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Home My WebLink AboutBuilding Permit # 10/3/2016 00RT#J BUILDING PERMIT 0 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Date Received Permit No#: ACHU Date Issued: plic,ciqlnus�complete all items on thi�sR,�ge IMPORTANT: Applicant LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT:_ --Historic District yes no Machine"Shop Village yes no TYPE OF IMPROVEMENTPROPOSED USE Ras'd tial Non- Residential Icl 10 s� EI New Building One e amily 11 Li Addition Cl Two or more family Li Industrial Alteration Commercial [I Repair, replacement 11 Assessory Bldg [I Others: Cl DemolitionLl Other _ CS Flood lawn 777 etIands,,,;, c,,'I We I I as Wer, ....... 6 S, CF RK TO BE PERFORMED: 'TION OF WORK ea --Fit(d,ent" -catiow- PI Type or Print Clearly L 3 ,Y" 13 OL Phone: OWNER. Name: Address: Contractor Nam IPho Email: Address: ' Supervisor's Construction Licensef"'XI Exp. Date: Exp. Date: Home Improvement License:,r , ARCH ITECT/ENGINEER Phone: Address- Req, 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-, $ FEE: $ ? / Check No.:_S1V10!i Receipt No.: 3 Cc) ? 7 NOTE: Persons contracting with unregistered Contractors do not have aecess the guaranty e--af caDtra-cl atur_ f-Ag-en 7, � ctORT� Town of s 6Andover No. ° g , Mass coc.n��wKh �. ver , • U BOARD OF HEALTH PERMIT T D Food/Kitchen septic System THIS CERTIFIES THAT ............... ........•..•..•.....•.....•.•.....•............... ...................... BUILDING INSPECTOR has permission to erect.......................... buildings on .................................................... .......... FRough ion to be occupied as ......................... .......,.... provided that the person accepting this permit shall in every respect conform to the terms of the application y . Chimney on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Final Construction of Buildings in the Town of North Andover. PLUMBING INSPECTORVIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS C STUCTI ST RTS ELECTRICAL INSPECTOR Rough ................................................................................ Service BUILDING INSPECTOR Final OCey2ancv Perm2it Requi to ®c��uilcli� GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not RemoveRough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT PROPOSAL WeAL.E. Morgan Construction Company 11WW pt: Y.O. Box 75, 100 Iron Horse Park [[ W '' ' N. Billerica,MA 01862 DISMVIA Office: (978) 670-47471 Fax: (978) 670-6477 """ Im } - PROP ,LKTTED TO .+e t PHo1UEo DATE �1I e M JOB NAME J flim s. v V,-ST IPC DE Joe LOCATION CO TACT CELL PHONE OT Strip down to the wood deck, - layers of shingles, dispose of debris to a licensed recycling facility: Install -ALL ice and water shield at the gutters —,-3— feet of ice and water shield in valleys. Install synthetic underlayment on the remainder of the wood decking. Install 8" aluminum drip edge on'all perimeters color choices: 14 White, ❑ Mill, ❑ Brown, ❑ Copper. Installs year _-k 1_-<wVV4r"'r';j architectural asphalt shingles, and hurricane nail. Install ridge vent manufactured by 6 "Zi_ to all ridges and dormers. Install new skylight flashing kits manufactured by A Flash all cheek walls, pipes, skylights, p penetrations to manufactures specifications. Remove existing lead flashing /V's /0" chimneys and install new lead flashing" Install matching cap shingles to all ridges, hips and dormers. WE PROPPhereby to fur sh material and labor-complete in accordance with above specifications,for the sum of.. rss i ��C r-5-p. O ,• , 3 _ x =IaJ @� � t` <�� dollars($ 7K,&& All material is guaranteed to be as specified.All work to be completed in a workmanlike Autltarized Signature• manner according to standard practices.Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders,and will C become an extra charge over and above the estimate.Our workers are fully covered Note:This proposal maybe withdrawn by Workmen's Compensation Insurance and Liability Insurance, by us if not accepted within days" ACCEPTED AS A CONTRACT-The above prices, Date of acceptance specifications and conditions are satisfactoryand are - p Authorized Signature: r✓r -� It accepted,You are authorized to do the work as specified.Payment will be tuned above. Authorized Signature: Additional Re rks: SHINGLE COLOR= THANK YOU .FOR. CHOOSING L.E. MORGAN CONSTRUCTION The Commonwealth of*Massachusefis Department qfIndustrialAccidents n.r....... I Congress Street,Sy.fte 100 Boston,MA 02.1.14-2,017 www.mass-gov1d1a Workers'Compensation.Insurance Affidavit:Builders/Contractors/Flqctriciansffllumbers. TO BE MED WITU TUR,PE RMITTING AUTJIOMTY. A -'bl �_pplicantlhfbrmation Please Print ed L -1 NaMo(Diisinoss/organization&dividtial): Address: f"V N City/state/Zip CO _ne ol- Areyou�:u employer?Chql 11, plJ1.0priate box; 'o, Typo of project()r�q'uiired): 1� I'maomployerwith r employees(full and/orpart-thno)." 7. E- 1 New construction I 2. 1 am a sole proprietor or partnership and have no employees working f.br rao in 8. Fj Remo doling any capacity.[No workers'comp.insurance required] 3.0 I ant ahomeowner doing all work myself,[No workers'coirilj,.insuraticoreqtiired.] §. F!Demolition T 4.0 f am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 F-1 Building addition ensure that all contractors either have workers'compensation insurance,or are sole If, Electrical repairs or additions pr6Vri,etors-with no oniployces. li L]Plumbing repairs or additions 5.E]I am a general contractor and I have hired tho sub-contractors listed on the attached sheet. These sub-eontraators r P p 419res and have workers'comp.insurartcO 14.ls.n P 6f-ip Ts, 6.[:]We are a c oxp oratign pnd ijj qffiqcrs,bavo exofolsedth c ir righ t ofexerriptionperMM e. 152,§1(4),anti tiyo haya rtcp pl�loy?es,[No workers'comp.insurance required,] Mny applicantthat checks bdx-91 must also fill out the section below showing tlieirworkets'coinponsationpolicy information. I U homeowners who subaf Phis affidavit indicating they are doing all-work and then hire outside contractors Must submit a new affidavit indicating such. tContractqTs Pat check st-affached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. ff tho,sub-c=avo their workcis'comp,policy number.' f aiii an employer that ispiavi g worker-s'compensation insurance for my empl6yees.'.below h thepolley and job site, Insurance Company Name: Policy#or Self zns.ZzcI?x Ir iration Date fob Site Address-. City/Statc/Zip:3,M Atta(ift a copy of the workers'c61npooqationpolicy declaration pagq(showing the policy number and expiration date). Failure to scourc cov6xago as required undorMOL o. 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 intho form of a STOP WORK 01WER and affie,of up $250.00 a day agamist 1h I Ic t r.A copy Of this statement may be forwarded to the Office offiivestigations oOtho DIA for instuance, coverage,Ver, tion. I(to It ereby tify under thepains andperAlfies 0 Vujy that e in/orinationprovided above Is,true and correct. Sign Date: hone Of use lily. Do not 1prite in this area,to be completed by city or town official.. Cit Veoix'Yown: Permit/License it Issuing Authority(circle one): i 1.Boar of Health 2.Building Department- 3.Cityffown Clerk 4.R lectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone R.: LEMORGA-01 SBOYER '4 � CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY) 4/1 4/2016 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 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 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 endorsement(s). PRODUCER CONTACT Welsh 8 Parker Insurance Agency,Inc.l Hudson Office NAME:PHONE 978 56 FAX 878 5 131 Coolidge Street,Suite 100 {Arc,No,E1111): 2-5652 INC,No): ( ) 62-7120 Hudson,MA 01749 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Western World Insurance Company INSURED -`"- INSURERB:SAFETY IND INS CO 33618 LE Morgan Construction Inc INSURER :Scottsdale Insurance PO BOX 75 INSURER D: - — Billerica,MA 01821 INSURER E: INSURER F: 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. 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 TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IVSD WVD POLICY NUMBER MMfDDlYYYY MMIDDlYYYY LIMITS A X COMMERCIAL GENERAL L1AsiLiTY � EACH OCCURRENCE s 1,000,000 CLAIMS-MADE ! ^ f OCCUR NPP0301520 04/13/2016 04!13!2017 P s s rrDence) s 100,000 """ --- MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY S 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,0QO,DQD POLICY JET [ I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B (Ea accident) S 1,000,000 ANY AUTO 6230688 10/13/2015 10/13/2096 BODILYINJURY(Par person) S ALL OWNED X SCHEDULED — AUTOS AUTOS BODILY INJURY(Per accident) S HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE 5 Per accident 5 UMBRELLA LIAR X OCCUR C X EXCESS LIAR CLAIMS-MADE XLS0099346 04/93/2016 0411312017 EACH OCCURRENCE S Jr,OQtI,ODfl AGGREGATE 5 5,000,000 DED RETENTION S S WORKERS COMPENSATION PER DTH AND EMPLOYERS'LIABILITY Y!N STATUTE E32 ANY PROPR€ETDftrpARTNERlF,CECUTIVE OFFIGERlMEMBEREXCLUDED? ❑ NIA E.L.EACH ACCIDENT (Mandatory In and E.L.DISEASE-EA EMPLOYE 5 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.Of5Eg5E-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 161,Addhlonal Remarks Schedule,maybe attached if more space is required) WORKERS COMPENSATION CERTFICATE OF LIABILITY WILL BE SENT DIRECTLY BY THE CARRIER. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood Street,Bldg 20,Suite 2035 ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM�DDNYYY) T 191171 QJ 5 TIFiCATE 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 ACONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE R PRODUCER,A D THE CERTIFICATE HOLDER,-- PORTANT: O DER.PORTANT:11 110 certificate holder is an ADDITIONAL INSURED,the Policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the Policy,certain Policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BALDWINIWELSH PARKER INS PHONEFAX 131 COOLIDGE ST,SUITE#100 (AIC,No,Ext): (A1C,No): HUDSON,MA 01749 E-MAIL ADDRESS, 27KLD INSURER($)AFFORDING COVERAGE NAIL# INSURED INSURER A. AMERICAN ZURICH INSURANCE COMPANY L E MORGAN CONSTRUCTION INC INSURER B: INSURER C: PO BOX 75 INSURER D: NORTH BILLERICA,MA 01862 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER. - 7141S IS TOO CERTIFY THAT 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 35 SUBJECT TO ALL 7HE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN5R ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) fMMIDDIYYYY) LIMITS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE [�D OCCUR. DAMAGE TO RENTED $ PREMISES(Ea occurrence) MED EXP(Any one person) Is GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ __J� POLICY 0 PROJECT[:]LOC ENERAL AGGREGATE $ I PRODUCTS-COMPIOP AGG $ AUTOMOBILE LIABILITY ANY AUTO ICOMBINED SINGLE $ LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ {Per accident} UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-5B738312-15 12114/2015 12114/2016 X LIMITS ANY PROPER€TORIPARTNERIEXECUTIVE N NIA OFFICERIMEMBER EXCLUOED? E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIRESTRICONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. ERTfFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD STREET,BLDG 20,SUITE 2035 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI2£O REPR TA VE NORTH ANDOVER,MA 01845 ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1986-2010 ACOR CORPORATION. All rights reserved, Massachusetts Department of Public Safety --- Board of Building Regulations and Standards -� Office of Consumer Affairs&Business Regulation License: CS-079476 HOME IMPROVEMENT CONTRACTOR Construction Supervisor Registration:,-.-13.7913 Type: ; Exp€ration. J&—(2#11.7 individual LAWRENCE E MORGAN,JR 100 IRON HORSE PARK LAWRENCE E_MORD. -AN JR NORTH BILLERICA MA 01862 LAWRENCE MORGMW 100 IRON HORSE PARK ' � Expiration: B€LLERICA, MA 01862 t)ndcrsearetaty-� �=,- Commissioner 06/03/2017 �""11.FSt"'snratyam[Saarlh- , Thise2rdaeknopviecigesttraiffterecFp€orithas'Stt0b Wfuilyo6rrmp1eteda 3i]•hour 00uP8tionalSafietyand HeaIll TrafningCoursein _ �cn;�aticnarSare; ar�tl i ar:r ,•st;au n Con*uction Safety and Health 1 fLARRY MOR&N-J has succnssfutl,,complere(i¢e trl ft�u G<;;upttifUn 71 SafeSr end Ffoafth t - 7r2s'ring Cavrsa r - - i f Constructio;t Safety 2,He�iiti€ (Trainer manta-Printnrtype) ^f_ � .(Course ena date) "_ c _f Dale) t