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STRIP AND REROOF (2)
T4 RT}{ BUILDING PERMIT 1�YLEo I6,1 U + TOWN OF NORTH ANDOVER o� APPLICATION FOR PLAN EXAMINATION * = e �'. o Permit No#• s Date Received ��SSRC HuS�'�ty Date Issued: �-� -A tM ORTANT AApplicant must complete all items on this page LOCATION la . ., �... it+� 3�®�, s; 1+Ff Pant PROPERTY OWNER 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 eptrc ❑llell� ❑ Floodplain ❑�1Ffetlands - ❑ atersed District �,❑� aterlSewer � , 4 �� ' p L ,� �s ��-5��' DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please T pe or Print Cleary OWNER: Name: s'�t -dammer-11 ' 4 3 Phone: - - 3 Address: 0o� t `-ki Contractor Name: 6�'-L ,l zC�_ Phone: 9 Email: ��� �► � a �v Address: Supervisor's Construction License: C01 Z Exp. Dater Home Improvement License: Exp. Date: 4 Z-1 ARCHITECT/ENGINEER 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:: $ 2.2_ FEE: $ , Check No.: a�n Receipt No.: a�l DOTE: Persons contracting with unregistered contractors do not have access to the ranty fund OO R Til '4 own of af, b ndover 0 . . No. 3c � — c4► ; — I � b a LA�[E ver, Mass, zjj ;kj1)F COC Nit NC WICfi 4 °Ra TE D Pk4��.(5 S � BOARD OF HEALTH Food/Kitchen PER T D Septic System THIS CERTIFIES THAT .....M.. .. ............ ........................... ....... 5 ........ . . .. . BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on R ....... .. ...... ,........ rlm.e Rough tobe occupied as ............. ........ ....M .............................................................. chimney provided that the person acceptings 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 CONSTRUCTION STARTS Rough Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR ccuc arc Permit Required to Occupy Bu 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. 1 '.. '7*'"i+�'f 4'ly�►lrl,kyl a 37' � • ` ty 4S H. y•. ori•;,.. ' 1 `r '1'ff ,, '1,• Y,„1�!drj la`i.;'r�{34MA :r s,• yr r.. ;�fl:'r ti , 'li•� v11Frr,^^^.J:<':a s GLL',7 c7�'•�+�, yy� ,�r'y.• S [� rrl,.Yl�''T All, .� {µ,• n 1'��:{j,,fl�''F Gi, 4 '�ti+��r•,�'"'�;�,`F'=Yl„j• +' v I" .r]a�%7�s� 1 C.i' �('"�,' VC "�• + '.. .. ,�';l:,t [ ��rr`` y•��,p;� ,,IN_t lk:;�.y� + ��rrf,ii ,r,pp +, t"+ to �4 '., '', ti:$ 'i: 3• •.n,!}'!tt}€j}' •i.' ���^ r••-r� �r "e•,s'. '•_. ^2' J y •1' x, �f•,t }.�i .r.lY� '' 'r.•. �,,}I;'<,,2 •.r .?tI�'t1Zo�'� •1 ` s{=,' .(�•j+ t. 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'��+ .>`.%{.,vf'', �[+In•'�ll.., :��li}I?7.,.n"�ly.f "' sr. •t il.n' . .'�'Y�''J7��, rr'rsi e`�+hs^i1 �.',� , �.�.1��3�,f..• ��,•.':°�;I?;,4."'a;'S�?:1,Ct•C#�a�„ � � n�:Yvy,�••,Nr]�.X� l; �iy... �� (°�/� /` � 4JU V A ALL CBMIMER 40NE Rt3CPF Chimneys Residential & Commercial Roofing All Types Of CHIMNEYS POINTED-REBUILT-CAPPED Siding Expert Masonry Work Mass Toil FreeRoaf Leaks Exprfs of Licensed& Insured 1-800-WAIT-4-US Locally Owned do Operatort Sirce J 97 ----- !"K: License#034200 (924-8487 IKO d?a& ozoz t ox,,?�vls� 4� We Work Year Round Proposal To: Village Green West Date 5/21/2016 Street: 200 Kingston St. N.Andover 603-382-6166 68-82, 108-138, 156-170 Roof proposal picaeng@comcast.net 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 0 6. Install IKO Storm Tite or Certainteed Diamond daily interruptions. g 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) 0 Non pro rated 10. Cut and install all new(ASTM certified) nylon Labor, material and workmanship. Debris removal I mesh ridge vents to code to all four buildings and not available with 3 Star coverage !' capped with IKO or CertainTeed color matched j hie+ and ririnn nat% 011;1nrV1^d Rath F.YtP3ndP.d warrantiov int`1ndo.t] in rirtlnnenl NOW C31 CD Chimneys Residential & Commercial Roofing All .Types Of Siding"t-a CHIMNEYS POINTED-REBUILT-GAPPED Expert Masonry Work ri-Roof Leaks--XFerts �f Licensed & Insured Mass Toll Free Locally Owned do Operated Since 1976 i lz"eI License#034200 1-$00-WAIT-4-115 IKO96 aee 'nC euw oz�9ahm We Work Year Round (924-8481) s Proposal To: R. J�i4� a Engineering Date 5/21/201G (Pag ) Street: Village Green West (Phase 1) 603-382-6166 68-82, 108-138, 156-170 Roof proposal picaeng@comcast.net IKO Cambridge/Certainteed Landmark Total cost and payment schedule Total IKO Cost: $1069000.00 4 n: C, • ��000.00 � � . ; aTotal Certainteed Cost. , Total Gutter Cost: $15,000.00 (Balance due upon ompletion of all four buildings) * Upgraded ice and water shield options (For best defense against water infiltration caused by ice dams) -IKO Premium Goldshield: $3,400.00 additional cost -Certainteed Premium HT : $2,600.00 additional cost Payment schedule: Balance including any additional costs due at the completion of each building. No deposit required. IK er building Certainteed $28,504.00 per buil g Commercial references: Jackson Lumber Heavenly Donuts CSI (Cementary Services Inc) Shaheen, Gurearra and O'Leary Law offices A Plus rated member of the Accredited BBB since 2001 5 year consecutive Super Service Award winner from Angie's list (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 authoriPayment will a e as outlined above. zed to do the work as specified, Signatu Date of Acceptancc: t � � The Commonwealth of Massachusetts Department ofIndustrial Accidents -1 Congress Street,Suite 100 Boston,MA 02114-2017 wwmmass�goyldia Workers'Compensation Insurance Affidavit:Builders/Conh-actors/Electiricians/Plumbers. TO 13E FILED WITH THE PERMITTING AUTHORITY. eLyi Applicant Information Please Print Lb Name (Businesf-JOrganizationnMividual): QLL QtaQ<-A cy\< Address: YM k4"/IIJ Phone#. City/State/Zip: A.you An employer?Check the appropriate box: Type of project(required): LL2'ram a employer with___T employees(full ao& pador Aime).* 7. []New construction 2.E]I am a sole proprietor or partnership and have no employers working for me in 8. E]Remodeling any capacity.[No workers'comp_insurance required_] 9. El Demolition3.OI am a bonx*wnr-r doing oil]work myself.[No workers'comp.insurance required-)t 10[3 Building addition 4.[:]]am a homeowner and will be hiring contractors to conduct all work on my property. I will I I.E]Electrical repairs or additions ensure that all corift-aclors either have workffs'cOmPcnsa1iOn insurance Or am sole proprietors with no employees. 12.E]Plumbing repairs or additions So I am a general conti-aclor and I have hired the sub-couu-i�clors listed on the attached shed. 13.E]Roof repairs These sub-contractors have employees and have workers'comp.im%rancc-1 6.Fj We are scorporation and its officers have exercised their right of exemption per MGL c. 14. er 152,§1(4),and we have no"loyces.[No workers'comp,insurance required.] *Any applicant that checks box 111 must also fill out the section below showing their workers'compa3usion policy information_ Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating sucb. tContractors that check this box must attached an additional shed 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. Name: ow u Insurance Company N 2*)_/Expiration Date: 1 ic.M Policy H or Self-ins.L Job Site Address: City/statdzip- 1,J,4 Attach 2 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 51,500.00 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 acts and penalties of perjury that the information provided a&We is true and correct. Si azure: Date: 12 Phone#: 0fi7ciAd use only. Do not wife in this area,to be completed by city or town officiaL City or Town: Permit/License H Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 9/2.1 /22016 9 : 07 : 39 AM 8975 p 02/02 r ® DATE(MMIDONYYY) t ,�►cvr�a CERTIFICATE OF LIABILITY INSURANCE ,r r 091211201,6 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 cettifcale holder is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the pokey,certain policies may require an endorsement. A statement on this certificate does not confer rights to the cerliflcate holder In fleu of such andorsement(s). PRODUCER 02051-001 �RgTeCT Branch 2051-1 Perry Insurance Agency LLC A7CNNo.Eat; (978)685-7690 A1C No: 1978)687-0149 522 Chickering:Rd EMAIL North Andover,MA 01845 opRlass: INSURERfSIAFFORDIN INSURERA: A.I.M.Mutual Insurance Company iNSUREO All Under One Roof INSURER e: INSURER CIO John Lanzafame 30 Temple Drive INSURERD: Methuen, MA 01844 LINSURE E 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 PERIOD INDICATED. NOTWIT.HSTANDINC 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 3iJ5R 1NVe0 POLICY NUMBER IAMID➢fiIYYY MM1tlDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 COMMERCIAL GENERALLIABILITY DAMAGE To RN-4D $ PREMISES. grrencel. CLAIMS-MADE 0 OCCUR MED EXP(Any oris person) 3 PERSONAL&ADV INJURY '( GENERAL AGG.REGATE $ - EN't AGGREGATE LIMIT APPHI SPER PRODUCTS-COMPIOP-AGG 3 OLICY R0 OC AUTOMOBILE LIABILITY COtvlt)INEq SIPIGLE LltdlFT 5 E3 accidem ANY AUTO BODILY INJURY(Per person) $ ALL OW14ED ISCHEDULED " AUTOS AUTOS BODILY~INJURY(Per acadenq $ HtRED AUTOS NON-OWNED PROPERTY DAMA_E AUTOS Rer�ccrtlent $ S UMBRELLA HAS HOCCUR - EACH OCCURRENCE 3 EXCESS UAB CLAIMSPAADE AGGREGATE g yy KKDppED MM RETENTION f 3 AND EMPLOCYO RSF'L ABILITY X TORY LI3 175 FR A iy PRp PR€�7p RtPp RTN R!ENF CUTIVE YIN E.L EACH ACCIDENT $ A OFICERrMELvIBEREICCLuEU?' NIA AWC-400-7008464-2015A 11/912015 11/9/2016 �Q•uoo.ao {fFAanddatosry in NH) E,L.DIPCASt:-EA EMPLOYEE $ D�%I'I SON Of OPERATIONS below E.L-DISEASE-POLICY LIMIT I; 00 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attgch ACORD 101,Additional Remarks Schedule,It more space 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 DATE THEREOF; NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR12 ED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rinhis reservad- I V 1 3 I ` CERTIFICATE 4F INSURANCE DATE 09/20/2016(MMIDDNY) I 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 Retention Purchasing Group qualified under the Risk Retention Act of 1986;Federal CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Law 9745. CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY OR P.O.Box 469 NEGATIVELY AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED Sandy,UT 84091-0469 BY THE INSURANCE POLICIES BELOW, 800-851-8364 INSURERS AFFORDING COVERAGE INSURED INSURER A: NOTICE:Coverage is being g provided as part of a Master Group All Linder One Roof INSURER B: Policy issued to members of the Transworld Building Trades and Contractors Liability Association,Inc. INSURER C: ,a Risk Retentlon'Purchasing Group'authorized under the Risk INSURER D: Retention Act of 9966: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 contractor 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 MMIDD/YY) DATE(m5T/AD/XY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S $1,000,000,00 COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one t re) S NIA Claims Made PRC2656-16090011 09/13/2016 09/13/2017 MED EXP(Any one person S NIA �I Exclude Products PERSONAL ADV INJURY S NIA .I Exclude Completed Operations GENERAL AGGREGATE S $2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AG S PRCT O- LOC POLICY JE J Per Person S $300,000.00 AUTO LIABILITY ANNUAL AGGREGATE s $4.44 ANY AUTO BODILY INJURY ALL OWNED AUTOS (per Person) S $0.00 ❑ SCHEDULEDAUTOS BODILY INJURY HIREDAUTOS (Per Accident) S $0.00 ❑ NON-OWNEDAUTOS PROPERTY DAMAGE DRIVE AWAY (Per Accident) S $0.40 GARAGE LIABILITYIMANUSCRIPT FORM PER PERSON $0.00 SCHEDULEAUTO $ ❑ G.K.L.L. PER ACCIDENT S $0.00 ❑ O.T.R.P.D. AGGREGATE g $0.00 ❑ D.O.C. PROPERTY DAMAGE CARGO S $4,44 ❑ ON HOOK ❑ EMPLOYEE DISHONESTY ❑ WRONGFUL REPOSSESSIO EXCESS LIABILITY EACH OCCURRENCE S $0 OCCUR ❑CLAIMS MADE AGGREGATE RETENTION $ S $0 S LIMITATION OF COVERAGE FOR ADDIT€)NAL INSURED DESCRIPTION OF OPERATI)NILOCAT€ONSIVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL 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. U-/ 1CFERTIFICATE HOLDER ILI I ADDITIONAL INSURE U I LOSS PAYEE Village Green West SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL END FAVOR TO MAIL€0 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 KIND UPON THE INSURER.ITS AGENTS OR REPRESENTATIVES. North Andover, MA 01845 Attn;Andrea Georgetti AUTHORIZED REPRESENT IYE Fax Number: 9785326023 i Board of suiwing S�C�uIuITIC� �:+:� �;�; .. .•. Conitructholl `UTiVITi'mI, am License: CS-069920 JOHN W LANZAFzkME,,.,,_<_�, 30 TEAVLE DR 14UTHUEN MA TII$44 r r Ct�,Mrrt;ssi zr i�: G4103I2017 Click on the registration number to view complaint history. YOU Can also Xlew-arbitt-atigrland Q„igranty Fuad history. The list is current as of Wednesday, October•8, 2014, Scarnh Results REGISTRANT RESIa+4)3 ME REGISTRAMON ADDRESS EXPIRAT110N STATUS NAME INDM, DUAL NUMBER DATE ALL UNDER#tea;ROOF 1;.ANZAFAME, 13N5 rr 166 A ME.RRIMACK ST 10102/2016 Csjrrent .JOHN METHEUM., MA 01044 — Ck 2012 OO,TEmon%Veattl}Of Massachusetts, MaSa.GovO Is a.registered service mark of the Commomasbith-of MassachuseftA. n!mmnr e