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Home My WebLink AboutBuilding Permit # 10/21/2015 oRTH BUILDING PERMIT Oy TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION - Per NO: Date Received t V ,maRATED Date Issued: - 9SsgcHusEt MPORTANT:Applicant must complete all items on this page -777777 LO'CATIQN4 Y . Priht PROPERTY OWNER � MAP NO W TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building q ne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ["Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic Ell 1/Uell ' ❑ Floodplain CI Vlletfands a Watershed:District . p UVaterCSewer Identification Please Type or Print Clearly) OWNER: Name: � �-- � Phone: Address: <.h.K' CONTRACTOR "Name Plorte:= ,; Atldres s Supervisor's Consfructton Licertise Exp Date Horne (npro�rement License ' Epp Date 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: $ , �7 O FEE: $ CA Check No.: 2-12 � Receipt No.: �I c:&ZW NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Jy� re of contractor—= � � r-111111111-111 Affib oORTH ' town 2 t e ..h'ofmi-isdover O �-+ '�' M No. h ver, Mass,&WxK O LAN! 1. COC NIGNl WICK � S U BOARD OF HEALTH I D P E L Food/Kitchen Septic System THIS CERTIFIES THAT ....... BUILDING INSPECTOR . ... ............................................ ...... ...X........................... . .....o.... .... Foundation has permission to erect .......................... buildings on . ...... ... ® Rough tobe occupied as ........ ........ ... .......................................................................... 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 EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR CONSTRUCTIONUNLESS T RTS Rough Service ................ ..... ... .. .. .y e....,....................... Final UILDING INSPECTOR GAS INSPECTOR ccupanCV Permit Required to Occupy.Buildin Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathmg �.w � e Craig LaCrosse-Owner • ESTIMATE PO Box 728,Tyngsboro MA 01879 978-580-7376 October 8, 2015 craig@roofingkinginc.com Customer: Mark Halbach Address: 20 Walnut Ave,North Andover MA Postal Code:01845 Phone: 508-954-2785 Email: halbach.mark@gmaii.com Thank you for allowing Roofing King Inc.the opportunity to work with you. Here is a list of the work to be completed,the agreed price and payment structure. Please feel free to contact me with any questions or concerns at the number listed above. SCOPE OF WORK: Full roof replacement House will be covered with roofing blankets to prevent any damage and for easy cleanup -Remove all shingles right down to existing wood and re-nail and prep before installation process begins(Est.#of layers ) -Install up to 96sq ft of rotted plywood(3 sheets 1/2 roof plywood)at no charge on any full roof replacement&$50 per additional sheet if needed -Install 6 ft of GAF Storm Guard ice and water shield leak barrier along base of roof and areas listed below -Cover all valleys,snow load areas,under all flashings,wrap all penetrations including but not limited to chimney's and sky lights -Remove and re-install new plumbing flashing on soil pipes vented through the roof -Install Felt Buster on any exposed wood before shingles are applied -Install new 8" (color)drip edge on all edges of roof for proper protection -Install GAF Pro Start starter strips around entire perimeter of the roof to create a 1/2 inch overhang for proper install -install GAF Architectural Timberline HD LIFETIME Ltd.Shingles will be storm nailed with 6 nails per shingle 130 MPH resistance -Cut 11/2 inch opening on peak of roof if it wasn't previously done for proper installation to meet building code(on full replacements) -Remove old lead around chimney and reinstall 12 inch lead and reseal joints(if applicable) -Install Cobra exhaust vent on peak of roof to allow proper ventilation and meet building code -Hand nail Seal A. Ridge caps on peak of roof with 2 inch nails to complete installation. -Blow off entire roof, driveway and all walking surfaces and clean any loose nails with 3 ft rolling magnets daily or on completion -Clean all gutters and downspouts(if applicable) -Existing roof will be removed and recycled at Roof Top Recycling(Certified Green Roofer) Job Specifics and Upgrades (on full roof replacements) -Weather watch upgraded to Storm Guard Ice and Water Shield $0.00 Included -Remove skylight flashing kits to install ice and water on all 4 sides(reinstall existing kits) $0.00 Included -Deck Armor in place of Felt Buster $250.00 Not Included k vt c-UIJ a-s h e d s ,v 0,et-c " 'f-d Warranty Roof comes with 50 Year Weather Stopper System Plus LTD manufactures warranty Promotions Military, Veterans and Retirees receive a$250 Rebate through GAF when purchasing a GAF Lifetime Roofing System. PAYMENTSTRUCTURE: This price includes labor, material,trash removal, building permit if required and contract may act as signature for permit. (Any additional work will require separate pricing) Make all checks payable to Roofing King Inc. �• . Total: $7,700.00-$500 Act Fast Coupon(Exp. 10131) $�$0,g0 7 Deposit(due at signing): (1/3) $2,400.00 7 3 a 2nd Payment(due when material is onsite): $0.00 Final payment(due upon job c?mpletion): (2/3) $4,800.00 6 SHINGLE COLOR: L�ln�r��lr Initial: ACCEPTANCE OF PROPOSAL.The included specificationsand conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above and accept all terms included.All discounts on all work to be done must be presented to Roofing King Inc.representative before contract is accepted. If rotted wood is discovered AFTER removing the existing roof,or it could not be identified at the time of sale an additional charge of$50 per sheet. If this account is collected through legal actions customer will be responsible for all attorney fees and court costs. Disclosure:Customer responsible to cover any valuable items in the attic to protect from debris.Roofing oes not assume spo ibility for acts of Mother Nature. d Owner/Contractor Property Owner Craig LaCrosse ,�� Mark Halbach The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,M4 02114-2017 www.mass.gov1dia Workers'Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTMIG AUTHORITY. Applicant Information Please Print ibly Name (Business/OrganizWioft4ndividual):Roofing King Inc Address:Po Box 728 City/State/Zito: yngsboro MA, 01879 Phone #: 978-580-7376 Are you an employer?Check the appropriate box: Type of project(required): I.[J I am a employer with___--employees(full and/or part-time).* 7. New construction 2.E]I am a sole proprietor or partnership and have no employees working for me in 8. E] Remodeling a"capacity.(No workers'comp.insurance required,] 9. El Demolition 3.01 am a homeo.doing all work myself[No workers'comp.insurance required.]1 4.01 am a hwill and It be hiring contractors to conduct all work on my property. twill 10 n Building addition ensure that all contractors either have workers'compensation insurance or are sole I Q:]Electrical repairs or additions proprietors with no employees. 12,E]Plumbing repairs or additions 5.El I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.: 13.W]Roof repairs 6.0 We are a corporation and its officers 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#I mum also fill out the section below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tiContractors that check this box must attached an additional shed 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. am an employer that is providing workers'compensation insurance for my employees. Below Is the policy and job site information. Insurance Company Name.Star Policy#or Self-ins.Lic.#:WC 0742797 Expiration Date: Job Site Address: u "o e�_a City/State/Zip: 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$J,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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do kereby certify under the paim and pen aMes of perjury that the information provided ab _V �ve is true and correct. D Sim,ture: Date: Phone#:978-580-7376 OficialTower: use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License 9 use 0' Cityorwn To I qsin ssuhtg Authority(circle one): 1.Board of Health 2.Building Department 3.City/Yown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other LContact=Permson: Phone#: ACCORe CERTIFICATE OF LIABILITY INSURANCE F 8/20/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If thecortificate,holder Is an ADDITIONAL INSURED,the policy(iss)must be endorsed. if SUBROGATION IS WAIVED,subjeetto tim terms and conditions of the policy,certain policies may require an endorsement A statement on this cortificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER McSweeney&Ricci Insurance Agency, Inc. PHONE NO Erti:781:848-8M Noi:781-843-8807 420 Washington Street -MIL P.O. Box 850984 ADORE S: eceGon mr—eene, com Braintree MA 021860)AFFORDING COVERAGE "AIC 09 R lusuRERA:BerkIev Reuional Insuwnr&L_ojD______._ INSURED ROOFK-1 INSURER B Roofing King Inc Craig LaCrosse INSURER D: Box PO x 728 Tyngsboro MA 01879 _NSURER E. PER F: COVERAGES CERTIFICATE NUMBER:677678720 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 SHO MAY HAVE BEEN REDUCED BY PAID CLAIMS, 0" ADDL=--- —POLMY POILICY LTR TYPE OF INSURANCE INSR POLICY WME9XIEFF M EKP juva)Or"M LIMITS A GENERAL LIASHJTY Y Y CGL 0059562-21 12111/2014 12/11/2015 EACH OCCURRENCE $10000M RENTED X COMMERCIAL GENERAL LIABILITY pRESES(Ea owarence) $100000 CLAIMS-MADE K OCCUR _MEDEX!JAtty ons person $5,000 JTRS�&ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 0 XI JFrT LOC POLICY L�]PRO- F C AUTOMOBILE LIASUM Y M1T5776F 8/2012015 8/20/2016 ccwsfwD _LE;q---�—__jj�q 000 ANY AUTO BODILY INJURY(Per person) $ ALL OVWED SCHEDULED AUTOS X AUTOS BODILY INJURY(Per goddenI) $ NON-OVMED PRO—PERTY DAMAGE X HIRED AUTOS AUTOS (per _IX $ _U'VEIREIIAA LIAR X OCCUR CU0071022 1211112014 12/11(2015 EACH OCCURRENCE $2000DOO X EXCESS IJAB CLAWS-MADE S AGGREGATE S2.000,000 LL DEO RETENTION$ $ B WORKERS COM TION WC074279703 8/20/2015 e12()12016" 777j�W�CMSTATUJX_10ET!H_ I 'AA AND EMPLOYE 'LIABILITY YIN )MM ANY PROPRIETORMARTNERIEXECURVEEL.EACH ACCIDENT aw.000 OFFICERIMEMBER EXCLUDED? [N-1 NIA (Ma in Na) E.L.DISEASE-EA EMPLOYEE $5W,0B0 ifMd1W'be-Is' R ION OF OPERATIONS Wow E.L.DISEASE-POLICY LIMIT I$500 0w DESCRIPMN Of MRATIONS I LOCATIONS I VENCILES(AftCh ACORD 104,MOftnal fterns"Sche*jW,11 mom space Is reqLdmd) Roofing(commercial and residential)and siding operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Roofing King Inc ACCORDANCE MTH THE POLICY PROVISIONS. PO Box 728 Tyngsborc,MA 01879 AWHORCZED REPRESENTATTVE ®19 21)10 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD aTE CERTIFICATE OF LIABILITY INSURANCE E3/13/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS S UPON THE CERTIFICATE HOLDER. IS CERTIFICATE S NOT AFRRMATIVELY 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 HMDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pofty(les)mug be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policles may require an andorsament A statement on this certificate does not confer rights to the certificate holder In lieu of suchPRODUCER NAME; Melissa Warren Risk Strategies Company (781)966-4400 FAX .(781)963-4420 15 Pacella Park Drive E Suite 240 WSURERIS1 AFFORDING COVERAGE NAICO Randolph KA 02365 IUSMERA:Scottsdale Insurance Co INSURED INSURER B:Guard Insur c2 Cron Junior T F Construction wSU"Rc, 406 Bridge Street INSURER D: #3 WSURER E: Lowell MA 01550INSURER F: COVERAGES CERTIFICATE R:CLIS31391061 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 SHOVVtd MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBERGENERAL POLICY F EACH OCCURRENCE $ 1.000,000 X COMMERCIAL GENERAL LIABILITY PREMI b 100,000 A CLAIMS-MADE ®OCCUR P31914893 /11/2014 /11/2016 MED EXP(Any one person S 5,000 PERSONAL&ADW INJURY S 11000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG 8 2,000,00o X POLICYPRO LOC g AUTOIAOEKE LLA TY NE LI. I b ANY AUTO BODILY INJURY(Per per on) S ALL OWNED SCHEDULED —m�... AUTOS AUTOS BODILY INJURY(Par ) 5 HIRED AUTOS NON-OWNEDRTY DA3AAG E AUTOSLIAS $ b SUR EACH NCE b EXCESSLJAS CLAWS-MADEAS�GP.E z`xAA'EE $ '... DED ETENTION 5 S S COMPENSATION TIOPd 1A 7ATU- OTH AND E O 'LIABILITY Y t N ANY PROPRIETORIPARTNERfEXECUTNE E.L.EACH ACCIDENT 100,000 OFFICERIMEMSER EXCLUDED9 N I A ff�ssdttl orylnN,a,,er 2W627911 111/2015 /11f2016 5E.LDISEASE-EAEMPLOYEE $ 100,000 DESCRIPTION OF OPERATIONS be4oa E.L.DISEASE-POLICY L14A1T S 500,000 :::L DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 9463,Addkmra RenseAs SchedWs.if ) Evidence of insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES CANCELLED BEFORE THE EXPIRATION DATE THEREOF, HOME L.L BE DELIVERED IN Roofing King, Inc. ACCORDANCE WITH THE POLICYPR . 1.2 Malvern Avenue gaboro. MA 01679 AUTHORMED REPRESENTATIVE Michael Christian/ a ACORD 25(2010/05) 01 0 ACORD CORPORATION. Al!rights r INS025 pwo6).a9 The ACORD name and logo are registered marks of ACORD & ofpff�HMPRCJ` EM,ENT CONTRACTOR Ty PQ. "tration: 173117 F IF,�1, CSFA-101-415 j,— 9M J "Vat 0 Al i 7 1)1 b CRAIG A LACRXWE �COFINIG K INC,,INC. 12 MALVERN A TYN UG SSMO E 2 M/%L'-VEFRN AVE GSB 0 1L0. M,A 0 18 7 9 t 7 :7 ........ A, ----------