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HomeMy WebLinkAboutBuilding Permit #714-11 - 115 VEST WAY 4/25/2011 BUILDING PERMIT °* AORTH q �Squto,1, �O TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION e" Permit NO: �x� Date Received Date Issued: o? / IMPORTANT: Applicant must complete all items on this page LOCATION_ It 6 Ve4i aw �or+k Anda it/ Print PROPERTY OWNER c luL6 t- Pdnt MAP 210 16H.'8 PARCEL: 0/-61 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial ✓ Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: t% and r Inc o-j a Identification Please Type or Print Clearly) OWNER: Name: 11441 CAA 6t Phone: 1617.561 di /I Address: Veil- W Ner44, Ardortr. MA-- 01841 CONTRACTOR Name:( -vt tONGPoo PtNtr! Jib/Nr Phone: q78 („93 V2-0 Address: 200 tSU`I E00 STr-ttd . Eu IT-1 ZZ-G k 01 '!— Supervisor's Construction License: Qq Exp. Date: I Z• I L .Zo i Home Improvement License: Racl ..Exp. Dater 2.0/Z ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSSTTT BASED ON$125.00 PER S.F. Total Project Cost: $ 79 6 0• a' FEE: $ !i� Check No.: 100-4-- Receipt No.: 4V f � NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor 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 i THE FOLLOWING SECTIONS. FOR OFFIGE,USSE"ONLY INTERDEPARTMENTAL SIGj1 60---1 FOW" DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS ~' CONSERVATION Reviewed on Signature COMMENTS ; �.� '� b ig 1.14 i i IS i ! .,,•e ♦ ..,P, w .i �'�3 tyZ1 Q' •�Jr �v f'. it HEALTH z Reviewed on _l Signature COWENTS j 1 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: Signature: ._ Located'-�384*Os ood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.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 C.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 ❑ Floor/Crossection/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 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 ❑ 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 ❑ 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 LocationT,4_, No. — Date 4 NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ *'�s'••'°'tt�' Building/Frame Permit Fee $ J�cMus / Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ) 24 1 4 6 Building Inspector DAVID CASTRICONE !,r u- w CASTRICONE ROOFING& SIDING INC. ROOFING,SIDING&REMODELING REPLACEMENT WINDOWS . HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 200 SUTTON STREET,SUITE 226,NO.ANDOVER,MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In HaverhX 978-374-7314 APR 2011 Uwe the owner(s)of the premises mer.ioned 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 below described: ,nor -anis Owner's Name...../W.4.&...i lia( a .......................................................................Telephone#.........................,........................ Wityv Lir- .........State............JobAddress ...............C ... .. °`? :.. .............{............................. Specifrcal.— w, ut` I k......... ......... ..........................................•....................................................................................... ,......... . ........................................ Str�xisting shingles. Appiy new drip edge to all edgM .............I.................................................................................................................. .....................................................................I............ Apply C, feet ice and water s`tield membrane to bottom edges of house. 3 feet ice and water shield membrane in valleys and bottom edges of any unheated areas of house. *_ h`// Aewtbl?+.ve- 04 4,e,- Swt M-C-w fit. .............................�............................................................................................................................................................I..........I............. Appl elt palBer.pnderlayment. Install ridge vent to uc�i oo,r.t f2!:1 v20+-r /....77..11w�.................................................................... .................................................................................................. Reroof using „h�c'id ��rmeydG �hi��T'�j shingles with a 3© year warranty. .............................................................................................................................................................................................. Countflash chimney. New vcp(pipe flashing. Legal disposal of all dPfrs. r........................................ .......!....3.:'.... ..........................................✓...................................................................................... Area(s)to be worked on: t �%........fl..�....;.� ....1. ArrZ5...............t ...,:. �1 :.... t ., &6 ihc✓dL , eroi � . ....... . ?. J�r1... ^^ . 011 w/, •.�cL r �.�?- shre�cf .............. ... x..................... ...................................................................................................................................................................................Z/..................c............ Roof board rep!acement if necessnry@ ivy/sheet or /foot. Ai-A s �L F� c� J ar ................................................................................................................................................................................................ Two Year Workmanship WarrWy(Not Transferable) Wanufacturer's Warranty as specified by manufagtuYer The contractor agrees to perform the work and furnish the materials specified above for the SUM of$........ Y...O...V............... Payable.............................on................................. Payable.............................on.................................. Balance 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 damagc 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 covend by homeowner.All materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion of above work,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,eontractot 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 s"all be paid by the owner(s)all reasonable costs,attomey fees and expenses,in addition to the amount due and unpaid,that shall be incurred in enforcing the terms and;ondifons of the contract and/or any lien in connection herewith.It is further agreed that this contract may be assigned by contractor,and also that the obligations here:4shall 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 incr.rporated,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 r Terence 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:Director,Hoine Improvement Contractor Registration, One Ashburton Place, Room 1301,Boston,MA 02108 Tel:617-727-8598 Any and all necessary construction--,elated 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..... .1� : ....)il. ....G.�.... .C1r? � Receipt of a copy of this contact is!:ereby acknowledged,and it is further acknowledged by th undersigned that the foregoing . provisions have been read and the contents thereof 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 Owner has three business days to cancel this contract and incur no penalty (see notice of cancellation). , IN WITNESS WHEREOF,the parties have hereunto signed their names this...�.v.........day of........ `:......... ,20..(.� Accepted: 1 Signed../... .......C"L-Jt- .................. Owner C.. Signed............................................................................. Owner ...................................................... ..:.......... David Cas tricone,President ORTH TO" of . _ 6Andover No, / -K O dower, Mass.,_q A_ �COCMICMEWICK , ADRATE D P'P�,��Cy `S U BOARD OF HEALTH Food/Kitchen Septic System .PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT........ ...... . ..........6^6r................................................................................................ Foundation has permission to erect.................:...................... buildings on ........IT .V.40M.......0jo. ........... Rough to be occupied as.............. .. .. !!'r....... .. .. ............................................................. ............... Chimney e provided that the person ccep g this permit s all in every resp conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relatin 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 46 ' UNLESS CONSTRU O ST S ELECTRICAL INSPECTOR Rough . 7 Service BUILDING INSPECTOR 1, Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts I Department of Industrial Accidents 1 Office of Investigations 600 Washington Street Boston, MA 02111 *f W, www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): .NV I D CASTrtfCONt PO O F t M- -i sib/N(r INC. Address: 2C) C) Sv TTo o SjRr E—t SU r r& 22-(0 Ci /S f 1 �{ ,3 2 c' tate/Zi : N o. �N 1)0��� ti A d S Phone #: q�$ b�3 'I tY P Are you an employer?Check the appropriate box: Type of project(required): I.® I am a employer with 4. ❑ I am a general contractor and I . 6. E]New construction * - have hired the sub contract employees full and/or part-time).* ors ( P ) 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers'comp. insurance 5. ❑ 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 12.[M Roof repairs insurance required.]t employees. [No workers' 13.❑ 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors a»d 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: A(2 A Policy#or Self-ins. Lie.#: 1�C(�d`�3 97a3 Expiration Date: q Job Site Address: / Ves City/State/Zip: No.AndenC! N- 01HS ((f Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requited 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 fonn 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 certify under the pains and penalties of perjury that the information provided above is true and correct.' Signature: - �'^"✓ �J ' - Date: Phone#: q17% (1%3 J4;10 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): I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: .11;u�ailuurtl� - Urii;u'liitrnl ul Puhlir 1uFct� � l / t Buartl ul' liuiltliu,� I�r ulatiun-s anti Sl: ndal-lb, of'c Tsuln,.iuAnlirs /r less .d�u latioll Construction Supervisor Specialty License 1lttire of Cuusumer A1lsiirs 8e lii�.iucss Rcgulxtiou HOME IMPROVEMENT CONTRACTOR License: CS SL 99358 yRegistration'. 104569 Type: Rest6cled to: RF,W5 yrs"" .,;, r. Expiration: 7114!2012 Private Corporalio` DAVID CASTRICONE rizF:.l.:M', . DA" ID CASTRICONE ROOFING,.SIDING 8 31 COURT STREET NORTH ANDOVER, MA 01845 . . Y, David Castricone 200 SUTTON ST SUITE 226 NORTH ANDOVER, MA 01845 llndci�ecrctury Expuatwn: 12/16/2011 t uuui..i iiw Tm: 99358 V ACORD„r CERTIFICATE OF LIABILITY INSURANCE 9/24/2010YY' PRODUCER Phol'ie: 508-651-'?700 Fa,_: 508-653-8089 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC -Commercial Lines ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Natick MA 01760 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED I14SURERA:C1 at'on Insurance- 40274 David Castricone Roofing & Siding Inc 200 Sutton St uvsuRERB:CHART IS Suite 226 INSURER C: N::Il:th Andover MA 01845 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW --AVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOP. THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, PERM 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D POLICY NUMBER_ POLICYEFFECTIVE POLICY EXPIRATION LIMITS GENERALLIABWTY EACHOCCURRENCE $ _ DAMACETORENTED COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurence $ CLAIMSMADE 0 OCCUR MEDEXP(Anyone person) $ PERSONAL BADV INJURY $ GENERALAGGREGATE $ GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPIOPAGG S POLICY JECTPRO- LOC A AUTOMOBILE LIABILITY BCNCCV 8/1/2010 8/1/2011 COMBINED SINGLE LIMIT $1, 000, 000 1 000 000 ANYAUTO (Eaacciderd) r r ALLOWNEDAUTOS BODILY INJURY X SCHEDULEDAUTOS (Perperson) $ HIREDAUTOS BODILY INJURY X NON-OWNEDAUTOS (Peiaociclem) $ PROPERTYDAMAGE $ (Per aoddern) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO OTHERTHAN EAACC $ AUTOONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACHOCCUFIRE14CE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ S B WORKERS.COMPENSATION AND WC003989723 9/23/2010 9/23/2011 X WCSTATU- OTH- EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACHACCIDENT $100 000 OFFICERfMEMBEREXCLUDED9 E.L.DISEASEEAEMPLOYEE $10 0 000 Ilyyes desaibewrder SPECIAL PROVISIONS below E.L.DISEASE-POU CYLIMIT S 5 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED David Castricone Roofing & Siding IncBEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER g g WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE 200 Sutton St CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO Suite 226 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY BIND UPON North Andover MA 01845 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 2S(2001108) pACORD CORPORATION 1988