HomeMy WebLinkAboutBuilding Permit #930-15 - 296 BERRY STREET 5/15/2015Permit NO: �
Date Issued:
I -r- TOWN OF NORTH ANDOVER
APPI ICATION FOR PLAN EXAMINATION
-IWORTANT:)
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Date Received
must comi)lete all items on this
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MAP NO: /OS/ PARCEL: V-3 ZONING DISTRICT;
Mstoric District yes
Machin * e Shop Village yes
10 0 year-old structure yes
TYPE OF IMPROVEMENT
PROPOSEDUSE
Residential
Non- Residential
D New Building
D90ne family
0 Addition
El Two or more family
11 Industrial
D Alteration
No. of units:
11 Commercial
Ji�epair, replacement
D Assessory Bldg
D Others:
D Demolition
D Other
'P. 0
IV J. e
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DESCRIPTION O(WO_F�K TO BE PERFOKMED:
i ) iLw 6Q_ �M
(Identification Please Type or Print Clearly)
OWNER: Name: ffikil(&A I �/ - Phone:!j-�J,'- 7(z�6
Address:
CONTRACTOR Name A(/6V,5k/J9CkL& Phone:
- --CL _-J
Address: �/�X S4- CAA*A-101--Ck� 1
*V
Supervisor's Construction License: _Exp. Date:
Home Improvement License:J Exp. Date:
ARCHITECT/ENGINEE
Phon
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT. MOO PER $1000-00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F.
Total Project Cost: $ FEE: /6
Check No.: 1�4 szo Receipt No.: c2A�-7&-"
NOTE: Persons contracting,#iAunregisteredqontractors do not have access totheguarantyfund
Locati
No. Date
Check # Azik
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee
Foundation Permit Fee
Other Permit Fee $-t
TOTAL $
uilding Inspector
Plans Submitted El Plans Waived El Certified Plot Plan El Stamped Plans El
TYPE OF SEWERAGE DISPOSAL
Public Sewer El'
Tanning/Massage/Body Art El
Swimming Pools
Well El
Tobacco Sales 11
Food Packaging/Sales
Private (septic tank, etc. El
Permanent Dumpster on Site El
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED
IN
DATEAPPROVED
CONSERVATION Reviewed on . Si-qnature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS ''
Zoning Board of Appeals: Variance, Petition No:
Plat , ining Board Decision:
Conservation Decision:
Comm
we I =11
ning Decisionfreceipt submitted yes _
Water & Sewer ConnectioniSignature & Date Driveway Permit
DPW Town Engineer: Signature: Located 384 Osgood Street
FIREDEPARTMENT - Temp Dumpster on site, yes no
Located at 124 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 LITE IATURE: Yes__________No
MGL Chapter 166 section 21 A —F and G min.$100-$1000 fine
—A�A A 11cal
NUjt%z5anuLj,Rim—j ul
Q Notified for pickup - Date
Doc:.Building permit Revised 2011 June/mi
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
u Building Permit Application
Li Workers Comp Affidavit
Li Photo Copy of H.I.C. And/Or C.S.L. Licenses
Li 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)
Li 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)
o Building Permit Application
u Certified Proposed Plot Plan
u Photo of H.I.C. And C.S.L. Licenses
Li 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 Yermit
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 Registry of Deeds. One copy and proof of recording
Imust be submitted with the building application
Doe: Doc;.BuildingPermit Revised 2008mi
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andla
ROOFING, Inc.
Submitted To:
Brenden Murphy
296 Berry Street
North Andover, MA
Phone sp 978-766-7264
Email: None. Proposal Mailed.
Proposal dab: May 5, 2015
Offices:
383(Rear) Lowell Street, Suite 2G
Wakefield, MA 01880
Tel: 617-571-9056
352 Main Street, Suite 3C
Gloucester, MA 01930
Tel: 978-559-7333
www.PeterRyanAndSonRoofing.com
Job Location:
296 Berry Street
North Andover, MA
We are pleased to hereby submit this proposal to furnish materials and labor, completely in accordance with the below specifications:
(Additional charges may applyfor any change's not included below in proposal either by request of owner, or if Peter Ryan and Son Roofingfinds
unforeseen circumstances that will affect the performance, quality or integrity of thisjoh). In the event legal action is taken to enforce any provision of
this agreement, the prevailing party shall be entitled to all its reasonable costs, including reasonable in-house or outside attorney'sfees. Not responsible
for debris in attic.
S C 0 PIE" OF, W OR! t -
Install vinyl siding: $13,000.00
0 Remove existing siding on house
0 Prepare existing walls of house for installation of vinyl siding
0 Install Tyvek house wrap on entire house
0 Install vinyl siding on house
BBEL0 Install J- channel to match siding color around all windows and doors, to receive siding
W�11 0 Install all outside comers to match siding color
JEM�
Install white vinyl soffit
Wrap all soffit, fascia and rakes in coil stock of your choice
Clean UP:
PAY, 'EIN
Will cover area with tarps to minimize debris and remove debris related to work
NOTE: Please cover any belongings in the attic, as they will get dusty, i(applicable
ist payment due upon signing: $ 3,000.00
T0181 COSE SIZA00.00 Total balance due upon completion: $10,000.00
Kindly remit payment toleter Ryan". Thank you!
Respectfully Submitted by: Accepted by:
Our craftsmanship is 100% guafanteed al 0-years.'AaadO-warrantees are through the manufacturer. All warrantees will be null & void ifjog is rbt paid in full.
Peter Ryan anj�oofing, Inc. Licensefl 78871 —Thank you for letting us serve you!!! cc: Peter/Leo
The f'oit%,ii.i.i.:oi,?�iiyealtft:ofilf(I.57,T(Icflll.F(?tfS,
DeTaIlMeW of 1whistrMl A reArlentS
0jri've of In vestIg"(10011S
I:Cangaresi- Sli-eet, Stilte 100
Boston, JIL4 02114-2017
JOV1411. flfass,golvdla
Workel's, Compensattoll IRS111-ance Affidavit: Millden/Co.i.i trn-ctors/Elec t.1.1c hi 11 S/P111 In]) e I'S
Maine Peter Ryan and Son Roofing, Inc.
Address: 383 [rear) Lowell Street, Suite 20
cjt),/,stat.t./Zi.j): WaRefleld, MA 01880
pjjolji� #: 617-571-9056
Are yoti an employer? Uied� div: appl,oprhate box:
El i alyin, twooyer witi, 4. FN] I am i genevat oo.ritrclvorarid I
en,111ploy-tes (full alid/or Part-time). Ilavel-iired flie "ib:-,wu:tnnctOrs
F I mil a iok proprittor or partticr- fisvtd oii the atuwhed slieet.
$41 '1114 havc 110 4:1 1 rte�s These wb-oontraotors, haw
,w�orkhig for mciii any cipagity.
[No worki:rs' "mp. bismaiiczc
rt'!C1t1irC4.j
3.0 1 am a bomtowmer doing all work
i,ii.y.w1f, [,No work,:,rs' comp.
iiismatioe require-cl] t
ela,pl,oyets Slid llwvt Workers,
COL111). illsalralice.l
F-] We are n ootporation arid its
offiQers 11.1m!C cxfrci.scd flieir
r4,11t of extniption pcil, MCIL
c. 1.52. §1(4)� -atid wc li,,we tio
tmployecs, [No N�,-orkers'
T),I)e of pi-oject (reqWred):
6. F_j N,:w cowstvuetioti
7. Rem.odclfiig
8. Demolition
9, Bilildhig additioii
10.7 Ebtvrical. re:11),git-s' 04' kidditiolis
11 .7 Plmll-bill'o reixiirs oradditiolis
12.F� Roof rcjxqlr�
13. E:j 0 dicr
*An�yippficaw thatcheckibox.fl 11111'st'also fill o1vt thesectio'n tielow illowing their porlicy 0ifomiltion.
Homeo-%Ilers who sliblitit th i's affid;wit fadi ci ling, Illey art d0illg 81.1 wofk ',Uld thtilhire outside gutyalit I -new afridavit indicating SuC11.
k,olitnictors thit chvcR thii�*box mustattache(I mi additionalsh"t,,Aioxviag the.naine of the and Male whether or n(m those entities have
If the. sO-coatfictors have elliploy"s, the -Y limst provide, their wor�ers' comp. policy number,
fri an einployer 11im 4 pro i4ding wo'PA(RIS., cantpen.5(Wioll hisH iv.n eefio I, iriy e tjjpjaYiw. Beloi I , Is th e po Hcy andjol) s1te
P111(1-1101,1"
fio
111silratic-C Compica-YINT'I'llic; N/A (I am not required to carry WX, as I have no employees) Please seethe Sub -Contractor's W.C..affidavit attach
Polky iior Self -ins, Lic, 0, R/A Bviimmimi Datc,;
Job Site Addrtvss:
city !,tntvZ�p;.4L
Afta-ch a eopy of the W'Orke'us, coillpeus,�N,0,11 prolicy de,�laimdoia Page (S.11ON1,1112 the policy w)-inklel. alld (late),
Failure -to se,(�vvr,-, ocovtrage as rtqviired.twider Se,�q,,ticm 25A of MOL C. 1,52 iz:an leacito th,'t: uii�powion oferimiwil pt=,Aties, of a
fine v1p to $1,500.00 i1xprisol,1111C.,11t, rm wAl as civil petl:attics iti. flit fo-1-111 of a STOP NVORK ORDER rm:d a fmc
of ly to $250,00 a day against the violator. Bc advise'd tfint a tx)py of this stat,:m,,�W may bc.f6iiNf1rdCd to ths: Offi" of
111vestigations of thc DIA for inwratw-c cov�cxage VClific-atioll.
do hepebv eqvl yrtfl.,d.er (he J.mhl� (111dP4,110fias OfPelylo"I" f1tatt/re Infoi-itradotiproi,fifed- alwiw is truo arld. ValfrOrf.
... . ...... . . . .... ........
Qffl�c.haf -rise Do: Y'rot tvplte 1.11. this- a,�refi, to be roinpdeied by ri�p ai, towil offIrl'al,
City Or TOW11'.
PerimWLkeilse 9
Issidag AIT01,011t),
1. Board or Health 2, Bmildhig Depa rtmetat 3, Cfh�!/Towa C,'1exk 4, Eleef�t*�n - I 111"'Pector :5, plitilibilig Inspector
6. 0-di-er
C, o a t 8, c f Yer S 0 n ;
P110fle q.
The Connnompealf1i ofMass(tchmwfts
Department qf IndustrMlAccklenty
I Congre.s�s Street, Stilte 100
Bos -ton, JWA 02-1144617
1-opm Inass'gowma
Work.ers'Compeasn-tton Bu i Id ers/C ou tra ctors/Efectrtd n ms/P III mb e i's
A121.11tcant Inforimation. Pleme Print Leg-d-bly
Nalne. �Lema Construction, Inc.
Address: 71 Procpect Street
City/smtejzip: Brockton., MA 02301 Phone #: 508-232-1,194
Are you an emplaye.r? Check the appropriate. box:
1, 1 am n employ1:1. vvith '10
4, Iam iq-,geneml wtitract*r and I
C111ployets (fillt aad/ar
hnw hired the sub-contrictors
, Sole proprictor orpaxtlier-
81111
listed on the stfached s-hect.
ship aild have no Clivloyces
Thesc sub-coutractors, ha-ve
wovkingg for me hi ati-y c!apacity.
imiployees mid Ivive �vnorkers'
[No mrorkers' comp, bistirmice
C01111), illsm-naGc"t
required.)
51 We, nre �i i;oij,)orntion.,,md its
3, 0 1. Rill 'q hoalcomier doing all work
oft-icer.s have c�,-�emiscd their
mysclf [No workers' "mil),
right of exemptioll Per M'�aL
insummc.
c. 1.12, §.1(4), mid Nve have. no
cmployee�.-. [No workers'
T�j)e of project (repired):
6, New comstructimi
7� Remodediag
3, F-1 Demolition
9, 7 Biiildiiig additioii
10.0 El,:(�trit�al mpairs oradditioms
I I � E Plumbfiig repairs or ndditiom'
12.[].Ro,,)f repairs
131-1 011icr
*Aayapplicintthatchecivs box# 1 must also fill outfliesection below showing fbeirwoi7Rer.,s* couipensiflon policy iuformitioli.
t Homeowners whosubinifth-isamdtivit in4icitiug they "Ire doing III WOO" mid thelibire out'sidecontricloysmusl siAmlit vnew iffidivit indic-mingsuch�
box alust 1MIclied 'madditi:Omd.sheet showi:ug the mune of the sub-coumiclors ;md�umtewbether or not those entities Imve
employees. If thestib-contincloTsliaveeni.ploym. they must, provide their Workess, C -0111p. pc�filcy 111luiber.
I am an emph�vei, that isproviding wopkem-1 compensadon. Ins.u.mince.fol, my emplo�vees. Below i:� the poliq andjob site
infopmation.
Insurmice Comp'nny Mum: Insurer A: Northland Insurance, Insurer B: Arbella Protection, Insurer C: Travelers A/R
6S60UB-5B86069-2-15
Policy 9 or Sclf-ins. Lic. 4 Expiration Date� 03-01-2016
Job Site Addres�,: city'�St'ate/zip:266�
Attach a copy of the workeus' compeasatioll Polley declaratioll plige (5110:N�qng the Policy number mid e�xpfrnflmi date),
F�qilure to strcurt C�ov'mmge as re(pired under Section 2 5A of MCTL c. 15-2. caii kad to the iii-yositim of cr�iumal pe-maltics of a
fille III) to $1,500.00 an-ClJor olit-yeal, imprisoallicat, 'Is well as civil pen'91ties, in the fbim of a;,STOP WORK Q-RDER alid a fm�:
of 11.1) to $2.50,00 a day argaili-st the �!ioiator' Be klclvise�d flim I Copy of this may bc:f6,r"1ar&d to tht OffiQe of
hlws4ptions of the DIA for fiistivamt: ;zo-vcrag t 011,
p: mifien i
I do here�y rertlfj� under th e palm ait o' f.mijuly that fh e inforatation Provided above 1.5 rpm e androrrect.
Phone 9 -____LQ§ -232-1194
Offlelat use onty. Do not wr1re In this, ama, to be rompleted bY Oty o.V tamw qffidal.,
City or TOW'1111
Perailt/Lfelense #
0�-
Isstilng Authority (eirde one):
1. Board of Hen1th :2, Buildlug Depai,tmeut. 3, Ci-ty/Toi-va Clerk 4. Efec:trilca I Iuspector 5. Plumblu Implector
9
Otber
Contact Person: ph.011-e #'
ATE (Mmlonlyyyy))
CERTIFICATE OF LIABILITY INSURANCE 04/09/2015
THIS CERTIFICATE)S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R113HTS UPON- THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES -
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN T'HE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(los) must be endorsed, If SUBROGATION -ISWAJVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement, A statement on this cortIficato does not confer rights to the
certificate holder In lieu of such ondorsement�s),
PRODUCER CONTACT J____
MossPayinswance Ser�ces, LI_C NAMM..._ Owe M Keller
ONE
(97M 774-4338 x1 15 -1318
27 Garden Street, Unit I B W11c. N I (AIC No): (978) 774
E-MAII.
Damers, MA 01923 K)DRU$S: lo�ce@masspa�nsurence.com
INSURER($) AFFORDING COVERAGE NAJC #
INSURERA: Northiandlnsuranco NOR
IN3VREQ Lema Construction, Inc INSURER B : Arbella Protection 41360
Jesus Loma INSURER C: 'TRAVELERS AIR TRC
71 Prospect Street
BrocNon, MA 02301
COVERA(7117-1.; r.FRTIFIr.ATF NtIMRPP-
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 OTI-iER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFUROED 13Y THE nLICIES DESCMBED HEREIN 15 SU13JECT TO ALL THE TERMS,
EXCIL-USIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE 13ECN Rr:()u(7,F.o BY PAID CLAIMS,
1RSR
LTR
TYPE OF INSURANCF
ADDI.
SUaR
POI.ICYNUMBER
170 —LI CT_ E F F —POLICY EXP
(MM/DD(YY Y)�IMM/D01YYYM
LIMITS
A
OENERAL LIABILITY
WS236181
01/31/2015 01/31/2016
EACH OCCURRENCE S 2.000�000
COMMERCIAL GENERAL LIABILITY
—7 CLAIMS -WOE F-71OCCUR
07WW� 100,000
PREMISES (Ea occurrence)
MED E>F (Any one person) 5,000
PERSONAL & ADV INJURY $ 2,000,006
GENERAL AGGREGATE S 3,000,000
GENL AGGREGATE LIMIT APPLIES PER:
V/ POLICY 0 'E'C'T. F7 LOC
PRODUCTS - COMPIOP AGO $ 3.00OX0
$
B
AQTOM OBILE LIABILITY
1020009274
11/2012014 '-11/28/2015
C ONSINISO _SIffG_L E-TIMIT 1,000,000
(Ea accident) $
BODILY INUURY (Per person) S
ANY AUTO
ALL OWNED SCHEDULED
AUTOS V AUTOS
V HIRED AUTOS V ACT�QOSWNEQ
BODILY INJURY (Per accident) $
_(PGr accident)
OCCUR
EACH OCCURRENCE
CLAIMS -MADE
AGGREGATE
DED RETENTION S
C
WORKERS COMPENSATION
AND 5M PLOYERS'LIABILITY YIN
ANY PROPRIETOPJPARTNERIE>F-CVnV '
OFFICERIMEMSER EYCLVOED? E
(M andplory In NH)
It us, describe under
OnCRIPTION OF OPERATIONS below
NIA
015 03/0112016
_,7r;W�c �STLA,,,TLT� JOTI�+
ER
E.L. EACH ACCIDENT 5 500,000
—5
E.L, DISEASE - EA EMPLOYEE S 5Q0'Q00
E.L. DISEASE -POLICY LIMIT 1$ 500,000
DESCRIPTIONOF OPERATIONS I LOCATIONS /VEHICL(28 (Altach ACURD 101, Additional Ro marks Schedule.lfmora space Is required)
Proof of Insurance
utnH I iFir. ai,F. Hni nFH r6Nr9I I ATIr)?1I
QD 1988-2010 ACORD CORPORATION. All rights reserved,
ACORD 26 (2010105) The ACORD name and logo aro registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIE�EQ POLICIES BE CANCELLED SEFORC
Peter Ryan and Son Rooring, Inc
THE EXPIRATION DATE THEREOF, NOTICE WILL, BE DELIVERED IN
383(Rear) Lovell Street
ACCORDANCE MTH THE POLICY PROVISIONS.
Suite 2G
AUTHORIZED RFPRESENTNrIVF
Wakell at d, M A 0 1580
QD 1988-2010 ACORD CORPORATION. All rights reserved,
ACORD 26 (2010105) The ACORD name and logo aro registered marks of ACORD
. LICENSURE
Lema Construction, Inc.
HI*C#: 159106 Jesus Lema
fklioso or relilitrittlou valid for lodividol list only
A
0 F R? VEM ��Nl CONY)RAOTID R boforli tilt, oxii1rittion lisle, If found rellorn ftit
onico orcoosonier ikfrnir4 sooi wixioes iioguiptioo
10 Pork Pl(wA -Snito 5110
I orimp", -110"I'M-111"P�
LEMA CONSTRU(MONINIC.
JESUS LEMA
71 PROSKOT ST,
HRocKroN, mA mol . ..............................
Uado-fier-roll Not vid Id ivithoot signatu m
ffte or Cqllllnllti� AIN Irs & 111151 Uess Ilegill"tilou Uicv.nioi or registrationvalld for Intilvidol uso wily
-0 ME IMPROVEMENT CONTRACTOR. b0fore (lit'. ow.pirlitIgn dille, [I' found rolaril lot
T Office. of Coominow AIN[ i's no d Busintisi; Regulation
� 10, ypo' 10 Nork I'litza - Sulto $1.70
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LEMA COW)TRUCTIOWINC.
jAME6 DOHERTY
71 PROSPECT 6T.
BROCKTON, MA 02301
LICENSURE
Peter Ryan and Son Roofing, Inc.
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MCA:, T 7"88,713 PetrerRyan
CONTRACTOR
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Corportikion
pCTC[i RYAN 80WROOFING, INC.
Pf.T[-.R RYAN
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VVAKEFIrL0. MA 0`1880 Unk.rsew.wry
CS Lice. n -se,#,:,. C5304865,
Massachusetts - Department of Public Safety
Board of Building Regulations and
Standards
Cons t r1tv lion Supervisor
License: CS -104"s
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