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Home My WebLink AboutBuilding Permit #518 - 231 CHESTNUT STREET 3/11/2008BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Issued: ✓ �' �� Date Received ., .. 3? of TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ,(New Building /-Mne family ❑ Addition ❑ Two or more family 0 Industrial Iteration No. of units: ❑ Commercial Kkepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition 0 Other Q Septic I Well . = D Flo plain CT Wstlarida- D Watershed Oistr 0. Waterl5ewer DESCRIPTI N OF WORK TO BE PREFORMED: Sf- o d re. - rb af- �.J J)JA- OWNER: Name: Please Type or Print Clearly) ✓IMA/ 1 ho 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: $ 3 D - 4y FEE: $' z Check NQ/��3 Receipt No.: r?0 / NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of AgenttOwnet Signature of contractor Location V C/L,&eA►'T s No. Date NORTH TOWN OF NORTH ANDOVER O A wowR Certificate of Occupancy $ s�CHusa Building/Frame /Frame Permit Fee $_ 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Building inspector 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 DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS HEALTH COMMENTS 0 DATE REJECTED DATE APPROVED IN Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp dumpster on, site yes l� Located at 12`4 Mairr Street - Fire Department signaturetdate 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 2 1 A —F and G min.$100-$1000 fine Doc.Building Permit Revised 2007 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 71-. Board of C tl n' g e ,o� 1;"lld HOME IM tis RROVEMENT CONTRACTOR . . s�egt�n; 104569 icpirat.- -7/14/2008 .. TYpe Supplement Card DAVID CASTRICONE ROOFING yS kgVfN °STROMii SK► � . 200 SUTTON ST SUI't,226�, NORTH ANDOVER,A,01845 �`. Qdminishator'. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANOIN 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. IL TR NSR D TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE S1000000 COMMERCIAL GENERAL U421LITY L001319-01 9/6/07)/6/08 DAMAGE TO RENTED i 50000 (Fa wavence) CLAIMS MADE M OCCUR MED EXP (Any one Person) i 1000 A PERSONAL a ADV INJURY $100000.0 GENERAL AGGREGATE $ZUO U00 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $1000000 POLICY dECT El LOC AUTOMOBILE LIAaK= COMBINED SINGLE LIMIT i ANY AUTO (Ea ALL OWNED ALTOS BODILY INJURY i SCHEDULED AUTOS (Per P-) HIRED AUTOS BODILY INJURY i NON -OWNED ALTOS (Per Wim) PROPERTY DAMAGE i (Per ate) GARHGELIABILTY ALTO ONLY -EA ACCIDENT i ANYAUTO EAACC i OTHERTHAN AUTO ONLY. AGG i EXCESSIUMBRELLA LIABQM EACH OCCURRENCE i OCCUR CLAIMS MADE AGGREGATE i S DEDUCTIBLE _ RETENTION i i WORKERS COMPENSATION AND WC STATU OTH- EMPLOYERS' LIABILITY r ANY PROPRIETORUPARTNERUEXECUTIVE E.L. EACH ACCIDENT 111 OFFICERUMEMBER EXCLUDED? Kyes, de=ibe under E.L.DISEASE - EA EMPLOYE i E.L. DISEASE -POLICY LIMIT i SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, TS AGENTS OR REPRESENTATIVES. ATIVE ACORD 25 (2001108) OACORD CORPORATION 1981 ACORD,. CERTIFICATE OF LIABILITY INSURANCE 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 9DATE(/25/20000.YYYY) 7 PRODUCER Phone: 508-651-7700 Fax: 508-653-8089 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC -Commercial Lines 233 West Central Street Natick MA 01760 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. POLICYEFFEC71VE POLICY EXPIRATION INSURERS AFFORDING COVERAGE NAIC # INSURED David Cast.ricone Roofing & Siding Inc 200 Sutton St INSURERA:Citation Insurance 4027 INSURERB:The Insurance Co of State PA INSURER C: Suite 226 INSURERD: North Andover MA 01845 INSURER E: COMMERCIALGENERALLIABILITY 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. INS LTR NSR TYPE OF INSURANCE POLICYNUMBER POLICYEFFEC71VE POLICY EXPIRATION LIMITS EACHOCCURRENCE $ THE INSURER, ITS AGENTS OR REPRESENTATIVES. GENERALLIABIUTY COMMERCIALGENERALLIABILITY PREMISES Eaoacurenoa $ MED EXP (Any one Per son) $ CLAIMS MADE FIOCCUR PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMITAPPLIESPER : PRODUCTS-COMP/OPAGG $ POLICY PRO- JECT LOC A AUTOMOBILE LIABILITY ANY AUTO 07MMEETNXT 8/1/2007 8/1/2008 COMBINED SINGLE LIMIT $ (Ea accideri) NJURY BODILY (Perperson) $ 250000 personn) X ALL OWNED AUTOS SCHEDULEDAUTOS X XNUN-OWNED HIREDAUTOS AUTOS (Peet Bacccitl rn)RY $ 500000 PROPERTY DAMAGE $ ZOOOOG (Per acdclarA) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EAACC $ OTHER THAN ANYAUTO AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACHOCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC7222278 9/23/2007 9/23/2008 X TwoeSTAby O R ANY PROPRIETOR/PARTNER/EXECUTIVE E.LEACHACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 OFFICER/MEMBER EXCLUDED? Il yes descdbeunder SPEG�IAL PROVISIONS below EL_ DISEASE - POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT! SP ECIAL PROVISIONS CERTIFICATE HOLDER r.ANrrFI I ATInN AcURU Z5 (Z001/0U) " -11 - ._ O ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZEDREPRESENTATRA AcURU Z5 (Z001/0U) " -11 - ._ O ACORD CORPORATION 1988 m m m C ,mww YI m v m v, y d C � r CO) Cl) 10 CD n Z y d0 -0• r C ?� CZ S. y aC= 7� CD o p EDCL o Q CD Er CD 0 CD C CD Na — CD =0 CO) CO � CD F v COO O CD CD Z O � • CD C CD I C CD c 57 om N = Q' SoA:*CO)oC C o co m dC w n M gE g m .N N : w ..r"y'� 0 n?d ,� ///x111 ro TI m CD O m CO) C y O m m = CD CA � C d p =r40 CLo� _ f O O N :� mom: CD m � N poil O. p� C o W `C m �tC w cp gE g m .N � : w N ,� ///x111 ro � °� Qm so CA 00 o o � C11 � o a .%j �- 00 � sa CDo y O CA O -yo o � CD CD =CD:y _ cn rb Ci rb poil a'_ o o � w cp o � : w o ,� ///x111 ro � °� n C 00 o o (� ►� r-, � o a .%j �- M w � y O O � 0 z 0 y 0 c Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM 1 O - coc Hic�u wKh 1. 40R�reo �19SACHUS�� 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 c,l 1, sl 50a. The debris will be disposed of in /at: 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, L DAVID CASTRICONE V 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 Baxjord 978-887-6147 In Haverhill 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, terns and conditions, on premises below described: (e) 778 ,. ?73 -- T—Cl 3 Owner's Name.... F44.....5/1 M!tfA,1 TZjUo ........... Telephone #... . � !,�...?V 2...I.U.7........ Job Address .....Z.. �.......Cf/ESTiVVT......7........................... city .....1!�:.... .............. State.2�......... ...............)........`../................................................................... �..............................I.................... .... YStrip existing shingles. (�� YApply new drip edge to all edges.WHTT A ✓A.................................................................................................................................................................................................................... pply FJ feet ice and water shield merobraoe to bottom edges of house. 3 feet ice and water shield membrane in valleys and bottom edges of any unheated areas of house. Fv46 r`ME'la o'—C �',v tocvg2 sypr per,�S dpply felt paper underlaymentostallridgeventto v4,o �................................................................................................................................................................................................................ YReroof using %A'r1 tCo ��FRr n9 c:E A Al shingles with a 3U year warranty. ... . �/............................................................................................................. ....................................... u(ounterllash chimney. ew vent pi ashing. egal disposal of all debris. ............................................'.y........................................................................................................................................ Area(s) to be worked on: ^ f l t L .... ?l!�G � .�......: A. �J 5.... eF.....0 ....tia.. T:.... ?'� :!f Er:K....... "5 .............................................. . A -vi? v4U'rY RrMovge soc4.({.....�A.v�ey. %!?�%c+.(Z 7;F ...................... ..............................................//.................................................................................. ....... .Qp cP=iz �MtALurIJv:✓t %iCT"OVFRr..................... .tBo ED .................i..................r� IlF�u9�.......�..r3......TR3'!......^!.....R�lvr..!:.y...w.Y.................................t� TN...yG`............ �oof board replacement if necessary 6d—//sheet o?52"-/foot. ...................................................................................................................................................................................... Two Year Workmanship Warranty (Not Transferable) NV"anufacturer's Warranty as speciri man facture? The contractor agrees t erform the work and furnish the �n}pateria specified above for the SUM o .........� ..1..?... . Payable ........�,�.............. on ...:S 7?q,RT....... U, � 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 damage to the interior of property, including preexisting 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 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 warrants) 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 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 .................. day of ............................ 20........... Accepted: Z Signed................................................................ Owner Signed...................... ...... ....................... ............ Owner ................................................................... David Castricon ,President , �j 7 U The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www. mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): EIV 1h 5l'1Jt A; c \ NC. Address: �ev n 6 u Tr0Q S ?12L�_T — 5u lTE City/State/Zip: �, 4N D o vee, NA 01945 Phone #: a Z g (v S 3 3 y oZ Q Are you an employer? Check the appropriate box: 1. ® I am a employer with $ 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.$ 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. ❑ Plurnbuig repairs or additions 12. ❑ Roof repairs 13. ❑ Other *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 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 is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: —Fh G 1 h5 u mnce— CO of 5+t,*c. VA Policy # or Self -ins. Lic. #: W C 7 � a A 2 ri 0 Expiration Date: 3 Job Site Address: 1 Ch e,54'nc1J' SJ �e C4 City/State/Zip: 1 & /7Ylcloye/ /' ` 1 61 P�'r 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 certz 5#der thelpains and penalties ofperjury that the information provided above is true and correct. Phone #: J A („ U 311" use only. Vo not write in this area, to be completed by chly 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 #: