The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #315 - 248 GREENE STREET 11/7/2008 BUILDING PERMIT "O RT"�a TOWN OF NORTH ANDOVER F APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date Received X1,9 °gwTeo♦ra�,�9 C SSACH�15� Date Issued: �/' �" Q v IMPORTANT: Applicant must complete all items on this page LOCATION A? ea Print PROPERTY OWNER �t-F F Z NArut ,(b WSILi Print MAP NO:bJ PARCEL ZONING DISTRICT: Historic District yes no 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: Seri rL 5 Wits le, —two S )Jn 84 ;,, w U � Identification Please Type or Print Clearly) OWNER: Name: .�- k Zrvtirr1ernwsLi Phone: 97 �6 Yk (JJ� Address: a,A S 6(ftn S) �)d AY)dQVt,1 M CONTRACTOR NamePhone: 6 Y3 3 2U Address: 1,0S }t�ne-� , 2 Zo0Y"1C(c}V C�1P Supervisor's Construction License: � � Exp. Date: I b Home Improvement Licenser C Exp. Date: iq -,4, u 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: $ l.�(yU. CO FEE: $ ,S Check No.: �% f> Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the g ranty 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 COMMENTS HEALTH 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 Durnpster 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 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 ❑ 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 BUILDING PERMIT poM RT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: �/� `�" � WI ��SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION- oJq g (2E Print PROPERTY OWNER_ _ )ZEE Z NAmjE ko W fLl Print MAP NO: PARCEL:U 4T ZONING DISTRICT: Historic District yes no 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: rri i res Nina Ie, —two s )Jr3 n4 MbL;h Yz A Identification Please Type or Print Clearly) OWNER: Name: ZbarAi p snw.,o 1r ; Phone: q7 Flo Yk (j Address: fP n CONTRACTOR Name: bpi Phone: 6B ,30-L) Address:Z.0a_ _s n � -� , S��' ,a `ZZ.b 0 Anc(OyU RA 017 r P � Exp. Date: l�, b dO 1l Supervisor's Construction-License: Home Improvement License: ` Exp. Date: (q -�.0 + u 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: $ 15 U +t3. FEE: $ ,S Check No.: yo Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the g ranty fund Signature of Agent/Owner Signature of contractor YK'!�- Location No. -�%S Dated NORTFTOWN OF NORTH ANDOVER O:t � o :stip 9 • ; . Certificate of Occupancy $ Building/Frame Permit Fee $ G� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ h Check # C--7//10 26C ,) j Building InspectorU lo�a��d g DAVID CASTRICONE 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 Boxford 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,terms and conditions,on premises below described: Owner's Name....... .... Gannn .tel A.tr? . .1..........................Tele ne#..feslr. (.a. ......... Job Address....v�. Gt-C�.....�) ... ................. ........................city....... /`........State..... Specifications: *i5trip existing shingles.�i) ✓Apply new drip edge to all edges. etl�r'�� t� ................................:................................................................................................................................................................................... /Apply _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. ...... ......................................................................................... yy e Apply felt paper under) ment. rlUstall ridge vent to -� �1 �QLA i,.n ��X. .............. ... -..... .... 77.......................`........................ eroof usingJ-'.'*_ t �F shingles with a 3Jyear warranty. ...................................................................................................................................................................................................................... n eounterflash chimney. 4 New vent pipe flashing. ,Joegal disposal of all debris. ............................................... . ..�..J..`f..................... ..............................:......��F/ Area(s)to be worked on: ........../..1..... ..................p ....S..L �!a!!.fit-rq /...... ................................................................... .......... tl-C.0.1........10......1'ktioa.f' GY/...an.-A.................. .......................................................................... �. ••....+n ........ 1.�r.�.,./.......�a1.. .......... ............................................................................. ........................................................................ ................... Roof board replacement if necessary @ t:b /sheet or y—/foot. ........................ ..................................................................................................................................... ......... ... ................... Two Year Workmanship Warranty(Not Transferable) Kanufacturer's Warranty as specifi y manufacture The c for agrees to perform the work an CIPth materials specified above for the SU of$...t„S �...... .... ayable... `.UD........on... .. +aysWc....:.......................on...................:.............Balance payable on completion of iob Owner or Owners are not responsible for Property Damage or Liability whr etob rs 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 owners)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 wartangs)that be 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).. yy� IN WITNESS WHEREOF,the parties have hereunto signed their names this...�,.�day of.....Qt:A...'.........20..Pg. Accepted: - . Signed.... . ... ............ .....»............................. Owner Signed............................................................................. Owner .. .. David Castricone'President The Commonwealth of Massachusetts r Department of Industrial Accidents j Office of Investigations 600 Washington Street Boston, MA 02111 Z wwminass. ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information p Please Print Lel4ibly Name (Business/Organization/Individual): "Daut d Cai tri LO n c- o'tl nog J l�i tl a 61 G, Address: fin 5�ir7C�-4 S,�Oy. 2Z City/State/Zip: N AnLici& HAS 6 114 J" Phone #: q7% 183 t 3 4 A O Are you an employer? Check the appropriate box: Type of project(required): 1.R I am a employer with S 4. ❑ I atm 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. E] Building addition comp.[No workers' comp. insurance p. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12:KRoof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ 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. tContractors 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: 'T'Yv— \meso('ami, JA��ttL. A Policy#or Self-ins. Lic.#: w C. �j 8 �1 y (p Expiration Date: g Ida ,O ci �L �— Job Site Address:—. R (�Qt-I fl_�- City/State/Zip: 06 j��tl ,- `l pi��>' 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer ' under tl ains and penalties ofperjttry that the information provided above is true and correct. Signature: J Date: Za Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town of North Andoverti VAOR H o Building Department o 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 �R�reo �Fwy,�5 ��$ACHIJ5 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" � � 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. ACORQ. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 10/3/2008 PRODUCER Phone: 508-651-7700 Fax: 508-653-8089 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC -Commercial Lines ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Natick MA 01760 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Citation insurance2 David Castricone Roofing & Siding Inc 200 Sutton St INsuRERe:The Insurance Co of State PA Suite 226 INSURERC: North Andover MA 01845 INSURER D: INSURER E: 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 TETE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICYEXPIRATION LIMBS GENERALLIABILITY EACHOCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Eaoocurerrce $ CLAIMS MADE OCCUR MEDEXP(Arryone rson) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GE NL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ POLICY PRO LOC A AUTOMOBILE LIABILITY 08MMBBTNKT 8/1/2008 8/1/2009 COMBINED)DINGLEUMIT $ ANYAUTO ALL OWNEDAUTOS X SCHEDULEDAUTOS B(Perperson) ereon) $250,000 X HIREDAUTOS BODILY INJURY NON-OWNEDAUTOS (Peraoc brq) $500,000 PROPERTYDAMAGE (Perecclden) $100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO EAACC $ OTHER THAN AUTOONLY: AGG $ EXCESSIUMBRELLA LIABILITY E ACHOCGURRENCE $ OCCUR F]CLAIMSMADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WC5877756 9/23/2008 9/23/2009 X I WCST TU- 'ETH - EMPLOYERS'LIABILITY ANY PROPRIETOWPARTNERrEXECUTIVE E.L.EACHACCIDENT $100,000 OFRCERiMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $100,000 If yyees describe under SPEGIIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED David Castricone Roofing & Siding IncBEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER g g WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE 200 Sutton St CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO Suite 226 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON North Andover MA 01845 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) m ACORD CORPORATION 1988 Massachusetts - Department of Public Safe} e omnaoru� a ✓ acfeude�l6 BOaI'tl of Builllin!, Rr��ul ICiUns anti S[anllal'tls Board of Building Regulatio sand Standards Construction Su ervisor Specialty =-- p p y License = HOME IMPROVEMENT CONTRACTOR License: CS SL 99358 = _ Registration: 104569 Restricted to: RF,WS Expiration: 7/14/2010 Tr# 270265 DAVID CASTRICONE "` ,;°'" Type: Private Corporation 31 COURT STREET DAVID CASTRICONE ROOFING,SIDING& NORTH ANDOVER, MA 01845 David Castricone 200 SUTTON ST SUITE 226 ",q��` Expiration: 12/16/2011 NORTH ANDOVER,MA 01845 Administrator ( uuuii siuucr Trr: 99358