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Home My WebLink AboutBuilding Permit #82 - 146 MIDDLESEX STREET 7/31/2008 NORTF/ BUILDING PERMIT o� ,""D 16qti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received _ ��SSACHUS�� Date Issued: 3 IMPORTANT:Applicant must complete all items on this page LOCATION 141& Rlddluex ?N'(!l Print PROPERTY OWNER �a e e hri c f Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no 0 d !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: Sir-10 refAi6g t/aby i left idej d( u�l/y loA� side, 01 vOgef ma,n rte a�' Identification Please Type or Print Clearly) OWNER: Name: i3o 6 Se thr, st Phone: q 7J q(o d Address: /y (o 1qldd1tfeY Jfieet AbtIq AAS/fives CONTRACTOR Name: .Ofiitn(unp #OhAE Phone: k 61,3 3yd-O Address: 6 0 So tAn S1 �w& Z-2-L, Raaf- Aa-tau x,-. k A 01 Yr p cl 9 MExp. Date: �', 07011 Supervisor's s Construction License: Home Improvement License. D'-J Exp. Date: r7liqaUl " 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. Uv Total Project Cost: $ -716 U FEE: $ Check No.: v2 I a Receipt No.: NOTE: Persons contracting with unregistered contractors do not Tuve access to the g I^anty 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 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS 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 Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood 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) 0 Notified for pickup - Date Doc.Building Permit Revised 2008 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 u 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location &Z No. Date �oRTM TOWN OF NORTH ANDOVLR Certificate of Occupancy $ �'�s'••'°' US E Building/Frame Permit Fee $ — AC M Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Lollr 2 i t� Building Inspector { j iss Date..s. ...........`.............. t NORTH 1 °f�"•°;•_'"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ............................................................................................. has permission to perform ?^-*!. .................................................. wiring in the building of..... �f��'-��............................................ at.�yi ."..... ` ................. —..= ....... ,North Andover,Mass. x ao , Fee''l............. Lic.No ELECTRICALINFIC, fOR i irCheck # o� E Jul 05 06 12:31p NORTH RHOOVER 9786889542 p. l UtTieial Ilse Only commonwealth of Massachu"t" 77U Permit No._ — Depar&nent of Fiire Services occupancy and Fee Chedced�,. J BOARD OF FIRE PREVENTION REGULATIONS Rev.9/051 kaveblank APPLICATION FOR PERMIT TO PERFORM�ELECTRICAL�WORK All work to be pori'omred in accordance (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (a City or Town of: 6he electrical work described below. Cf To the Inspeclor of Wires: By this application the undersigned gives notice of his or her intention to perform t� t o r dVt:�' zid Location(Street&Number) Owner or Tenant b Telephone NR -�/GO- 7 Owner's AddressA Appropriate Box) Is this permit in conjunction with a building rntit? Yes No ❑ (Check PP purpose of Building R C e,() Utility Autborizatbn No. Existing Service Amps / Q Volts Overhead X Undgrd❑ No.of Meters New Se Amps ! Volts Overhead C] Undgrd❑ No.of Meters �_ �----- Number of Feeders and Ampocity Location and Nature of Proposed Electrical Work: lctfon o/'the oitvwl table in wai►�ed b the Ins°motor IYlr�e. Co 0.0 No.of Recessed Luminalm No.ofCeiL-Sasp.(Paddle)Fans Transformers KVA Generators KVA No.of Luminaire Outlets No.of Hot Tubs a.o mergeacy Lighting No.of Luminaires Swimming Pool rod e 12 ;d_ LiBatte Units No.of Oil Burners FIRE ALARMS No.of Zones ? No.of Receptacle Outlets o.o a No.of Switches 3 No.of Gas Burners Initiating Devices Tour- No.of Alerting Devices NEof Ranges No.of Air Coad. Tons ca eat amp am ons . Detection/AlertingNoo-° nDeviees NWaste Disposers Totals: OdorNe.of Dishwashers Space/Area Heating KW Loral❑ Connec 'on [1 No.of Dryers Heating Appliances KW SiiNa of bevices or Equivalent No.o Data Wiring: o. Hare KW °'S Ballasts No.of Devices or ivalent Telecommunications r n No.Hydromassage Bathtubs No.of Motors Total NP I No.of Devices or EaulvLat OTHER: end by rhe l rspectaw n/iFtres. Attach additional detail if cleated ur•m req' When required by municipal policy.) Estimated Value of EI eat Work: ( n completion. Work to Start quo inspections to be requested in accordance whir MEC Rule 10,and apo Issue unless INSURANCE COVERAGE: Unless waived by the owner.no permit for the performance of electrical work may provides f of liability insurance including"completed operation"coverage or its substantial equivalent. The the licensee p proof undersigned certifies that such coverage is in ford and has exhibited proof of same to the permit issuing office. i CHECK ONE: INSURANCEIBOND ❑ OTHER ❑ (Specify:) llcetten is true and complete I cert►,angler the pehts and dhs of perjury►than the Inforaratlon otr this app L� LIC.NO.: FIRM NAME: LIC.NO.:,f,f�► Licensee: Signature' Tel.No.:g 2_ _ 1 l Bus.Tell.No.• f n the Ji nae nwtrber line.) Alt. -- 1 c I�4Yibf8.N'fer 'e\Y'RlJN••i` Address: d, l .�._�...esa..., 'Security System Contractor License required f6r dris work;if appiicarbie,enter the license number here: ___.___� OWNER'S INSURANCE WAIVER: I am aware that the Licensee dues trot har-e the liability insurance cove rag naleM required by law. By my signature below.l hereby waive this requirement. I am the(check one) owner Owner/Agent Telephone No. PERMIT FEE.S50 Signature I he Commonwealth of.Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 _ wwrv.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electi-icians/Plumbers Applicant Information (� Please Print Legibly Name(Busin � ess/Organization/Individual): AV 1 h l I/ `t 1 Ln ti t , S m t tys N C. Address: o_U 0 S u Tr0Q S Tl2U.T — 5u t-rE City/State/Zip: k A N D 0 VLr 61A Odt+S Phone#: a 19 6 3 4 a Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with $ 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. E]New construction 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' insurance.$ 9• ❑ Building addition [No workers'comp. insurance comp. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Pl u ibuig repairs or additions myself (No workers' comp. right of exemption per MGL 12 Voof irs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.[_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. {Contractors that check this box must attached an additional sheet showing the name of the sub-contractors curd state whethor or not those cntitios 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 emplQpees. Below is thepolicy and job site information. Insurance Company Nalene:7[h e— r,h5 uro nCC„ Co of S}� 'pA Policy 4 or Self ! ins. Lic. #: W C, Expiration Date: q a 2, I B Job Site Address: NU City/State/Zip:I V 6 6:6,it/ HA 01 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 I do hereby ce nder th ains and nalties ofpeljury that the information provided above is true and correct. Si 1latur D te: la _ Phone#: Official use only. Do not write in this area, to be completed by city-or tower 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#: G43a/0� DAVID CASTRICONE CASTRICONE ROOFING&SIDING INC. ROOFING,SIDING&REMODELING REPLACEMENT WINDO HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 iUL 1 200 SUTTON STREET,SUITE 226,NO.ANDOVER,MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In HaverhiU 978-374-7314 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 premise elo described: i Owner's Name......... e . Z. Tele one#....f 2,r:'�{f✓!`1"� rE./ Job Address......�.�....1...C 1� 1 .lex....... .............city..... ............State.... Specifications: .�. .... . .................................................................:............................................................................................................................. vStrip existing shingles. pply new drip edge to all edges.91-a w'.r 81/ ...................................................................................................................................................................................................................... ,�C ply 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. � i... ............................................................................................ t/App y.......p p.•....... rlayment. Install ridge vent to n � , o� b.r %�� e .................. .........1.. ..........` tea_..... tf2XX_� eroof using l un Q i r shingles with a�U year warranty a ✓Goer erfash'c' . mew vent pipe flashing. -Regal disposal of all debris Area(s)to beworked on: ✓ .................. ............... !.o:ra F... ....... ..................................................... 41-1=...... .J.. . . ........V-'.... . . . .... ITT. 1-41-2=F .. .......S�. � ....6kNA . ... A4-. ..,."E..........-.... ..................................... ...................................................................... .................. .; Roof board replacement if necessary @ (o /sheet or 31--/foot. ...................................................................................................................................................................................................................... Two Year Workmanship Warranty(Not Transferable) Wanufacturer's Warranty as specifi nufacturer The contractor agrees�to�perform the work h the materials specified above for the SUM 0($..........y.b..0......... Gayable.......Vr ................on................. 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 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 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.It is further agreed that this contractmay 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 tide 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 Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to:Director,Home Improvement Contractor 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 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 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........j...7.day of.... Accepted: � U Signed...... tl�......I�'4. Owner Signed............................................................................. Owner David Castricone,President 01-1 Town of North Andover * 41, Building Department �� - a O 0 " m 27 Charles Street � North Andover, Massachusetts 01845 h . (978) 688-9545 Fax (978) 688-9542 reD �SSNCNus�� 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 shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: �. Z' s - e Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector, IAORTH ToNvn of Andover .No. Q LAKE o , dover, Mass., I� COC MIC ME WICK 00 p'Pjk�� C) _ ANNE& V BOARD OF HEALTH Nor- nmm Food/Kitchen IN 2W t I Z �, Septic System �� G � 1 � BUILDING INSPECTOR THISCERTIFIES THAT......... .......... ........................................................................................................... Foundation has permission to erect........................................ buildings on ...1.. . ..... .......(::4.....t ............. Rough to be occupied as..... 6l. ............................�.[�..f.0..... ......lee .4/.�........"... ... .---.............................. Chimney provided that the person accepting this permit shall in every respect'conform to the terms the application on file in Final 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 CONS TRU ST TS Rough ........... ... ...................................................................... ........................ Service BUILDING INSPECTOR 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 x Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SODS Smoke Det. q }= Massachusetts - Ucltartment of Public Safct' ff,� ��,,,,��uueQ/C/ a�✓�c aT�i�rQe/a a Board of Building Rc!,ulations and Stan(j ujrds Board of Building Regulatio s and Standards Construction Supervisor Specialty License — HOME IMPROVEMENT CONTRACTOR License: CS SL 99358 Registration: 104569 Restricted to: RF,WS Expiration: 7/14/2010 Tr# 270265 DAVID CASTRICONE �r" Type: Private Corporation > . 31 COURT STREET DAVID CASTRICONE;ROOFING,SIDING& NORTH ANDOVER, MA 01845 David Castricone 200 SUTTON ST SUITE 226 �,,aQ c_.�_ NORTH ANDOVER, MA 01845 � '` Expiration: 1211612011 Administrator ('uuniiaiuu•r Tr : 99358