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Building Permit # 10/19/2016
Of IAO oT"�ro BUILDING PERMITS TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 01 Date Received e7 4Top Date Issued: r ©f IMPORTANT:Applicant must complete all items on this page LOCATION �� l�ula�� F'rin# MAP N� J PARCEL_ ZZONIIG DISTRICT NIa4cirSot yds .w,Uillage yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: Atommercial Repair, replacement i I Assessory Bldg ❑ Others: Demolition ❑ Other I I Sep��c I �Well i I Flootlplatn I lfl�'etlands � � Watershed D�stnct I WaterlSwer S'rg 0> A 36o identification Please Type or Print Clearly) OWNER: Name: 1 � Cop ohez, Phone:27 --715-- 33 Address: 77- CbNTRACTQR Name �' . , � Phone. Sc��er►r�sor's GQnstr�ctton Ltcen�e, I�xp Date �, �� � Y Home Improvement License ? Exp date , 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: $ vim, Z3b -� FEE: $ � � Check No.: 2,S—:a:�7 Receipt No.: 0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agen. wner' 'Signature o contractor FORTH Town ® -1 1r 6 ®ver p No. 41 �. � � � _ _ � h ver, �Mass 110QA CONIC IW.CR V � it 4ATiw) S BOARD OF HEALTH Food/Kitchen PERMIT .T LD Septic System O� 51�� ��� ��THIS CERTIFIES THAT ......... .. ...... ............... ....�C A.. (BUILDING INSPECTOR 0.�.. �. �. ..^. has permission to erect ..........................buildings on ....... ....2.. ...... Foundation to be occupied as ........... .SA.....`..........R.c..0t.0.6f..................................... 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 ®® 1 Final PERMIT EXPIRES R THS ELECTRICAL INSPECTOR LESS, CONSTRUCTISTARTS Rough Service ........ ... ... .............. ...........,..,.,................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occy2y Building 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. Old School Roofing 297 Littleton Rd. EQ Chelmsford, MA 01824 978.251-7663 (Office) 978-251-7664 (Fax) New= M n - G1 WIN= www.ol(].,school.gi°ot.I.P.coi�ri 13Y MEIR 1C ' t., .f GE'l' ttOOFIi G d .f' Gf,A ,"ru ER Edgewaad Retirement Community Proposal September 29, 2416 575 Osgood Street North Andover, MA 01845-1935 Phone: (978) 725-3300 Attn: Bob Copolla 1. Job Specifications: Building 3000 2. Job Preparation: +Set up job site and insure attention to your particular concerns. Installing tarps around the areas being worked on to prevent damage to siding, plantings and any landscaping. 3. Remove Old Roof: *We will remove the existing layer of roofing. This allows for inspection of the roof decking, and repair any damaged boards. fl°I't°�:.. We will replace any dew riaged or, irolled plywood at x`2.00 per square fout rot" YZ CDX plywood, $2.25 for 518 C;IIP.°."W plywcould and$y00 peer lineal front lor d:,mck Ilboards 4. Install Leak Barrier. *Install full cover ice and water barrier. ♦This for extra protection against"ice damming"-as recommended by manufacturers, 5. Flashing Details: *Install new 8"aluminum drip edge to all rakes and eaves,and pipe flashings All side walls will be removed and ice and water installed with new step flashings. B. Shingle Application: ♦install a Lifetime Architectural Shingle, Certain7eed Landmark Colonial Slate. 7. Ventilation: *Install a new ridge vent on all dormers. We use a ridged vinyl baffle vent which allows for the best ridge ventilation. 8. Hip&Ridge Shingles: *Install new hip and cap shingles, this provides protection of the ridge vent and a finished look to the roof line. i 9. Roof Warranty: ♦Limited Lifetime Manufactures Warranty. (40yrs Commercial) 10 Year Workmanship. 10. Glean-up/Disposal: *Old School Roofing supplies the dumpster. Our disposal costs are based on recycling of the asphalt shingles. Please do not throw any household trash or foreign materials into the dumpster. We will thoroughly clean up and dispose of all materials and debris associated with the job. ...�.......m..�,..�..."Protectioin.. "lconq2! o. ro o! oe 1911 agfol cs : ° t 91. Permits: *Old School Roofing will be responsible for obtaining any and all necessary permits to insure the work is performed legally. 1 i 12. Scheduling: +We do our best to stay within stated scheduling, estimated mob completion 12-14 days. However, Mother Nature and emergencies can lead to delays. We will do our best to limit those delays. We will contact you within 48 hours before installing your new roof and work will not be commenced until you are contacted first. If more time is necessary to accommodate your schedule, kindly let us know. Job Cost. $53 230.00 Payments shall be made as follows: Y2 deposit due before scheduling work, balance due upon completion of the work. QU01'E, 600F) FOR 10 DAYS QNLY !icalfle diSCqU11tS,,.y?j21i(,,d, SIGNING INDICATESACCEPTANCE oF ,rHE PRICES AND SPECIFICATIONS SE,r :VORTH HEREIN AND ACCEPTANCE OF" THE TEIMS AND CONDITIONS OFT1118 CONTRACT. Old School Roofing: Property Manager: Date: Date Authorized Representative All rubber porch roofs will be done with.060 VM adhered to 312 Insulation Board. Additional Work Anduded.- RemogLng siding on dormers to install ice and water shield and new"e flashin g s. If new siding needed an additional cost would Fu//ins ectian of the main rubber roof. Too include.-Inspection of a//penetrations 6WProx 78)clean and sea/any ftng seamsInspection of all rubber kpg4pints clean and seal as needed. Amus Issues discovered wi//be written up and discussed prior to any work started Please feel free to call me with any questions. Thank�rou. Tony Dowd-978-251-7663 M#099649 HIC#157447 2 The Commonwealth of Massachusetts F Department ofIndustrialAceideftts ' h � 1 Congress Street,Shite 100 a, L'oston,a MA 021x4--2017 - any wWMmass.govldia Workers'Compensation Insurance A,fhidavit:Builders/Com#xactaxslEZectricianslP umbexs. TD BE FILED WITH TM Pr',PJ&I TANG.AUTHOMY, Please Print Legib A ' licant Tnforxnatian p Name (Business/Organization/Individual): ti b Address: V f ' kA MK&Y Phoma#: 7? �- �'/ '76 4 3 city/state,/Zip: _. Areyo an employer?Cliecictlie appropriate box: Type of project(r•eguired} em to ees full andlor part time).' 7• ❑l w COnstrtxbtloxl 1 I am a employer with__ _...—..__ P y 2.Q I am a sole proprietor or partnership and,have no employees working for mein S. Remo deliiig any capacity.[Noworkers'comp.insurance required.] 9• ❑Demolition 3,E]I am a homeowner doing all workmysel£tNo workers'comp.insurance required.]t 10❑Building addition 4.❑lam a homeowner and-will be,hiring contractors to conduct all work on my property. I will 11.0 Eleatxical xepavrs or additions ensure that all.contractors either have workers'compensation insurance or are Solo ensure P�umbg repairs or additions proprietors with no employees, LJ 5❑S am a general contractpz and I have hvrediba sub-contractors listed on the attached sheet. 13. 1(06f repairs ane arnplayees and have workers'camp.insnrance.t These sub-contractors bld Other 6.0 We are a corporatioii and its.offiic6rs have exercisedtheir right of bxeruption per MGL v. 152,§1(4),and ive have no empioy6es.[Noworkers,comp,insurance required.] Any applicant that checks b-6k 0 must also fill out the section below showing their workers'compensation policy information, Homeowners who submit this a##iclavit indicating they are dourg all work and then hire outside contractors must submit a new affidavit indicating such, that checkthis lioicraust attaclied'an additional sheet showing the name o£the sub -contractors and state whether oir not€inose entit€es have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. X am an employer iliac is providing-ivorlcers'compensation insurance for my employees Pelow is the po1'icy aridrob site information. Insurance CompanyNatne: Expiration Date: Policy#or Self-ins.Lie.#:. City/State/Zip: lob site Address: campezrsatian.policy declaration page(sho�vixrg the policy number and expiration date). Attach a copy of'the vvoxlrexs' Failure to secure coverage as required under MGL o_152,§25A is a criminal violation.punishable by a fide up to$1,500.00 and/or one-year imprisonment,as well statement to civil may ebe the f037m of a STOP forwarded to the ffice o�ORDER �t'sof the DIA for insuranced a fine of UP to 00 a day against the v o lox•A copy of this statem y coverage verific do . t da liere7�y cer ' •thepains and penalties ofperjury that the information provided above is tare and,correct. Date: Simature: Offlcial use only. Do not write in this area,to he completed by city or torvri Of ficial Permitweense# City or Town: issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerk �€,Electr 'lurnbiug inspector6.Other Phoxxe Contact Person: OP ID:JG AC[�RD° CERTIFICATE OF LIABILITY INSURANCE DATE(IILN1eDD1Y �-� 10wv2011 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 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 endorsement(s). PRODUCER CONrACT Segreve&Hall Insur.Assoc.lnc PHONEME: 305 North Main St. Nno E, : Andover,MA 01810 ELLAIL ADDRESS: ID Lawrence J-Hall PROOUC R OLDSC-1 CiISTOMER 1k INSURER(S)AFFORDING COVERAGE NAIC# INSURED Old School Group Inc INSURER A:Northland Insurance dba Old School Roofing INSURER 0,Arbella Protection Ins.Co. 41360 297 Littleton Rd.Unit 1 Chelmsford,MA 01824 INSURER C:Travelers Ins.Co. 25658 INSURER D 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INR TYRE OF INSURANCE O B POLICY NUMBER MM�ICfY MNU�I}p EXP LIMITS - GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 AMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY 5260133 1711612015 1211612016 PREMISES Ea occurrence $ 100,00 CLAIMS-MADE 1XI OCCUR MED EXP(Anyone person) $ 1,00 5260133 12/1612014 12/16/2015 PERSONAL&ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ 2,000,00 POLICY PE, LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 (Ea acddent) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Pot amfdent) $ X SCHEDULED AUTOS PROPERTY OAMAGE B X HIRED AUTOS 1020000245 0610112015 11610112016 (PER ACCIDENT) $ X NON-OWNEDAUTOS 1020000245 0610112016 06101/2017 $ a UMBRELLA EL1B OCCUR EACH OCCURRENCE $ EXCESS LUIB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERSCOMPFJNSATION WCSTATU- OTH- AND EMPLOYERS`LIABILITY X TORY LIMITS ER C ANY PROPRIETORIPARTNERIEXECUTIVE Y!N UB-9F630350 04/13/2016 0411312017 EJ_EACH ACCIDENT $ 100,00 OFFICER)MEMBEREJCCLUDED2 NIA 2E9Q922715 10/20/2015 03108!2016 E.L DISEASE-FAIEMPLOYE $ 10000 (Mandatory in NH) If yes,describe under 500 00 DESCRIPTION OF OPERATIONS below ELDISEASE-POLICY L1MH" DESCRIPnOH OF OPERATIONS!LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if mora space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY of THE ABOVE DESCRIBED POLICIES BE CANCEL IED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WHM THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ®1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of^CORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-099649 Construc.tir:r) " w. pervp'soj Speckilt7 ANTHONY N DOWD 9 DIGITAL OR#202 NASHUA NH 03062 E,,4 p vation: COr"'Missioner 02/28/2018 (J" „� r>arrxurr�rci�rnCl�a�!?./�l,,Jfrrr��rt�rt�s _ 'Tice Of COnsulne:Affairs&rosiness Regulation License or registration Valid for individul use only OA4E IMiPROVE&JENT CONTRACTOR before the egistratien: expiration date. 1F Found return to: 1 157447 Tyre: Office of Consumer Affairs and Business Regulation Expiration: Private Corporati,i 10 Park Plaza-Suite 5170 OLD SCHOOL GROUP, INC. Boston,XIA 02116 ANTHONY DOVE D 297 LITTLETON AD CHELMSFORD,MA 01824 1lndersecreta'r Not valid without signature I