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HomeMy WebLinkAboutBuilding Permit #429-16 - 86 MAPLE AVENUE 10/6/2015 J# TOWN OF NORTH ANDOVER NORTH q APPLICATION FOR PLAN EXAMINATION � 9 Permit NO: / �+� Date Received r°4 • ''� . �1 wONwi°- 9SSACHUS�t Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION R-(o 69 Mkp V PROPERTY OWNER adkh Print - -O r-ck- Print MAP NO.O�o PARCEL: ) ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential 0 New Building ❑One family OjAddition ❑Two or more family 11 Industrial 4 Alteration No. of units: 0 Repair,replacement ❑Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving relocation ❑ Other ❑ Others: 0 Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) J��n r� C�-�-U r cam. - `f-7 q - L OWNER: Name: Phone: Address: CONTRACTOR Name:v4q- P,-q Phone: ' (, 5-7 Address: �� e+1 S I S Supervisor's Construction License.T4 e r Exp. Date: Home Improvement License: l` Exp. Date: S 2 l ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$1200UR R$1000.00 OF THE TOTAL ESTIMATED COST SED ON$125.00 PER S.F. Total Project Cost :$ r0 x12.00=FEE:$ Check No.: 1 0 Receipt No.: Page 1 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ F1 Tobacco Art ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to th9tampedPlan n Signature of Agent/Owner c91 Signature of contract Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments I Water& Sewer connection/Signature&Date Driveway Permit f Temp Dumpster on site yes—no— Fire Department signature/date C" NORTy BUILDING PERMIT oF�tLE° "6o TOWN OF NORTH ANDOVER F APPLICATION FOR PLAN EXAMINATION * SS M � ZTil7 .ch Permit No#: Date Received A°RATED�Pa c5 �SSgCHUs�t Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no it MAP PARCEL: ZONING DISTRICT: HistoricDistrict 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 El Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other - - u.. O,Septic ❑ IlUelh ❑fFlootlplain;; D`1Netlands _ _ �,. -. - °WatershedifDistrcic t� f DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Ex Date: Supervisor's Construction License: p i Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: i � 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.: Receipt No.: NOTE: Persons co_r rating with unregistered contractors do not have access to the guaranty fund 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 OTE: 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/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 4 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 Fire Departmentartment prior to issuance of Bldg. Permit OTE. All dumpster permits require sign off from 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 Dg oe:Buildin Permit Revised 2014 w Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tannin� Pools ansag eBodYArt 5� nnmin 11 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 & DEVELOPMENT Reviewed On Signature_ COMMENTS i CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Si nature COMMENTS a Zoning Board of Appeals: Variance, Petition No. Zoning Decision/receipt submitted yes Planning Board Decision: Comments •� r Conservation Decision: Comments Water& Sewer Connection/signature ®ate Drivewav Permit ]DPW Town Engineer: Signature: .� Located t d 384 Osgood Street �v ENpk-v- rnp Dumpstera$an �L�cated at1�24 Maml�Street� �� y °�iii'• .� ���j��� .,�+ .ate �`�. S. :.� Iv i I t SY f a t �C t t�� Ka L Fire Department signature/dates TY �j{t'' ` W1ry "`g.�" ¢¢ic rote�-t�.. -.r.��YGa..a,1LA!«.�.•aL.ar«—�..`,�. .. ...... �,R ^� t++i a �B r 3'!. 'tii��9��+a�ldP � ;x^'.+ *�°�-.�_ ."_ l '7+Fs��.•f6,.,-�.o.�. �.,, '.� } i �,: .vim 7,• .L_ .s att A. 4 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.$1oo-$1000 fine NOTES and DATA— (For department use) I I ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 it 1� Location 1e No. Date U t . • TOWN OF NORTH ANDOVER s v Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ ' Other Permit Fee $ TOTAL $ Check# II 29466 ..Buildincj I spector MIVE Hown of Andover 0 0 No. ,f f _"_W7 * 1 _ hver Mass, 2= o COC MIC KE WICK ORATED S U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ................. v1.�..... ........!!P .:... ...... ..... ..................... . . .. .. .... .. .. Foundation has permission to erect buildings on Rough tobe occupied as ..............5_00 .... . .1,20 .t..................................................................... 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 CONSTRUCT TATARTS 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. f a We,SoiTICA w PkuLt- L-PL 1b'Re wo C:r—"cis) Mailing Address/Main Office: 377 Lowell Street,Wakefield,MA 01880n.`+�. � Tel: 781-245-4900 PETER RYA Fax: 781-245-4999 www.PoterRyanAndSonRoofng.com and i ROOFING, Inc. Submitted To: lob Location: John Tortora Ci 86-88 Maple Avenue 86-88 Maple Avenue North Andover,MA 01845 North Andover,MA 01845 Phone P 978-479-9541 Email: JCTortora@gmail.com Proposal data: August 18,2015 We are pleased to hereby submit this proposal to furnish materials and labor,completely in accordance with the below specifications: (Additional charges may apply for any change's not included below in proposal either by request of owner,or if Peter Ryan and Son Roofing finds unforeseen circumstances that will affect the performance,quality or integrity of this job).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's fees. Not responsible for debris in attic. Stull WWWOR, ' Strip entire roof to bare wood and re-shingle: $61180.00 • Strip existing shingles down to bare wood Check for rotted wood and replace(at time&material) • Nail down any loose wood • Install ice&water shield to first 6-feet,and in all valleys and around any protrusions • - Install premium synthetic underlayment(in place of standard 301b.felt paper) d BBEL • Install all new 8"white drip edge on perimeter and step flashing,where needed • Install manufacturer suggested starter course of shingles 1 �; • Install IKO or GAF Lifetime/architectural shingles in color of your choice • Install ridge vent,where a ridge vent exists r • Cap ridge vent properly with manufacturers suggested cap,where a ridge vent exists(GAF Timbertex® or IKO Hip&Ridge 12) • Properly flash any protrusions and all new pipe flanges,if any on roof Clean Up: • 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,if applicable PAYINE TYT A e COSI IIegl allS In hides cost of ° ,emit labor dutrt &�mater�ai � P8y11tent��hEtftlle 1st payment due upon signing: $1,980.00 Total Cost: 6 980.0 Total balance due upon completion: $5,000.00 C l 3 `Peter Ryan ._ //0 Respectfully Submitted by: Accepted by: Our craftsmanship is 100%guaranteed for 10-years. 1 other s are through the manufacturer.All warrany9kill be null&void if job is not paid in full. Peter Ryan and Son Roofi c.License#178871 Thank you for letting us a you!!! cc: Paul Please mail all correspondence to our Main Office: 377 Lowell St,Wakefield MA 01880 1 Tel:781-245-4900 New Location:352 Main St,Gloucester MA 01930 1 Tel:978-559-7333 E; ; .Tragi C:'agar,.r�r:.r°'c�:rr,rt'-�irt'1�.Ir,:n,�'111rrssr�-rly•rr.s.�r`fs • - .I7°��:�err•t,ti:r'���r:f opt'frr.e�lrr;sfr�9rlF�:rr�rF.��rtt;s 7 Y' BoWoif-i, JIM 0211.4-20.17 W-ns'k:+z ':SGgrn..1peus t:�i.013 Z:1x 31'1�''i'1.T1 'Af kilt ' t. -A M,1.1,-CA1n,_1:T,I->faz<:tral..'adon Peter Ryan and Son Roofing, Inc. Ca Addxess: 383 [rear) Lowell Street,Suite 20 C, WHOM,Wakefield,MA 0188.0 p11:o1.1,� #; 617.571-9056 Are yoet it>TTetla1llayeT°'7 lc f`h.e°tlI7I:T�'r��31'��fie br,�t T�,17e'of Ia:i;<uject .(r esltfit ecl): 4. 0 I.ain n gpeti .vn:l ac,.r.ttra:et.oi atlil I. 1..❑ I t1s.11 ll triTtlato'y�r. �ti�itll 6. Q NAnv coilst:v-ewtiari ei:ylalo,}gee (fi'atl i i�c loi Iait>t:�t:i'.t l ).'f I1<7ve:luv�xl-die 5111,-'Cl7Eltl�ctcary �•..❑ T Y.1111 n solr l.)1��I:}i�it;t:ax•�-ri•laa:i'ttter. Iistecl mitlle otuwh,e6l dloet. 7, ❑R:et.1.lvrlel`.iri . slli';la ai'lcl.11nve >lo enlla'lo)r�e's "l hese �v -ooxi 1.eto'rs lin-ve D�tliul.iticlrt ❑ : workii,1a fora'111e ill ally cn:lagit)y nare{ h.a\le G,.r:I:Ex's' a. Q Bl1ildirig additioil No 1§'o:Ck�'1's' Q0111a h11SlU Cf114t C'l',tll), 'fi'LStah'tld'1C�.i [ {: 4, [] AUC are n�..w aor'ntxo.rl alid 1'f.S 10.❑ Ea:rcal°kill.r�l)n.it:'s ctr a'c1cLi.ti��n re,cftiirecd,] , ;i.❑ I nlfl 7t. s. llcy111etttialec Cd`G)f11ft all \�co1'Ic tfti.c:e::i'�I:11�,`°e eX: 1'Cisctl tYlei.T' 11.❑ P.l.t.tittibii'Y .r.apa.irs orit{Ii"{'ft.1Ct'il' i'i: llt.of zx+~u-11an laCa ) I7:o�a:t i e•�tlii s Tr>yself, [No work,:.rs ixi-.aip. 12.7. y. iilstarn.lrce lie t.1il:ecl,. t e. 1.5'Z, y 1(q),.nl:lr{ t�-e la.�•e laic, g ] 13,Q O tht.1, eir.1�1)Ioyz.es., [1Vt�«�at:l�,es•y� cc,:tl.i.p.hisu..1:'rtitce:i•".guireel,] *,�11y 1.1)til`tG.11lA1 IIl1t'G1l�G1G5 bo�.�:t rtnas.t.a.tsa till oLrtthasectitsil tet°�1T�sllo�^�.ill�ttleir,vo�keny'coatipeftsai:i.pn t��liry ilrtr�riutr';tian. t Honlaomners who tmfk 1,114 tllen.Ili It 01-Mi°de Mtatr.WOM faltis4 strt)alt'it.a:tae.w a:#Fd'1U.f.f illttfG11:111g Sf.i4ti. lVolunctol.s thiel died I.11i,s W.,nanst.tittached Til.a;ld.itiollat sT1e'e:t.sho'tti.i'tib the.11eilla of the mid tae wbe1I1e1"or Clot:triose•eit'ti'.Yiei helve. employees. If the stab-contractors haw.eu1 p. loyaes,'they fledge 11.rotride:their wockecs''contp.I)oli.C,y lrtiiilber. I wrl r17r e1arp1,gy8r t.ear h P-1,0:14dirt:a'wt;rker<s' B:00.1t, Is the pal.fc l'(7:r'idjol).s'dre lit�t�yfilarl bit, I115tr1'ili:t'GC Goflalallily ta.11lc; N/A (I am not requlred'to carry W,C as I have no employees) Please see the Sub•Contraotor's W.C.0Idavlt att,' Po icy'!f'o.v tie°l:f=ills, Li.c. #; R/A B~vaail:�+:ti.c>t1 D�t.te: t�.tfine•ln n: Cole> . _.. Cit) Job SiteAddress'...,.- 6.f d ress'...:. .of(ie.))'ralcel,S, de:Cla:.I"•r1.6.0:t1I)a.ge (.01,0'N igtrili5e tnroz-�i:kZy ; irr-nibei' ct.li=:de�.7ir,n''tie,n tlrrt:e).. Fn:illiie to secellE ouvea ale 1iy 1eGtriirec{ llrlcler S,e,aioil 25A c+E M;C.TL•e. 1.5 A.,an le.•i.cl to of exilnisir,t {aeriti{fics of I •lecke u�l) t.e, 'I;.1.,500.flQ:lt:iclru:r 17rle�ycrlr i111}�iis>cra:ullerlt., tis well as 0ivil I)en:atties ill.:tht tanil o .a STOP WORl' () DER ai:ic{ -1 f of of Ili tG, ;?5CI,4U a:clay i1;i7yn:1tiSt the S'io:L.ztc,t'. Be'rt.&.,ke,d t.l.t'<1.t l �cz1sY o.f t{.lis st;1tk.lntilt:illn.}� 1)z fa11�'rtrclGrl rG� rllz <�ftrce of IC1.Cr>'SI:l �f1CTFi'S 0f the MA for iilstwria:lcc cl�`�:1ii: z v+r1'i.tienti:ail. 1�r.o her'e:t),v ef"i-yi cr'.ii4e'r rlt.o.p(1:111;s rr1r:rlxa'.arr7:ndtles' tb....w t17w (:$17:C)w i!s'rrrw.e, arrrl.c)or-roes. .� 617.571.9056 .. �)f cl:rr.l r<rs�tr orillr. ,Do itatl-lyr to ltr.:ll7.ls (.T,,m r, tt) Ue rnrtr!1441ed.41.1 alt j� c)r'tn",up. cr��clrrl.. (::it\' or ToNvir: Pie rlrlitlLloe.11s'e L9sal.:�:1.g.�tl�tli:c'i�lty (,c.I:rra;e oa e)1 Ba1.i1.c1'1a1 Be,a)l.rtrllelit �i,'Ci"t}'lTow1C_;Ue 1. 4<E<I'.e:ctt%iia1InSpiee'to1, 55..P"�ltcrrrl�,illigTU.-speCtur '.l Bo�l �cl vT T3etn1`tll 2 � I , C:olr:t:7r>'t FpT s':o'aa `1rtl:tti:e: ^. ,. Th:e C;onnn'ort>uer lth of l'as a-Cliffse-US Departn..ient ofIrr.duslr.ialAo(??,detrfs 4 q-ffice of.Irrlje:s-fivit ons X ('orr r i�ss ,S`tr'eet,, SO(e 100. BoVort, MA 02114-.29.17 a v ,mss tlu>•l,r/rtr>s.,govNdtr. Workers' C4T1PT14i iati Ilsl > lnceAfialv i11 �3T1i1'IIeT"5/(.;O..lltl''tlCt.�Z,'S/E�@::r.11'ifii�115lPi.11lllber's A li 'rant.Izi.for--rtafloll'. P�ease Pruitt Legbl. ' N1.111t' (13t1hilless/nrgatliZa.tioll/Inxl3vidlaa'1):. Le'mia Construction, In. ,4C1d1`ess: 7'1 Pro-sped Street City/'Swle/Zit); Bro' ckteln, MA 02:301 F'i11J11e #: 8018-232-1194 Are Voll all eln:i7loyet'? t3veck ft1.e. appropl'.I.I1te buxs T"e of project (recllti'red): l ) 4, I salt��.r'erlel'll.l i gIrtra�'tat'a.11d I 6 ❑ New coli4tYllotiall 1,FW I.,1111 a van)lo pit'1Vit11 'I 0 ,lo �eCS'Hitt a.1�d/0:1' )t11't•t.ilrle;),1` h11.ve 1lireci t11�' SUb'•l`orlt:l°aCtO]'S I' ) listccl.ail the a:-twl llyd sheet. 7. ❑ Relnocle:l.i11 2.❑ I aln a.sole proprietor or•pl}a'tuer- '--hip -alld Have no e11*10yees Thew stip=cantrllct.��rs lz:a_�,�e g, � Det�tiol.il�l;�n 1uclrkill t for tile'in ally cl�:ptl:w.ity, lnployees alad have Nvovkers' q., ❑Building tlelclit.iau No\,vorkers' oomp, til-surii-me. 1:��11117, fI1St31'111:ICk,1 1 10, Electl'ical 1'e)Bit's or addition." recllllred.] g, [� We a:re a ��c�l�)arlltlatl.alld�ats ❑ 1 3.❑ I.alll a 111)nlea�v�ller daillt;.all wal�lti a1�.tlCel'S`lla.��e�e�crcisx:cl tlle�.ir l�t.❑.Plu1T1Ui11i� re]7tlri'S or aClCt1t1o11S rig+l'.lt of exemptioI1 pernri.C1 � rC ail's 111ys,lIf [Na worker-5' Conap, 1 ❑ Rod 1) , itlsurarlce rerluirel�..�t c.. 152, i1(4),atld sue.hale tlo elliploye:ea, [No-workers T;i,❑ C)t:ller VUllip: 1t1:41)6'aS14� 1"ZClr1tY'+rCl,� "'Ally applicant that:chel ks bvs#1 Ilius-.also fill out.the sectiou below worker-9,coulpeas'ntion policy iufonllaiioll. t Hutlleol+alers lvlio subolil this ItMdavit ialdiclltiug.they are doing,a.tl work"Uldtheal hire outside cotltrectors must S-11billit a:clew affidavit indicating such. tt:ontractars that.check ibis box showitlg the llwre of`the sub•c.o.I lradors alld l tlrte whether or not those entities I1ave etlilployaes. if rise sub•contrnct'oralla've.earploye-es, they their wcirkers'romp,police-nuuibes. I ant an ei-nplc ywli,that 4ppol'0111.8 wopkep.s"'compensation Ins•ura-rrre for rrl,y etnplo,yees•, Below is flit,polls)(711djob site InfioPitt ration. I1ls1ari111ce Comp,myNmne. Insurer A. Northland Insurance, Insurer B. Arbella Protection, Insurer C: Travelers A/R Policy#or Self i11s, Lie. : 6S60U13-51386069-2-15 Exl)iraticra Date:; 03-01-2016 Job Site.Address; tate Att.a.c11 acopy of the workeus' compe matioll p011e:), decl,11^11(.foll plig:e(FI10;Ing.the p011c), utlulber raid e.xpliratio-11 ante), FMI111•e t0 SeCGIt'C'GOwrtip us rt'-gllirt:d 4C11C1e1' Si Goion 25.A of M-OL C, 15:21.Call lead 1.0 the Ill-1positioll o:f gxilluf7al p€lla.l.t.ies of a tll:le Alp to$1,500.00 111.1.dVa1:oll�:-ye"a.l' Y111pr14071111elit., m., wt1 ll as QiVll J.,nnalti'C5 in the fol,111 of a;STQP WORK,ORDER.and 'a flll� of rlp to$2.50,00 a clay auaul.st the vio.iat.or, Be rick'iced that:a copy'of this_staternellt:Wray.be:fol-vardee! to the C7ffioe of Investi a.tious of the DIA for ialsm-mmiot; Qovts.r"1gpe V'twi:i'ontioil, Lilo 1'mweby oerttfy r n-der th-ErPntmrtheft tyre 117fbrum-t'j.orl pi,ol4ded robot+e J•s r-rue and mrPe(I. f . t _. ........ nil ELI ..._....,_...,...,._....,...._,_.,..........._.._.................. ............._..._....,........,...........,.,.M.............,.................,,�,..._...,....._,..,,...._,.,......,.,....,....,......_•_............. .............................. Ufflclal.asEl only, Do nor.ipp to ill t$rt':s e were, to be oom leted by e'1t;y yr tcrmw off rola/. C1ty or Towilt Permit/Lice.nse 9 Fssta.n-g Autliorlty(drele 0,11(91 L.Boa.rd ofHet:i.ltll :�, B>tllclizlg.I3epllitlrrell#. 3, C:itvlTolvrl. C:lel'1,. 4,.EPer:tllc.al Zu.slrerf.ol' :+. Platt11b111;r Lu:spec:tol G, Otber Contact Penson" P+.hnn.e.91 1 ' ar °t �.I INSURANCE DAT04I09/2016 YY) CERTIFICATE OF LIABILITY 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 hoidor Is an ADDITIONAL INSURED, lho policy(los)must be endorsed, If SUBROGATI N IS WAIVED, subJacl to the terms and conditions of the policy, certain policies may require an endorsement, A Statement on this cortlficato does not confer rights to the cerllficate holder In Ileu of such endorsement v)' co ncT JoWe M KBiivr PRODUCER NAM L;, � MassPaylnsuraClce Services,LLC ___..._.._....._...___.....•._._..._._...__.,.__.____..__.._._.. PHONE —1 (878)774.4338 X115 r FAx (978)774-1318 27 Garden Street,UnlI 1B I (ac,Nc); MNI. 0 e mass a nsurence.com Danvers,MA 01923 AnGREssI l � @ p N INSURERS)APPOROING COVERAGE _ NNC q INSURER AI Northland lnsuranD� NOR INSURED Lema Construction,Int INSVRER a; Arbelle Protection _ T 41360 Jesus Lama INSURER C: TRAVELERS AIR TRC- 71 Prospect Street __.... INsuRER D; _ Brockton,MA 02301 �..... .�__..._.._............. ........_.._.__.. ................ ... ......_.. ............ . INSURER B, INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIIcS OF INSURANCE LISTED BELOW I.1AVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEb, NOTWITHSTANDING ANY REQUIREMENT, TCRM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY RE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUDJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS_SHOWN MAY HAVE BEAN R11D_UCE:D BY PAID CLAIMS. WE NSR S a I'OL CY EFF POLICY E PLIMITS LTR TYPE OP INSURANCP. POLICY NUMBER (MMIDD/YYY t(MMIOO/YYY A GENERAL LIABILITY W52361 61 0113112015 Q1131/201E S _ 2,000,( -` 100,( \ COMMERCIAL GENERAL LIABILITY urrent S _ CLAIMS•MAOE ©OCCUR parson T S 5,( INJURY $ 2'000'( GENERAL AGGREGATE S 3'000'( GENL AGGREGATE LIMIT APPLIES PER: I PRODUCTS •COMPIOP AGG 8 3,000,( I S 77PRO•POLICY LOC ^^" COMB. 0 NO E L MIT 1,000,1 B AU TOM OBILELIABILITY 10200092.74 11/2012014 1112012015 sac Ids„ BODILY INJURY(per person) S ANYAVrO ALL OWNED ✓ SCHEDULED BODILY INJURY(Per accident) 5 AUTOS AUTOS _.... NONOWNED PROPER Y OlAIv1AGE S ✓ HIREOAVTOS ✓ AUTOS (Par accldentl „_r I 5 UMBRELLALIN3. OCCqMAOE ~ EACH OCCURRENCE $ _. EXCESS UAB CLAIAGGREGATE $ OED RETENTION S S G WORKERS COMPENSATION 6S6OUB iB86069 7.-15 03/0112015 03101.2016 WCS7A7U OTH AND EMPLOYERWI.IABILITY 500 ANY PROPRIETORIPARTNERIVECVT14N N 1 A E.L.EACH ACCIDENT•,.• __ S`_ OFFICEP4MEMBEREXCLIJOED7 �� E•l•DISEASE•EAEMPLOYEE S 500 (M andelory In NH) 500 II yas,describe under E.L.DISEASE•POLICY LIMIT $ DESCRIPTION OF OPERATIONS below --- - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Mach ACORO 101,Additional Remarks Schedule,11 mora space is roqulred) Proof of Insurance CERTIFICATE HOLDER CANCELLATION _T — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORC Peter Ryan and Son Roofing,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 383(Reer)Lomil$reel Suite 2G Wakefield,MA 01880 AUTHORIZED REPRESENTATIVE Q 1988.2010 ACORD CORPORATION. All rights reser\, ACORD 25(201Q/05) Thu ACORD name and logo aro reglstarod marks Of ACORD a_ ( 777 ` LICENSURE Peter Ryan and Son Rooting, Inc, H11 :. 7/8-87 l P Peter Ryan - �.;iynYP•m�lmnnm/// rog.lin'trtlon vnlltl for Indleldut 1149 olity g•�; ()rO9aIIrG011A111n9r hlrpll'A(r4'iiIlAI11UtA(t9F11111ti11n b9rpre.1110 9xI)INd11n tintw rf NnuQ 1,401'n Im rtrt,, PMa iMpR,0VEMEHj 0ONTRA010R Typo (1f1loo nrCous11nlor AfMI's 1111dlluel1104s It9pulo1lun n pietmllont 1'18611 101'nrk Plnan'W4,6'170 , >cplralton; 0IW2010; Cnrpoa+tion puarnn,61A 021.1.6 00•.1 8R'(A1V B BgN•.W)PING,INC f:RRYAN . l•; pltlRYANr1( .I.BT.(Sl�l'rC 7. 101(RNAR)LOWI:I �a7;;.—tom Nnt vnllrl Ivl(ly Lsltinnurr9. 95•AKEFIIcLnIdA0166V linckrae9retnr)• Massachusetts Department of Public Safety � i Board of Building Regulations and Standards License: CSSL-106054 Construction Supervisor Specialty PETER RYAN 377 LOWELL ST RE '00WAKEFIELD MA,011 ` �•�n l-J� Expiration: Commissioner 05/17/2019 J MA 0 LES r R a--- HN2 2429 Date... �U..... l NORT1, TOWN OF NORTH ANDOVER p PERMIT FOR WIRING i i This certifies that J— �.( R.!S.��?q.�l.......1!1, ...... ....... .................................... i has permission to perform .......5.�.. c��. IP....../.(..P7........................................ wiring in the building ofT .Q.e....... .. ............................................ at.... ........ .. ........ .. ,North Andover,Mass. Fee.... Lic.No!l. . ........ .. ' /� ELECTRICAL INSPECTOR Check 4 �J�S �/ WHITE:Applicant CANARY: Building Dept. PINK:Treasurer The Commonwealth of Massachusetts occtce Use o„lr — Department of Public Safety ver.lc No. BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 occupancy b Fee Qhecked (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be periortned In accordance with the Massachusetts EJectrical Code. S27 CMR 12:00 (PLEASE PRINT IN INR OR TYPE ALL INFORMATION) Dat /17 A)6 Cit Town f Y ^ J/_,� �� ��7�"6l �[11G�Ve� To the Inspector of Wires: The undersigned applies for a permit torform the electrical tical work described below. Location (Street &.Number) p p/e 4 a Owner or Tenant C& /��' Owner t s Address_ ,S CLQ e- Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building ��j� e�-f1 R L Utility Authorization N0. wq,3 dR Existing Service -9-26—AMPS 420 , aZ LO Volts Overhead D/Undgrd❑ No. of Meters_ New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters t Num bet of Feeders and Am act .. t P tY Location and Nature of Proposed Electrical Work r er' 5oc e No. of Li htin Outlets Total g g No. of Hot Tubs No. of Transformers RVA No. of Lighting FixturesAbove In- Swimming Pool grnd. ❑ grnd. ❑ Generators RVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No, of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zofies No. of Ranges No. of Air Cond. Total No. of Detection and tons Heat Total Total Initiating Devices No. of Disposals No. of Pumps Tons KW No. of Sounding Devices No.-of Dishwashers Space/Area Heating KW No. o fSelfDetection/Sounding Devices No. of Dryers Heating Devices KW Local[] Municipal ❑Other Connection No. of Water Heaters KW Sitnsf 116-7-0r— Low Ballasts Wiring oltage No. Hydro Massage Tubs No. of Motors Total HP OTHER: ,4r^ INSURANCE COVERAGE: Pursuant to the requirementsof Massachusetts General,Laws I have a current Liabilit Insurance Policy including Completed Operations Coverage or its substantial l equivalent. YES® N08 I have submitted valid proof of same to this office. YES M NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® 'BOND ❑ OTHER [J (Please Specify) Estimated Value of Electrical Work $ Expiration Date Q Work to Start &lqlOo Inspection Date Requested: Rough c.,)i(f CV Final (,,>jdClj(/ Signed under the penalties of perjury: FIRM NAME ELECTRICMAN INC. LIC. NoA1 6199 Licensee Peter Manzelli II Signature g !� LIC. N0. Address Bus. el. No._ 7R1 _393_851 1 it. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not h ve the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent COMMONWEALTH OF MASSACHUSE S :'DIVISION OF REGISTRATION OF ELECTRICIANS EGISTERED MASTER ELECTRICIAN ISSUES THIS LICENSE TO ELECTRICMAN INC PETER MAN ZELLI II 462 MAIN ST N MEDFORD MA 02155-6540 16199 A07/31/01 748459 i I r TOWN OF NORTH ANDOVER OFFICE OF O COMMUNITY DEVELOPMENT AND SERVICES 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 pOFTF� of t..5 ,��tio Telephone(978)688-9545 FAX(978)688-9542 ►. p 4110 �,SSACH 5 t� June 21,2000 Penn Millers Inc. Co. PO Box 75 Manchang,MA 01526 Re: Maple Ave, 88—Claim No:2000-2687 Dear Mr. Baker: Please be advised that the Massachusetts Electric Code does not address the locations of meters. Mass O Electric has control of the locations of meters and required location must be adhere to by the licensed electrician. The Town of North Andover enforces the Massachusetts State building code in reference to construction, demolition,remodeling,renovations,and repairs of property including removal of resulting debris. I If you have any questions please call me at 978-688-9545. Sincerely, James DeCola, Electrical Inspector JD:jm File: Maple St,88 O BOARD OF APPEALS 688-9541 BUILDINGS 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 e 0 PENN MILLERS INSURANCE COMPANY P.O.Box 75,MANCxAUG,MA 01526 -(508)476.1120-FAX-(508)476-1120 June 14, 2000 Town of North Andover - Wiring Inspector Town Hall. North Andover, MA 01845 RE: Our Insured:Joseph Routhier Date of Loss: 06/06/2000 Loss Location: 88 Maple Ave, North Andover, MA Policy No.: PGP 7015969-02 Claim No.: 2000-2687 OGentlemen: Penn Millers Insurance Co. is the homeowners insurance carrier of Joseph Routhier of 88 Maple St., North Andover, MA concerning a windstorm claim where a section on tree fell damaging the main electrical wiring cable to his household. This is where the electrical meters to his household were located in the basement. After the loss occurred we believe that the power company advised our insured that the meters had to be located or mounted on the outside.We do not believe that there is a code requirement that electrical meters should be mounted on the outside. We would like to determine if the Town of North Andover has an Ordinance or Law in affect requiring the construction, demolition, remodeling, renovation or repair of property, including removal of any resulting debris.Also we would like to determine if the Town of North Andover has such an ordinance and if it is enforced and obtain a copy of that ordinance. We await your acknowledgement regarding this letter and your earliest most anticipated cooperation will be greatly appreciated. Sincerely, 0 im Baker, MA Adjuster