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HomeMy WebLinkAboutBuilding Permit # 9/28/2015 TOWN OF NORTH APPLICATION FOR PLAN EXAMINATION Permit NO: " Date Received Date Issued: P Z I, IMPORTANT: Applicant must complete all items on this page 01 r, r ..- ,, ,100 Year Old S ructure yes, no ' MAP`NOPARCEL // ZONING DISTRICT Historic�D�stnct ' yesrio `Machine/Shop Village'` Ya, no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more fa fly ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Sept'ic' ,❑Well ❑Floodplain, ❑Wetlands ❑ Watershed District q Water/Sewer DESCRIPTION OF WORK TO DE PERFORMED: pf- 4 ... „f Identification-_ lease'Type or Print Clearly) a.. OWNER: Name: - Phone: Address: r CONTRACTOR Name 1 Phone ;t Address , �� / rr Sup/ervisor's Construction License � r '�� /�r Exp Date Home lmpr•oVernenf,License �� �„ °` ':, Exp Dater 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: ._ ., Check No.: Receipt No.: NOTE: Persons contracting with unre ' tere o tractors do not have access to the guaranty fund � r Signature of Agent/Ow � - ° g, a ure o ne f contractor Plans Submitted Li Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ IAORTH -Town of :. ,, Andover ® T �® LAKE h ver, ass, c Oc NIc KEWIc. $` U BOARD OF HEALTH Food/Kitchen PERM, I �T IFU LD Septic System THIS CERTIFIES THAT DPnnCV. Z ...... BUILDING INSPECTOR has permission to erect buildings on , , Foundation p .... . .. .. ...�.. �°`� 4 .... . ....................... Rough tobe occupied as ...................... .. .... ....... .. ........ . .t� ........................................................... Chimney provided that the person accepting this permit shall in every r ect 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 PERMITIN ONTHS ELECTRICAL INSPECTOR • UNLESS CONSTRUCTIOTIJITS Rough Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathirig or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedy the Building Inspector. Burner Street No. Smoke Det. PROPOSAL/ESTIMATE 170 Main St,North Reading,MA,01864 781-321-1991 W INTER [��i Claudio Araujo—License CS 105185 104C www.winterhillgc.com DONNA JAHNSON Email: donnahvac@yahoo.com 2241 Turnpike St—North Andover-MAPhone: 781-334-7068 --'F—Date:09/26/2015 Job Location: Shingle Roof Tear Off: The following paragraphs describe the work that will be performed. Remove existing shingle roof on the entire house • Install an 8 inch drip edge on all leading edges(Color:_____j • Install 12 feet of ice&water shield on front leading edges&valleys Hurricane Railing:6 Halls per Shin& • Install starter strip on all leading edges. • Install shingle mate felt paper on all areas not covered by Ice&water shield, • Install New Ridge Vent • Install new vent pipe flanges • Replace any rotten or damaged roof decking ledger board(we allow 32 ft.at no charge,$3.501ft thereafter) • Replace any rotten or damaged fascia or rake boards at$10.00111t. • Install new GAF Timberline High Definition Architecture Shingles • Remove existing lead flashing on cMmney,install Ice&Water Shield,ate?flashing,and grind New Lead Flashing into Chimney • Warranty included in contract -(x)Golden pledge • Shingle Color= WILLIAMSBURG SLATE • All debris will be removed from the property • Replace skylight top coverwith not charge(customer will provide the material). Cost for Labor&Material for New Shingle Roof: $ 18,400.00 Payment Terms: 1/3 deposit due upon signing contract: 1/3 payment due upon start of job, 113 payment due upon completion of job: Total Amount Agreed To Be Paid: $ Work Scheduled to Begin:— TBD Job expected to be completed within 60 days of actual start date. I Warranty:GAF.guarantees all material and labor for lifetime for any defect problem. Claudio Araujo Project Manager bonne Jahnson Winter Hill General Contractor,Inc. Date Home Owner Date 09/21/2015 9:22 AM FAX U0003/0003 Cost for Labor&Material for New Shingio Roof: $ 13,200.0p Cost for Labor&Matorial for Siding replacement: $ ,gzoxg Cost for Labor&Material for 60 feet gutter Installation: $ 95M 't ITYM Fayment Terms, ,f 413 doposit due upon signing contract: $ `� 713 paymont due upon start of job: $ / 113 paymont due upon completion of job: $ Total Amount Agreed To Be Pald: $ ... . Work Scheduled to Begin: 0 09,c r t, 2.07'9- Warranty: .07'9-Warranty:GAF,guarantees all material for lifetime and work performed for a period of ton(45)years.If any problems occur we will cover the cost of all labor and material to correct the problem and moot the customors satisfactlon. Claudio Araujo,Project Manager Winter Hill General Contractor,Inc. Date Home Owner Date Payment types accepted: '�1S''f °`u"�" available The law requires the fallowing FOURTF.FN items to he included in any contract botweon a 1101110owher and a registered home improvement contructor Ibr home improvement work Subject to MGL c.142A: I,Thu complule ngreemunt between the conintclor and the owner and n eleur dcscripliun of any other documents which arc part of the agreement. 2.The full names,ibderal I.D.number(if applicable).addresses(NOT PO.Box numbers),of the parties,ore contractors rogisltalion number,the nume(s)of the salcspenon(s)involved,r1'uny and the Jule the contract was executed by the parties. 3,Tho date on which the work is sehedulod to hegin and the date the work is Scheduled to be Subs4urlially coniplulcd, 4.A detailed description of the work to be dune and the materials to be used. 5.The total amount agreed to be paid for the work to be pertbrmed under the contract. 6,A lihlu Schedule of payments to be made wilder the contract and thu anlounl of each payment stated in dollars,including any finance churges.Any deposit required to be pard in advance of '.. [he stun of the work SHALL NOT exceed one-third of the total contract price or the actual cost ofany material or equipinent On special order or custom made,nature,which must be ordered in advance of the start of the work to assure that the project will proceed on schedule.No finul payment shall be demanded until the contract ig completed to the satigfaetion of oll panic;:, %.All panics most sign the contract. 8.A clear and conspicuous notice stating: a,That all homo improvomont contractors and Subcontractors.shall be registered and that any inquiries about a contractor or subWnin ctur relating tun regisindiun should be directed to: Ornee or Consumer Afralra and Buslnps RcAulgtion Ten Park Plaza,Suite 5170 Boston,MA 02116 Phone;(617)973.9700 h,The contractors registration numlkr must be on the fire,page ofthc contract, c.The homeowner's three day cancellation righty under MCL c 93 s 48:MGL c 14013%10 or MGL c 255D s 14 as may be applicable, d,All warranties on the owner;¢right,;under the provi%iomi of mid M01,e,t42A, e.In ion point bold type or lurgcr,directly above the space provided for the signature,the following statement: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES, r,Whether any lien or security interest is on thu residence as a conscyuencc lathe contract. The Commonwealth of Massachusetts z f Department oflndustrialAccidents d 1 Congress Street, Suite 100 Boston,MA 02114-2017 .� -.,: �SJ`4 Vp www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERIVHTTING AUTHORITY. Applicant Information ) Please Print Lei4ibly Name (Business/Organization/Individual): r4 Address: _ rte-t ✓� City/State/Zip: > ' Phone#: Z 3 -2 *4 Are you an employer?Check the appropriate box: Type of project(required): 1 am a employer withemployees(full and/or part-time). 7. F1 New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.F1 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. F1 Demolition 10 ❑Building addition 4.F1I am a homeowner and will 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.E]Plumbing repairs or additions 5. I am a general contractor anI have hired sub-contractors listedon the attached sheet. ❑ d hid thb tt13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.❑We are a corporation and its o£�cers have exercised their right of exemption per MGL C. 14.❑Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit#his affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors 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 must provide their workeis'comp.policy number. I am an employer that is providing workers'compensation insurancefor my employees. Below is the policy and job site information. Insurance Company Name: , K X Policy#or Self-ins.Lic.#: -t'V 3 l Expiration Date: J / r16 Job Site Address: V t City/State/Zip: AA Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). 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 of the DIA for insurance coverage verification. I do her•ehy certify under the pain and penalties of perjury that the information provided above is true and correct. Signature: Date: C57 2 Phone#• j I q Official use only. Do not write in this area,to he completed by city or town official.. City or Town: Permit/License# 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#: WINTE-2 OP ID:JJ ACOR® �� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYW) 03/18/2015 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 CONTANAME: Crown Insurance Agency,Inc. _ Bradly S.Michals Insurance PHONE — FAX Agency,Inc. A/C No E.11:617-924-1100 (A/C,No):617-926-2162 85 Main Street E-MAIL Watertown,MA 02472 ADDRESS: Crown Insurance Agency,Inc. INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Acadia Insurance Company INSURED Winter Hill General Contractor INSURER B:Essex Insurance Company Claudio Mcuhna Araujo — -"--w 170- 170 Main St INSURER Insurance Co. 000 North Reading,MA 01864 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. INSR DDL;;SS BR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ❑X3DX7960 02/13/2015 02/13/2016 DAMAGE o� NTS 100,000 CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $___ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT PRO 7] LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINEDccident SINGLE LIMIT $ 1,000,000 Ea a C+ ANY AUTO 1020001551 04/09/2015 04/09/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPER Eiden DAMAGE $ X HIRED AUTOS X AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE WC-20-20-003174-01 03/2612015 03/26/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? [N]NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Operations of The Named Insured CERTIFICATE HOLDER CANCELLATION XXXXXXX SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FOR BIDDING ONLY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR BIDDING ONLY ACCORDANCE WITH THE POLICY PROVISIONS. FOR BIDDING ONLY AUTHORIZED REPRESENTATIVE FOR BIDDING ONLY FOR BIDDING ONLY FOR BIDDIN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 4, _�y `��e�0917i17LO�Jtt[1gC[�f�0����[IJJC[C�tfJe��J I \ Office of Consumer Affairs 8c Business Regulation (i OME IMPROVEMENT CONTRACTOR rType: egistration 1,68583 Expiration:-= 3/8/2017 Corporation WINTER HILL GENERAL CONTRACTOR, INC.... OLAUDIO ARAUJO 170 MAIN ST NORTH READING,MA 01889 I Undersecretary, a 1 it Massachusetts-Department- - of Public Safety Board of Building Regulations and Standards 1 License: CS-105185 r Claudio M Araujo�" � 7 163 Hancock StreQ_N,% Everett MA 0214 = Jam"" Expiration Commissioner 07/13/2017