HomeMy WebLinkAboutBuilding Permit # 5/5/2015 & 5
BUILDING PERMIT 00 oT"��,
TOWN NORTHANDOVER � ._,'' 16 0
APPLICATION FOR PLAN EXAMINATION ® '< A
Permit NO: .5 ' Date Received
'... .,
re
Date Issued:
IMPORTANT:Applicant must complete all items on this page
'LOCATION
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=PROPERTY�OWNER ' ""i "
`Print
MAP NO: ' PARCEL: ZONING DISTRICT' Historic District 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
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well 'Floodplain ' Wetlands Watershed District
Water/Sewer
PREF RMED:
ESCTPT1.0N OF WORK TBE
Identification Ple se Type or Print Clearly)
OWNER: Name: / Phone: "
Address: A .
gg �
.CONTRACTOR Name' `Phone: : G t
Address
Supervisor's°Con struction'License: Exp. Date: ii e *
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $__ FEE: $ -756)1)
Check No.: Ao2 Receipt No.:
NOTE: Persons contracting with unregi tered contractors do not have access t .e guaranty fund
Signature of Agent/OwnSgnafiure of contractor `"
of . 0It
Town
OE:. ,, ®ver
�� .:�.: 0
O LANE h ver, Mass, �� 0
COCHICNEwicK
A°4ArED J`Pa,��`�
S ll BOARD OF HEALTH
M in
Food/Kitchen
rER MIT LD Septic System
THIS CERTIFIES THAT 10h.4. BUILDING INSPECTOR
has permission to erect ......
. Foundation
p .......................... buildi gs on ........ .......`�,�f.................................................
r` � Rough
tobe occupied as ................. . ..... ................................................................................................... Chimney
provided that the person accepting this ermit 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
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS �+ ELECTRICAL INSPECTOR
UNLESS CT S S Rough
Service
.......... . ..... ......................................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Islay 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.
Offices: t
{ d
383(Rear)Lowell Street,Suite 2G �r�i
Wakefield,MA 01880 ;,
Tel: 617-571-9056
PETERARY352 Main Street,Suite 3C
and Mi Gloucester,MA 01930
Tel: 978-559-7333
ROOFING, enc. www.PeterRyanAndSonRoofing.com
Submitted To: lob Location:
John DiStefano
42 Jerad Place Road 42)grad Place Road
North Andover,MA 01845 North Andover,MA 01845
Phone#: 781-389-5456
Emall: John@FirstFidelityAppraisal.com
Proposal date: March 13,2015 Revised date: April 1,2015 2"d Revised date:May 5,2015
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 parry shall be entitled to all its reasonable costs, including reasonable in-house or outside attorney's fees.Not responsible
for debris in attic.
Strip NOUN&GARAGE roofs to bare wood and re-shingle: $6,010.00(Labor Only)
• Strip existing shingles down to bare wood
---- - 0 Check for rotted wood on roof decking,and replace as needed
• Nail down any loose wood
• Install ice&water shield to first 6-feet,and in all valleys and around any protrusions
A • Install premium synthetic underlayment(in place of standard 301b.felt paper)
BBRInstall all new 8"white drip edge on perimeter and step flashing,where needed
• Install manufacturer suggested starter course of shingles
! '►' Install IKO or GAF Lifetime/architectural shingles in color of your choice
• Install ridge vent
• Cap ridge vent properly with manufacturers suggested cap(GAF Timbertex(M or IKO Hip&Ridge 12)
• Properly flash any protrusions and all new pipe flanges,if any on roof
Clean Up:
• Will 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
PAY NT I'114%
Cust�detalls: Inchides�cost`of ertn!]t,lrthirr;durh &iliaerial PAymentSch�etlule:
ist payment due upon signing: $1,021.00
Total COSI: S600.00 Total balance due upon completion: $4,249.00
Kindly remit payment to 'Peter Ryaw. Thank you!
Respectfully Submitted by: Accepted by.-
Our craftsmanship is 100%guaranteed f 10-years. A warrantees are through the manufacturer.All wary t "will be null&v ifjob is not paid in fill.
Peter Ryan and oofing,Inc.License#178871...Thank you for letting erve you!!!
cc:Evan
The Contmottive(ifth of Aftissachitsetts
Del.wrtmeiif qfhi(his1r1a1.4cq1deti,7.Y
OJ)70 e of 111.1,es figa flo I I S
1 CongressSfi-eet, SuM, 100
Boston, MA 0211.4-2017
)VIVIV.M(Iss.govIdla
W011(el"S' Compewso4ion Insuvance Affidavit: Buildevs/Cwi tvacW n/E lee fi-te ha iis/Plu itilm,s
Please Prt4zLeg1b,l),
Name (Bilsine5s/Ot-gaiiizttiot-L/JtidividAi-,vl): Peter Ryan and Son Roofing, Inc.
Address: .383 [rear)Lowell Streot,Suite 20
City/,stage/Zile: Wakefield,MA 01880 617"571-9056
Are you an employer? C%�-ck the appropriate box:
I till a eillployer with . , 4, FM_] I aina general cowrictor.wid I T�.I)e of pvojeet (i,equived):
elliploytes (Rill and/or part.time).* have.lured the sub-contractors 6. F�New coii,,tructioii
2,E] I aill a 501C proprietor or listed oil the atmelled slleet. 7, 0 Rcii.iodcliiig
ship and have no employees These sub-cojitractors ha-\-e 8. F-1 Demolition
workingf6j,nae ill any capacity. caiployees anti have workers' 9additiol,
r ,illwralloe.,
requi , F
(No W011,11,j M,�.1, cony, itisill-illicc C01111).5, We are a coq)oratioa and its 10.❑ E.1cctrical,repaivs, or additions
re.d
3,El I aiii a lioilwoAviier doing 911 avoir officers have exel-cised their I I E] Phiiiibinc, repaivs,oi- idditiow.,
thyself. [INo workers' couip. right of cxctnptioii per MC3L 12,F-1 Roof repairs
ijisurance required,] t c, 152, §1(4), and xve have iio
einployee.s. [No workers' 13F] Other
Azolllp. illsill'alice required.]
`wry applicant that checks box-41 mist also fill out the-wetion below showing,their workers'compensation policy inforiiiition.
t HonieoxNqierS who submit this affidavit indicating they are doing III work and then hire outside contractors must submit i new affidavit indicating such.
lCoatractors that check this box must attached an additional sheet showing the name of file sub-contractors and,.,tate whether or not those entiries have
employees. If the stab-colltwdors have.employees, they must provide their workers'comp.policy number.
I nin nit enq.)1(7yet,fitat Is pioviding coiuj)eti�Fadon histwance./oi,inns einj)lo�jws, Below is the poli(;)!and fob site
111fopoladoll,
111suralwe coillp"Illy_irallle: N/A (I am not required to carry W.C.as I have no employees) Please see the Sub-Contractor's W.C.affidavit attache
Policy 9 or Serf ins, Lic, g. N/A Expiratioti Date:
r—r—
Job,sitc Address: CitY!St1teizip:N,,d-A&
A
Attach a copy of the))',ovkevs' coinpells"Itioll polley declavAtioll page (s.howliig the policy uui-n.l.)ev and eNpivatioii date).
Failure to seciwc coverage as Seotioti,25A c)-f VIGL Q. 152 call lead to the iiiipositioii of criminal petialties of
fine lip to $1,500.00111&,o),olle-yeal,ill 1prisolullelit, as well as ].)Qiiilties in the foi-iii of a STOP WORK ORDER awl a fine
of 111)to$250,00 a day agaillst the.N,iolator. Be advkcd that I copy of this statelilelit 111fly befolivardc(l to the Office of
1jivestilgatiojis of the DIA for hisllraiicc coverage -verificatioli.
I do here-lily lf! widet,rhiqiafits widpetta(des.ofj)e)j111,,V that the lltfc)iiii(itiotipi,ol,1(1,-d(iltt)re is fl-ue wid co),fect.
S i,,114 tr1 rg, Date,
Plion' 4,: 617.571-9056
Offtelat use oitly, Do nol wi-Ite In this,atea, to be roni.pleted 41,H(j,oi,towit offidul,
(Ity or Toww -PeririftiLiceiise H
Issuing kii(hovity(circle oiie).
1.Board of Hen1th I Buildiiig Depai-Wient 3, CIO/Towii C.'lexk 4, Electrical liispectoi5).Pluiijbfiig
Inspector
6, Othei,
C,01AR0 Pel'soll; Pholle 4:
Vve C'c m.ntotrtpealth of M(t.ssrtclmsetfs
Del -fitment of Irr.rlrrstHOAcelde t.#.s
C)ffllce of Investigations
I C'ongr ess Streef, SON? 100
v Boston, JWA 02114-2017
tnt'mnuts'gowdla
Worken' C'oinhejlsOion Lnsimmice Affidhavif: BI131deI°slC:oili rt 1�slElectric ��1slPlllrnhet's
A >lir.x311t I ifopliation. Pleme Pitit Leggib1�T
M111le (Busuiess?grgeruzrstiosrtirreli.viclnal): L ft}�i �i0n t1{ICtlOrl, Inc.
Address: 71 Prospect Street
city/state/zip: Brockton, MA 02301 F'1lollt #: 508-232-1`194
Are you all e:mnployer? Check the appropriate bolt T)gme of project(required):
1,IN-] i ani a employar%vitli '10 4. ❑ I am a general emitrutor and I
etnplayees (Bell atmd'or hart-tsmem+;.),;�`
lmave hired the stmt}-contractors 6. F-1 New eorlstr taction
2.Elaum a sale proprietor or pamtmmer- listed oil the attached slieet. 7, ❑] Remodeling
ship and leave no ermml)loyees These smilm-commtrnctoms have S. (❑ Denmolitiomm
Working for IIIc ill any capacity. employees and have workers' 9, ❑Building addition
[No workers' comp. bisurance commmp, instn•ance.t
required.] 5. ❑ We are a mporation amid its 10,❑ Blectrical rel7ains or aclditions
3.❑ I anm n lmonmeoevner doing;all work officers have exercised their 11•❑ Plumiibi i?, repairs or additions
myself [No workers' comp. right of exemption per MOL 12.❑ Roof mpairs
insurance recluii'vd.]t c, 152, §1(4),and Nve have no
,�!mployees, [lila workers' 13.17-1 Other
comnp, itlsurance required,]
"Any applicant that checks box 41 mustalso,fill out the section below showing their wort ers'compensation policy iuiomiation.
t Homeowners who submit this affidavit indicatirig.tleey are doingill work rued then hire outside cotitraetors must submit a new afdavit indicating such.
'Contractors flim check this box nnistattached w additional sleeet showing the name of the sub-contractors and state whether or not those entities have.
employees. If the sub-contractors haveem_ployees,they mist provide their workers'comp.policy number.
I carr rat emplo>jer that lsprovlding workers'compertsatlon Inut aiwe for nt,y emplo,l'ee,�, Below fs the polfq,and job site
lrifvr�rrtrr-Harr,
Insurnncz tloimapammy�inrmme. Insurer A: Northland Insurance, Insurer B: Arbella Protection, Insurer C: Travelers AIR
6S60UB-5BS6069-2-15 03-01-2016
Foley�or Self-ins, Lic. #: Expiration Date:
Job.Site Address:..��a,.. �, `".. �� "�, C'ityrtf5tate/Zip:
Attach n copy of time workers' com pemmsatiomm Policy declaration Page(s1momlig the policy number and eNpiration (lrtte),
Failure to secure cows age as rehired under S:ectiorr 25A of MGL c. 15.2 can lead to the immmpositiou of cruninal peamalties of a
fine 1e1)to$1,500,00 ammdlor one-yens imprisommmermt, as well m civil laermatties in time form of a.STOP WQR1�_ORDER mid a fine
of up to$250,00 a clay ngahist the viols+tor. Be ncls7ised tlmat a copy of this st.atenment nmay be.fcmvarded t+7 the Office of
Investigations of the DIA for hismanoe covera:gt,verification.
T rid lay?ratlyh e�ertlfy rr.rrtfet�tlr�r pnlrrs Amar# �,q e' '. f�etjnry that the hiformatlon provided above is true and Correct,
Sj zetitre:_. De__ •
n
Phone 4 508-232-1194
Offlolat ase only, Do not write In tin's ama) to be completert4l, nr town official,
City ov Town: Perm It/License #
Issuing Authority(shale one):
1. Board of Heiiltli 2,Bttildfng Depai,tmnent 3, City/To)vii Cleric 4,Electrical Inspector S, Plumbing Inspector
6, Other
Contact Pe.rsoml: Phone#:
W DATE(MMIDD/YYYY)
CERTIFICATE QF LIABILITY INSURANCE E04/09/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CER`IIFICATE 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 certiflcate holder IS an ADDITIONAL INSURED, the pollcy(los)must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this cortiflcat0 does not confor rights to the
certificate holder In Ileu of such ondorsement s)'
PRODUCER CO TACT Jo e M Keller
MassPaylnswance Ser41CeS,LLQ P.HDiNa --� --- — ' -' FAx
27 Garden Street,Unit 1B (978)774.4336 x115 I (ND No),(978)774-1318
Danwrs,MA 01923 ADDRESS; Joyce@masspayinsurance,com
_ INSUREIR(S)APFORDINO COVERAGE NNC H
_ INSVRERA; Northland Ins NOR
INSURED Lema Construction,Inc INSURER B; Arbella Protection ^m 41360
Jesus Lema INSURER c: TRAVELERS AIR TRG
71 Prospect Street
BrocHon,MA 02301 INsuRi R D
• INSURER U:
INSURER P: .��....__...... .,._,...�,.._.,,,_,__ '...
COVERAGES CERTIFICATE NUMBER; REVISIQN NUMBER;
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 REQUIREMEM', TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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. _
1NSR ADOI. SUER POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER IMMIDD/YYY�� hi MIDD/YYYY _
A GENERAL LIABILITY m_ WS236181 __
_ 01/31/2015 01/3112016 EACH OCCURRENCE _ s 2,000,000
AGE To RENTED
\ COMMERCIAL GENERAL LIABILITY DAMPRfiM
IM SES(Ea occurrence) S 100'000
CLAIMS-MADE 1-71 OCCUR MED EXP(Any one peraon) _ S 5,000
PERSONAL S ADV INJURY 3 2000'000
I GENERAL AGGREGATE S 3,000,000
GENL AGGREGATE LIMIT APPLIES PER: I PRODUCTS•COMP/OP ARG S 3'000'000
J POLICY PRO• LOC I S
B AUTOMOBILE LIABILITY 1020009274 11/28/2014 • 1112812015 CEOM�BINdED SINGLE LI IT 11000,000
AW AUTO BODILY INJURY(Per person) S
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUros
HIRED AUTOS �� NON OWNED PROPERTY DAMAGE S
AUTOS (Per accident)
� � S
UhfaRBLLALIAB OCCUR EACH OCCURRENCE
EXCESS LIAR
CLAIMS-MADE AGGREGATE $
DEO RETENTION ,T s
C WORKERSCOMPEN$ATION 6S60UB•5B86069-215 03/01/2015 103/01/2016 WCBTATIJ DETR+
AND EMPLOY ERS'LIABIQTY YIN 500,000
ANY PROPRIETOR)PARTNERIEXECVnVE � NIA E.L.EACH ACCIDENT _ S _
OFFICER/MEMBEREXCLUDED? - — -------
(Mandolory In NH) , E,L DISEASE•EA EMPLOYEE S 500,000
V Kos,describe under 500,000
PESCRIPTIONOF OPERATIONS below •� _–, E,1,DISEASE•POLICY LIMIT $ •_
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Ntach ACORD IQI,Addltlonal Romarks Schedula,It moro space Is re quirod)
Proof of Insurance
CERTIFICATE HOLDER _• CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIFS BF CANCELLED BFFORE
Peter Ryan and Son Roofing,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
383(Rear)Lovell Street ACCORDANCE WITH THE POLICY PROVISIONS,
Suite 2G
Wakefleld,MA 01880 AUTHORIZED RF.PRESENTA•rIVE
(D 1988.2010 ACORD CORPORATION, A)l rights reserved.
ACORD 26(2010105) The ACORD name and logo are registered marks of AGORD
LICENSURE
Lema Construction, Inc.
HIC#; 159106 Jesus Lema
.... ...^.... Cw,a Yt`anroroenrn/I/i or'/Giir(rier r�t+:rlh
Oftiev of'C°nwmer.tffrb:f fi f1aSIaC5St2Cgalfl(i°II fa.keir or regklrotion valid for Indivithd Ilse only
1f _{IOME.IMPROVEMENT CONTRACTOR heforo the expirationdare. Iffound return Fu;
a OfilcoorConsutnerAffairsand BusinessIlegulntl°n
RR4r(opistrntion; 189100 TYPo: 6 ._
Expiration; 3/3112010 Priva(e Corporalic, 10 Park 1'InYn-Soho 5110
uF ' Iloston,MA 112116 -
LEMA CONSTRUCTION.INC.
JESUS LEMA T'
71 PROSPE(;f ST. � —
nROCiCrON,mA 023011. Undermnlilry Not volid%Yllhoulsignatun. r`
f'
H1C#' t59 'Q.6 James Doherty
`�(face at(ensmnci nf0+irs k Itusluess llcgulapuu License or registration valid for IIIIIIs'Idol use uuly
ME IMPROVEMENT CONTRACTOR. before the evpirntlon date. If found roan n lo;
Office ofConsunierAffol+sowl BusintnsRogula(iou !
P Roplstrallom 199106 Typo' I(1 Park I'inza-Suite 51711
i. Expirallom 3/31)2016 Supplefiant and Ruston,AIA 02116 ;1.
LEMA CONSTRUCTION INC.
JAMES DOHERTY '
71 PROSPECT ST. Y---- f<
BROCKTON.MA02.301 Untlosocrctnry' �otvolitl vilhnnlstgnahnro �',
LICENSURE
Peter Ryan and Son Roofing, Inc,
HI`C#; 178871 Peter Ryan:
..`. �•'r l: .rx wrrrr r/!�t !�s r<'�rur!/;
l.lccaso or r°gtsb•nilon vnlitl far individnl usr onh
Vii;\Otllfx of Cnnswner tl'faii s&BuOlies ltcgulntiun before tho°xpiralion date. if found return to;
OMC IMPROVEMENT CONTRACTOR Office(If Coasomvr A,frill will ilushiess Ileguladnn i,,.
� V 1Roglstraaom 178671 ryp0' 10 fork 1'Inzn-Suite 5170
tjxplta(lon; 612W016. Corport+tion ilos(on,17.1112116 r
PETER RYAN&SON ROOFING.INC.
W.
PETER RYAN
383(RF:AR)LOWE1.1.ST. -4i
tvlsigniumcOAKEFIELO,ldA 01880 Undersecretary i
CS License#; CS 10845
Massachusetts-Department of Public Safety
Board of Building Regulations and Standards ;
Cuash'uctiutt Rupei'visor
License:CS-104888
CLINTON A GAL N x-
229 Vernon SLreoG
Wako"(cWel MA M80 1
n+` Expiration +?
Commissioner 07/01/2018 '',
AMWORMATION FROM CONTRA-rTORs FOR nCOM- ART TO
COWA.NY 4- &)k
TQ WhOm it may wmma,
Co, kv c avy my
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