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Home My WebLink AboutBuilding Permit #279 - 44 WOODCREST DRIVE 10/8/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page r ,LOCATION ` / (SCI ✓� ' x Print ,,PROPERTY OWNER,- ` e3CYjti 'o rC( MAP NOPhnt PARCEL:.71 s -ZONING DISTRICT: Historic District yes � �o - -Machine Sf�op 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 UVell Floodplain Wetlands Watershecl=District "`Ut/aterlSewer; _ DESCRIPTION OF WORK TO BE PERFORMED: ��n r��h► I e rb (J F Identification Please Type or Print Clearly) OWNER: Name: 3r\C �: -Rbra Phone: Q-)g �Slb 123 811 Address: q4 WOO&YCA *bnVe if 14, A(Idayu MA d i� y Y- CONTRACTOR Name: ' , tYIaL#Ylaoi r Phone: Address: C?O ScJn io 22-moo'. Ct li(>r'� Cif )f -Supervisor's Construction License: 1�t s 'J Exp. Date: I None Improvement License: 1,.0 `s Exp. Date: 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: $ D a00 , FEE: $ ZZ 1 Check No.: 3 j q, Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund gnature�of AgentfOwner' Signature of contra 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 Sig nature COMMENTS Zoningloard 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'Dun psterron site yes no Located at 124 Main Street. m Fire Department signature/date COMMENTS 4 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 ofElectrical Inspector Yes P No IL 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 2111 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 .h ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract L3 Floor/Crossection/Elevation Plan Of Proposed Work UVith 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 o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Spr=inkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products r ' 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: Doc.Building Permit Revised 2008 Location 01 No. Date f MORTN TOWN OF NORTH ANDOVER � a * ; : Certificate of Occupancy $ �^ �s Etn Building/Frame Permit Fee $ - s�cHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 225x5 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 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: M � J Owner's Name......./••••1..G .. ..................................................Te one#.....�....�.�..�.��....... Lj�[ Job Address......F...G........Jit/fT. G fi.Kt......city..., r .>.... Cz.httiv ^............State.....l.:L ...... Specifications: ........................................................................................................................ ...................................................t1� .... ....................... ✓trip existing shingles.0) ✓Apply new drip edge to all edges k1k; 12- �' ...................................................................................................................................................C?� 2...' � 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. Fic.l�l �i , /6 ¢/ Imo[ r ................................................................................................................ .............................. ..................... . ,Apply felt paper u rlayment. -Install ridge vent to ` � 6G/ .1.C............................ ..........:............... ..... ...................................... ............................................................ Reroof using shingles with a year warranty. ...................................................................................................................................................................................................................... k6unterflash chimney. —New ventyipe flashing. --Legal disposal of all debris. " .................................................�.,.., .._�.a .................... Area(s)to be worked on: r I J ....... ....... ............. ,� ! . .. bt� e ra 5... ..I r et t t 2�.xV q. .......................................... ...... ...��.. ........... ... rlia ...... ..... �........ .. ........ .........��i.�.t)�...... .............. �..... .................. .............................................. ....... .......................��. ............. .......... . 026 �� v replacement if necessary " Roof board re ' p ry @ �(� /sheet or�-afoot. ................................................................................................................................................................................................................... Two Year Workmanship Warranty(Not Transferable) 11;('anufacturer's Warranty as specify y a mn acturer The c ctor agrees to perform the work an4fumi�h.the materials specified above for the SUM o $...../.�..y .Q.�............. ayable......... ............on.....�. r� Papei�ir............. .............on....................... ......... 2 Balance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability while job is rn 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 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 commct 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 patties have hereunto signed their names this,i2 ...day of :� ....20.1?. . Accepted: Signed ` G... . \..F.....V1D.......:G....—L:>... »........ Owner 1L.j..CLZ� Signed............................................................................. Owner David Castricone,President �C S The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations 600 Washington Street 1 Boston, MA 02111 4 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationdndividual): DAV 11 C N-161 C O N it R U FIND d J O L Address: 20 b S u-rspn) S--t:(Z-t-&-'t" Sy ��F_ Z2 to City/State/Zip: 4N bo 46 K. NA 0 19 uS Phone#: 9-)$ (p t 3 3 4 20 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with $ 4. ❑ 1 am 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 workingfor me in an capacity. employees and have workers' y P �'� 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.E]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 12.0] Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.[1 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. lContraciors 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. fl Insurance Company Name:Mn e— Ccs -04 cn MD rxnTf- S' e 'Vh Policy#or Self-ins. Lic. #: W (,9 9's a,I y to Expiration Date: Ot Job Site Address: (44 M_v_kol i11e._ City/State/Zip: N ApdQVe/ I 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 certify under thepains and..pp_enalties of perjury that the information provided above is true and correct. Signature: .� )_ . C°,x"�""�� Date: Phone#: LU 3110 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#: }(m*xrhv^cu, Vqmmocniv[ puWic -Sx[c/) ' Board o[ QoiWio" Qc�v|xhvoxmid 'standards B..,-df ConatrucdonSupervisor 5peciahyLicense m»^/w/»uu'm`m/»m`ovu0ummnw ' License: CS SL 99358 HOME IMPROVEMENT CONTRACTOR ' ' Restricted to: RF.VV6geRegistration: 104569 , � ^ Expiration: 7114/2010 Tr# 270285 DAVID CASTR|CONE Type: Private Corporation J1COURT STREET VU DAVID CA3TR|CONERDOF�NG 00NG& NORTH ANDOVER, �A01845 ' . DavidCasthcone --~— uOOSUTTON STSUITE 22G sxpimxon: 121'1612D11 '�- NORTH��D0VER. �AO1845 A«omm,unm, T,,-: 00358 ` ' ` ' , ` � ' _ ' ` ` ' ` ACD-RDM CERTIFICATE OF LIABILITY INSURANCE 19/28/20 9 PRODUCER (508)652-7700 FAX 508-653-8089 :THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC - Commercial ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER,T"15 CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Natick, MA 01760 Select Ext.53389 INSURERS AFFORDING COVERAGE NAIC# INSURED David Castricone Roo Tng & 5iding Inc INSURER A: The Insurance Co o State PA 200 Sutton St INSURER B: Suite 226 INSURFjRC, North Andover, MA 01845 wsU1zERD: INSURER E. COVERAGES THE POLICIES OF IN5URANGE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION 05 ANY CONTRACT Oil OTHER DOCUMtN r 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY I-.nCH OCCURRFNCQ $ COMMERCIAL GENERAL LIABILITY DAMAGE-TO RCNTED rS 1F..^r CLAIMS MADE ❑OCCUR MCD CXP(Any one person) $ PCRSONAL S ADV INJURY $ r3L-.N1-HAI AGGREGATC $ GLN'L AGGREGATE LIMIT APPLIES PER. vm000C 1.5-COMPIOP AGO E POLICY PRCTO LOC JE AUTOMOBILE UABIUYY ANY AUTO ICO pBcNdeDl'INGL6I.IMIT $ ALL OWNED AV700 BODILY INJURY $ SCHEOULEDAUTOS (Pei oamn) MIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Por ac idenl) PROPFRTV DAMAC1= $ (Per accident) GARAGE LIABILITY AUTO ONLY,EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC, $ AUTO ONLY: AGO S EXCESSAIMBRELLA LIABILITY CACI I OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S OLUVOVIDLk L RETENTION S WORKERS COMPENSATION AND WC9752746 09/23/2009 09/23/2010 X I WCSTATU- I OTH- EMFLOYERS'UABILITY A ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S 100,000 OFFICER1MEtN8ER txCLUDEm? E.L.DISEASE -EA EMPLOYE $ 100,000 11yo s,dcscnbc under SPECIAL PROVISIONS below E-L,DISFASF-POIJCY LIMIT $ 500,000 OTHER OESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE N EL N SHOULD ANY Op THE A90VE 0E5CRIBED POLICIES OE CANCELLED 9EFORE YHE 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 QF ANY KIND VPQN THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Stace Brice PKG `:� --I1 ACORD 26(2001108) OEACORD CORPORATION 1988 Town of North Andover t%nwTl o t,.k° ,a ti Building Department o - �'. � a .' 27 Charles Street '} North Andover, Massachusetts 01845 4L (978) 688-9545 Fax (978) 688-9542 �S3NC1-IUS�'� DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of. Building permit # the debris re%.,Iting from the work sluall be disposed of in a properly licensed solid waste disposal facilit.} as defined by MGL c11, s150a. The debris will be disposed of in/at: WZ-) Facility 1.c.al'ion a 4 signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project tluough the Office of the Building Inspector. ,AORTH Tovm of , t _ Andover . :. 0 .07 No. o) _ LAKE dower, Mass., COCMICMEWICK y�. %d ADRATED `S BOARD OF HEALTH PERMIT D Food/Kitchen Septic System BUILDING INSPECTOR �R THISCERTIFIES THAT.....A............ .................. ..... ... ............... ............................. ........................... Foundation. has permission to erect..... ............................... bullings on ........... .. . .......W�Dr.......0 .T Vii. Rough to be occupied as.... .......... ... F . ........ ... Chimney provided that the pe on a pting this permit shall in every respec form to the terms of the application on i e in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Afteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ZZ I ELECTRICAL INSPECTOR UNLESS CONST S Rough .. ..... .......................................................... ......... Service BUILDING IN 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.