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HomeMy WebLinkAboutBuilding Permit #139-11 - 27 PHILLIPS COMMON 8/18/2010 BUILDING PERMIT of "°pT" TOWN OF NORTH ANDOVER02 s`��•- • :'�6'6 ° APPLICATION FOR PLAN EXAMINATION '- �• �p e"e Permit N0: v _ Date Received �qATED �` SSS E� Date Issued: r q'd gcHus IMPORTANT:Applicant must complete all items on this page r•i:� ...g. ��..-pa f `��:aYl-3,`-•-- �yrl� y i �) ✓ �L`j-v�v;Arr�5. a F.r� i, •y' - - -- - - -ti' 1, .kF `ra+f R ! 1 { r I(rrf I 4 1'' I-�• K 1�"1- t: g...V 4. 00 1'7! i� ? t- 7 C.'' ;`,+ '�]]J F3 r4- c •;.. 0�-�-h��al,©� �Jo ?L;a�„.,'`au$>,,i.'^r..r s,�;e F'�e'��-I-.'•'.`•w,.-��rI'7aaT_1.::.`� rc.^ "I r4'7Lr ..5p''St ' fir?c�a'_3��'F'�FyT`.",`� :kai..L,}�.+a�' � �a•rti.vsis1�1<-pi��Try-�p`�a�._�Y�d{�;�-..k� =d^lL_ir��'r2•r='�'�5a''?K'�,.nv2.&��q:c-Yp_�`�:i�}.�. �fi"1r- ;;>k�aLF�Cr^r1..^��.r'`•�t.l'r`.r�4'f.aahqN,s-•r�MOM, a 81 ' !i. ^•r-'� r r 'N`-1,_+ , ki^,xz :s ..�..'��• .s..b = ,. _ c.:c?P .w;�� _r }�r � +- &�('s.1 -r' 3. !ems,,.- -� !>:-•+<, ..a• -.,, r p?� �s_.I�,td-;L �.i...'4�'�".vh'Hi--rc stl- ��t'fA^:� t Yc-y � �-f5°ay-S�'n zaa,. .N � �+., I,Ra ���_ ^�.�'*t �,d�'r-r ryt.: tS �""�i��`�, 3rm..�•°,• T��`�?„rrb,��'�?r,N,lf;��Flw:` 'rr�'�+�r d(r .� �K'.+^. v I. y�4-v Y w 45 ,�y� '��'�” ;tS�th.J� "� �`�rsJ"_'{�, r.l?n�.c.rt. i.Ly, �r.:.�•�I"3r °��'�.�; 1� 'T:.-`moi. i?'r'�nS1�SF" �F..c-!-`rq"`I'�S' 'r�...p� z'TS,.� s ,y�.ri.,�v`fc'�,� �3r�1�, �"1::;.� k'SINd -r��. �f3•;�`` ,m"lr �/}}''s'���� fihS r.y y„�[`� rr��'fir- h"T *�`1� 3�t �''S'� � xr° 4 ^-a �Y✓'` l L C `� + � e I f � s ro- I +z .1 .yL� �'-tm e i,-g-61 �-� y� w.�rr'•+e-, x e � �."�. !DJ"1�7 ��`l�TI,CT '9 it'��s�a'nt� �s�z`i��-��.; -�a u._ � r.. -k4�...>n i. �;; �;��"'��y,L4 s`i�� mr y - -rrh��rw•�a+.. r s tr r rc �t,,. tr ti-"lh x 1 1 r^�w a ..� ,,� ' ����-�; x'taJ, � y�,y,�r�,��rr C .•ys �.e;..vf:^,z��sn"W.�e,�Pr�u � *'"-t's-.x�i=�'. ;.�. ,i` ���5_....�y„���.� .s,• zS.a, x,�"�Js''�lJ..r ,pia ir"'�,-,. �•-.ut7•N� a.lt' v �f�^v�,��.r��t-',u7 '+. i 7+ 4 4 ..r�-L�r��S c�''n'-y�`�.�- -a�.5`-'ur"r�.•al � I .a k F '�• ��-f,��s�, .e-,L� 1yf„r Id,�y 7 - r ._.,,.,I.��r .. �'r,',.•:',..�• {� �laC�]lil� n,��.��la,g � , 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 ^� �`�'Ty��a�+yi�x,� 7 1 a��.v�...r..�su wriya�`nr���`,•��'r`i�'IL t, W. �'""�' ��^r�-� i%�.W {�l4,�, " -:r�� ae+l�.*� s -'f�4% '4i,�yr".�r•'a a � r 'v a .n;3d'-rcm-.:'.F LI' +t ,tom .z2-N..Tti; e�='•.'�,s. s�v �� {s"„, sem. .xk-•'f�•'x�3�1��;?'”,r.u_'��`�x��:_p P......"' '�' -�' $ -�ft'� 1 '� at,w, Y'i�,: '�'"rPri u�,�s3 r.�rc:�'.R •„;��r�3�El' �, s r r,�,t. �, �` i�' ;� �'_�-,�"?y•,+€.syc� yam& ��'�,�'�xr�.- '�z� [=��n!`n a -- a, ..•......,.__.,._..._ &L.}4:-_.=�`FM:nt fi.,��. •e rr,.,..c7.rte.i!S.�i .��r+.yrL.y _._:. .'tn4 1�'W�� _ a"���n� p�M'�)�'F�J�c.a,� K•T �-,:1.'..7� .-.. _...• rl':•-~<r-�`.^r,_M i v. .r�K M'y;4�7.-ra,���==°!:�.d "'" �� 5_'-�_:i DESCRI TION OF WORK TO BE PREFO ~ED: Identifi ation Please Type qr Print Clearly) OWNER: Name:_ rPhone: Address: i 4"'w 'R 5� Y ?:f<IN- n=om,MOM Hf e-x��tt' s...f�! k ,r-r ��' � .. 1 ti ,R16 `�'- -`-�ttr ` .¢ iL,f�i r�-n`c`� �k'�.; * s_ ,+-_/gym,. ,A;rr �t -.+,:trpt--yam^a. :3 /4,n ue,.,r � RIM,"„1Z'n •-`�' Yr ,ter.-�.,,ry �-ur- r r .Ff;t.` _ •+s. � `� J�J Iii .'N-rw `�I ifi•. m,.. f 2,s c i_ '34 -,.F.ti_r 1-b�i F h '7' -• r',',r`4' k It-� �, , i••� t,�^f�l -�r��'a '^.�i•�r }"'”r a'e +'� WTIm a:� �-'".ham' r r� r � . �� rot�T r � �E i ��,�' ,.x- ri',y7.. �. '� �� ham.Y����`'���, �'i �-•r.��'�'r4Efi'„�.M..X^r".t"'`�`�' � �I __�s� d � �?C '?� � y. � '�. y, y r i„�� < ... �.. a.•� $ '�/�-+ � � x. s ��x1N fish ,r ,y tsJ ' i,�� � �°-r"4 -'S,u.�.G",y`( r�;- 7 Ir"°..m.�.ey r �����•s,,.. � +.k _alp--� 1 �''�'-,_ � ..f1��, c� �e•pi / -.c��.'k'-. u f 7t ��r�.`...�"�`4�'9rr `sl'L,ak,, ly�'•x,my�•�k,F ��* �r �c`F4 ?4,L't.+i�,J +„ 7 1r y���rsl'��3c-d'.-3a'-�v�'�'rr:�r- /y- r Z c .r� € � � a'I:1'�w7 `�= c al" i4,d- �, ..,` r1,'�C.a .�• 3- r s'tiR�.'y' r^"' �.:w• L y�'^,'`�"f�`�- 7°i',•;1 y, its .4C .3-i.- �p 7 y�'4f+ '.7z1.�r.-,. T"'111 A7�.�+�r��'- •JS�' h i .! .a -tc� '7- La{ '� y '�7;y^. fi „c1_tif:'" ';�.JF'b-h4 <y 1, -` {'p= �. ��a #% tL• ��='��-tri..{� a�=-''�z'..•''ski`'`y�'����: �-�?i�„;r. e �"k_ '3"a w-i .,�l'.,��.C����;x;> �.v;�,.,��lr 'u�.r '.` ;:rr-'''°1",'^71 � .r ifs .J L;,���.k.fi ;rw�ac�'t +r�.��YLr•ry:::J.l... Yi2.Vl='�C x•Y� �fisaa4../`y.4. r *�,�, � .e��aF _ .v..-:5r�:'->`L'"�•;+,^' -vra. 7 ue4 s!'�, r�� ���p�`'`r,,'J��u •r,�.��,F?�r c' y.,�Y = Ylw"�`��r r P]ert�rR�,y..a.f'.�'�-L..�-tT��<k�s�'r'�ri,J� tr �,tf,.{*�c:=`s� '•s3?7��'1, k=."�.�"�ti�:,--..,�2t`J. r .t �srift�Y�tr_ yn•�4ijius=��.v�j`F�I}ryt',.E-� ^�%A '�; � �'s4 �}.esr L^�avy,rYi�"F����,'��Sr�Ir.�4:thy.�5$-f�a Tyx .i'-�'� r. _- ..,Ta ����i%1�"•I•�`��'r'% ;�� ���g5141 bp�r��..�r.`�S�r� i �/ny� �w�p d�- �� �, -lfi�lr r I�,f:� !lr�sz. ,.�-t..._-i hti -r.n� ,��.,F•a t �.a ��' �..-r. ,c3�� 4t i _-•i..}+ .-..-5,:. � �1f7G�%7.G 1"r 1 'f"rt at.Y.:.I.a...1._._A'�. M. .ELL�= rp�`)'k.,-"�t�cw�+ �C��. ��.J Y` 7 -. �r �}3'e�-•].-�'/a�JR . 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 Cost: $ FEE: $ Check No.: c��'� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have to th guaranty fund Si riaturE�of�A�nt/Oan -ernes g v Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Swimmin Pools Tanning/Massage/Body Art g n F 1 Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Siariature I�0IVI1VIE_NT0 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments i Conservation Decision: Comments Water $ Sewer Connection/Sisnature Date Driveway Permit 1 DPW Town Engineer: Signature: 4 Located 384 Os ood Street = a�R EjPAT1f1E#IT51 f erp'Drpstr� �tir ye 'tin w{ Brio , 24-1. 0 t ,�F�reDeparenfsIn� reldate` � u5 f a t s J � C01lI ' 'T.S - yi- 'r h Dimension Number of Stories: Totals square are feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ' ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No - DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) � I ❑ Notified for pickup - Date i Doc.Building Permit Revised 2010 1 I Building Department j i The following is'a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits i ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or..Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ IVI "'ass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit --_New Construction (Single and Two Family) ❑ Building Permit Application ❑ CerfifieU Proposed Plot Plan. o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract E3 Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Regi"of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2008 Location073— ���f —d/'my� No. �. Date MORTq TOWN OF NORTH ANDOVER F .. A + Certificate of Occupancy $ �SS�CHusEt Building/Frame Permit Fee $ n Y Foundation Permit Fee $ ` Other Permit Fee TOTAL $ Check # 233 ; Building Inspector F ORTH 014M OfAndover `� O ;� ti:`,. 1 ;:.,,. 0 INTO. 13 Q _= LAKE O lover, Mass., COCKICMEWICK y�. !,9 AQRATED APS, C2 sum SS BOARD OF HEALTH -Food/Kitchen Septic System iat: RMIT T D C.6491. BUILDING INSPECTOR THIS CERTIFIES THAT rr...:.:..... ... . ............. . ................. ................................................. Foundation has permission to erect........................................ buildings on l��..:.sf. ......... ..... .�.. .. ...... :...::.....:..... Rough to be occupied as........ Mey ............. Chimney . .. . . . ... . .. . . . . . . .. . . .. . . ..................................... provided that the pers M&�� n this permit shall in every respect conform to terms of the application on file in Final 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 Finai d PERMIT EXPIRES IN 6 MONTHS UNLESS CONS U STARTS ELECTRICAL INSPECTOR Rough ...................... Service 13 LD ECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. Massachusetts Rome Impl"ovement Sample Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice If necessary. Any person planning home improvements should first obtain a copy of"a Massachusetts consumer guide to home improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer htforruation Hotline at 617-973-8767 or 1=888-283-3757. Homeowner Information Contractor Information Name- / n I omp,tny Name �+V`C Street_Address(do t Ise a VipfOffice Box address) Contractor/Salesperson/Ownr Name �7t6t S0/�IIVYIVf'1 �1 (L l �E' Cityfrown State Mode usiness Ad ess(must include a street d ess), a 6 Da ime Phone Evening Phone ityf wn State Zip Code Mailing Address(!t different from Tb Business Phone ederal Employer 1D or S.S.Number Law requirer Wal matt home lin- Homer vement Commetur ret.Number Gxp¢ation date -- pruv hent coutraerors have a I olid¢gist-d.. =t— The Contractor agrees to do the following work for the Homeo ner: ` (? 3 / eftne m7tnlg��Mpe r ,nuu/ n s o Required,Permits-The following building permits are required Proposed Start and Completion Sche ule-The foll wing schedule will and will be secured by the contractor as the homeowner's agent, be adhered to unless circumstances beyond e th contractoYs.con Y trot apse (Owners who secure their own permits will be excluded from.the Guaranty Fund provisions of — Date when contractor will begin contracted work. MGL chapter 142A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of («) Payments will be made according to the following schedule: E 3� l upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) �u v by __ _/�/_ or upon compledowof So?l b l ��.,,jj y ___ or.upon completion of $ �Uy �llll . upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special S to be paid for ordered before the contracted work-begins in order $ to be paid for to meet the completion schedule.(**) NOTES:(+)Including all finance charges(•+)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranh.is an express warranty beine provided by the contractor? No Yes (all terms of the marranty most r Subcontractors Tht•>ontrector agrees to be solely responsible for completion of the work described regardless of the actions of any third e party(subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this aarcPment _ Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract • Don't be pressured into signing the contract Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the cgnttaGulr has a Valid Hgmc r rn� P tractor R eeiatreHsrThe law acquires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by;writing to the Director at One Ashburton Place,Room 1301,Boston,MA 02108 or by calling 617-727-3200 or 1-800-223-0933. • Does the contractor have insurance? Check to see that your contractor is properly insured. • Know your rights and responsibilities. Read the Important information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a plass other than the contractor's.normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following.the signing of this agreement See the attachecl notice of cancellation form for an explanation of this right- DO ightDO NOT SIGN THIS CONTRACT IF TIFCERE ARE ANY BLANK SPACESHI Two identicat copies of the contract must a completed and signed Qne copy should go to ho wner. The other copy should be kept by the connector. 2 Homeowner's Signature 4Dat oe's Si nature a LVDate I ~ i CERTIFICATE OF LIABILITY INSURANCE 8116/2010DnYYY' 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 Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Circle Business Insurance Agency Inc HONK Ed. 978-777-5619 FA,No):978-777-4898 247 Newbury St. ADDRESSpaulahalas@circleinsurance.net Danvers, MA 01923 PRODUCER 1781639 CUSTOMER ID9: INSURER(S) AFFORDING COVERAGE NAIC S INSURED Eric Teel INSURER A: Atlantic Casualty 33 Hammond Street INSURER B: Travelers Insurance Co. Rowley, MA 01969 INSURER C: continental Indemnity Company INSURER D: MAX SPECIALTY INSURANCE 978-479-7420-CELL 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MWDD/YYY MIDD/YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA A13t' U X COMMERCIAL GENERAL LIABILITY PREMISES=nence) $ 50,000 (CLAIMS-MADE CI OCCUR MED EXP(Any oneperson) $ 5,000 A CLS1448853 12/20/09 12/20/10 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY FX] PROJEC- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ 1,000,000 ALLOWNED AUTOS BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ B X SCHEDULED AUTOS BA-8744N206 09/10/09 09/10/10 PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ $ 'UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 F�CCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 D X DEDUCTIBLE MAX012401000554 2/12/09 12/12/10 $ RETENTION $ 5,000 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS X ER C ANYPROPRIETORIPARTNERIEXECUTIVE NIA 46-819686 11/19/09 11/19/10 E.L.EACH ACCIDENT $ 500,000 OFFIC(MandatoryERIMEMin NH)BER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 Ifyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if morespace is required) CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 146-MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATI ©1988-2009 ACORD CORPORATION.All rights reserved. ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD v ME r iNlassachusetts- Department of Public Safete Board of Buiidin-Regulations and Standards Construction Supervisor Specialty License License: CS SL 99509 Restricted to. RF ERIC TEEL 33 HAMMOND STREET ROWLEY, MA 01969 IL �-�- -�'- .Expiration: 623/2011 ( nanixbnrr Tr#: 99509 s r Illi Office of Consumer Affairs and usiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement, Registration - RenktraWn: 150452 `> Type: DBA ERICA Expiration: 4/312012 Trd 293914 TEEL _- ERIC TEEL - -- PO BOX 46 ROWLLEY, MA 01969 f' Update Address and return card.Mark reason for change. 0 SM&0404-101216 n Address C] Renewal EmPloyment ❑ Lost Card i i i I ERIC A. TEEL ROOFING Commercial and Residential • Fully Insured 978-479-7420 ROOFING ESTIMATE ESTIMATE SUBMITTED TO: _ JOB NAME JOB# ADDRESS JOB LOCATION CITY/STATE/ZIP DATE li PHONE# FAX# CELL# W — 660 1.-z L r WE HEREBY AGREE TO SUPPLY THE MATERIALS AND LABOR AS SPECIFIED IN THE MARKED BOXES BEII ... I ' NOTE:ONLY THE MARKED BOXES/PERTAIN TO YOUR ESTIMATE. it WE AGREE TO: 1 1. COMPLETELY STRIP THE ENTIRE ROOF(S) OF THE EXISTING LA ERS OF SHINGLES. I ❑ 2. INSTALL A NEW LAYER OF SHINGLES OVER THE EXISTING ONE LAYER OF SHINGLES ON ROOFS. i� �� ❑ 3. INSTALL A NEW RUBBER ROOF(S), USING ALL NEW RUBBER ROOFING MATERIALS ON THE e ' 4. INSTALL NEW ICE&WATER SHIELD ON C� ROOF(S), III ROOFS EDGE,RAKES,VALLEYS,DORMERS,SKYLIGHTS,CHIMNEYS,&FLAT ROOF AREAS. S. INSTALL NEW LB.ISPHALT FELT ROOFING PAPER ON THE ENTIRE ROOF OF THE j 6. INSTALL NEW 8 INCH ALUMINUM DRIP EDGE ON THE ENTIRE ROOF(S). ❑ 7. INSTALL NEW ALUMINUM STEP FLASHING ON ROOF(S). 1, 8 INSTALL NEW(VENT PIPE BOOTS)ON ROOF(S). ❑ 9. INSTALL NEW(ROOF BOX VENTS)ON ROOF(S). NOTE: (IF)MORE LAYERS OF ROOFING MATERIALS ARE FOUND THAN INDICATED ABOVE,AN EXTRA CHARGE WILL BE ADDED FOR THE LABOR&THE REMOVAL OF DEBRIS OVER AND ABOVE THE PRICE OF THE ESTIMAT . We propose hereby to furnish material and labor—complete in accordance with the abov ifications for the sum of: $ �.a. Dollars 99 with payments to be made as follows: Any alteration or deviation from the above specifications involving extra costs Respectfully will be executed only upon written order,and will become an extra charge over submitted and above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our control. Note—this proposal may a withdrawn by us if not accepted within days 2cceptattce of Proposal The above prices,specifications and conditions are satisfactory and are hereby Signature accepted.You are authorized to do the work as specified.Payments will be made as outlined above. &/v Date of Acceptance Signatu e i