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HomeMy WebLinkAboutBuilding Permit # 9/24/2015 %aoaTtr BUILDING I PERMIT 0 ,1 ED p� TOWN OF NORTH - APPLICATION FOR PLAN EXAMINATION Permit No#: � ' Date Received RAreu P� n> RAo Qp,,,�5 �SSgC14 5�t Date Issued: r IMPORTANT:Applicant must complete all items on this page LOCATION AdoI _ ' 1 - \j N, PROPERTY OW NER Print 100 Year Structure yes no MAPt� PARCEL. � �� ZONING DISTRICT: Historic District yes no Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE ResijoKial Non- Residential ❑ New Building Vbne family ❑Addition ❑Two or more family ❑ Industrial ❑AI on No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 101 �,,,rfim 9m,.°�! ,ura unwq(�/r �!r/rlf %/�J/1/ r!/ 1 JVr /;,,,,,,r�fu!„!le,Ylyh r�+fYF V'(I,Nt.dllrl�ujJ r/!'I,., ;`,LY/ �I�Rlrr�d�f�tYi;y(�// /(f� ;� ,,!7��'f,�'��''F(I� �r✓,ljl'( ..0 ,h,.��xlll r1 �f;�(', �l%r' i T Lei ( ' el �r>>1, �I ; ;�x,yFloodp a n Wetl nds;l l UUaters°ed f,,1 tnG tri l�� 'fi�Yie r r r ° DIST ON OF WORK TO BE PERFORMED: } Location r< r /'7 ”. Date "4. .I entifi OWNER: Name: 1 V Address: „�, , TOWN OF NORTH ANDOVER Contr�ac�tor Nm ' e: I"1Certificate at Occupancy Email: L of(( i NhAf Building/Frame Permit Fee Address: Foundation Permit Fee Supervisor's Construction Licer other Permit Fee TOTAL Home Improvement License:_ ARCHITECT/ENGINEER Check# of Address: Building Inspector FEE SCHEDULE:BULDING PERMIT:$9' y r 0 Total Project Cost: $ 1 �. FEE: $ _ Check No.: ti 7s Receipt No.: co NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund all1 T F N®RTH q Town 4 _E. ....1' ndover No. 2,os ' S CA . h Ver, Mass, ';? COCNICNEMCK 41. AERATED PC , S V BOARD OF HEALTH PERM- IT T LU Food/Kitchen Septic System THIS CERTIFIES THAT l G �r.Sl. .: ................... BUILDING INSPECTOR .. /... .... has permission to erect buildings on ... L aC , wis 14 '/6 Foundation ... .............................. .................................... Rough to be occupied as S..�r ... ... .X d p6, v ................. ...................................................................... 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 EXPIRESI MONTHS ELECTRICAL INSPECTOR UNLESS CO STRCTIO STARTS Rough Service ............f,...... ..�r r.:,,Tom,............................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough 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. PROPOSAL L.E. Morgan Construction Company We Accept. 86 Billerica Avenue, Unit#1 VLA . � .t N. Billerica,NIA 01862 - � Office: (978) 670-4747/Fax: (978) 670-6477 " PROPOSAL SUBMITTEDAO PHONE DATE •e- QtZ leas 7?-6,Pb -7-0,PP STREET JOB NAME CITY, STATE AND ZIP FCODE / JOB LOCATION A) IV A CONTACTR e- ACE7-P-A73 3(v�[ OTHER JOB PHONE Strip down to the wood deck, -I- layers of shingles, dispose of debris to a licensed recycling facility: , Install & ice and water shield at the gutters 3 feet of ice and water shield in valleys. Install synthetic underlayment on the remainder of the wood decking. Install 8" aluminum drip edge on'all perimeters, color choices: A White, ❑ Mill, ❑ Brown, ❑ Copper. Install d'b year Ger'T�%�►� )01-4> architectural asphalt shingles, and hurricane nail. Install ridge vent manufactured by ef� �r-ti to all ridges and dormers. Install N new skylight flashing kits manufactured by A�/,4 Flash all cheek walls, pipes, skylights, and penetrations to manufactures specifications. Remove existing lead flashing /sofa Nem 6,0 � � chimneys and install new lead flashing. Install matching cap shingles to all ridges, hips and dormers. WE PROPOSE hereby to/furnish material and/labor-complete in accordance with above specifications,for the sum of- 42, £+�� .� dollars($167.4-JR0 ). All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above Authorized Signatur . specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.Our workers are fully covered Note:This proposal may be withdrawn by Workmen's Compensation Insurance and Liability Insurance. by us if not accepted within days. FheMby D AS A CONTRACT—The above prices, Date of acceptance: l s and conditions are satisfactory and are �-Authorized Signature: pted.You are authorized to do the work as �/1yment will be made as outlined above. Authorized Signature: Additional Remarks: 81 INGLE COLOR— lw e f �w d C„�5 NZ ee�r THANK YOU FOR CHOOSING L.E. MORGAN CONSTRUCTION i The Corn' o ealth o Massachusetts I)epartme t Industr'i lAccidents d X Cone es Street, , i ite 100 Bos o MA 0211712017 t w mass.gov/ Workers'Compensation insurance fi avit:Builde s/Contractors/Electricians/Plumbers. TO BE�FILED WEPERNRTFING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/fn dividual): i , M ' r �1Address: ► Cul City/State/Zip: � Phone#: I � Are yon a p oyer?Check tli appropriate box: I Type of project(required): 1-a am a employer with employees(fiull and/or part 'Ir 10.# 7. El New Construction 2.❑I am a sole proprietor or partnership and have no employees c rking for me in 8. Remodeliri any capacity.[No workers'comp.insurance required.] g 3.Q I am a homeowner doing all work myself.[No!workers'compnsranee required]t 9. F1Demolition 10 0 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct a I o on my properly_ I will ensure that all contractors either have workersi compensation ur nce or are sole; 11.Q Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors lk ted on the attached sheet. 13. RO ep s These sub-contractors have em Io ees and have workers'co m urance t P Y �� J Nr+9 6.F1 We area corporation and its officers have exercised their right E oI ' emption per MOL c.! 14. Other 152,§1(4),and we have no.employees.[No workers comp.i $ ce required.] 1 yrat`Any applicant that checks box#1 must also fill out the section belo slno ing their worke s'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all rk d then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet shog he name of thelsub-contractors and state whether or not those entities have employees. Ifthe sub-contractors have employees,They must providelth it orkeis'comp;(policy number. Iam an employer that ispro iding0",workers",COMP U1 n insurancefo-my employees.'Below is thepolicy andjob site information. r Insurance Company Name: 11 Policy#or Self-ins.Lic.#: V6—;5 3� pf Expiration Date; o? Z t 1S Job Site Address• 0 / aw vY Y e— City/State/Zip.9 V"r rn 0 � Attach a copy of the workers'compensation policy d Ic ahowing the policy number and expiration date). Failure to secure coverage as required under"VlGL c. 1522,§25A is a trim al violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties i1i the form of a S OP WORK ORDER and a fine of up to$250.00 a day against t e iolator.A copy of this statement may b r arded to the Office of Investigations of the DIA for insurance coverage v ifiation. Ido here c tify under thepains n p ti fperj y at the i %Aenat7Date: vided ove is true;and7correct. Si a 0'2� S Phon #: Ofcia use only. .Do not write in this area,to be coca et d by city or; own official.. City Town: I Permit/Lic nse# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City y o n Clerk 4 {lectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Prone M u I CERTIFICATE OF LIABILITY INSURANCE DATE(Mm/DD/YYYY) 07/08/20 TIFICATE 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 and endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsements). PRODUCER CONTACT NAME: BALDW ',AIELSH PARKER INS PHONE FAX 131 COOLIDGE ST.SUITE 9100 (A/C,No,Ext): (AIC,No): E-MAIL HUDSON.MA 01749 ADDRESS: 27KLD INSURER(S)AFFORDING COVERAGE NAIC# INSURED I INSURERA: AMERICAN ZURICH INSURANCE COMP NTY L E MORGAN CONSTRUCTION INC INSURER B: INSURER C: INSURER D: PO BOX 75 INSURER E: NORTH BILLERICA MA 01862 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 19 75 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. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE Is COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ �tCLAIMS MADE 7 OCCUR. PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY Is GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE Is POLICY [:]PROJECT LOC PRODUCTS-COMP/OP AGG IS AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE I$ LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB 8 OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE g DEDUCTIBLE Is RETENTION S Is to WORKER'S COMPENSATION AND X I WC STATUTORY OTHER '... EMPLOYER'S LIABILITY YIN UB-58738312-14 12/14/2014 12/14/2015 LIMITS ANY PROPERITOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? FN7 NIA E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT Is 1,000,000 '.,. DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION TOWNT OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD ST.BLDG 20.STE 2035 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR TA)VE NORTH ANDOVER,MA 01845 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. LEMORGA-01 BBOYER CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 7/7/2015 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 BYTHE 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 NAME: Welsh&Parker Insurance Agency,Inc. Hudson Office PHONE FAX 131 Coolidge Street,Suite 100 Arc No Ext:(978)562-5652 Arc No):(978)562-7120 Hudson,MA 01749 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC M INSURED INSURERA:western world Insurance Company INSURER B•Safety LE Morgan Construction Inc INSURER C:Scottsdale Insurance '... PO BOX 75 INSURER D: Billerica,MA 01821 INSURER E INSURER F l 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 TOVTAICH 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. INSR ADM SDEP LTR TYPE OF INSURANCE INSD VD POLICY NUMBER MMIDDY EFF MMIDDDY EXP WLIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR NPP8237995 0411312015 04/13/2016 PREMISES Ea occurrence) S TO 100,000 X Contractual Liabilit MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 POLICY 0 PRO- JECT El LOC PRODUCTS-COMPIOP AGG S 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B (Ea accident S 1,000,000 ANY AUTO COM6230688 10/13/2014 10/13/2015 BODILY INJURY(Perperson) S ALL OX SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS x HIRED AUTOS X NON-OWNED PROPERTY DAMAGEAUTS Per accident/ S UMBRELLA LIAB X OCCUR CX EXCESS LIAB EACH OCCURRENCE S 5,000,000 CLAIMS-MADE XLS0096729 04/13/2015 04113/2016 AGGREGATE S 5,000,000 DED I RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? ❑N/A '.. (MandatoryfYes,d be un) EL DISEASE-EA EMPLOYE S If yes,describe under DESCRIPTION OF OPERATIONS belmv E.L DISEASE-POLICY LIMIT I S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Proof of Workers Compensation coverage will be sent directly by the carrier. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood Street,Bldg 20,Suite 2035 ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIIV�E ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD - ------------- — Massachusetts-Department of Public Safety - Reg W ation Office`/" surae ctea/f7t��� C.� Board Building ,.y 'a�i.,,,S«;:u�ta,�;ares oeeo mer f#aus&r a, c =_� Srt nSIne s egUfation I� HOME IMPROVEMENT - _ s CONTRACTOR License: CS-0794.76 a j_ _'!, Registration• 137913 Type: yP Expiration: 1/27!2017 Individual LAWRENCE E MRG3R 86 BILLERICA ASE ,�_ , P LAWRENCE E.MORGAN JR. N BILLERICA MA 0jig-1 n % = LAWRENCE MORGAN JR. 86 BILLERICA AVE UNIT 1 fit= � a J�,.��.��.�•-'t-741� E:.piration N.BILLER[CA,MA 01862 — Commissioner 06/03/2017 Undersecretaryf5arnryang7iealtfi {{ _ - _�- - --..--- A3r1inIY.n9on - j 0.y,, i1=9 h This card acknowledges that the recipient hassuccessfuliy completed a Cs,a to art of et , i 30-hour Occupational Safety and HealthT`raining Course in O;c,_pa;onafSafety and Health;,,c.,,,,.,iratic.:q f Construction Safety and Health 'LA R R Y MO G-A t _ Y it �/� 1 has successful(,completed a?c1`"ur Q;;;upaE;p,u! Training Coume in Safety and Health 1 {{ E {{ y Construction Safety 8 Health (Trainer name-print or type) I / S Rc:1r-1 J, V OSA(& ` - (course end date) (Trainer) (Date) - ROOF TOP RECYCLING SEAN ANEsTIS PRESIDEArr&CEO 369 CODMAN Hu.[.ROAD TEi~ 978-263-1899 BO)MOROUGH,MA E4_X_ 978-263-1879 EMAIL:RooFropi@VE IZON.NET CELL. 508-726-5341