HomeMy WebLinkAboutMiscellaneous - 873 CHESTNUT STREET 4/30/2018 (2)0
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Location ku I� ey--Ai�
No. Date &/''
NORTH TOWN OF NORTH ANDOVER
OL
s
9
�o Certificate of Occupancy $ '
s;. CHUs <� Building/Frame Permit Fee $ `
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
2 4 7 V S Building Inspector
Date-�
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit'Fee l $
Building Inspector
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Telephone:
Alt.
T.
"OUR PROOF
IS ON amber
YOUR ROOF"
.••
•
Roffng
• SfMCliZ 932 Co.
265 Winter Street
Haverhill MA 01830
,^Insured w,Factory Trained , Factory Certified
Date:
E -Mail: . -Py y 73#"I7
Billing Address: ..X 7 ? C' r-3 ( v- v fr- —594, NAnt", _ b Address:
Scope of Work C9P3fr_ip and Re -roof 4in lQ,7 f- ❑ Re -roof Approximate Roof Area: •
E7.�a e for re -roofing by ensuring all safety measures in accordance with OSHA standard regulations and landscape is properly protected.
Q-Rfmove existing layers of shingles down to roof deck and dispose of in a legal fashion from the job site.
I t
❑ Wood deck, if we discover any rotted wood, replacement will be performed at *$ per LF for roof deck boards. If.
substantial deck rot is discovered, re -sheathing of roof deck can be performed at *$ /__eZ' per SF. If individual sheets are found to be
rotted/or de -laminated, removal, disposal and replacement will be performed at *$ = per sheet. If any trim boards are rotted,
replacement will be performed at *$ M__ per LF for new pre -primed pine. Inspect siding at roof line and all flashing behind siding, if
we discover any damaged flashing or siding at the roof line, replacement will be performed at *$ %rte — . If wood deck, siding, and
flasbj.pg is sound, we will re -nail any loose wood to rafter sweep deck, and prepare for roofing.
ErInstall 8" drip edge to all rakes and eaves. Color
-pp p water shield (UNDERLAYMENT) as per manufacturers' specifications and/or
pply premium (UNDERLAYMENT) to the balance of the exposed wood deck.
Re-flash all plumbing stack pipes, and any roof penetrations as required and dictated by good roof practice to ensure water tightness.
�of upon inspection, we discover chimney lead to be worn or deteriorated, repla ill be performed at
Install a new: _� ear ❑ Traditional chitectural ❑ Designer
Furnish and Install a new shingle over style ridge vent system ❑ Soffit vent system *$> ____ .
44tl`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.
*Denotes potential additional costs above the total estimated price. /7
Haverhill MA 978.374.9224
Lawrence MA 978.687.7339
Hampton NH 603.929.9224
Hampstead NH 603.329.8200
Toll Free 1.888.SOS.ROOF
Special Notes
UPON COMPLETION AND PAYMENT IN FULL, ROOF SHALL HAVE A WORKMANSHIP GUARANTEE FOR A PERIOD OF_C;�
YEARS HONORED AND ISSUED BY THE LAMBERT ROOFING COMPANY AND'EARS HONORED AND ISSUED BY THE
SHINGLE MANUFACTURER. ❑ MANUFACTURER UPGRADE $
TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE
The Contractor agrees to perfouDAhe work. furniAl th�aterials and �bor sppifiedpove f94epl;iI sum of: $ ,,�00 �� (*)
Payment will be made according to the following work schedule:
$__. upon signing contract
$ by _/_/_ or upon completion of _
$ by _/_/_ or upon completion of
$�'`J upon completion of contract.
(Law forbids demanding full payment until contract is completed to both party's satisfaction)
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the
contractor in writing at his/her main office or branch office by ordinary mail posted, by telegram or by delivery, not later than midnight of the
third business day following the signing of this agreement. See attached notice of cancellation for for an explanation of this right.
Home Owner:
Home Owner(s) Signature(s):
Contractor:
Contractor's Signature:
DO NOT SIGN THIS CONTRACT IF THERE ANY BLANK SPACES
Acceptance of the Contract Proposal
www.lambertroofing.com
Date:
Date:
Date:
Date: /0
(Please see reverse side)
EIN # 51-050-3313
MA Reg. HIC # 149221
BBB.
MA Lic. UCS # 78130
Single -Ply License# 1711
Telephone:
Alt.
T.
"OUR PROOF
IS ON amber
YOUR ROOF"
.••
•
Roffng
• SfMCliZ 932 Co.
265 Winter Street
Haverhill MA 01830
,^Insured w,Factory Trained , Factory Certified
Date:
E -Mail: . -Py y 73#"I7
Billing Address: ..X 7 ? C' r-3 ( v- v fr- —594, NAnt", _ b Address:
Scope of Work C9P3fr_ip and Re -roof 4in lQ,7 f- ❑ Re -roof Approximate Roof Area: •
E7.�a e for re -roofing by ensuring all safety measures in accordance with OSHA standard regulations and landscape is properly protected.
Q-Rfmove existing layers of shingles down to roof deck and dispose of in a legal fashion from the job site.
I t
❑ Wood deck, if we discover any rotted wood, replacement will be performed at *$ per LF for roof deck boards. If.
substantial deck rot is discovered, re -sheathing of roof deck can be performed at *$ /__eZ' per SF. If individual sheets are found to be
rotted/or de -laminated, removal, disposal and replacement will be performed at *$ = per sheet. If any trim boards are rotted,
replacement will be performed at *$ M__ per LF for new pre -primed pine. Inspect siding at roof line and all flashing behind siding, if
we discover any damaged flashing or siding at the roof line, replacement will be performed at *$ %rte — . If wood deck, siding, and
flasbj.pg is sound, we will re -nail any loose wood to rafter sweep deck, and prepare for roofing.
ErInstall 8" drip edge to all rakes and eaves. Color
-pp p water shield (UNDERLAYMENT) as per manufacturers' specifications and/or
pply premium (UNDERLAYMENT) to the balance of the exposed wood deck.
Re-flash all plumbing stack pipes, and any roof penetrations as required and dictated by good roof practice to ensure water tightness.
�of upon inspection, we discover chimney lead to be worn or deteriorated, repla ill be performed at
Install a new: _� ear ❑ Traditional chitectural ❑ Designer
Furnish and Install a new shingle over style ridge vent system ❑ Soffit vent system *$> ____ .
44tl`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.
*Denotes potential additional costs above the total estimated price. /7
Haverhill MA 978.374.9224
Lawrence MA 978.687.7339
Hampton NH 603.929.9224
Hampstead NH 603.329.8200
Toll Free 1.888.SOS.ROOF
Special Notes
UPON COMPLETION AND PAYMENT IN FULL, ROOF SHALL HAVE A WORKMANSHIP GUARANTEE FOR A PERIOD OF_C;�
YEARS HONORED AND ISSUED BY THE LAMBERT ROOFING COMPANY AND'EARS HONORED AND ISSUED BY THE
SHINGLE MANUFACTURER. ❑ MANUFACTURER UPGRADE $
TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE
The Contractor agrees to perfouDAhe work. furniAl th�aterials and �bor sppifiedpove f94epl;iI sum of: $ ,,�00 �� (*)
Payment will be made according to the following work schedule:
$__. upon signing contract
$ by _/_/_ or upon completion of _
$ by _/_/_ or upon completion of
$�'`J upon completion of contract.
(Law forbids demanding full payment until contract is completed to both party's satisfaction)
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the
contractor in writing at his/her main office or branch office by ordinary mail posted, by telegram or by delivery, not later than midnight of the
third business day following the signing of this agreement. See attached notice of cancellation for for an explanation of this right.
Home Owner:
Home Owner(s) Signature(s):
Contractor:
Contractor's Signature:
DO NOT SIGN THIS CONTRACT IF THERE ANY BLANK SPACES
Acceptance of the Contract Proposal
www.lambertroofing.com
Date:
Date:
Date:
Date: /0
(Please see reverse side)
Masac
Alim— . hum-Ats - DQpartwnt Df pin)fi�" S:!fetj
Boanj Of Budding R-YuLjt;j)ns �jjj(g
Construc;Vlon-Supervisor
L6
License: CS 78130
RICHARD LAMBERT
94 PICADILLY RD
HAMPSTEAD, NH 03841 . A
C7—
txiwafion, 6/212012
30062
T Xe
eotwn�eaa
Office of Consumer Affairs & Business Regulation
HOME IMPROVEMENT CONTRACTOR
Registratioll. 149221
Expirat-o---
Tr# 290268
Type '_-P V, Corpct tion
LAMBERT
RICHARD LAMkf
265 WINTER Gs'-
HAVERHILL, MA 01830`'.=:`''='Undersecretary
A-CORP. CERTIFICATE
DATE MWOONY
1
OF LIABILITY INSURANCE
09/0 6/2011
PRODUCER
THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ALLAN INSURANCE AGENCY INC.
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
63 1/2 Jefferson Avenue 2nd F
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW'
P.O. BOX 511
COMPANIES AFFORDING COVERAGE
SALEM MA 01970-0511
.......... . . . ............ .. ............ . ... .
A Seneca Insurance Company
INSURED
.......... ..... . 11 .. ......... ..... .. ... . .. . ... ............... - . .. ............ . ......
�OMPANY
B Safety Insurance Group
TGLRC 114C dba Lambert Roofing
265 WINTER STREET
j.MPANY
C Landmark Insurance Company
HAVERHILL MA 01830-
C.ONIPANY
D National Union Fire insurance
COVERAGES
i HIS IS 10 CERI'IFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT,
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO'YNIH!Ch THIS
�,"ER'r!FICATE MAY BE ISSUED OR MAY PERTAIN, THE
INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS $IjBJ:=CT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS:
..................... . . . ...........
CO POLICY EFFECTIVE POLICY EXPIRATION;
TYPE OF INSURANCE POLICY NUMBER LIMITS
TRI
DATTE(MMIDDIYY) DATE (MMIDO/YY)
GENERAL LIABILITY
. ........... .
BOrJ[.Y INJURY 00"' !s 1,000,000
SIVE FORM
X C 0 I.,1P RE I E N,
SGL3000422
11/12/2010
!1/1�)/2011
.. .. ..... ... ..
'RODILY NJUH'f AGe 21000,000
. .........
X
PROPER*ry UI '1 ("C", 2, 0 0 1) - 00 ". 0
A
U N1) 1: R GR 06 N 9
Exp'� 0, , HA:IIRD
s N & COU
PROPLklY DAMAGE Ao'(� 2,� 000, 000
11 ... . . ...... . . . . .......
- 'APSE
P R 0 Dt IL SIC 0 NIP L,-- TED 0 PE R'
9 'wr
X rONTRA;i'JAL
%
. ......... .............
HI & PC: COMBINED AGt:'T S
CONTFlACTOIR'S
X t.!RQAD PrOPERI Y I)AMAGE
%
.. . ......... - ................ - .. .........
PERSONAL IN
00JURY AG" 1,000,,000
Medical Pa. 50
.... .. . .... .
tt
X IF F RS ON A 1, 1 NBURY
AUTOMOBILE LIABILITYBODILY
IINJURY
ANY Ai'.JTI')
cis "Pma;e pil's;
BODILY INA)R
A%1, (YN�R-A� AUTOS
x
�0';I'.C�!horl P-va"'i-- Paslerqer)
x
07/16/2011
07/16/2012
XA;JT(—
(;Ar;,G�� lARI I_TY
BODILY !NJORY tx
1PROPERTY
C
EXCESS LIABILIT`Y
XILIMBREUAFORM
LHA054597
11[12/2010
11/12/20114
0ANIAQ--11000, 000
1 EAC I OCCU PRIENGF $1 000, 000
D 1HER'THAN UMBRELLA FORM Y
I
I
I S
I -C
FD
WORKERS COMPENSATION AND
EMPLOYE PS'LIABILITY
'009934145
STAT
x T H. - -.-
FtEAAC_Cj�7IENI 5 6 boo
T HE PROPMET)R.' I X INCL
PARTNERSiEXECOTWE
KA, NH
08/28/2011
08/28/2012
'Ft. nISCIASP - POLICY OMIT 1,000, 000
i�ric ' EXCL
x.Rs A
R'� DISEASE FA FNIPLOYEE 1,00C_.000
OTHER
DESCRIPTION
............ .......... .......
OF OPERA WNSNEMCLESISPECIAL
.... .... ..... . . . . . . ... ......... ................. . . .
ITEMS
...............
. . .... .....................
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
DATE THEROF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Lambert Roofing Co.
IIIEXPIRATION
30 GAYS WRITTEN NOTICE- TO THE CERTIFICATE HOLDER NAMED TO THE, LEFT,
BUT FAILURE TO MAIL SUCH NOT4CE SHALL IMPOSE NO OBLIGATION OR LIABILITY
265 Winter St.
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Haverhill HA 01830-
AU'DiORIZE16 kEPRESENTA-,TVE
fill
ACORD 25-N (1195)
CORD
0 CORD CORPORATION 1988
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street,
Boston, MA 02111
www.massgov/dia
Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers
Naive (Business/organization/lndividual):
Address:
Z( /0 %BO Phone #:
Are you an employer? Check the appropriate box:
1. I am a employer with
4. ❑ 1 am a general contractor and 1
employees (full and/ -time).`
have hired the sub -contractors
2. ❑ 1 am a sole proprietor or partner-
listed on the attached sheet.
,ship and have no employees
These sub -contractors have
working for me in any capacity.
employees and have workers'
(No workers' comp. insurance
comp. insurance.,
required.)
5. ❑ We are a corporation and its
3. ❑ I am a homeowner doing all work
officers have exercised their
myself. [No workers' comp.
right of exemption per MGL
in �ce required.)
c. 152, § 1(4), and we have no
employees. [No workers'
comp. insurance required.l
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling
8. ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
11. ❑ Plumbing repairs or additions
12.❑ Roof repairs
06. [1 Other
*Any applicant that chocks box 01 num also fill out the section below showing their workers' compensation policy inform ation.
* Hom awnets who submit this affidavit indicating they arc doing all worts and then hire outside contractors must submit a new affidavit indicating such.
:Coem ms that cheek this box aum attached an additional sbeet showing the narne of the subcontractors and state whetber or not those entities have
employees. if the wb•coaftetom have employees, they roust provide their workers' comp. policy number.
I am all mq*yer that is providing workers' compensation insarance for my mooyus. Below is the
policy and *'sae
Insurance Company Name:
Polity # or Self -ins. Lic. #: Lie
Expiration Date:
Job Site Address.— 9Z2 �S 7sJvl S C ity/State/Zip:
Attach a copy of the workers' compensation policy 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 S1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fV%e
of tip to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DLA for insurance coverage verification.
I do herby certify under the s and aalties of perpury that the informMion provided above is true and correct
e' �
Signaw Date: _ AD—/3 /�
T 3�y9 a
(Ficial use only. Do not write in # i; area, to be completed by city or town offWaL
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 #:
P
4.NO. O APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
/PAGE 1
MAP 440.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK ;PAGE
ZONE
SUB DIV. LOT NO.I
LOCATION - ,�I'PURPOSE
OF BUILDING
OWNER'S NAME Vt
NO. OF STORIES sizir
OWNER'S ADDRESS ^
BASEMENT OR SLAB
ARCHITECT'S NAME v
SIZE OF FLOOR TIMBERS IST 2ND
3RD
BUILDER'S NAME
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
POSTS
DISTANCE FROM STREET
DISTANCE FROM LOT LINES — SIDES REAR
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
s
PLANS MUST BE FILED.AND APPROVED BY BUILDING INSPECTOR
RE OF OWNER OR AUTHORIZED AGENT
FEE r V 62
PERMIT GRANTED
c 19
1
0
V
OWNER TEL. # 6I. G
CONTR. TEL. #�----�
CONTR. LIC. #� i
3 7
Ao33s4-
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
BUILDI INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY
STORIES
MULTI. FAMILY
t
OFFICES
APARTMENTS
__
CONSTRUCTION
2 FOUNDATION
—I
8 INTERIOR FINISH
CONCRETE
PINE
a
l
2 13
CONCRETE BL K.
BRICK OR STONE
i
HARDW D
PIERS
PLASTER
DRY WALL
_
UNFIN.
3 BASEMENT
AREA FULL
If
FIN. B'M'TAREA
_
1/1 1/1 1/
FIN. ATTIC AREA
N_O B M T
FIRE PLACES
_
_
HEAD ROOM
MODERN KITCHEN
4 WALLS I
9 FLOORS
CLAPBOARDS
B
_
l
2
�_
3
_
_
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
HARDW'D
COMMCN
ASPHALT SIDING
ASBESTOS SIDING
_
VERT. SIDING
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK N MASONRY
BRICK ON FRAME
_
ATTIC STRS. & FLOOR I_
CONC. OR CINDER BILK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I� POOR _
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
HIP
BATH 13 FIX.)
GAMBREL
MANSARD
TOILET RM. (2 FIX.)
FLAT
SHED
WATER CLOSET
_
ASPHALT SHINGLES
LAVATORY
_
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
_
TAR & GRAVEL
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
_
_
TILE FLOOR
TILE DADO
6 FRAMING I
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. R COLS.
STEAM
STEEL BMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
_
AIR CONDITIONING
_
RADIANT H'T'G
UNIT HEATERS
7NO. OF ROOMS
GAS
OIL
B'M'T 2nd _
1st I 3rd
ELECTRIC
NO HEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
t
n
I
i
OFFICES OF:. :?� Town of
''
A''EI,'-S NORTH ANDOVER
RUIIX)ING
CONSE:11VA'11UN "' DIVISION OF
HEALTH
PLANNING PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON. DIRECTOR
120 Main Slreet
North An(lover, i
MitSSit('l1USCl1S O I fi4 i
(Ii l?) (iti i•4i i i
In accordance with the provisions of MGL c 4U, S 54, a condition of Building Permit
Number /09 is that the dcbris resulting from this work shall be
disposed of in a properly liccnsed solid waste disposal facility as defined by MGL c 111, S
150A.
The dcbris will be disposed of in:
__ _ ______J/
INS
Signature • Applicant
L
Date
;TOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
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