The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 10/15/2015 It 0ORT11 Q "-Judo 1" BUILDING PERMIT VO 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: ATOP I IMP ANT:Applicant must complete all items on this page 'gog cry N Sp I gg" TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building R'One family El Addition 11 Two or more family 11 Industrial [O'AIteration No. of units: 11 Commercial 0 Repair, replacement [I Assessory Bldg 11 Others: 11 Demolition 0 Other 9/10 7"10 Identification Please Type or Print Clearly) OWNER: Name: 'buaerta-a Phone: 972 Address: .............. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.,MOO PER$1000.00 OF THE TOTAL ESTIMATE BA ON$125.00 PER S.F. Total Project Cost: $ t FEE: $ Check No.: m Receipt No.: NOTE: Persons cofiWa wit unregistere ,4 contractors do not have access to the guaranty fund 'A 004) 0 "of'),goh tkORTH Town of Andover No. _ h Ver, assr-A a tow o . 9 COCHICNE WICK �• 9S RATED U BOARD OF HEALTH PER T D Food/Kitchen Septic System 4 THIS CERTIFIES THAT BUILDING INSPECTOR has permission to er t ..........................tuildings on ..... .... ....... Foundation to be occupied as .. ... . qVI ..S. .. .�.... .....� ...�...... ' ... Chimney Rough ' ey provided that the person acceptin his permit sh in every respect conform to the terms of the app ' tion 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 ONTS ELECTRICAL INSPECTOR LESS C C 10 AR Rough Service . .. BUILDING INSPECTOR. Final 1 GAS INSPECTOR Occupancy Permit Required to Occupy By 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. s i F 4 }� 1 f s t � � — o Rtor cordi7`o� 6-1 LA)irdc�ti T d4v e AJ. ,41,Jd o v eV- 44 i cu FIT e Ice 0 ew S-ecz4 o a —— — _ %�(ISTIN l�ld c 7-0�fMRrp Nc«a s[GToo� O � l2 a Gt v� f 04 P,,j EEI 0� L7- +f W A a^40p r`' ary J-,� CONTRACT ROBERT ROHON ONEY CONSTRUCTION CO. 12 HALL STREET METHUEN, MA 01844 978-665-0970 (office)/978-685-6262 (fax) Fully Insured Construction Supervisor License #979 Exp 4/21/2016 Home Improvement Contractor#114238 Exp 8/16/2017 bo-h ndoneyconstruction ahem!cQm Customer Name: Andy Dugerian Property Address: 14 Wright Ave, North Andover, MA 01845 Contract Type: Repairs Date: October 12,2015 Scope of Services: Repairs 1. Supply local building permit. $250.00 2. Supply workers compensation and liability insurance certificate. 3. Roof—approx 22sq $8,850.00 1. Strip existing roofing to bare sheathing. 2. Supply and install Eft of ice and water barrier at all lower roof edges. 3. Supply and install synthetic shingle base on all remaining roof areas. 4. Supply and install new aluminum drip edge at all roof edges. 5. Supply and install new 30yr architectural shingles on entire building. 6. Supply and install continuous ridge vent on entire peak. 7. Re-lead, re-point and cap existing chimney. 8. Provide job site clean-up and safe work zone. 4. Insulate attic to meet MA State Code(1138)—existing is approx R13. $1,400.00 5. Remove section A of roof and re-frame. $2,800.00 6. Remove section B of roof—frame gable end with vinyl siding and gable louver. $4,000.00 7. Venting $4,300.00 a. Remove existing aluminum facia trim—vinyl sophits and wood sophits. b. Install new insulation baffles at eaves. c. Install new fully vented vinyl sophits. d. Install new aluminum facia trim. e. Install new attic vent through roof and outlet for power. Pagel of 2 8. Provide job-site clean-up and safe work zone. 9. Dispose of all construction debris from site. $450.00 TOTAL CONTRACT AMOUNT: $22,050.00 Payment Terms: Deposit amount of$7,350.00 to begin project,progress payment of $7,350.00 at inspection of roof frame and balance of contract in the amount of$7,350.00 at completion. Customer Signature: a-- Date: 1 :2,/ 15— ; Contractor Signature: - Date: Page 2 of 2 The Commonwealth of Massachusetts Department ofIndustrialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov1dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legib Name(Business/Organization/Ind' idual): T�)Vto Address: \�[OLJ City/State/Zip: Nt�UtUA Phone#: q, `29 LR,6_bq')r Are you an employer?Check the appropriate box: Type of project(required): I.El I am a employer employees(full and/or part-time).* 7. ®New construction 2.®1 am a sole proprietor or partnership and have no employees working for me in 8. F1 Remodeling any capacity,[No workers'comp.insurance required,] 9. 0 Demolition 3.E]I am a homeowner doing all work myself.[No-workers'comp.insurance required.]t 10®Building addition 4,E]I 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 ILE]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 listed on the attached sheet. 13,[:]Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.E]We are a corporation and its officers have exercised their right of'exemption per MGL c. 14.E]Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] L *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 11orneowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a now affidavit indicating such. $Contracters 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 workers'comp.policy number. I am an employer that Is providing workers'compensation Insurance far my empl6yees. Below Is the policy and job site Information. Insurance CompanyName:N N �uluod Policy#or Self ins.Lic.#: _.q00—�03,q Expiration Date: Job Site Address: City/State/Zip: Ndc 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 hereby certify under the pains andpenalfies ofpeiyury that the information provided above Is Inte and correct Si nature: p4t,,/d Date: Phone#: Official use only. Do not write in this area,to be completed by city or to)PI1 offleial City or Town: Permit/License 0 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#: ' CERTIFICATE OF LIABILITY INSURANCE DATE`"�o/14/'15 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(es) 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: Bates Insurance Agency Inc. PHONE FAx 395-9454 92 High Street, Suite Bl E-MAIL (781) 396-4985 No: (781> Medford, MA 02155 ADDRESS: Andrea@BatesIns.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A:RCA—Essex Ins CO INSURED INSURERB:A.I.M. Mutual Ins. Co. Robert Bohondoney INSURERC: Bohondoney Construction INSURER D: 12 Hall St INSURER E: Methuen, MA 01844 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 AML SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD/Y MN/DD/YYYY LIMTS A GENERALLIABILITY 2CM7759-15 2/3/15 2/3/16 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERALLIABILITY PRMMGETO RENTEoccurre c $ 100,000 CLAIMS-MADE F—x1 OCCUR MED EXP(Anyone person) $ 5,000 PERSONALBADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AG G REGATE L IMI T APP UE S PE R PRODUCTS-COMP/OPAGG $ 1 000 000 POLICY JECOT- LOC $ AUTOMOBILE LIABILITY COMBINED�SINGLELIMITga $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED (per.. accident PROPERTY $ DAMAGE HIREDAUTOS _AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS M4DE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AWC40070243322015 8/9/15 S/9/16wcSTATT.RYLIMIT. OTH- AN D EMPLOYERS'LIAB W TY FR ANY PROPRIETOR/PARTNER/EXECUTTVE YIN N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Ifyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is requi red) 14 Wright Ave North Andover, MA 01845 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE '@1913. .20 W ORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: 1 Massachusetts - )epartment of Public �afeiv Board of Building Regulations and Standard, !)Ivorucrilin 5u��crii,nr I_.ic:ense: CS-000979 ROBERT A BOHQNDONEY - 12 HALL ST MEDWEN MA 01844 ;umrnissioner 04/21/2016 _Office of cons ��..,.,,,,...•... OVt;MNT °Sjpess Regulation <� 'RegisfrafiPRCONTRACTOR Rxpirafion: 114238 8/16/2017 Type: CONST ROBERTBOHONtiONeY DBA CO ROBERT SOHONDON[;y 12 HALL ST METHUEN'MA 01844 Undersecretary