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HomeMy WebLinkAboutBuilding Permit #857-14 - 1 Surrey Drive U-2 5/1/2018 BUILDING-PERMIT Of tAO or"otic 6 TOWN OF NORTH ANDOVER i APPLICATION FOR PLAN EXAMINATION Permit NO: I�I Date Received rED Date Issued: IMPORTANT:Applicant must complete all items on this page -'" ��t'�:I•�cti�_ _ -:t'�:'xsr�:,�_^� - -_ _ _ _ _ _ _ _ '•: rf, >-SS�--•if.' - a'{— r•-,t.:- kJr.�:,.,u�ar1:: ; a_F•x =.$�tis.s- `rte •-,k� -va=^ T� - ;ar? - __'ice` '"f' - ..e •4h...a. -'#�rl•T2_:a±.'.� .iwi' c._. _ ^}"�-`�t �4^�.�:idz_..�,e..p,:Y�-'^sT�._ S''r'• - - - L^v.f.R _3_�4-..er..:Y,:J`-rir�� .i .ei tireL-,;r.� - �-U� = :�t•i�-=31=:P�1^r.:`.� _ a 4:..tiic'•c-��+:-=1..^r_^.�-_+:t cam'-_-`..n�J=a'' ::.� ���.� .C4"7'.<py, .:+r:..--g:74►X% �.:� :rJ= - Aja._ - .«r-"w—i5.—=:...,r..� �5:�lir�d_ '�;-,-,.. •,��:r.,�-^�'i - a���� -- y.c..'-4'...��-`n="`=�,.,, � .r---� -r it_.a.-.A�_�'s5�'`Yy_,�-it';;•?•t ' _,Jµ•"sr• -"-"inti-cit J.:f_'.. -r�. _ �7 �J�^.::=" :...:F.rt sn- `��S'-y.�::�.- - - rt:,X�A3i4N.�r: �'1� _ ft�-sJ?•_.q�"`9+._ti�., :�T�i1F' yµ.r'-.�:t=_ f �"" .c4,�:c:�C'-` - 1 - -s.�r,...- i=`�? 4.Stag. _�.;f.�,"S ..-'� a7 �«3. 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'.�;W-,�. � - �-�� -.--..�� _�.f�ran^ -,, -e�..__5��s-r�`.tu.'.?.rr. - .rr.�.�s''G ski- >5��-'k�•"_s,`sty-e'�"'�'�' �T.=�. ��'J�7831� ��r�7<;�J .�!:• .iii=;�: .� • I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building VOne family Addition Two or more•family Industrial Alteration No. of units: Commercial ,,/Repair, replacement Assessory Bldg Others: Demolition Other A�.�:�:�,<;;,� __ _ ..n.�,,; •'S_:-.rf _ _ix.=4La'_;^'^4''=r`::°- � .�>�u��-�'-�_ _ - _ -.w:`a.�.r-s=-•�,r,:a-�- - _ _.���--�"�` :� �r i �',�� _�+vf ..u`.�r'�.� ,�(.''a'"t''�' ^��.-3'' v« �.��t:�,�� ,��.,�_.--.+�-n�:,�a't`��7k�5„-=:,�� •t:�''„}�"'r_•.a;'? n;. ��• � .��,�+�ra,x,.F-� sr�=,R” �"'�.ct„�,w ,.��,W^lp����' p, ��"�����'�'�"��' ���a[1111:.�.�' •ti!-� y� ��r�a` �S""F- ��� DESCRIPTION OF WORK TO BE PREFORMED: �'�i-i p a.�d -r e,.r1,s�'/c.• •� /nc��zl �c�o�►� -�� �a/ Identification PIease Type or Print Clearly) OWNER: Name: A//cam Phone: 97F 795 I/d -'2 Address: cSUr/1" Di-7W, �:..�.ftV s''-•;� !- .:.'4 -.OEMaP —•3`r�;• ,.�r, -_ice.,.. amt-.?S�,d'"•^-,;,-c'"':x5�� � - -``SY��.r`��l.s.^-'•F.'-`. .T'?i---_� 45=:"�_,�f<""-f- r _ _ - _ �. ..'�-'��_t•_�' ��� '- r �i -�t �•'T-��555 cs ` :-''"?- ta t... 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'"sr�- -�e ..��-5,'�-:•1-max• �r�.�: "�. ?.�`"Yt.;����`�"-`.sir-�-� �..-,,.,.ski - '_y�������r�r�:�'_��..�••g= z�^�==ti���l����.?:FL! gnu.�?-�� �SJ�x�..._��^P� �6�.�-:.2 K `s�S�LJy'Y'f�.L 3'+�T�cf-Z� � lZ-1 �WnS SV-...v'c`a-,F!•53 e�3'• x�%raG�'�',Sr- �':','r" 6^�.u]Sz'� �- , --11SSVV t•=� �'o{:�yy 3���q^k.� ��;,,,iSa 'L.�- __ _ 6 7?} �.��•. �-.r�Jrt 'tea"�. �fl� � -L;�'_ '�"-y' c� 5 '..`r'4��^'�,.,-�,y'-,rzT3.`� y k`•f�3r.�+"-r'� ' 1,.�...c•:�• RIM I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 73 ` FEE: Check No.: IQ Receipt No.: o'�1 (1 NOTE: Persons contracting with unregistered contractors do not have access to the guual anty fund Chir� 04,MentYfl ner - :;•. Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools -Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATEAPPROVED. PLANNING DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature l�lJl1%111%ICIV 1 J HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments -Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signatvire: Located 384 Osgood Street jK[`.e:-sy l�sii�'i^w-L-`.`_..•�9.n ^Lhr'r' - Z. 4-1 ray: ri..H1 cated� ���rlaln::�#�.e�et •—� w�.s. _��_,--K - •-=��„'� - - ' ` -��,"= -- - - - -.4r.::::-;srsa+•� - - "��:�' _Z'��4-:-: moi,=�::.>:•.�.4' r:,n_`.-��`;�'� - - :eY3^i:_.:3'1T - ^d -- rte `_. —-•;:ic-"-»ye� - n.F :]:e= •>'„a.i .V P..-lu'_+..._ ,i r - - - - min - +ti _ - .: ........... ..u:.F =y-...sem-.-,•*.:�:_:-,...,:.:_„-,_.;•.-.,.. -- - -'.r•+'��--.;.v::, �J+YII'��1ww1''��II3 - t Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector lies No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) 0 Notified for pickup - Date Doe.Building Permit Revised 2010 Building Department The following is'a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or G.S.L. Licenses ❑ Copy of Contract ' ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or.-Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ iviass check Energy Compliance Report (if Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit ".:.New Construction (Single and Two Family) ❑ Building Permit Application -r+ —0.0 J n 'I i ", ❑ Uelli:ieU r- VW %.1d r L `i'i�tn-. ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the-building application Doc:Building Permit Revised 2008 Location t ISU i2 2 P %��'✓Q� No. � � � V Date . - TOWN OF NORTH ANDOVER • S°iTT DI . • _, Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ � y 5' Other Permit Fee $ eta" TOTAL $ t ' Check# 2761 .7 Bui ing nspector NORTH own of E I. Andover o No. , 61- iq 2Rh ver, Mass, i �� 14 COC NIG MI IN%,- %J %S' V BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT ............................... BUILDING INSPECTOR ............................................................................. � Foundation has permission to erect buildings on .......................... .. .. . ... hV L. .............. �� � Rough to be occupied as . ! .. .. .. ....... .. .Aft&F. 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 UNLESS CONSTRUCT 0 Service STARTS Rough .�'.�:-;':..................................... ""' ""' Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. 3 Oil' DAVID CASTRICONE, PRES. 5 CASTRICONE ROOFING & SIDING INC. ROOFING, SIDING & REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 231 R SUTTON STREET UNIT 3A,NO.ANDOVER,MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In Haverhill 978-374-7314 I/we the owner(s)of the premises mentioned below,hereby contract with and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the following specifications,terms and conditions,on prey se�below/d scribed: Name. �f 3�� Owner's ........Il..1.ZX...C�C).4 :#1 S......................................... `n.�.':'. .tryy ............�elephone#...9.2 ?..t.Y..'-1,d3,� ... MAJob Address.......1....> U44A Dit..................................City.. r..�SLId'R..�'. ..................State.., ...... Specifications: ......................................................... / �...... O..ii 1...... f-0..FS..t....C....(�i).5.. ... ................................ 4�..� L. ?......�..11.J.�fi.1 �!. ......................... ' r `... '. .c�J�.... .�f. l 1 ..... �1' .. .fi.r.� �.... ......................................... .......................................... ,.E. .. .L61 l.t? ..I� S.j.t1 .......:j. .....1,....4:, ' t�..f. tae �;.... .... Y1?ceXe...................... �� u ...............4?�l`� J..l.. : �., ...j.r."t .e.. ..... �.�.1r'.t^..r......../.a G ................ �.: � .�.•t�. r..:..7./t,1.I.t ..1�i�.....f.t' ...;.�+C'.Ga't(.Q!'($i ......... ................................ ,� �-- ..l �..l..l`"1. ...... .. / J..kYf�W rC..v..... l.t.'nY.1. ,.....�1 c�S.. �......c 'tc3: :�"..ia�P t �`... j' ..�e,:F....�...':.�. .....�....C.��.�r�.5��.r.....aea.�e �,- ��"�'�Q.. Five Year Workmanship Watfanty(Not rransffrable) Manufacturer's Warranty al:specific y m ufacturer �U1!k, The ctor a rees o erform the work d fu 'sh s cified above for the SUM $..... ` Q................ g j P �! Pe 1 P gable...:...,1 rid............on..Siz .(...... lac' rJC c, a Payable..........:.�.............on................................. ,;� glance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability w ' bis in operation. Contractor is not responsible for any damage to the interior of property,including pre-existing conditions(i.e.water stains,crumbling plaster,exposed nails)or conditions resulting from application of materials specified above(i.e.objects coming loose from walls,crumbling plaster,exposed nails,dust in attic or otherliving spaces). Items in attic may need to be covered by homeowner.All materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion of above woik,all undersigned agree to execute and deliver to contractor,their joint note in accordance with his(their)above obligation as requested by contractor. Upon refusal to do so,contractor may at its option declare the entire contract price or so much as then remains unpaid,immediately due and payable. It is agreed that,if permitted by law,contractor shall be paid by the owner(s)all reasonable costs,attorney foes and expenses,in addition to the amount due and unpaid,that shall be incurred in enforcing the terms and conditions of the contract and/or any lien in connection herewith.Property may be subject to mechanic's lien if unpaid.It is further agreed that this contract may be assigned by contractor,and also that the obligations hereof shall bind and apply to their heirs,successors or estates of the parties.The undersigned warrant(s)that he is(they are)the owners(s)of the above mentioned premises and that legal title thereto stands of record in his(their) names(s).There are no representations,guaranties or warranties,except such as may be herein incorporated,if any,nor any agreements collateral hereto,nor is the contract dependent upon or subject to any conditions not herein stated.Any subsequent agreement in reference hereto shall be binding only if in writing and signed!iy all parties, All Home Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to the Office of Const`dner Affairs and Business Regulations,Tel.(617)973-8700. Any and all necessary construction-related permits shall be obtained by the Contractor. Any Owner who secures his own construction- related permit or deals with unregistered contractors is excluded from the Guaranty Fund provisions of MGL c.142A. Approximate starting date of work.................................................. Completion date......................................................... Receipt of a copy of this contact is hereby acknowledged,and it is further acknowledged by the undersigned that the foregoing provisions have been read and the contents the understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and understandings of said parties are contained herein. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES This contract may be cancelled,without penalty or obligation,within three business days of the below-referenced date.Mail or deliver a signed and dated notice or send a telegram to Castricone Roofing&Siding Inc,23 utton St.,No.Andover,MA 01845. IN WITNESS WHEREOF,the parties have hereunto signed their n es this. ... :� .day of..HAI- .........,20-A-F.. Accepted: , Signe ..... ..................................... Owner 1 Signed... ......................... Owner David Castricone,President Town of North Andover o N The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name Business/Or anization/lndividual ( g ) I)fkV l D �,A S T21�aNc-� �c�b1=�r�1 it S i D I N G �NC- Address: oZ 1 ,�,u T-ThN S att.i UN i T JA City/State/Zip:N u, A mbN w MA d I N Phone#: 979 t A 3 -3 Are you an employer?Check the appropriate box: Type of project(required): 1.RT I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. El Building addition [No workers'comp.insurance 5. [1 We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12eKRoofrepairs insurance required.]t employees.[No workers' comp.insurance required.] 13.❑Other 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. 0I•i�ll Policy#, or Self-ins.Lic.#: 39 gIC8 Expiration Date: )) Job Site Address: �U�YC'� .��'/ City/State/Zip: /y, 'A'A ve, h4-o 4-�(J/ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certto under ��the pains and penalties ofperjury that the information provided above is true and correct. Sienature: Date: Phone#: q /D 3 3 a0 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#: I Town of North Andover o��t,�o ,bgti� Building Department a 27 Charles Street 10 North Andover, Massachusetts 01845 (10 (978) 688-9545 Fax (978) 688-9542 t p4 °° "w<• ,. SAC DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work sliall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, Sl 502. The debris will be disposed of in /at: Facility location J—, Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project tluough the Office of the Building Inspector. ''cama CERTIFICATE OF LIABILITY INSURANCE Da?E1M1��DD'Vl'YY) 10' ;71):2 , 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), AUTHORIZE[ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 thl certificate holder in lieu of such endorsement(s). 010—UCEa CONTACT NAME:____ Eas?ern Insurance Group LLC - Main PHONE FAX No Exit 508-651-7700 I to+c -.1.78 1-586-8 -44 33':A!es1 Central Street EMAIL Nalick MA 01760 AODRess:' I c rk erninsur nce.com INSURER(S)AFFORDING COVERAGE I NAIC% 1 —0-mmerce I .34754 I'N``0 c0 31969 INSURERS ComMerce & Industry 11a1 DaviO Casiriccne Roofing& Siding Inc INSURERC: estern WorldI e Co Casu icone ;CDiing Inc INSURER 0 231 Rear Sutton Street, Unit 3A -- — PvOr±h Andover MA 01845 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 1701011967 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO1 INDICATED. NOTYIITHSTAN'DING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIEICaTE t•„1AY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLU510N5.�ND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS�,' TYPE OF INSURANCE e POLICY EFF POLICYEXD �7➢ 1NSR WVO POLICY NUMBER MMr00'VYYY MM/OD' YYYY LIMITS LIe31liTv NPP1350515 i6!2013 60014 EACH OCCURRENCE Si,000,000 ''t C Y"J'tERC.r�.L GENERAL LIABILITY I t C ED —i PREMISES iEaeccuriancel 550.000 — ( C!alkls HkDE i X�OCCUR I NIED EXP(AnY ona person) S1,000 = I PERSONAL t ADV INJURY S 1.000.000 I. GEPIERAL i•.GGREGATE S2,000.000 _I'L:GGREG4TE L!^.11??.PPUES PEP.' PRODUCTS COMP-01?AGG .S2,000.000 P UCv PRo. —'-----� S I.�' LC)(! I eU i0RtD31Lc U431LITY B(:NGC..V g1U20i.3 �,),-2014 I n oEaaociderv' $1,0„0,000 :1_r'`'UT:'i I ! DILY IN!URY iPet person) I S -- aL )"VNr1X X SiHEDULED &O I — AUTOS I BODILY INJURY(Pei ac,jem) s DWTOS ,�NUN.06vNED.aU70S I I PPOPE14TY DAMAGE I S ----- I (Peramrienl) -- —I ------ UtBr-File LIAR I I OCCUR i xC cSS LIAS EACHcXG:JRRENCE ! CLAWS MADE AGGREGATE s ' 'DED ! I QE7cNTl[tt.IS S —. "'C;Ki,4L0V-:R 'LI AMT 'V0009989?23 J%23!2013 11i23r20)e VIC.STA Iu ,^ ^�'�L:,Yc;w;'LISBIUTY Y;N nAY I IMI'r I — OP�IETOF= �TNER�ExECu71;E C •=1Ct;3A--'rA"eER EXCLUDED? N'/A E-L.EnGrt ACCIDENT 15100 000 ihte nca��rym N") r-- -- -it cesn��E unJE; i I E L DISEASE EA E&APLOYEEI 5100,000 Jc_C IpT:::uli:rFOPESaitlrlSbeiuw IEL DISEASE POLICY Lc.1tT s500.000 C_SCRI?TION OF OPERATIONS;LOCATIONS r VEHICLES (Attach ACORD 101•Additional Remarks Schedule.It more space is required I i I CERTIFICATE HOLDER CANCELLATION CastriCone Roofing & Siding SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Unit 3A THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 231 R Sutton Street North Andover, MA 01845 4UTHORI2E0 REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserve, ACORD 25(2010:05) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Super%isor Speciulh License: CSSL-099358 DAVID T CAST1g1tONE 31 COURT STREET -(a [ NORTH ANDOVtR 1VIAM_018.5 �-�• Expiration Commissioner 12/16/2015 SCA 1 0 20M-05/11 a �lerrrr.iizanruer<�C�o��C lCu c�c�a.ie%Y �\ Office of Consumer Affairs&Busi6ess Regulation „�, OME IMPROVEMENT CONTRACTOR aegistration: 104569 Type: expiration: 7/14/2014 Private Corporatic i DAVI CASTRICONE ROOFING, SIDING 8 David Castricone 231 R SUTTON ST SUITE 3A _ NORTH ANDOVER, MA 01845 Undersecretary