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HomeMy WebLinkAboutMiscellaneous - 121 BAY STATE ROAD 4/30/2018 - -� 121 BAY STAT- E� q�Ap i°`� 210/045.6 0039-0000.0 Date TOWN OF NORTH ANDOVER z PERMIT FOR GAS INSTALLATION This certifies that . . .�! . . . . . . . . . . . . . ////(1.�.�. . . . . . . . . . . . . . . . . . •\/ `/ F. has permission for gas installation . . . . 0.7 lel . . . . . . . . . . . . . . . . . in the buildings of. . . Dom- / . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . 12.1. 4�?/ 5 /e /�� . . . . . .NOrth Ando er, Mass. OWFee ."." . Lic. No. . -�,. . . . GASINSPECTO Check# r 8357 Nil MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY �(y _f �' MA DATE G PERMIT# JOBSITEADDRESS _ OWNER'SNAME GOWNER ADDRESS TE FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: (� RENOVATION:D REPLACEMENT:R.k PLANS SUBMITTED: YES F-1 NOE] APPLIANCES Z FLOORS-- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 1 14 BOILER _I' ! �I _., ::D(R, f_ I.I._ -1 I--- BOOSTER CONVERSION BURNER COOKSTOVE ([ nI DIRECT VENT HEATERT DRYERI FIREPLACE FRYOLATOR FURNACE : GENERATOR GRILLE - INFRARED HEATER f .~f __ LABORATORY COCKS 1.-.___.-I L—_a--j I�-1 I_-,__>1 L MAKEUP AIR UNIT -I �f�- ._- f _-.._N I-.--_..I_n.- OVEN POOL HEATER _.._—a I 1 I I (I _ ( — 1. 11 T._ _ 1. —J ROOM I SPACE HEATER _— ROOF TOP UNIT TEST _= _I f I i I .__(I -- I I- [f��._I UNIT HEATER UNVENTED ROOM HEATER .. I -.._._ I_ _ !_ i-_ WATER HEATER I-_ _ . OTHER - INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MOL.Ch.142 YES �f„J_(NO E] IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND I _( OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0-1 AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to t e best of my nowledge and that all plumbing work and installations performed under the permit issued for this application will be in coma with all P ent provi ' he Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 1-1 PLUMBER-GASFITTER NAME LICENSE#:95! _ SIG URE _� -- MP W_I MGF D._ Ii JP [J� JGF RLPGI CORPORATION D#=PARTNERSHIP[2#=LLC l# COMPANY NAME: r.. __. _ _ ADDRESS CITYSTATE ZIP C3 8 m TEL _ G FAX -�CELLEMAIL jui lit t 1 (/ ROUGH GAS INSPECTION NOTES TRIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ fD�ti' /Z ��`�' FEE: $ PERMIT# sr✓c �.2 C�q ` PLAN REVIEW NOTES "T-��-�-�- �s ►'►�-�r-r►�' rte- / r " i The Commonwealth of Massachusetts Department of Industriol Accidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizationAndividual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. am a sole proprietor or partner- listed on the attached sheet.2 7• F1 Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. E]Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.0 Roof repairs insurance required.]i employees.[No workers' comp,insurance required.] 13.0 Other !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 anew affidavit indicating such. TContractors that checkthis 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 insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy 4 or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 requiredunder 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 cer ?der th ins d p a s of perjury that the information provided above is true and correct. Signal Date: 6 �� Phone#: Official use only. Do not write in this area,to he 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#: r i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,. express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. AIso be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commomealth of Massachusetts Department of Industrial.A.acidents Office of Investigations 600 Washington.Street Boston,MA.02111 Tel,##617727-4900 ext 406 or 1-877rMASSAFF Revised 5-26-05 Fax#617-7277749 wwwmass.govfdia Location et � d t G I Arp f No. �� � � Date NORTH TOWN OF NORTH ANDOVER 0 9 41 r ' Certificate of Occupancy $ cNusE` Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ! t� P 19798 Building Inspector M f,T' TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONof 40 RT" ? 6 o 1 � t - Permit NO: Date Received !J �of�" *� Date Issued:� �9 �9SSACHU`����y IMPORTANT:Applicant mustcompleteall items on this page LOCATION �a/ /9,4Y f7--4740 Print PROPERTY OWNER C14At�y N W i N b L.e- If Print MAP NO.✓0-15.8 PARCEL: ZONING ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building j*One family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: Repair, replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition % ❑ Moving(relocation ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED 'SMIRI1 y- Rk-&0 AM �4PF. Identification Please Type or Print Clearly) OWNER: Name: GA RG L yN \k; N 0 LIE Phone: 97T 6Sro a5/7 Address: a ays�4 M CONTRACTOR Name: I4M6etQ.r &)661IU4 Phone: X175 37V 9;; Address: o1CeS tA/tt-21L U�, A1jf Supervisor's Construction License: O 7 13 O Exp. Date: (eQ Home Improvement License: � a' Exp. Date: a 4 ARCHITECT/ENGINEER Name: Phone: ,-address: Reg. No. FEE SCHEDULE:BULDING PERMIT:512.00 PER 57000.00 OF THE TOTAL ESTIMATED COSTS D O 5'125.00 PER S.F. Total Project Cost :$ SGQU. = FEE:$ Check No.: 3 �' Receipt No.: Page I W'4 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 ❑ Mass check Energy Compliance Report 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:INSPU TION.AL SERVICES DEPAR 1A1EN'T:9PF0RiN105 Pave 4 44 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools Public Sewer 11 Well Tobacco Sales Food Packaging/Sales Ell _. Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner t/ Signature'of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS - DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS + . DEPARTMENT - Te Dump ster on site es v nb FIRE DEPART mp p y _ Fire Department signature/date 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 Building Setback Front Yard Side Yard Rear Yard RequiredProvided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) Paye 3 of a Doc:INSPECTIONAL SERVICES DEPARTMEN'r:BPFORM05 Crcnted]NIC laa]006 %0RT?j own of over 0 No. �- o t dover, Mass., lift 3 496 0 LA �g A_ COCMICMEWICK 7,9 A�Rgreo PP '�C `S BOARD OF HEALTH PERMIT T D . Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...CIaim. .....Q11M.Ae. ....................................... ....... ............. Foundation has permission to.e�set. `... . �.! ....... buildings.on ....�... .�........31. r ► �...... ..... Rough to be occupied as......�. . ....... . Chimney provided that the person ac epti g his permit shall in every respect conform to the terms of the application on file in Final 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 UNLESS CONSTRUCTIO STARTS ELECTRICAL INSPECTOR Rough „•,:, Service ... . ...... .............. .. . BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. N° ' FD 4885 Date 0 TOWN OF NORTH ANDOVER RECEIPT s`SgCHU This certifies that ................. haspaid ........................................................................ for. �.;<A;.�.!.L e. .................... Received by ...................... �7 Department......... ....................................................... C/ WHITE: Applicant CANARY:Departm ent PINK:Treasurer The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.O.Box 1025 State Road,Stow,NIA 01775 PERMIT Date: //—dr`0 e North Andover Permit No Dig Safe Num er (City of Town) (If Applicable) rn accordance with the provisions of M G.L.14 8 Chapter_L(L as provided in section 5?7 ( MR 34 Start Date This Permit is granted to: Full name ofperson,Firm or Corporation Pennissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be . 25 ' from structure if unable to place with required Restrictions: cleaarrance dumpster must be covered with plywood or tarp end of work -day at (Give location by street and no.,or describe w s h a s to provied adequate identification of location) FeePaids 50.00 / Fire Chief This Permit grill expire6 (Signature of offical granting permit) Offical granting permit (Title) CERTIFICATE OF INSURANCE ISSUEDATE(MM/DD/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE Boyle Insurance Agency Inc DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 Box 606 COMPANIES AFFORDING COVERAGE Woburn, 06 01801 INSURED T G L R C Inc COMPANY A.I.M. Mutual Insurance Co dba Lambert Roofing Co. LETTER A 265 Winter Street Haverhill, MA 01830 COVERAGES 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 RESPECTTO 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIO LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOPAGG. $ LAIMS MADE[:::]OCCUR PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE S FIRE DAMAGE(Anyone fire) S MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE S EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM X OTH- WORKBR'S COMPENSATION AND RY LIMIT i EMPLOYERS'LIABILITY WC STATU. �_. 6009966012006 06!28/2006 08/28/2007 $ AI THE PROPRIETORi NEXCL INCL $ PARTNERS/EXECUTIVE EL DISEASE--POLICY LIMIT 500 OOO OFFICERS ARE: EL DISEASE—EA EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEIECLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �\ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 149221 Board of Building Regulations and Standards Expiration; 13/ti/2007 One Ashburton Place Rm 1301 Type: Private Corporation Boston,Ma.02108 LAMBERT ROOFINC:CO _ RICHARD LAMBERT 265 WINTER STREET � HAVERHILL,MA 01830 Administrator Not valid without signature Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 149221 Type: Private Corporation Expiration: 12/6/2007 LAMBERT ROOFING CO RICHARD LAMBERT 265 WINTER STREET HAVERHILL, MA 01830 Update Address and return card.Mark reason for change. DPS-CA1 0 50M-04/05-PC8696 El Address D Renewal Employment Lost Card Board of Building Regulations One Ashburton Pace, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Number: CS078130 Expires:06/02/2008 Birthdate: 06/02/1972 Restricted To: 00 RICHARD J LAMBERT 95 MAPLE AVE ATKINSON, NH 03811 Tr.no: 27100 DPS-CAI Ca 50M-04/05-PC8696 Keep top for receipt and change of address notification. Ein#51-05033313 T �SSE0."'�t rs9 MA Reg. Hic#149221 tube cy MA Lit. #UCS 076130 Mpg gi gi BBB y Single-ply Lic. #1711 Gue Z 932 v' T y~ 265 Winter Street,Haverhill,MA 01 830 MEMBER We are: ✓Licensed ✓ Insured ✓ Factory Trained ✓ Factory Certified Installers Date: �'OU- '' �� Estimate for: ;ijIAjF%� Telephone 1: c.>_ . `'< Telephone 2: —26 8 5-2-7 -2-6��� c,C Address• $ ym 11 Ci ty/Town: � H rJ1%�j E L- Statw r_�Zip: — Job Location: City/Town: State: Zip: L.R.C. agrees to commence described work on/or about <'" '� F: " and described work will be completed in about g p orking days. L.R.C. shall not be held liable for delays due to circumstances beyond our control. L.R.C. shall not be liable for any damage to landscape,attics,interior walls or ceilings and/or fixtures due to circum- stances beyond our control. L.R.C. can not 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 not limited to mold and/or wood rot,defective,faulty,rotted or worn building counterparts such as but not limited to siding,gutters,masonry,plumb- ing,and windows that jeopardize the watertight integrity of the building and are not covered under the roofing warranty. The following work includes all permits,labor and materials needed to complete your job in a professional workmanship like manner. Steep lope Quick-quote proposal to furnish and Install the following: Approximate roof area )Via'=`"' r. 0`,New Roof ❑ Re-roof Ll Gutter Ll Repair Ll Ventilation a"' Prepare for re-roofing by ensuring all safety measures are taken in accordance to OSHA standard regulations and landscape is properly protected. ❑ 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 discover any rotted wood, replacer ent will be performed at 5 :y1 *per LF for roof deck boards.If substantial deck rot is discovered,re-sheathing of roof deck can be performed at per SE If individualsheets are found to be rotted and/or delaminated,removal,disposal and replacement will be performed at$ per sheet.If any trim boards are rotted,replacement will be performed at$ *per LF for new pre-primed pine(not to exceed 1"x 8").If wood is found,we will re-nail any loose wood to rafters,sweep deck and prepare for roofing. C9 nstall 8"Drip edge ❑ Install 5"Drip Edge ❑ Install Hug edge(Re-roofs only) r+�.._. r'�:: s rir %- Color-�i,!4 Ar•.. © Apply ice&water shield(UNDERLAYMENT)as per manufacturers'specifications and or C� F'L!,.J a Apply / #felt paper(UNDERLAYMENT)to the balance of the exposed wood deck. �Ieflash all stack pipes,tie-ins,chimneys and/or any roof penetrations as required and dictated by good roof practice to ensure water tightness. ❑ If upon inspection,we discover chimney to be worn or deteriorated,replacement will be performed at S per chimney for single flue and -�Inst *per chimney for multiple flues. l� all a new :% Year ❑ Traditional ® chitedural style shingle roof system Color?,,,6-C—, a Manf. F ❑/,Fornish and Install a new shingle over style ridge vent system LJ Soffit vent system $ ® All debris generated by Lambert Roofing Co.,Inc. will be cleaned up and disposed of from the job site in a legal fashion. Under no circumstances will the watertight integrity of the building be compromised. Special Notes:irwt( Warranty options: 11(Standard LRC ❑ Manufacturers Upgrade $ * Denotes additional costs above the total estimated price. UPON COMPLETION AND PAYMENT IN FULL,ROOF SHALL HAVE A WORKMANSHIP GUARANTEE FOR A PERIOD OF TEN YEARS HONORED AND ISSUED BY THE LAMBERT ROOFING COMPANY AND A YEARS HONORED AND ISSUED BY THE SHINGLE MANUFACTURER. This document can serve as a contrad,however if a more elaborate contract is desired we will issue it at the owners request. Please sign and return one copy upon acceptance. NOTE:if this contract is not accepted indays,it may be withdrawn by LRC. Financing is available A finance charge of 1.5%per month(16%per year)will be charged on past due accounts over 30 days. Total Estimate Price: $ Date of Acceptance Payment to be made as follows: (Home/Business owner) r'},9 rf.a±,i. Signature (LRC) Signature Haverhill MA 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 Roof" unuw tnmt�ar4rnn�inn nn► Date.... f pORTh 1 ° "`" '• TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ACNUSE� f LC- This certifies that :..-`- .......`.. ....................................................................... has permission to perform . : < ~-.....:.... 'r........................................ wiring in the building of.. .... ................................. ' ...,North Andover,Mass. Fee..`S` ........... Lic.No. J .................................................. / ELECTRICAL INSPECTOR Check # 4826 //� (/1 /(7/1 // Official Use Only l�Olnm(!/7lVe((LI/t O//1L(.1.faC�(l.iel[.S I 2�xx Permit No. )ep(whnen1 o1 Jire Service-5 cp-e, z Occupancy and Fee Checked J BOARD OF FIRE PREVENTION REGULATIONS (Rev. 11/99) tleaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK ORT PE ALL INFORMATION) Date: City or Town of: A01�.��1�,0A i10—K To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street Eek Number) colrotur, W I ndle Owner or Tenant Ow ki C Y Telephone No. 0111 %pklollsl l Owner's Address ' YI & U1 At*, Ad.,tr Is this permit in conjunction with a buildin ermit; Yes ❑ No (Check Appropriate Box) Q Purpose of Building �I vo, ti'V< (4 Utility Authorization No. _ a 3 y I -I Existing Service 00 Amps 116 ;V40 Volts Overhead Undgrd❑ No.of Meters i New Service 2,00 Amps U V Volts Overhead Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ei--Yi Lt— Aepq)-Q de Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Sus (Paddle)Fans Transformers sf Total p• ) Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA AboveIn No.of Emergency Lighting No.of Lighting Fixtures Swimming Pool gmd. ❑ gmd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number __Tons_ __KW _ No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ Municipal❑ Other P g Connection Security Systems: No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force.and has exhibited proof of same to the permit issuing office.. ll CHECK ONE: INSURANCE F1 BOND F1J OTHER V (Specify:) c. c (vee (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. 1 certift, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Gt Nt G LIC.NO.:2YIN S Licensee: e0Wf (�7 C.,, Signature e— LIC.NO.:c13 Y t Y 4 (Ifpp alicable.enter"erentpi"in the license number line.) Q Bus.Tel.No.:l)i 12..).z-V 5 Address: .�cZ&.br1 �V� • �Y�w r G�. • 0 LI� Alt.Tel.No.:61) q30 Y.3X1 OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.By my signature below,I hereby waive this requirement. I am the(check one) I–] owner _ owner's agent Owner/Age y �PF-RMIT FEE: $Signature Telephone N