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HomeMy WebLinkAboutBuilding Permit # 9/9/2016 BUILDING PERMIT NORrh OF� eb�Np TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �A�o cr Date Received ' t °��` 7� �R�ieo PermitNOM A 5 / �ssaC Hus�� Date Issued: I `0, to IMPORTANT: Applicant must complete all items on thispage LOCATION C[LyIKI C e'r— P int PROPERTY OWNER 'r Print 100 Year Structure yes no MAP PARCEL: C ZONING DISTRICT:-Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Buildingnefamily 11 Addition [I Two or more family Li Industrial �Aiteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: 11 ✓tion 0 Other ,. �;,ti ,����ti �.x y , :. ;;����©,.'lIV'etla= -s��¢�� � - ale s::ed.t��str cf�✓ ��-� . DESCRIPTION OF WORK TO BE RFORMED: Ideniific tion- lease Type or Print Clearly OWNER: Name: Phone: 1 Address: L� PoOJ Contractor Nam e: tryyVa Phone: CI' Email: Q f Address: tiMoll Supervisor's Construction License:_ Exp. Date: �'a• �'1 Home Improvement License: @_ Exp. Date: ' ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S-F. Total Project Cost: $ (.p,!5 FEE: $_ OT _— Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access ranty fund ,z NORTH awn of = . l ...% 6Andover O A7s ,� 0 4AKE h9, 0110ver, Mass, C0C"1C"g WKK wry' ArEo U BOARD OF HEALTH Food/Kitchen PERMIT. T LD Septic System �41'N �OO THIS CERTIFIES THAT A BUILDING INSPECTOR has permission to erect.......................... buildings on ..,.., q ,...,�,�'r�A .,�Q ,... Foundation Rough to be occupied as s k .............14..�.... ... ......I..................... 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 EXPIRES4INMONTHS', ELECTRICAL INSPECTOR LESS C STRUSTAR Rough Service ..... .... .... ... ......... ................... Final BUILDING INSPECTOR GAS INSPECTOR ccupaucV Permit R! squired to Occupy By 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. EIN#51-0503313 T- Haverhill MA 978-374-9224 MA Reg. HIC#149221 a'rnts,rrr Lawrence MA 978-687-7339 MA Lic. UCS#78130 Hampton NH 603-929-9224 BBB asaf5� Hampstead NH 603-329-8200 s �� g ®_ Toll Free 1-888-SOS-ROOF w W W,LAM BE RTROOPI NG.Com 265 Winter Street Haverhill MA 01830 Name: Moira Goodman Date: 9/8/2016 Telephone: 617-851-6461 Cell Phone: Click here to eater text. Email: Goodies6@comcast.net Billing Address: 894 Great Pond Rd City: N.Andover State: MA Job Address: 894 Great Pond Rd City: N.Andover State: MA Scope of Work ®Strip and Re-Roof El Re-Roof Approximate Roof Area: ®Prepare for re-roofing by ensuring all safety measures in accordance with OSHA regulations and landscape is properly protected. ®Remove existing layers of shingles down to roof deck and dispose of in a legal fashion from the job site. ®Inspect wood deck,if we discover any rotted wood, replacement will be performed at*$3.95 per LF for roof deck boards. if substantial deck rot is discovered,re-sheathing of roof deck can be performed at*$1.25 per SF.If individual sheets are found to be rotted/or de-laminated, removal,disposal and replacement will be performed at*$65.00 per sheet.If any trim boards are rotted,replacement will be performed at *$12.00 per LF for new pre-primed pine, Inspect siding at roof line and all flashing behind siding, if we discover any damaged flashing or siding at the roof line,replacement will be performed at*$12.00. If wood deck,siding and flashing is sound,we will re-nail any loose wood to rafters, sweep deck,and prepare for roofing. ®install 8"drip edge to all rakes and eaves.Color: ®Apply ice&water shield(UNDERLAYMENT)as per manufacturer's specifications and/or ®Apply premium(UNDERLAYMENT)to the balance of the exposed wood deck. ®Re-flash all plumbing stack pipes,and any roof penetrations as required and dictated by good roof practice to ensure water tightness. Zif upon inspection,we discover chimney lead to be worn or deteriorated,replacement will be performed at*$450/ea ZIInstall a new:Year 03 Tab MArchitectual El Designer Color: ZFurnish and install anew shingle over style ridge system Soffit vent system *$n/a MAII debris generated by Lambert Roofing Co.will be cleaned up and disposed of from the job site in a legal fashion. Under no circumstances vial the watertight integrity of the building be compromised. ipecial Notes:6'of ice and water shield to be installed to entire building. Synthetic paper to be installed above ice and water shield. 40 yr architectural shingles. Ridge vent all applicable areas. )PON COMPLETION AND PAYMENT IN FULL,ROOF SHALL HAVE A WORKMANSHIP WARRANTY GUARANTEE FOR PERIOD OF 10 YEARS IONORED AND ISSUED BY THE LAMBERT ROOFING COMPANY AND LIMITED LIFETIME YEARS HONORED AND ISSUED BY THE SHINGLE nANUFACTURER MANUFACTURER'S UPGRADE *$N/A OF i otos potential additiollal casts above the total estimated price. TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE ' he Contractor agrees to perform the work,furnish the materials and labor specified above for the total sura of:$ 16,500.00(*} ixteen Thousand, Five Hundred (Dollars) Payment will be made according to the following work schedule 5,500.00 deposit upon signing contract by or upon completion of 3olonce upon completion of completion. (Law forbids demanding full payment until contract is completed to both party's satisfaction) You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram or by delivery,not later than midnight of the third business day followin the signing of this agreement.See attached notice of cancellation for an explanation of this right. DO NOT GN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Acc tante of the Contract Proposal )me Owner(s)Signature: 9�rol(� Date: ,ntractor's Signature: bate: www.lambertroofi com ( se see reverse side} The Commonwealth of Massachusetts Departntent of'TntittstriatAceictettts Qlfice ofIttvestigations I Congress Street, Suite 100 0; Boston, MA 02114-2017 im winass.goVllha Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Avolicant Information Please Print Le ibi Name (Btisiness/ort;ini tttion/ltidividtrttl): Address: ACP Cit y/State/Li : ` ",�I 1 o Phone #: Are on an employer? Check the appropriate box: Type of project (required): L 1 am a employer with. a 0 4. [_� I am a general contractor and 1. ��� * have hired the sub-contractors C F-1 New construction employees (ft,t11 rand/orpart-lime). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. © Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for fine in any capacity, ernployces and have workers' 9. ❑ Building addition[No workers' comp. insurance comp. insutance.T. required] corporation We are acorporation and its 10.❑ Electrical repairs or additions ❑ 1 3.❑ 1 am a homeowner doing all work officers have exercised their 1 l.❑ Plumbing repairs or additions myself'. [No workers' comp. right of exemption per MC�iL, 12.[] Roof repairs insurance required.] c. 152, §'1(4), and we have no employees. [No workers' 130 ther comp. insurance required.] *Any applicant that checks box tll nntst also fill out the section below sliowing their workers'compensation policy informalion. t torncowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. "C"ontractors that check this box must attached an additional shcct showing;the nanlc of the sub-contractors and state whether or not those entities have. employees. if the sub-contractors have cinhloyecs, they niust provide their workers'comp.policy number. I aro an employer that is providin,4,workers'couilumsation insurancef for nij,enrpCol,ees. Below is the policy aur!job site iu forItration. Insurance Company Name: Policy# or Self-ins. Lic. #: (0�>IQQ 'a�" (C� Expiration Date: �3.6?J Job Site Address: �qq--a-cat fl) al _[� City/State/lip: , &V&Qr Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Ftlilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of'criminal penahies of a fine up to $1,500.00 and/or one-year imprisonnicnt, as well as civil penalties in the form of STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy ofthis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I da hereby certify under thepahis r het attics of peryuj'y that the infor'matirn�r provider!alcove is true and correct. . _ Sianature: . - ��� �� .. Dat c: _ Phone#: j' � Q11icial use on1j,. Do not rprite in this area, to be completed liy city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Hoard of Health 2. Building Department 3. City/Town Cleric 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Pei-son: Phone##: Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-078130 Construction SUperv¢sor RICHARD J LAMBERT 266 WINTER STREET HAVERHILL MA 01830 r--1tirr -A— Expiration: Cot brnissioner 06/02/2018 " Office of Consumer Affairs fat!s and. Business Regulation. `r 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Tlome Improvement Contractor Registration Registration: 149221 Type: Private Corporation Expiration: ?2/6/2017 Tr# 273093 T.G.L .R•C dba Lambert Roofing Company RICHARD LAMBERT _ ....._ _ 265 WINTER STREET ___.._.-.... HAVERHILL, MA 01830 —. Update Address and return card.Marls reason for change. SGA'r t', 20ra-05r1r Address Renewal L.._I Employment _J Lost Card I- I