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Building Permit # 7/27/2015
BUILDING PERMIT o"O oTH q • „ o TOWN OF NORTH ANDOVER a�''z"_` APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received g�"SSq�HnsEt� �—� Date Issued: ' IMPORTANtcta,/ st co'plete all items on this page LOCATION'! PROPERTY OWNER Pr nt loo Year Structure yes 0 4 MAP 0. PARCEL: ZONING DISTRICT: Historic District Machine Shop Village yes a j1 TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family Addition wo or more family Industrial Alteration No.of units: commercial epair,replacement ❑Assessory Bldg ❑Others: ❑Demolition ❑Other DESCRIPTION OF I O TTO E PERFORM _..3J P%}'Ifs7 I`Fr 1 it f"Ysl' c^rA Identification-Please Type or Print Clearly OWNER: Name: Phone Address: Contractor Name: '1 f 1� v Phone ` "�-�v__7g' Email: Address: !it fid" 1 Supervisor's Construction License Wim .. _ � Exp. Date: Home improvement License: f`-s�> Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg.No, FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PE".F. Total Project Cost:$ /,31 r v i FEE: fj� Check No.: Receipt No.: , NOTE: Persons c tracting with unregistered contractors do not have cess to the guaranty fund w�..A..e.� ...:...� _. 01 111 T" Andover Town ®f No. �1 !11W 2oi� T h ver,Mass, U BOARD 01 HEALTH F:,d'Kit,h E RMIT T I L D P pt c System THIS CERTIFIES THAT............. BUILDING INSPECTOR r............ ............................. has permission to erect................ buildings on J& j,7.. R-gh to be occupied as ......tom. chi—Y provided that the person"acce.Ing this permit shall in(Very respect conform to the terms of'the"'application Fmal 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 RoughVIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC S Roull BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises—Do Not Remove Fin,] No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street N,. Smoke Det. The Commonwealth of Massachusetts q-- Department of IndustrialAceidenis I Congress Street,Suite 100 Basten, 0go i 017 www.mamasago vIdv/ia Workers Compensation Irrsnranee Affidavit:Buildors/Contraetm's/E(Gohdciane/Plumbms. T'O BEFIGED WITH THL PLRNRTTINC='AUTHORITY. A h—tloformatlon PI ase Print Le ibl Name(Dn:;ne:;s/organiaanewrnatydnaq: Com. 1.r'7C..i' Address: 7/7 CitylState/lip: F.?�HY--" Phon©#: Arcyou au employerR Cheelc fyyhe appropriate box: Type of project(regnired): 1.�Iam aemployerwith >._employees(full end/or'part-time)." 7.❑New constivction 2.❑Iamasole Pmprietorcr parNerstdp and havememplcyeas working for mein 8.❑Remodeling any capacity.[Noworkem camp.insmen required.] 9.❑Demolition 3.❑Iema homcowmr doing sl work myself.(No workers'wmp,hvomnae req*vd]i m h 4.❑I om a omeowner andwm be biting--s m ao„dnet all work= .11111 10 Building addition Pmp retnatau aommorom eitherbaveworknm'wmpensadon inamanne er are sNa 11.❑Electical repairs or additions propHet—ithno employees. 12.❑Plumbing repairs or additions - 5.❑I am a geneal centracmrand I havo ldredihe sub-contmetors listedenfbe atfachedsheet. 13.❑Roof repairs - Thesesub-contractors nava omptoyees and haveworkers'comp.msmance.t 6.F-1 corpornt,o snd its oftgge aveexeccbed then ught at—pti.n MGL e. 14.❑Othe1' 152,§1(4),mdwe have omployees.fse—kem' p.i,oavau requlmd.l .. 'Any applicantthat cheeks 6oxN1 must also 5l1 out No sectionbelowshowing theirwerkers'compeusationpelicy ieSormatien. t Hem who submit#his affidavit indicating they are doing al(workand[harthirc outside contactors mustsubmitanew afSdavitiudicafing such. ,ConVacotors that d wkthis boxmust'ar,sluden additimmi sneetshowing the name ofthestib-Contractors and stats whethu ernot mese entities have . employees.If the sub-rAnhac(ors liav employees,l6ey rirust provido tlmir warl<ei omp.policynumber. Z am arz employer tHad ispro'v8diug rvarlrers'compensaflme Insurance far y eugloyees.Belmv is tkepoliey and job site Inf rmzation. Insmence Company Name: Policy#or Self-hu.Lr If: 00—f-�y... _.EpirstionDate //�/ cJ Job Site Address: Lt LJ _—City/state/Lip. r U Atfaelr a copy of tke warrmrs'compepsationpokcy doclaration page(showing the policy number and expk'ation date). Zz Failure to secure coverage as required under MGL c.152,§25A is a criminal violation pmishable by a Sue op 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 ofup to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations ofthe,DIA for insurance rmo,mge verification. Ido hereby certify under thepahzsand penna,ate.9J'perjury that thainjojmakon prrovided also,is•nvre and ewsecG ..r.-" .. eJ Siem t .✓""<":,........�,..,..� ..._ Dat: .... phone i Official use only.Do not writ,in this area,to be completed by etty or townofficial., City ar'Town: P—it/License N -. htaningAstimeity(thele one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Imports,S.PI—big Iaspectur 6.Other Contact Perasou Phone k:__ A�ROx CERTIFICATE OF LIABILITY INSURANCE nATE,MMIDO 7/zv/zo15ls THIS 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 PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:Fthe—111 ate holder is an ADDITIONAL INSURED,the pelicy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain poll,IRA may require an endorsement.A statement On IN,—N-1.does not confer rights to the certificate holder In I-of such-d---X). uccT James Tarpey, CIC, V Pres PROD ER IOR A _ Tarpey Insurance Group UH Ea�(781)296-26'1'] - ^X,No/_<71i 4-0973 E✓.tAIL _..-y 942 Water St ADwxEss:Iimptaxpeyinsurance. DO Box 567 --(B)ArroROl..covERacE rvAlcs 4Takefield N.A 01880 _ aEssex Isux _nance company Irvsua[a INsu— - —C The Hartford Insurance Com an _ A.C. Castle Construction Co.Ine IrvsuReRc Continental-Casualty 9 Tibbetts Avenue Danvers MA 01923 COVERAGES CERTIFICATE NUMBER:-15 wC 195VR 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILV FINSUP.ANCS D LIsVBR po ICV NUMBER MMIDorvYYv orvWY uMOs X c RCIALG ILm g 1,000 omME EJErRa''LILIPS FaGI_o[,^�JRRENCE _ _ A cul-mle U—LIF PkEiulsEs Ee ociFmnce P 50,DOD 3eeoT2e "//x0/z17s 7/20/2016 MED ExP IMyane per-onl e 5,000 PF.Rs INJJ2Y 1,00,000 eEN'La F-1�TI-.I.^nli MPUES PE GEVE 6AT[ 2,00,000 X PoticY` JAR �LOc PRODuc/s-LbN,c/aPnc;; b 1,000,000 OTHER. E LIAOILItt�—L' Ee eulaonlvFluidXFDlILY rveuuvLOwrvFoTD (PeP n1ex s - RREUAB uM LIAp� Each occuNNENrE E .LUAB cl niMa NaoE AG6REGarF (g LTE -cuTVE Ylry xL En s 50 00 a N,A e5Rea953e 4.P 4_Ae _ C R__111 q 'I Lo 50 00 ff S 00 0 seRIPTION of OPERanONsl LOcanONs I VEHICLES(acORO tat,aealllonal Remarxz scM1aeule,maY be mleenea II more space is ragmr el ' CERTIFICATE HOLDER CANCELLATION (978)688-9542 HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOvm o£North Andover THE EXPRATON DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 blain BE CCOROANCEIWITH THE POLICY PROVISIONS. North Andover, — 01845 S 211pey, CIC, V Pce x01988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name—d logo a re registered marks of ACORD INS025(211411) Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 166565 Type: Corporation Expiration: 6/9/2016 TM 251720 A.C.CASTLE CONSTRUCTION CO INC. BRIAN LEBLANC 9 TIBBETTS AVE - _--- -- -- DANVERS,MA 01923 --- -- ---- Update Address and return card.Me,It—.on for change... sone s,zom o,nt Ff Address Renewal []Employment iJ Lost Card �. IN/iG! frlh Off fC me Aff.s&eosin RIgullow. Liconeo or registration valid far indrvidul use only 11f, OME IMPROVEMENT CONTRACTOR before[he expvatimr date.If found.etarn to: eels t d 166565 Type: Office of Covaumer At'tairs avd Bnsmess Regnlehon Exp rat on. 6/912016 Corporal on IO Parl<Plaaa Suite 5170 Boston,MA 02116 A.C.CASTLE CONSTRUCTION CO INC. BRIAN LEBLANC 9 TIBBETTS AVEC–�® DANVERS,MA 01923 Cnderserretary N[alid rvitlu tMg-ftio, Ir LYl B d f ft-Ir7'y 6t g I R 1 bt ndards "l/,//� N 4 ¢ ce v 'unr L4.evrae CS-054882 BRIAN A LEBLANC 9 TIBBETTS AVS Danvers MA 01923 Ex,,r69lon ro.,.mos. 09/17/2015 HHB eF A.C.CASTLE CONSTRUCTION CO.INC. MEMBER Telephone(800)505-LEAK(5325)-Fax(978)777-7750 Brian LeBlanc,President Please mail accepted proposal to the office located at: r , 9 Tibbetts Avenue•Danvers,MA 01923 '-- Unrestricted Mass Builders License No.054882 Contractors Registration No.166565 PROPOSAL SjB ITTEDTO PH DATE �Ut> h f. €/ - �lnli O_ Y STREE lfi�2 O cl tl J 27&. _l ZZ 4 til" CIN,S ATE AND ZIP ODE JOB LO ATION - 4 Al—,2`� n DATE WORK IS SCHEDULED TO BEGI DATE WORK IS SCHEDULED TO BE COMPLETED JOB PHONE 3VC VTOp09C her by to fursshm ter and labor pleten ordanc th sped i elowfor the sum of t h, en -�)�� a/(1 �� ,, ¢w dollar¢ Pay tt b follows - 1/3 dow the balance due upon conhi Yl. ✓^V'eJ ( T 1 F r ? ; NOTICE: All h—c improvement contractors and subcontranors engaged in home Auth ' dd/ improvement Chepe,114 unless sG,,,Czlly exempt from registration by b $i ndturg. provisions of CM1epter 162A of the Generel Laws,must be registered with \\\\„�.//"NNpp9t�f/ Agent the Commonwealth of MassapM1usetts.Inquiries about registration and Th' proposal may b¢ s should be made to the Office of Consumer Affairs and Business F19-11,Ten Park Plaza,Suite 5170,Boston,MA os11 It. thdrawn by us if not accepted wIthin days. WE HEREBY SDBMn SPECIFICATIONS AND ESTIMATES FOR: A ROOF STRIP We will cover the,aiging,bushes,and grasses with Blue Tarps in order to protect the property during stripping. We will Strip up to l yens of roofing and remove all nails,screws and staples dawn to the Bare Wood and renail all loose boards. The Ice and Water Shield will then be installed at the bottom of all Edges,under all Step flashings,under all Roll flashing, around all Chimneys,Skylights,and into all Valleys,in heated areas only. We will install 30 Up Synthetic Deck Protector Underlayment to all other areas of the roofdeck. The e"aluminum Dripedge will than bei tall d to all roof edges.Any ex'stin9 Pipes will be covered wit] Aluminum Rubber Flanges. r! he roofing material to be used will be�l g �i>�)= 8 iIa"13('—/A P /' OJ IrS!, P The bottom of all roof edges will have a Pro Starter course with a glued edge for wind uplift.We will Storm Nail II shingles,using 6 nails per shingle. All the Debris will be cleaned and Dumped by us on a daily basis.We will cleanout all Gutters,Downspouts and Elbows.Magnetic brooms will be used to extract all nails from your property.We will protect your property as best we can,however some foliage matting,breakage,or marring could occur. We cannot accept responsibility for possessions inside of the house,or debris falling into attic areas.Customer should protect personal belongings. EXTRA WORK IN WHICH A COST WIL EE ADDED TO THE ABOVE PRICE. Replace Rotted Roofboards$`' 1 / Install Aluminum Gutters Relead Chimuey(s)r'1 Install Aluminum Downspouts Replace Facia Boards )G Install Skylight(s) rr B 1 Install Ridgever - Lti Rotted Roof To Wall Flashings Install Roof Louvers a fy 1n Gutter Repairs NOTES: 71 R G l t Pn'3C7rrP .Jr n 1 "Je� I Fm e�c� rF�r bra n Warranty by�rranufastu free of defects for years,see manufacturer's warranty for exact warranty performance. All labor perforLn er}his can ct shall 6e of good quality and free from defects not inherent in the quality required or permitted for a period o Is ehis we'an excludes remedy for damage or defect caused by abuse,modification,improper or insufficient maintenan e,Iop rati ,or normal wear and tear under normal usage.This Warranty shall be limited to the Work performed by A.C.Castl n and limited to either repair r replacement by A.C.Castle Construction Co.,Inc.at iis'sole discretion and election. claims are waived unless made in writing to A.C.Castle Construction Co.,Inc.within 21 days after the e ce of the event giving rise to such claim.This warranty shall not extend beyond any limits imposed by applicable law. occurrence It isourobligation to obtain any and all necessary related permits.PLEASE NOTE:owners who secure their own construction-related permits shall be excluded from access to the Guarantee Fund. Payment and Penalties-Upon substantial completion of all work under this contract,customer shall within 3 days make final and full payment of the contract price.Any and all unpaid balances shall accrue with interest at 5%interest per month.You agree to pay all court costs and collection expenses incurred by A.C.Castle Construction Co.,Inc.in the collection of any amount you owe under this contract,including without limitation reasonable attorney's fees.Please note:any illegal layers of roofing beyond a second layer will be an extra cost of 35 cents per square foot. Arbitration-Any controversy or claim arising out of or related to this contract,or the breach thereof,shall be settled by arbitration with the American Arbitration Association or a mutually agreed upon third-party.Any judgment upon an award entered in arbitration may be entered in any court having jurisdiction thereof.This section shall not apply to claims of A.C.Castle Construction Co.,Inc.for collection of past due accounts owed by the customer. The homeowner's three day cancellation rights under MGL c 93 s 48;VOL c 140D s 10 or MGL c 255D s 14 as may be applicable. 21tteptante of Proposal-Signing this proposal means you have accepted all the terms as stated and us as acting agent for permitting. Date of Acceptance ia ).5—,� SignatUrt, J ?3