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Home My WebLink AboutBuilding Permit # 11/15/2016 � No�zrty BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR.PLAN EXAMINATION ~ Permit No#: 9c,17 date Received �r� O'�^TED PX s�ACHUB pate Issued; INLPORTANT:Applicant must compl.ate all items an this page LOCATE PROPERTY OWNER Print 1NYearStructure yes MAP .__. PARCEL: ZONING D]STRICT- Hsor�c District yes Mach�n�:5hnp V�Ilag Yom. o 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 p Sepfiic Well' _ ❑ 1 (oodpfain 1llletlarieIs L7.'Vllatershed l]iStfi6- Cj Wate ISewpr_.: - DESCRIPTION OF WORK TO BE PERFORMED: J entificatio - Plqase Type or Print Clearly' OWNER: Name: Ph e: Address. &�4 Gdntractor Na e:::.:. ..:._._ Ph. .Address: . - 5u ervis_or's Construction Exp: Date Herne irn}ro.vemenf License /7 _7 = Exp. Date - l - _. P, _ ARCH ITECTIENGINEER Pham: Address: Reg. Na. FEESCHEDULE,SULDINGPFNMIA$12.0O PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ V FEE: $ - Check No.: I _` Receipt No,, E-7 .COTE: Persons contracting with unregistered contractors do not have.,access to t guard fund S�gr at�rre af.Ag�n low er Sign4 Ljp� of:corifracfor., � N067T�t Town of Andover No. �AKE h ver, Mass, I[ t Coc"Ic"twicN �.4SRR�xER Ap�`��(y U BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT .,D!y ..t1QVS„C',,......�Qp; !:! ,,...�..., /..c BUILDING INSPECTOR has permission to erect.......................... buildings on ...... ....$,0+??h,.,. ?.2 d S '.....R-,1. ...... Foundation to be occupied as ......... T2, 1®,,...,s4..,...(/�E -F Rough ........................................................... Chimney provided'that the person accepting this permit shall in every respect conform to the terms of the application 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 INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI STARS Rough ......,., , ...,....� ............. . .... ..................... Service BUILDING.... INSPECTOR Final . GAS INSPECTOR Occu anc Permit Required to Occupy Buildin 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. .. 4„ p „ Proosal ] � � HIC#174377 Dam `hv�usse pi , ,. Roofn eg w i' A trusted;namsince 1938 ' Roofing • Siding,-Windows 87 Belmont Street • North Andover; MA 01845 P: 978-683-4588 il F. 978-685.7446 NAME OF OWNER Z4" kil 1) ADRESS OF JOB-3U- TEL, � "`� --z we will remove all roof shingles off total roof area, layer. Replpce any boards or sheathing at additional cost. A new 8" white aluminum drip edge applied on all edges. Approx. 6ft of ice and water membrane applied on eaves, 3ft in valleys, strips around skylights, along chimney flashing and sidewall junctions. Existing step flashings to remain. A new base sheet applied. Architectural roof shingle. installed with a limited lifetime warranty. Inst I new ventpipe boat ashings. Waterproff existing chimney flashing and remove debris. Shin le Col r• r Rid e Vent Upgrade Wood Sheathin Re air 3.50 er ft. Z" ' ) . u We Propose herby to furnish material and labor•complete In accordance with above specifications r the sum of: � dollars{$ -� � )• f r � . Payment to be ade as follows l — f Authorized Signature %��•�` �'��' NOTE:This proposal mayp"e wlthdrawn by us if noV6coepted with inP days u Acceptance of Proposal - The above prices, specibcat€ons and conditions are' satisfactory and are herby accepted.You are authorized to do the work as specified:Payment will be made as outlined above. f Signature ° Date of Acceptance: I Signature i HOME IMPROVEMENT CONTRACT TERMS AND CONDITIONS(M.G.L.142A) 1.WORK:Provided the Homeowner performs under this agreement,the Contractor shall perform the work on the Property as specified Proposal,attached incorporated herein.The work does not include extraordinary conditions of which the Contractor could not reasonably be aware.If such conditions arc encountered,this shall be an additional cost to the homeowner. Materials selected by Homeowner may have to he ordered or custom made,which items are specified in the Proposal.The Conti-actor is not obligated to agree to any modifications,extras or change orders unless such items are agreed to in writing by the Contractor.All extras and changes shall be at au additional cost to the Homeowner.Contractor shall perform the work in a good and workmanlike manner using materials consistent with this contract. Lawn or Driveway may be damaged by dumpster or equipment. Due to material shortages Contractor may substitute materials of equivalent grade. 2. PERMITS: If a building permit is required for the work,the Contractor shall obtain same as Homeowner's agent.Conti-actor is not responsible for any other permits that may be required for the Work,and Homeowner is responsible to dete€mine whether any zoning,planning or wetland related permits or approvals are necessary.Homeowners who secure their own permits or deal with unregistered contractors will not have access to the Guaranty Fund. 3. COMMENCEMENT AND COMPLETION:Homeowner acknowledges the commencement date of the work is fluid,and is subject to numerous factors such as scheduling other contractors,delivery of materials and weather.Contractor and Homeowner shall determine the commencement date of the Work when a more definite determination can be made and shall execute a written acknowledgment of same.The Work shall be substantially completed within 7 days of commencement,except for longer periods as may apply to particular projects as Contractor shall notify homeowner in the Proposal,and subject to delays for circumstances beyond Contractor's control.Notwithstanding,the commencement date and substantial completion date may be extended,and the Contractor will not be liable for delays caused by,labor or material shortages,delays in delivery of items selected by the Homeowner,governmental action, and unforeseen events beyond the Contractor's control,including but not limited to weather,strikes,war,the acts of third persons or the acts of the Homeowner.The Homeowner recognizes that the commencement date may be delayed due to scheduling or the completion of Contractor's other jobs. 4. PAYMENTS:Contractor agrees to perform the Work and to furnish the materials and labor specified in the Proposal for the amount as stated in the Proposal.Thirty percent(30%)of the total is to be paid as a deposit with the signing of this contract.Upon cancellation prior to commencement of the Work,any remaining deposit will be returned less the costs for materials ordered for which Contractor was unable to cancel.Final payment shall be due upon completion of the Work and Homeowner agrees it may not hold any retainage.Late fees may be applied for late payments.Homeowner shall pay Contractor's reasonable costs of collection,including attorney's fees and costs.Time is of the essence hereof. 5. WARRANTY:For a period of 2 years after substantial completion of the Work the roof will be free of leaks caused by defects in workmanship, but not those caused by ice backing-up or extraordinary weather events,including blizzards,tornadoes,hurricanes or storms of greater than a twenty-five year duration or intensity.Contractor gives no warranties with reference to any materials or equipment installed in the Premises,passes any such warranties directly to Homeowner,and Homeowner agrees to look only to the manufacturer with reference thereto.This Limited warranty extends to the Homeowner only and is not transferable to succeeding Homeowners.This Limited Warranty specifically excludes(i)all consequential and incidental damages;(ii) da€nage due to ordinary wear and tear,abusive use,misuse,or lack of proper maintenance;(iii)defects which are the result of characteristics common to materials used;(iv)defects in items installed or supplied by anyone other than Contractor;(v)work done by anyone other than by Contractor;and(vi)loss or injury due to the ele€nents.There are no other expressed or implied warranties or representations made or given. 6. ENTIRE AGREEMENT:This contract and all documents referenced herein constitute the complete and final agreement between the parties.In the event that any of the provisions of this contract shall be held to be invalid,the remainder of the provisions of this contract shalt remain in full force and effect.Two identical copies of this contract have been completed and signed.Homeowner acknowledges receipt of a completed contract signed by the Contractor. 7, HOME.IMPROVEMENT REGISTRATION:In accordance with M.G.L.c. 142 A,§9,Contractor is registered with the Bureau of Building Regulations and Standards Re0stration No: 1743.77.Homeowner may verify by contacting the Director at(617)727-3200,ext.25205.A Homeowner's rights under the Home Improvement Law(M.G.L.c. 142A)and other consumer protection laws may not be waived in any way.Homeowner acknowledges receipt of a copy of 780 CMR R6 and Massachusetts General Laws chapter I42A,and which are available online at www.mass.gov.Questions may be directed to tine Consumer Information Hotline,(617)727-7780. 8. ARBITRATION:Contractor and the Homeowner hereby mutually agree in advance that in the event the Contractor has a dispute concerning this contract, the Contractor may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in M.G.L.c, I42A.No lien or security interest is imposed on the Property as a consequence of this contract,but Contractor has the right to record this contract or a notice of this contract,or sock a lien if the Homeowner breaches this Contract. 9. HOMEOWNER COVENANTS:The Homeowner agrees,represents and warrants that(a)the Homeowner grants permission to the Contractor to enter the Property to perform the work as covered by this contract;(b)the Homeowner has funds available to make frill payment under this contract to the Contractor upon completion;(c)the Homeowner understands that construction as contemplated by this agreement creates a dangerous condition,and agrees not to enter portions of the Property under construction until the Contractor advises the Homeowner that the construction is completed;(d)Contractor may need use landscaped areas of the yard during the Work and Homeowner is responsible to provide protection for landscaping and(e)that code requirements may result in roofing nails penetrating through roof decking and will be visible on the underside of some surfaces.The Homeowner indemnifies,exonerates and holds harmless the Contractor frorn any loss,damage,claim,liability or expense(including reasonable attorney's fees,deposition costs and court costs)resulting from a breach of this provision.Contractor is not responsible for damage to landscaping that will grow back during the next growing season. 10.CANCELLATION:Homeowner may cancel this agreement provided Homeowner-notifies the Contractor in writing at the address listed in the Proposal not later than midnight of the third business day following the signing of this agreement. HOMEOWDATE: -- r-- t Shingle: _.� DEPOSIT: —�-- — F Tile Cotliratonivealth of Massachusetts Department of IndustrialAccidents .�.1� .f g P.2 ce o Invesfi rltions E_ �t 600 ffrashington street { L! Boston, PIA 02111 1t+1pw.massg'ov1dia Workcers' Compensation Iusurance Affiditvit: Builders/Contractors/Electricians/Plumbers Applicant Inform[a]tion Please Print Legibl Name, (Busine torgatEizatioiVIndividaal): Acfdress: City/State/Zip- l` � Pllolle,T- 5, Are y an employer? Check the appropriate box: Type of project(required): 4. E] I am a general contractor and I I. 1 am a employer frit][ 6. E]New construction employees(foil and/or part-time)."- have hired the sub-contractors 'Z.❑ I am a sale proprietor or partner- listed on the attached sheet. 7. E] Remodeling and lave no emQloyear These subcontractors have 9. E]Demolition employees and have workers` 1working for me in any capacity. 9. [J Building addition [No«+orl:ers' comp,insurance comp,insurance.= 5. 0 We are a corporation and its IO.❑Electrical repairs or additions required.] �.❑ I am a lromeo�i'ner doing aIl work officers have exercised their 11.Q Plr Laing repaixs or additions right of exemption per MGL myself_[No workers comp. 12.0,ftoof repairs insurance required.] c. 152, §1(4),and we have no 4 ] 13.❑ Other employees. [Na workers - comp.insurance required.] $5 nr upplicant Eimt check[rax 1 must also lilt alit the section below showing their workers'compensation policy information. t Hmneulrnt=rs who submit this nlirdavit indicating they are doing all wank and then hire outride coutmetors must submit a new affidavit indicating such. IContmetors that chack this box must attached an additional slice[shoeing lilt name of Elie Sub-canttactors and state whether or not those entities Bove employces. IE tine sub-coatractors have employes,they must provide dteir tivorkers'comp.polio-number_ 1 am all employer that isproviding workers,compensation insilrance for my anlployees. Beloit;is the policy and joh site information_ A , Insurance Company Name: y .. 1•� s- ,—y.� �` Expiration Date: ' Pn1lc ri or Self-ins.Lre.Tr' �' �' �`dc � �/ 9 p Job Site Address 4 �.. , City/State/Zi �� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of IrtvesUgatious of the DIA for insurance coverage verification. I do I1e�rL�L}�cern, old�r the pnirls and perlulties of perjury that flit,hiforltlation provirted above is tare and con-eel. S iettature: G�•;• ,�r�lz Date: Phone F": Official use only. Do not 3vrite in this arta,to be completed by city or lown official City or Town- Permit/License Issuing Authority(circle one), 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Ll lectrical Inspector 5,Plumbing Inspector G.Other Contact Person: Phone N: 0 DASE(MMIDDIYYYY) ACC>RV CERTIFICATE OF LIABILITY INSURANCE 11/0912016 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(les) must be endorsed. It 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 NONTACT AME; Diane LeBlanc DOHERTY INSURANCE AGENCY INC PHONE . (978)475-0264 _[FAX ,Nos: MAIL dlebtanc dohert insurance.cam ADD ESS: P,O BOX 1985 INSURER(S)AFFORDING COVERAGE _ NAICN ANDOVER MA 01810 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURER 0: _ DAMPHOUSSE ROOFING LLP INSURERC: INSURER 0: 87 BELMONT STREET INSURER E: NORTH ANDOVER MA 01845 INSURER F; COVERAGES CERTIFICATE NUMBER: 101761 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILSR TR TYPE OF INSURANCE B POLICY NUMBER IPOLI pY EFF MM/Dom EXP LIMITS COMMERCIAL GENERALLULBILETY EACHOCCURRENCE $ CLAIMS-MADE D OCCUR PREMISES JEa ox_vrionce) S MED EXP(Any ano poman) S NIA PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY E]PRO" ❑LOC PRODUCTS-COMPIOP AGG $ JECT OTHER'. S AUTOMOBILE LIABILITY C11BBIN D SIN LE LIMIT S Ea-cadent ANY AUTO BODILY INJURY(Per person) S ALL OWNEDSCHEDULED AUTOS AUTOS NIA BODILY INJURY(Por acadenQ $ NON-OWNED PROPERTYDAMAGE S HIRED AUTOS AUTOS Por accident S UMaRELLALIAB OCCUR EACH OCCURRENCE b EXCESSLIAD CLAIMS-MADE N/A AGGREGATE S HDED RETENTIONS I I S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY IS ER ANYPROPRIETOR/PAATNER+EXECUTIVE Y f N E.L.EACH ACCIDENT $ 500,000 A OFFIC EPJMEMBER EXCLUDED? NIA NIA NIA AWC40070287742016A 04/17/2016 04/17/2017 (Mandalary 1n NHI E L.DISEASE.EA EMPLOYEE S 500,000 II yes,dasaihu undo v DESCRIPTION OF OPERATIONS 4urow A E L.DISEASE-POLICY LIMIT 8 500,000 NIA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Addlllonal Rarnarks Scheduto,may W attached it more apace is raituirud) Workers'Compensation benefits will be paid to Massachusetts employees only,Pursuant to Endorsement WC 20 03 06 B.no authorization is given 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 cartificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gDvllwd/workers-compensationrinvestigationsi. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street AUTHORIZED REPRESENTATIVE North Andover MA 01845 I Daniel M. ry By,CPCU,Vice President—Residual Market—WCRIBMA 01908-2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Client#:14415 DAMPHOUSSE ACORb. CERTIFICATE 4F LIABILITY INSURANCE 11,09/o SYY"' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty Insurance Agency,Inc. ONLY AND COFFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 1985 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 21 Elm Street Andover,MA 01810 INSURERS AFFORDING COVERAGE MAIC# INSURED INSURER A Western World Damphousse Roofing LLP INSURER 8: 87 Belmont St INSURER C North Andover,MA 01845 INSURER D: INSURER E; COVERAGES 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 TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NS TYPE OF INSURANCEPOLICY NUMBER FOL CY EFFECTIVE POLICY EXPIRATION__ Y LIMITS A GENERAL LIABILITY NPP8296488 04/12/16 04/12/17 EACHOCCURRENCE S1,000,000 X CDMMERCIAL GENERAL LIABILITY DAMAGES I RENTED S1001000 CLAIMS MADE F-X�OCCUR MEQ EXP(Anyone person) $5,000 PERSONAL 6 AOV INJURY Si 000 000 GENERAL AGGREGATE $2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCT$-COMPIOP AGO s2,000,000 7X POLICY D PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO (Ea aoadenl) ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Porperson) S HIRED AUTOS BODILY INJURY S NON•OWNED AUTOS (Per socidenl) PROPERTY DAMAGE S (Por accidonl) GARAGE LIABILITY AUTO ONLY•EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTOONLY: AGG $ EXCESSIUMBRELLALIABIUTY EACHOCCURRENCE S OCCUR ❑CLAIMS MADE AGGREGATE $ S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND IOR WC STATU• DTH• EMPLOYERS'LIABILITY ANY PROPRIETOFVPARTNERIEXECUTIVE E.L.EACH ACCIDENT 5 OFFICER MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S tim,dostnoo under SPECIAL PROVISIONS belmv E.L.DISEASE•POLICY LIMIT I-S OTHER DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS Covering operations usual to Damphousse Roofing LLP... CERTIFICATE BOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL in DAYS WRITTEN 1600 Osgood Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 80 SHALL North Andover,MA 01846 IMPOSE NO OBLIGATION OR LIABILITY OF ND UPON THE INSURER,ITS AGENTS OR REpREBENTATIVE3. AUTHORIZED REP EG�ENTATnIE ACORD 25(2801108)1 of 2 #S34292/M34248 IML 0 A D CORPORATION'1988 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-067560 Construction Supervisor SHAUN M TWOMEY 61 PATROIT ST NORTH ANDOVER MA 01848 Expiration: Commissioner 10/2512017 Office aConsumer Aftraiia& 3p(si,css Rctrot S t_3 HOME IMPROVEMENT CONTRACTOR Re0istration: 174377 Type: Expiration: 2/4/2017 LLP DA1vlPHOUSSE ROOFING LLP SHAUN TWOMEY 87 BELMONT ST r ��¢ N.ANDOVER,MA 01845 Undersecretary