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Home My WebLink AboutBuilding Permit # 10/5/2015 BUILDING PERMIT ao or m�o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: r_,,2'-- I,.$,, Date Received '�yssq,.,tis�s<s Date Issued C8 IMPORTANT Applicant must complete all items on this page I/ Y I If ;"Y F (« I�« ("1'I�'e�"O// rIJJ �J" %I��fII�«r ��uPlr �O� I! PY✓ fp( rlrJ(�, G,>?�s�' TYPE OF IMPROVEMENT PROPOSED USE _ ... Residential _ Non-Residential _ C]New Building One family ❑Addition ❑Two or more family I]Industrial ❑Alteration No.of units: a Commercial ARepalr,replacement ❑Assessory Bldg ❑ Others ❑Demolition fl Other �a#4 f� u,7�t rr,�Y� ��1��/r�1��1/�!f��/��/�arll//�G�,��nGr / /,DyVrESCRIPTION OF WORK TO BE PERFORMED(J: / 54 I G/� $ f� Rc) r A-K ek c,l t Identlficntion-Ple LPypeor Print Clearly OWNER: <N��a /Y/G Phone Address > ��5� S� ��'VE il" i 4dijj� f�m.Ir�aA�i r A ��- ll7r i r��rr rrGrrr i /I/�11111/� lj�,P'elil ,i,fir(/ l ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.$1E,00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. C Total Project Cost:$ ,? U�"'� FEE:$ 5� ✓ _ Check No.: �� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access moo/jke ga m fund Sigriatufe of'%igent/Owrier Slgnatuie pf cont'racto`-`/�' rimORTH -town of Andover 0 Noa h, ver,Mass, pq U BOARD OF HEALTH Food/Kitchen PERMIT T I OLD Septic Syrte THIS CERTIFIES THAT................_... r/ BUILDING INSPECTOR Fd�ti has permission to erect................. buildings on 5�1_ to be occupied as 115-1 1 R..gh /."�.......... .................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Fi-I 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 Fimal PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS R-gh l,rv,,, ................. ................ BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building- Rough Display in a Conspicuous Place on the Premises—Do Not Remove Ff.[ No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. B-u Street W. Smoke Det. QUOTE CONTRACTING 81 Bailey Rd INVOICE NO. XXX%00162 So Mbr ,MA02145 DATE July 27,2015 781-267-6771 CUSTOMER ID Mat BLUEROOFCONTRAOTING.COM EXPIRATION DATE 9/30/2015 BLU EROOFCONTRACTI NG(a�G MAI L.C OM TO Mat Carpenter 458 Johnson Street N.ANDOVER,MA 01845 781-710-9063 SALESPERSON JOB PAYMENTTERMS DUE DATE ROOFING/GUTTERS/RAFTE Carlos Pereira RS 1/3 Signing;t l3 Mid-point;1/3 Earn'"an QUANTITY DESCRIPTION UNIT PRICE LINETOTAL DEMO:Remove asphalt shingles to roofing deck(33 Squares).Replace rotted roofing boards,no to 32 Sq.Ft included.DEMO entire 40X15 main ranting-tion including all boards and rafters.Extra boards will be additional cloqp,'1 Install 8 Inch white dripe edge through-out roofing perimeter.Instal! step flashing on a6 chimneys and walls.In-it pipe flanges nn all pipes Re-frame 40%15 roofing section,both sides that were damned.Install plywood as decking.ACI framing and materials m be used need is be up to code - InstaR I_Water shield on all valleys and roofing pcdmet111 i Grave or Equivalent in quality&price) Flash it pipes and protruding elements,Skylights Install LIFETIME rated architectuaC asphalt shingles of owners choice of color,based on color board provided _ Install ridge vent and terminate with caps Replace it gutters and add gutter by Porch and main roof that are sing gutters Dispose of all debris to local dump site Not t0 touch rubber rooting 11855gFt RE FRAMING ROOFING $7.75 9,183.75 163R $10.00 1,630.00 33.00 ASPHAL SHINGLE ROOFING $475.00 14'850'00 320 DISPOSAL $540.00 - 1n600 ALL WORK CARRY 5 YRS WORKMANSHIP WARRANTY FROM START DATE pared an�p.re,re 'mi.i.eaw�ar�o:�on cbegouas namee,sub�ca Dene one�nons nocca below: SUBTOTALF$ 27,391.75 �pnre.ugereminnea.e euemunrurseen occuancus.iremawork is waded ro u,is escimam arter scan or protea' SALES TAX ALIro miP•i ey1 Yana.s �e aea rewrn:� $ 29.391.]9 THANK YOU FOR YVUR BUSINESS! Y l_ A T M-� 7lyL--d pyo DLO-CY C e "nc-c.- -- TTL` �ed �Q v"d �(z�lS . ,The Commonwealth ofMassaehusetts Department of IndustriaiAccidents '. I os Street,Suite 100 Boston, MA 02II4-2017 www.massgov/da Workers Cmupensat]on Insurance Affidavit:Builders/Contractors/L(eetrieians/Plumbers. TO BE FILED WITIITHE PLITAITTTINGAUTMORTPY. Applicant Information Please Print Le'bl Nan16(Business/0rgaaizatioWlndividnal): �p G ev)o UCt I�VI S Address: �l 6C6 i EV 9�. City/State/Zip: SOW(RPV IlIQ -�.02PYs Phone#: Aroyou av emplayerP Chcd<tho eppiopriate box: Type ofpr'oject(required): I.�am employerwith emPloyaes(fullaod/arparbhme).* 7, New constractimi 2.[]1amaso1apropd-11 paNmmhip and have no employees woddac fox mein $,C7 Remodeling airy caPe,ity.ggo workem'comp.fio" ce csFku dd 9.❑Demolition 3.ElI..hr.,.,,doingail warkmy T r[\roworkcre'ce p.msumnca ngnired]t 4.Q I—a homooamcr avdwW be hiring conhaatomto oonduot all workonmr property.111111 10 Q Bmilding addition nethata11—aaomrs eimarhawwmkars'oomp,moion i--orare sola 11.❑Elecla'ica]npair 'additions p�oPiiemra wimnn employees. _ 12.0 Plumbing repairs or additions 5.E]lam a gcnmalconhactor and i hope hued thesub-conmctors listed on fla,—ched sheet 13 2oofr'epahs Thesesub-conimamrs havo employees and have workers comp.licca—t 6.Q We are a corporation and its officers I—ezeroised their rightof'exemption per MGL e. 14. Other . 152,§1(4),and we have no employees.[Noworker..comp.insmancerequired.] <Any applicmrtihat checks boz#I must also fdI out the section 6elowshowingiheirworkers'compensationpolicyirSormatiov. t Born who sutimiE(his affidmit indicatingthcy arc dov�g alt work andthenhira outside conhacrom must spbmltamw�ffidavit mdicatingsuch YConVact setbat checkthis bozmust attached anadditionol sheet showing the name of the svbconhac[ors audstete whether or not tfioso entities have . employees.Ifthe sa6conGactors Have employees,'itiey mast providatheu workeis'comp.policy number. I man am employer thaHspi•ovidiag rvwkers'conxpensatiora irzsurancefor ury er ployees.'Allam is thepolicy and jab site im ori imz. _ Tana—Company Name:�-27,f— S-00- 2 ,f— Policy#orsePri-L//ie.#:�i✓G`G�I"o0-SD///�/9-'/.Sy Expiration Dates:/ ,(t Job site Address:�y,5 � noAILSo tp St __City/state/zip.k ndoyEP"04 o i p q Attach a copy ofthe workers'c-armis ation policy dnelaratimr page(shorving the policy number and expiration date). Pailme to seem,coverage as required under MGL c.152,§25A is e,miminal violation punishable by a fine up to$1,500.00 and/or o—Year,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Sue of up to$250.00 a day against the violator.A copy ofthis statement may be forwarded to the Office ofbivestigations of the DIA for b atnonce crag.verification Idol -by tdjp unde-T prdr I ndpenaities ofp jary Uzat thein nnaltmvprovdded a bo pis tri madcmrecE e/ Si rah ra: -� Date' ' Phone 9: 75� Official use onty.Do notnrite in this area,to be coinpleted by city or tmvrz official.. City or Town: Permit/License ft IssningAuthority(circle one): 1.Board of Health 2.130dmg Department 3.City/Town Clerk 4.Electricallnspectc r 5.PlumblagInapector - 6.Other Contact Person: Phare 9:_. '.. A� CERTIFICATE OF LIABILITY INSURANCE 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 POLICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder is as ADDITIONAL INSURED,the policy(ies)must be ead....d. If SUBROGATION IS WAIVED,subject to the terms aad mndifons of the policy,certain Policies may require as endorsement.A statement on this certificate does not confer rights to the cedifcate holds,In him of such end, rsements. r—d— .AsE Insuxanc.e Center 1 Aiska, Ltd. R E BBB-"1"13-'19'15 Ira 913-"181-0050 Specia 20 --1 Cold 5t e—,oaass. fc@specialrisksl[d.Cum __ tr'ee P.o dor 1250 _ IN 1) nous E - Ayawa�n, NA 41001 RaeE x a E CEX B IxsVREo MSURER B.: __ __ __ BRC RENOVATIONS 81 BAILEY AOAI1 IxsuaER c: SOMERV.ILIF.,NA 02195 Ix res. 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 PERIO 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 15 SUBJECT TO ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, AxL UAanm 3..6862 Le a/o3/RR.s .......... oc RRENCE 1 000 000 _ cE vd REMED CACI X co..ENCIAL GENERAL IA.ILTY PRENI5E5(Ee occwrenae $50 000___ __.ADE❑ d N .EO ECP A eye as�I s 1 as x!556d.e.flcmleLenxductible 5-1,000,944 rERsoNAL a Aov wlusv _ - cwenaL aeeaeaaTe - s z oao 000 _ c r11 no 000 cENI.AccREeATE u.n APPREc PER Pxonucrs-oo.P,oP Ac x PouC:Y_-PRo Loo s AUT....1.UP.LIT. _iE°•.alNeuswcLE LIMIT _. ANYAN,O ao LY INJURY $ I ALL0.WNeo —IIHMILEI -.11 INILRY(1,eac—I)5-... _. -._. -_ NON.OwNEN aatiPPR,Y oA.AOE -- -__ NIEO Auroa AT Pe,aa�eem - s x....U-BAaI «UIR EAdH 01dURRENCE s EXc I Lw.E_xwOE AEOreECA,E._ s E. IA11"ON we srATu. NORxeae eo.eexeArlex ! o R. Axe eFaC-s•WPARrr EL.EACH AcaoEM s DR ANY RxoeRlerowPAre,NERrexECR,Iv"�" NIA _-- ( ICEw.E.aER EXCwoeor - Imaneaan m xx) I E L.oleeAst-PA EMPLo o�sCB R s —RAR oxsl U.—I...l--s(Aram—R.fol,Aaa1—x«m.,R�s�naama,amo R .,ua��ar CERTIFICATE HOLDER CANCELLATION Town of N—h Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 36 Bartlett street ACCORDANCE WITH THE POLICY PROVISIONS. Andover,Ma 01810AUTD.RI I 019 8-2010 ACORD CORPORATION.Allrightsreserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD DSM2395695 ,(NiMIODM'YY) ,C� CEI2TIFIGATE OF LIABILITY INSl1RARICE Ito%/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CE TIFICATE HOLDER PHIS CERTIFICATE DOER NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INBURER(S),AUTHORIZED RE ESE TA VE O PRO UCER AND THE CERTIFICATE HOLDER IMPORTANT:If the certificate M1Ditler I an ADDITIONAL INSURED,lM1e pohcyQes)must ba entl ed If BUHROGATION IB WAIV 1 the terms and conditions of the policy,ceUaln pollcles may require an entlorsamenl.A statement on this ceNlicete does not confer rigM1ls l0 tha ceNiflcate M1oltler in ileo of such entloraemen[IsI. rcPONTE INSURANCE AGENCY INC NE 7)492-7600 ).(617)354-040 oDu 819 Cambridge Street �cREss.claudia.victoria@thepontegrou .com Cambridge, MA 02141 ,s,U,D BRC RENOVATIONSINs—R e: 81 BAILEY RD I—SID 0. -T--- SOMERVILLE, MA 02145 PN '0 BRACES CERTIFICATE NUMBER: IxsureER F: 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,NOTWfSHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF AN'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, EXCLUSIONSANOCONDITIONSOFSUCHPOLICIES.LIMITRBNC.MAY HAVE BEEN REDUCED BY PAID CLAIMS_ _ TYPEOF INSUPFNCF _ MIiS$ GENERAL uAEILRY <ECC�URR�ENCEO_ $ - COMMERCIAL GENERAL LNBI DYMISS s ocwtrenca CLAIMS Nn E OCCUR &ALI(INATV person) $ _LB ev INJURY $ -- AGGREGATE $ PRO)UCTS-COMPIOPAOG $ .IN L IGII RATE U111 APPILIE1 PER S Ll IF LDC Ea evitlen� S Au AU BaC LwaILm - EO BOOL _RV IPer parson) $ ALL OIN _ aomLr .IURY IParaameem) $ TOSNUroe LE P SI SMF- 5 ED AUTO NIABLELLA B AGGREGnTERRE $ IMI NIADI TIONS C A WC SrANs O H- WORKMRSyOMPExSALOY TORLIER AND WCC500-5014518-15 4/17/5 4/17/1 EncR AcCOENr $ 100,000 D apoao, OlsensE'EA,EMPLOYE 11 100,000 D ODcv LIMIT s 500,000 s DESCRIPTION OF OPERATIONS r Lacnnorvs,MERCIES Nllecc AGORD ml,Aamno�al Rarsama smeawa,nmo p rs q ree) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 36 BARTLETT STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ANDOVER, MA 01810 ACCORDAN'E�iNITH THE POLICY PROVISIONS. � UTHORI)F R rATIVE 1908-2010 ACORD CORPORATION.All rights raservetl. ACORD25(2010105) The ACDRD name and logo are Rgi,twed marks of ACORD OOff e of C e.Afters&R sRcgJ non L nse or registration valid for indrvrdtd use only {4iOME IMPROVEMENTCONTRACTOR _ before the expiration date If found reWrn to: �g trat n 173394 Type Offleo of Consumer Affaas and Business Regulation ' Expiration: 10/'1/2015 Individual 10 Park Plaza Suite 5170 Rte,_" CARLOSAAEREIRA Boston,MA 02116 '., - CARLOS PEREIRA 81 BAILEY RD p„ SOMERVILLE,MA 02145 Oren—nretary Not valid without tore Signa Massachusetts-Department of Public Safety Board of Building Regulations and Standards estla"r -- y, License: CS 706349jgm CARLOS APEREJ�A 81BadyR d fffflp S-burcille MA 0i145UV Expiration 7/15I