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Home My WebLink AboutBuilding Permit #646 - 32 PILGRIM STREET 5/27/2009Permit NO: Date Issued: BUILDING PERMIT O* "ORTFIq TOWN OF NORTH ANDOVER Q? 86�t LeD.xb �6�01A APPLICATION FOR PLAN EXAMINATION 70 Date ReceivedA �4 IMPORTANT: Applicant must complete all items on this LOCATION JAj w Print- T PROPERTY OWNER Print MAP NO. PARL:. CEZONING DISTRICT: Historic District yes Machine Shop Village yes o ; TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building x One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands WatershedDistrict Water/Sewer . DESCRIPTION OF WORK TO BE PREFORMED: OWNER: Name: 6 am << Address: CONTRACTOR Name: � G Please Type or Print Clearly) iS Colo-- Phone: :(q,0 3g?- 54q? Address: 0 J St No hhd& "___- Supervisor's Construction License: JL, EL 94,35? Exp. Home Improvement License: I b Exp. Date: r7 t 0. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 1 g 0 O FEE: $�� Check No.: L4-�)J 3 Receipt No.: �� D NOTE: Persons contracting with unregistered contractors do not have access to the gua ty fund 7[it®Y- Ito IC=*]K4901oil d-T-84rel-WW�Y■ 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 o 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 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 3 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 364 Us ooa Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 blain Street Fire Department signatureidate 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 Location3z- 10115o", il— /0 1 Date No 6x ,40RTN TOWN OF NORTH ANDOVER Certificate of Occupancy $ .2 A CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Pd 33 22U62 Building Inspector 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 Barjord 978-887-6147 In Haverhill 978-374-7314 I/we 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 Job P.-t•y,a....... Specifications: ..d ............. State .... 'HI -4....... ,-Areas to be covered: ------ ............................................................................................... ..................................... 1/......�...� m .......... . f o..u..S•�✓............... ,'A'pply vinyl siding and corners. TyPes U, ,I� i/ ......-- ....................... ..... /"i : .....« .....Qi?� .`....... k.✓,l....�1......l.Yta.1....1r!�`� ..... ..... ,.. over fascia boards and rake boards. Install vinyl soffit - sol. d / perforated ............................................................................................. ............ Nor.. rn a wL v . ,,Cover .XPPIy .............................. casings around windows. Replace any gable veuts and dryer..vents.with.viny...l. r;A.'•............................................................................................ ...... . _ -Existing siding Type: V V—C¢w go -over --Legal disposal of all debris. .. �0..../ sheet or 3 b>.../ foot....................................................................................................................... Rotted wood replaced @ .......... r. t......ir4 .........�1 ...............a�1. ...Gu .4 ....... ........... .a..�! ............2.1..:...i ..1F....0 ......................................... ............................................................................................................................................................... One Year WorkmanshipWarranty ) , ty (Not Transferable Manufacturer's Warranty as spec ed by m nutTZ The co tractor agrees, tt Iierform the work d h the materials specified above for the S of E...... 2 �/ Payable .... %v2 ............ . on ...5 7s ......... ............................ on .......... .r ...........,QBalance payable on completion of job Owner or Owners are not responsible for property Damage or Liability while job is mi operation. Contractor is not responsible for any damage to the interior of Property, including pre-existing conditions (i.a wafer stains, crumblingplaster, conditions resulting from application of materials specified above (i.e. objects coming loose from walls, Crumbling(aster, P t irk trot) or spaces). Upon completion of above work, all undersi ed i exposed nails, dust in aeric or oilier living undersignix! agree to execute and derive to contractor, their joint note in GOOrdance with his (their) above obligation as payable. Its agree Contractor. Upon mi tsar to do so, contriictor rosy at its option declare the entire centred price or so much as than remains unpaid, immediately due and P$Y agreed That if permitted by law, contractor shall be paid by the owners) all reasonable costs at[omey foes and expertces, in addition to file amount due and unpaid; than shall nt 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 wnurango) that he is (they are) the owners(s) of the above mentioned premises and that legal title thereto stands of record in his (thou) nerr a Par Them arc rro reptcsarwarras, conditions or warranties except such as may be heroin incarpcxated, if any, nor any agreements collateral hereto, nor is the contract dent conditions no herein stated. pay subsequent � upon or subject b my agreement in reference hereto shall be binding only if in writing and signed by all parties. All Horn 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 constructi- related permit or deals with unregistered contractors is excluded from the Guaranty Fund provisions of MGL c. 142A. on Approximate starting date of work ................................................ Completion nate................ . Receipt py 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 noti f cancellation). IN WITNESS WHEREOF, the parties have hereunto signed their names this ..a� day of .../.14--/ Accepted: � / Signed»».....».».».......»...»... ........ _............. .....------ Owner r Signed »...»..»...» ...... ................... _........ ........»..... ». . Owner David Castricone, President U) m m m m El mm v y C � mom �. 'C O CD n Z y Q.Cl n. C d •� O d = y a� -v 0 CD CD o CLQ CFD CD CD CD c CD y CD CL CD O CO) CO CD I v CO) O *0 Z CD .O•t O CD a C CD I cn c ?0O d S Z O FL C., C m 'O N E a®n m n H m aC m I' N .► ^F a O T CD = m �o0y O y o m=m m 2 (a ' n 110, �• _� O O COL CCDJ =r 7a: +� ? H co a = CD 1 C-)� C� CL 3 CD C d y CL.d: Cr 0 �CD CD. H COD m .Ort CO) ** = O� * OVA, ti ® o 0 oI,,, 33 G CO) w S G tz C CD „r n ?' m cm >a tz _ 32m -3 0O '"i W H .4 IM IM m CO) ** = O� * OVA, ti o=' 0 oI,,, CO: G w r v C/) p ** ° ro * OVA, ti 0 oI,,, x!Z a G w S G tz C z n ?' pl � >a tz r v C/) p C/) ro I w w C G w S G tz C z n ?' O G tz U U n E3 O a rb 0O '"i The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LelZibly Name (Business/C�rganization/Individual): �iAy 1T CAs Tfluco Pic Woo 1-t51h1 a& Im(, Address:_g-r(2 ac --r c54Z City/State/Zip:_ N. A lA Dpitq _M 01 &4S Phone #: 01-1$ & 13 t3 *,.)-U Are you an employer? Check the appropriate box: l.X I am a employer with $ 4. ❑ I am a general contractor and I employees (fu)l and/or part-time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for ine in any capacity. employees and have workers' [No workers' comp, insurance comp, insurance.1 required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. G Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. El Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13. [N Other �� — Y a1JI)M4111 uiai cnla:Ks oox ffi must also nu out the section below showing their workers' compensation policy information. t IIomeowners who submit this affidavit indicating they arc 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-coraractors 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:_ `noic, 1�n� P of., S &XG, "PA Policy # or Self -ins. Lic. #: WC -5 U rl qq`j (o Expiration Date: q , a 3 QCj Job Site Address:P r City/State/Zip: J'1 f1 Attach a copy of the workers' con1pensation policy declaration page (showing the policy number and expiration date). Failure to see }ire coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1 5p0.00 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 thrr violator. Be advised that a copy of this statement may be forwarded to the Office of Investip,ations of the DIA for insurance r vPt'9nf I do hereby �� p^ s andpenalties of perjury that the information provided above is true and correct NUM, Phone #: use only. vo 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 Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM t ORTpy A 04�S4iE0 +6'l,y ..�1 O L M d e of0 41 LOLMI[M� W K M 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 a Signature of Applicant -,6� 1 Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. llassachusetis - Dcpartment of Public Safet'N ? Board of Building, Re.-ulations anti .Standards Construction Supervisor Specialty License License: CS SL 99358 Restricted to: RF,WS DAVID CASTRICONE 31 COURT STREET _ NORTH ANDOVER, MA 01845 t f, Expiration: 12/16/2011 t'uumi.<iuu'r Tm: 99358 7 �� ✓i2e {aa�rrmoru�,w,a�C� o '✓ltaarcu,�uideCld Board of Building Regulatiotis and Standards HOME IMPROVEMENT CONTRACTOR Registration: 104569 Expiration: 7/14/2010 Tr# 270265 Type: ` Private Corporation DAVID CASTRICONEROOFING, SIDING & David Castricone 200 SUTTON ST SUITE 226 NORTH ANDOVER, MA 01845 Administrator N