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Home My WebLink AboutBuilding Permit #41 - 334 OSGOOD STREET 7/18/2007 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION of N°pTH •a pL 1°• Permit NO: Date Received211247i Date Issued: '® �9SSacauSE�� IMPORTANT: Applicant must complete all items on this page _. LOCATION` SGS Print PROPERTY OWNER_ C11 an,L Print MAP NO.: PARCEL:..—?7 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ^epair, replacement ❑ Assessory Bldg ❑Commercial Demolition Moving(relocation) ❑Other ❑ Others: :'� Foundation onl DESCRIPTION OF WORK TO BE PREFORMED 4-ad Itihil2gle- rouev Identification Please Type or Print Clearly) OWNER: Name: (_ h 1n,_[f 60"e- Phone: v 6 •!3/33 Address: 3-1 V ��ria o d cfflC C.f 0rA A2(,1V vt-- H4 O/"YJ'— t �� (' CONTRACTOR Name:,–Z. [ars C a vT7n�-, S Phone �� c�f�� 0 Address:__ D SU}7�•, , — tJl/! LP ZZG t)QtyA &doves /-1,4 ()/f yj^ Supervisor's Construction License: Exp. Date: Home Improvement License: �Qys(o 9 Exp. Date: ARCHITECT/ENGINEER Name: Phone: :address: Reg. No. FEE SCHEDULE:BULDING PERM/T:$11.00 PER$1000.00 OF THE TOTAL EST/MATEDT BASED ON$125.00 PER S.F. Total Project Cost :$ /p r ro. o u FEE:$ � % r-- Check No.: ! `710 Receipt No.: 6 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 a Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building 1'�Permit Application o Surveyed Plot Plan a Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) a Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) a 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) a Copy of Contract a Mass check Energy Compliance Report 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:INSPH TIONAL SERVICES DEPARTMEN'r:BPFORIN105 Page 4 ot'4 TYPE OF SEWERAGE DISPOSAL Swimming Pools Tanning/Massage/Body Art ❑ Public Sewer �� Tobacco Sales ❑ Food Packaging/Sales Well ED Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantty�fund Signature of Agent/Owner , _ Signature of contractor.��'",' Plans Submitted ❑ Plans Waived=❑ ` . Certified-Plot,Plan ❑ Stamped Plans ❑ 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 j DATE REJECTED DATE APPROVED HEALTH. ❑ - ❑ • a COMMENTS V . FIRE'DEPARTMENT =Temp Dumpster onsite yes -' no Fire Department signature/date COMMENTS- v Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer connection/Siunature& Date Driveway Permit Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Re uiredProvided +— - Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Parc 3 of d Doc:INSPECTIONAL SERVICES DEPARTMENT:1311Fi)RM05 Crcmed WC Jan 2006 Location No. Date r: NORTH TOWN OF NORTH ANDOVER 16. Certificate of Occupancy $ � �i�s',^°•E<�' Building/Frame Permit Fee $ s�CHus w Foundation Permit Fee $ --„— Other Permit Fee $ TOTAL $ y Check wilding Inspector 6 IgI67 DAVID CASTRICONE �c'TE%P CASTRICONE ROOFING&SIDING INC. ii''II11 ROOFING,SIDING&REMODELING REPLACEMENT WIN OVVS 1 2007 HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 1045 YY 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: is Owner's Name......�4'LF .i..l..d. t.1 ...................................................TAlephone#....�a.D..Gr...-..t�j.,� ....... Job Address....21Y.......S. tial !R....................City.../V fr....l.Za.Y..s'/'................State.....K'.1/x'..... Specifications: .//................................................................................................................................................................................................................. Strip existing shingles.�3 t�ply new drip edge to all edges wk1 l e.g .. .............................. ..... ......................................................................................................................................................................... ypply�teet ic..e..and..water shield membrane to bottom edges of ouse. 3 feet ice and w er shield membrane in valleys and bottom edges of any unheated areas of house. ..................................................................................................4............... .................................................... ....................... w4ply felt paper unde I yment. vl'stall ridge vent to fo-w hr. Q CA acb r�rD ,lS".P.r.. '7... ' - ....I...-............. ....................................................... �. . . ...... vlteroof using T K n 0 r�FA_c o , aU i 1_ shingles with a 30 year warranty. .... ................................................... ........................................................................................................................I............................ -Counter0ash chimney. mew vent pipe flashing. '-)regal disposal of all debris. ea(s)t..be worked on.. Ar .. `. :./ill.... ,.. f . .s......� ...... .a.t,�s.. ............. ................................... ... . ......... . ...... ...................................................................................................................... ...................................................................i.. .... ................ .... ..................................................Zo....8..8...0................................ Roof board replacement if necessary @ CoJ-/sheet or 3°°/foot. ............................................................................................................................................................................. ...................................... Two Year Workmanship Warranty(Not Transferable) Wanufacturer's Warranty as spec' y manufacturer The co ctor agrees to perform the work fi�d,.,,,, isIt the materials specified above for the S of S..../4.2.8..iJ..... .... /i.Payable..J�X..V Q........on..,$,:,.N� ............ 3INJabie........-..................on..................................(J�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 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 expanses,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 warrant(s)Wet 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 aro 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.....(3.......day of..,1W.. .........200'41- Accepted: Signed...... ........ .. :.:.:....... .. Owner r Signed............................................................................. Owner r/ David Castricone,President�� ( n� � Sc�7 -71 )3I Q 1 �CGtk l ►�'lfi'1"I v� � n The Commonwealth of Massachusetts Department of Industrial Accidents r Fi r_ Office of Investigations <z 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): MAV 1 D C A STR I C.O N e __a0 0 E/H& , J !U i , WL. Address: ��p _ - -O,y S-ra e�--_T y 1'J_ ZL� City/State/Zip: NO AAIW64 W 0 )74S Phone 4: V-)--U Are ou an employer?Check the appropriate box: 4. I am a general contractor and I Type of project(required): 1. am a employer with g ❑ g 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. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ 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.[2 oof 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. $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. nn Insurance Company Name: Policy #or Self-ins. Lic. #: Expiration Date: 9•d,3 .Q 0 Job Site Address: � �°� City/State/Zip: lu6 . &6L & AA of h(l Attach a copy of the,---____ _ _..r...,.,�.,,..vV0111-y UL&Idl ar,un 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Sienature: � 2 C Date: 7 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#: NORTH Town of No. .. TO , dover, Mass., 0� COCMIC Ew.CK V^ Q �,9s RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT • d ✓�� ....... ........................... 6 .......................................................................................... Foundation has permission to erect........................ buildings on . 3YOWW-A Rough to be occupied as ,� � ................ '� ..�. .. ......... !................................................... Chimney ............... . . . . ............. provided that the person accepting thi permit shall in every respe t confo o the terms of 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 13) a PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR, UNLESS CONSTRUC T TS Rough . . .................. ... Service BUILDING INSPE R Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No- Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Town of North Andover tAoRTHII 0 Building Department Q - 27 Charles Street North Andover, Massachusetts 01845V. o^ (978) 688-9545 Fax (978) 688-9542 °� �LA: K, 4. SAcNusA 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 C,11, s150a. The debris/will be disposed of in/at: Facility location Signature of Applicant 9 //g /0" Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through t P J g he Office of the Building Inspector.