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STRIP AND REROOF
tk0RT#j BUILDING PERMIT Q��YLEO ,6 9q, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * " � Date Received 6 Permit Nod• � �SSRCHUS Date Issued: ORT.ANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER V i 04/ -4 ""x � , Print 100 Year Structure yes no MAP PARCEL: _ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others- ❑ Demolition ❑ Other D Septrc ❑1111e[1 ❑ Floodplain ❑Wetlands ❑ Watershed Distrrct DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please.T pe or Print Cleary OWNER: Name: 0 i'tt. -- ��'t s � I Phone: `��� - a3 ' G 3 Address: L ��i Ll CsSi t � Al/3- Contractor Name: Phone: 7'7 Email: 9 a Ad-dress: fit-- -`3---I t m.�5 Supervisor's Construction License: V Z 0 Exp. Date: Home Improvement License. / Exp. Date: ARCHITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:DULDINC p_ERM1T.-$92.00 PER$9000.00 OF THE'TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. j Total Project Cost: $ FEE: $ Check No.: `- Receipt No.: � '` NOTE: Persons contracting with unregistered contractors do not have access to the guaranty-unci ,.... i — -- - -- ......... .. ....... .. ... . ...... . ..... ................... ... ...... .... .... .......... ................. . .. ... ...... ...... .......................................... k tACIRT� own of 1 aF, 6 ndover 0 sn L % 4.K, h ver, Mass, toc.uc„ewOCK �'�' �q A04ArFo tPa��y �a BOARD OF HEALTH T _T LD Food/Kitchen Septic System THIS CERTIFIES THAT PER!M a 01% ....... BUILDING INSPECTOR has permission to erect .......................... buildings on ....1109n.A.401...k N..... e.�`44.m4 i AFoundation.• , Rough .. to be OCCUpled a5 ............ ...,�. .... .... ...mfoo.Ip ............................................................. Chimney provided that the person accepting this permit 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTION STARTS Rough Service ................................................................................ Fina BUILDING INSPECTOR GAS INSPECTOR ®ccyRancy Permit Required t® Occupy Building Rough - Display in a Conspicuous Place on the Premises -- Do Not Remove Final YY No Lathing or Dry all To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. ' ' •ri1' ,,' i �;.•,>„',f.•d��a�r.C�'ii L;�,..�Y �1�+;ry 'iy t:, �,h v , ,�.� �� V C } • • •r= s:• tr t,i„ ,I.,A'�::r< h•9� � �S••p't• -,• 1 a4�x � y�h '!' _• •, ''�•'i';'Yi�.'i�"Y �w.,��••''YYFFt7y ri;1'��1`',�s'�k>{'L' Y ;.�i,`�.; t {,`�r�,:, u''45"3S,.�T��"�?.�l'��,^� i r ;'1 t •:r !' ,al•�,C r'Tir�1T '�'`y�,,�s,I,S C� y'Y,S rx, , �.:”},� ''' _•' yHt5�{, . i' � i. 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C�t+,,� ��,5, •,ie,.eslcl:� ��i I•'{f+'9��.,1�,`•C�`��y}� y�g�t7Y`r 7 1�''''l{ � 1'�`r, V •�, —.i:°,t, 1�a,}.4f.� .��'iFr.,�SY73•=GE���.�;'s}�iq��l:ri,� ' ,. . . ` r � a• w�., �� 'S�v^}� JMLL UMI3MR 4DME R©tDF Chimneys Residential & Commercial Roofing All Types Of CHIMNEYS POINTED-REBUILT-CAPPED Siding Expert Masonry Work Mass Toil Free *Raaf Leaks Experts * Licensed& Insured r-orally Owned do Operated Since 1976 �......� License#03420© 1-800-WAIT-4-US m (524-8481) IKO C z& � azm no 7ahw �"� We Work Year Round 1 Proposal To: Village Green West Date 5/21/2016 i Street: 200 Kingston St. N.Andover 603-382-6166 9 68-82, 108-138, 156-170 a Roof proposal picaeng@comcast.net e IKO Cambridge/Certainteed Landmark 1. Extra caution will be taken to protect all buildings, 11. Counter flash existing chimney lead,wall walkways and landscaping as best as possible. connections and all roof protrusions (pipe boots and Debris will be removed and magnets run daily. vents)with ice and water shield, tie into new shingles Not responsible to move tenants personal items. and sealed with clear Geo-Cel sealant. All installation procedures will follow state code 12. Bath Exhaust vents: Install all new black low and OSHA compliance. Caution tape outline all profile bath exhaust vents on roof line. Counter work areas. flashed with ice and water shield. One for each unit. 2. Remove all shingles and roofing materials as best No interior connection included. Will coordinate with as possible from all four buildings. Association for best locations per unit 3. Inspect and re-nail any loose or lifted plywood. 13.Wall connections: Remove existing siding or Any compromised plywood will be replaced at an aluminum trim as needed. Counter flash at least 18" additional cost. up the wall with ice and water shield. Install new 4. Install heavy gauge 8"white F8 .019 aluminum 5"x7"aluminum step flashing. Re-install siding and drip edge to all eaves and rakes. trim. Install new aluminum siding or trim if 5. Install 6' of IKO Storm Seal or Certainteed Winter compromised. Guard ice and water shield to all eaves and top to 14. Removal of all work related debris. Planks will be bottom in all valleys. All drip edge nails will be placed under dumpsters to prevent any damage to covered with 12" strip of ice and water shield. existing asphalt. Placement and removal of dumpsters (ASTM D6757 certified) will be coordinated with Association to minimize 6. Install IKO Storm Tite or Certainteed Diamond daily interruptions. Deck synthetic underlayment to remaining 15. Contractor Workmanship warranty: 15 years under sheathing up to the ridge. (ASTM D6757 certified) normal wind, rain, ice and snow conditions. 7. install all new pipe boot flashings. Counter flashed (Please see extended warranty) with ice and water shield. 8. Install IKO or Certainteed starter shingles to all Extended Warranty: (Against material defect) eaves and rakes. *IKO Shield Pro Plus* 9. Install IKO Cambridge or Certainteed Landmark • Full 20 year coverage direct from MFG. Limited Lifetime architectural shingles to all four • Non pro rated buildings. All shingles and roofing materials will • Labor,material,debris removal and workmanship be fastened and installed per MFG specifications. All valleys will be woven. Commercial MFG *Certainteed 3 Star Sure Start Plus* warranty up to 40 years. (Please see extended • Full 20 year coverage direct from MFG. warranty) • Non pro rated 10. Cut and install all new(ASTM certified)nylon • Labor, material and workmanship. Debris removal mesh ridge vents to code to all four buildings and not available with 3 Star coverage capped with IKO or CertainTeed color matched T2n+h Fv*nnrina warran+ipe ineindoA in nranncal 1 LL IE ChUnneys Residential & Commercial Roofing All Types Of Siding CHIMNEYS POINTED-REBUILT-CAPPED Expert Masonry Work Mass Top free � Rauf Leaks ExX erfs * Licensed &Insured Locally Owned do Operated Since 1976 �~�- License#034200 1-800-WAIT-4-US I]KO® ` e� ?Zai D0/SVA-v "r-� We Work Year Round (9248487) R Proposal To: R. J Pica Engineering rDate12112016 (Page 4) ' Street: Village Green West (Phase 1) 603-382-6166 g 68-82, 108-138, 156-170 a Roof proposal picaeng@comcast.net IKO Cambridge/Certainteed Landmark Total cost and a meat schedule Total IKO Cost: $106,000.00 b nF Certainteed Cost: $1 4,000.00 Total , Total Gutter Cost: $15,000.00 (Balance due uponIpletion of all four buildings) *Upgraded ice and water shield options (For best defense against water infiltration caused by ice dams) -fKO Premium Goldshield: $3,000.00 additional cost I -Certainteed Premium HT : $2,600.00 additional cost ,-Balance including any additional costs due at the completion of each building. Payment sehedUle No deposit required. . IK %26.1-500.00 ier building Certainteed $28,500.00 per buil g Commercial references: Jackson Lumber He Donuts CSI (Cementary Services Inc) Shaheen, Gurearra and O'Leary Law offices A Plus rated member of the Accredited BBB since 2001 , list 5 year consecutive Super Service Award winner from Angie's (Top 5% of all New England roofing contractors) above prices, specifications and conditions are satisfactory and are herby Acceptance of Proposal--The accepted. You are authorized to do the work as specified. Payment will a e as outlined above. Signatu Date of Acceptance;—L L i Ot11 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 wwm mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers— TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print L b ly Name (Business!Organization/Individual):_ L� 11✓l�J �� U�l^C l���f� Address: City/State/Zip: YM�- > �? Phone#: Are you as employer?Check the appropriate box: Type Of project(required): 1.La'1 am a employer with employees(fu)l and/or pari-time).• 7. ❑New construction S 2.❑I am a sole proprietor or partnership and have no employees working fes mein $. 0 Remodeling a any capacity.[No workers'comp.insurance required.] � 9. El Demolition 3.❑1 am a hor000wner doing all work myself[No workers'comp.insurance required.]t 10 [] Building addition 4.[:])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 arc sok 1 l.El Electrical repairs or additions proprietors with no urspbyccs. 12.❑Plumbing repairs or additions 5 I am a genal contractor and I have hired the sub-contractors listed on the attached sbect. 13.0 Roof repairs These sub-contractors have employers and have workerscomp.irtstaancc.t 14.[AOhher W' 6.F1 We are a corporation and its officers have exercised their right of exemption per MGL c- 152,§1(4),and we have no employers_[No workers'comp_insurance required.) "Any applicant that checks box fit must also fill out the section below showing their workers'nompe�rsation policy information t Homeowners who submit this affidavit indicating they arc doing all work and them hire outside contraclors meal submit a new afTidavit indicating such. tConiractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have pemployee. 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 Company Name: +t M-- h'Ybvw � i 3' Policy#or Self-ins.Lic.#: MtjC a0. — �'� G T ``��E piration Date: r 2.�I fo Job Site Address: J 1\Vl,�� C'no, L�-I / 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 MGL c. 152,§25A is a criminal violation punishable by a fine up to S 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 coverage verification. I do hereby certify under th6pains and penalties of perjury that the information provided above is true and correct Si afore: 'i Dat : �1 /� 1.2 Phone#: Offieial use only. Do not write in this area,to be completed by city or town officiat City or Town: Permit/License# Issuing Authority(circle one): 1.Board of lRealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 9/21 /2016 9 . 07 : 39 AM 8975 p 02/02 .acv CERTIFICATE OF LIABILITY INSURANCE pATE(MMIOQIYYYY[ r.. 091211201.6 i 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(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and cond€tions of the policy,certain policies may require an endorsement. A statement on this certiflcate does not confer rights to the certificate holder III lieu of such endorsement(s). PRODUCER 02051-.001 NAtlNEACT Branch 2451-1 Perry Insurance Agency LLC q/ No,Ext; 4918)68,5-7690 � .Ne.: (9784687-0149 522 Chickering Rd EMAIL North Andover,MA 01845 ADDRESS: u INSURERA: A,I.M.Mutual Insurance Company 'INSURED I All. tinder One Roof INSURERe 9 C/O John LanzaEame INSURERO: 30 Temple Drive I Methuen, MA 61844 INSURERE: B COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE..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, ILTR TYPE OF INSURANCE INSR VWD POLICY NUMBER MMNDN�YY MM+DOfFYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 COMMERCIAL G ENERAL LIARLITY DAMA ,) PREMISES. aotcurrence - CLAIMS-MADE OCCURMED EXP(Any one pRrSan) PERSONAL&ADV INJURY 1 G.ENERALAGG,REG,ATE S EN`L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG 3 j OLICYF 1E RD OC AUTOMOBILE LIABILITY 01111 INED SINGLE LIMIT Es accident ANY AUTO BODILY INJURY(Per person) S 3 ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS HlREDAUTOS NON-OWNED PROPERTY DAMAGE AU74S POO-accident S UMBRELLA LIAB OCCUR EACHOCCURRENCE 1 E%CESSLIAB CLAIMSMADE AGGREGATE g yy�� DI=D RETENTION S y�C L� S ANHOL8OYEft$LIA$[punY X TORY LIhIITS DER A IY PR PRI RtPARTN ! XECUT#VE Y J N E L EACH ACCIDENT Ii fl A OFFICE IMERREXCI 0 NIA AWC•400.7009464-2015A 11/912015 111912016 �(fMaenddatory in NH) ELL-DISEASE•EA EMPLOYEE T D�SS-A I i0N 19P beloer ELL-DISEASE•POLICY LIMIT i nfl fl DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES 4Allach ACORD 101,Additional Remarks Schedule,it mors spact is required) The workers compensation policy does not provide coverage for John Lanzafame CERTIFICATE HOLDER CANCELLATION Village Green West Condominiums 200 Kingston Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE North Andover,MA 01845 THE EXPIRATION GATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR12ED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.Alt rlah(s reserved. DATE(MMIDDIYY) CERTIFICATE 4F INSURANCE 1 09/20/2016 PRODUCER AND THE NAMED INSURED THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Transworld Building Trades and Contractors Liability Association,Inc.Inc.,A Risk CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Retention Purchasing Group qualified under the Risk Retention Act of 1986;Federal CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY OR Law 97-45' NEGATIVELY AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED P.O.Box 469 Sandy,UT 84091-0469 BY THE INSURANCE POLICIES BELOW. 800-851-8364 INSURERS AFFORDING COVERAGE INSURED INSURER A: NOTICE:Coverage is being provided as part of a Master Group AfI Under One Roof INSURER B: Policy issued to members of the Transworld Building Trades and Contractors Liability Association,Inc. INSURER G: ,a Risk Retention'Purchasing Group'authorized under the Risk INSURER D: Retention Act of 1986:Federal Law 97-45, 30 Temple Drive Methuen, MA 01844 "LIMITS SHOWN ARE THOSE IN Prime Insurance Company EFFECT AS OF POLICY INCEPTION" COVERAGES The policies of insurance listed below have been Issued to the insured named above for the policy 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.Aggregate limits shown may have been reduced by paid claims. POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) DATE(MMIDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $1,000,000.00 COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fre) s NIA CIaims Made PRC2656-16090011 09/13/2016 09/13/2017 MED EXP(Any one person $ NIA Exclude Products PERSONAL ADV INJURY S NIA Exclude Completed Operations GENERAL AGGREGATE $ $2,000,000.00 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAG S PRO- D POLICY JECT LOG Per Person s $300,000.00 AUTO LIABILITY ANNUAL AGGREGATE s $0.00 ANY AUTO BODILY INJURY ALL OWNED AUTOS (Per Person} S $0.00 ❑ SCHEDULEDAUTOS BODILY INJURY HIRED AUTOS (PerAccldent) S $0.00 ❑ NON-OWNtDAUTOS PROPERTYDAMAGE~ DRIVE AWAY {PerAcddent) GARAGE UABILITYIMANUSCRIPT FORM PER PERSON $ $0.00 SCH EDU LE AUTO ❑ G.K.L.L. PER ACCIDENT s $0.00 ❑ O.T.R.P.D. AGGREGATE ❑ s $0.00 D.O.C. ❑ CARGO PROPERTY DAMAGE $ $0.00 i ❑ ON HOOK ❑ EMPLOYEE DISHONESTY ❑ WRONGFUL REPOSSESSIO EXCESS LIABILITY EACH OCCURRENCE S $0 OCCUR ❑CLAIMS MADE RETENTION $ AGGREGATE S $0 S I� LIMITATION OF COVERAGE FOR ADDITIONAL INSURED o 0E8CRIPTiON OF OPERATIONILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPEMAL PROVISION Coverage is limited to only insured activities or operations on the Participant Member Declaration Certificate or as may be separately endorsed,Contractors-Executive Supervisors,Contracted Services-Using fully insured subcontractors. k/J1 CERTIFICATE HOLDER ADDITIONAL INSURE LJ I LOSS PAYEE Village Green West SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL iD DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 200 Kingston St. FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. North Andover, MA 01845 Attn:Andrea Georgetti i' Fax Number: 9785326023 AUTHORIZED REPRESENT EVE �� iVfnS5aCl1tms8 5 -ne'IYOt _')df Board Of i3tailding ;icquiari:nu - tili]�t]'ttl;tilli] .fiillri�i'�1+u t' �, License: CS-069120 JOHN W LANZA.T .....,,,..,. 30 TEWLE DR METHUEN RA 01844 _YOrnr Isstamm!v 04103/2017 Click on the registration number to view complaint hislory, You can also view-arbitratign and t�„iarantyFund The list is current as of Wednesday, -October S, 2014, Search Result REGISTRANT RESPCItl.;t>i LE REGISMATION ADDRESS EXPIRA�HON STATUS NAME INDlk1/lDUAL NUMBER DATE ALL ORDER ONE ROOF! t.ANZAFAME, I"1 166 A MERRIMACK ST 10102/2016 Current -JOHN 'METHF-UN., MA 01844 02412 Commonwealth of Massachusettr.. Mass.GovQ Is a registered service mark of the Corrmmonwbt%1tt]-of MassechusettA, nrnIII rk] n