HomeMy WebLinkAboutBuilding Permit # 6/11/2015 BUILDING E �,o�arH
IT of txOR
TOWN OF NT
APPLICATION FOR PLAN EXAMINATION10
Permit No#: 1 — 6 Date Received —AT.E
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Date Issued:
IMPORTANT:Applicant must complete all items on this page
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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
/❑ S'eptic;;'❑rWell ❑/Floodplain 11,Net ands Watershed District
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DESCRIPTION OF WORK TO BE PERFORMED:
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Identification- Please Type or Print Clearly
OWNER: Name: v L= *-)\1�\\%3 Phone:
Address: e ®��-c- e�YZ�uz f dno4oQ=/Z
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Contractor,Name,'�'�•%� , '�na�i'�?�Phone �l"� �
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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: $ ��. `� FEE: $ _
Check No.:
Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor
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t A 0 WT ,7 "IAnduver
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No. /0
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`'o L"" h h Very `c15S
cocmc NEW.CK y1'
RATEDT T L D
U BOARD OF HEALTH
Food/Kitchen
Septic System
O
THIS CERTIFIES THAT ,!.,,,.I BUILDING INSPECTOR
.............. . ......... .... ....................................................................
Foundation
has permission to erect .......................... buildings on ...4.1
Rough
tobe occupied as ......� . ...,'ii ............. ..... ...er .................r............................................. chimney
provided that the person accepting this permit 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
PERMIT EXPIRES IN 6 NTHS ELECTRICAL INSPECTOR
LESS CONSTRUCTI AR Rough
Service
................ ..... ...................... ......................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy BuildihRough
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.
�i
Cll�i id roti lornmercial Roofing
J 1 Types Of POINTED-REBUILT-CAPPEDapertt
asonry Work
Mass Toll Free 1 Licensed & insured
1x.dl Owned --Op refd ' ,r-es 1976 1-800-V'JAPT-4-t
License#034200
(924-8487) ere k- Work Year Round
r j i s5.. ? S mss. NIME�" x 7 -_. , .�7=- 49
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Proposal To: Sue Willis Date 51812014
Street: 41 Copley Circle = -
N.Andover, NIA 978-974-0167
Roof proposal cassieImarie@a comcast.net
Certainteed Landmark
1. Extra-eaution will be to protect house and 12. Removal of all work related debris. Planks will be
landscaping as best as possible. (tarps etc.) placed under dumpster to prevent any damage to
Magnets,run at final clean up. driveway.
2. Remove all shingles from entire house. 13.Building permit included.
3. Inspect and re-nail any loose or lifted plywood 14.No painting or staining included in proposal
Any compromised plywood will be replaced at an 15.Contractor workmanship warranty: 10 years under
additional cost of$70.00 per sheet of 1/2"CDX normal wind and rain conditi
` 4. Install'beavy gauge 8"white aluminum drip edge Total roof cost: 15,ZOQ.QQ
1'\ to all eaves and rakes.
5. Install 6! of Certainteed Winter Guard ice and Upgrade to Pr0's: 1,200.0O
water shield along all eaves and top to bottom in ® Option:Instal!(1) new Velux S06 FS Fixed
all valleys. Full coverage on all rear low slope skylight and flashing kit. $800.00 a ><hon'a '
roofs. . Option: Install(1)new Velux MOS FS Fixed
6. Install Certainteed Diamond Deck synthetic skylight and flashing kit,$700.00 ad id�"io-na"7"-""-"
underlayment to remaining sheathing_ up to ridge. cost,
" 7. Install all new pipe boots. • Option.- Manual filtered tight single pleated
8. Install Certainteed Swift Start starter shingles to blind and operating handle: $375.00 per
all eaves. 0Option: Solar powered double pleated room
9. Install Certainteed Landmark Limited Lifetime darkening blind with tempered LOW/E glass:
architectural shingles to entire house. 10 year $550.00 per
material MFG. warranty.(See extended (Qualifies for 30%federal tax rebate)
warranty)All shingles will be installed and (5 standard color choices)
fastened according to mfg. specs. Certainteed 4Star extended direct MFG warranty
` 10. Install new OAF Cobra ridge vent and cap with A fully transferable 100% coverage against
color matched Certainteed Shadow hip and ridge material defects for a fully non pro rated period of
shingles. 50 years. Please refer to pamphlet left in estimate
11. Counterflash existing chimney lead,skylights and folder.Offered to our local referrals and included
all roof protrusions with ice and water shield,tie in this proposal at no additional cost.
into new shingles and seal.
- `:� 12. Over garage wall connection: Remove Balance due upon completion
" approximately(15)courses of siding. Install ice Highly rated member of the accredited BBB and
and watr shield to entire removed area and roof Angie's List Y.
connection. Install new aluminum step flashing. Thank_you!
Install all new pre-primed cedar(rough)siding.
The Commonwealth of Massachusetts -
Department of kdustrigl AccWd is
Office of Investigations
600 Washington Street
Boston,MA 02111
Uf www.mass gov1d1a
Workers' Compensation Insurance,Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Informationn Please Print Legibly
Name(Business/Organization/Individual): Adyoo-rnit c t C tZ-o
Address: �-
City/State/Zip: cin e. SS Phone
Are you an employer?Check the appropriate box: Type of project(required):
LEI I am a employer with 4. - am a general contractor and I 6. El Now construction
employees(fall and/or part-time).* have Hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑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 10.❑Electrical repairs or additions
required.] officers have exercised their
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.❑Roof repairs
insurance required.]t employees. [No workers' 13.Ei-Othera
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
tHomeowners who submit this affidavit indicating they 9're doing all work and then hire outside contractors must submit a new affidavit indicating such.
1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information.
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self ins.Lic.M Expiration Date:
Job Site Address: ( cop k'�Q.L� 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 required.under 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 civilpenalties in the form of a STOP WORM ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
X do Hereby cert under tl pains and penalties ofperjury that the information provided above is true anti correct.
Simafore: Date: (e 9
Phone#: Q✓l — 1 rl S3
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 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
p [_DA7TE�1DJYYYy)
CERTIFICATE [ 5128120
15
T S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE 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 PR 3UCEPI AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the poky(ies)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 certificate does not confer rights to the
Certificate holder in lieu of such endorsement(s).
- R
=CT Berkle Ass' ned Risk Services
UnWersal Insurance Agency Inc .IC L.En1 800&344589 (ac.No_): 866 215-8118
374 Belmont St AIDIss= PolicySerAces@berkleyrisk:oom
Wmeester,MA 01604 tMURERS AFFORDING COVERAGE NAICN
iNsuRER A: Acadia Insuranm Co. 31 a25
INSURED INSURER B:
MW Construction Inc INSURER O
93 Congress St INSURER D.
Milford,MA 01757 INSURER E
INSURER F;
COVERAGES CERTIFICATE NUMBER: REVISION 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 REQUIREMENT,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 POLICES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
- INSR TYPE OF INSURANCE ADD S BR pOLI CY NUMBER POLICY£FF POLICY EXP LIMITS
INSR MD (MM7DDIYYYY) (M€b JDDtYYYY
GENERAL LIABILITY
.AUTO MO B LLE LIABILITY i $
k: III
_. WORKERS COMPENSATION0TH-
AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER
ANY PROPRIETORIPARTNERILXECUTiVE FRIEl EACH ACCIDENT s 1,000,000
OFFICEIMEMBER EXCLUDED? NIA F1 WC-20-20-005659-00 05/20/2015 05/20/2016 —
(MandatoryinNH) E.L. DISEASE-EAEMPLOYEE $ 1,000,000
If yes,describe under I1,000,000
DESCRIPTION OF OPERATIONS below ___ _.I_. _-- _DISEASE_.-FOLIC _LIMIT-
. _.... __. ...__. _ .... ... ___ - --_
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AttachACORD 101,Additional Remarks Schedule.#more space isrequired)
Coverage
Eleftn Category Elect.Status Name State(S) All Entities/Locations
Officer Indude Maria Guaman MA MGG Construction Inc
93 congress St Milford,MA 01757
1
L
CERTIFICATE HOLDER CANCELLATION
SHOULDANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AN Under One Roofing AUTHORIZED REPRESENTATIVE
30 Temple St
rMethuen,MA 01844
Signatures ! -`
4CORD 25 12010/051
RRA(:S1AP
DfiTx 01-?400fY...
CERTIFICATE OF LJABILITY INSURANCE
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VMS CERWWATEM UMMOASA Y AWCOMMASNO FaGHTS UPM THE CERWICATE HOLDER THiG—
MfTiFICATE VOM NOT AFTIRMIATMELY OR MISMAMISLY _ Y THE PoL+e}E&
Y. Vii $ - bf tt1 NOT c A THE t ), AUTHORUED
oM _
@9 D. C Ro
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NNS IS TO C Y 'U9»IES E& TOT Sc FOR TpiE k�OLtCY PERK-7-7-
MICATED. NOTMOSTANOW A T Mv4 RESPECT TO VMCH 71s
T TF. Y rmO aR Y .3 1E - S UE -D fWEREW }S SUWFCI TO ALL THE TFRM`
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Massachusetts -Department of Public Safety
Board of.Building Regulations and standards
i'so'tvtTi3i�i€aa't iFt6-d'§irt4ir
License-GS-M..120
Jo"NWL" A
30 TEMPLE DR ` a
METHOEid MA 01>
)1 Ott Expiration
Gonwnissioner 04103120117
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City/Town State F-- Zip
code
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REGISTRANT RESPONSIBLE REGISTRATION EXPIRATION
ADDRESS DATE STATUS
NAME INDIVIDUAL NUMBER
ALL UNDER ONE ROOF LANZAFAME, 137057 166 A MERRIMACK ST 10/02/2016 Current
JOHN METHEUN,MA 01844
0 2012 Commonwealth of Massachusetts.
Mass.Gov®is a registered service mark of the Commonwealth of Massachusetts.