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HomeMy WebLinkAboutBuilding Permit #588 - 287 CHICKERING ROAD 3/4/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION' - -� C..1w(- ki-A Print PROPERTY OWNER S�I-e+p�� � Y A-e SS %* h A Print 100 Year Old Structure yesFno I, MAP NO: PARCEIi�ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building &Zne family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial 17Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District El Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 4 P7A we Lo V�2°1�t� � Lt3 i'►'� � �t �s Identification Please ype or Print Clearly) OWNER: Name: „ ,� ���; A& Phone: s Address: U16-- CONTRACTOR 16_CONTRACTOR Name: T A—e, Cs' �"+'� T > S✓lC Phone: q Z Z 6. 0 Address: 2 i _ 4 tS _ L cin C ciS+C Supervisor's Construction License: �aS r Exp. Date: ?,6 13 Home Improvement License: 1 D S�3 Exp. Date: t 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. e7 14. I / Total Project Cost: $ FEE: $Tjp�r� Check No.: Receipt No.: oZ NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own& Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan 0 Stamped Plans ❑ Location aO7 Cl-h L L Gt I sof � . No. Date r L • ' TOWN OF NORTH ANDOVER 1446` • a r e ' . Certificate of Occupancy $ ` Building/Frame Permit Fee $��- +- � - Foundation Permit Fee $ Other Permit Fee $ � ,r TOTAL $ Check# 14,1�01B 26186 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS F . , OR OFFICE USE.ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ d ❑ COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS i HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit Ilk DPW lbw- Engineer: SigAtfilre: --` Located 384 Osgqod_Street, FIRE DEPART M SVT -remp'Dumpsteron site yes no Located at124 Main Street . Fire Department signature/date COMMENTS Dimension Number of Stories: Total square 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 Q Notified for pickup - Date F Doe.Building Permit Revised 2010 i Building Department 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 ❑ 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) ❑ Mass 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 ❑ Certified Proposed Plot Plan ❑ 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 ❑ 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 app: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;4ted with the building application Doc: Doc.Building Permit Revised 2012 AC40REP CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 11/29/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS I 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. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sarah Brussard NAME: Cross Insurance-Peabody PHONE (978)532-5445 FA (978)532-2217 x IA A/C No: 139 L . nfield Street E-MAIL ADDREss:sbrussard@crossagency.com "t INSURERS AFFORDING COVERAGE NAIC# Peabody MA 01960 INSURER Merchants Ins Group INSURED INSURER B:Commerce & Industry Ins Co +TNR Gutters, Inc. INSURER C: 38-40 Lancaster Street i INSURERD: i INSURER E: 1 Haverhill MA 01830 INSURER F: COVERAGES CERTIFICATE NUMBER:CL12101073428 REVISION NUMBER: i 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 INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ i CLAIMS-MADE D OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- [__1LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED CA701513A 6/21/2012 6/21/2013 BODILY INPer accident $ AUTOS AUTOS ( ) `� HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident $ PIP-Basic $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ a� WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/NTORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) C009774192 9/20/2012 9/20/2013 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 j i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Refer to policy for exclusionary endorsements and special provisions. CERTIFICATE HOLDER CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Insured Purpose . I AUTHORIZED REPRESENTATIVE 1 Timothy Tramonte/2ID1 `,..f.�>'Yo. ° ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. )61Bf92-1argmnnsim Tho APnDn..-.. r�. a a a. __�,_-9 nnnon The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/Zia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly -Name(Business/Organization/Individual): h , Cc-, I�-P_r S 7L 14 G , Address: ' Lt City/State/Zip: r ALW k ,,� y� Phone ►re you an employer?Check the appropriate box: Type of project(required): 17I am a employer with 4. ❑ I am a general contractor and I 6 employees(full and/or part-time).* have hired the sub-contractors El New construction El am a sole proprietor or partner- listed on the attached sheet.t ? E]Remodeling ship and have no employees These sub-contractors have 8. []Demolition working for me in any capacity. workers'comp.insurance. g, [—]Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions ❑ I am a homeowner doing all work right of exemption per MGL 1111 Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]i employees.[No workers' comp.insurance required.] 13.[:]Other iy applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. )meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ntractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. w an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site grmation. urance Company Name: VV1 ct-+_L icy#or Self-ins.Lid.#: W C. ( 7 .(,i l 2 Expiration Date: 4Tz 2 (> �� G�� 4 Site Address: �_ ��L1.�P t..•� t� City/State/Zip:_ �. (�1't�bt-''l�# ach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). lure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 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 tp to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of astigations of the DIA for insurance coverage verification. 0 hereby certio under the pains and penalties of perjury that the information provided above is true and correct. iature: tr Date: 3[ U 1241.3 ne 2 3? 2 L/ ?fficial use only. Do not write in this area,to be completer)by city or town official. Aty or Town: PermitUcense# , ssuing Authority(circle one): .Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Other '.nnfarf PPrenn• PhnnA#� Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant . that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each Year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, Tease do not hesitate to give us a call. he Department's address,telephone and fax number: The Commonwealth of Massachusetts Depadmeut of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 021.11 Tel.#617-727.4900 ext 406 or 1.877-MASSAFE Fax V 617_7'77_7749 GUTTERS INC. HIC#108503 Al[Types of.Hone.Improvement www,jgutters.com CLIS#50515 38-40 Lancaster Street•Haverhill,MA 01830 Haverhill,MA: (978)372-4088 Nashua,NH: (603)595-2272 Andover,MA: (978)475-3723 Portsmouth,NH: 603 433-1811 Woburn,MA: (781)937-4212 Manchester,NH: (603)666-5502 i Natick,MA: (508)653-2200 Dover,NH: (603)740-3099 Boston,MA: (617)423-3559 Rochester,NH Lakes Region: (603)335-0068 i Toil Free Nationwide:(800)966-9238 Fax:(978)372-0360 PROPOSAL SUBMITTED TO PHONE DATE stcpkfmic ktossina 978- 1 17 21113 STREET 615 Mass Avcnue JOB NAME RWofkoplaceinGait Al ,1 'ri s_- ,r, ! 7 f lir •4.. . 3 a �p r _ 4y�__ _ CITY,STATE and ZIP CODE JOB LOCATION E FxiYnse hereby to furnish material and labor-complete in accordance with specifications below, for the sum of: u e , 1 a n _ M? dollars($ Payment to be made as follows:_ 4 L s tirr t� - llklVF iasa bT ara r s>t's ku V Iqlailud (Owrmf s wto secure ttmhrrnr portnift w.,41111 excluded from the Guaranty Fund provisions of W*L chaptar 142A.) Authorized t Note:this proposal may be Signature i withdrawn by us if not accepted within ---— days. ;scope of work We hereby submit specifications and estimates for: Tarp and crwer all areas at work area to help protect against damages caused by striping. o Remove existing roofing system dawn to roof deck and dispose of in a legal fashion. Check existing sheathing and replace and ronail as necessary. Install 2 rows of Ice and Water Shield along bottom,T along rakes, 3' in valleys and a minimum of 12" up all adjoining walls. Install new step flashingg at all roof transitions. Install 9" white aluminum drip edge to all ektorlor edges,then apply s" strip of lce and E water shield over exposed edge of.drlp edge. • Install 3' ice and water shield arourid all existing roof penetrations. Install neve pipe flanges around all existing soil pipes. Install 115#felt paper to remaining roof surface, • Install new GAF Timberline Lifatime architttic ral shingles or Certalnteed Lifetime arcli tect€iral shingles to roof surfa p nailing in a hurricane nailing pattern. • Check ridge vent for proper ventilation and cut as nCCO55dry, & install a`'! €;er, shingle ridge vent. 4 J--n-fit Gutters can't be held responsible for debris and or dust in your attic. We recommend removal and or covering any valuables. 0 Clean job site on a daily basis and run magnet around entire house to minimize nails left behind from roof removal. • Additional cost or install 3 rows of Ide&water shield would be$425.44. Additional cost to install ice S water shield over entire roof surface would be g1,M-00. • Additionaal cost to replace any rottreq sl acing would be at a cost of$2,95 per quare foot • Additional cosrt for GAFwarranty or Certainteed a Star Surestart Ptus coverage would be $ .4O(can only be aficred by certified master elite GAF Contractors or certified Cerintd contractors). Additional cost to install now lead and re point chimney would be$1125.40.(needed) r Do not sign this contract �>rClt�Tf�CCI'CirE,-of VX_,LT�iITSCCi The prices,specifications and 9 conditions.listed above and on the back of this form are satisfactory and are if there are any blank spaces: hereby accepted. You are authorized to do the work as specified.Payment will be made as-outlined above. Three day cancellation rights under section forty-eight of chapter ninety three,sec- �L tion fourteen of chapter two hundred and fifty five,D or section ten of chapter one Signature hundred and forty D as maybe applicable. Date of Acceptance: Signature i oaf$ w_ 711 v Hlc#108503 All Types of Home Improvement WW.W,t utters.cv>n f LS'8051-538-40 Lancaster Street•Haverhill,MA 01830 g f Haverhill,MA: (978)372-4088 Nashua,NH: (603)595-2272 I Andover,MA: (978)475-3723 Portsmouth,NH: (603)433-1811 Woburn,MA: (781)937-4212 Manchester,NH: (603)666-5502 Natick,MA: (508)653-2200 Dover,NH: (603)740-3099 i Boston,MA: (617)423-3559 Rochester,NH Lakes Region: (603)335-0068 1 ; Toll Free Nationwide:(800)966-9238 Fax:(978)372-0360 i PROPOSAL SUBMITTED TO PHONE DATE tcpharlic 979- 1 17 2013 STREET 46 INT.ass Awnuc JOB NAME'Siding RcphiCCment WIT �•. CITY,STATE and ZIP CODE JOB LOCATION 3WMC jUhrV)TIIB.e hereby to furnish material and labor-complete in accordance with specifications below, for the sum of: n .-g : -dn-d Tvvepty Senicy .__ _,t, - _'}q a dollars($ i 9)? 1 ' ). Payment to be made as follows: rx '€ .424 4 sill$ She 2612E+ l4 buildingt vju f w,,•uv-i uai ( 't i tw.. % 6Y d'tili Y i! be excluded from the Guaranty fund provisions of ly#GL chapter 142A.) Authorized Note:this proposal may be / Signature _i g � withdrawn by us if not accepted within days. We hereby submit specifications and estimates for: I ! Remove old siding and dispose of in a legal fashion. 21 Install green guard house wrap and'tape seams. 3) Insfall ice and water shield at all inside and outside corners. 4) Install Carvedood vinyl siding by Masfic wood grain of sn tooth satin ponel. 5) We will use regular "J around the windows and doors. i bj Cover all soffit areas on top and lower sections with vinyl soffit. 'j Custom-bend rakes and `ascia with white aluminum. 8) Clean and rake areas in a professional manner. 9) We give a one-year warranty on.workmanship and a liflatime warranty ori ' .Materials fron-r the manufacturer. turer. I j. ****ADDITIONAL CHARGE TO REPLACE ANY ROTTED SHEATHING WOULD BE AT A COST OF$2.95 PER SOFT AND ROTTED FRAMING MEMBERS WOULD BE$12.25 PER BOARD FOOT. AND LABOR RAVE FOR MSC=ELANEOUS REPAIRS WOULD BE$0.50 PER VV41AN HOUR PLUS MATERIALS. We carry $2 million dollars liability insurance in addifion to worktra�' compensation. i l; n this contract s � ��T CCt�CkTCE o£.�XO�tLT$?xC - The prices,specifications and Do no conditions listed"above and on the back of this form are satisfactory.and are if there are any blank spaces:. 1' hereby accepted. You are authorized to do the work as specified.Payment will. be made as outlined above. Three day cancellation rights under section forty-eight of chapter ninety three,sec- � tion fourteen of chapter two hundred and fifty five,D or section ten of chapter one Signature hundred and forty D as may be applicable. l Date of Acceptance: Signature �t it UTTERS INC. HIc#'J08503 All Types of Home improvement Cl #8051,5 38-40 Lancaster Street•Haverhill,MA 01"830 www•jnrgtitters.com ` I` Haverhill,MA: 978 ( )372-4088 Nashua,NH: (603)'595-2272 Andover,MA: 978 475-3723 Portsmouth NH: 603 433-1811 Woburn MA: I (781)937-4212 Manchester,NH: (603)666-5502 1, Natick,MA: (508)653-2200 Dover,NH: (603)740-3099 Boston,MA: (617)423-3559 Rochester,NH Lakes Region: (603)335-0068 Toll Free Nationwide:(800)966-9238 Fax:(978)372-0360 ' PROPOSAL +♦SUBMITTED TO `- PHONE 9 DATE ! f 1-3 STREET 615 N-Lass Avcnue— JOB NAME iVlililU►� i c li:3`•+:i11S llt kT _rAJA S Z _ t sr CITY,STATE and ZIP CODE JOB LOCATION - - C jJrVPV5-' hereby to furnish material and labor-complete in accordance with specifications below, for the sum of: .' x>,� v i 1 ?6 dollars($ 15�, )- -. -.-. ... F ... ....�.. ,. �... t Payment to be made as follows: s u s�. ,.4staitat�- r i c r r �r ''-¢ txz ries °��u.ti neo sc�ti.rxc�l i V ftners who v.4TV 7f f S.Mt Rl .. w-1111 R excluded from the Guaranty Fund provisions of MGL ciuiipter 142A.) Authorized Note:this proposal may be Signature withdrawn by us if not accepted within �_days. We hereby submit specifications and estimates for: -n-f; Cutters purpose is to install 20 double Hung, 1 casement, 1 pictuie and 5 basement hopper vinyl windows in the tollowing manner: I- Remove ofd windows and storms in a neat and professional mannet. 2. Replace any rotted woad at additional cost, 3. Fill all window cavities with insulation to prevent any draft& and beat loss. 4. Friar to installing the new windowvs, J-n-R will seal edges around window casing- 5. Whenever renioviing the old woad around the window, we reit ISl=_all ll-1e wood unless it breaks, then we replace it with new wood at additional cost to the customer. 6. When we remo=ve the old wood the-customer may have;, 3o louch up lite vvos:d with paint or strain. i. Upon completion of insialling neer windows, J-n-R will then insulsatr: Larry spaces prior to replacing trim around window. 8. Upon completion and payment in Kill, cafl"woitkni anship is to be warr;ar Tied tor: l year. 9. All jobs are to be done in a professional and courteous manner. II Pcriept art of 19-raposal - The prices,specifications and Do not sign this contract i conditions"listed above and on the back of this form are satisfactory and are if there are any blank spaces: hereby accepted. You are authorized to do the work as specified.Payment will be made as outlined above. Three day cancellation rights under section forty-eight of chapter ninety three,sec- tion fourteen of chapter two hundred and fifty five,D or section ten of chapter one Signature _ hundred and forty-D as may be applicable. Date of Acceptance: Signature Massachusetts- Department of Public 5,afet�) _ Board of Building; Regulations and Standards Construction Supervisor License License: CS 80515 KEVIN M FRANCIS 35 WANNALANCET RD HAVERHILL, MA 01830 { Expiration: 7/21/2013 C'uiiimissioucr Tr#: 16840 .----. -_--. ✓lie -C�a.axmantuea� o��iYl,�anac�utJe�d } office of Consumer Affairs&Bdsiness Regulation HOME IMPROVEMENT CONTRACTOf2 Registration: M1 1,08503' Type: Expiration 9/2014 Private CorporAtic{ J GUTTERS, '- l.rf _ w Jonathon Raymond - � `'j • 38-40 LANCASTER\S { yC f•J gati��.����.Tp j�,. } HaverhiII..MA,01830 ti --- Undersecretary 1+ f y 1 , tl ® DATE(MM/DD/YYYY) ACOR® CERTIFICATE OF LIABILITY INSURANCE ik , _ 12/1/2012 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. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 978-374-2500 866-494-4513 NAME CONTACT Daniel J. Seaman Daniel J. Seaman HONE EAI:978-374-2500 A c N,):866-494-4513 229 Primrose Street ADDRESS:dan@seamaninsurance.com PRODUCER CUSTOMER ID#: Haverhill MA 01830 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Atlantic Casualty JNR Gutters Inc INSURERB:The Hartford 38-40 Lancaster Street INSURER C: Haverhill, MA 01830 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR r07/20/2012 POLICY EXP LIMITS LTR INS WVD POLICY NUMBER MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $1000000 DAMAGE TO A V( COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $50000 CLAIMS-MADE � OCCUR MED EXP(Any one person) $5000 L18507 07/20/2013 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $2000000 �GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN N I ER ANY PROPRIETOR/PARTNER/EXECUTIVE F_ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Business Property Equiptment Leased or Rented from Others I 08MS HE3720 17/20/2012 07/20/2013 Limit $275,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Siding, Gutters, Roofing, Windows and General Repair CERTIFICATE HOLDER and Additional Insured CANCELLATION Barer Please be advised the above policies are in Full Force SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE and Effect. Policies have been aid in full. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE � s ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD NORTH Own Of 2 . 1 E ndover No. hver, Mass, A- COCNIc"aws" y�. 7a p�aArED 7S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System I_ THIS CERTIFIES THAT �L�.. '4 !?^-4r........l.►l:>� . !!� .......................................... BUILDING INSPECTOR ............. ...... ....... + Foundation has permission to erect ........................... buildings on ....t .....Ctiit.len..eA.j.!,-�......AU............ - Rough nn,�,, 1 . to be occupied as ..4�. .. ..1' - 0....... ... .1�[( .g...�.... .�:...! I!ada :=..... 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 Q PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST RTS 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. SEE REVERSE SIDE ttORTH own Of soh ver, Mass, comic«ewicw �1' p�RATIE to) S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System I- ,nn BUILDING INSPECTOR THISCERTIFIES THAT ............. . ...... . !'!:�. ........ .......................................... c has permission to erect ................ buildings on c`�•. �:N:L�C,�.4.P/.t,�1.!�-� Foundation ........... ., ... .... .....�............ Rough to be occupied as ..4.. &a...6?Q.d0ArX....... 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 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS 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. SEE REVERSE SIDE