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HomeMy WebLinkAboutBuilding Permit # 9/15/2016 teoRrry BUILDING PERMIT TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION Permit No#: } 2 1 Date Received �q�garEoW,ea SSRCF1tul Sf� Date Issued: IM RTANT: Applicant must complete all items on this page LOCATION i A/Z,--T� Print PROPERTY OWNER O NJ Print 100 Year 5#ructure yes o MAP P PARCEL:r ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ane family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial L°Repair, replacement Cl Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septzc ©WWII Ffoddplatrs I16( etlartds Q 1Natersled Disfnct Q DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: E - G i 0 I Phone: Address: Contractor Name: rl;_7AI- .` Phone: 9 `� ��"-7> Email: i�� c� �t U-0-4 C-1 Address: / Supervisor's Construction License: (DJ� I z Exp. Date: I 3 Home Improvement License: 1 03- 2 Exp. Date: 1 2- ARCH ITECT/ENGINEER -ARCHITECTIENGINEER Phone: Address: IReg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$12,5.00 PER S.F. Total Project Cost: $_ & ' FEE: $ Check No.: -71 Receipt No.: 6�ot NOTE: Persons contracting with upregistered contractors do not have access to the uaranty fund tAORTH q Town o _ 6Andover ILI. x h ver Mass O - LANE 160 (a 'ThA coc"EC„EWICm`y S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT d�N... . .� �1!�.Ml� .............. BUILDING INSPECTOR has permission to erect .......................... buildings on ...111...0 A LL*#N....L04................. Foundation . r.^. .0........�. Rough to be occupied as ...... PlYn. ...... .................................................... 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 ® EXPIRES PERMIT EXPIRES IN +MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC STA Rough ...... .... Service ..... .... ... ..L.. . . .... .....,......................... Fina( BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Rfyuired to ®ccu BuRough 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. Aqk OWE RC3)CDF Chimneys Residential & Commercial Roofing All Types Of Siding CHIMNEYS POINTED-REBUILT-CAPPED Expert Masonry Work Mass Toll Free lt_ROof �xpOrt J Licensed & Insured Locally Owned&Operated Since 1976 1-800-WAIT-4-US �, s��� License#034200 (9248487) IKO off ` ozm or 9ojiv We Work Year Round g A 11 IBM 1, ISO Proposal To: Joe Quinn Date 9/6/2016 Street: 189 Carlton Lane 978-975-7150 N.Andover, MA \,,. Roof proposal Joe.aardvarkltd@comcast.net Certainteed Landmark 1. Extra caution will be taken to protect house and 12. Removal of all work related debris. Planks will be landscaping as best as possible. (tarps etc.) placed under dumpster to prevent any damage to Magnets run at final clean up. driveway. 2. Remove all shingles from entire house and shed. 13. Building permit included. 3. Inspect and re-nail any loose or lifted plywood. 14.Contractor workmanship warranty: 10 years under Any compromised plywood will be replaced at an normal wind and rain conditions. additional cost of$60.00 per sheet of 112" CDX. 4. Install all new (customer supplied) copper drip iv 2 Sa� edge to all eaves and rakes. Install aluminum drip Total Certainteed cost: �., edge to shed. Pro Upgrade: 900.00 5. Install 6' of Certainteed winter Guard ice and water shield along all eaves. 5 6. Install Certainteed Diamond Deck synthetic Certainteed 3Star extended MFG warranty: underlayment to remaining sheathing up to ridge. A fully transferable 100% coverage against 7. Install all new pipe boots. material defects for a fully non pro rated period of 8. Install Certainteed Swift Start starter shingles to 20 years. Please refer to pamphlet left in estimate all eaves. folder. Offered to our local referrals and included 9. Install Certainteed Landmark Limited Lifetime in this proposal at no additional cost. architectural shingles to entire house and shed. Certainteed 10 ygar material MFG. warranty. Balance due upon completion (See extended warranty) All shingles will be installed and fastened according to mfg. specs. References available upon request All valleys woven. 10. Install new GAF Cobra ridge vent and cap with Highly rated member of the accredited BBB and. color matched Certainteed Shadow hip and ridge Angle's List shingles. (MA code) Thank you! 11. Counter flash existing chimney lead, wall connections and all roof protrusions with ice and water shield, tie into new shingles and seal with ..� clear Geo-Cel sealant, 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. Date of Acceptance: `/ /IL�2'I Signa tur - The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mas&gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/P)urnbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print L bl Name (Business/OrganizationAMividual): t-2 4"1— Address: " . C City/State/Zip: Phone#: 94 Are you an employer?Check the appropriate box: Type of project(required): 1.O 1 am a employer with employees(full and/or part-time).* 7. ❑New construction 2.[]]am a sole proprietor or partnership and have no employers working for me in $, ❑ Remodeling any capacity.(No workers'comp.insumnce required.) 9. ❑Demolition 3.[J homeowner do 1 am a hoeowning all work myself.(No workers'comp_insurance required.]t 10E] Building addition 411 1 am a bomoowner 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 sok I I.[]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5�a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.[:]Roof repairs These sub-contractors have employees and have workers'comp_insurxwc_r 14. fl?b.❑ fi we are a corporation and its ofcers have exercised their right of exemption per MGL c. Other 152.§1(4).and we have no employees.(No workers'comp_insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-conmactors and stale 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 far my employees: Below is the policy and job site information Insurance Company Name: Policy#or Self-ins.Lie.#: p, � ) Expiration Date: Job Site Address: City/State/Zip: !� AT Attach a copy of the workers'compensation policy declaration page(showing the 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 a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance 'q coverage verification. I do hereby certify under the pains penalties ofperjury that the information provided above is true and correct. Si afar 'tr Pile: Phone#: Oficial use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityfTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone N. From:Univefsal Insurance To:19789750461 06114/2016 13:15 #533 P.0011002 colo® CERTIFICATE OF LIABILITY INSURANCE DA7EtMMlbDNYYY) 06/14/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOWTHIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; It the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER NAME. Leandro GulmaraeS UNIVERSAL INSURANCE AGENCYPHONE -- 508 752-9333 >ax N AppR1. leandro@universalinsagency.com 374 BELMONT ST. INSURERJS)AFFORDING COVERAGE NAJCA WORCESTER MA 01804 INSURERA: ACADIA INS CO 31325 INSURED --•-�-- INSURER 8: MGG CONSTRUCTION INC INSURER C, INSURER D: 12 WATER STREET APT 1 INSURER E: MILFORD MA 01757 1H$URERF: COVERAGES CERTIFICATE NUMBER; 61101 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 REOUIREMENT,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. IL7R 7YPEOFINSURANCE L BR POLICYNUMBER P L1CY FFA M LDICDYEXY LIMITS COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ CLAIMS-MADE ❑OCCUR PREMISE6 Ea occ mance $ ,,.,...........— MEO EXP M one arson $ NIA PERSONAL 8 AOV INJURY S GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S ;! POLICY 0 PECTRO 1:1 LOC PRODUCTS-COMPIOPAGG $ J s OTHER: $ i AUTOAtOS€LELIAHILITY COMBINEDSE GEE LIMIT $ acekl n f ANY AUTO BODILY INJURY ift ps(s*n) S E AUTOS OWNED AUl-aSUL� NIA BODILY INJURY(PWateidant) S NON-OWNED PROPERTY OA.MAGE S HIREDAUTOS AUTOS Peraccid $ UMBRELLALIA13 OCCUR EACHOCCURRENCE S EXCESSLIAS CLAIMS-MADE NIA AGGREGATE S DEP RETENTION �/ 5 WORHERSCOMPENSATION X PTAT E FR H AND EMPLOVERV LIABILITY ANYPROPRIETORIPARTNEREXECUTIVE Y r N E.L.EACH ACCIDENT s 1,000,000 A DFFICERIMEMBEREXCLUDEO? rau NIA NIA MAARP301454 05/20/2016 05!2012017 (MaodatoryinNH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 lr yes,dasvlba under 1) RIPTION OF OPERATIONS bairxa E.L.DISEASE•POLICY LIMIT $ 1,000,000 NIA a a DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES(ACORD 101•Addlnonl RemArks Schsduls,may he attached If mora spate is rsqufred) Workers'Compensalion benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization Is Diven to pay claims for benefits to employees In states other than Massachusetts if the Insured hires,or has hired those employees outside of Massachusetts. This certificate of Insurance shows the policy in force on the date that this certificate 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,govllwdAvorkers-compensation/investigations/, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN All Under One Roofing ACCORDANCE WITH THE POLICY PROVISIONS. 30 Temple St AUTHORIZED REPRESENTATIVE Methuen MA 01844 Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(20141D7) The ACORD name and logo are registered marks of ACORD iY I A�� � cERrIFILCAr� o ... . F LIA131LITY INSURANCE I OAIE(MMIDDM'Y Tuts caRTiFtcaTE Is IssL)BD As q MA TER OF INFOIZMATtoN ONLY AND CONFERS NO 48128/2076 CliRTII:ICATHISTB D4E8 NoT gFMATIVBY OR NEOA'tJ11l:LY AME'.t+Et) EJC END, OR ALTI?R 7Hl: CO RE77 PRESENTATIVE NTA CEERT(F1CA1'I= rg INSURANCE DOES NOT CotHMEN E I CONTRACT s�TwsEN T Rl:PRESI:NTATIVE t}R hFtbtfUCSR,AND THE CERTIpICATE HOI.DI7tt, RIt31iTg upp THE CE?RTIF CQ E HOLDER. THIP VERAGE AFFORD D Y THE POLICI91 IMAORTANT:IC the coflcltte holder Is an ADDITIONAL INSt1REI3�tha policy(tes)moat be endorsed. If g lssWHa INsu rt {s), AUTrIOr4lZfw( the terms and conditions t g the a cyr coital"Policies may requlre an endordemebt, A statement on this;certiTicate certificate holder In Ileo of ouch endorsement(s). IrBROt3ATI0N I ANEt} subject t( Prtooucra D2p51.081 does tslot c ntorr6htS to the Percy Insurance Agency LLC 1111 c srasaah 2olss- 622 Chickering{td �� o,l xt; (978)685-7690 p� ! North Andover,MA 01846 1UC,No.* (9 0)687-0149 IRAQCRoot On All ID A,1.M.Mutual Insurance Cam arty All. Unda>: one PER ft. C/0 aghn Lanza2ame 30 Temple Drive mstshus>rr MA 01844 CCVEFtAt3ES CBFtTIFICATiS NUI4lBERs THIS I$ TO CERTII+Y THAT THE POLIClEsB OF INSURANCE LISTED BlrLOW HAVE BEEN ISSUED TO`ryr; INSURED INDICATt:il, N011MTH3TANDINQ ANY REQUIREMENT, TERM OR CbND11TON OF AV CONTRACT T OR INSU n O AMrN yytp( RC P C TO CEgTIFIOATE [NAY Be t8sUf3p OR MAY PERTAIN, mE INSURANCE AFFORDED O 9 NAMED ABOVE FOR TH PC 10 PERIOD I;XCLU310N5 AND CONDI"ONS OF ffiUCH pOl(CIEB.LIINITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Wi 1ICH THIS Y THE Pt3LICIES DESORIBED HEREIN l9 SUBJECT TO ALL 7HE TER 1418, r TYPE DF IIVa'uRANcfw 01r?I>:RALLIABILITY I PDLICYNVINI I! P COMMERCIAL oEN&K LIABILITYLIMITeI EAGI{OCCURRE;NCE ii McDEXP Myons Person) PERDONAL6AD FINda.ORY i EN'LAGGRRCATELIMrrAPPLII;8PER; GENERAL AOGREOATFe s aucY A0. OC PRODUCTS.CCMPlCPAO 1$ A00MOBILR UABILII"Y ANVAUTO ALL Oth+NI:D s AUTOS LA BODILY INJURY iPat Dena" S HfRE17AUTQS BODILY INJURY(Par eenld U TM UMBRELLA LIAR >:7CCEDDLIA6 EACHOCCURR—ENC: R�erEAflflltt DAYS Npg��r � ImendEteryIrkNN)J) voEUi M NIA AWC�00.7008484.2ataA 11I8120ta 77/9/207 8 B L.MCH ACCIVarr B.+»nree=naS•eA�yPLorr 0 00 TSON bar fl 0 ffL.DrrrEABB.POUCYtaMl� ; 600,000,00 i GFSaRIPT1oN OF O?BRAItONti 1 LOCA11CNt1WHICLl:O(Attach ACOItp i01,Atltllti0oel Rlhlerk$$ChWttIR,Irmore$Pace($reg17IC$d) The workers compensation policy does III Provide coverage for John Lanzater"e CERTIFICA 1 E HOLDBR,� CANCELLATION SHOULD ANY GP HE AItOVH DESCRI86D POLICIES BE CAt+CCEllED BEpORE THE ExP1RA7lOf,f DATE THERE NOncB WILL, 8E: DELIVERED IN . ACCORDANCE WITH THE POL(CY pop' N071C i AUTAOIGT:tf01(EPREBSNTAT1Vel i !replsterod marks of=CORD co ° P ti s reserve , I MaSBaChUsBtts -f321:,'�F`ti71e"s'lY C1f?us�1,y;;j,�"<�'; I Basrel of Building Rogulhtiona a:tu ;z;• :•.:: con.trueticun Sup'll-imn. License. CS-069120 30 TEAWL AR .' METHUEi NMA 01844 �L,inmsssl,atl�r 04/03/2017 I Click i i i W§LO the re91stration number to view complaint hislory, You can also f roti � hist,. an Ftl The list Is Current as of WedneSday, October,, 2()14, .9earch Results REGISTRANT RESPO1 UUX RlEGISTRI4rTI[ON NAME 1lt1I]11fIt�ltAlE. ADDRESS -EXP1RAT14N NOu3LlOwt STAT TU3 DATE ALLUMERWEROOF LANZAFAf. E. .JOHN q— 156 A MERRIMACK ST 10/02/2016 Cu rent METHEt1N, MA 01044 .......... ! 0201$pommonwealth of Massachusetts. Maes.GQv0 Is a,registered servios mark or the 00rnM0awbalrith nfMaven cl►utoltrt. 1 n rrl"'(114