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HomeMy WebLinkAboutBuilding Permit # 9/1/2015 * BUILDING PERMIT ® OORTH "LED TOWN OF NORTHA OV o APPLICATION FOR PLAN EXAMINATION Permit NoDate Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION °jz Print PROPERTY OWNER a '' 'gip 191V, Print 100 Year Structure yes no MAP 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 ,,;•. -., .,,.. . . r r � ,iii., / . /, . i //,,,/li/�. ,rr � r<i , rrr / i .rig i rii/ r, ✓ vi,, , / , / , r / r / Wetlan DESCRIPTION OF WORK TO BE PERFORMED: " ,.. Identification- Please Type or Print Clearly OWNER: Name: ` l rte ' R Phone: Address: ° � c� f = �✓ Contractor Name: 1?0191f ,. ���"�� � Phone' Email: /' i C,164y Address:. 61 ^ � ..a� Supervisor's Construction License: ,. °, '.. d',3 Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEERPhone: Address: Reg. No. . FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. FEE: $ Total Project Cost: $_ c Check No.: Receipt No.: � NOTE: Persons contracting w th unregistered contractors do not have access to the guaranty fund �� .. _.. _ thO TH v P r E. ....1,.' `/ i. _t own of i No. AK. h ver, ass, �s COC HICHCWICK y�• 14 0.q S U BOARD OF HEALTH P RM-IT T L mum"' Food/Kitchen Septic System THIS CERTIFIES THAT ................... .. .......................... ... ....... ... .......... ...... ........... BUILDING INSPECTOR has permission to erect g .,{„ .. .. .. , Foundation .......................... buildings on ............ ....... ... ..... . ® Rough tobe occupied as .......... .. .. ....... ...... ............... ..................... ... ..................................... Chimney provided that the person accepti this permit shall in eve respect conform he 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 I O S ELECTRICAL INSPECTOR Izq - UNLESS CONSTRUCTION T Rough Service ............................. ......... .................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Oceupy BuildlinRough 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. ROOF� Commercial Roo-fing Specialists July 31,2015 Mr. Steve Lanaan Submitted by: Fran McBay 41 Marbleridge Road North Andover,Ma. 01845 Re: 41 Marbleridge Road North Andover Re-roof Dear Steve, I am pleased to provide you with a quotation and specification for the above-referenced roofing project. SHINGLE RE-ROOF (1) Remove all existing asphalt shingles completely on above surface roof. (2) Install new#30 felt underlayment paper. (3) Install new aluminum drip edges and rake edges. (4) Install three foot wide roll of ice and water shield barrier at drip edges and valley locations. Please note that along drip edge areas we will be installing ice and water shield six feet up from drip edge. (5) Install new Certainteed Landmark Ar(limited life-time) asphalt shingles over entire roof area. (6) Membrane and waterproof all units protruding on above surface roof using appropriate flashing components. (7) Provide and install new Cobra ridge vent along top ridge area. (8) Along one(1)front dormer sidewall(left side only)we will remove and replace existing damaged clapboard siding. (9) All debris will be cleaned up and removed by Roof Solutions, Inc. SPECIAL NOTE: Please be advised that during the ripping operation that dust, dirt,and debris may fall through the wood planks of the roof deck and enter into the building. We highly recommend that precautions be made by the owner in the interior of the building to prevent any damage to items directly below. Roof Solutions cannot be responsible in the event that these issues occur. 2 Aberjona Drive - Woburn, Ma.01801 - tet.781-939.5830 - fax 781-939-5831 -www.roofsolutionsinc.net Commercial Roofing Specialists SPECIAL NOTES PAGE 0 Please note we must be allowed access of logistical areas surrounding the building for crane access,debris removal and/or dumpster placement. Discussion and contingency must be made with the owner prior to job commencement. 0 GENERAL AlA TERML INCREASE NOTE. Due to the reality of roof raw materials unexpected shortage and price increase, we will have to pass on any material increase which occurs prior to the signing of the contract. This proposal is valid for only thirty(30) days. • Please note installation of ice water shield will not stop ice from forming on the roof surface but should provide extra protection from melt water infiltration into living space. • LANDSCAPING -NO LIABILITY CLAUSE Although every attempt will be made to eliminate or minimize the passibility of landscaping damage,Roof Solutions,Inc. cannot assume liability far any such damage which occurs in connection with the roofing operation. In accepting this contract, the customer agrees to exempt Roof Solutions,Inc.from any liability due to landscaping damage. • DECKING CLAUSE WITH ESTIMATE Insofar as we cannot determine the condition of your existing deck until the ripping operation has begun,replacement of decking will represent an additional charge on a per sq.ft. basis. The deck replacement charge will be$ 7.00 per sq.ft. 2 Aberjona Drive - Woburn, Ma. 01801 - tel.781-939-5830 - fax 781-939-5831 -www.roofsolutionsinc.net ROOFmommmmil Commercial Roofing Specialists ROOF SOLUTIONS proposes to furnish labor and materials, complete in accordance with the above specifications,for the sum of: TWELVE THOUSAND EIGHT HUNDRED & FORTY ****** DOLL ARS($12,840.00) *Stock Payment: $6,640.00 %Way Payment$3100.00 *Completion: $3100.00 PROPOSAL ACCEPTANCE The specifications,prices, and attached DATE: conditions are satisfactory and hereby accepted. Roof Solutions is authorized to SIGNATURE:"A N\ Kku A perform work as specified. Payment will be made as outlined above. TITLE: I I will follow up with you with regards to this proposal. In the meantime,please call me at (781) 858-8594 if you have any questions. Thank you for your consideration. Sincerely, Fran Mcbay,Principal Roof Solutions, Inc. 2 Aberjona Drive - Woburn, Me. 01801 - tel. 781-939-5830 - fax 781-939-5831 -www.roofsolutionsinc.net X`he Commonwealth ofMassachusetts Department of. ndustiliaZ.Accide��s W s .tl 1 Congress Street,Suite 100 Bos,�tyo(ny�,)M[A��g0211y�4-20 7 ,�'..•;• Sy;y4r Y ww.Fl4{�s .g1/{Idia, Workers'Compensation insurance Affidavit:�uiXdexs/ContractorslE�ectricians/PXumbexs- TO BE MED WXTH THE PET2MITTTNG AU'T'HORITY. A licant Information Please Print Legibly Name(Busiaess/Organization&dividual): (.��f` ,S000T/comer City/Mate/Zip: L,//C) Phone#: Axeyou an employer?Check the appropriate box: Type of project(xequixed): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2. I ama sole proprietor or partnership and have no employees working for me in 8. [1 Remo delirig 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 0 Building addition 4-E]I am a homeowner andwill be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole ❑ 11. Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions S.E]I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Lg Roof repairs These sub-contractors have employees and have workers'comp.insurances 14 El Other 6.[]We are a corporation and its offlcers have exercised their right of exemption perMCTL c. 152,§1(4),andvaehaven'Q employees.pworkerscomp.insurancerequired.] "Any applicantthat checks box4l must also fill out the see tionbcows howingtheir Workers'compensation policy information. i Homeowners who submif$his affidavit indicating they are doing all work andthen hire outside contractors must submit a new affidavit indicating such. rContractors 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 crust provide their workers'comp.policy number.' ..l'am an employer thatispiovidingwork`errs'compensation insurancefor my employees.'Below is thepolicy andjab site information. ,� Insurance Company Name:_, /4 i/e k, <A/yG� G � Policy#or Self ins.Lie.#: ga2 �� �� ExpirationDate: 3 Job Site Address: YX �/ City/State/Zip: /i/D/</ �v'/�a Attach a copy of the workers' c'ompensatiorl•p olicy declaration.page(showing the policy number and expiration elate). Failure to secure coverage as required under MGL o.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 fnvestigations of the DlA.for insurance coverage verification. Y do hereby eertijy under t7iepains andpenalties ofper jury that the information provided above is true and correct. Sign o: �12 Date: Phone Z/ Official use only. Do not write in this area,to be completed by city or town official.. City or Town: Permit/I icense 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#: DATE(MMIDDIMY). CERTIFICATE OF LIABILITY INSUMNCE4/17/2015 IN j TE HOLDER. THIS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO EXTEND OR ALTER RIOTS H COVERAGE AFFORDED ABY THE POLICIES CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, 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 certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A Statemen�`on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). A PRODUCER NAME: - - The Driscoll Agency,Inc. PHONE -681 aC No 93 Longwater Circle E-MAIL ADDRESS: Ila -� P.O.Box 9 .120 INSURER(D AFFORDING COVERAGE NAIC# Norwell MA 02061 INSURER A WCAR AITIG 0 InCI Vance Comoan INSURED 4007 INSURER B:BprklQy RegIO61 Roof Solutions,Inc. INSURER C: it ,�+�F, 2 Abelona Dr. INSURER D Woburn MA 01801 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:50791296 = REVISION NUMBER: INDICATED.THIS IS To EEN ISSUED To THE INSURED NAME 1 1,13 C'1.1 E F DR THE CERHATTHEUS:ED aO NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION LOW HAVE FBANY CONTRACT OR }TER DOCUMENT WITH RESPECT TOUWHICH CY TH S 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 MAIMS- EXCLUSIONS POLICY EFF POyy EXP LIMITS ILTR POLICY NUMBER I MMIDD/YYYY MMI1311 SURANCE NSR Y Y TYPE OF IN Y CGL0072706 1112015 /1/2018 EACH OCCURRENCE $1,000,000 B GENERALLIABILITY A GE OR ED $100,000 PREMIS S a occurrence X COMMERCIAL GENERAL LIABILITY MED EXP( one arson) 5 CLAIMS-MADE FX�OCCUR PERSONAL BADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP AGG 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: $ POLICY PRO LOC Y PRC00001003394 /112015 /1/2018; a acctdenU 1.000,000 C AUTOMOBILE LIABILITY BODILY INJURY(Per person) 5 ANY AUTO BODILY INJURY(Per accident) $ ALLOWNED X SCHEDULED PROPERTY DAMAGE AUTOS $ NON-OWNED Pera ent ' X HIRED AUTOS X AUTOS S B UMBRELLA UAB XOCCUR Y C00072706 1112015 /11201&_= EACH OCCURRENCE $3,000,000 AGGREGATE $3,000,000 X EXCESS LIAR CLAIMS-MADE $ DED RETENTION S WC ST ATU O7H- A WORKERS COMPENSATION TO BE ISSUED BY CARRIER 1112015 /112016TORY LIMI AND EMPLOYERS'LIABILITYY/ E.L.EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE r N/A E.L.DISEASE-EA EMPLOYE $ OFFICERIMEMBER EKCLUDED? (Mandatory In NH) E.L.DISEASE-POLICY LIMIT S Ifyes,descr be under DESCRIPTION OF OPERATIONS belmv pESCR1P790N OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Addltlonal Remarks Schedule,If Moro space Is require,. CERTIFICATE HOLDER SHOULD ANY OF THE AE1pVE DESCRIBED POLICIES BE CANCELLED BEFORE I THE EXPIRATION DATA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIV9- ©1988-201`0 ACORD CORPORATION. All rights reserved. "'—,,a registered marks of A99RD DATE(MMIDDlYYYY) A CER ' LIABILITY ' 04/17/2015 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: If the certificate holder is an ADDITIONAL INSURED,the policy(les) 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). CONTACT PRODUCER NAME: FAX DRISCOLL AGENCY PHONE AIC No 93 Longwater Drive E-MAIL Norwell, MA 02061 ADDRESS: INSURERS AFFORDING COVERAGE NAIC tk INSURER A: INSURED INSURERS: AmGUARD Insurance Company 42390 ROOF SOLUTIONS INC INSURER C: 2 ABERJONA DR INSURER D: WOBURN, MA 01801 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE AOS L SUER POLICY NUMBER POLICY EFF Y MWDD/YYYYY PO LIMITS GENERAL LIABILITY EACH OCCURRENCE S 0 D ORE ED O COMMERCIAL GENERAL LIABILITY PREMISES a occurrence S CLAIMS-MADE FlOCCUR MED EXP Any one person) S 0 PERSONAL&ADV INJURY S 0 GENERAL AGGREGATE S 0 GEN'L AGGREGATE LIMIT APPLIES PER: ( PRODUCTS-COMPlOP AGG S O POLICY PRO- LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S BODILY INJURY(Per person) S ANY AUTO ALLOWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS PROPERTY DAMAGE S NON-OWNED (Per accident HIREDAUTOS AUTOS S UMBRELLA LIAR OCCUR EACH OCCURRENCE I S EXCESS LIAR CLAIMS-MADE I AGGREGATE S S DED RETENTION S I WC STATU- O]rR I WORKERS COMPENSATION TOY IMIT X R AND EMPLOYERS'LIABILITY E.L. ACCIDENT S 1,000,000 ANY PROPRIETORIPARTNER/EXECUTIVE❑ NIA R2WC627084 03/01/2015 03/01/2016 B OFFICERIMEMBEREXCLUDED? N E.LDISEASE-EAEMPLOYE S 1 000,000 (Mandatory in NH) OOO 11g, describe under E.L DISEASE-POLICY UMIT S 1,000, DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i E ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD v'1,aaar'4.C.huse'ls -Depalment of z wbac Jc"3 Ci's' Bc , Cl, wid3i3Cg' ReCg.ul Sons ara Siandards _;cense: CS-022830 M h FRAIIQS J MCRA-Y~ 9 OAKWOOD RI Wilmington MA 01887 ' i s,-10495M. Expnavw C�rnmBssone. 01/13/2016