applied. Architectural roof shingle installed with a limited lifetime warranty. Install new ventpipe boot flashings. Waterproof existing chimney ;,flashing and remove debris. Shingle Color, ' r'3 + Ridge Vent Upgrade ^ Wood Sheathin Repair$3.50 per ft. - ,/ °® !:-~DA We Propose herby to furnish material and labor-complete in accordance with above specifications,fo th sum af: dollars($ Payment a ode as follows Authorized Signature NOTE:This proposal may be withdrawn b s if not accepted with i ays I I Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and are herby " accepted.You are authorized to do the work as specified.Payment will be made as outlined above. LSignatureDate of Acceptance: / HOME IMPROVEMENT CONTRACT TERMS AND CONDITIONS(M.G.L.142A) 1.WORK:Provided the Homeowner performs under this agreement,the Contractor shall perform the work orr the Property as specified Proposal,attached incorporated herein.The work does not include extraordinary conditions of which the Contractor could not reasonably be aware.if such conditions are encountered,this shall be an additional cost to the Homeowner.Materials selected by Homeowner may have to be ordered or custom made,which items are specified in the Proposal.The Contractor is not obligated to agree to any modifications,extras or change orders unless such items are agreed to in writing by the Contractor.All extras and changes shall be at an additional cost to the Homeowner.Contractor shall perforin the work in a good and workmanlike manner using materials consistent with this contract. Lawn or Driveway may be damaged by dumpster or equipment. Due to material shortages Contractor may substitute materials of equivalent grade. 2. PERMITS:If a building permit is required for the work,the Contractor shall obtain same as Homeowner's agent.Contractor is not responsible for any other permits that may be required for the Work,and Homeowner is responsible to determine whether any zoning,planning or wetland related permits or -tits or with unregistered contractors wiEl'•not have access to the Guaranty Fund, approvals are necessary.Homeowners who secure their own per 3. COMMENCEMENT AND COMPLETION:Homeowner acknowledges the commencement date of the work is fluid,and is subject to numerous factors such as scheduling other contractors,delivery of materials and weather.Contractor and Homeowner shall determine the commencement date of the Work when a more definite determination can be made and shall execute a written acknowledgment of samc.The Work shall be substantially completed within 7 days of commencement,except for longer periods as may apply to particular projects as Contractor shall notify i Eomeowner in the Proposal,and subject to delays for circumstances beyond Contractor's control.Notwithstanding,the commencement date and substantial completion date may be extended,and the Contractor will not be liable for delays caused by,labor or material shortages,delays in delivery of items selected by the Homeowner,governmental action, and unforeseen events beyond the Contractor's control,including but not limited to weather,strikes,war,the acts of third persons or the acts of the Homeowner.The Homeowner recognizes that the commencement date may be delayed due to scheduling or the completion of Contractor's other jobs. 4. PAYMENTS:Contractor agrees to perform the Work and to fi►rnish the materials and labor specified in the:Proposal for the amount as stated in the Proposal.Thirty percent(30%)of the total is to be paid as a deposit with the signing of this contract. Upon cancellation prior to commencement of the Work,any remaining deposit will be returned less the costs for materials ordered for which Contractor was unable to cancel. Final payment shall be due upon completion of the Work and Homeowner agrees it may not hold any retainage.Late fees may be applied for late payments.Homeowner shall pay Contractor's reasonable costs of collection,including attorney's fees and costs.Time is of the essence hereof j 5. WARRANTY: For a period of 2 years after substantial completion of the Work the roof will be free of leaks caused by defects in workmanship, but not those caused by ice backing-up or extraordinary weather events,including blizzards,tornadoes,hurricanes or storms of greater than a twenty-five year duration or intensity.Contractor gives no wan•antics with reference to any materials or equipment installed in the Premises,passes any such warranties directly to Homeowner,and Homeowner agrees to look only to the manufacturer with reference thereto.This limited warranty extends to the Homeowner only and is not transferable to succeeding Homeowners.This Limited Warranty specifically excludes(i)all consequential and incidental damages;(ii) damage due to ordinary wear and tear,abusive use,misuse,or lack of proper maintenance;(iii)defects which are the result of characteristics common to V materials used;(iv)defects in items installed or supplied by anyone other than Contractor;(v)work done by anyone other than by Contractor;and(vi)loss or injury due to the elements.There are no other expressed or implied warranties or representations made or given. l 6. ENTIRE AGREEMENT:This contract and all documents referenced herein constitute the complete and ficial agreement between the parties. In the event l that any of the provisions of this contract shall be held to be invalid,the remainder of the provisions of this contract shall remain in full force and effect.Two identical copies of this contract have been completed and signed.Homeowner acknowledges receipt of a completed contract signed by the Contractor. B 7. HOME IMPROVEMENT REGISTRATION:In accordance with M.G.L.c. 142 A,§9,Contractor is registered with the Bureau of Building Regulations 1 and Standards Registration No:_174377.Homeowner may verify by contacting the Director at(617)727-3200,ext.25205.A Homeowner's rights under 3. the Home Improvement Law(M.G.L.c. 142A)and other consumer protection laws may not be waived in anyway.Homeowner acknowledges receipt of a copy of 780 CMR R6 and Massachusetts General Laws chapter 142A,and which are available online at www.Mass.gov.Questions may be directed to the Consumer Information Hotline,(617)727-7780. 8. ARBITRATION:Contractor and the Homeowner hereby mutually agree in advance that in the event the Contractor has a dispute concerning this contract, the Contractor may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in M.GL.c. 142A.No lien or security interest is I imposed on the Property as a consequence of this contract,but Contractor has the right to record this contract or a notice of this contract,or seek a lien if the 1; d; Homeowner breaches this Contract. ry. 9. HOMEOWNER COVENANTS:The Homeowner agrees,represents and warrants that(a)the Homeowner grants permission to the Contractor to enter the Property to perform the work as covered by this contract;(b)the Homeowner has fumds available to make full bayment Ender this contract to the Contractor upon completion;(c)the Homeowner understands that construction as contemplated by this agreement creates'a dangerous condition,and agrees not to enter portions of the Property under construction until the Contractor advises the Homeowner that the construction is coil pleted;(d)Contractor may need use landscaped areas of the yard during the Work and Homeowner is responsible to provide protection for landscaping and(e)that code requirements may result in roofing nails penetrating through roof decking and will be visible on the underside of some surfaces.The Hoineowuer indemnifies,exonerates and holds harmless the Contractor from any loss,damage,claim,liability or expense(including reasonable attorney's fee ,deposition costs and court costs)resulting from a breach of this provision.Contractor is not responsible for damage to landscaping that will grow back during the next growing season. 10.CANCELLATION: Homeowner may cancel this agreement provided Homeowner notifies the Contractor in writing at the address listed in the Proposal not later than midnight of the third business day following the signing of this agreement. HOMEOWNER: rv_- y � �rtJJ i�i DATE: Shlugle: � / 1 REPOS 1l 'Ire Corrfrltortrveadth ofMassachnsetts Depaiglarejtt of lndusfr ial Accidents Q_ J ®ff f ee of 111restigations 600 pJttshington ,5hwet .Boston, PIA 02111 ''c��� �t�tr�fi�.lruass.go�t/dia � Workers Compensation Insurance�dav-it- Builders/ContractorslElectriciansll'lumbers Alicant I ,formation Please Pratt Legibly Name (Busines�10fgani.zationlIsidividual): F Address: Y / /' GitylStatelZi10 '` W� „� �" Phone#: ' Are y an ez3n�yloyer? Check the appropriate box: Type of project(required): ° 4. [� 1 am a general contractor and I 1. 1 am a employer«Rth 2 — have lured the suis-contractors G. ❑New colistin ton employees(full andlorpart time).= �. Remodeling ?.LJl am a solelproprietor orpartner- listed on the attached sheet. ❑ g These sols-contractors have g, ❑Demolition ship and h�ve no employees working f¢r i oe in any capacity. employees and have workers' 9. ❑Building addition i comp.insurance.= [No worke s comp.insurance 14.❑Electrical re;airs or additions required.] 5. We area corporation and its 3-El I am a homeowner doing all work officers have exercised their 1 L❑Zof ins re airs or additions myself right of exemption per MGL 12_ epairs y [1�o workers'comp. insurance equired.]; c- 152, §1(4),and we have no employees. [No workers' 13•❑ Odler comp,insurance required.] *fitly onplicnrll filo[c ecks box#1 must also rift out lite section belo-,shuwing their workers'compensation pofiCV iinformation. i T l'tptllz'oSt'tkel'S tV}1n,, bmit this affidavit indicating they are doing all work and then/lire outside contractors[Host submit a new affidavit'ndicating such. -Contractors t11a1 ChCC'this box nlllst nuaclied an addition/SlleeE 511QSVin�the namC of the sub-Lomractors and stale whether or not flies entities have cu-iplayces. If the sula cautractors 11ave empfoye.=s,they must provide ale's worf.ers'comp,policy number. nils an elllfffajref�tttat is pf'01fidiltg ivarkers'collrpellsation i!lsuratice fDr rrrjl employe-es. BPforP Is tilepoli v alid]ob SftB ilafarrrratiatl. Insurance Company Name: -� .F s Policy or Self iss.Lie.;r;4&1K .� �` j Expiration Date; III City/State/Zi li Job Site Address: - Attacir a Copy a the cvorltecs' compensation policy declaration page(showing the polies=number and a piratialr date). Failure to sectue overage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500100 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK s RDER and a Elsie oCup to$250.00 day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certif rfld'l the pufllS allff perlultfes oftfetJrlry that the to fo!'111 ati0tl pTol=i{fed above i5 true air correct. (1 Sintra titre: �t Date: Piton official use oidj% Ito slot write ill this Area,to be colupleted by city or fou'll gfficiaL City or Town' Permit/License n Issuing M016 (circle one): 1.Board of rr ea 2.Building Department 3.City/Town Clerk 4.> lectrlcai>Ens1>ectol S.Plumbing Inspector G.Other Contact Vers n: Phone TM• Cliernt#: 144415 DAMPHOUSSI= wD CORD, CERTIFICATE E �F LIABILITY INSURA C D4I13/ CI 6YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 1995 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 21 Elm Street Andover,MA 01810 INSURERS AFFORDING COVERAGE MAIC# INSURED €NSURER A Western World Damphousse Roofing LLP INSURER B: 87 Belmont St INSURER C: North Andover, MA 01845 INSURER D- INSURER E: COVERAGE$ 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 tS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTA NS TYPE OF INSURANCE POLICY NUMBER Po LILY EFFE©TINE POOLE E Al PIflAT1V N LIMITS A GENERAL LIABILITY NPP8202847 04112116 04/12117 EACHOCCURRENCE $y 0flQ00Q� X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 5100 000 CLAIMS MADE r ••f OCCUR MED EXP(Any ono Demon) $5,000 PERSONAL E ADV INJURY s1 oao 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $2,()00,000 X POLICY Pq LOG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Ea ac4Cenll ANY AUTO ALL OWNED AUTOS BODILY IWURY SCHEOULEO AUTOS (Per aerscn) HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Por arcdera) PROPERTY DAMAGE S (Par accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC 5 AUTO ONLY: AGO S JEXCESSTUMSRELLALIABILITY EACH OCCURRENCE $ OCCUR F1 CLAIMS 161ADE AGGREGATE S i S I DEOUGT18LE RETENTION 5 S WC 5TATU• OTH• WORKERS COMPENSATION AND X EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S ANY PROPRIETORiPARTN£R:EXECUTWE OFF€CEPw5mBER EXCLUDED? E DISEASE•EA EMPLOYEE 5 p If yes.describe undor 0 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S OTHER V -- E p DESCRIPTION OF OPERATIONS 1 LOCATIONS J VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Ij Covering operations usual to Damphousse Roofing LLP... CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TOMAIL in DAYSWRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE To DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRE NTAT ACORD 25(2001108)1 of 2 NS334841M33480 ML © ORD CORPORATION 1988 I AC6 O ! CERTIFICATE IFICATE ®F LIABILITY INSURANCE DATE(MMlDD1YYYY) �4� i 04/18/2016 THIS CERTIFICATE IS ISi UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NO AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TME POLICIES BELOW. TH15 CERTIFI TE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PF ODU CER,AND THE CERTIFICATE HOLDEN. IMPORTANT_ If the certl tate holder is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions f the policy,certain pollCles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu a such endorsement(s). PRODUCER hAME;oT Diane LeBlanc DOHERTY INSURAN E E AGENCY INC j CNP n.Exa, (978)475-0260 _ �F�'4" _ I IAlc,Ne): ! aoaesS: dleblanc0dohertyinsurance-com { _ P-O BOX 1365 INSURER€Si AFFORDING COVERAGE _ E MAIC9 ANDOVER MA 41814 INSURER A; AIM MUTUAL INS CO i 33758 INSURED INSURER 0: DAMPHOUSSE ROOFING LLP UISURERC: INSURER D: 87 BELMONT STREET INSURER E NORTH ANDOVER MA 01845 INSURERF; COVERAGES CERTIFICATE NUMBER: 45466 REVISION NUMBER: THIS IS TO CERTIFY THAT I HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN €NG ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSU. D OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIO S OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CL11MS, 1NBR TYPEOFINSURA�4E D L U POLICYNUMBER R1MIi1DffYYYY FF M.6fnoYfYiYY LIMITS R COMMERCIAL GENERAL IAHILr[Y EACH OCCURRENCE 5 OAMAG j CLAIA45- ADEOCCUR U � I PREMISES Ea occunonce I S MED EXP(Any one,person) $ NIA I PERSONAL a ADV INJURY 5 _ g GE1YL AGGREGATE LIMIT AP�PEP EES PER: I GENERAL AGGREGATE _is 5 g R POLICY OTHER;❑PRO- LOC ( ( PRODUCTS•tahhPlOP AGG AUTOMOBIL£LIABILITY COMBINED I 1 Ea acciacm �5 r I. ANY AUTO I BODILY INJURY(PM person) !S ALL OWNED SC, EBULEB NIA BODILY INJURY(Per accident) 5 AUTOS AUTOS _ NON-OWNED p r)accRidn DAMAGE HIRED AUTOS AUTOS t i5 UMBRELLA LIAR OCCUR EACH OCCURRENCE S I EXCESS ifA9 CLASMS-MADE NIA AGGREGATE $ BED RETENTIONS W $ WORKERS COMPENSATION i X STATUTE ER PER O7H- �'.. AND EMPLOYERSLlABILnY �. YIN ANYPROPRIETOHfPARTNERlEX UTIVE 1 E.L.EACH ACCIDENT 5 500,000 A OFFICERIMEMBEREXCLU0E07 i NIA NIA NIA AWC44O70287742D16A t141171201t3 04/17/2017 (Mandatary In NH) I E.L.DISEASE-EA EMPLOYEE $ 600,000 If yes,dosvibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY L1Mti 5 500,000 NIA DESCRIPTION OF OPERATIONS I LOC' TIONS I VEHICLES(ACORD 101,Add€tionol Remarks Schedule,may ho artachad If more spaeo Is roqu€rad) Workers'Compensation bene its will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 O6 B,no authorization is given to pay claims for benefits to employe es in slates other than Massachusetts If the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurances,ows the policy in force an the date that this cerliffcale 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`Iwdtworkers-c,)mp,)nsallonfnve,ti,aliansl. CERTIFICATE HOLDEN CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ! MA 01810 Andover 1 Daniel M.Cron ey,CPCU,Vice President—Residual Market WCRIHMA ©1988-2014 ACORD CORPORATION. All rights reserved, ACORD 25(2014101) Tho ACORD name and logo are registered marks of ACORD I � - Massachusetts Department of Public Safety Board of Building Regulations and Standards } License: CS-067560 r Cr)bISkruction SU:r--rV Sot• r SHAUN M TWOMEY 61 PATROIT ST NORTH ANDOVER MA 01845 Expiration: Commissioner 10/25/2017 i I yLOffacc f`(onunreitAffit rs&Iii c//tc6 I t on1 HOME IMPROVEMENT CONTRACTOR J Registration, 174377 Type: W � Expiration: 2/4/2017 LLP DAMIHOUSSE ROOFING LLP SHAUN TWOMEY 87 BEL.MONT ST N,ANDOVER,MA 01845 Undersecretary i E