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Home My WebLink AboutBuilding Permit # 9/16/2015 BUILDING PERMIT 0. O®DT6 t TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ m4 Permit No#: Date Received SRA°RgTEn°PPa' ACFiUS`�� Date Issued: 41P�O—P.TANT: Applicant must complete all items on this page k LOCATION Print PROPERTY OWNER k�Ck',ki ` Print 100 Year Structurees (n(o MAP PARCEL: ZONING DISTRICT: Historic District Yyes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 14ne family ❑Addition ❑Two or more family ❑ Industrial Al ration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg 0 Others: 0 Demolition ❑ Other ❑ Septic p Well ❑ Floodplain ❑Wetlands 0 Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please'Type or Print Clearly OWNER: Name: Phone: Address: Contractor Naml Phone: Ze 77 Email: a CU,,' Address: , / >`e , Supervisor's Construction License: f Exp. Date: 19�Z-,W1 Home Improvement License: 7Vkl Exp. Date: f 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: $ 1&) , Check No.: Receipt No.: '7 NOTE: Persons contracting with unregistered contractors do not have access to the gu ranty fund 7 Signature of Agent/Owner Signature of contractor tk®RTH luvvii 01 nclover O . �} ver, ass,;;s.*-- h A- COC NIC NE wt[w V J,9 A04gTEO A��,��y S U BOARD OF HEALTH PER IT T LU Food/Kitchen Septic System V•� G &A ` Z %'D BUILDING INSPECTOR THIS CERTIFIES THAT ................ . ......................................................................................................... �� . has permission to erect .......................... buildings on .�.��...�........�.....�............&.............Q+ Foundation.. Rough tobe occupied as .......... ...... ... tl. ..................................................................... Chimney provided that the person acceptin 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 IVIONTHAS ELECTRICAL INSPECTOR LESS S N ST S -.00001 Rough Service ...... ...... .......... ..................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Islay 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. IAO '1'H-.g UW11 Uf Andover p gee . Z °' 11A y c+0 R�'_ � h vel' Mass, COC NIC Nf WICK � �,p AERATED �'Pa��y S U BOARD OF HEALTH Food/Kitchen PER.. 1T T L &O Septic System THIS CERTIFIES THAT %A a+l ` .Z �� BUILDING INSPECTOR ................ . .............................. .....`.. .... .......... ......... .... ........ . ....... .... .... ........ .. �t 4 Q� Foundation has permission to erect .......................... buildings on . ... ........ ..... ........................... Rough tobe occupied as .......... ...... ... d. ..................................................................... Chimney provided that the person acceptin 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 IT EXPIRES IN 6 MO TH§ ELECTRICAL INSPECTOR LESS T ST S Rough Service ...... ...... ......... ..................................................... Final BUILDING INSPECTOR ` GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Islay 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. E`TiA' 4 Date: October 27, 2014 Customer: Kevin Galizio Re: Roofing Proposal Project: 326 Chestnut St \. S North Andover, Ma 0011 � • Description of work area: Entire house excludingbac of m in house. • Install tarps from roof to ground to protect landscaping,then, remove existing layers of asphalt roofing and dispose of properly. • Inspect all sheathing for rotted wood. If new plywood is needed it will be installed at $1.875 per s.f. If roofing boards are needed it is an additional charge of$3.75 linear foot as needed for labor and materials. • Re-Nail deck to ensure proper installation. • Install 6 feet of GAF Weather watch Ice &Water Shield to all eaves. • Install Grace Tri Flex Synthetic paper to remaining exposed areas. • Install heavy duty 8" drip to all rakes and eaves. Color to be:TBA • Install GAF Pro starter course to all eaves over drip edge. • Install a GAF Timberline Architectural Shingle per manufacturer's specifications.All shingles will be nailed using 11/4" nails. Color to be: • Install GAF cobra Ridge vent and capped with GAF Hip and Ridge Caps. • Install all new pipe flanges to all pipe boots. • Work site will be cleaned on a daily basis and all area will be gone over using a magnet to pick up all the nails. • Twin Metals will furnish manufacturers System Plus lifetime material defects warranty,as well as a 15 year non-prorated workmanship warranty that entitles homeowner for coverage to include all labor, materials and disposal cost. • Twin Metals is responsible for pulling all permits to complete the job. • Twin Metals will supply customer with a Liability and Workers Compensation insurance certificate prior to any work being performed. • Twin Metals is NOT responsible for debris that might fall into the attic. Please cover any valuable items. • Any changes to the specifications will be executed on a written change order and will become an extra charge above and beyond the original contract price. Any siding that needs to replace will be an additional charge. • All jobs to be started approximately 14-21 days after the signed contract. (Pending weather conditions) $8360 Total Job Cost **Eight Thousand Three Hundred Sixty Dollars Any questions or concerns please call me at 978-663-2563. Thank You, Tom Gordon Twin Metal Rep: - date: ai N � **ACCEPTANCE OF PROPOSAL:The above prices, specifications and conditions are satisfactory and hereby accepted.Twin Metals is authorized to do the work as specified. Balance is due upon completion. Please make checks payable to:Twin Metals. ** Price is good for 30 days only an includes all applicable discounts. Authorized Signature: date: A ,`� Xhe Commonwealth of Massachasetts Department of IndlusiWarlAccidents _ X Congress Street, Svelte 100 Boston,MA.02114-2017 40 www mass.go-v/dia Wal kers'Compensation Insurance Affidavit:Builders/ContractoxsfElectriciaus/PXuziabers. TO BE 1+'1LED WITH THE PERAUTTTNG AUTHOR1Ty. A lrcant Information Please Print Le 'bl Name(3rYsiness/Organizaiion/Ind'Vidual): �,' Address: G, .� '��'i�rI cxtylsateizxP: 4011t� �ft 2- Phone Areyon an employer?Cheektbe appropriate box: Type of project )Vequired): 1.�S am employer with employees(fall and/or part timeM 7. ❑New construction 2, I am a sole proprietor or partnership and have no employees working for me in &. [1 Remodeluig any capacity.[No workers'comp.insurance required] 9. U Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 ❑Building addition 4.[]lam a homeowner andwill be hiring contractors to conduct all work on my property. I will ensure that an contractors either have workers'compensation insurance or are sole II.E]Electrical repairs or additions proprietors with no employees. 1 ,❑pl repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof rep airs These sub-contractors have employees and have workers'comp.insmanco.� 14.❑Other 6.Q We are a corporation and its officers have exercised their right of exemption perMGL e. 152,§1(4),and we havena emplayePs.[No workers'comp.insurance required.] xAny applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. 7 homeowners who submit phis affidavit indicating they are doing all work andthen hire outside contractors must submit anew affidavit indicating such. YContractors that check thus box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. lfthe sub-conlracfors have employees,they must provide their workers'comp.policy number. I am an employer that ispidviding workers compensation insurancefor my empl6yees.'Below isthepolicyandjobsite information. Insurance Company Name: 4�✓1 141, ' z I 1 Policy#or Self-ins,Lic.#:/1 C " ( �0 Expiration Date: Job Site Address: �24, OO '± City/State/Zip: /' Attach a copy of the workers' compepsation•policy declaration page(showing the policy aumber and expiration elate). 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 ofthe DIA.for insurance coverage verification. 1 do hereb�ertify un r ae ai a alines ofperyz�ry Haat the informationpr ovided alcove is trace a/nd cor�r`ect .�,�...n.,-,m_ _......_ Date: Si na �,/ Phone#: �L�� C//; Official use only. Do not 1przte in this area,to he completed by city or town official.. City or Town• Permit/License# Issuing Authority(circle one): 1.Board of Ifealth 2.BuildingDepartm.ent 3.City/Town Cleric 4.Electrical Inspector 5.Plumbingfuspector 6.Other Contact Person: Phone#: TWINM-1 OP ID: RR DATE(MMIDDNYYY) CERTIFICATE LIABILITY 1 02103/2015 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(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). PRODUCER CONTACT Llsa NAME:,_-., 163 Main St. (AIC o Ex1:978-686-2266 11AIc,Not:978-686-6410 Foster Sullivan Insurance North Andover,MA 01845 E-MAIL —- Foster Sullivan Insurance LLC ADDRESS:Ilariviere@fostersullivangroup.com INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:THE HANOVER INSURANCE COMPANY 22292 INsuRED Twin Metals Inc — 1NsuRERB;MERCHANTS INSURANCE GROUP 12775 86 Billerica Ave Unit 6 — " North Billerica,MA 01862 INSURER c:MARKEL INSURANCE COMPANY 38970 INSURER D: 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. ILTq TYPE OF INSURANCE MAIPOLICY NUMBER MMIDDfYYFYY MM1DDfYYYY1 LIMITS '.... GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AZ;E TO RFNTE _.__..__.__. A X COMMERCIAL GENERAL LIABILITY OHN4850163 01/19/2015 01/1912016 pREMiSES Ea occurtenca) $ 300,00 '..... CLAIMS-MADE L-A-1 OCCUR MED EXP(Any one person) $ 5,00 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP12P AGG $ 2,000,00 POLICY FXI PRO- LOC —�--- $ ' AUTOMOBILE LIABILITY EO accidentBIND SINGLE LIMIT $ 1,000,00 BANYAUTO MCA7015114 05/2112014 05/2112015 BODILY INJURY(Per person) $ ......_. ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTOS NON-OWNED PORP ROPERTY DAMAGE X HIRED AUTOS X AUTOS (PTA $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 C EXCESS LIAB CLAIMS-MADE XOBW5114114 01/19/2015 01/19/2016 AGGREGATE $ 2,000,00 DED I I RETENTION$ $ WORKERS COMPENSATION WC STAIMITS TH- AND EMPLOYERS'LIABILITY YIN — -- ANY PROPRIETOR(PARTNERIEXECUTIVE❑ NIA E.L.EACH ACCIDENT $ — OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,desctrbe under DESCRIPTION"O OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A RENTED/LEASED OHN4850163 01/19/2015 01/19/2016 LIMIT 120,00 EQUIP FROM OTHERS DEDUCT 1,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) r f r CERTIFICATE HOLDER CANCELLED BEFORE :L BE DELIVERED IN LNorth etals AveUnit 86 erica Billerica,MA 01862 nghts reserved. — .............. The ACORD name and /% �/ // ��// /�/ ACORO 25(2010/05) � � �� / MMYY)AC CERTIFICATE OF LIABILITY INSURANCE D25/2016E 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($), 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 statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). Nip PRODUCER 06106-001 NAHpM�EE:CT Hays Companies A/C.No Ext 1612)333-3323 pgC.No Mp 1_ --- --��__.. _. — 80 South 8th Street ER%SB: #r Minnea lis,MN 55402 Po A.I.M.Mutual Insurance Company INSURED INSURER B: Surge Resources __...... 920 Candia Road Manchester, NH 03109 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, �gEXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED yB�Y�pPAID C�L�AIMS.}' ILTR 1 SR D �— MMIODIYYYY MMIDY TYPE OF INSURANCE POLICY NUMBER OMITS GENERAL LIABILITY EACH OCCURRENCE $ $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENT15-- PREMISES Ea occune e _ CLAIM &MAOE OCCUR MED EXP(Any one petson) PERSONAL&ADV INJURY $ ...... ._......___._ _._----_ GENERAL AGGREGATE $ EN'L AGGREGATE LIMITAPPLIES PER PRODUCTS-COMPIOP AGG $ OLICY F-20- 20 OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ Fa accidep �..__._ ............ .___. _ __... _...__. '.. ANY AUTO BODILY INJURY(Pet person) $ ALL OWNED ISCHEDULED AUTOS AUTOS BODILY INJURY(Pot accident) $ NON-OWNED O YDAMAGE HIRED AUTOS AUTOS Pet acdd t $ $ UMBRELLA LIAO OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS MADE AGGREGATE S DED RETENTION$ $ X I TVAN MIT$I I Dk A AWXIEVffflMVJM1b6WEC1l1EY1 N NIA AWC-A00-7030053-2014A 11/17!2014 11H712015 E.L.EACH ACCIDENT $ 1,000,000.00 '(rrMandattodorr�y�,Ino�INt�H))o� ll N_1 E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 D9�CRIPT�ON vF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,8 more space Is required) WC coverage applies to MA employees only RE:Evidence of Coverage.This policy covers those employees leased by Twin Metals through Surge Resources Inc,Manchester NH 03108 CERTIFICATE HOLDER CANCELLATION Surge Resources 920 Candia Road - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Manchester,NH 03109 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE 1988-2010 ACORb CORPORATION.Ali rights reserved. ACORD 26 (2010!05) The ACORD name and logo are registered marks of ACORD dl Office of Consumer Affairs and Business Regulation - rt 10 Park Plaza - Suite 5170 Boston, Massachusetts'02116 Home Improvement Contractor Registration Registration: 174281 Type: Corporation Expiration: 1/23/2017 Tr# 262649 TWIN METALS, INC. Y - -- THOMAS GORDON - 154 NEWBURY ST. d DRAG UT, MA 01826 "caLclressd Yeur� carch Matrk reason for change Lost C- CA CA? �� 20Jvi-05/71, rt `W F I � d� i n:� I i��epartm ril of t� �k safety .� Board of Uaii ung Regut a i ns and Standards q:°abr t�r,dr��oariu uperlkor tti eciialf",, i t. tensa. CSSL-105991 THOMAS GORDON 151 NEWBURY STREET Dracut MA 01826 i J h Expiration Cor`inn'u.�swo� eu, 07/09/2017 ® 4� RIiAX. A+ FiCI��T�f BOARD C� SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE 1w AS A MASTER UNRESTRICTED l4 ig THOMAS E GORDON ;w 154 NEWBURY ST DRACUT MA 01826-5733 Office of Consumer Affairs&Business Regulation OMEIMPROVEMENTCONTRACTOR egistration: 174281 Type: xpiratiain:, 1/23/2015 Corporation TWIN METALS, INC. T&oN WB ORDdN x URY ST. DRACUT,MA 01826 Undersecretary