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HomeMy WebLinkAboutBuilding Permit #125-2017 - 12 HOLBROOK ROAD 8/8/2016 �) rl] BUILDING PERMIT NORTH V l O��j,e o 6��O TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION lPermit No#: 7 Date Received �,9A�R�reu f SSACHU`�� Date Issued: 1 I PORTANT: Applicant must complete all items on this page LOCATION I �� f Print PROPERTY OWNER eu l as le Print 100 Year Structure yes no MAPPARCEL: ZONING DISTRICT: Historic District yes . no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE II� Residential Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: I, ❑ Demolition ❑ Other Ei Septic D Well Floodplain ❑Wetlantls 'I ❑ Watershed Distract DESCRIPTION OF WORK TO BE PERFORMED: s't 1 I JO Identificat7j�� Please Type or Print Clearly OWNER: Name: t l it l&I ► (� Phone: Address: [ ��u trbU lG 66k-,e) y oY Contractor Namel- nYi rr�Ce_ �o�i �q tai�Phone: S7� (A 3 01, U Email: dCx r 6 Address: H)4- 0 J F Supervisor's Construction License: q�-(�� Exp. Date: I a -.t (o -,�Q (7 Home Improvement License: Slocl Exp. Date`. ARCHITECT/ENGINEER Phone: fl 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: $ q:J'� , �c6�, FEE: $ �_ Check No.: �qq� Receipt No.: '46 NOTE: Persons contracting with unregistered contractors do not have access to the uaranty fund 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. ❑ Pennanent 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 Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments r� , Conservation Decision: Comments e Water& Sewer Connection/Signature& Date Driveway Permit -PW Town Engineer: Signature: Located 384 Osgood Street FIREDEPA TMEil1T �rnp ®urnpster ositees' . ,y =� z ; n'o "=xex# Located'at 124 Main Street ° d+" :. 3a 'Iii+ae+:� Fire TDepartment si-gnature/date S « •y 'r ,Y s+.� t' � t .s.:4M �� R S�� "` .i v b� t 4 �� #z i Dimension Number of Stories: Totalsquare feet of floor area based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL; Movement of!deter 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) i ® Notified for pickup Call Email Date Time Contact Name Doc.Bnilding Permit Revised 2014 is 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 Permit Building Per Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses 4. 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 Addition Or Decks Building Permit Application Certified Surveyed Plot Plan 4. Workers Comp Affidavit 4 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 I 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 1 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 i - / ;Location . Dated f �y"" • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ w TOTAL Check#! / t' i Building Inspector 3071 E pORrN q ` Q ,,to �° N O N y p Town of North Andover D.B.A. —Zoning Compliance Form "ssgc►+uss��y 978-688-9545 v This form must be reviewed with the Inspector of Buildings. Office Hours are Monday-Friday 8-10 am,and 1-2 pm Monday-Thursday. Applicant Name: link, C6ssdU Name of Business: ArSluin�_�-f a Y3f Addres's of Business: 1?d Zoning District : Map Lot Phone: Email 0' � rrml CCh'f Nature of Business 1 �n �E l CSYI Do you own this property? Yes ;/ No If no, written permission is required from your landlord. Will you have clients coming to this property? Yes No Will you have any employees? Yes No i✓ Will you have any major deliveries? Yes No Description of Business Activity (Must be Completed) h ipce_L C0rnPJ1CAnL 0 utIOn Signature of Applicant For Signage Refer to North Andover Zoning Bylaw Section 6 The proposed e i allo ed e in this zoning district. Issued B Date ;y North Andover MIMAP March 29, 2017 016.079029021.0-0014 021.0-0016 29 HAMILTON RD h 016.0-0035 44" 016:0 003.Of, 021.0-0017 0,16.0-0034 28 HOLBROOK RD .. s ^� 21 HAMILTON RD 1 016.0-0036 ` 20 HOLBROOK RD 016:0=0033 r' f1.HAMIL-TONAb m; J. as w..R 016.0-0037 z° 4.' 4' x . . °NL 021.0-0020 O16!0 .0032 to 12 HOLBROOK RD MASSACHUSETTSfAVE �° 272 (016.0;0038 \ / 4.HOLBROOK RD y 021.0-0041 • 15 HOLBROOK RD 6 - • 9 S �saCh 016.0-0039 308 MASSACHUSETTS AVE Sr 016 U05 4P� 95 016.0-0041 ,016:0=0051'' E]MVPC Bo Zoning Overlay Zoning [i Municipal Boundary [3 Adult Entertainment Distric Busim s 1 District 0 Machine Shop Village Ove C Busine s 2 District Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Rail Line 0 Watershed Protection Dist Y Busine s 3 District Meters Data Sources:The data for this map was produced by Merrimack Interstates El Historic Mill Area O Busine s 4 District AORTFf Valley Planning Commission(MVPC)using data provided by the Town of Interstate []Medical Marijuana O Gene Business District Ot+t�t o , 4tip North Andover.Additional data provided by the Executive Once of —Major Road [3 Downtown Overlay District ®Planne Commercial Dev t +e Environmental Affairs/MassGIS.The information depicted on this map is Roads 0 Historic Distdct 0.i Corido Development Dist ,�.� " OL for planning purposes only.It may not be adequate for legal boundary Osgood Smart Growth(40 R Corido Development Dist O - A definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER ,Easements Hydrographic Features R Corrido Development Dist �' A MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING ❑Parcels Industri 11 District 4t - * THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY Streams , Industri if2 District * c * OFTHESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT f3 Industri 13 District Wetlands 11 ndustri I S District o'q �+ # ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF Exempt Lands Reside ce 1 District •ti °++.... 'y.(5 THIS INFORMATION q r�o Reside ce 2 District $$A�Hu§E tE Reside ce 3 District dei ce 4 District 1"=50 ftode ce 5 Distric " Y de ce 6 District ,,,oge esidential District NORTfi '9 Town o _ s ndover No. ♦ _ a L�K, h ver, Mass, coc«ic«ewrcw 1' A_ o S U BOARD OF HEALTH Food/Kitchen PER IT. T LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ........... .... .. 1. . ........ .. .�r� ........ ....... . ....... . .... .. . .... ..... Foundation has permission to erect .......................... buildings on ....1z......... .. �... ..... . Rough tobe occupied as ....... .. .. ...... �. �. .. ........................................................................... chimney provided that the person acceptin�this permit shall in ry respect conform to the terms of thea application pp 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 CONST; TION T S Rough Service ... .... . ..... .. ....... ...... ........ Final BUILDIN SPE TOR 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 CASTRICONE ROOFING&SIDING INC. ROOFING,SIDING&REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 1 ""UTTON STREET,SUITE*26,'NO.ANDOVER,MA 01845 O� In North Andover 978-693-3420 In Boxford 978-887-6147 In Haverh U1 9 78-3 74-7314 Uwe 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 below scribed: Owner's Name...S r... Y I .��)..... /. � ...�L?�i....�.. :..................... ...T phone#...... � .. L. ..... Q.... ....�11.G1 ..1,.... �.Vf_ . . .....State....a.........City.. ... .......Job Address..... Specifications: L ............. ............................................................ . I................................."Areas to be covered: .......... ZApply vinyl siding and corners 'Type: .....Q.r- 31)"GS�kt�..1. ...../... 6!� .. tit over fascia boards and rake boards. nstall vinyl soffit - solid / perfora e ( rC' .. .......... ...... .....around.... ...w.... ... ............ ........... ..ep. ..lace......an..Y g. ....able... .vents............ ..dryer. .........vents......with........viny1. ..... ........................................... over..wood.... casings.. indows... .. .. t,..1'tand.... v�pply uaderlayment. Type: ---T-- ........................................... �.. .V. �'.i 1ktCL' ..W�Sca. lJktr...•./G. ..... ✓Ezisting siding stripped go-o Ir I Si egal disposal of 11 debris. ............................................. ..f.................... ....... ............ Rotted.wood replaced taY /sheet oto � ,�.s ((JJ �. n � G d let ............................................................................................ XLe-p-, C-4 A...0-r-..I7 7 FF �.............................. One Year Workmanship Warranty(Not Tra> erable) ILlanufacturerWar oty as spec' y mant�actnr�, The tractor agre s to rform the work d lythe materials specified above for the SU of$...... . ^+\. � Pa abl i ff•r•go. ...... q F� 1 Y ;v? Gtr........on..SJa i-......... Z.. �.alance Payable.........-- ...............on.......::. ":............... payable on completion of jOwner or Owners are notresponsible for Property Damage or Liabilitys in operation: Contractor is not responsible for any damage to the interior of property,including preexisting conditions(i.e.water stains,crura t g p as ,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 oth r living spaces).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,contractor may at its option declare the entire contract price or so much as it=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.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 us 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 gball be registered and any inquiries about a contractor or subcontractor relating to a registration should be diriectedto:Director,Home Improvement Comrae:or Registration, One Ashburton Place, Room 1301,Boston,MA 02108 Tel:617-727-8598 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 co is excluded from the Guaranty Fund 1�ovisioqs of MGL c.142A. i Approximate starting date ofwork.r.�. 5¢.?,,.,,��V6,,, Completion date ,ty y((lau�, Receipt of a copy of this contact is her ack wledged and it is further acknowledged b the undersigned that .provisions have been read and the con y the foregoing/ tents 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 f cancellation). // IN WITNESS WHEREOF,the patties have hereunto signed their names this..l.; day of....tl.i A/ ...........20...f 6. Accepted: _ � , Signed......24."aeg.... ............. Owner Signed............................................................................. Owner David Castricone,President The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 t Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): -!°AV i T) C-AS-19 1 C&NE Rnc,F i N c� i.D iKJ i MC. Address: -'>I E 0(\%N- 6 A City/State/Zip: IJ0. A N b0 41~L NA 61 6 4 S Phone #:3 79 .6 93-3 Yd-0 Are you an employer?Check the appropriate box: Type Of project(required): II am a employer with _employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in S. ❑Remodeling any capacity.[No workers'comp,insurance required.] 9. F-1 Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 E]Building addition ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t Other S I,UI 1.�C 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 1// `` 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. 3Contractors 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: ( A N 1 Tt JT R-T J rc/-N N C l= Policy#or Self-ins.Lic.#: CU 6 3 q 2 9 7A :S Expiration Date: ci .1A3 `1Zc 10 Job Site Address: [ C), `k ry)k- RA City/State/Zip: 01). QoL\xI 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 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.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 andpenalties ofperjury that the information provided above is true and correct. Sinature: C Date: Phone#: L3 3 q dU 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#: ,acoCERTIFICATE OF LIABILITY INSURANCE DATE(M9/28/22015015YY) II 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(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 the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Select Dept. NAME: P Eastern Insurance Group LLC PHONE (800)333-7234 x66807IAIC,No (761)566-8244 233 West Central St E-MAIL ADDRESS:selectwork@easterninsurance.com INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURER A Western World Insurance Co INSURED INSURER B:Commerce Insurance Company 4754 David Castricone Roofing & Siding Inc. INSURERC: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 ADDL SUER POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDrYYYY) (MM/DD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 }� COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence S 50,000 A CLAIMS-MADE �OCCUR P1404373 9/6/2015 9/6/2016 MED EXP(Any one person) S 1,000 PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 }{ POLICY PRO- LOC S AUTOMOBILE LIABILITY EOMaBINEDt SINGLE LIMIT S 1,000,000 BANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED CNGCV /1/2015 /1/2016 AUTOS AUTOS BODILY INJURY(Per accident) S Ix HIRED AUTOS }{ NON-OWNED DAMAGE AU70S Per accident S 5 UMBRELLA LIASOCCUR EACH OCCURRENCE S EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEC J RETENTIONS S C I WORKERS COMPENSATION STATU- TH- Y AND EMPLOYERS'LIABILITY YIN X WC O FR ANY PROPRIETOR7PARTNERlcXECUTIVE OFFICERlMEMBER J(CLUDED? � NIA E.L.EACH ACCIDENT S 100,000 (Mandatory in and E.L.DISEASE-EA EMPLOYE S 100 000 Ryes.DESCRIPTION OF C003989723 9/23/2015 9/23/2016 DESCRIPTIO\O�OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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, MA 01845 John Koegel/KH3 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 oninn5)m Tho A(()P 1--ma nnri Inns zra ranicfar&H mar4c of ARflPn Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-099358 Construction Supervisor Specialty DAVID T CASTRICONE 31 COURT STREET NORTH ANDOVER MA 01845 (�.nn Expiration: Commissioner 12/16/2017 ... �.��rfrr.iir it<rirrrlvr�/�r• ��ILL;ni�rr.iC//; Office of Consumer Affairs&Business Regulation ;; .:• HOME IMPROVEMENT CONTRACTOR o Registration: 104569 Type: Expiration: 7/14/2018 Private Corporation DAVID CASTRICONE ROOFING,SIDING& David Castricone 231 R SUTTON ST SUITE 3A _ NORTH ANDOVER, MA 01845 Undersecretary