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HomeMy WebLinkAboutBuilding Permit #074-2017 - 41 OAKES DRIVE 7/25/2016 Aflb OJ4 I v Vl NORT/i BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO:d Date Received Date Issued: �� �9SS�CHUS t IMPORTANT:Applicant must complete all items on this page LOCATION L4 1 txt S D,(' Print PROPERTY OWNER L Print MAP NO: �Q PARCEL: 141 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial N/Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer S-k,o-r ce. cddlo Identification Please Type or Print Clearly) OWNER: Name: �` '� L,v�`0�'� Phone: a'17� �0— U �8b Address: 6alrS �� CONTRACTOR Name: Phone: 7 37� �ru (C4 L-o' C r�S Address: P � �- 0) .Y7 Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: ' Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: e �_�q Receipt No.: C NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature ofAgent/Owner Signature of contractor - � s e Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL r. 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 FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING a DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed ori 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIREDEPARTMENT" TempDumpsteron site.z;Yves:;,�� , ,�; _'y,, } Tno _ fs ,t d at`1 > zL *�a ��. rrt �. kMaj e 24We:fintStreet. ,, .; ;�+: � � �� • �,ru_. . .� _� .F'ire De art y ^rrr dij ;>>qn `stiignatiire/dater �. �'•! �, � r�ru�.. ' ._ _ Vf 'COIVIMEIVTS. �4 'F. M , �4} ._Sr '►-�: , '� ..h ;' ;r i 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) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Bi lding Permit Revised 2014 r 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4. 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/Cross Section/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 OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location 41 ( ),n � t J No.(.) (4 �J r,L Date • - TOWN OF NORTH ANDOVER r�n Certificate of Occupancy $ Building/Frame Permit Fee $ : Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#;,?n i ,,, ,; Building Inspector Town of NORT Andover 0 No. _ 0 Zo 11--- 7 � � h ver, Mass 0 LAKI A- Q COCHICM[WICN y1• 7,9 p°KATIE° ►Pa,��(5 S U BOARD OF HEALTH Food/Kitchen PER T D Septic System THIS CERTIFIES THAT ....... U"x BUILDING INSPECTOR .. .. .. ...has permission to erect ...... buildings on ... � ..... ... . �/+�............... Foundation ...... Rough 41111 to be occupied as ................. . . .. .......... .....� ;1C........................................................ Chimney provided that the person accepting this p rmit 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 CONST TIONPA Rough Service .. . 4B61LD61iN�G�1� .. ...... Fina PEC OR 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. o404G Craig LaCrosse-Owner ` CONTRACT PO Box 728,Tyngsboro MA 01879 June 21, 2016 978-580-7376 cralg@roofingkinginc.com Customer: Peter Longo Property Address: 41 Oakes Drive,North Andover MA Phone: 603-893-3631 Email:plongo@autouse.com Thank you for allowing Roofing King Inc.the opportunity to work with you. Please feel free to contact me with any questions at the number listed above. SCOPE OF WORK: Full Roof Replacement House will be covered with protective blankets to prevent any damage and for easy cleanup during removal process -Remove all shingles right down to existing wood and re-nail and prep before installation process begins(Est.#of layers ) -Install up to 96sq ft of rotted plywood(3 sheets 1/2 roof plywood)at no charge on any full roof replacement&$50 per additional sheet if needed -Install 6 ft of GAF Storm Guard Ice and Water along base of roof,snow load areas,valleys,chimneys and skylights for proper protection -Remove and re-install new plumbing flashing on soil pipes vented through the roof -Install Felt Buster on any exposed wood after Ice and water is applied to cover any exposed roof decking -Install new 8" (White,Brown or Mill Finish)drip edge on all edges of roof for proper protection -Install GAF Pro Start starter strips around entire perimeter of the roof to create a 3/4 inch overhang for proper install -Install GAF Architectural Timberline HD LIFETIME Ltd.Shingles will be storm nailed with 6 nails per shingle 130 MPH resistance -Cut 11/2 inch opening on peak of roof if it wasn't previously done for proper installation to meet building code(on full replacements) -Remove old lead around chimney and reinstall 12 inch lead and reseal joints(if applicable) -Install Snow Country exhaust vent on peak of roof to allow proper ventilation and meet building code -Hand nail Seal A. Ridge caps on peak of roof with 2 inch nails to complete installation. -Blow off entire roof,clean gutters,driveway and all walking surfaces and any loose nails with rolling magnets daily and on completion -Existing roof will be removed and recycled at Roof Top Recycling(Certified Green Roofer) Job Specifics and Upgrades -Weather watch upgraded to Storm Guard Ice and Water Shield $0.00 Included -Remove skylight flashing kits to install ice and water on all 4 sides(reinstall existing kits) $0.00 Included -Deck Armor in place of Felt Buster $200.00 Not Included -Gutter work to be determined $TBD Not Included Warranty Roof comes with 50 Year Weather Stopper System Plus LTD manufactures warranty Promotions $500 off Coupons(Act Fast Offer,Angies List,Home Advisor and PAF$250 military rebate) "11f SHINGLE COLOR: Ct/ L� L Initial: J� PAYMENT STRUCTURE: This price includes labor,material,trash removal,building permit(if required)and contract may act as signature for permit. Any additional work will require separate p6cin . Please make all checks payable to Roofing ing Inc. Total: $6,500.00 Deposit(due at signing): 1/3 $2,166.00 2" Payment(due when material is onsite): Final Payment(due upon job completion): 2/3 $4,334.00 ACCEPTANCE OF PROPOSAL.The included specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payment will be made as outlined above and accept all terms included.All discounts on all work to be done must be presented to Roofing King Inc.representative before contract is accepted. If rotted wood is discovered AFTER removing the existing roof,or it could not be identified at the time of sale an additional charge of$50 per sheet.If this account is collected through legal actions,customer will be responsible for all attorney fees and court costs. Disclosure:Customer responsible to cover any valuable items in the attic to protect from debris.Roofing Kingg es not assume responsibility for acts of Mother Nature. litct,cy �� V Owner/Contractor Property Owner/Represent e Craig LaCrosse Peter Longo -\ The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. AnWicant Information Please Print Le:ttbly Name(Business/OrganizatiorAndividual):Roofing King Inc Address:Po Box 728 City/State/Zip:Tyngsboro MA, 01879 Phone#: 978-580-7376 Are you an employer?Check the appropriate box: Type of project(required): 1.[J I am a employer with employees(full and/or part-time).' 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 9, ❑Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp,insurance required.]t 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.a 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑f Roof repairs These sub-contractors have employees and have workers'comp.insurance? 14.[1 Other 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Star Policy#or Self-ins.Lic.#:WC 0742797 Expiration Date:08/20/16 Job Site Address: `I-( C)a k-(, D`- City/State/Zip: NO Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Shmature: Jt� Date: Phone#:978-580-7376 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• ACORV CERTIFICATE OF LIABILITY INSURANCE 02ATE 2120M/DD/YYYY) 7/22/2016 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(les)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 NAME: McSweeney&Ricci Insurance Agency, Inc. PHONE FAX 420 Washington Street E-MAIL - -8600 A/C No): - - 8807 Braintree MA 02185 ADDRESS;ITnreCep16on(Qm *m INSURERS AFFORDING COVERAGE NAIC# INSURER A INSURED ROOFK-1 INSURER B:National Grange Mutual 14788 Roofing King Inc INSURER C:Star Insurance Company Craig LaCrosse INSURER D: P.O. Box 728 Tyngsboro MA 01879 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:869719680 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. ILTR TYPE OF INSURANCE ADDL SUBD POLICY NUMBER MMIDD EFF MPM/LIDCY EXP UMITS A GENERAL LIABILITY N N CGL0059562 12/11/2015 12/11/2016 EACH OCCURRENCE $1,000,000 DAMAX COMENTED MERCIAL GENERAL LIABILITY PREMISES TO occurrence $100,000 CLAIMS-MADE a OCCUR MED EXP Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2,000,000 POLICY X PRO- LOC $ B AUTOMOBILE LIABILITY Y M1T5776F 8/20/2015 8/20/2016COMBINED INGLE LIMIT Ea accidentS $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED r;---1 SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS a e $ A UMBRELLA UAB X OCCUR N N C00071022 12/11/2015 12/11/2016 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION WC0742797 8/20/2015 8/20/2016 X WC STATU- I I OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBEREXCLUDED? N❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 ff es,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 more space is required) Roofing(Residential/Commercial),Siding Installation and Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main St ACCORDANCE WITH THE POLICY PROVISIONS. North Andover MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 4®� tYIgJJgV114JGltJ VGtlglil llGllt VI / YYI/V Vql Gl� ' j Board of Building Regulations and Standards License: CSFA-101415 Construction Supervisor 1 &2 Family "' CRAIG A LACROSSE 18 HIGHLAND STREET TYNGSBORO MA 01879 �-J- OK Expiration: Commissioner 06/25/2018 7 ��e�cam�anna�c2l�alr�-1�Itrssa���sse/�d� k Office of Consumer Affairs&Business Regulation . OME IMPROVEMENT CONTRACTOR egistration: 173117 Type:; expiration: 9/4/2016 Private C �. orporadoj ROOFING KING INC. ' CRAIG LACROSSE 12 MALVERN AVE. TYNGSBORO,MA 01879 Undersecretary