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Home My WebLink AboutBuilding Permit # 11/3/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N®: „ I� `�°""� ''�� Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION x Print PROPERTY OWNER ,h Unit# Print MAP NO: PARCEL:bb ", ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure ye no r' TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Buildingne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑Ass ssr/ Bldg ❑ Others: ❑ Demolition I...,„.iM��,<i❑....„.....::e..<a4t.e,ci w � �❑� Fl � l/:m7m/r./�./.1,��-r��:,.I�:i�rI:ll,"s/.f,'/u,:,.J�.i�.Fu�i„orro,f,bN.'7r//id.,saM,l.i'(e.�/ /-❑u,1,i�/✓rWn,%/�.r..�ata,� �r�, lh�e'n1i�DM ""T' zqMejlnstrict r, /, 1rlyFi@ 1RI, "'/ l6 RN ood SIN� „ 1 wt�I.,S � ,r /l l��1 oiire er, r r��rt,r , DESCRIPTION OF WORD.TO BE PERFORMED: . -6Nl tnfifica on Pease Type or Print Clearly) OWNER: Name: Phone: % �(0 Address: . .' .gym. e CONTRACTOR Name: U tlbdej L Lrine r- Phone: e&!6-6-,)333 Address: Supervisor's Construction License: Cif°� Exp. Date: Home Improvement License: _ /, Exp. Date: 46 — ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: FEE: 9L67z $ Check No.: Receipt No.: (ta _ NOT Fea^so contrrcctzng Wath ur9regasteYed contrczctoYs d ve access to the guaranty fund Si - „ - --. ue r -.o�,�A Arm F FORTH [0,k w n ndul'%ver 0 ® L^KE h ver, Mass, cocNicNew�c.c �1. � �®ADRATED � Rm T LU S VSmoak BOARD OF HEALTH Food/Kitchen Septic System off I— E I T THIS CERTIFIES THAT 2 BUILDING INSPECTOR has permission to erect buildings on �SSe Foundation .......................... ............................ . ............................................ ............................................................. Rough to be occupied as ...........�......�........`�....r.C.�J .......: 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 PERMITI IN 6 MONTHS ELECTRICAL INSPECTOR UNLESST TI RTS Rough Service .................. .. ....................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy BuRough 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. EXPRESS wn W m w-n S ROOFING - ESTABLISHED PROPOSAL DATE OF PROPOSAL llIZ12010 www.expressroofer.com o-Iftammaurt!g mcaal HOME IMPROVEMENT CONTRACTORS LICENSE#108126 P 0 Box 642.Chelmsford,MA 01824 CONSTRUCTION SUPERVISOR LICENCE#99497 Phone 978.266.2333/Fax.978-261-2907 +* PROPOSAL SUBMITTED TO: m WORK TO BE PERFORMED AT: NMAL, STEPHEN PINCHER -""Ess 32 ESSEX STREET nuoREss 32 ESSEX STREtET INORTH ANDOVER MA 01845 NORTH ANDOVER MA ,0 PHONES 817.840-83�`E We hereby propose to furnish materials and perform the labor necessary for the completion of: STRIP ALL ASPHALT SHINGLES OFF HOUSE-PORCH-GARAGE CLEAN UP AND HAUL AWAY TARP OFF HOUSE TO HELP PREVENT DAMAGE TO HOUSE AND LAWN AREA COMPLETELY DE-NAIL OLD ROOFING NAILS AND RE-NAIL ROOFING BOARDS AS NEEDED WITH 8D RING SHANK NA LS ALL WALL FLASHING WILL BE INSPECTED AND REPLACED AS NEEDED Install:IKO Storm Shield 6'up from the bottom eaves IKO Storm Shield under chimney lead and T down on roof RHINOROOF SYNTHETIC ROOFING UNDERLAYMENT over roof boards IKO Storm Shield 3'on roof where roof buts into walls IKO Leading Edge Plus Starter strip on all roof decking edges IKO Cambridge Architectural shingles We install 6 nails Der shingle for a 130 mph IKO wind warran Cut in 1 1/2"opening on eak of roof and install Roof Saver ridge vent along all ridge surfaces All rid a vent is Hand Nailed IKO ridge cap shingles 8"Drip edge on all outside roof edges white New pipe flan es over vent i es 2"-4" All shin les will be fastened using 1 %11-1 1/"roofing nails BLOW OFF ENTIRE ROOF AND CLEAN GUTTERS AND DOWNSPOUTS ROLL 3 FOOT MAGNETS OUT TO PICK NAILS OFF LAWN AREA FOR FINAL CLEANUP INCLUDES:ALL LABOR AND MATERIALS FOR THE ABOVE AND ROOFING PERMIT ALL ROOFING MATERIALS STRIPPED OFF YOUR ROOF WILL BE RECYCLED AT ROOF TOP RECYCLING 16 YEAR WORKMANSHIP LIMITED AND A LIMITED LIFE TIME IKO SHINGLE WARRANTY CLEAN UP AND HAUL AWAY ALL SHINGLES Note.No warranty on problems and/ordama ed caused b ice backups No warrantyon old sk 0 Y A ._,®...._ YliOhfs All material is guaranteed to be as specified,and the work to be performed in accordance with the drawings and specifications submitted for above work and completed In a substantial workmanlike manner for the sum of: 1 @8t?r:89-- 9 PAYMEN r iN FULL AT COMPLETION OF JOB WITH CASH OR BANK CHECK WADE OUT IN THE NAME OF Michael L.Cortner Call Toll Free Respectfully submitted ,111.- - *1�. 1-888-21 0-1100F .m• 0-This proposal may he withdrawn by us if not accepted by: BL 9i2b1201 S All workers fully insure ACCEPTANCE OF PROPOSAL, The above prices,specifications and conditfons are satisfactory and are hereby accepted You are authorized to do the work as specified, Payments will be made as outlined above.Any additional work than the above will be an extra charge, UP„ 117 TC1'OWENS CORNfNG DURATIQN AtCH1TEURAL SHINfal;�",1A111"H”,SURE NAl1 PATITD;PIWC,FiNiD1:QGX'" INCLUDES A LIMITED 50 YEAR NON-PRORATED COVERAGE ON MATERIALS"AND;LABOR OWENS CORNING SYSTEM ADVANTAGE WARRANTY IS FULLY TRANSFERABLE Signature C4 Date SHINGLE COLOR WO C(APS(ZiCoAL, GVkS Homeownc r s rer onsiblo for protecting and c/atanirlg content of attic from possible dust and debris during your roofing project. Nat rosponslbio ror any Issuers caused by mcdd Any 112 in.Plywood installation will he an additional charge of$60.00 per shoot Labor and materials ANY BOARD REPLACEMENT WILL BE AN EXTRA CHARGE OF$4.00 PER BOARD FOOT We recommend now chimney lead with all now roofs for an oxtra charge of$695.00 por chimrnoy The Commonwealth of Massachusetts a Departmen.toflndustrialAccidents 0 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information �± �t Please Print Legibly Name(Business/Organizati n/Individual): ut l� Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.E]I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.O I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.[:]1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure!Ystall contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions prorfetors with no employees. 12.El Plut ng repairs or additions 5.2K. a general contactor and I have hired the sub-contractors listed on the attached sheet. 13. oof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.❑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#1 must 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 contactors must submit a new affidavit indicating such. $Contactors that check this box must attached an additional sheet showing the name of the sub-contactors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ann an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: � i Policy#or Self-ins.Lic.#: � � Expiration Date: A— Job Site Address: J 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$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 pain n nalties of peijuny that the inforination provided above is ue and ct. 1 Si nature: Date: Phone#: Official use only. Do not write in this area,to be 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#: DATE(MM/DD/YYYY) ACORQ, CERTIFICATE OF LIABILITY I 04/03/2015 TH(S..ERTIFICATE 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 certlficats halder is an ADDITIONAL INSURED,the PDlicy(iee)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 endorsemen4s). rPRODUCER CONTACT NAME: ANDRE SILVA Rapo & Jepsen Financial and Insurance Serviceslae.Ezt� 508-875-5600 1� Noi 50187817-57-S88.5- 1103Commonwealth Ave .M L . _.. __.... w.. ADDRESS: Boston, MA 02215 INSURER(S)AFFORDING COVERAGE NAIL 0 _._ ....__._.._..___._..._m _....,.... _ ....__._,. INSURER A. Essex Insurance Company INSURED EcuAUA CONS,_t.. , .. _.ION, _ . .._._..v .._. __..___...._....._ _.............. _... if ON INC INSURER 8: AMCUARD INSURANCE CO 153 ARLINGTON ST APT 2 INSURER C: FRAMINGHAM, MA 01702 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: EXPRESS ROOFER REVISION NUMBER: THIS IS TO CERTIFY THAT THE PUMB OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI D 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 1.0 ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR _.....___ `ADDLSUER POLICY SEE POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYV LIMITS GENERAL LIABILITY TBA 03/12/2016 03/12/2016 EACH OCCURRENCE 1w,000,4" DAM'AGE"TCT'RENTE'D'.,. 000 _ . ,.,.. ...,.,... ., X ...,.COMMERCIAL GENERA!.LIABILITY $ . 100,00 CLAIMS•MAI)E X OCCUR MED EXP(Any one Person) $ 5,000 �. , .......... .person) , ._.. _ _.....,_. .w...... A PERSONAL.B ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2 000 ADD GEN'L AGGREGATE LIMIT"'APPLIES PER PRODUCTS-COMP/OP AGO $ 2,000,000 X. POLICY ,. .._ PRO- _.., .. ._....,..._ .,.._v.._._... ... _.._ ....... _....._..... JECT LOG $ AUTOMOBILE LIABILITY IT— lGeacclde��tk.., ._ ....... ._.._......................... ANY AUTO BODILY INJURY(Per Person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Por accidoni) $ NON-OWNED PROPERTY'TDAMAGE HIRED AUTO 4 AUTOS UMBRELLA LIAROCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION �. �.. .�� WO KERS COMP NATION RZWC62345301/16/2015 01/16/2016 X TCJRYlr,IMITS ..., ERM1 _._.-.. t ------- ANY EL EACH ACCIDENT 11000AB OFIC /MEMEL D, NIA _000 ___ (Mandatory andato y�n u�r cion E i DISEASE I-.A EMPLOYEE $ 1,000,000 D:S(RIPTION OF OPERATIONS below E I DISEASE -POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,I1 more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C CELLED SEFO THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELI RED IN ACCORDANCE WITH THE POLICY PROVISIONS. EXPRESS ROOFER AUTHORIZED REPRESENTATIVE mike@expressroofer.Com 16 JONAS RD WE TFORD, MA 01886 , X71988-2010 A OR ORPOR TION, All rights reserved. ACORD 26(2010/06) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction arper�i�,or S,pecmftm Lions : CSSL-099497 MICHAEL L C04-TN->{ 16 Jonas Roadw Westford MA 01986 r Expiration Cormmsioner 04/24/2016 of Consumer &B'si�dess Regulation Office eglation i QME IMPROVEMENT CONTRACTOR r � �egistration: 108126 Type: ' xpiration: 8/13/2016 DBA MICHAEL L.CORTNER-EXPRESS ROOFING Michael Cortner 16 JONAS RD rte' WESTFORD, MA 01886 undersecretary