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Home My WebLink AboutBuilding Permit #832 - 73 HOLLY RIDGE ROAD 6/15/2007BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 1001\ DESCRIPTION OF WORK TO BE PREFORMED: ARCH ITECT/ENGI NEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PER $ PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F ,�ZIT: 12.00 -13 x, 3 q Total Project Cost: $1 FEE: $ Check No.: Receipt No.: NOTE: Persons contra'c'fing with'unregistered contractors do not have access p-thie�ffqrantyfund Plans Submitted 11 Plans Waived 11 Certified Plot Plan El Stamped Plans El TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales 11 Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS,FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATEAPPROVED PLANNING & DEVELOPMENT F] 11 COMMENTS DATE REJECTED DATE APPROVED CONSERVATION 11 11 COMMENTS HEALTH COMMENTS - DATE REJECTED DATE APPROVED F1 Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood 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 MGL Chapter 166 Section 21 A —F and G min.$100-$l 000 fine No Doc.Building Permit Revised 2007 A2Ed 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 I Building Permit Application Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses Li Copy of Contract Li Floor Plan Or Proposed Interior Work Lj Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Li 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 I Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) u 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 Li Workers Comp Affidavit Li 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 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 Doe: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 W Location 0. N Date Check # (a - / (' —v? - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL 2 0 3 0 5! Building inspector 10/28/2015 19:01 FAX 1� 003/003 I ISSUE: DA CERTIFICATE OF INSURANCE PBZ29 PRODUCER Boyle InsuranCe Agency Inc TMS CERTEFICKTE IS ISSUED AS A KAYI EX Ut 114"� 'E I ILP11 V11L, A, ful- TE CONFIERS NO RIGHTS UPON THE CERTIFICATE HOI D R, TWS CERTIFICA DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW - COMPANIES AFFORDING COVERAGE P 0 Box 606 Woburn, MA 01801 INSURED T G L R C Inc COMPANY A.I.M. MUtUal InsuranCC CO LETTER A dba Lambert Roofing CO. 265 Winter SIrCCI Haverhill, MA 01830 COVERAGES THIS -IT TO -CERT" THAT THE POLIC0 Of INSVRAtICE LLSTED 139LOW HAVE BEEN ISSUED TO THE INSURED NIAMrt) ABOVE POR rHP. POLICY P9PJO INDICATED, NOTWITHSTANDING ANY REquIREmENTI TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WIUCH TK CERTIFICATF MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDRD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THR TERM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIM17S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 0 C co LTR TYPE 11 -INMAIIM TYPE OF INSIMANCE T POLICY NMOER POLICY EFFECTIVE DA'M(MM1DD)YYJ POLICY EXVIRATIOP DAIM(MMIDDiVY) mrrs GENERAL LIABILITY GENERAL AGGREGATE s PRODUCTS-COMNOP AGO, I COMM9 C�AL GgNPRAL LIABfLrrY FERSONALAADV INJURY I =�LAIMS A.9=CCUR EACH OCCURRENCE OWNER'S & CONTRACTOR 'S PROT FIRE DAMAGE (Afty We AW s M5D, EXPENSE (Art), 9M pamn) s AUTOMOBILE LIABILITY ANY Auro COMBINED SINGLE LIMIT BODILY INJURY (Psi pgflah) ALL OWNED AUTO$ SCHEDULED AUTOS IDODILY INJURY Mat addem) 41REDAUTOS NON-OWN5D AUTO$ PROPERTY DAMAGE 5 ARAGE LIABILITY EXC9$6 LIABILITY BACH OCCURRENCE AGOREPATE =�MGRELLA FORM HER THAN UMBRELLA FORM ,tMILOIGIS A i0IFFICHAS WORI(ER'SCOMFENSATION AND 1.11,11LITI THE PROPRIETOR. X INCL PARTNSRSISXECUTIVS AR& 6009966012006 03/2ZI2006 09128f2007 X I rw' 'TA' 0- nox ww EL EACH ACQQENJ ">Vuxuu-- EL DISEASS-pokicy LIMIT 500,00, AL D,sEAsE-vA EMPLOYEE 500,000 DESCRIPTION OF OPERATIONS/LOCATIONSASMCLES/SPECIAL ITEMS CERTIFICATE HOLDER CANcELXATION SHOULD ANY OF THE ABOVE DESCRIBED POLICMS BE CANCELLED BISFORE THE EXPIRATIO14 DATE THEIRMOV. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRnTEN NOTICE TO THE CERTERCATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO ODLIOATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPMENTATIVES, AVTHORLZED REPRESZNTATIVE The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly I--, Name (Business/Organization/i ndivi dual): 11;vF,- ' Address: J el "/, �Te-, S ) City/State/Zip: Phone Are you an employer? Check the appropriate !!9e I. El I am a employer with 4. [E] I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. [:11 am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees working for me in any capacity. [No workers' comp. insurance 5. El required.] 3.0 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have workers' comp. insurance. 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.] Type of project (required): 6. F� New construction 7. E] Remodeling 8. E] Demolition 9. E] Building addition I Ofj Electrical repairs or additions 11.0 Plumbing repairs or additions 12.n Roof repairs 13.n Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. f 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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurancefor my employees. Below is the policy andjob site information. Insurance Company Name: Policy 4 or Self -ins. Lic. # Job Site A rI 60(� �5 Expiration Date: j � City/State/Zip: A/ - y�� d Attach a copy of the workers' compensation liolicy 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 certif y r ains andpenalties ofperjury that the information provided above is true and correct Si�4 atui7 Date: Official use only. Do not write in this area, to be completed by ci(y 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 #: A 6 z E 0 0 Cf) z 0 C/) fl, C/) z 0 u Cf) C/) 4-) co 9 E CD CD CL 0 COD a) cm ca E C'o co CL CD Q C= M C* CL CL CM< ca 0 cc C.2 CD C* CL C.3 ca cc cc CL U) Ck uj U) LU cc LLI 19 LLI uj U) LE u Irl C/) 0 M LE u x Aw X x 6 z t V) 0 U) Cf) z 0 C/) fl, C/) z 0 u Cf) C/) 4-) co 9 E CD CD CL 0 COD a) cm ca E C'o co CL CD Q C= M C* CL CL CM< ca 0 cc C.2 CD C* CL C.3 ca cc cc CL U) Ck uj U) LU cc LLI 19 LLI uj U) CD cl C5 CL'o CO :01 r CD CF C.2 cm mi CD CD CD 3: COD cm cc 0 zip cc =0 CA :9 73 co S, 0 CL CO CD 10, a; =0 3: CL— ID COD =0 ca *1 CL= 33 , .0 co 10 cm U= i C.2 w CM 0.00 E �s 4D — C2 m .0 211 m 0 C2 b -Z's CL 4- cc rw Cf) z 0 C/) fl, C/) z 0 u Cf) C/) 4-) co 9 E CD CD CL 0 COD a) cm ca E C'o co CL CD Q C= M C* CL CL CM< ca 0 cc C.2 CD C* CL C.3 ca cc cc CL U) Ck uj U) LU cc LLI 19 LLI uj U) 10/28/2015 19:01 FAX 1�002/003 ......... - -TC—)ATE(MW4 DD/YYYY) ,ACORD TK CERTIFIdATE OF LIABILITY INSURANCE 1 10/1612006 OF INFORMATION PRODUCER phoj�j. (Ta I j 033.YiDo Fox: (741) 033-9046 THIS CERTIFICATE 18 ISSUED AS A MA-TTER ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE 3ALEM FIVE HOLDER. THIS cERTIFICATE DOES NOT AMEND, EXTEND OR BOYLE INSURANCE SERVICES ALTER THE CpMRAQF- AFFORDED E THE POLICIES 06 443 MAIN ST BOX 606 WOBURN MA 01801 INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURER 0: T 6 L R C INC DBA LAMBERT ROOFING INSURER C: 26S WINTER 3T INSURER D: HAVERHILL MA Oi83G -... 1— - THE POLICIE3 00 mrijuiNce LISTED lit-.—OWHAVE BUN ISSUED TO THE INrVML BE OR OTHER DOCUME ANY REQUIOmENT, TERM OR CONDITION OF ANY CONTRACT FFORDED by THE POLICIES ORSCRIBED HFRFIN 11 MAY PgRTAIN. THE INSURANCE A ..-- -- .— acmir-rn RY PAID rLAIMS. PANY ;SPECT To WHICH THt3 CERTIFICATE MAY 'IE ISSUED OR TO ALL THE TERMS. EXCLU31ONS AND CONUIT*ma OF SUC" ACORD 25 (2001t08) I-ervIrIcale vp cova w ^44wmw U-1 -- I.-- I... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLGI) 96FORETHE TypC OF INsuRA Net EXPIRATION CATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS ICY armoTpa DATE fM POLICY &VgtA?WM LIMITS OR imsm -(�WNE PAL UA 0-1 L Il TV NO $09679 lom2loo 10111=7 EACH OCCURRENCE YO ARNTED 1,000.000 =661 mr!2autm x COMPIGRCIALGONERALLIABILIrY .j MCC. UP (AAY o" P--) 1 5.000 CLAIMS k4AQE OCCUR PERSON kL 6 ADV INJURY 11000.000 A GENERAL AGGRI50ATE s 2,000,000 PRODUCTS-COMNOP AGG, 1 1,000.000 GEN'L AGWGATE LIMIT APPLIES PER; POLICY C EILOC F7 [: 'PROV AUTOMOBILE LIAINILITY ZT6915 07116108 OT/16/07 COMBINED SINGLE LIMIT I (Em arodrni) ANY AWTO BODILY INJURY (Per Pvw) 300.000 — — ALL OWNED AVVOS X SCHEOULFO AUTOS 50DILY INJURY 1.00,000 B — x "IFeD AUTOS x Nom -OWNED AUTO$ I (Pow ecd&-41) PROPERTY DAMAGE s 500.000 I — (per seddent) GARAOr UANILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC ANY AUTO AUTO ONIY: AGG S exclE33 / UMBRELLA LIABILITY FACH OCCURRENCE s AGGREGATE OCCUR FICLAIMS MADE DEDUCTIBLE s wopireRs ComPfN6ATION AND IWO STA TO. Z—L I o— El. EACH ACCIDENT 9 EMPLQYCRS- LIABILITY ANY PROPFICTO"A0WEAfFMCUTIVE OffiGERrAMBEft UGIJ619907 G.L. OtSEASE-SA EMPLOYEE I E.L. DiSEASE-POLICY LIMIT s It Y.O. do"Ato U."? L a maw L OTHER: DESCRIPTION OF OPERA'rIONS/LOCATIONS/VEHICLES/EXCLUSION$ ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS WORK COMP CERTIFICATE WILL BE SENT DIRECT TO YOU FROM A.I.M. MUTUAL WORK COMP CERTIFICATE HAS 13EEM RECUESTED. ACORD 25 (2001t08) I-ervIrIcale vp cova w ^44wmw U-1 -- I.-- I... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLGI) 96FORETHE EXPIRATION CATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO 30 S14ALL IMPOSE NO OOLtOATION OR LIABILITY OF ANY YJNO UPON THE INSURER, IrS AGENTS OR RFIPRESENTATIV", AUTHORIZE0 REPRESENTATIVE Attentign: ACORD 25 (2001t08) I-ervIrIcale vp cova w ^44wmw U-1 -- I.-- I... 10/28/2015 19:00 FAX Board o(BuildIng ]Regulations and Standard3 HOME IMPROVEMENT CONTRACTOR RoplAtrattion: 149221 EvIalration: 1,2)P/2007 Type: Private Corporation LAMBERT ROOFING CO RICHARD LAMBERT 265 WINTER STREET HAVERHILL, MA 01830 Administrator License or registration valid for ladividul use only before the expiration date, If found return to; Board of Building Regulations and Standards One Asbburtan Place Rm 1301 Boston, Me. 02108 Not valid witbout signature Board of Building Regulat2ons and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 LAMBERT ROOFING CO RIC -HARD LARAInEPT 1-- � 265 WINTER STREE I HAVERHILL, MA 01830 OPS -CAI 0 56M-0410S-PC&698 Z001/003 RegIstration: 149221 7 - 0 U , ypo: PrIvat Corpora! C -in Expiration, 12/6/2007 VpdAte Address and return card. Mark reason for change. D Address 0 Renewal 0 EmployMent C) Lost Cart Board of E3 Uilding Regulations One Ashburton PTace, Rm 1301 Boston, Ma 02108-iplq License: UUNSTRUCTION SUPERVISOR LICENSE Number: CS 078130 ExpIres: 0610212008 RICHAIRID.1' LAMBEART 95' MAPLE AVE ATKINSON. NR 03811 OPS -CAI 0 SUM-OdMS-PC&699 13irthdate: 06/02/1972 Restricted To, 00 TF, no.- 27100 - m MUL P top �ar racnin! ano "- , Ch-Ingeofaddrassnotiflearion. j tVLN M4'S Ein # 51-05033313 T* mbe MA Reg. Hic # 149221 MA Lic. # UCS 078130 M-fing 5 BBB -4 Single -ply Lic. # 1711 C�l -9 3 2 ___F_ z? '40 AIR C. MEMBER 265 Winter Street, Haverhill, MA 01830 We are: V Licensed V Insured. V Factory Trained V Factory Certified Installers Date: MA'i Estimate for: 1y) I P, - k r- V - Telephone 1: Telephone 2: IF- 6 93 & Z Address:7S 0 L V, Q C, V_ bIL City1rown: i 4rV Do V rF rL State: wid. zip: Job Location: Cityfrown: State: Zip:_ L.R.C. agrees to commence described work on/ ciriabout'. 1-3 k)K_1 _and clescribedwork,will be completed in'about 1-3 orking days. L.R.C. shall not be held liable for delays due to circumstances beyond out control. L.R.C. shall not be liable for any clarnage to landscape, attics, interior walls or ceilings and/orfixtures due to circum- stances beyond our control. L.R.C. can hot and will not be held liable for any damage to the surface that the disposal. container is placed on. L.R.C. - shall not be. held liable for pre- existing conditions including but hot limited to mold and/or wood rot, defective, faulty, rotted or worn building counterparts suc I h as but not limited to siding, gutters,.masonry, plumb- ing and windows that je parclize the Watertight integrity of the building and are not covered under the roofin w rr nty. 0 - I ''"g a 0 The following work Includes all permits, labor and materials needec! to complete your job in a professional4orkinanship like manner. Steep slope Quick -quote proposal to furnish and install the following: Approximate roof area 3aoo Ile New Roof Ll Re -roof U. Gutter El Repair Ll Ventilation "'Tepare for re -roofing by ensuring all safety measures are taken in accordance to OSHA standard regulations and landscape is properly protected. 21' Remove existing layers of shingles down to roof deck and dispose of in a legal fashion from the job site. Inspect wood deck, if we discoverany rotted wood, replacement will be performed of $-a pet LF for roof deck boards. If substantial deck rot is discovered, re -sheathing of roof deck can be performed at $J per SE If individualsheets are found to be rotl4and/or delo.inihated, removal, disposal and replacement will be performed at per sheet. If any trim boards are rotted, replacement will be performed at $ S_ 1z per LF for new pre-primied pine (not to exceed I" x 8'). If wood is ,Aound, we will re-noil any loose wood to rafters, sweep deck and prepare for. roofing. 9 )nstall B" Drip edge 0 Install 5" Drip Edge C] Install Hug edge (Re -roofs only) ALL� Color W iA C�,F_ V,Apply ice & water shield (UNDERLAYMENT) as per manufadureri';spec.ification.s and or 2- g5oorzvr_z 1194-L- (,1ALL6Y-9 U�Apply # felt paper (UNDERLAYMENT) to the'balance of the exposed wood deck. Ed Reflash all stock pipes, tie-ins, chimneys and/or any roof penetrations as required and dictated by.good, roof practice to ensure water tightness. U/ If upon inspection, we discover chimney to be worn or deteriorated, replacement -will be performed at $ S 1, Q per chimney for single flue and $ a�o- iser chnimney for multiple flues-, VA Yea r� nstall a new C] Traditional aa/Architecturdl style shingle roof system Color S4-6LCbL Manf. �)J' V 6rnish and Install a new shingle over style ridge vent system El Soffit vent system $ " M All debris generated by Lambert Roofing Co., In(. will be (leaned up and disposed offrom the job site in a legal fashion. Under no circumstances will the watertight integrity of the building be compromised. Special Notes: Warranty options: id Standard LRC 0 Manufacturers Upgrade S Denotes additional costs above the total estimated price. UPON COMPLETION AND PAYMENT IN FULL, ROOF SHALL HAVE A WORKMANSHIP GUARANTEEFOR A PEIZIOIJ.OF TEN YEARS HONORED AND ISSUED BY THE LAMBERT ROOFING COMPANY AND YEARS HONORED AND' ISSUED BY THE SHINGLE MANUFACTURER. This document can serve as a contract, however ita, more elaborate contract is desired we will issue. it at the owners request. Please sign and return one copy upon a I cceptance. . NOTE. if this contract is not accepted in days, it may be withdrawn by LRC Financing is available A finance charge of 1.5% per month.'(18% per year) will be charged on post due accounts over 30 days. Total Estimate Price: $ 1 q , 46 61 - "' Date of Acceptance Payment to be made as follows: E ��o 0 3A z -,A C_ P�L (Home/Business owner) - Signature 60 (LRC) ��Tl Signature Haverhill NIA 978 374-9224 Lawrence MA 978-687-7339 - Atkinson NH 603-362-9500 1 -888 -SOS -ROOF (767-7663) Fax: 978 521-5791 "Our Proof is on Your RooP I www-larnhartroofine-net