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HomeMy WebLinkAboutBuilding Permit # 12/13/2016 - 1 BUILDING PERMIT NORrH °�� q'�o TOWN OF NORTH ANDOVER O ,T APPLICATION FOR PIAN EXAMINATION Permit No#: (42 Date Received L tt�4pRnrP wee`�5 �Ssac►+us�i Date Issued: TMYORT.ANT: Applicant must complete all items on this page LOCATION Print F� PROPERTY OWNER (� 14 of 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 PaTne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �Septic ❑Vllell � ❑ Fl�odpla�n ❑�lUetlands ❑ Watershed District ��� i ' ❑U1laterl.,S ewer.. � � 4 ��� �� � ��� , -�,� DESCRIPTION OF WORK TO BE PERFORMED: -Tdentification- Please Type or Print Clearly OWNER: Name: + i4 4 Phone: Address: 2 >� Contractor Name:77 kA Phone: '1,,f -- ` -2 —_`'7 Email- Address: r2 � Supervisor's Construction License: ��`�' 1z � - Exp. Date: L'4 L2 , Home Improvement Licenser Exp. Date. z 2 fi ARCHITECT/ENGINEER Phone: Address: Reg. No, FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Coit: $ ", 6 < FEE: $ / :7 Check No.: l L( Receipt No.: 313 _ NOTE: Persons contracting with un egistered contractors do not have access tot e guaranty fund 'T ¢ tjoraT�y own o T ndover _ 0 No. t � z �h ver, Mass, l T O L Ctl[.S[t Cot ME WICK ti ATED APa4,��j lj BOARD OF HEALTH Food/Kitchen PE Septic System THIS CERTIFIES THAT ...... .. ... �!! � )�N BUILDING INSPECTOR ,. . . . .... . . A .... .. . .. . Foundation has permission to erect buildings on • ....R �....04 ..�Cis ..�. .re�� Rough t0be occupied as ....., .. ................................................................ Chimney provided that the person accepting 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 CONSTRUCT A Rough Service ........ ........... ...................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to ,Occupy Ruildin 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. COME RCOC30F Residential & Commercial Roofing Chimrxr�ys All Types Of Siding CHIMNEYS POINTED-REBUILT-CAPPED Expert Masonry Work Mass Toll Free *Roof Leaks k'xperEs * Licensed & Insured 1-800-WAIT-4-U5 ® Locally Owned&Operated Since 1976 9'W License#034200 (924-8487) IKO Cage Woem oe,9ah-v � We Work Year Round 1 f 1 Proposal To:Nick Daher Date 11/16/2016 Street: 1675 Great Pond Rd. 978-423-7782 Methuen, MA Roof proposal nicholasdaher@dahercompanies.com IKO Cambridge/Certainteed Landmark 1. Extra caution will be taken to protect house and 12. Removal of all work related debris. Planks will be landscaping as best as possible. (tarps etc.) placed under dumpster to prevent any damage to Magnets run at final clean up. driveway. 2. Remove all shingles from entire house. 13. Building permit included. 3. Inspect and re-nail any loose or lifted plywood. 14.Contractor workmanship warranty: 10 years under Any compromised plywood will be replaced at an normal wind and rain conditions. additional cost of$60.00 per sheet of 112" CDX. 4. Install heavy gauge 8"white aluminum drip edge Total IKO cost: $159600.00 to all eaves and rakes. S. Install 6' of Certainteed winter guard or IKO Armourguard ice and water shield to all eaves and IKO Shield Pro Plus or Certainteed 3Star top to bottom in all valleys. extended MFG warranty: 6. Install IKO Cool Grey or Certainteed Diamond A fully transferable 1.00% coverage against Deck synthetic underlayment to remaining material defects for a fully non pro rated period of sheathing up to ridge. 20 years. Please refer to pamphlet left in estimate 7. Install all new pipe boats. folder. Offered to our existing customer referrals 8. Install IKO Leading edge or Certainteed Swift and included in this proposal at no additional cost. Start starter shingles to all eaves. 9. Install IKO Cambridge AR or Certainteed Balance due upon completion,no deposit required! Landmark Limited Lifetime architectural shingles to entire house. IKO 15 year and References available upon request Certainteed 10 year material MFG. warranty. (See extended warranty)All shingles will be Highly rated member of the accredited BBB and installed and fastened according to mfg. specs. Angie s List All valleys woven. 10. Cut and install new GAF Cobra ridge vent and cap Thank VQUI with color matched Certainteed Shadow hip and ridge shingles. (MA code) 11. Counter flash existing chimney lead, wall connections and all roof protrusions with ice and water shield, tie into new shingles and seal with clear Geo-Cel sealant. i e Commonvealth of'Hasw chuseits .l)epaytMegi of id �t ao�l ccit e t n _ I Congress ee_gostow,HA 02.414 2017 t,suite ��D S yw. www mass govldia oto? ers,Co,-piWft-don S>3snranceAffldadt:Binders/Cnz�E�ac�oxsL��eefxzc slPZmmT�ers. TO BES WffBC TOE TEptTMITING AUTHORITY. A Iicant�oxizzation P1e�ePxxnt �,e�I •�-� 1 L Na-�7.� �iiS7L1P,SS��S��1�3�I0Il�'i1�VSdII2��� L�- �Y� I'�"'�, ` �'J✓l /0 City/State/Zip: Irl --71.1 -3-`/' An A-fJ Phone ArsYou au amlalayex? Ll?ecIti3ie a�pxapxiaehox< a)Te of project(xgclraxed): .t LEI I am a employervau employees(fig and(orpaittima)* NB-Vr calisftticloIl 2.�T am asoTe prop,zetororparfnerslup andltavenv eznployees,Vorking f Ez in $. Rezrioelel rig y capacity.pTo woiicers'comp.insorancc reciukcd.] g, ❑DemoXitzoa IQ!amahozneov ae daiugallvvoxk�nyselZ�Towazkers'comp.ins�raace clniced] 10 EIB-EdJ#ig ad[{TEt07x 4_E]xamah meownezmawill.behiringruftad=tocmdactaTlworkonmypropel f-WM ea orare sole er• 11.E]Electdcal.repairs or additions ensure Qaa;all C;Gnta_ctvzs eitbhave workers'compensation i�sr�ran proprietors vrithr4aempleyees. 12 OT lumb ing xepairs or additions . arz�sgenexalDE)nkadorand Shavehiradthesub-cant�actorslzsteduUflioa�hedsheet. 13. RobzTapa S Thesesob-coaz[zacrorsl_�e employees audhavework�ss'comp_�sruancex 14.kaOtbbx \1 u N • 6.Q'4Ye areaoorpozai�utt�tzdits oi�eershave emezcisedthezz right flf'e�empuonpez�rf'�e. 752,§I{Q),andwefiavengemplgyees.Iljoworkers'mmp.iigmaneerepaired.] t... *"Anyapplics rlaahehae7 sbox�#lmastaIso ITcaut�seot£onbeIowshavingtheirwoTkers'campensatianpolioyinfvzmation �omevwners aha Haigit, A ai daviti�c3ica tgtbeq ate dvang ai1Wo k mdjheaYTe outside matracinrsznisstsi Ltuit anew affidav mdica{ing srreTz Coniactoxs haEreckthzsbr�matst €acLtedanadrlikaza�Isheetshflv� ugthenaruenfihesab-caaoiracievsaudstatewhetherornoihoseesiies7aave employees. Sfthesnb-otir33rarmrs eeu�ployees,&-Ymn4ravidot eirwork� nomp.policynumber., a a erri aloyer tlz at as�iovz g ar rer s'carrt�ner2sc are insrxraracefor racy erazplayee�:'Bera7v is the_pozicy grad job sltg irzfar��atio�t. - . lh=anoo Company Tame: PaX%cy#or Self ins. Expiration.Date. r ,Toll Site Addtess: I t�.) S� 6N� �� CitylStateL ap ry AitacTa a copyof tbev a kexs' deciaxatronpage(showing UiepolieyzaTMDax aua exPixatioxa Faffmo to secure covr rage as Tegi fixed imde:MM G. 152, §25A is a Grhainal vioiattOn pt>nishably a ane tip to$1,500-00 and/or oneryea€ p o�ment,as well as civil penal es iv.the f=oxm of a STOW WORK ORDER and a,fine ofup to$250-00 a dap against Fhe violaar_A copy of statement may be fox4varded to the Ora ozStvestigattoz�s ofthe DSAoxi :turauce coverage verfflcailon!_ ado her ere-by certify rc def tJa rxcr ciPerzaiti s afperj�zxy tiatai'the innfmaiiort�oVided above�-agearty correct Date 2 Z S3 atUxe: ' Phone# OfficiaZ rise o iy. _Do not-ppr&e hY this area,to be compZded iiy city ar fawn offxcEair City or Town- Per n tlX,zcerzse I;ss-afixtg.Authoritp-(circle Me): � �.Eleetxical ector 5.I'IumbzngSx�s ecta�- 1.Boaxd of ffealt i Cityl'ovm Clerk J Sp p 6.Other Contact I'exsop.: 1.'b"oxte#: From:Universal Insurance To:19769750461 06/14/2016 13:15 #533 P,002/002 'icopa UATEI CERTIFICATE OF LIABILITY INSURANCE hi4/2016 06r14/aD1s 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 eartificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION 13 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 ties of such endorsements , PRODUCER Benhalina I'ucclo Universal Insurance Agency.Inc. NAME: 374 Belmont Street PHONE FAX ,;(508)752-8303 Worcester,MA 01604 -M pIL BPUCCIO@UNIVERSALINSAGENCY,COM INSURERS AFFORDING COVERAGE NAIC# INSURER A! ESSEX INSURANCE CO 39020 INSURED MGG CONSTRUCTION INC INSURERe; 12 WATER STREET#1 Milford,MA 01757 INSURER C; INSURER D. INSURERS; 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. "s NSR ADDL TYP1 OF INSURANCE SwynBR POLICY NUMBER MIC Fi P LI Y BXP LIMITS A GOMMERCIALGENERALUABIUTY 3EA6951 051201201x6 5!20/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS•MADEOCCUR 0 , 3 60.000 # MED EXP(Any,ate MA S 51000 I I PERSONAL4ADV INJURY $ 1,()00,000 GEWLAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE S 21000,000 POLICY El IRO, F1,000,000 JECT LOC ARODUCTS•COMPlOPAGG S H M f AUTOMOBILE LIABILITVCOUBIIdent ED SINGLE LIMITIgo jx ; ANY AUTO BODILY INJURY(Pot peroon) S ALLOWNED SULEO AUTOSAUTOSBODILY INJURY(Par ecoident) S NON-OWNED HiRE�AUTOS AUTOS PDAMAGE a�cdtl S UHBRELLALIA$ OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-/RADE AGGREGATE S DED RETENTI N S WORKERS COMPENSATION 7A OR AND EMPLOYERS'LIABILITY Y!N ANY PROPRIETORIPARTNEWEXECUTIVE ❑NIA E.L FACKACCIOENT S OFFICERrMEM4EREXCLUDEO? -- IYRndatory In ) E.L.DISEASE-EA EMPLOYEE 3 Hyes desctlbeUntla PE$UIRIPTiON OF OrPERA7tON8 below E.L.DISEASE•POLICY LIMB S ;v ` DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 101,AddlUanatl Ramuks ZehMule,may ha anacMd ll moo sl-L.I@ requirad) ;x CERTIFICATE HOLDER CANCELLATION Fax#:(978)975.0461 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ALL UNDER ONE ROOFING THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 30 TEMPLE STREET ACCORDANCE WITH THE POLICY PROVISIONS. Methuen,MA01844 AUTHORIZED REPRESENTATIVE N►I�(1 ►^a. ?VGGIO <t; 1998-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD L ..- . ACCM0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDMYY) �� 11roEl2016 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 p°Ilcy(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 02051.061 QaeoT Branch 2053-1 PerrCyInsurance Agency LLC A 9 8% Fx* (978)685-7690 AlC,Nn. {978)687-014 g Rd North A ckedoverr,MA 01846 ADDRESS: A.I.M.INSURER A Mutual Insurance Company ENSURED All Under One Roof INSURER S' C/O John hanzafamc 30 Temple Drive INSURER 0, Methuen, MA 01644-0000 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 VNTH 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,pp r TYPE OF INSURANCE 41 RRA WNPOLICY NUMBER MMfO�IY MM b�IYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITYO RENT S - SES fEa octur CLAIMS-MADE OCCUR MED FXP(Any one parsonl $ PERSONAL d ADV INJURY $ GENERALAGGREOATE S EN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMPIOPAGG S LILY 0 OC AUTOMOBILE LIABILITY COMB NGL I S ANY AUTO BODILY INJURY(Poi person), S ALL OWNED SCHEDULED -•- AUTOS AUTOS BODILY INJURY(Pas accidenti S HIRED AUTOS AUTOSWNED PROPERTYD G S UMBRELLA LIAR OCCUR EACH OCCURRENCE; -- S EXCESS LIAR CLAIMS MADE AGGREGATE $ yypRKD@ERDg RETENTION S Ai16 EMPL�YERSLIA BILITY Y! x TORY LEMITS °f� A a" Ic�J9Pn ` [Ifs �IJTIVE NIA AWC-400.7000484-2018A 1118/2016 11!8!20'17 E.L.EACH ACCIDENT s1,000,000.00 [iMandddatorylI��InNnHII �.�..r E.L.DISEASE-PA EMPLOYEE s D�UI #(Of MPERATIONS below E.L.DISEp.S5-POLICY LIMIT s DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) PROOF OF COVERAGE The workers Compensation polity does not provide coverage for John Lanzafame CERTIFICATE HOLDER CANCELLATION All Under One Roof 30 Temple Dr SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Methuen,MA 01844 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ACORD 25 2010!06 0 1888.2010 ACORD CORPORATION.All rights reserved, ( ) The ACORD name and logo are registered marks of ACORD r : It Mskss90hus4tt6-De�:+�rtrna t or P,�al,n b•1•!; . BOOM of building Regulationa an*8rdraa•.err I Conitructlon.SuPen sur • License,,C840120 , imw W LAN 30TLM=DR„ �} " 1, MMMMISNUA 81844%17. S r Lamm:asla:lar 643&17 Office of C synAffairs an �' ¢ d Business Relation 10 Park Plaza- Suite 5170 Boston, Massach;isetts 02116 Home Improvement C© traptor Reg" tration R89€8t(itt0n: 137057 ALL UNDER ONE ROOF i r _ ��, �:` ... I+xptrat om 1o/212018JOH89'13 1fi6 N LANZAFAME ;"M~ - :'! ; �ti ss A MER �.; ..a•' . METHEUN,A 01844T : . r MA i 4 zeMn ` • ; s`; ti. update Address and return card.Mark reason for change. (� Address � Renewal gn, t �] p oyment El Lost Card "'� Ulylce o Car�hJ>tI11n11rnnrlrl n i'+rinu�r���lnl�'j ruuwerAffalsx dt Haeli is=ReEutsHo4 gsg>s �oa vaitd for Individual use only before t HDIRE IMPROVEMENT C014'RA6TOR e:plraNtI date. ><f ibund return to: he Reglstrattoq: 137057 Expiration: 1OW201e DBA '1�pes Office of Consumer Affairs and Business Regulation 'p- w 10 Park Plaza-Suite 5170 ALL UNDER ONE ROOF Boston,MA 02116 JOHN LANZAFAMr= ; 160 A MERRIMACI<sT METNEWN,MA Ole" ��dcrsetretsry 7N-0-1V-M" ot V-M"wlthout al nate a