Loading...
HomeMy WebLinkAboutBuilding Permit #726-14 - 342 MARBLERIDGE ROAD 4/16/2014Permit NO: 12—(D-1 Date Issued: '� �� I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received � I, IMPORTANT: LOCATION- .. _ PROPERTYOWNE1 MAP NOP. rit must complete all items on this page Print 100 Year Old Structure yes no: ZONING DISTRICT: -Historic District yes no Machine,Shop Village __ yes. no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building , One family ❑ Addition 11 Two or more family [I Industrial O?Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0 S-eptic 0 Well ❑ Flop dplain ❑ Wetlands ❑ Watershed' District _ E! Water/Sewer DESCRIPTION OF WORK TO BE PERFORMtU: Identification Please Type or OWNER: Name ArlAreee- Phone: 97 , , e/0. Z'��/ CONTRACTOR Name:/ Phone:_ - Address: /0 c i , 9_ , i_+ Supervisor's Construction License: -0 Q o'Z.1 0 _ Exp. Date: 3 - )-A . Home Improvement License: - 7 �_Z _ Exp, Date: 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. Total Project Cost: $ FEE: $_ fir% Check No.: 2 Receipt No.: 2_14(7 NOTE: Persons contract i regtMered contractors do not have access to anty fund Signafure of.Agent/OvVne gnature;of contractor , Plans Submitted ❑ lans Waived ❑ Certified Plot Plan 0 Stamped Plans ❑ Building Department The fol;owing 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 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 ❑ 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 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.tted with the building application Doe: Doc.Buiiding Permit Revised 2012 TOWN OF NORTH ANDOVER �U' b APPLICATION FOR PLAN EXAMINATT"d 1 � c.Q Permit NO: ` I Date Received I Date Issued: ` I IMPORTANT: Applicant must complete all items on this page LOCATIO PROPERTY OWNER _ _ _ MAPNO PARCE ZONING DISTRICT:_ TYPE OF IMPROVEMENT PROPOSED USE Exp: Resi ential I ❑ New Building PrOne family ❑ Addition El Two or more family Iteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Demolition ❑ Other Septic ❑ Well ❑ Floodplain ❑ WEd 11 Water/Sewer OWNER: Name DiJr __8 DESCRIPTION OF WORK TO Identification Please Type or ;Js. C 7 IJ: +-rin_TN%ztriCt -- -,.- yeS P� III Iq 6le, -L07 CONTRACTOR Name: A �? �Iv/� -Phone: Address: Su pervisor's,Construction License: 0 0 0-LL3 V Exp: Date: 3 Home Improvement License: Exp. Date:/ 4)`//G' 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: $ FEE: $ -9 , Check No.: Receipt No.: 2-14% NOTE: Persons contractinz_wjdi,Ye eyed contractors do not have access to!,*TWanty fund Sim natur`e of:A gent/Ow6ei__ idnature of contractor Y = 9 .._ ._.� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Building Department The folt'owing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofivg, 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 L, Floor Plan Or Proposed Interior Work Li 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 L3 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) o 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 apwal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building Permit Revised 2012 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGEDISPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑ .. Swimming Pools ❑ 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 PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE APPROVED El Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Com Water & Sewer Connection/Signature & Date Driveway Permit DIPW To` o Engineer: Signature: FIREDEPARTMEN' t -' Temp Durnoter on site yes Located at 124 Mair, Street Fire Departinert signature/date", COMMENTS N Located 384 no Street - ., 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 Doe.Building Permit Revised 2010 F— Location No.72(o —% Date ®- TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ a Foundation Permit Fee $ ,, ^ Other Permit dee $ aS'�Y TOTAL $ Check #� 27467 �� Building Inspector P CD O Cr Q �. >cm O O v Q as CCD O Owe 0 cn 0 O N CD CD CD CD v O z CD O CD c� to Z Cl) ic cn nm Ox z in:2 � m c Cl) q z < 0 O -0 c � -i —Di M_ m O � n O c' z o cn � T rt O O rt CL m -+, O C CD -0 CD O O .n+ N C O _ O CCD) OCA. HIM W "f CD y _ CD -4 p O O to 0 CD 3 o o s On c=p y v, = C0. U3� v, a Q. y O O CO) 71 a, CD CD CD CD oo r (D ■ to %) vat o •d� oN' .q O � CD rt U! O <D l7y 0 rt DCD CD 0 o CU; 0 0 CL T tD ID � N (D ~' Z O WT C :3 m v y m 7 m O QO S N E H O T 7 N N < F rD .Z7 O Oq 3 m '° v m 0 T - ;;o O W S C z M m 0 T 3 (� S 3 m -< w O 00 =r T O 3 Q v O C v n 0 N rD _. n N < 3 T O Q 3 ' W > v O r _ J\ a** w E O N The Commonwealth of Massachusetts _ Print Form -- - - Department of Lrdustrial Accidents Office of Investigations i Congress Street, Suite 100 n - Boston, MA 02114-2017 wwminass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationlhidividual): AB CARNES ROOFING, INC. Address:30 ARROWHEAD FARM RD MA 01921 Are you an employer? Check the appr ❑ I am a employer with employees (full and/or part-time).* !. ❑ 1 am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] ❑ l am a homeowner doing all work myself. [No workers' comp. insurance required.]'' Phone 4:978-887-1431 ✓❑ I # a general contractor and I ave hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' Trip. insurance.- ❑✓� e are a corporation and its officers have exercised their right of exemption per MGL c. 152. § i (4), and we have no employees. [No workers' insurance Type of project (required): 6. ❑ New construction 7.✓❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 1 1.❑ Plumbing repairs or additions 12.❑✓ Roof repairs 13.❑ Other *Any applicant that checks boa n l must also fill out the section below showing their workers' compensation policy information. L Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees. they must provide their workers' comp. policy number. 1 am an employer that is providing workers' compensation insurance for my emploveec. Below is the policy and job site information. insurance Company Name: Policy # or Self -ins. Lic. #: .lob Site Address: Expiration Date: City/State/Zip: Attach a copy of the workers' compensation policy 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 imprisonment, 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 verification. I do hereby • r y under the painslind enalties o perjury that the information provided above is true and correct. Official use on1v. Do not write in this area, to be completed bt, 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 #: FORM 153 The Commonwealth of Massachusetts, DIA Use only Department of Industrial Accidents ,;, Office of Investigations - Dept. 153 I Congress Street. Suite 100, Boston. Massachusetts 02114-2017 °,. http:/hvww.mass.gov/dia Invest./SNVO ID #: y" AFFIDAVIT OF EXEMPTION FOR CERTAIN CORPORATE - OFFICERS - OFFICERS OR DIRECTORS Chapter 169 of the Acts of 2002 amended .1L G.L. c. 152, x'1(4) by adding the, follo)t;ing 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 corporation. 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. Said commissioner shall promulgate regulations to carry out the purpose of this paragraph. Violations of this paragraph shall subject the corporation to the penalties set forth in section 25C." Pursuant to M.G.L. c. 152, 41(4) as amended. 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. 425A 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 injuries that may be sustained while in the employ of the above -nailed corporation. Further, I/we the undersigned do understand that. should the above-named corporation hire or have in its employ any employee(s) in addition to the undersigned corporate officer(s) or director(s), said corporation is required to obtain workers' compensation coverage for the employee(s) as prescribed by M.G.L. c. 152, 425A. I/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 names) indicating my/our desire to be exempt or not to be ,xempt frbin the provisions of M.G.L. c. 152. under thehains and penalties of perjury: BARRY CARNES, PRESIDENT 09/24/2013 S &WurxPrint Natne & Title ❑✓ 11 wish to exercise my right of exemption or ❑ i wish NOT to exercise my right of exemption ANASTASIYA CARNES, DIRECTOR Signature Print Name '& Title ❑✓ i wish to exercise my right of exemption or ❑ I wish NOT to exercise my right of exemption Signature Print Name & "Title ❑ I wish to exercise my right of exemption or ❑ I wish NOT to exercise my right of exemption Signature Print Name & Title ❑ I wish to exercise my right of exemption or ❑ i wish NOT to exercise my right of exemption Date (tnm/dd/v)}w) - 09/24/2013 r, r Date (nunidd/yyyy)t\) Date (mm/dd/Nvy Date (mnvdd/yyyy) Note: ALL ELIGIBLE CORPORATE. OFFICERS MUST SiGN. THERE. CAN BE, NO INIORE THAN 4 SiGNATURFS. histruetious ott back. Form 1 �;3 - 7/2010 MA SOC Filing Number: 201340178570 Date: 6126/2013 6:21:00 PM •4= ; The Commonwealth of Massachusetts Minimum Fee: $250.00 b.Z William Francis Galvin Secretary of the Commonwealth. Corporations .Division y ` One Ashburton Place, l 7th'floor _ BOStOn, MA O2IO8-I S12 Saecini Filing Instructions tt .\� Telephone: (617) 727-9640 - - �`•�C�i 7� • p Vii' • � �iiG-34t��} Federal Employer Identification Number: 00 1110484 (must be 9 digits) ARTICLE I The exact name of the corporation is: AB CARNES ROOFING, INC. 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: COMMERCIAL & RESIDENTIAL ROOFING AND ROOFING RELATED WORK. THIS SHALL INCLUDE ALL TYPES EXTERIOR & INTERIOR REMODELING ARTICLE III 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. If only one class or series is authorized, it is not necessary to specify any particular designation. Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Mein c f Shares Tewa1 Par Value. Num 0/'Shares CNP $0.00000 1,000 50.00 1.000 G.L. C156D eliminates the concept of par value, however a corporation may specify par value in Article III. See G.L. C156D Section 6.21 and the comments thereto. ARTICLE IV If snore 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 class 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 Other lawful provisions, and if there are no provisions, 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. ARTICLE VII The effective date of organization and time the articles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective date is 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 Vill The information contained in Article Vlll 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 registered office: Name: BARRY CARNES No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD Stater 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 corporation (an address need not be specified if the business address of the officer or director is the same as the principal office location): Title Individual Name Address (no PO Box) First. Middle, Last, Suffix Address. City or Town. State, Zip Code PRESIDENT BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 01921 USA TREASURER BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD. MA 01921 USA SECRETARY ANASTASIYA V CARNES 30 ARROWHEAD FARM RD BOXFORD. MA 01921 USA DIRECTOR BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD. MA 01921 USA DIRECTOR ANASTASIYA 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 ROOFING 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 State: MA Zip. 01921 Country: USA g. Street address where the records of the corporation required to be kept in the Commonwealth are located (post office boxes are not acceptable): No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State: MA Zip: 01921 Country: USA which is X its principal office _ an office of its transfer agent an office of its secretary/assistant secretary _ its registered office Signed this 26 Day of June, 2013 at 6:23:02 PM bv the incorporator(s). (Y'an existinq corporation is acting as incolpol"atoi", tVpe in the exact name Qf the business entity, the state or other" jurisdiction tivhel"e it ivas incorporated. the name of the person signing on behalf of said business entiti., and the title he%she holds or other authority by which such action is taken.) BARRY S CARNES . C 2001 - 2013 Commonwealth of Massachusetts All Rights Reserved MA SOC Filing Number: 201340178570 Date: 6/26/2013 6:21:00 PM THE COMMONWEALTH OF MASSACHUSETTS I hereby certify that, upon examination of this document. duly submitted to me, it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles; and the filing fee having been paid, said articles are deemed to have been filed with me on: June 26, 2013 06:21 PM WILLIAM FRANCIS GALVIN Seereiai'} of the Comn.ionviFeallh Proposal AB Carnes Roofing, Inc. 30 Arrowhead farm Rd Boxford, Ma. 01921 978-887.1431 MA. CS -000230 and HIC Reg. 176928 Proposal Submitted To: BILL WHITTAKER Date April 10, 2014 342 MARBLERIDGE RD Project Name SAME NORTH ANDOVER, MA 01845 Addre55 978-618-2699 We propose to furnish material and labor- in accordance with the specifications below: Seventy Six Hundred Seventy Five Dollars ($7,675.00) Payment to be made as follows: $300.00 Deposit, Balance Upon Completion Page 1 of 1 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 tc 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 AREAS 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 ®AS NEEDED 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 REGLET . P IISE ADD $475.00 TO ABOVE PRICE. ® COVER ROOF SURFACE WITHCERTAINTEED LANDMARK ARCHITECTURALLIFETIME W RRANTY 240LB SHINGLES. ® REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH CDX PLYWOOD AN"QDI 4egAL COST OF$4.50PSQFT. ❑ COVER ROOF DECK WITH CDX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING, AT AN ADDITIONAL COST OF 0 STORM NAILING: (HURRICANE NAILING) SECURE SHINGLES WITH SIX NAILS AS THIS IS CODE IN ESSEX COUNTY. ❑ 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 EXCLUDED. ❑ 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 ROOF SECTIONS 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 AWUPGRADE TO THE CERTAINTEED HIGH PERFORMANCE HIP & RIDGE CAPS AND STARTER COURSE AT NO ADDITIONAL CHARGE. MESS EMAIL ADDRESS: .^ a. bwl 4 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 Horne Improvement Law 142a: Ail parties agree that any and ail 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. *Date of Acceptance ' 4 *Sign PLEASE SEE REVERSE SIDE ,d 6 1 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS -000230 BARRY S CARNEsS' 30 ARROWHEAD FARM D ✓� Boxford MA 01911 'itl7v Expiration Commissioner 03/07/2016 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration AB CARNES ROOFING, INC. BARRY CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 0.1921 SCA 1 :a 20M-05/11 Registration: %1 Type: Expiration: 176928 Corporation 10/10/2015 Tr# 245633 Update Address and return card. Mark reason for change. r-] Address (J Renewal f— Employment r--! Lost Card ACORU® CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) `� 1 11/4/2013 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 CONTACT Commercial Lines NAME: Harris -Murtagh Insurance Agency, Inc. 30 Central Street PHONE (978) 532-2844 IA ac No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # 0/11/2019 Peabod 01960 INSURER A Western World Insurance CO eSTR�ED INSURER B: INSURER C: AB Carnes Roofing, Inc 30 Arrowhead Farm Rd INSURER D: INSURER E: INSURER F �i3oxford 01921 C V€RAGES-- -- ` CERTIFICATE NUMBER-CL1311417584 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 LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY. X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x_1 OCCUR 9PP137217 0/11/2013 0/11/2019 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0i L1LOC PRODUCTS - COMP/OP AGG $ 21000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- OTH- ITORY EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Town of North Andover 1600 Osgood Street North Andover, MA 01845 ACORD 25 (2010/05) INSn25 /9mnn.m m Lei_1► L";4 01 4_t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE S Scholnick/PJR .-.dp ©1988-2010 ACORD CORPORATION. All rights reserved. Tho Ar:r1Rr1 nnmo and Innn 2ro ronia4ororl mnrlrc of Arnpn ,F CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDKYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. 11/8/2013 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 COMACT NAME Berkley Assigned Risk Services Ace Insurance Services Inc PHONE 675 Warren Ave AC. rro.Ex : 800634-4589 tAc. No.) (866 215-8118 E -MAI ADDRESS: PolicyServices@berkleyrisk.com Brockton; MA 02304- 1 INSURER(S) AFFORDING COVERAGE NAIC # /rt INSURER A Acadia Insurance Co INSURED WC STATU. OTH. x 1 American Construction Inc INSURER 6: 242 Belmont Street Unit 2 INSURER C INSURER D. Brockton, MA 02301 INSURER E: (Mandatory in NH) If yes, describe under INSURER F' 11 EL DISEASE - POLICYLIMIT 1,000,000 Cr%I IrI\.AI c IVUM0tK: REVISION NUMBER: Tul ICaIGSn rc oT lcv ru rTr� .- LL r y�r�--C- IVLr\,Ic,0 'Jr !MOUKAIVL,t uJ I tU tttLUW 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 LTR TYPE OF INSURANCE ADDL NSR SUER POLICYNUMBER V�VD POLICYEFF POLICY EXP (MMiDD1YYYY) (MMlDD; YY YY) LIMITS - GENERAL LIABILITY Signature: ----- -- I ---- ---- AUTOMOBILE LIABILITY I WORKERS COMPENSATION YIN WC STATU. OTH. x A AND EMPLOYERS' LIABILITY ANYPROPRIETOR!PAP,TNER/EX-ECUTIVE O i oFFICEiMEMBER ExcLUDEe? N!A .WC 20-20-004%17-00 04/24/2013 04/24/2014 TORY LIMITS ER E.L EACH ACCIDENT $ 1,000,000 E.1 -DISEASE -EA EMPLOYEE IS 1,000;000 (Mandatory in NH) If yes, describe under EL DISEASE - POLICYLIMIT 1,000,000 DESCRIPTION OF OPERATIONSbelow I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Adtlitibna! Remarks Schedule, d more space is requited) Coverage Election Category Elect. Status Name State(s) A11 EntitiesL ocations Officer Include Manuel 7 Lema Caguana MA 1 American Construction Inc 242 Belmont Street Unit 2 Brockton, MA 02301 / G.ER "FICA IC HULUtK ""v. CANCELLATION ACORD 25 (2010/05) BRAC 3139 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AB Carnes Roofing Inc ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 30 Arrowhead Farm Road Boxford, MA 01921 - Signature: ACORD 25 (2010/05) BRAC 3139 MA SOC Filing Number: 201316881130 Date: 4/23/2013 10:36:00 AM The Commonwealth of Massachusetts Minimum Fee: $250.00 William Francis Galvin Secretary of the Commonwealth, Corporations :Division E1I One Ashburton Place, 17th floor j, Boston, MA 02108-151 Special Filinfl Instructions �' f► z "r'`�x Telephone: (617) 727-9640 Federal Employer Identification Number: 001098338 (must be 9 digits) ARTICLE I The exact name of the corporation is: I AMERICAN CONSTRUCTION INC ARTICLE it 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: ARTICLE III 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. If only one class or series is authorized. it is not necessary to specify any particular designation. Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding ,Num of Shares Tolal %'ar Value Num of Shares CNP $0.00000 20,000 50.00 20.000 G.L. C156D eliminates the concept of par value, however a corporation may specify par value in Article III. See G.L. C156D Section 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 class 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 Other lawful provisions, and if there are no provisions, 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. ARTICLE VII The effective date of organization and time the articles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective date is 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 Article Vill 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 registered office: Name: MANUEL LEMA-CAGUANA No. and Street: 12 WALL STREET City or Town: BROCKTON State: MA Zip: 02301. Countrv: USA c. The names and street addresses of the individuals who will serve as the initial directors, president, treasurer and secretary of the corporation (an address need not be specified if the business address of the officer or director is the same as the principal office location): Title Individual Name Address (no PO Box) First, Middle, Last, Suffix Address, City or Town, State, Zip Code PRESIDENT MANUEL LEMA-CAGUANA 12 WALL STREET BROCKTON. MA 02301 USA TREASURER MANUEL LEMA-CAGUANA 12 WALL STREET BROCKTON, MA 02301 USA SECRETARY MANUEL LEMA-CAGUANA 12 WALL STREET BROCKTON. MA 02301 USA DIRECTOR MANUEL LEMA-CAGUANA 12 WALL 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 business in which the corporation intends to engage: GENERAL CONSTRUCTION f. The street address (post office boxes are not acceptable) of the principal office of the corporation: No. and Street: 12 WALL STREET City or Town: BROCKTON State: MA Zip: 02301 COUntrv: USA g. Street address where the records of the corporation required to be kept in the Commonwealth are located (post office boxes are not acceptable): No. and Street: 12 WALL STREET City or Town: BROCKTON State: MA Zip: 02301 Comm USA which is X its principal office _ an office of its transfer agent an office of its secretary/assistant secretary _ its registered office Signed this 23 Day of April, 2013 of 10:37:21 AM by the incorporator(s). (I f an existing co,poi-ation is actino as incorporator, type in the Bract name of the business entity, the state or other iurisdietion where it was incorporated, the name of the person signing on behalf of said business entity and the title he/she holds or other authorih> by whichsuch action is taken.) MANUEL LEMA CAGUANA © 2001 - 2013 Commonwealth of Massachusetts All Rights Reserved MA SOC Filing Number: 201316881130 Date: 4/23/2013 10:36:00 AM THE COMMONWEALTH OF MASSACHUSETTS l: hereby certify that, upon examination of this document, duly submitted to me, it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles; and the filing fee having been paid, said articles are deemed to have been filed with me on: April 23, 2013 10:36 AM WILLIAM FRANCIS GALVIN Secretaryof the Con�nioinvealth 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: 4-14-2014 SIGNATURE OF APPLICA