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Home My WebLink AboutBuilding Permit #344-11 - 51 JETWOOD STREET 10/25/2010 BUILDING PERMIT o` pORTH tt,.Icl 16 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: / Date Received f—0SSgcHuS��`� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION '51 Jct d( --EE I PROPERTY OWNER Looks '-b6 ri r\Print n IN3 fl ed Print MAP 210 PARCEL: 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 el Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: }ri an� h't o2 Identification Please Type or Print Clearly) OWNER: Name: Los ' bnnry, ._ 9 Jo-po I', Phone: 97� $ 1 Address: 51 Je-4 Wtki6 UI w r CONTRACTOR Name06LA 'COne- ` o Phone: 9`�)k( d 33 V10 Address: a cJ Su-fi- , S�,`ee.,,A ..x'11-te ZZ( Po Ncbye,r Mom- Supervisor's om-Supervisor's Construction License: Exp. Date: 19,- f (0' 0,)-0 t Home Improvement License: `" Exp. Date:-7-1 -d 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: $ r79C. 0, ()L) FEE: $ Check No.: Receipt No.: ��.� 50 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contracta 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:Building Permit Revised 2008 ti Dimension square feet of floor area, based on Exterior dimensions._ Total Number of Stories: ft" Total land area, sq• drop requires approval of mast or serviced Movement of Meter I Ye No tion, I ELECTRICAL- No Electrical Insgactor DANGER ZONE LITER- TORE. Yes r 166 Section 21 A—F and G min•$100"$1000 fine MGL Chapte t S and DATA— lFor departm ent use NOTE Date ............. p Notified for p ........_._.- _ .......__.._..................... _ Doc.Building permit Revised 2010 `ontYact eceipt No.: S do ��--- not have access to the _-_`_ ____ ----------- --- Signas tY.fund ture of contract guaYan The following Building Department - --- __ Is a list of the required Roofing, Siding, Intpr:_ forms to be J � Stamped Plans plans W aived Certified Plot Plan Plans Submitted Swimming Pools TYPE OF SEWEc'E DISPOSAL e/gody Art Tann�g%assag in ISales Food Packag g public Sewer Tobacco Sales Well permanent Dumpster on Site private(septic tank,etc. OFFICE USE ONLY SECT oSIGN OFF . U FORM THE FOpEPARTMENTA INTER DATE APPROVED DATE REJECTED PLANNING &DEVELOPMENT COMMENTS NOTE: Si nature N Reviewed on CONSERVATION ❑ COMMENTS Si nature Reviewed on ❑ HEALTH ❑ M . NOTE. ❑ Er COMMENTS A11 dum ` fitted yes In all cases if Zoning Decision/re ceipt submitted that the a varia ::� must be appeal perio Variance, Petition No: submitted w;, Board of Appeals: Zoning Comments D°c.Building permit, planning Board Decision: Comments Decision' privewa Prm eit Conservation r &Sewer Connections; nature t;<Date ood Street W ate Located 384 Os ineer: Signature: Dpw Town Eng stet on site Yes FIRE DEPARTMENT " Temp Dump Located at 124 Main Streenatureldate Fire Department sig COMMENTS - --- - i 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 21 A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified foricku - Date P p Doc.Building Permit Revised 2010 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 c, 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 Location "Ji 7-Gh4o.,?y No. Date ,2 " d �ORTM TOWN OF NORTH ANDOVER F w 41 a �e Certificate of Occupancy $ skMus,<� Building/Frame Permit Fee $ Foundation Permit Fee $ , Other Permit Fee $ TOTAL $ Check # 23556 Building Inspector - \1;t��arhus�ft, - prllartntrnt of Puhlir lufct� - , I wieuact,�l✓ Board of liuilllin� Re"lllilt iolls ;uttl 1t;ul/l:u'tls "�" Office of Consumer Affairs 5} BlesinessRegulation Construction Supervisor Specialty License � IMPROVEMENT CONTRACTOR License: CS SL 99358 II `y Registration: 104569 Type: Restricted to: RFAS �� Expiration: 7/1412012 Private Corporation _ 1 DAVID CASTRICONE +t•r }91i DAIh[5 CASTRICONE ROOFING, SIDING& a ?' 31 COURT STREET NORTH ANDOVER, MA 01845 j " David Castricone 200 SUTTON ST SUITE 226 dL z _ NORTH ANDOVER, MA 01845 Llnticrsecrcl;uy � - y�'5� Expiration: 12!16!2011 l uuui..i wrr Trx: 99358 s ' V MAS. i ORTH F Town of No. o LAKE -O dover, Mass., COCh1'C..' IC" 7�S C5 RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System ^ ' BUILDING INSPECTOR THIS CERTIFIES THAT...............(.V.1!..!...1......./.. .. .G.. . ...................... .............................................................. Foundation has permission to erect.................:...................... buildings on ....;J...... c 0.ZfU.....5' .... .......... ................... Rough to be occupied as Chimney ....T d �� } .................. ............. .. . provided that the person accepts g this permit shall in every sped conform to the terms of the appli tion 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 6 , PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC TART 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. Town of North Andover1 tAOkYM Building Department o - o� 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 °� w,• �` A04�reo �S''SpCHUS�� i 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 wore- 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.- A)d 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, The Commonwealth of Massachusetts I Department of Industrial Accidents Office of Investigations 9t ,u 600 Washington Street Boston, MA 02111 "u www.mass.gov/dia Workers' CompensaCon Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business!Organization/Im°ividual): l t\V i .b CAST P i c o Ne o 0 r' i N S lb/tJ U I N C. Address: O 0 S L, rz- t-- City/State/Zip:N o . A ks -6 o v Phone#: 9r-/6 (A33Y-z r Are you an employer?Check tae appropriate box: Type of project(required): 1.91 I am a employer with `) 4. ❑ I am a general contractor and I 6. ❑Newconstruction 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.❑ 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 12Roof repairs insurance required.]fi employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#l 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 acid 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: L 1-f Pr/<-T vs Policy#or Self-ins. Lic.#: yy try o U )q ,3 Expiration Date: 9 'of Job Site Address: --,�OO 0 S, tCZ,+ City/State/Zip: PW 1 V& W d 1 7'f— Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requited 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 WORI<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 andpenalties of perjury that the information provided above is true and correct.' Sigznature: . J2 : Date: 10 �10 Phone#: q (o U 3q Z G 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#: ACORD,. CERTIFICATE OF LIABILITY INSURANCEDATE(MMrDD1YYYY) 9/24/2010 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 Insurance 40274 David Castricone Roofing & Siding Inc INSURER B:CHART IS 200 Sutton St Suite 226 INSURER C: 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 SR ADO'L POLICYEFFECTIVE POLICY EXPIRATION TYPEOFINSURANCF POLICY NUMBER LIMITS GENERAL LIABILITY EACHOCCURRENCE $ COMMERCIAL GENERAL LIABILITY DT6A PREMISES ffaoa urence CLAIMSMADE F�OCCUR MEDEXP(Anyoneperson) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCIS-COMP/OPAGG $ POLICY PRO- LOC A AUTOMOBILE LIABILITY BCNGCV 8/1/2010 8/1/2011 COMBINED SINGLE LIMIT $-1 000 000 AtJYAUTO (EaecGdern) , r r ALLOWNEDAUTOS BODILYINJURY $ X SCHEDULEDAUTOS (Pei person) X HIREDAUTOS BODILY INJURY r, $ X NON-OWNEDAUTOS (Peraoddenl) PROPERTY DAMAGE $ (Per accldenl) GARAGE LIABILITY AUTOONLY-EAACCIDENT $ ANYAUTO EAACC $ OTHER THAN AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACHOCCURRENCE $ OCCUR CLAIMSMADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WC003989723 9/23/2010 9/23/2011 X •WCSTATU- OTO- -� EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.E-ACHACCIDENT $100, 000 OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $100 000 If yyes describe under SPEC IAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $-,00, 000f OTHER 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS `'�,�� CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED David CdStriCGne Roofing & Siding IncBEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER �I J 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(2001108) p ACORD CORPORATION 1988 DAVID CASTRICONE ff 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 978-887-6147In Haverh111978-374-7314 E1 i Uwe the owner(s)of the premises mdrtioned 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;t'e'Hh';and, conditions,on premises below described: , J r pp `` q Owner's Name...... ......U:.4k/r�..... ,. /Gt td (.%........................................ ..........Tel hone#.....QL 4• •� � C .......10. .. ................................Job Address...... 2 ............... .. Specifications: ................................................................................................................... -Strip existing shingles r, ply new drip edge to all edges. WA 8 ...........................................................::............................................... ........................................................................................................ pp y_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. ............................................................................................................ (�... � pa�e _.-App F underlayment ltfstall ridge vent tort.` J � „ � .......... ......... ... ... . .............. ..................................................... Reroof using shingles with a 3r') year warranty. ...................................................................................................................................................................................................... .eounterflash chimney. -ew vent pipe flashing. ,.Legal disposal of all debris. IV :...... ....... ............................................/. 4rea(s)to be worked on. u ^ `. ... ....Jl7L7.E.. Q :..:.............,.......................... ILrat.[ ... 2 .. �.i<t a ...r.. .......................... .. .....................................................................e.:.................. .............................................................................:....................................... 1/ Roof board replacement if necessary @ lip /sheet or °:-;-/foot. .........................g.................................................................................................................................................. Two Year Workmanship Warranty(Not Transferable) Nranufacturer's Warranty as specified anufacturer The co fora ees to ppeerform the work an� s the materials specified above for the SUM 5.....714.0... ........... J ayable..:. D.��.......on...;s �............... Payable..........—............on........:::-.............. Balancayable on completion of job Owner or Owners are not responsible for Property Damage or Liability whi6is e pm 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 aro) the owners(s)of the above mentioned premises and that legal title thereto stands of record in his(their)names(s).There are no represpmations,guaranties or warranties,except such as may be herein incorporated,if any,not 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-f cancellatioonn). IN WITNESS WHEREOF,the parties have hereunto signed their names this da of....... ....'.......,20.�Q.. Accepted: Signed....:.. ...... ............:.�............... ........... Owner G(L� r Signed............................................................................. Owner . ..... ... .... David Castricone,President