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HomeMy WebLinkAboutBuilding Permit # 7/10/2015 %%ORTn BUILDING PERMIT ®��TLED INo Z' uJYr.,�f• K..�r• 6 TOWN OF NORTH ANDOVER ) (APPLICATION FOR PLAN EXAMINATION Permit No#: ���kkk Date Received ��A��ATED•4a'�c� S�Ac aaus`� Date Issued: 14ILWO—R—TANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER o`I Print 100 Year Structure yes no MAP 7 PARCEL: ZONING DISTRICT: Historic District y s no Machine Shop Village s no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family ❑Addition ❑Two or more family [I Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other , m,., r;.;,�,,. ,_,,�e,.,, r i�ei'�a,Nr I lu rr! „ �,�� IS ✓i/.r�I Gi ra i�p��"y/%/ ..:.... ..... ..r,,,,,., ri.,,.,ux� r r i/rh, r r«�r✓�.u.,.,; rrr rn N4f,2 � / F� �,Pf ldl/tYdNFkilYf(J,`�I'Y'ihiiV ,Vli/.r .,r/,/y/, ,/.//,,/,..,. aY .rf,S.te,,Ulle.,)r; DESCRIPTION OF WORK TO BE PERFORMED: r Identification Please Type or Print Clearly , OWNER: Name: / &- A T-c— Phone: Address: 1,13 CJ Contractor Name: 1A4 Phone: Email: Address ""` v tin -r- Supervisor's Construction License: cl? <2 D Exp. Date: Home Improvement License: ` Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $, K C FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with r stered c ntract s do not have access to the guaranty fund Arb SORT own ot Anctover ® ® .' . V LAKE h h ver, SS' COC 41CMEW.cx A°RarED S � BOARD OF HEALTH Food/Kitchen PEtXMIT T LD Septic System 0000TMM% 00%. QA THIS CERTIFIES THATBUILDING INSPECTOR ..................... ........... ......Z: ..... ........ ..... ................................................. has permission $o erectlle.!44 .... .. ..... .. . Foundation .......................... buildin son ................ .. ". . .. ..... .................................................... Rough to be occupied as ............ .. .......... .......................Vzo a............... Chimney provided that the person accepting t is 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 S ELECTRICAL INSPECTOR ® UNLESS CONSTRUC I S T Rough Service ........... ...... ............................................................. Final BUILDING INSPECTOR GAS INSPECTOR ccupanap Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — ®® Not Remove Final O Lathing Or Dry Wall T® Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector'. Burner Street No. Smoke Det. POFuse176"10d/1,76.'Complete 1#t��rrh';�rcr ter rr err f'L�r=t:onllolete' Il Types Of Sidin 1=~ nit Masonry ' Jock Mass Tall Free Licensed & Insured 1-800-WAIT-4-US r ocalb,Owned c@ 0PC)Y 1!d V ee_- 1076 u o License#034200 (924-8487) ti' as ?tis k' �� y r� t <. r� i4 We. Work Year ].found r , Proposal To: Tim Southgate Date 5/18/2015 Street: 13 Cleveland St. 978-943-0198 N.Andover, MA Roof proposal Timothy.southgate@verizon.net IKO Cambridge tsouthga@us.ibm.com L Extra caution will be taken to protect building 13. Building permit included. exterior,pool area and landscaping as best as 14. Contractor workmanship warranty: 10 years possible. (tarps etc.)Magnets run at final clean up. under normal wind and rain conditions. 2. Remove all shingles from entire house. Remove Total roof cost: $ 8,900.00 ' and dispose of old antennae. (See Garage option) 3, Inspect and re-nail any loose or lifted roof boards. ' Option: Garage: $750.00 additional cost Any compromised roof boards will be,replaced at ' Option: Chimney: Cut and grind out mortar an additional cost of$3.00 per lineal foot of 1x8 joints. Re-tuck point with adhesive based mor- Spruce. tar. Apply silicone based waterproof spray. 4. Install heavy gauge 8"white aluminum drip edge $700.00 additional cost. to all eaves and rakes. • Option: Cut and install all new lead flashing 5. Install 6' of IKO Armourguard ice and water into chimney, counter flashed with ice and shield along all eaves. Install full coverage of ice Fater shield and sealed with clear Geo-Cel and water shield on rear lower addition. sealant. $200.00 additional cost. 6. Install synthetic underlayment to remaining sheathing up to ridge. IKO Shield Pro Plus extended MFG warranty 7. Install all new pipe boots where applicable. A fully transferable 100% coverage against 8. Install IKO Leading Edge starter shingles to all material defects for a fully non pro rated period of eaves. 20 years. Please refer to pamphlet left in estimate 9. Install IKO Cambridge Limited Lifetime folder or go to www.iko.com. Offered to our local architectural shingles to the entire house and referrals(Tim Cresta) and included in this proposal carport. 15 year non pro-rated warranty by mfg. at no additional cost. All shingles will be installed and fastened accord- ing to mfg. specs. All valleys woven. *Note*: Please be advised if applicable, valuables in the attic should be moved or covered due to minor 10. Cut and install a new GAF Cobra ridge vent debris, dust and asphalt particles that will accumulate capped with color matched IKO hip and ridge shingles. during the stripping process. All Under One Roof not 11. Counter flash existing chimney lead with ice and responsible for any damage or clean up that may water shield, tie into new shingles and seal with occur in attic. black rubberized cement. (See option) Balance due upon completion, no deposit required! 12. Removal of all work related debris. Planks will be References available upon request placed under dumpster to prevent any damage to Highly rated member of the accredited BBB and driveway. An2ie's List Thank you! The Conrnlonlvealtk of111assachusetts Departntent of Industrial Accidents Office ofbivestigations 600 TMashington Street Boston, A 02111 l vwm/nass.go vldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant inforination Please Print Legibly Name (Business/orgailization/Individual): �% �+ �� Address: � �- City/State/Zip: VhA Phone Are you an employer? Check th'e•appropriate box: Type of project(required): I.❑ I am a'employq Arith. 4, am a general contractor aIIIemployees (full and/or pari-tune).* have hired the sub-contract6. ❑ New construction2.❑ I am a sole proprietor or partner- listed on the attached sheet. �• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me.in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' cornp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their •10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' cornp. c. 152, §1(4),and we have no 12.0 Roofrepairs insurance required.] t employees. [No workers' 13 �ther�141.comp. insurance required.] *Any applicant that checks box t!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 and then hire outside contractors must submit a new atiidavit indicating such tContraclors that check this box must attached an additional sheet showing the name of the sub-contactors and their workers'comp,"policy idforrnation. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Lliforniation. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: ' � � ' ' 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 ofcrirniml penalties of 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 rine of up to$250.00 a day against the violator. Be advised that a copy of this statement.may be forwarded to the Office of Investigations of the DIA for insurance coverage verification- 1 do hereby certify under the pant's anV)enalties ofpelizity that the information provided above is true and correct Signature: •Datc• 1 I � � S Phone#: Oficial use only. Do not write in this area, to be completed by cif)or tolpn official City or Town: PerrnitfUcense# Issuing Authority (circle one): 1. Board of Health 2.Building Department 3. CityiTown Clerk 4.Electrical Inspector S..Pluutbing Inspector 6..Other Contact Person: Phone#: R �94o�'i�� 4d Ll ��l� l� i�[1t C DE�TE(1 vDdrYYYY) AN IFiCA'rE IS j—MED AS A mATTER f]F mFoFtmA'I on ONLY AND CONFERS No RIGHTS UPON THE CERTfFICATL HOLDER. THIS fiCA'rE DOES NOT AFFiRpaxnYELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ft CERTIFICATE OF INSURANCE DOES NOT COMMUTE A CONTRACT BETWEEN'tH E ISSUINO INSURER(S),AUTHORIZED REPRESERTATIVE PORTANT;if the certificate holder is an ADDITIONAL MURED,the pullcy{ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the and conditions of the policV,certain PO toles may require and endorsement. A statement on this certificate does not confer rights to the e holder in tied of suet endoruemengs.1 CONTACT t ucr:R "A`IIIE: s s�fr'IIJ E YELLER INS AGCi P3t>?�tE FAX U F Y't'?�iWAY (arc,Na): EMAIL LYNN,NIA 01901 ADDRESS: �°aj3 tib tRWRER(S)AFFOR1pING COVERAGE NAtC N --- RMSER A: AC'S At+ ICxtTaT}TSURA 4CE C01APANTY Ed BERRY.FRANK di.BERRY,i l�MES DBA FRANK SONS INSURER s: 901RER Cz INSURER D: 45 WIN BROOK DRIVE INNSUREMR E: EPPJ,NG,NIH 03042 1"SURERF: ERAGSS C1:R7IF1G�lTEtdllhti8ER ngvISION NUMBER; O 0. Tt P !Wr—;D�OWIfAlvSllt?EDl7dtidF�AEGYEFUIitHEFQ1tCYffER ItO�ATEU.NO1V�8TFtSTAN6HiCi tiEOUtREITENT'TERGA OR C QiM"fit`A%Y CONTRACf ON QTttEft DOCUMENT WITN REBPECTTCT Wt i TH14 CEtTi>€it"ATE MAY M ISSUED OR GI0.Y PERTAIt.THE INSURANCE FORTED BY THE.POLWAES UM IIMEtN 1S StMJECT TO AUUMTE EXCLUSIQl2S Ate} IFN OF SUCH Ft}t 1GiE9 LNJtR89ti01�lN MAY HAVE BEEN REDUCED BY tan ADD Rio psatCte OATS PQLA.:V GIP D TE t RAFTS LIR TYPE OF WSURAUCE L R POLICY NUMBER {TblGDA1YYYYI {ktiltDHiYYYYI GENCRAL LIABItTTY GH OCCURRENCE $ GOkWERCIALGENERAL I-IABILnN AMAGE TO RENTED .$ CLAIMS MADEf—n OCCUR. REMISES(Ea omatenm) ED EXP(Any one petsoni is ERSONAL&ADV IriJURY S GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE 3 flOLtCV PROJECT� LOC Rt?I)UCTS Gf?S19PlOP AGG $ AUTC&I'DOILE LIABUTY COMBINED SINGLE (S { ANY AUTO WIT(Ea acciden) I ALL OYJ}VEB A'JT{1S BODILY INJURY --,� {Per person) cCGHEDJLE AUTOS BODILY IMURY S HIRED ALITOS (Per accid@N) NON-OWNED AUTOS PP.OPERTY DAMAGE iS {Per acckierg) EliVrBFLEA LIAR CG',,UR EACrE OCCURRENCE �5-----�— GCzREGATE iS EXCESS;:_IAS C `409—MADE DEDUCTIBLE $ RETEt.ITEOitl $ ;tNC STATtiTORY OTHER; A WORKERSG£EMI"ETISATFt)4lAND i1B BL43314 1ttD5I2flt4 1t/051Z4tS tkAtTS _ EMPLOYEE`S LI"IUtTY YIN ANY PR0PE911D9'PAFW4EFLk-Xr=GVT1VE M<WA E.L EACH ACCIDENT �I 100,000 0Fi;10iR,"ME1�`SER EnLUQEG? E.L.DISEASE EA EMPLOYEE,$ 100,000 (1latary fi rat} ayes aeccrAZa+x+A EL.DISEASE-POLICY L[MIT $ 5gp,gqti flESCRIPT CYl OF OPER,AT;MS glow IfBmaY.t11"ON OF OPERA71ONSILCCoAltONS11 MCLESfRF-STMC'nONSIWEGtAL ITSAS 1 GTiS 1zEPi ACl?S 0.TdL MoltC F ATtFICA`C'EE'SSUr doToIM.CMkUF1Cr1rRH02.DER AFFEC ENG WORMS f:ON4P COVERACE. NO PAR9:NERS AVE£;D1r?ED EV 103 ORhERTCO- NSA'RON}OLiCY. C ATE HOLD ER GMICELLA+Ttt?N ,e....�. . ALL UNDER ONE ROOF AW OF THE ABOVE DESCRIBED POLICIES BE CANCELLED T3EFQRETtfE 1=XPtt9cA7it9d1[}ATE IHEf4EOf,NOTICE WILE.8 UEUV D `{{1 Tr-MI >T F IF IR ...=l+ns.a�a.engine-:e�s+..asurnr+.:nvnrv+ans+sasen r fi S Massachusetts -Depa;ttyl:�nt cr Public Safety Board of Building ReyuiaYions and Standards Construction <i SUiiri ti iKi;i' l x� License: CS-069120 JOHN W LANZAF.IAME, - !. 30 TEMPLE DR METHUEN MA 01844jW , a: ✓.�..� 111 Expiration Coanntissicr;et 04/03/2017 Zip City/Town state I code i 1 Search Registrants Click on the registration number to view complaint history,You can also view arbitration and Guaranty Fund histo The list is current:as of Wednesday, October 8, 2014. Search Results REGISTRANT RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS NAME INDIVIDUAL NUMBER DATE ALL UNDER ONE ROOF LANZAFAME, 137057 166 A MERRIMACK ST 10/02/2016 Current JOIN METHEUN, MA 01844 "---- - ©2012 Commonwealth of Massachusetts. 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