HomeMy WebLinkAboutBuilding Permit # 6/9/2015 i1
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BUILDING PERMIT &1%Y4M�
TOWN OFNORTH AN OVE 0 �
APPLICATION FOR PLAN EXAMINATION -
Permit NO: Date Received
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Date Issued: SACH 1J6�
MPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential it
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial t
K Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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Identification Please Type or Print Clearly)
OWNER: Name: I:-q' vr.1 Ve Phone:
Address: Hfl" .e MA, o I °
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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: $ 5b4_ FEE: $
Check No.: Receipt No.: Z- 66`34
NOTE: Persons contracting wi unregistered contractors do not have access to the guarantyfun4
S gnature,af AgeiltllJwner , `a�.. Signature of contractor
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FORTH
Town of
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ndover
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h ver, Mass,
coc...c..ew.c.. y1'
A°RaTeD
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BOARD OF HEALTH
PER Food/Kitchen
Septic System
THIS CERTIFIES THAT 4D,(,. BUILDING INSPECTOR
Foundation
A7404"dhas permission to erect .......................... buildings on ..... . ........ ........Zc ...... ...........
' Rough
to be occupied as .... ............. ..... ....... ................. ...... .�. rr...Now............ Chimney
provided that the person accepting this rmit 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
E I IR 6 MON S ELECTRICAL INSPECTOR
® UNLESS CONSTRUCT S S
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.
The Commonwealth of Massachusetts
r Department of IndustrialAccidents
1 Congress Street,Suite 100
Boston,AIA 02114-2017
www.mass.gov/dia
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davit:
Builders/Contractors/Electricians/plumbers.
Workers' Compensation Insurance Affi
TO BE FILED WITH THE PERMITTING AUTHORITY. Please Print Le 'bl
A licant Information
Name(Businessiorganization/Individual): '
Address: S �
City/State/Zip: �'� ' ✓!/l� a��J7 Phone#: t�� l6 7
Are you an employer?Checic the appropriate box: Type of project(required):
1. I am a employer with ( part-time).*em to full and/or 7. ❑ ew'construction
4-1
❑ P y ees
2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling
any capacity.[No workers'comp.insurance required.] 9, ❑Demolition
3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10[]Building addition
4. 1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole ll.[:]Electrical repairs or additions
proprietors with no employees. 12.[]Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.j/Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t 14.Q Other
6.❑We are a corporation and its.officers have exercised their right of exemption per MGL c.
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*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 andthen hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing wor kers'compensation insurance for•my employees. Below is the policy and job site
information.
Insurance Company Name:
Expiration Date:
Policy#or Self-ins.Lie.#:
Job Site Address:
Z- �� City/State/Zip:
ion page(showing the policy number and expiration date).
Attach a copy of the workers' compensation policy declarat
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify de' he andpenalties ofperjrrry that the informatior2 provided above is true and cor'r'ect.
Date: �= ?
Signature:
Phone#:
Official use only. Do not write in this area,to be 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 S.Plumbing Inspector
6.Other
Contact Person:
Phone#:
—� * NORT11 q
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BUILDING PERMIT ,.� .t:,r- ".'• °oma
TOWN OF NORTH ANDOVER °
APPLICATION FOR PLAN EXAMINATION
e
Permit NO: Date Receivedrep
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�4SSACHUS��
Date Issued:
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE U UJ o
Residential Non- Resident',
❑ New Building ❑ One family a
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commerci, ° = M
-
X Repair, replacement ❑Assessory Bldg ElOthers:
❑ Demolition ❑ Other x Q ` .O(
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Identification Please Type or Print Clearly)
OWNER: Name: F—�VrA A Nn Phone: q7�-•6(�6-,35_gG
Address: ff" r MAgm
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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: $ (P. . J FEE: $
Check No.: Receipt No.:
NOTE Persons contracting wit
,,h unregiste ed contractors do not have access to the und
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04/21/2015 09:39 9786884353 ETHAN ALLEN PAGE 01
Proiect Summary
2�oof Wepfacement Option # 1
The roof replacement summary outllned below will be Completed acconling to the prvject specifications within this proposal. Before approving and
authotizing any worts,please be suis that you have carefully ravlewed and understand the roof replacement speciffcatlons for this project.
SCOPE OF WORK:
Master Roofers agrees to remove and dispose of the existing roof system on the specified roof sections. Master Roofers will
furnish and install a new fully warranted, GAF asphalt shingle roof system as per the project specifications outlined in this
proposal agreement.
INCLUDED ROOF SECTIONS:
1, All attached asphalt shingle roof sections on the main building.
OAF ROOF SYSTEM AND ACCESSORY PRODUCTS:
1. GAF Storm Guard self-adhered,filmed surface ice and water shield leak barrier membrane
2. GAF Deck Armor breathable synthetic shingle underlayment
3, 8"aluminum drip edge
4. GAF Pro Start starter course shingles
5. GAF Lifetime Warranted Timberline High definition, fiberglass laminated, architectural style shingles
5. GAF Snow Country baffled style, continuous ridge ventilators
7. GAF Seal-A-Ridge matching color hip and ridge cap shingles
8. Lifetime warranted vent pipe flashing collar
9. New custom fabricated aluminum chimney base flashing system below existing lead counter flashings
10, Custom fabricate and install new standing seam bronzed coated aluminum ice belts along the entire length of eaves on
the south facing side of the building,
GAF MANUFACTURER'S WARRANTY:
All GAF manufactured shingles and GAF accessory products will be fully covered by the GAF System Pius materials warranty.
This warranty covers GAF materials from manufacturing related defects for up to forty years.
MASTER ROOFERS WORKMANSHIP WARRANTY: The installation of your new roof system as specified In this proposal
will be warranted by Master Roofers for a period of five years from the date of project completion, Should any issues arise as
a confirmed result of our installation techniques; Master Roofers will perform fair and reasonable repairs at no charge to
ensure the roofs integrity. This warranty does not cover materials or workmanship by others or roof sections outside of our
specified work areas.
ORIGINAL COST ESTIMATE: $59,161.52
JOB COST REDUCTION: $3,000.00
TOTAL PROJECT INVESTMENT PAYABLE TO MASTER ROOFERS: $56,161.52
r
CLIENT APPROVAL: DATE:–Y—i r 1 i5
CLIENT APPROVAL: DATE:
04/21/2015 09:39 9786884353 ETHAN ALLEN PAGE 02
PROJECT APPROVAL AND AUTHORIZATION To PROCEED WITH WORK
TOTAL.PROJECT INVESTMENT PAYABLE TO MASTER ROOFERS:
PROJECT PAYMENT SCHEDULE:
One-third project deposit due upon approval:
Total project balance due upon completion:
STANDARD PROJECT PAYMENT TERMS: On normal cash,check,or Visa/Master Card credit card orders a deposit in the
amount of one-third the approved project cost will be due. The total balance of the project investment will be due upon
substantial completion or within twenty (20)days of date of our final invoice.
PROJECT WARRANTY: 0 GAF System Plus Materials Warranty 0 Master Roofers Workmanship Warranty
DATE OF PROPOSAL SUBMISSION: Thursday April 16,2015
PROPOSED START I''DATE: To be determined. Project commencement is contingent upon date of project approval by the
client; Master Roofers production schedule; availability of materials; delivery of materials; roof top conditions; and
environmental weather conditions.
NOTICE:This Proposal is based upon current materials and labor costs. This proposal may be withdrawn if not accepted
within thirty(30) days of the submission date noted above. After thirty(30)days, prices may be subject to revision.
ACCEPTED AND AGREED: The prices,specifications, terms and conditions contained within this proposal agreement are
satisfactory and hereby accepted. Approval of this proposal agreement authorizes all specified work to be performed and
completed.
CLIENT(S): Sandy Kinney—C/O Ethan Allen
PROJECT ADDRESS: 419 Andover Str et, North Andover, Massachusetts 01845
Accepted By: Dated: I J 1
Accepted By: Dated: 1 I
Master Roofers Authorization: Dated: 1
Thank you for your consideration of our professional services. We trust that our comprehensive proposal will meet with your
approval. Please contact us at your convenience if you have any questions.We are looking forward to working with you.
Respectfully Submitted,
Daniel G. Bolduc
President
John R. Burton
Senior Project Manager