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Home My WebLink AboutBuilding Permit #418-2017 - 114 SECOND STREET 10/19/2017 L t%ORTh OF y q BUILDING PERMIT ,.CUED TOWN OF NORTH ANDOVER o , APPLICATION FOR PLAN EXAMINATION Permit Not#: 201 Date Received 10 - 1614() 0 qTED SACHUS Date Issued: to ° i - o i IMPO TANT:Applicant must complete all items on this page 0 7L LOCATIONre��' `__ ( int � n PROPERTY OWNER D be ;'I � y ` Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family El Addition ❑Two or more family 11 Industrial El Alteration No. of units: [I Commercial (,C Repair, replacement'- ❑Assessory Bldg El Others: ❑ Demolition ❑ Other � Septic �V1hel1 D Floodplain `Wetlands ;-� 1Nate�shed.Distnct - DESCRIPTION OF WORK TO BE PERFORMED: I-I�dentifica ' n- Please Type or Print Clearly -7 y Q OWNER: Name: 1� �X'� f ��r��✓1 Phone: q7 Address:11 '4 a21st d �W(4-h ��' • 1 I d Gr�� [Home actor Name:.11. �(•� Phone: : dW ss: 3 `j ! �j rvisor's Construction License: � 1� _Exp. Date: l o� `l fo Ex Date: Improvement License: � S� p ARCH ITECT/ ENGINEER Phone: Reg. No. Address: FEE SCHEDULE.BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ rI 0° 03 FEE: $ f0 Check No.: 3 Receipt No.: 3 1 0(o d NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund -lghature. - --- - r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tamiug/Massage/Sody Art ❑ SwiLaming Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature- COMMENTS ignatureCOMMENTS CONSERVATION Reviewed on Signature COMMENTS t - I ,z HEALTH Reviewed on' Signature COMMENTS I f Zoning-Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments I Conservation Decision: Comments I Wafter& Sewer Connection/Signature gate Driveway Permit _ DPW Town Engineer: Signature: Located 384 Osgood Street F,IREDEPAR4TMENTT,emptjD£ umpsteron.sitex,y_es�4,� ted of 124jMain Street t ' ' ,�,cj ° , +'F. , a + _ , •� �U,g 'F Pe Der .r .:i•`si;213x',-.u-< 1 parfinent signature/date i '., •.ft +,eta YY r .4+,.. / r �vzt:,t�f tS f?3r + ,►: -_ {...d'Y'wsif'6 Jw�-•.:f+d.-�l4 c;_h Y+1......`' ....�...�SR. i�.}`Fr._ . Y r t . - r. ;. :ri}- t .a`.i- � :+,�fi t.r•,R_,r 147'1:- -.We •74�41�7f_� �."7�"�'°,��Tt COMMENTS.,. . .�.{W►_.•. ,•,. ;-.. , :;zt,. , , t ,� •- tS�r`�t;��=R+T : 3i 2 , I'I 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 Yes No DANGER ZONE LITERATURE: lies No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA,— (For department use) I I I ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 i r 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 C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All durasp ster 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 ;4. Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) i Building Permit Application Certified Proposed Plot Plan 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 2014 Location 1144 57-04, C Q. No. �t '�Of'� Date �V (p • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 3 s ;� i jBuilding Inspector NORTFt Town of d ndover O No. 2-6t7 4 , ,� oh ver, Mass, f • / 6 COCHIC Nl WKw y1' A�q�1TED S u BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT D • BUILDING INSPECTOR �' 4a.w �T Foundation has permission to erect .......................... buildings on .......... .... .......... ............... ........................ Rough tobe occupied as .......: .�. ....4M.................... .............................................. 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 CONSTRUCTIO TRT Rough Service .... .. .. .... .......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to 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. DAVID CASTRICONE, PRES. 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 premises bellow described: r Owner's Name.....RL Z.D.fZ1' .1Ea4 .LV.l..Yl.r...............................T hone#...f� rt�.:.l•�Q-'-Z.3 Job Address......../..L... .... 1!ti .....(...t J.�. ........................City...1..1.C?... X74 ..e.(..::............State... ...... Specifications: .............................................. ............................................................................................................................................................ / J/ +trip existing shingles. ✓Apply new drip edge to all edges. 1,t1j��Q ... ........................................... ............................................. ......................................................................................................... vl(pply_feet M- membrane to bottom ed..es of house.3 feet in valleys and bottom edges of any unheated areas of house. .............................................................................. ........................................................................................................................................ ,,Apply ftkl papgx rrderlayment. '4t>1T�i cTa ,�}.::.... .. .. .......................................................................................... i ......... t/'Iteroo usin shngles with a_Jn year warranty. . . ...................................................................................................................... Countertlash chimney. ew vent pipe flashing. egal disposal of all debris. ................................................... . 7, ...._.....-----...._-.-.---- Areas)to be worked on: d ..........................................F . ...1, P .e('-...� .�l .... ,............................................................................... kef �J....11. ......Y..a.........�?�... .....L'�.e� .. 1. 1°.exde ....................................................►''Vx}.....L....... e,e. ....1.,5..... .1:1.C. u ... f. 1...Gt—f�.2. .....�.t7..W.V.�.....4 . 1......�.....E.......,C'rr....�� 5.�.t.......................................,............................ Roof board replacement if necessary /sheet or .,_/foot. ................. Five year Workmanship Warranty(Not Transferable) Manufacturer's Warranty as sp ified by ma ufact rer The c for ayes to perf rm the work an t��e materials specified above for the S M of$..... ..0............ l ayablE...42,Q ......on...j$..l•6J [............ Payable.......... ..........on............-- ...............�alance payable on completion of job ......... Owner or Owners are not responsible for Property Damage or Liability while job is 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 other living 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 ofabove woitr,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 fees 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).Thele 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 by 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 Consumer 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,231 Sutton St.,No.Andover,MA 01845. IN WITNESS WHEREOF,the parties have hereunto signed their names this..��7.d.h r day of.0di riQ&J-,20./jp.. Accepted: Signed.. . .. .. ............ ....... .................................. Owner o Signed............................................................................. Owner David Castricone,President "� / The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 kv www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): DAd 1 b L'.A sTf-I( d Nt: i Rl)O F I G c S 1 p Address: A 3 I R 5 0T7( .N S i t GE T V N 11 3 City/State/Zip: hl p, A ml p v MA ) I �`)5 Phone #: cA (o 3 31,� c) Are you an employer?Check the appropriate bog: Type of project(required): 1. I am a employer with 4. E] I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their 11.[:] Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 1 oof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 131-1 Other 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 contractors must submit a new affidavit indicating such. lContractors 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 for my employees. Below is the policy and job site information. Insurance Company Name: 6(ZA N I T E S f 1 L I t j�-) AA N C E Policy#or Self-ins.Lic.#: U lY U 0 3 clz e�-? � 3 Expiration Date: -I -c�3 "off L J (' Job Site Address: I`[ n 1{ C�.� City/State/Zip: 1'l t� . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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. Ido hereby certifyunder the pains and penalties of perjury that the information provided above is true and correct. 5- Signature: - J2 �J- C Date: &I Phone#• US (op 3 3ydo Official use only. Do not write in this area, to be completed by city or town offfciaL 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#: ,aco CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIY 9/27/20166 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 CONS71TUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTA7IVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 endorsements. PRODUCER CONTACT NAME Select Department Eastern Insurance Group LLCPHONE (800) 72-4538 FAX A1C No:781-586-8244 233 West Central St ADDRESS:selectwork@easterninsurance.com INSURERS AFFORDING COVERAGE NAIC 9 Natick NIA 01760 INSURERA.Western World Insurance Co INSURED INSURERB MAPFRE Ccumerce Insurance 34754 David Castricone Roofing & Siding Inc, DBA: INSURERC:Granite State Insurance CO. 231 Rear Sutton Street, Unit 3A INSURERD: INSURER E: North Andover iia 01845 INSURERF: COVERAGES CERTIFICATE NUMBER:14aster 16/17 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 S POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDD LIMITS GENERAL LIABILITY Jun WVD EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE FOOCCUR rBA GL 2016 /6/2016 9/6/2017 MED EXP(Any oneperson) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO'IECj LOC $ AUTOMOBILE LIABILITYi E' axident L 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED r-"7 SCHEDULED BCNGCV /1/2016 /1/2017 AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OX HIREDAUTOS X AUTOS MlED PROPERTY DAMAGE AUTOS Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE $ AGGREGATE $ DED RETENTION $ C WORKERS COMPENSATION V�t:STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X T I I ANY PROPRIETOR/PARTNER/EXECUTIVE ER OFFICERIMEMBER EXCLUDED') a N/A E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) RC003989723 /23/2016 /23/2011 If yes,describe under E.L.DISEASE-EA EMPLOYE $ 100,000 DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) ROOFING & SIDING INSTALLATION 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. BUILDING INSPECTOR 1600 OSGOOD STREET AUTHORIZED REPRESENTATIVE NORTH ANDOVER, NA 01845 John Koegel/MET ACORD 25(2010105) O 1988-2010 ACORD CORPORATION. All rights reserved. INS0251201005).01 Thw ACORN name anri Innn nrw ranicfarwrl markt of ACnpn r��tcv�r nrvrri�•n�/�r. flrr„�ir�u,r//, Office of Consumer Affairs&Business Regulation License or registration valid for individual use only ... before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration: 104569 Type: 10 Park Plaza-Suite 5170 Expiration: 7114/2018 Private Corporation ;:;,;;r•; Boston,MA 02116 DAVID CASTRICONE ROOFING,SIDING 8 David Castricone l 231 R SUTTON ST SUITE 3A NORTH ANDOVER, MA 01845 Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-099358 Construction Supervisor Specialty DAVID T CASTRICONE 31 COURT STREET 13 NORTH ANDOVER MA 01845 Expiration: Commissioner 12116/2017