The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #415-13 - 186 BOSTON STREET 11/26/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ✓� P � Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print ° PROPERTY OWNER �� at f1 5� � Unit# / Print MAP NO: 0�kARCEL: ZONING DISTRICT: Historic District ZyesnoMachine Shop Village100 year-old structure 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 ..F .�,._ RrA _ P �,�� t, 9 iFloodp vii? Wetlands. II [] Wate she Disti7ct ❑ Se he ❑Well ,- ` 4 r`/Sewer DESCRIPTION OF WORK TO BE PERFORMED: S�"f I ►� AnA Y_sY\1%1e– roJ (Identification Please Type or Print Clearly) OWNER: Name: a Phone: Address: 1n 3os�c� �ct,& `nog k CONTRACTOR Name: 0 L�hto Re- 2Oo'C11 Phone: Address: a.� 1 ��s- nY. SA-1, Supervisor's Construction License: qC 3S v Exp. Date: 1 b 3 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ q 00 .ou FEE: $_ �— Check No.: � Receipt No.:. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Cinna�ira nf.diicnf%Cliiiinar_ - . `:is 1_Ctrinafiiia'nfniinfr� tnr;t l l!� � A,. Location/ Date No. << TOWN OF NORTH ANDOVER 6 - • $ t' ancy Certificate of Occup t ' Permit Fee • Building/Fra Buildin Foundation Permit Fee Other Permit Fee - k '` TOTAL Check#�� Building inspector '. 25973 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 ❑ Notified for pickup - Date E::- Doc-.Building Permit Revised 2011 June/mi 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 Perr Addition or Decks ❑ Building Permit Application -u 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 Permi* 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 .fermi 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: Doc.Building Permit Revised 2008mi �Ot�`1i'ty e Town of Andover 0 No. - o �A�, h ver, Mass, 1 A (a a I COC"I WICK Q S U BOARD OF HEALTH 1PERM T T LD Food/Kitchen Septic System THIS CERTIFIES THAT ........ .....1:'. BUILDING INSPECTOR ......... .... ......... ..... ... .. .. ...... . . Foundation 4has permission to erect ..... buildings on ..I ,.. ... . . .. .......... .....••• •t••••••••••• ..................... Rough Chimney to be occupied as ......••• e provided that the person accepting this permit shall In every respe onform 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. . Final PERMIT EXPIRES IN 6 MONT S ELECTRICAL INSPECTOR ' Rough UNLESS CONSTRUCTIn Service ................ .................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina' No Lathing or Dry Wall 1 o Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE DAVID CASTRICONE PJ -s ' CASTRICONE ROOFING& SIDING INC. ROOFING,�'IDING&REMODELING REPLACEMENT WINDOWS HOME!n1PROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 ,)311 -2-O,+SUT1-ON STREET,SUITE 226,NO.ANDOVER,MA 01845 In North Anr:aver 978-683-3420 In Boxford 978-887-6147 In Haverhlfl 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 premises below described: Owner's Name.... i " . " . 1Z-8 2 G ..................... ..... 1tIcJob Address....... .......... .. .............................City....N ......ACC�i :.......................State....i1.Y4..... Specifications: ], ................................. jBtrip existing shingles. I•p ................. .....n.........d....rip...................all....ed......s.................................................................................:........................... � � ly ew edge to ge ��+� �rr ... ..................................................................... : .......................................................................... limply __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. .......................................... pply f It pa r u4dcrlayment. Install ridge vent to 2 c{Z�k 'rwvi f4L .GT.f.0........................./.: C.r„........`..' ..r. ..,........g.. year warranty.................................... Reroof using�"�r el t�, ee,,1 zC;e tl%d'I' �r /'� r 1 ce-tshin les with a 30 ....................................y..... �t ...... erftash ehimne . mew eat pe flashing. al disposal of all debris. ............................................. ....... ,7....................................................................................................................................................... Area(s)to be worked on: t. "" ......lyb.!CrLtt......ic'ct.5.: ... ?.��i. ........-.....-3.....5.�..nG'.......................................................... ........................................ 9 75• � .............. ............ .... . ... . ............................................................2 :... �i d PC : � 10- ..... � .. . ...... ................................................................................. ......... . ` � /5� . .................................................................................................................................................................................................................... Roof board replacement if necese.:,ry @ GO /sheet or tV /foot. ..................................................................................................................................................................................................................... Two Year Workmanship Warra•,iy(Not Transferable) N)anufacturer's Warranty as specified by manufacturer The contractor agrees to perform ti::;work and furnish the materials specified above for the SUM of$....................................... Payable............... ...........on................................. Payable................`...........en.............`.................. Balance payable on completion of job Owner or Owners:le not responsible for Pic,arty Damage or Liability while job is in operation. Contractor is not responsible for any dams-_:o the interior of property,including pre-cxisting conditions(i.e.water stains,crumbling plaster,exposed nails)or conditions resullin�;from application of n• ::rials 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 cover d by homeowner.All materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion of above work,all undcrsignc:i cErec to execute and deliver to contractor,theirioinl note in accordance with his(their)above obligation as requested by contractor. Upon refusal to do so,contrac� 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 perr„itted by law,contracto.•.'.:all be paid by the owner(s)all reasonable costs,attorney fees and expenses,in addition to the amount due and unpaid,that shall be incurted ir,enforcing the terms an.;:;:nditions of the contract and/or any lien in connection herewith.It is further agreed that this contract may be assigned by contractor,and alio that the obligations he.,: f 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 pre: ,cs and that legal title thereto stands of record in his(their)names(s).There are no representations,guaranties or warranties,exeept such as maybe herein i....-porated,if any,nor any agreements collateral hereto,nor is the contract dependent upon or subject to any conditions not herein stated.Any subsequent agreement w,clefmcc hereto shall be binding only if in writing and signed by all parties. All Home Improvement Contractot>shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to:Director,1.1,me limprovement 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 unreg;,:ored 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+intents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that ai.of the agreements and understandings of said parties are contained herein. DO NOT SIGN THIS C)NTRACT IF THERE ARE ANY BLANK SPACES Owner has three business days to c:,rcel this contract and incur no penalty (see notice of cancellation). IN WITNESS WHEREOF,the patties have hereunto signed their names this...� .........day of..!%- r...........,20..'., Accepted: �r Signed1 � ..�::.:5 .`..:...:!i .c 4 : .... Owner JtJ • Co a.�.+a+...o� Signed............................................................................. Owner .................................................................... David Castricone,President The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . s 600 Washington Street Boston, MA 02111 s •�'y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information CPlease Print Lelzibly Name (Business/Orgaaization/Individual): CA 578I Cbllt'C Poo r/ N Address: T rb N ST(e 3A City/State/Zip: K6, An o oy of MA 6 MS Phone #: Are you an employer? Check the appropriate box: Type of project (required): 1. ® I am a employer with V 4. ❑ I am a general contractor and 1 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. EJ 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 officers have exercised their 10.❑ Electrical repairs or additions required.] o 3.❑ I am a bomeowner 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 121,�<Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.0 Other 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: Homeowners wbo 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 and their workers'comp.policy information. am an employer that is providing workers'compensation insurance for my employees. Below is the.policy and job site nformatiom nsurance Company Name: 1k A(t rl S ?olicy#or Self-ins. Lic. #: CO o 31 s 9 713 Expiration Date:_ 9. a3 -1) fob Site Address: 1 (0S_�t 1_1 Ro6-d Ci /State/Zi ty p._N,� A(J a�e—�1/I 0 1 W kttach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date), ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a -me up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a SWOP WORK ORDER and a fine )f up to $250.00 a day against the violator:-Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage.verification. do hereby certify under the pains andpenalties ofpeijury that the information provided above is true and correct 3�ature: '2D L C Date: 'hone#: 9U ( 8 3 13 y d o 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#: A� CERTIFICATE OF LIABILITY INSURANCE FATE/11/DDIYY2illi2o12 PRODUCER 978 273 6368 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willows Insurance Agcy ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 51 Cochichewick Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. i North Andover MA 01845 ! INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER&WESTERN WORLD INSURANCE CO DAVID CASTRICONE ROOFING & SIDING INC & INSURERS CASTRICONE ROOFING & SIDING INC INSURER C: 231 Sutton St #3A i INSURER D: NORTH ANDOVER MA 01845 -__-- INSURER E: j COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR�4DD'L POLICY EFFECTIVE POLICY EXPIRATION LTR N TYPE OF INSURANCE POLICY NUMBER DA MMIDO DATE(MMIDDfYYYYI LIMITS GENERAL LIABILITY _ I GGE EACH OCCURRENCE $ 1000000_ AMA ST RENTED COMMERCIAL GENERAL LIABILITY (Ea occurrence� $ PRE50000 MIES CLIMS MADE 7OCCURPP1332888 9/6/A 2012 9/6/2013 MED EXP(Any one person) i $ 1000 j ----------- PERSONAL 8 ADV INJURY $ 1000000 — -! -- -- -- i GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2000000 i POLICY. EO LOC j AUTOMOBILE LIABILITY t- COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY L�SCHEDULED AUTOS (Per person) $ HIRED AUTOS F j BODILY INJURY NON-OWNED AUTOS (Per accident) 1 $ PROPERTY DAMAGE ---I$ i (Per accident) i ' I 1 GARAGE LIABILITY i- i AUTO ONLY-EA ACCIDENT $ _ i ANY AUTO ACC A $ E OTHER THAN EA AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY I EACH OCCURRENCE $ — �- OCCUR ------ - -- CLAIMS MADE AGGREGATE yI$ DEDUCTIBLE I - --I _ $ j RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TQRYIIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE —'- i OFFICER/MEMBER EXCLUDED? I i E.L.EACH ACCIDENT $ (Mandatory in NH) I EtL.If yes,describe underSPECIAL PROVISIONS below E.L.DISEA OTHER I I i DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Castricone Roofing & Siding DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Unit 3A NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 231 R Sutton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR North Andover, MA 01845 REPRESENTATIVES. AUTHORIZED R E5 ACORD 25(2009/01) / INS025(200e01).01 The ACORD name and logo are registered marks of ACORD RD CORPORATION. All rights reserved. DATE(MWDD/YYYY) AC`OR0 CERTIFICATE OF LIABILITY INSURANCE 9/24/2012 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 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 NAMEA Selec: Eastern Insurance Group LLC-Main PHONE., E 08 651 7 00 ac No: 6 3 8 8 233 West Central Street E-MAIL Natick MA 01760 ADD REss: e ctworkeeaste rn i nsura nce,com INSURERS AFFORDING COVERAGE NAIC X INSURER A:Cornmerce & Industry 19410 INSURED 31969 INSURER B: David Castricone Roofing&Siding Inc INSURER C: 231 Rear Sutton Street, Unit 3A INSURER D: North Andover MA 01845 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1538501247 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 ADDLTYPE OF INSURANCE S POLICY EFF POLICY EXP LIMITS LTR IN POUCYNUMBER MMIDDIYYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ A A CSTa�iJTE�— COMMERCIAL GENERAL LIABILITY PREMISES Ea occurtenoe $ CLAIMS-MADE D OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY Ea aocIda ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC003989723 /23/2012 /23/2013 X WC STRLIMTU- O R AND EMPLOYERS'LIABILITY Y/N T [IS ANY PROPRIETORIPARTNERIEXECUTIVE❑ E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN David Castricone Roofing &Siding Inc ACCORDANCE WITH THE POLICY PROVISIONS. 231 Rear Sutton Street,Unit 3A North Andover MA 01845 AUTHORIZED REPRESENTATIVE ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Massachusetts - Department ut'Public Saferh Board of Building Rei ' ulations and Standard . Construction Supervisor Specialty License License: CS SL 99358 Restricted to: RF,WS DAVID CASTRICONE 31 COURT STREET NORTH ANDOVER, MA 01845 Expiration: 12/16/2013 Coll III i.siuner Tr#: 7924 SCA 1 e: 20M•05/11 �\ Office of Consumer Affairs 8 Busidess Regulation OME IMPROVEMENT CONTRACTOR registration: 104569 It' Type: � Private Corporatic 11 A 7/14/2014 DAVI6CASTRICONE ROOFING,SIDING& David Castricone 231 R SUTTON ST SUITE 3A NORTH ANDOVER, MA 01845 Undersecretary Town of North Andover SORTH 0�4t i'`' h.., Building Department o - 0� � m 27 Charles Street 3 North Andover, Massachusetts 01845 4 f " . V. (978) 688-9545 Fax (978) 688-9542 .E 9A 7 �R�re o r.P"y,th SSHCHU50 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 sliall 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: L� Z_ NIV Facility location ^ Signature of Applicant Date NOTE; A demolition permit from the Town of North Andover must be obtained for this project tluough the Office of the Building Inspector,