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HomeMy WebLinkAboutBuilding Permit #344-2016 - 118 MARBLEHEAD STREET 9/17/2015 BUILDING PERMIT o� NORTH 6w. ,q t.ED Iby"IO TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION * _ Permit No#: W/� Date Received �, oR 4q<oc gSSACHUs�� Arev Date Issued: NJ/ IMPORTANT: Applicant must complete all items on this page LOCATIONul CC Pr'fnt_ PROPERTY OWNER J��►'�- 1� �X�I P.( Print 100 Year Structure yesno MAP Q PARCEL:�� ZONING DISTRICT: Historic District yes no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential NNI ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial t�Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑ Well ❑ Floodplai.n ❑ Wetlands 0 Watershed District El Water/Sewer _ DESCRIPTION OF WORK TO BE PERFORMED: S W aaq 0� kmA-t— Identificatio Please Type or Print Clearly OWNER: Name: .SUz�c �Pf-� t(- Phone: qlt Address: 9 MokbI Q LAi S+- IvoLL,�� MA- 0 Contractor Name: ed5f-�L"Rw �-&Q";i4Phone: Email: Q re Z Address: I Supervisor's Construction LicenseG�� - 6 Exp. Date: (5 Home Improvement License: 0 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ k g p o t FEE: $ Check No.: ?Md Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the uan�nty fund _ _ I �I 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 dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 1 Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit j Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract 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) 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 Doe:Building Permit Revised 2014 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped !Tans ❑ 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS i I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS I T Aning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafter& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: ,. Located 384 Osgood Street SPAR -r §- - - r FIRED ; ���„Ternp ®umpster ora te,.y s? .' -z Located a{ �Main Street, _ : S f�t ' ' t�+` t r +- N5 ` Ferre De .-� pa-rtmens:gnafure/date b _ COMIVIENTS�- .� F = y 1 Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I 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 I l NOTES and DATA— (For department use) Notified for pickup Call Email Date Time Contact Name ....._.........--................ ...... ---- ------------ -- —— - ! Doc.Building Permit Revised 2014 Location No. "T`'t —Z��� Date . = TOWN OF NORTH ANDOVER Moa Certificate of Occupancy $ Building/Frame Permit Fee $lv :- Foundation Permit Fee $ Other Permit Fee $ aTED� � TOTAL $ Check# � k" 293-66: Building Inspector NORTH own of E ndover 'A No. - �` yver, Mass oO1.NIC Ch ��A°A.,TE� ►`PP��(5 s U BOARD OF HEALTH Food/Kitchen PERIT ID. Septic System 1 �. t. .�.,.,,., , . . BUILDING INSPECTOR THIS CERTIFIES THAT ........... ...�14.Z..... r............. .... ........... ......... ....... � � � Foundation has permission to erect ...... buildings on .. 1.g .................... ..... . ..... .... .... Rough tobe occupied as ..................... ..� ........ ..... ............................................................. Chimney provided that the person accepting this pe it 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 b UNLESS CONSTRUWMvwi &���NlTS 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 [/we the owner(s)of the premises mentioned below,hereby contract with and authorize you as contractor,to famish 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: Owner's Name. ..s.�.L::� �..ii-le.......J \ yd' .�' ............................................. .... .....t..r'�,.....-/.^C.0 'I'plaphone Job Address....j..�. 1..`t:,, .k'`.�T .La-. .... .t r..............City... ;::'.i...1. .F1„zl:.h`.N.l.`................State.. ...... Specifications: VStrip existing shingles f I/�fply new chip edge to all edges. Lief i Ut> Yi it �..................................................................................................................................................................................................................... t/Apply Cc> feet ice and water shield membrane to bottom edges of house.3 feet ice and water shield membrane in valleys and bottom edges of any unheated areas of house. t� 1 11,/ m•z;ycblcz yv. 0l JL4b �/' !'(')t7 5, .1.....................................................................................•....... T................................................ x......................................................... vApplyefelt pa�erqqur*IW,erlayutent.r Install ridge vent to_ )`���cy � l�YA�l9. tL.C.:0�'- ........ .....................;/....................................................................................................... �/heroof using (MAF f rYWD shingles with a ')o year warranty. ............................................................................... . ....................................... . . New vent pipe flashing. •Legal disposal of all debris. s, �1..:'...........................................................................�.. !`)Z` .........t..d? ..�. C .3,f ..'4e.l.o. ................................:................. Areas to be worked on: t.................................. t....: LI..KJ. ... d?`.'... .:�`r < I.�t.. :.R...................... i /...1.�a1�EG..; .. :...�rY IxYi.k) GtlrUsd.I'/1Yt..C�GyC�Ct,rff'i.+ ' wt. ` h :..... J` /. lvt ! .......l.tz... r�.r�.'.c..i'.. t�-1..4j .' -�/k1.f�1�:.Gt. y�. Y✓..(y�c',�`...f'G�Li,t••............. L.r. .. C I �°tu bi`,r�iwt� t .... z c+.(`..'...... 5��!. l.t: � X ........................................................ .. ?........................................�::1t_. Roof board repl,tcementitnee scary (,�j /sheet or /toot./�5 1f ����N .r� � jYYG ....................................................................................................................................................•............................................. Five Year Workmanship Warranty(Not Transferable) Manufacturer's Warranty as spepiftei y man— ufe_Hure The c actor agrees to perform the work fsh the materials specified above for the S of$..... .a�.g.G'.... -' .......on.3i r..:................. Payable.............................on...........: alance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability whiie-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 work,all undersigned agree to execute and deliver to contractor,theirioint 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).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 by all parties. All Home Improyeme;tf Contractors shal(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 allpecessary 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.: r..... tr: .....l.,... ...... ompletron date........................................................ Receipt of a copy of this contact is acknowledge and it is further acknowledged by the 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 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 R Sutton St.,No.Andover,MA 01845. IN WITNESS WHEREOF,the parties have hereunto signed their names this....,.0.......day of�' {� �20.. ..... I_ J . Accepted: Signed.......::....................... .... ................................ Owner Signed Owner ................................................................... David Castricone,President The Counnonwec llh of Tfassachud,eas Departinew of Industr iat Accideflls Of lCE' of hwestig tions R.V>_-V 117=771 r /00 I-Vashinaton Street Boston, AL4 02111 1V iV DV.11lass.fgolrldia Workers' Compensation Insurance Aff da✓it: Puilde>i•s/Co>inti-actor•s/Elecei-icians/Plumbers kpplicant Information Please Print Legibly NTame (Business/organization/Individual): 'N'ti t* 6 l.t S l ( (. address: 3 I S-{J� S 1L (A (/�( 3A :ity/State/Zip: . Nu AY\ ili� MA O?K Phone #: re you an employer? Check the the appropriate box: Type of project (required): I am a employer withy 4• ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6_ ❑ New constntction 1 am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling These sttb-contractors have ship and have no employees 8. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. inst.trance.t required.] 5. ❑ We are a corporation and its l0.❑ Electrical repairs or additions officers have exercised their 1 am a homeowner doing all work o11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12." Roof repairs insurance required.] t c. 152, ](4), and we have no employees. [1,4o workers' 13.0 Other COMP. insurance required.] I applicant that checks box#1 must also fill out the section below showing their workew compensation policy urformation. meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tractors that check this box must attached an additional sheet showm2 the name of the sub-contractors and state whether or not those entities have oyees. If the sub-contractors have employees,they must provide their %Yorkers' comp.policv number. rt an employer that is providing workers'compensation insurance f or nttr emplovees Below is the policv and job site rrmatfotl. Trance Company Name:���CM! cy # or Self-ins. Lic. M we oo7 9 on '? �-3 Expiration Date: 7 '/ Site Address: (Q 1 .j 1711 f6"d is+ City/State/Zip: No A-Aktq , Ilu ach a copy of the workers' compensation policy declaration page (shoNving the policy number and expiration date). Lire to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 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 !p to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of 2stigations of the DIA for insurance coverage verification. hereby cerci v_ dex exams and penalties of perjtery that the in ormatioti provided above is trite and correct. nature: Date: rite #: VI 1� X. Off-tial rise only. Do not write-in this area, to be completed by cit), or town o-ciaL City or Town:_ Permit/Licoise # issuing.Authority (circle one): 1. Board of Health 2. Building Department ,i. City/Town Clerl, 4. Elecirical inspector 5. Plumbiog Inspector ACORU CERTIFICATE OF LIABILITY INSURANCEF9/9/2015 DATE(MM/DDiYYYY) 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 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WANED,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 endorsement(s). PRODUCER GN%ERCT Select Dept. Eastern Insurance Group LLC PHONE . (800)333-7234 x66807 FAX (781)586-8244 233 West Central St E'NML .selectwork@easterninsuranee.com INSURER(S)AFFORDING COVERAGE NAIC 0 Natick MA 01760 INSURERA.Western World Insurance Cc INSURED INSURER B.Commerce Insurance Company 4754 David Castricone Roofing & Siding Inc. INSURER C.Granite State Insurance Co. 231 Rear Sutton Street, Unit 3A INSURER D: INSURER E: North Andover MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER-CL159964794 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER M LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DA AGE PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE Fx—I OCCUR rBA GL 2015 /6/2015 /6/2016 MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 7X POLICY JECTPRO- .LOC $ AUTOMOBILE LIABILITY COMBINED LIMIT11000,000 B ANY AUTO er person) $ AUTOS ALL ED X SAE�DULED GCV /1/2015 /1/2016 eraccident) $ XHIRED AUTOS XNON-OWNED GE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ C WORKERS COMPENSATIONX WC STATU- 0TH AND EMPLOYERS'LIABILITY YIN — ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100 QOQ OFFICERIMEMSER EXCLUDED? NIA (Mandatory in NH) 003989723 /23/2014 /23/2015 E.LDISEASE-EAEMPLOYE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below 003989723 /23/2015 /23/2016 E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Roofing & siding contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John Koegel/KR3 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r7ntnnsi nt Tha htlnpn n2rna nnA Inn^oro nanHcfanarl nurka of Aflmn Massachusetts - Department of Public Safety Board of BuildingRegulations and Stan dards C,n�trucriuu suhcn)Nm-SliciiAIN icense: CSSL-099358 J DAVID T CASTRICONE 31 COURT STREET NORTH ANDOVER RZ#0 I8 5 =xpi=anon Commissioner 12/16/2015 =Office of Consumer Affairs& Business Regulation RIQ i HOME IMPROVEMENT CONTRACTOR 1 E egistration: 104569 6 Type: ration: 7/14/2016 Private Corporatic DAVID CASTRICONE ROOFING, SIDING& David Castricone 231 R SUTTON ST SUITE 3A NORTH ANDOVER, MA 01845 — Undersecretary North Andover o� < �° 6 �o r- Building ]�epart�ent � '�� �� • Ch LrIes Street sects 01545 •o,,i, �.dov 954 Fax ) er; Massach y�R '?�) bRR- � .cs.vc�use i DL-BRIS DISPOSAL FOI��'1 ``,`• �e �N•th rJ�e prov�s1ons of MGL c .0 s 54, and a condition o[ sl -- the dehns resulting from the wort:lie 11 be. disposed l,censed sold waste disuosal facility as defined b I. he d�srosed of in .at GL facility iocar.!on N Signarure of Apohi ant DG'e I SOT dcmoi,, o rer�ui &oIn IIIc Town of Not?h Ar:duver must 'oc obta ned for t?vouch the OtTce of the Building Inspector A: �e k