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Home My WebLink AboutBuilding Permit # 11/10/2015 TOWN OF NORTH ANDER l APPLICATION FOR PLAN EXAMINATION Permit NO: , � Date Received Date Issued: t IMPORTANT: Applicant must complete all items on this page r r r / ,r f/ / r, / // ✓ r / ,i /✓ r, ,,, r /r i�,l rr u ( 1� / r i / ri , J/ ,/ � ., ,ri � r J / r „ <,fir+ „ , r u ,/, / �1/, / ,, -, r ✓�„ / �i/�i�/�/�/�/�1%��i//�i//�rl��„//�%///// �r/ r r . .;:,/LOlJATIONr/��,//l//�i/Orr „///,% //G,,,�/lU�� „ rl::r/fr�1J,,��h',,,,�:/v.d�/1�r�.� �J ,�9s„ �ir...,r,/✓ /�/rr.. r / riry r, a r ri / r r , i rr l i/.//r�/ / ,,,. rrr rn ///%r r,r/ r!./1! ra,rr//�r/////e//r/. �f/✓ ///,�c. / ,/!„///rrll, a -:. ,. . r,,,. „�i/ir TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building XOne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑septic' ❑Well-, Disirict ❑1Nater, ewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: / Phone. W... Address: " ° „ r r / /r�1..// // ./ //rJ✓ a,,...., � ///,,.,,r r/i// r/ //rr.,/ r//r//p�/r ///r.rli/ l r// ../l// Ir .,/ / !./ „r .�„l / ,... r a, l/ / ac,cc,,/, ,,,,,,,;:,; „e,✓;,r„.„�i/ ;,^.�� ,,,.” rr l/O/r� r /�///i/rid 1// / /////y sr //rr r /i /J�/% r , ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ .:�e d FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered cont ops o t t have access to the uaranty fund Signature of Agent/Owner ofd Plans Submitted Plans Waived ❑ C rtified Plot Plan ❑ Stamped Plans ❑ k �®RTH ow _ E ynclover 1580-- 2A I , h Verb ass, [OC MICNE WICK �9S R�+rEo U BOARD OF HEALTH Food/Kitchen PER IT D Septic System THIS CERTIFIES THAT .......................................a BUILDING INSPECTOR .......... . !!! +............... .................... has permission to erect........................... buildings on ... ..... .. .0 .. ..... Foundation Rough tobe occupied as ............. ....... .... ................................................................. Chimney provided that the person accepting thi 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final Final PERMIT EXPIRES 16 MONTHS ELECTRICAL INSPECTOR UNLESS_ COSTRCTI STARTS Rough Service ............... ....... .. :. ........................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building 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 Approved by the Building Inspector. Burner Street No. Smoke Det. ., Proposal AS Carnes Roofing,Inc, Page I of 1 30 Arrowhead farm Rd Boxford,Ma.01921 978.887.1431 MA.CS-000230 and HIC Reg.176928 6 Proposal Submitted To: MICHAEL&KATHLEEN SCANLON Date November 6,2015 155 DUNCAN DR Project Name NORTH ANDOVER,MA 01845 Address 508-265-1088 We propose to furnish material and labor-in accordance with the specifications below: Nine Thousand Seven Hundred Fifteen Dollars($9,715.00) Payment to be made as follows;$300.00 Deposit,Balance Upon Completion Notice:All home Improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from registration by provisions of Chapter 142A of the General Laws,must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Mass.gov4toenses website. ROOF PROPOSAL,. F,�J STRIP ROOF OF ALL LAYERS OF ASPHALT SHINGLES,COVER ROOF DECK WITH THE UPGRADED RHINOROOF TITANIUM U20 HIGH PERFORMANCE SYNTHETIC UNDERLAYMENT MEMBRANE,COVER EXTERIOR WALLS AND FOLIAGE WITH TARPS TO HELP PREVENT DAMAGE. rSJ ICE DAM PROTECTION.INSTALL CARLISLE HIGH PERFORMANCE ICE&WATER BARRIER OVER ALL HEATED AREAS SIX FEET WIDE AT THE LEADING EDGE OF ROOF AND THREE FEET IN ALL VALLEYS,WRAP THE CHIMNEY(S)AND SKYLIGHT CURBS WITH ICE AND WATER BARRIER. COVER ALL PERIMETERS WITH EIGHT INCH PREFORMED ALUMINUM DRIP EDGE. INSTALL GAF COBRA RIDGE VENT AND/OR(..I ROOF LOUVERS FOR ADDED ATTIC VENTILATION. 0 COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS AND FLANGE. REPLACE WALL FLASHING(S)AS NEEDED WITH ALUMINUM OR LEAD AT THE ADDITIONAL COST OF S25.00PLFT,WE MAY NEED TO REMOVE THE SIDING TO PERFORM THIS WORK AND YOU MAY NEED TO HAVE A CARPENTER REINSTALL OR REPLACE THE SIDING THAT WAS REMOVED. F CHIMNEY FLASHING:CUT ALL EXISTING TAR AND LEAD FROM ONtt„CHIMN Y(S),CUT NEW REGLET WITH CARBIDE SAW AND SECURE NEW LEAD FLASHING IN PLACE WITH METAL ANCHORS. PROPERLY SE C' PLEASE ADD$"of)0,f74]TO ABOVE PRICE. I COVER ROOF SURFACE WITHCERTANTEED I-M0MARK 240E °LIF L I YME W 'MNTY DESIGNER SHINGLES. ( I REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH 9M8LAAT AN„ADDITIONAL COST OF4.00PSOFT. _. COVER ROOF DECK WITH CDX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADDITIONAL COST OF C � NAILIf s:SECURE SHINGLES WITH EIGHT IN TOTAL COATED ROOFING NAILS AS PER CERTAINTEED SPECIFICATIONS. SKYLIGHTS.REPLACE EXISTING SKYLIGHTS WITH NEW VELUX OR WASCO UNITS.WE WILL PROVIDE THE SKYLIGHTS&FLASHING KITS AT OUR EXACT COST FROM OUR SUPPLIER.OUR LABOR CHARGE IS 075°0e EACH IF THEY ARE THE SAME SIZE.INTERIOR WORK IS EXCLUDED. I_.I REMOVE EXISTING GUTTERS C.-J INSTALL NEW SEAMLESS,032 ALUMINUM GUTTERS USING THE HIDDEN ZIP SCREW HANGER SYSTEM. .I REPLACE DEFECTIVE TRIM BOARDS WITH CUSTOMERS APPROVAL USING NO,2 PRIMED PINE,ADD$15.00PLFT TO THE ABOVE PROPOSAL, 1...] INSTALL NEW ALUMINUM DOWNSPOUTS AND MECHANICALLY FASTEN ALL CONNECTIONS. CLEAN ALL PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA. THE PROPERTY OWNER AUTHORIZES AB CARNES ROOFING TO OBTAIN ALL PERMITS,WE CANNOT ACCEPT RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS, CUSTOMER SHOULD COVER VALUABLES. GREAT CARE WILL BE USED TO PROTECT THE STRUCTURE AND FOLIAGE.HOWEVER,SOME MARRING AND OR MINOR DAMAGE COULD OCCUR. IN ADDITION,WE CANNOT BE RESPONSIBLE FOR ITEMS FALLING FROM WALLS,SHELVES OR CEILINGS DURING THE ROOFING PROCESS, SPECIAL INSTRUCTIONS, THE ABOVE PROPOSAL INCLUDES ALL SHINGLED ROOF SECTIONS OF THE HOUSE. SKYLIGHTS:PLEASE ADVISE IF YOU WANT TO REPLACE THEM WITH THE ROOF INSTALLATION 1 WARRANTY UPGRADE:THE CERTAINTEED WIND WARRANTY WILL BE UPGRADED FROM 110 MPH TO 130 MPH WITH A UPGRADE TO THE CERTAINTEED HIGH PERFORMANCE HIP&RID?E CAPS A ARTIER COURSE AT NOA DITIONA CHARGE.YES EMAIL ADDRES kl� 1 I I Warranty:All work warranted against installation defects for 5 years;this warranty is limited to the installed item(s)and its repair only,Material is warranted by the manufacturer against defects for 50 years;see the manufacturer's warranty for exact warranty performance. PI anceflatlon:Customer has legal right under federal law to cancel this contract without penally or obligation within three business days from the date of signing this agreement via Priority Mail Delivery Confirmation. Please see reverse side. Dispute ResotuRaon sander Massachusetts Home lmprovernent Law 142a:All parties agree that any and all disputes relating to this proposal shall be settled by arbitration.This forum is user friendly and does not require lawyers.Please see reverse side. Signing this Proposal mean ,you have accepted all the terms as stated on the front and back of this agreement. Please see reverse side. *Date of AcceptanceSi i g C� � nature *Signature Signature PLEASE SEE REVERSE SIDE TOWN OF NORTH ANDOVER WASTE AFFIDAVIT As a result of the provisions of MGL Ch.40-s54, I acknowledge that as a condition of building permit# all debris resulting from the construction activity governed by this building permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL Ch.111-s150A. Waste Disposal or Solid Waste Facility: ALLIED WASTE Address: 300 FOREST ST Town/City, State, Zip: PEABODY, MA 01960 NAME OF HAULER: AB CARNES ROOFING, INC. DUMP TRUCKS DATE: 11-10-2015 SIGNATURE OF APPLICANT: F)'- - The Commonwealth of Massachusetts Department of In striaCAccidents 11Congress Street, Suite 100 .Foston, MA 02H4-2017 _. � ww>v.rnass.gov/dna Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information - Please Print Le lg_bly Name (Business/Organization/Individual):AB CARNES ROOFING INC Address: 30 ARROWHEAD FARM RD City/State/Zip:BOXFORD, MA 01921 Phone#:978-887-1431 Are you an employer?Check the appropriate box: Type of project(required): 1.0 1 am a employer with some 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. ❑ Remodeling any capacity,[No workers'comp.insurance required.] 9. El Demolition 3.®I am a homeowner doing all work myself.[No workers'comp.insurance required.]r 10 [] Building addition 4.E:]1 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.E]Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Z Roof repairs '1'hesesib-contractors have employees and have workers'comp.insurance3 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#I 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 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 workers'comp,policy number. I aiii an employer that i.vprovitling workers'compensation insurance for my employees. Below is tile]policy and job site information. „ CO OF AMERICA TRAVELERS Insurance Company Names Policy#or Self-ils. Lie.it:6HUB-OG36156-6-15 Expiration Date: 10/15/2016 i) Job Site Address: - — — - 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 iunnprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. �� iciaiZlties o 'Bei itr f l trite and correct. r .l1 J J' St/nattut�by certify iter hae�ttiiis�urrd� � ,that the�iii�information c: above cti — _ —_ Pirrone tf:97$-887-1 31 -- -- 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#: (M W W NOTICE z NOTICE TO MTO EMPLOYEES EMPLOYEES v 0,1M Sv,� i The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENT 1 Congress Street, Suite 100, Boston, Massachusetts 02114 — 2017 617-727-4900 — http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 &30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with. THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P .O. BOX 1 450 MIDDLEBORO, MA 02344-1450 ADDRESS OF INSURANCE COMPANY (6HUB-OG361 56-6-1 5) i 10-15-15 TO 1 0-1 5-16 w, POLICY NUMBER EFFECTIVE DATES }— PRESCOTT & SON INS 963 EASTERN AVE m ��— MALDEN MA 02148 NAME OVIN, AGENT ADDRESS PHONE # �, : .. o '"AB CARNES ROOFING INC "'�� 30 ARROWHEAD FARM RD BOXFORD MA 01921 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT h The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the 0— provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost 01' the services provided by the treating physician will be paid by the insurer, if* the treatment is necessary and reasonably ' connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 000849 W20P1G15 POSTED EMPLOYER 41 16:"1P1W'JW1(W111l e mm Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration: 176928 Type: i Expiration: 10/10/2017 Corporation AB CARNES ROOFING, INC. BARRY CARNES 30 ARROWHEAD FARM Rd _ BOXFORD, MA 01921 Undersecretary Board of twlr kdi ng Reguiatpons and StandardsI aS5a�i°�a S0ttS . Depamtrn nt c)( PUWic Safety Construction Supervisor bc n e CS-000230 w4 BARRY S CARNE,'" 30 ARRQWHEAIJ''F Boxford MA 01921 ,%t Ex rat ic)n �."aada��sra�a w°mao 03/07/2016