HomeMy WebLinkAboutBuilding Permit #440-15 - 143 DUNCAN DRIVE 11/5/2014 V� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: I Date Received Date Issued: 1� I IMPORTANT: Applicant must complete all items on this page LOCATION ' '�✓2_.. Print. PROPERTY OWNER 1. , L�✓L I rint 100 Year Old Structure yes no MAP NO: 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 ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Ado Id ratification PI ase Type or Print Clearly) OWNER: Name: l�1�' �C//�.y Phone:,..- OWNER: �� Address: CONTRACTOR Name: /4hone: ` Address: rl J.^ - Supervisor's Construction License: Exp. Date: 7 Home Improvement License: 9 1,6? Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. ' Total Project Cost: $ Uma • 62;9 FEE: $ �Z, Check No.: ? ,. t� Receipt No.. NOTE: Persons contracting with unregistered contractors do not have access to ara Nand Signature.of Agent/Owner igiiature of contractor I Plans Submitted Li Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location 14� S '" + No. q—40--t Date 1 . - TOWN OF NORTH ANDOVER • s�.��n r64�' • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# w Y Building Inspector - Plans-Submitted ❑ Plans-Waived-0 '.:Certified Plot Plan ❑ Stamped Plans ❑ :TYPE OF SEWERAGE-DISROSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑. ..Tobacco.Sales Food Packaging/Sales ❑ Private(septic tank,etc.- ❑ _ Permanent Dempster on Site ❑ r THE-.:FOLLOWING SECTIONS FOR-OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM -DATE REJECTED- DATE:APPR:OVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Nt— Water & Sewer Connection%Ssignature& Date Driveway Permit DPW ToNv,, Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT =Teraip Dempster on site yes_ no Located-at 124 Mair, Street - Fire Departine►it signature/date -_ :COMM.ENTS I mension umber of Stories: Total square feet of floor area, based on Exterior dimensions._ I dtal land area; sq. ft.: LECTRICAL: -Movement of.Meter.location,mast-or service drop requires approval of Iectrical Inspector Yes No f - DANGER ZONE LITERATURE: Yes No MGL.Ch'apter166.Section 21A—F and G min.$100=$1000..fine NOTES and DATA— For department use I h ' it �l I Ll Notified for pickup - Date Doe.Building Permit Revised 2010 i Building Department The fohowing is'a list of the required:forms to be filled outfor:the appropriate:permit to be obtained. Roofii,g, Siding, Interior Rehabilitation Permits o BEailding Permit Application Ll Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or"C.S:L: Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work D Engineering Affidavits for Engineered products NIC iTE: All dumpster permits require sign off from Fire'Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application i o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE:O All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report u Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit �In all casts if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm- ted with the building application Doc: Doc..Building Permit Revised 2012 NORT#r Town of 2 y. : : l� Andover O - 0% No. 44 dov * _ - ,� oh ver, M6 11 ass, C�2-1M� 2 COC NIC.&WICK"V� p0, .{7ED S V BOARD OF HEALTH Food/Kitchen PERMIT T L-D Septic System THIS CERTIFIES THAT ..............so'OA ..D ` BUILDING INSPECTOR 4 3 �2\xj., era �� Foundation has permission to erect .......................... buildings on ................... .............:................................... Rough - r2,2 raa tobe occupied as ..............E:.!?.' 1.P....................................................................................................... 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 Final PERMIT EXPIRES IN NTHS ELECTRICAL INSPECTOR • UNLESS CONSTRUCTIGICT S , Rough - - Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy 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. i The Commonwealth of Massachusetts Board of Build' g Regulations and Standards FOR Massachusetts tate Building Code, 780 CMR MUNICIPALITY USE Building Pen-nit Application To Construct, Repair, Renovate Or Demolish a. Revised Alar 2011 One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Building Official(Print Name) i Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Man& Parcel Numbers I.1 a Is this an accepted street?yes no I Map Number Parcel Number 1.3 Zoning Information: ; 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) 1'ront Yard Side Yards Rear Yard Required Provided R equired Provided Required Provided 1.6 Water Supply: (M.6.1,c.40.§54) 1.7 Food Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone'? Public❑ Private❑ Check if yes❑ Municipal ❑ On site disposal sy stem ❑ SECTIO 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record; l N. nc(Print) City.State.ZIP No.and.'treet Icicphone. Ismail Address SECTION 3: DESCRIPTI N OF PROPOSED WORK''(check all that apply) New Construction ❑ Existing Building Owner-Occupied Repairs(s) ❑ I Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of knitsOther ❑ Specify: _ Brief Description of Proposed Work': SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Cost : Official Use Only (Labor and Materials) 1. Building S A gall � 1. Building Permit Fee: S __Indicate how fee is determined: - � ❑ Standard City/Town Application Fee 2. Electrical $ s ❑Total Project Cost (item 6)x multiplier _ x 3. Plumbing S 2. Other Fees: $ 4. Mechanical (HVAC) S List: 5. Mechanical (fire Suppression)_ S Total All Fees: Check No. _Check Amount: —,Cash Amount: 6.Total Project Cost: S �l`J 0 Paid in Full 0 Outstanding Balance Due: i SECTIONi5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number i;xpiration I)atc. Name of'CSI I lot(VT List CSL 1'ypc(Sec belo") /� 0 tq) Tv e Description No.and Street cy U Unrestricted(Building,-s up to 35.(10(1 cu. It.) T Restricted l&2 Tamil Dwelling e ry Z'own,State.Z.11) i�1 Masonry i RC Roofing Cm Grin --1-- WS U indo\k and Siding SI' Solid Fuel Burning Appliances 9 )A , �� � 7��1 � 1 Insulation Tcic hone Email add eSS U Demolition 5.2 Registered Home improvement Contradtor(HIC) /��� �f'Llt✓t�J ��..�t�r /.�'r' ,� /t/L FITC ReYs ation Number f�,xpiratian Date -IJ Companv Name or HIC Registrant Name— 1 No. d Street Email address / n � U/L "14 z7 1 p Zr - Citv/rown, State.ZIP i 1'elephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit mint be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Isstjance of the building permit. Signed Affidavit Attached' Yes .......... No........... O SECTION 7a: OWNER HORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property, hereby autIltorize n , to act on my behalf.. in all matters relative to work authorized by this building permit application. l'rin nwncr's Name(Electronic S gnature) I)atc SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information costa its applicatio is true and accurate to the best of my knowledge and understanding. 11ri O\vncr's or i uthorized Agent's Name Datc IVO�'ES: i. An Owner who obtains a building permit too do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement(Contractor(I-IIC) Program),will not have access to the arbitration program or guaranty fund under M.G.L. c� 142A.Other important information on the HIC Program can be found at )L\t�t^ma,�, �y oc_a information on the C nstruction Supervisor License can be found at t���t�.ntnss.gu� rll» 2. When substantial work is planned. provid the information below: Total floor area(sq. IL) a (including garage. finished basement attics, decks or porch) Gross living area(sq. ft.) _ Habitable room count _ Number of fireplaces Number of bedrooms Number of bathrooms _ Number of half/baths Type of heating system — Number of decks porches 1'ype of cooling system_ Friclosed _ Open 3. "Total Project Square Footage" may be su stituted for"Total Project Cost- i TOWN OF NORTH ANDOVER WASTE AFFIDAVIT As a result of the provisions of MGL Ch.40-s54, I acknowledge that as a condition of building permit# all debris resulting from the construction activity governed by this building permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL Ch.111-s150A. Waste Disposal or Solid Waste Facility: ALLIED WASTE Address: 300 FOREST ST Town/City, State, Zip: PEABODY, MA 01960 NAME OF HAULER: AB CARNES ROOFING, INC. DUMP TRUCKS DATE: 11-5-2014 SIGNATURE OF APPLICANT: ' ® DATE(MM/DD/YYYY) AC<:)R o CERTIFICATE OF LIABILITY INSURANCE 9/26/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR ATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIV LY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NO CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICAT HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL It ISURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies ma require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONT PRODUCER _NAME: T Commercial Lines Harris-Murtagh Insurance Agency,Inc. PHONE (978)532-2844 FAIC,Nol* AX 30 Central Street E-MDRESSO AIL INSURERS AFFORDING COVERAGE NAIC# Peabod MA 01960 INSURER A:Western World Insurance Co I ED INSURER B: Barry Carnes, DBA: AB Carnes Roofi , Inc INSURERC: �30Lowhead Farm Rd INSURER D: INSURER E � MA 01921 INSURER F COVERAGES CERTIFICATE NUMBER CL1492319366 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIST D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM C R CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUR,NCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHC NN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBRI POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER / GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ — 100,000 A CLAIMS-MADE a OCCUR PP13721 0/11/2014 10/11/2015 MED EXP(Any one person) $ 5,0000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICYF7JFCT PRO- LOC $ ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY a accident ._ ANY AUTO BODILY INJURY(Per person) $ -_ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION E $ WORKERS COMPENSATION WC ST.,T DFR TH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE❑ E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE.EA EMPLOYE $ If yes.descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (Attach ACORD 101,A IdItional Remarks Schedule,If more space Is required) 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 (North Andover, MA 018 AUTHORIZED REPRESENTATIVE J S Scholnick/SJG ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD nanlIe and logo are registered marks of ACORD i Massachusetts -Department of Public Safety Board of Buildi g Regulations and Standards Constructi n Supen•isor License: CS-000230 BARRY S C b+ 30 ARROWHE FARM RD' fs Boxford MA 01921 Expiration Commis ioner 03/07/2016 Office of Consume r Affairs and Business Regulation 10 Park Plaza - Suite 5170 Bosto , Massachusetts 021.16 Home Improv ment Contractor Registration Registration: 176928 Type: Corporation Expiration: 10/10/2015 Tr# 245633 AB CARNES ROOFING, INC. BARRY CARNES 30 ARROWHEAD FARM RD VJ BOXFORD, MA 01921 __ -- -- - Update Address and return card.Mark reason for change. I Address Renewal r Employment lost Card SCA 1 0 20WOV11 i rr ., The Cimmonwealth of Massachusetts Print Form _ Depailtment of Industrial Accidents Office of Investigations 1 irongress Street, Suite 100 Boston, MA 02114-2017 • �,, s,•� www.ntass.gov/dia Workers' Compensation Insuran a Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le Name(Business/Organization/Individual): AB CARNES ROOFING,INC. 30 ARROWHEAD FARM RD Address: i City/State/Zip-BOXFORD. MA 01921 Phone#:978-887-1431 Are you an employer?Check the appropri oxType of project(required): I.El am a employer with • [D 1/n a general contractor and 1 * ave hired the sub-contractors 6• F-1 New construction employees(full and/or part-time). 2.El am a sole proprietor or partner- I listed on the attached sheet. 7. ❑✓ Remodeling ship and have no employees I These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' q ❑ Building addition [No workers' comp. insurance omp. insurance. required.] �' e are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 I.❑ Plumbing repairs or additions myself. [No workers' comright of exemption per MGL p. 12.Q Roof repairs insurance required.]t c. 152,§1(4).and we have no employees. [No workers' 13.❑ Other_ comp. insurance required.] *Any applicant that checks box 41 must also till out the sectidn below shoring their workers'compensation policy intimation. t liomeow•ners who submit this affidavit indicating they are d#ring all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this box nmst attached an additional s6cct showing the name oi'the sub-contractors and state whether or not those entities have employees. Irthe sub-contractors have employees,they must rovidc their workers'comp.policy number. I ant an empli ver that is providing workers'co perrsation insurance for n;v emphvees. Below is the police and job,site information. insurance Company Name: �T — Policy#or Self-ins. Lic.#: Expiration Date: _ .lob Site Address: � City/State/Zip: Attach a copy of the workers' compensation plicy 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 imprisorime�t,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 Investigations of the DIA for insurance coverage jverification. do herehr r ► ander the airs nd enaltie o er'ury that the in pronation provided above is true and correct. '11,N Date Si mature: Phone4: 9 7 6 b'B �5� 21 �II Official use only. Do not write in this area,ti)he completed by city or town official. City or Town: ! Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department; 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: i FORM 153 The Commonwealth of Massachusetts DIA Use Only ; . Department of Industrial Accidents -,j Officejof Investigations - Dept. 153 1 Congress Street,Suite 100,Boston,Massachusetts 02114-2017 •� http,//H-A,w.mass.gov/dia invest./SWO ID#: y AFFIDAVIT OF EX MPTION FOR CERTAIN CORPORATE OF ICERS OR DIRECTORS Chapter 169 of the Acts of-2002 amenddI d Al.G.L. c. 152, §1(4) by adding the.1611mving paragraph: "This chapter shall be elective for an officer or director of a corporation who owns at least 25 percent of the issued and outstanding stock of the cbrporation. Notwithstanding section 46. these provisions shall apply only if the corporate officer provides the commissioner of industrial accidents with a written waiver of his rights under this chapter. S4id commissioner shall promulgate regulations to carry out the purpose of this paragraph. Violations of his paragraph shall subject the corporation to the penalties set forth in section 25C." i Pursuant to M.G.L. c. 152. §1(4) as amefided. I/We the undersigned officers of- AB CARNES ROOFING, INC. (Name of Corporation and Address) each holding at least 25% of the issued and outstanding stock in said corporation. do hereby invoke the right to be exempt from the provisions of M.G.L. c. 152. §25A and therefore are not required to carry a workers' compensation policy covering the undersigned corporate officer(s) or director(s). I/We the undersigned do also waive any and all rights to make claims for benefits as defined in M.G.L. c. 152 for any in that may be sustained whilelin the employ of the above-named corporation. Further. I/we the undersigned do undersand that. should the above-named corporation hire or have in its employ any employee(s) in addition t6O the undersigned corporate officer(s) or director(s), said corporation is required to obtain worker4' compensation coverage for the employee(s) as prescribed by M.G.L. c. 152, §25A. /We the undersigned have read and understand the statements and obligations as delineated above and I/we have checked the appropriate box below my/our name(s) indicating my/our desire to be exempt or not to be exempt from the provisions of�4.G.L. c. 152. gbed under the ains and penalties 4f perjury: BARRY CARNES, PRESIDENT 09/24/2013 S Tint Name d.:"Title Date Omit/dd/yyyy) ❑✓ I wish to exercise m) right ofexcmplion or ❑ i wish NOT to exercise rm,right of exemption �1NASTASIYA CARNES, DIRECTOR 09/24/2013 iv rpt Signature Tint Namc&"I•itle Date ❑✓ I\\ish to exercise my right of exemption or ❑ I'Msh NOT to exercise m) right of exemption cJr Signature i'rint Name& Title Date(Unm/ddlyyyg F1I wish to exercise my right ofexemption or ❑ I wish NOT to exercise m) right of exernpiion r a !Print Name c� Title Datc(nini dd/yyyy) Signature ❑ I wish to exercise my right of exemption or ❑ 1,rish NOT to exercise my right of exemption Note:ALL ELIGIBLE CORPORATE OFFICERS Ml1i l'SIGN. THERE CAN BI?NO,MORE THAN 4 SIGNATURES. Insirtictlons on back. form I i? 7/20 1b • 1 MA SOC Filing Number: i 2013140178570 Date: 6/26/2013 6:21:00 PM The Commonwealth of Massachusetts Minimum Fee:x250.00 • . ` William Francis Galvin Secretary of the Commonwealth, Corporations Division On@ Ashburton Place, 17th floor Boston, MA 02108-1512 5oecial Filing Inctructinnv t i', ` ` Telephone: (617) 727-9640 Federal Employer Identification Number: 100 1110484 (must be 9 digits) ARTICLE I i The exact name of the corporation is: AB,CARNES ROOFING, INC. I ARTICLE II Unless the articles of organization otherwise provide, all corporations formed pursuant to G.L. C156D have the purpose of engaging in any lawful business. Please specify if you want a more limited purpose: I COMMERCIAL& RESIDENTIAL ROQFING AND ROOFING RELATED WORK. THIS SHALL INCLUDE ALL TYPES EXTERIOR & I111TERIOR REMODELING ARTICLE Ill State the total number of shares and par valu�, if any, of each class of stock that the corporation is authorized to issue. All corporations must authorize stock. If only one class or series is authorized, it is not necessary to specify any particular designation. i I Par Value Per Sure Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Oar of Organization or Amendments and Outstanding ,tivat of Shares 761111 Pur Pular rvtmt 61 Share,c I CNP $0.00000 1 1,000 $0.00 1,000 G.L. C156D eliminates the concept of par v�lue, however a corporation may specify par value in Article III. See G.L. C156D Suction 6.21 and the comments thereto, ARTICLE IV If more than one class of stock is authorized,(state a distinguishing designation for each class. Prior to the issuance of any shares of a class, if shares of another clajss are outstanding, the Business Entity must provide a description of the preferences, voting powers, qualifications, and special or relative rights or privileges of that class and of each other class of which shares are outstanding and of each series then established within any class. ARTICLE V The restrictions, if any. imposed by the Articles of Organization upon the transfer of shares of stock of any class are: ARTICLE VI i Other lawful provisions, and if there are no prdvisions,this article may be left blank. Note: The preceding six (6)articles are cgnsidered to be permanent and may be changed only by filing appropriate articles of amendment. ARTICLE VII The effective date of organization and time thl articles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective dat4 is desired, specify such date,which may not be later than the 90th day after the articles are received for filing. i Later Effective Date: Time: I ARTICLE VIII The information contained in I Artidle VIII is not a permanent part of the Articles of Organization. a,b. The street address of the initial registered office of the corporation in the commonwealth and the name of the initial registered agent at the regist6ered office: Name: BARRY CARNES No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State: MA Zip: 01921 Country: USA c.The names and street addresses of the!individuals who will serve as the initial directors, president, treasurer and secretary of the corporationl(an address need not be specified if the business address of the officer or director is the same as the prindipal office location): I I Title Individual Name Address Ino PO Box) First Middle,Last,Suffix Address,City or Town,Slate,Zip Code PRESIDENT W RRY S CARNES 30 ARROWHEAD FARM RD BOXFORD.MAO 1921 USA TREASURER W RRY S CARNES 30 ARROWHEAD FARM RD BOXFORD,MA 01921 USA I SECRETARY ANA§TASIYA V CARNES 30 ARROWHEAD FARM RD BOXFORD.MA 01921 USA DIRECTOR B/RRY S CARNES 30 ARROWHEAD FARM RD BOXFORD,MA 01921 USA I DIRECTOR ANAJTASIYA V CARNES 30 ARROWHEAD FARM RD BOXFORD.MA 01921 USA d. The fiscal year end(i.e.,tax year) of the corporation: October e. A brief description of the type of business in which the corporation intends to engage: COMMERCIAL& RESIDENTIAL ROOkNG f.The street address (post office boxes are not acceptable)of the principal office of the corporation: No. and Street: 30 ARROWHEAD�FARM RD City or Town: BOXFORD I State: MA Zip: 01921 Countrv: USA I I 9. Street address where the records of tho corporation required to be kept in the Commonwealth are located (post office boxes are not acceptable): No. and Street: 30 ARRO 'HEAD FARM RD City or Town: BOXFORO State: MA Zip: 01921 Country: USA which is X its principal office j _ an office of its transfer agent an office of its secretary/assistant secr�tary _ its registered office Signed this 26 Day of June, 2013 at 6:2.3:02 PM by the incorporator(s). (If an existing corporation is acting as incorporator, tvpe in the exact name of the busniess entity, the slate or other.lurlsdiction where it was incorporated. the name of the person signing on hehalf cif said business entity and the title heAhe holds Or Other anthorlty bP which such a-Iron is taken.) BARRY S CARNES i ©2001 -2013 Commonwealth of Massachusetts All Rights Reserved I i I I i i I I I i I i I MA SOC Filing Number: 20130178570 Date: 6/26/2013 6:21:00 PM i THE COMMO WEALTH OF MASSACHUSETTS i I hereby certify that, upon examination of this document, duly submitted to mc, it appears that the provisions of the General .Laws relative to corporations have been complied with, and I hereby approve said articl s, and the filing fee having been paid, said articles are 1 deemed to have been tiled with me on: i J,�ne 26, 2013 06:21 PM i i WILLIAM FRANCIS GALVIN Secr.lui-v of the Commoniveulth i I i I 1 7 i ACC CERTIFICATE IGF LIABILITY INSURANCE ;�z$.2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF NFORMATION 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 CERXIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESEfIITATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIO AL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,ce0ain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of sUph endorsement(s). PRODUCER I CONTACT NAME. ACE INS SERVICES INC I PHONE FAX 675 WARREN AVE EMAIL BROCKTON,MA 02301 INSURER(S)AFFORDING COVERAGE NAIC R INSURER A:AMERICAN ZURICH INSURANCE COMPANY IIISURED ` INSURER 8 APC CONSTRUCTION INC } INSURER C 51 FORD STREET UNIT 1 I, BROCKTON,MA 02301 I INSURER D I INSURER E INSURER F CQYERAGES CERTIFICATE NUM SER* 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. I OTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEC T TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OES RIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RIM TYPE OF NISURANCE INSR slow y(ID ICY NUMBER POLICY Mmsh EFF Mm EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 1CtAIMS.MADF( OCCUR i MED EXP(Any nnc porson) I PERSONAL d ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE LIMIT APPLIES PER PRODUCTS•COMPK)P AUG S POLICY PRO- LOC I S 'ECT A OMOBILE LIABILITY OMBINEO SINGLE LIMIT S ANY AUTO BODILY INJURY(Per Pereon) S ALL SCHEDULED AUTOOS OWNED ULEO AUTOS I ROOILY INJURY(PMacadnnt) S HIRED AUTOS NON-OWNEDOPERTY AMAGF- S AUTOS S 6ACH OCCURRENCI= S CESS UAB CLAIMS,MADE AGGRI•'ATE S DED RETENTION S I $ WORKERS COMPENSATION X WC STA V. OIH- AND EMPLOYERS'LIABILITY TORY LIMI S ER ANY PROPRIETORIPARTNERIEXECUTFV�Y 7N E L. EACH ACCT ENT $1,000,000 OFFICFRIMFMRFR FXCI.1J LN NIA 6Z UB 10-22-2014 10-22-2015 (MAndatory n NH) 2E�52818A F 1 nISrASF.0 rMPI OYFF' $1,000,000 II yes,descnbe under E L DISEASI PUUCY LIMI I $1,000,000 DESCRIPTION OF OPERATIONS below DESCRMTIO}t OPOPEMfl0N8!LOCATIONS./.V�IILfAE4 tAgh�►CD 101,Additional Rslnerks>ichedl'b Ntnore specs is required) I CERTIFICATE HOLDER CANCELLATION AB CARNES ROOFING INC. ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 30 ARROWHEAD FARM ROAD CANCELLED BEFORE THE EXPIRATION DATE THEREOF, BOXFORD,MA 01921 I NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AtlrHORIZED REPRESENTATIVE f// 01988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD na4ne and logo are registered marks of ACORD i • MA SOC Filing Number: 201499735200 Date: 10/21/2014 1:24:00 PM The Commonwealth of Massachusetts Minimum Fee:$250.00 William Francis Galvin • + '� Secretary of the Commonwealth, Corporations Division Oneshburton Place. 17th floor ';; •` Boston. MA 02108-1512 Teiephone: (617) 727-9640 (alt pr�•,�� .o,` t��' ffi ►C�i 3' �77Ls7.� Federal Employer Identification Number: 001149988 (must be 9 digits) ARTICLE I The exact name of the corporation is: A P iC CONSTRUCTION, INC ARTICLE It Unless the articles of organization otherwise prvide, all corporations formed pursuant to G.L. C156D have the purpose of engaging in any lawful business. Please specify if you want a more limited purpose: CONSTRUCTION RE-MODELLING AZWI D OTHER OTHER SERVICES PERTAINING TO CONSTRU C1'ION WORK i ARTICLE NI i State the total number of shares and par value if any, of each class of stock that the corporation is authorized to issue. All corporations must authorize stock. Iflonly one class or series is authorized, it is not necessary to specify any particular designation. Par Value Per Sire Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Pair of Organization or Amendments and Outstanding Num n/Shores Tolal Par I'clue Num of Shure% CNP $0.00000 20,000 $0.00 0 G.L. C156D eliminates the concept of par value, however a corporation may specify par value in Article Ill. See G.L. C156D Seddon 6.21 and the comments thereto. i ARTICLE IV If more than one class of stock is authorized, s6te a distinguishing designation for each class. Prior to the issuance of any shares of a class, if shares of another clas�are outstanding, the Business Entity must provide a description of the preferences, voting powers,qualifications, and pecial or relative rights or privileges of that class and of each other class of which shares are outstanding and of e6ch series then established within any class. i ARTICLE V The restrictions, if any, imposed by the Articles;of Organization upon the transfer of shares of stock of any class are: i I ARTICLE VI r Other lawful provisions, and if there are no prooisions,this article may be left blank. Note: The preceding six (6) articles are considered to be permanent and may be changed only by filing appropriate articles of amendment. i ARTICLE VII The effective date of organization and time the rticles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective date s desired, specify such date,which may not be later than the 90th day after the articles are received for filing. Later Effective Date: Time: ARTICLE VIII The information contained in ArticlVIII is not a permanent part of the Articles of Organization. a,b. The street address of the initial registered office of the corporation in the commonwealth and the name of the initial registered agent at the regist red office: Name: ANGELO P1NGU L No. and Street: 51 FOR D STREE UNIT 1 City or Town: BROCKTOPN State: MA Zip: 02301 Country: USA c. The names and street addresses of the individuals who will serve as the initial directors, president, treasurer and secretary of the corporationan address need not be specified if the business address of the officer or director is the same as the princial office location): Title lndf fividual Name Address(no Po Box) First, fiddle,Last,Suffix Address.City or Town.State,Zip Code PRESIDENT AN ELO PINGUIL 51 FORD STREET I BROCKTON,MA 02301 USA TREASURER ANGELO PINGUIL 51 FORD STREET BROCKTON,MA 02301 USA SECRETARY ANLO PINGUIL 51 FORD STREET BROCKTON,MA 02301 USA DIRECTOR ANI IGELO PINGUIL 51 FORD STREET BROCKTON,MA 02301 USA d. The fiscal year end (i.e., tax year)of the corporation: December e. A brief description of the type of busine3s in which the corporation intends to engage: CONSTRUCTION AND RE-MODELLING f. The street address (post office boxes are knot acceptable)of the principal office of the corporation: No. and Street: 51 FORD STREi?�1' City or Town: BROCKTONState: MA Zip: 02301 Country: USA g. Street address where the records of thel corporation required to be kept in the Commonwealth are � I i located (post office boxes are not acceptable): No. and Street: 51 FORD STREET City or Town: BROCKTON State: MA Zip: 02301 Country: USA which is X its principal office i _ an office of its transfer agent an office of its secretary/assistant secret�ry _ its registered office Signed this 21 Day of October,2014 at 1426:45 PM by the incorporator(s). (I f an existing corporation is acting as irac'UYpOi'atOr, tt/�c�in t{rc exact r�untc a1'lhe business entih, the slate or other jurisdiction where it was incorporated. the nurse of the pers(In signing on behalf al'said business entity uncl the title her/slre- hol(Is or other uuthoriri_,hu which such ac ion is taken.) ANGELO PINGUIL I I I ©2001 -2014 Commonwealth of Massachusetts All Rights Reserved i I I J Ii 1 s I i ` MA SOC Filing Number: 201490735200 Date: 10/21/2014 1:24:00 PM I I I I THE COMMONWEALTH OF MASSACHUSETTS 1 hereby certify that, upon examin ition of this document, duly submitted to me, it appears that the provisions of the General �aws relative to corporations have been complied with, and I hereby approve said articles; and the filing fee having been paid, said articles are i deemed io have been filed with me on: O�tober 21, 2014 01:24 PM I i I WIL6AM FRANCIS GALVIN Sect•c clr��nJlhc� C���t1m�1r7��c+uUh I Proposal AB Carnes Roofing, Inc. 30 Arrowhead farm Rd Page 1 of Boxford, Ma. 01921 978.887-1431 MA.CS-000230 and HIC Reg. 176928 Proposal Submitted To: SCOTT& KIM DURGIN Date October 9, 2014 143 DUNCAN ST Project Name SAME NORTH ANDOVER, MA 01845 Address 978-683-4623 OR 978-273-9385 We propose to furnish material and labor-in accordance with the specifications below: Ten Thousand Four Hundred And Five Dollars($10,405.00) Payment to be made as follows: $300.00 Deposit, Balance Upon Completion Notice:All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from registration by provisions of Chapter 142A of the General Laws,must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Mass.gov/licenses website. ROOF PROPOSAL ® STRIP ROOF OF ALL LAYERS OF ASPHALT SHINGLES.COVER ROOF DECK WITH THE UPGRADED RHINOROOF HIGH PERFORMANCE WATERPROOF UNDERLAYMENT MEMBRANE.COVER EXTERIOR WALLS AND FOLIAGE WITH TARPS TO HELP PREVENT DAMAGE. ® ICE DAM PROTECTION:INSTALL CARLISLE HIGH PERFORMANCE ICE&WATER BARRIER OVER ALL HEATED ARE�,S SIX FEET WIDE AT THE LEADING EDGE OF ROOF AND THREE FEET IN ALL VALLEYS.WRAP THE CHIMNEY(S)AND SKYLIGHT CURBS UNDER THE FLASHINGS WITH SAME ® COVER ALL PERIMETERS WITH EIGHT INCH PREFORMED ALUMINUM DRIP EDGE. ® INSTALL GAF COBRA RIDGE VENT AND/OR❑ ROOF LOUVERS FOR ADDED ATTIC VENTILATION. ® COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS AND FLANGE. ❑ REPLACE WALL FLASHING(S)AS NEEDED WITH ALUMINUM OR LEAD AT THE ADDITIONAL COST OF PLFT.WE MAY NEED TO REMOVE THE SIDING TO PERFORM THIS WORK AND YOU MAY NEED TO HAVE A CARPENTER REINSTALL OR REPLACE THE SIDING THAT WAS REMOVED. ® CHIMNEY FLASHING:CUT ALL EXISTING TAR AND LEAD FROM ONE CHIMNEY(S).CUT NEW REGLET WITH CARBIDE SAW AND SECURE NEW LEAD FLASHING IN PLACE WITH METAL ANCHORS. PROPERLY SEAL REG LET�JoI'I`— P1-E ,ADD$500.00 TO ABOVE PRIC=. ® COVER ROOF SURFACE WITHCERTAINTEED LANDMARK ARCHITECTURAL LIFETIME WARkNTY 240LB SHINGLES. ® REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH CDX PLYWOOD AT WADDITJ.ONALCOST OF$4.JOPSQFT. ❑ COVER ROOF DECK WITH CDX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADD TIONAL COST OF ® NAILING: SECURE SHINGLES WITH 1 '/4'GALVANIZED ROOFING NAILS AS PER.CERTAINTEED SPECIFICATIONS. ❑ SKYLIGHTS:REPLACE EXISTING SKYLIGHTS WITH NEW VELUX UNITS.WE WILL PROVIDE THE SKYLIGHTS&FLASHING KITS AT OUR EXACT COST FROM OUR SUPPLIER.THERE IS NO LABOR CHARGE IF THEY ARE THE SAME SIZE.INTERIOR WORK IS EXCLUCE.D. ❑ REMOVE EXISTING GUTTERS ❑INSTALL NEW SEAMLESS.032 ALUMINUM GUTTERS USING THE HIDDEN ZIP SCREW HANGER SYSTEM. ® REPLACE ANY ROTTED TRIM BOARDS AS NEEDED WITH 30 YEAR PRIMED PINE,ADD$15.00 PER FOOT TO ABOVE PRICE. ❑ INSTALL NEW ALUMINUM DOWNSPOUTS AND MECHANICALLY FASTEN ALL CONNECTIONS, CLEAN ALL PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA. THE PROPERTY OWNER AUTHORIZES AB CARNES ROOFING TO OBTAIN ALL PERMITS.WE CANNOT ACCEPT RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS. CUSTOMER SHOULD COVER VALUABLES. GREAT CARE WILL BE USED TO PROTECT THE STRUCTURE AND FOLIAGE.HOWEVER,SOME MARRING AND OR MINOR DAMAGE COULD OCCUR. SPECIAL INSTRUCTIONS: THE ABOVE PROPOSAL INCLUDES ALL SHINGLED ROOF SECTIONS. SKYLIGHTS:THERE ARE NO ISSUES WITH THE SKYLIGHTS CUSTOMER ADVISED US TO LEAVE THEM. CHIMNEY FLASHING:THIS SHOULD BE DONE AS PROPOSED ABOVE OR LEAKS MAY OCCUR. WARRANTY UPGRADE:THE CERTAINTEED WIND WARRANTY WILL BE UPGRADED FROM 110 MPH TO 130 MPH WITH A UPGRADE TO THE CERTAINTEED HIGH PERFORMANCE HIP&RIDGE CAPS AND STARTER COURSE AT NO ADDITIONAL CHARGE.YES EMAIL ADDRESS: � no M �,, f\) .;. Warranty:All work warranted against installation defects for 5 years;this warranty is limited to the installed item(s)and its repair only.Material is warranted by the manufacturer against defects for 50 years;see the manufacturer's warranty for exact warranty performance. Cancellation:Customer has legal right under federal law to cancel this contract without penalty or obligation within three business days from the date of signing this agreement via Priority Mail Delivery Confirmation. Please see reverse side. Dispute Resolution under Massachusetts Home Improvement Law 142a:All parties agree that any and all disputes relating to this proposal shall be settled by arbitration.This forum is user friendly and does not require lawyers.Please see reverse side. Signing this Proposal means,you have accepted all the terms as stated on the front and back of this agreement. Please see reverse side. f *Date of Acceptance /v&V V 2-6 Signature_ J'- 6` Signature Signature * F yr PLEASE SEE REVERSE SIDE