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Home My WebLink AboutMiscellaneous - 52 BUCKINGHAM ROAD 4/30/2018 52 BUCKINGHAM ROAD 210/015.0-0030-0000.0 .� S \\ V Icl( MORTGAGE INSOEC77OIN PLAN 52 BUCKINGHAM ROAD IN NORTH ANDOVER, MASS. MIDDLESEX SURVEY INC. LAND SURVEYORS 131 PARK STREET NORTH READING, MA. 01864 SCALE: 1"= 30' DATE SEPTEMBER 19, 1998 CER77f1ED TO. BANK AMERICA MORTGAGE e qo O 4100 Jv GARAGE O rn N0.52 � 2t STORY F' F LOT._ 6,057sff` 74.12' HERRICK ROAD - �`"OF�,Ssq ALPH. D. v H NOTES: 3t 1. OFFSETS ARE.NOT TO BE. USED..TO ESTABLISH PROPERTY LINES. 2. LOT LINES ARE. C0�1A LN A LON. LL REGISTRY OF ,�,S ( 'IM ) 800K 33 , PACE 109 C.O.T. 4877 I HEREBY CBRTIFSY BA p':QN t�lY` LDCE. INFORMATION AND BELIEF THAT THE Vn" �._ STRUCTURES e1N `TFIIS .;RLQ 'TAREA ►0ON THE GROUND APPROXIMATELY AS SHOWN AND 0O�IF'00*4. 147 TFIOF NORTH ANDOVER ZONING SETBACK REQUIREMENTS AT THE TIME Wee 110N AND THE PARCEL IS NOT IN A FLOOD HAZARD AREA AS SHOWN ON �F".,E�IYI.A. 'Ir1AP. COMMUNITY NO. 2 ;6ilC ZONE: X EFFECTIVE DATE: 6/2/93 P10208 7595 / J Date..3./ .1 ..... ... ... .. HORT1y +O 20ya 3 TOWN OF NORTH ANDOVER O ' ' PERMIT FOR GAS INSTALLATION s o • SSACMUS*' This certifies that . has permission for gas installation .4A ''4.-�? . . �i�4T-zg. . . . . . in the buildings of at . e� . .u�.&'. !t' ! i.` .�`^ , North �rr Mass. 3 Fee ?v . . Lic. No.. . . : . . . . . . . . .�J . . . . ►'..TOR GAS INSPECTOR Check# IW �f l3 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: -41 411A U L/—e,,, MA. Date: 3 / !( � l Permq�it# Building Location: S` 13✓0k 'V h Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes❑ No❑ FIXTURES to LU Cd Q~ N CO v = m =. wv F O0 LU cn = w w w W �z WZWop0W WW w 0 o Oa w X > ca v W 13 U )LLI O a O a W = LL Z W W Z e J I— I-- O z -I (9 LL W ca = w F w w U 0 LL O (9 2 2 O a W --- > > > O SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 41HFLOOR 51HFLOOR 6niFLOOR 7 FLOOR 8 FLOOR Installing Company Name: Check One Only Certificate# ��j ��'�«�u� ��--� / Address:Q t90yrd0-r- City/Town:-9, It joy-A— State:M 41 El Corporation Business Tel: S -7E 20Fax: -e El Partnership � /�-vw D Firm/Company Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 Yes[jr—No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only ❑ Signature of Owner or Owner's Agent Owner El Agent By checking this box❑;I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will bye in compliance with all Pertinent provision of the Massachusetts StatTS! atur;e ' Code and Chapter 142 of the neral Laws. By Ty License: Plumber Title ❑Gas Fitter of Licens Plumber/Gas Fitter O'1Glaster City/Town ❑Journeyman License Number: 3 APPROVED OFFICE USE ONLY ❑LP Installer Date.�. . . . . . . . . . f 1 "oRT:�ryo TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING $A US 11 his certifies that . . . . . --A-s'. . . /. has permission to perform_ plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . ; /r at, . . . . . . . ..,F`.. ...-•-- . . , N rth Andover, Mass. Fee-?C? ... . . .Lic. No.. . . . . . . . . PLUMBI SPECTOR Check # 5360 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) t NORTH ANDOVER,MASSACHUSETTS ,a � � �/ /'Date �Building Location t/G K , �v �' Owners Name vV (�l/L ermit# Cp mount _ (�• Type of Occupancy New Renovation Replacement P1ans�'Submmi tf'ed Yes No El FIXTURES �"� w � w w Z CCa a0 a x U Cn U d z x ST.B$StVIC BA WYM IS>:HDOR za HDOR -1M HDOR 4M 11" 5 SII3 HDCR 6M HDOR 7M HOOK j SIH HOOK (Print or type) // Check one: Certificate tlInstalling Company Name l'-e- Oji (� ❑ Corp. t SAddress -�� JX t' C�►Z cj � El Partner. Business Telephone �� V� � �� -Firm/Co. t Name of Licensed Plumber: Insurance Coverage:. Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity, ❑ Bond ❑. Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have bmitted r entered)in above application true and accurate to the best of my knowledge and that all plumbing work ane7se ions ormed under P t Issued for s applicatio be in compliance with all pertinent provisions of the MasSt I mg Code Chapter 1 the Germs ws. By: igna ure or Licen-s-FMum er Title Type of Plumbing License j City/Town icen um er Master journeyman p APPROVED(OFFICE USE ONLY 4069 71��l . ......... TOWN OF NORTH ANDOVER OL f- p PERMIT FOR WIRING CHUS This certifies that ......... .10.. -.r........ ............ has permission to perform ....dq. d.o.41........................................... I.. .......... ... .. .... A -e / g in the building of . ........................................... wiring ........ . . fatI ?.* 1W I?qorth And ....... ......ch..."v................................. I Fee,,.............. Lic.Ne-�.. .............. ... ............ ELECTRICAL INSPECTOR Check Commonwealth of Massachusetts utnc Use uniy MEMO Department of Fire Services Permit No. ---�— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(IP C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO TION) Date: e r" -k . -fc To the Inspector of Wires: City or Town of: /1/- By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street& Number) 457 Owner or Tenant Ny. 6_ Telephone No. Owner's Address , L Is this permit in conjunction with a building permit? Yes 11--'1q_o_❑ (Check Appropriate Box) Purpose of Building i ./7 e /%... X, Utility Authorization No. Existing Service ps /.2- / v Volts OY rhead E-Undgrd ❑ No. of Meters New Service Amps / Volts OOverhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity y Location and Nature of Proposed Electrical Work: k.< Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No.of Ceil:SusPPaddle (Paddle)Fans No. of Total Transformers KVA No.of Lighting Outlets No, of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In-dEDBo. o Emergency Lighting g rnd. rn . atte Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No. of Switches 7No.of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total No. of Alerting Devices Tons g t Heat Pum Number Tons KW No. of Self-Contained No. of Waste Disposers Totals " ' " ' "" Detect ion/Ale rtin Devices No, of Dishwashers Space/Area Heating KW Local ❑ Mun,cipaI ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No. of Water KW Ballasts o No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: 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 . -in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) - L (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 9 O 'Z. Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: LIC. NO.: -7-'3 Licensee: s v �/ Signature, I N O.: (If applicable, e� r "exempt"in the license number line.) Bus. el. No. -2�G Address '�' - �� F Alt. Tel. No.- OWNER SURA CE WAIVER: I am aware that the Licensee does•n t have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement/I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ ,C Location S `� q � w pw .- No. Date p0RT1y TOWN OF NORTH ANDOVER F , 9 i • }�q Certificate of Occupancy $ ...��_. Building/Frame Permit Fee $ sArun Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #15836 Q Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ;c ,: � }tw '.�n�,x•• yx YS�tf raw ss, w'. .., .DKK:.. ; � y r it BUILDING PERMIT NUMBER. 7 DATE ISSUED: M SIGNATURE: Building Commissioner/I for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property—Dimensions:. i Zoning Diaiic—t Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R 'red Provide 'redProvided R red Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Constnaction Supervisor: O 6.P ado WP- .014 License Number Address .42" 41 P 2"ZO 7a Expiration Date ic tgnature Telephone - r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v 4S "9-600 Ve, Company Name -0 f V M Registration Number r Address r G 2y' -2c�o � Z Expiration Date G) Signature Telephone i SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: ,('entIN � ,vd �1®o �e 4+7"� mile AtLs SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be £ OMCIAL'USE ONLYc a Completed by permit plicant 1. Building 00 (a) Building Permit Fee 3900, Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 10 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. -Signature of Owner Date SECTION 7b SOW;NER/9ArUTHORIZED AGENT DECLARATION I, S- J e P[4,P Iy ee i ,as Owne Authorized Agen of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief S%e P ,y �- Pri fie PT s- a 2- SignatA of Owne en Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T VIBERS 1 2 ND 3Fw SPAN DM ENSIONS OF SILLS DIMENSIONS OF POSTS DHv1ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) 19 Si nature of P mit Applicant -6 0 2- Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 1 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 101846 Expirations 6/29/2004 " Type: Individual STEPHEN M. KEISLING Stephen Keisling 68 Glenncrest Dr. �� N.Andover,MA 01845 Administrator ✓fie -V�o7.vnuva.�.ea,/,C� a�✓�a:sac`zuaetCa BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 027489 Birthdate: 07/16/1953 Expires: 07/16/2003 Tr.no: 12035 x� Restricted To: 00 STEPHEN M KEISLING 68 GLENCREST DR KI Ak1r%n%1M= RAA n4OAC v. Farm DECLARATIONS PAGE 1 CONTRACTORS ADVANTAGE SPECIAL Family Casualty Insurance Company POLICY NO. 2005XO431 ® Glenmont,New York NAME OF INSURED AND MAILING ADDRESS: AGENT NO. 2591 OFFICE NO. 2591 STEPHEN KEISLING JAMES W UGONE 68 GLENCREST DR FARM FAMILY INSURANCE N ANDOVER MA 01845-1315 10 S MAIN ST STE 208 TOPSFIELD MA 01983-1832 978-887-8304 RENEWAL TRANSACTION EFFECTIVE 03/21/02 POLICY PERIOD FROM 03/21/02 TO 03/21/03 12:01 A.M. STANDARD TIME AT THE LOCATION THE NAMED INSURED IS: INDIVIDUAL OF THE DESCRIBED PREMISES BUSINESS OF THE NAMED INSURED CARPENTRY—NOC LOCATION OF DESCRIBED 68 GLENCREST DRIVE PROTECTION CLASS IS: 04 PREMISES N0. 01: N ANDOVER MA 01845 CONSTRUCTION IS: FRAME PREMISES 01 BLDG 01 BUILDING MATERIALS / EQUIPMENT STORAGE BUSINESS PROPERTY COVERAGE: LIMITS OF TERM ADDL/RTN INSURANCE PREMIUMS PREMIUMS BUILDING 0 0 0 BUSINESS PERSONAL PROPERTY 5,000 46 46 BUSINESS INCOME AND EXTRA ACTUAL LOSS SUSTAINED NOT EXPENSE EXCEEDING 12 MONTHS INCLUDED INCLUDED BUSINESS LIABILITY COVERAGE: BUSINESS LIABILITY — PREMIUM IS SUBJECT TO AUDIT BODILY INJURY/PROPERTY DAMAGE 500,000 PER OCCURRENCE 1,000,000 AGGREGATE 500,000 AGGREGATE FOR PRODUCTS — COMPLETED OPERATIONS HAZARD MEDICAL EXPENSE 5,000 PER PERSON FIRE LEGAL LIABILITY 50,000 PER OCCURRENCE CODE DESCRIPTION PAYROLL TERM PREM ADDL/RTN 91342AA CARPENTRY—NOC 20,000 379 379 THE LIMIT OF INSURANCE FOR THIS BUILDING SHALL BE AUTOMATICALLY INCREASED BY 5% ON AN ANNUAL BASIS DURING THE POLICY PERIOD. ACTUAL CASH VALUE (ACV) — BUILDING OPTION DOES NOT APPLY. DEDUCTIBLE: $250 DEDUCTIBLE APPLIES EXCEPT WHERE NOTED IN THE POLICY OR ENDORSEMENTS. COUNTERSIGNED BY: BF 30 05 01 98 INSURED COPY PROCESSED DATE: 02/15/02 NOKTH Town of Andover ' No. s 0�AC0r., dover, Mass., ORATED PP�t�C) BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....A,&.w.a:.......... .....�lo h r ` ..............r..�.�.......�.......................................................,..........,....... Foundation has permission to erect... ..N..'��!r..... buildings on .... .a......3itc.kl!vj A g s....... Rough to be occupied as...........�.V.4...A0.0.t...... M: .. !!t....:.:............. . ... ...................................... Chimney provided that the person accepting this 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 I pection, Alteration and Construction of Buildings in the Town of North Andover. & S� T 0 A/m. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR C 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 Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. r SEE REVERSE SIDE Smoke Det. 'ion 0CK�ti .0. / Date �� /7,,b NORTh TOWN OR NORTH ANDOVER ` Certificate of Occupancy $ cNuSE< Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3 C Check # -:2D 3f 1 5 1 4 2 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING � s; .;� .. �i .r.�:__ � �r�4.a,�e;- x.:s:•�a gib- �'SY,,�. :s� STs; BUILDING PERMIT NUMBER: DATE ISSUED: 0c) / SIGNATURE: r�9 Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 0630 Q Map Number Parcel Number 1.3 Zoning Information: IA Property Dimensions: � Zoning District Proposed Use Lot Areas Fronta''e .ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.LC.40. 54) 1:5. Flood Zone Infomtation: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ .- Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZEp AGENT 2.1 Owner of Record \ AIN '�Ltd<L't'C4 u w. � Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ (� YC Licensed Construction Supervisor: rl License Number Address C icExpiration Date Signature ° Telephone . 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name 1 L 6 � _ (Jj �2 Registration Number Address �t `i'� Emma Expiration Date it nature Telephone SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed.and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check all a 6cahle New Construction ❑ Existing Building ❑ Repair(s) ❑ [Alterations(s) ❑ Addition ❑ Accessory Bldg: ❑ Demolition ❑ Other ❑ Specify Brief Description.�o/f Proposed.Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS IS30 O Item Estimated Cost(Dollar)to be SFE(} y .I i�Wm-o' r _. Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical -(b) Estimated Total Cost of Construction 3 Plumbing,,. Building Permit fee(a)X(b) 4- Mechanical. HVAC 5 Fire Protection' 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true_and accurate,to the best of my knowledge and -belief � D n'► cc S 0 Print Name Sip-nature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 S 2 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X s MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i 1 Page of Free Estimates l Fully insured 105 Haverhill Street Methuen, MA 01844 THOM PSON'S ROOFING (978) 691-1355 Shingles — Slate — Rubber Roof Single Ply — Copper Work PROPOSAL SUBMITTED TO PHONE r�997- Ann Morrisse 24-O1 STREET JOB NAME 52 Buckingham Road �� — �Q ��j CITY,STATE AND ZIP CODE JOB LOCATION North andover MA 01845 ARCHffECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: Strip off all roof shingles, on ho>>se an.-a na,-ar.A V Install aluminum drip edge around roof line Apply ice and water shield 3 ft. up all along edges Apply 151b. felt paper on rest of roof area Reshingle with a 25 year Architect shingle Install new 'flanges around soil pipes Cult in a ridge vent on house Waterproof chimney flashing Remove all work related debris 25 year warranty on material 10 year guarantee on labor construction lic. #060112 improvement#128612 e J)r0�10gC hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: Fi,,�e thousand three hundred Payment to be made as follows: dollars($ 5 , 300 . 00 All material is guaranteed to be as specified.All work to be completed in a workmanlike manner �f / according to.standard practices.Any alteration or deviation from above specifications involving Authoriz ext,a costs wiil be executed only upon written orders,and will become an extra charge over and Signatu above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully Note:This proposal may be covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. !Conditions rUPtdttte of Joropoga[—The above prices,specifications and are satisfactory and are hereby accepted.You are authorized to do the , work as specified.Payment will be made as outlined above. Signature Date.o?Acceptance: Signature �� II 4 CERT I F I C A T E OF L IAB I L I TY I N S U R A N C E DATE 08-15-01 (MM/DD/YY) PRODUCER THIS CERTIFICATE IS ISSUED A. A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER °ELHAM INSURANCE SERVICES INC THE COVERAGE AFFORDED BY TH_ iOLICIES BELOW. 122 BRIDGE STREET INSURERS AFFORDING COVERAGE PELHAM NH 03076- INSURER A: Liberty Mutual ~INSURED INSURER B: The Maryland Thomas Doyle DBA INSURER C: Thompsons Construction & Roofi 8 West St. INSURER D: Salem NH 03079 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED .i0 IFI[ ;Id' _i._D NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION Or �`Nly 'ON' : OR OTHER DOCUMENT Willi RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSUc'ANCL ..ii 'Dt "` POLICIES DESCRIBED HEREIN. IS SUBJECT TO ALL, THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE L ';+S 5i0,JN MAY HAVE BEEN REDUCED BY PAID CLAIMS. e'St POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 B [x] COMMERCIAL GENERAL LIABILITY SCP 34865353 04.17.01 04-15-02 FIRE DAJI�AC;- "i-Y ori fire) $ 300,000 [ ] [ ] CLAIMS MADE [x] OCCUR MED XP c,�e person) $ 10,000 PLRSU'dAi. AIV INJURY $1,000,000 $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PROi)ii,:T`., (7!V''/0P AGG $2,000,000 [ ]POLICY [ ]PROJECT [ ]LOC AUTOMOBILE LIABILITY COIi'�INLI; SINGLE Lli [ ] ANY AUTO (Each a.:c� : $ [ ] ALL OWNED AUTOS °'C'DIILY 'N URY [ ] SCHEDULED AUTOS (pe: oerscn) $ [ ] HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE [ ] (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ [ ] ANY AUTO OTHER THAN EA ACC $ [ ] AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ [ ] OCCUR [ ] CLAIMS MADE AGGREGATE $ [ ] DEDUCTIBLE $ [ ] RETENTION $ $ WORKER'S COMPENSATION AND [x] WC STATUTORY [ ] OTHER B EMPLOYER'S LIABILITY WC2-31S-314995.019 04-21.01 04-21-02 E.L. EACH ACCIDENT $100,000 E.L. DISEASE-EA EMPLOYEE $100,000 E.L DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Job: Roofing Job CERTIFICATE HOLDER [ ]ADDITIONAL INSURED: INSURED LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR ROBERT LAVIGNE TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED 109 CENTRAL STREET TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR HUDSON NH 03051 REPRESENTATIVES. A 0 ZE RESENTATIVVE (7/97) Page I of 2 ,ORT, Town E of :rAndover Ow.rr..�w. rn y•4 �.4. .. .. ... ... 0 �-oCH,C ,� dover, Mass., 7 RATE D PQM 5 S H BOARD OF HEALTH PERMIT T D . Food/Kitchen Septic System �� BUILDING INSPECTOR THISCERTIFIES THAT..... ......�N........................................................ .......................................... .................................. Foundation has permission to erect....S-t 0-. 1. p buildingson ...�.1�2..........1-3.. U.ce(v 4.!A ......... ... ...... .....j.......... -t.......... Rough e r vale t0 be Occupied as..... ... ....................................... ........ `i......... ..... .../2.........�-�/1/1-�............ Chimney provided that the person accepting this 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- ws relating t the Inspection, Alteration and Construction of Buildings in the Town of North Andover. /S/'3 OT 31-*�. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR C Rough .. ....... ... .. . . ......... ... ................ ...................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in ,a Conspicuous Place on the Premises -- Do Not Remove F nagh 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.