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Home My WebLink AboutBuilding Permit #218-11 - 36 PETERSON ROAD 9/15/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: I ' I Date Received Date Issued: IMPORTANT:Applicant must lcomplete all items on this age LOCATION SO r ma<�n /wad �� PROPERTY OWNER j'U 6 r'S Print Print MAP NO: 62 5 PARCEL:Q 123 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ErOne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair,,replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other _.__;'___ cI . ►j�aat�e'rsl.ReltdiD.. "i€srit�r 3yc�t wt f®Floopands 7 7 _ Cw.fy 1 yptx® -t s DESCRIPTION OF WORK TO BE PERFORMED: Jh 11, 11� Identification Please Type or Print Clearly) OWNER: Name: be lal Q Phone: / r `� d lye Address: �U r Mdh � m * ,�Vn al>� CONTRACTOR Name: r—'em-1Yud�E ieoo 7/15 Phone: 7q j Address: �0D Sof[on S Su i VC. Z2(a yye/ NA-0 4((J- Supervisor's Construction License: �G1,�S� Exp. Date: I a �((o -�0/ Home Improvement License: Q q J10 Cl Exp. Date: 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: $ `J `ll FEE: L Check No.: , a (o Receipt No.: 6 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Si nature:of-�A'ent/O.wner:-_�=,�::;:.=:•= ..:........:.: ..•.::_.:-.:;;:,;_Signature:ofcontractor;::=::::;;:..:-:- ,:.:_._.:.;.. ;�:.;�: 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 (VOTE: 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 DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit a all cases if a�variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ FPu PE OF SEWERAGE DISPOSALlic Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ i 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.$10041000 fine NOTES and DATA— For department use)_ ++i I I l ® Notified for pickup - Date 1 Doc:.Suilding Permit Revised 2008 I I Location l7Y1 Ci— i f No. C@ Date NORTp TOWN. OF NORTH ANDOVER r O L ` � R 9 Certificate of Occupancy $ s�C1.4 � Building/Frame Permit Fee $ Foundation Permit Fee $ _ a Other Permit Fee $ TOTAL $ Check # 24564 Building Inspector �1�� .11:u�:t�Iw.�rtl� - Drli:u'Ilitrl+l ul' Pultli� �afcn � ,/ , 1✓ Bu;U'll ul' liuilllitt I�r�Ul:1[iUth aull \Iaittl:U'll� "' V.+nicer-Affairs& ss Ilc uINiliOil Construction sup B(VISOf Specialty License �ltt�"of Cuusumcr'Aiiuifs&lii,tiucri Itcgulatiou HOME IMPROVEMENT CONTRACTOR License: CS SL 99358 Registration: 104569 Type: Restricted,u: RF,WSPrivate Corporalio�t xprao 7114/2012 DAVID CASTRICONE g5`. DAD CASTRICONE ROOFING,.SIDING 8 31 COURT STREET ` `' NORTH ANDOVER, MA 01845 ` ;` 7i David Castricone r 200 SUTTON ST SUITE 226 NORTH ANDOVER, MA 01845 llitdersccrctury y Expiration: 1 211 61201 1 ( nuuii�.iunrr I'M 99358 4 R' xAORTH TO" of : Andover- . . 0 No. _{ LAKE o dower, Mass. ' COCMICKEWICK oRATED 1�l BOARD OF HEALTH Food/Kitchen PERMIT 'T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... . ................. ...... .4. ..1�................................. ......... .................................................. Foundation has permission to erect........................................ buildings on...s0........... ..... ... ....... JVA........... .........S.. Rough to be occupied as a... .....P-W�ermft :......*.. ��.Q. chimney ......... ........... ................................................................ provided that the person accepting shall in every respect conform 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 a PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTI T Rough ................... .......... ................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final 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. ACORD CERTIFICATE OF LIABILITY INSURANCE 72T /201/YVYY) '"' /"LO10 PRODUCER Phone: 508-651-7700 Far.: 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 Insurance 40274 David Castricone Roofing & Siding Inc INSURER B:CHART IS 200 Sutton fit Suite 226 INSURER C: Nc>I:th Andover MA 01845 INSURER D: _ INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOV' 9AVE 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. INSRADD' POLICYEFFECTIVE POLICY EXPIRATION LTR NSR F1N1tkIRANrr POLICY NUMBER LIMITS GENERALLIABILITY EACHOCCURRENCE $ CNTED Cll.1MERCIAL GENERAL LIABILITY AM ESE PREMISES Eeoccurerwe) $ CLAIMS MADE 7OCCUR MED EXP(Any one person) $ PERS014AL&ADV INJURY $ GENERALAGGREGAFE $ GEN'LAGGREGATE LIMIT APPLIES PER: PHODUCIS-OOMP/OPAGG $ POLICY 7PRO-JECT 7 LOC A AUTOMOBILE LIABILITY BCNCC.V 8/1/12010 8/l/2011 COMBINED SINGLE LIMIT ANYAUTO (Eaaccloern) $ 1, 000, 000 ALLOWNEOAUTOS X SCHEDULEDAUTOS rpe INJURY o ' Pe $ X HIREDAUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per acoioern) PROPERTY DAMAGE $ 11 (Per axidern) GAR AGE LIABILITY AUTOONLY-EAACCIDENT $ ANYAUTO OTHERTHAN EAACC $ AUTOONLY: AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ B WORKERS.COMPENSATIONRND9/23/2010WC STATU- 10TH- EA EMPLOYERS'LIABILITY WC003989723 9,/23/2011 }{ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L_EACHACCIDENT $100, OFFICERIMEMBEFIEXCLUDED? II yes,c�scribe wxler _ E.L.DISEASE-EA EMPLOYEE $100, 000 SPE C:IAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500, 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT ISP ECTAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER David Castricone Roofing & Siding Inc 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 LIABILIT's OF ANY KIND UPON North Andover MA 01895 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZEDREPRESENTATIVE ACORD 25(2001/08) I&ACORD CORPORATION 1988 AC't->RH CERTIFICATE RTI Fi DAA�DDmm �- CATE OF LIABILITY INSURANCE 9�9/2011 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 polloy(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 endorseman s. PRODUCER CONTACT NAME: Willows Insurance Agcy 978 475 3414 AC,No);, 51 Cochichewik Dr E-MAIL ADDRESS:•---...... PRODYCER • —. North Andover tdAL 01845 _. . _iNSURER(S)AFFORDING COVERAGE _ NAIC 0 INSURED INauRER A Maidten Specialty Ins Co INsur�ea e� _ DAVID CASTRICONE ROOFING & SIDING INC INSURER 0: — __. INSUMR P: 200 Sutton St suits 226 -- -••- NORTH ANDOVER MA 01945 '"S"R `E' INSURER F: ..... _ ...._. _ . COVERAGES CERTIFICATE NUMBER:CL119906255 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, LTR SR TYPS•OF INSURANCE .�...__ b'C SUBp am WVD POLICY NUMBER OST EFF MPO ICY ExP ---• LNNRe __---• GENERAL LIABILITY EACH OCCURRENCE _ S 1000000 X COMMERCIAL GENERAL LIABILITY PREM�ISf§1Cyegwrrenm� I S_- _ — __50000 .M A _ CLAIMsADE I X l OCCUR UM0003160D 9/06/2011 /6/2012 MED EXP(Any one Breen S 1000 PERSONAL d ADV_INJURY 6 1000000 GENERAL AGGREGATE S 200000_0 GEKL AGGREGATE LIMB APPLIES PER PRODUCTS-COMPlOP AGG S 1 000000 PQ _._.. ... _ ._ .s .. . .. ... POLICYLOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANT AUTO (Ea acddent) S ALL OWNED AUTOS BODILY INJURY(Per person) S SCHEDULED AUTOS BODILY INJURY(Per accident) S –• HIRED AUTOS PROPERTY DAMAGE $ (Per a0I•Jdent) NON-OWNED AUTOS S a UMBRELLAlJAB OCCUR EXCESS Lute EACH OCCURRENCE S' culal5 MnDIE AGGREGATE S DEDUCTIBLE - s RETENTION ; WORKERBCOMPENSATION S AND EMPLOYERS'LIABILITY WC 5TpTu• p7µ. ANY PROPRIETORIPARTNERI XECUTIVE YIN TYT,RY LIMR•5 .,—�Eft OFFICERMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT f (Mandetery In NH) ...... If yes,describe under E.L DISEASE.EA EMPLOYE f TIO DESCRIPN OF OPERATIONS b0aw E.L.nIsEASE•POuOv UNIT. 6...��..—-- I 1 11 I DESCRIPflON OF OPERATIONS I LOCAflON61 VEHICLES (Attach ACORD 107,AddNldnN Remarke Schedule,R nwe apses 1e required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN David CaetriCOne Roofing & Siding Inc ACCORDANCE WITH THE POLICY PROVISIONS, CastriCOne Roofing 200 Sutton Street Suits 226 AUTNCRIM"I"MRIWATIVE N Andover, MA 01845 J n ACORD 25(2009109) ---4a2 OK V 1988-2CORD CORPORATION. All rights reserved. IN5025(21xleos) Tho ACORD name and logo are registered marks Of ACORD Town of North Andover p1 Nnkr� . Building Department p 27 Charles Street '' A North Andover, Massachusetts 01845 V (978) 688-9545 Fax (978) 688-9542 °° 4°R1rea SA L15 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, s15Oa. 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 ro ect through th e0 P JOffice of the Building Inspector, Commonwealth o Massachusetts The C f t Department of Industrial Accidents Office of Investigations 600 Washington Street J)'s, wBoston, MA 02111 -� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information * Please Print Legibly Name (Business/Organization/Individual): ,UAV I I Ny-K1(omE I?UQ F i Nls- ' Si p/t,l(r INt. Address: & (j Su%-,-To s3 STR t E T 5a City/State/Zip: N o. A N Do,t e f_. f A d I iV S Phone #: 9)� Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with e 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. $ 7. ❑ 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 required.] officers have exercised their 10.F-1 Electrical repairs or additions 3.❑ I am a homeowner 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 12$6Roof repairs insurance required.]t employees. [No workers' 13.0 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 afdavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: I-rl A 2=1-1 S Policy#or Self-ins. Lie. Expiration Date: Job Site Address: T �S�QQ r1 �-EX City/State/Zip: ULX& I►It9 ar/d �0 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 u to$1 500.00 and/or - p one ear imprisonment,as well a c' y p s evil 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 tnay be forwarded to the Office of Investigations of the DIA for insurance coverage overs e verification. g I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Siipnature: � J 131 C Date: Phone#: 63(7% U3 `3 q a0 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 S. Plumbing Inspector i 6.Other Contact Person: Phone#: I 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 HaverhU/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 premis below described: Owner's Name..... es'�i9rA fDi? . ....................................]obAddress... ( 1...... h�v.��... .1:................City.... b... •ci.k!.2 ...............State..... ........ Specifications: ...................................................................................................................................................................................................................... Strip existing shingles(r) ply new drip edge to all edges.ji,.'�z $ .........................................................................................................g........................................................................................................ ply��_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. ...........................➢........................................ ...................................................... .. ........................................... Apply felt, a underlayment. 7 stall ridge vent to < <, / tt'1.� t' ..} ...... ......... .........................•••.•••••••:./.•••.....r� ................................................. „Reroo using shingles with a �year warranty. ...................................................................................................................................................................................................................... L . ounterflash chimney. -New vent pipe flashing. -legal disposal of all debris. •--rea(s)to be worked on ........................... ......... .1. ....... �, .... ........ . .a.�Is. ., ...... w1..4✓z�;f e�1...� ,. .. �.sz. ................I........ ..........c �. .U..�.: y... x �, ...G�j.� �r� �................... ......................................................... ....................................................................�r.............................................................................................................................................. Roof board replacement if necessary @ �,.0 /sheet or,�'-"='/foot. ............................................................................................................................................................................... .... Two Year Workmanship Warranty(Not Transferable) Manufacturer's Warranty as specifre mJnufacturer The contractor a es to perform the work d�ish the materials specified above for the SUM f$...1 5.9�.�................ Payab 713.00.L)........an.: 5 �^1............... Payable.......--".-:�=...............on..........:—................. Balance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability whilejob 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 ofabove work,all undersigned agree to execute and deliver to contractor,theirjoint 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,U 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 wamint(s)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....P.,(.......day of........U.1...........20.... Accepted: . Signed...... ........_C.....�.�-.............................t..... Owner 1 Signed........... ..:.Ili ............ Owner David Castricone,President Date.... ... TOWN OF NORTH ANDOVER '0 —60009K PERMIT FOR WIRING �,SSACMUSEt This certifies that ......... z�;P-.-I'v4.....-zo'e....... has permission to perform ......P . ............................... wiring in the building of...................XA... ..................................... at.........S. ............... North Andover,Mass. s. Fee.&X................ Uc.No.....4.o ....... EL AL INSPECTOR Check # 7645 Camm.onwealth of Vaeeac4aletls Officia�l]Use,On/ly Permit No. d�y e[J¢partment o� }ir¢Jerviced Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: X101Q -A/ AA ,,0ive2 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&,Number) R T&'-e1'-0N RdA D - Owner or Tenant /�UA�J/ �!//t/ JV AP d- Telephone No. �7�'7Jf f�6jU Owner's Address <-'O ex c Is this permit in conjunction with a building permit? Yes ❑ No ®:' (Check Appropriate Box) Purpose of Building n}G Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number 6f Feeders and Ampacity Location and Nature of Proposed Electrical Work: ibis----- - - ER RE�o�NEe 1 A Completion ofthefillowing table may be waived b the Inspector oLf Wires. No.of Total No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- Elo.o mergency jg tng rnd. rad. tter Units No.of Receptacle utlets No.of Oil Burners FIR LARMS No.of Zones No.of Switches No.of Ga Burners No.of tection and Initia i Devices No.of Ranges No.of Air Co . Total Tons No.of Alerti Devices No.of Waste Disposers Heat Pum Nu....... er Tons KW No.of Self-Cont ed Totals " '' Detection/Alertin evices Municipa Other No.of Dishwashers U Space/Area Heating kw Local❑ Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or E uiv Lent No.of Water No.of No.of Data Wiring: Heaters KW Si ns Ballasts No.of Devices or E uivallen No.Hydromassage Bathtubs No.of Motors Total HP Tel No.of Devic esNo. E qui valent t OTHER: Attach additional detail if desired.or as required by the Inspector of Wires. y�r Estimated Value of Electrical Work: to C507 (When required by municipal policy.) Work to Start: �?_ 6- o 7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including`completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proVf of same t permit issuin office, CHECK ONE: INSURANCE ❑x BOND ❑ OTHER ❑ (Spec' _ I certify,under the pains and penalties of perjury,that the inform io o►`t app ' ad s e nd complete. FIRMNAME: Castle Electric Inc. LIC.NO.: A16191 Licensee: James R. Prescott Signat LIC.NO.: 26186E (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 7 81—7 6 2—9 8 9 it Address: Bld 21 Endicott Stree or nod Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires De ent of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware th a Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby wai a this requirement. I am the(check one)❑owner ❑owner's agent. Owner/AgentPERMIT FEE: $ o20.d-0 Signature Telephone No. Y w 1