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Home My WebLink AboutBuilding Permit #202-11 - 520 SHARPNERS POND ROAD 9/8/2010 BUILDING PERMIToNo DT06 M '+ TOWN OF NORTH ANDOVER I0 324`y?'- ~O� APPLICATION FOR PLAN EXAMINATION Permit NO: 'Zo Date ReceivedAr P �gSSACHUS Date Issued: IMPORTANT:Applicant must complete all items on this page 7-7 77 LOCATION _ -5 Rant PROPERTY OWNER �_�f�v^121 V,-A-t—ar1-. d Pn "MAP_ .290 !PMC OVZONING}DI 7RICT Histonc°Distr"ict Vires no - Machine Shop Villagejres 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 , Well � Floodplain. 1l�/etlands U1l�tershed District Water/fewer DESCRIPTION OF WORK TO BE PREFORMED: 6 d mer ke- 61 ,ShlAq le a-11 axXz , of he C, s Identification Please Type or Print Clearly) OWNER: Name: "l d Phone: 4: Address: S-ZO 5hal i i lDav d kacyd A)6 674c vel rr ;, CONTRACTOR Nirne Address: dayn �'` sij t '. =- th Supervisor's Cansti°uction .1 icense ' 'C'113- Sub , Exp. bate ,n Home lmprovementLcerase Exp. flue: . ,1 ` fl f 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: $ 161 RL O. °o FEE: $ 3 Check No.: �, N Recei t No.: F NOTE: Persons contracting with unregistered contractors do not have access the u{Ira?fi(nd �, 5ignature'aof.Agent/Owner� a:, .. ,:,,t Signaturehof�ontractor ;..� :- ��` ��, l 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 I Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED k-;� OATE APPROVED: PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature .4 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:-Tem YDum seer. n sl#e> yes. . w no z rg= L.ocated.at124 Main Street _4 9 Fire DeparFment si9hature/cute e 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 i ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 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 "-t co, M-EtU S — Location No. ea CR "/l Date �J 40RT1y TOWN OF NORTH ANDOVER so , 1yo P 9 ' Certificate of Occupancy $ �sS CHUSE< Building/Frame Permit Fee $ 1 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # j 2344 Building Inspector ORTH TONM of _ Andover0 No. odower, Mass., o _ L �. A_ COC HIC HE WICK y '7 AD Cl S'A T E D '9SS BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .1'•f^1!".............� �... .............. .............. ........................................................... Foundation has permission to erect........................................ buildings on ........ �....5 . . . . s.....+ ....� Rough 20 Chimney to be occupied as.......... :M.......................................... .. ................. ...:......: provided that the person accept ng this permit shall in every respe nform to the terms o 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIM S TS Rough . ........... . ........... ............................................... ..................... Service BUILDING INSPECTOR Final Occupancy Permit Required t0 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. Smoke Det. SEE REVERSE SIDE ORTH Tovm of Andover No. LAKE o dover, lViass., -4� COC M ICMEWICK 7AORATED qSS BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT r41................. ... . ........................................................... Foundation ............ . has permission to erect........................................ buildings on ......... s. fatid....ta• Rough to be occupied as..........8^6.4"p `�........................ .�. .. ... ........................ Chimney provided that the person accep ng this permit shall in every '.- nform to the terms o 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 . PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTM, StARTS Rough ........... . ............... Service BUILDING INSPECTOR Final OCCupancy Permit Required t0 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. DAVID CASTRICONE CASTRICONE ROOFING& SIDING INC. x/`30 ll d 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 Bazjord 978-887-6147 In HoverbUI 97&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 worlonanship,to install,construct and place the improvements according to the following specifications,terms and conditions,on premises below described: Owner's Name......... 1'. (.....(...1.Z .Q Tel hone#.....1'ra.g.✓�.. ... � h c Job Address.: !....:J. errs .fr1�z f... ...��a:. .......J.City....�.1(6... p..tla.k...............State..../..aJ.l........ Specifications: ........................................................................................................................ ......... ..................................................................... ✓Stripn existing shingles. •-4ply new drip edge to all edges. M l `�„ t g& Cosle ........................................................................................................................................................................................ *,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. ........................................ �pply f It pa er and layment. stall ridge vent to�2�n---�� a L6�as„— �, �,,�, L�� ... ...... ... .. ... -Reroof using zD shingles with as year warranty. ...................................................................................................................................................................................................................... Xounterflash chimney. —blew vent pipe dashing. —regal disposal of all debris. ............................................................ .:�................................................................ Area(s)to be worked on: t ,. �)..... ,.. ..... . ....................................................... ............ ,. ...'.........t:�........Al ..... ........... ......... ..................... . ... ....::. . .t....... r , �... . .�. �. ..... 9... . ................... . ... s.�.�. .......... ........... ......................��.5...ID..................................... Roof..board... .. p replace.mry @ LD /sheet or ent' necessa oot o� ........ ...... .. ............................... �--!fer ....................................................................................................... ............................. Two Year Workmanship Warranty(Not Transferable) Manufacturer's Warranty as I y manufacturer The c tractor agrees t9 perform the work Id fitfttis] e m pals specified above for the SUM f$.... ............. ayable...... 4�..................on Payable.............................on..................................Balance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability while job is inti�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 warrant(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 aot 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 bedirected 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 b.k.day of./.lJt�[L� .......,20J.0.. Accepted: ! I Signed..... . ............. .... ...}}.--.J1K........... .......... Owner VSigned....................... ..1..4.0 .......... ......... Owner. David Castricone,President T. Commonwealth of Massachusetts � ..._ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insi-rance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leuibly Name (Business/Organization/Individualj:_ _D AV I I C ASTR{C.O NL 00 FACT S ID 1 N�, I N L Address 2bC� S�,-+;�ptJ -c(Lt✓ r Soy-t >` City/State/Zip: pc CC 0 1 4S Phone#: (o Are,you an employer? Check the appr,,Vriate box: Type of project(required): 1.X I am a employer with , $ 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). ; 2.❑ 1.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. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. ❑ Building addition 5. We are a co 10.❑ Electrical repairs or additions required.] ❑ corporation and its 3.❑ 1 am a homeowner do=ng all work officers have exercised their I L❑ Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12. Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13T] Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the;section below showing their workers'compensation policy information- r Homeowners who submit this affidavit indicating the;are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an addit onal 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 ant an employer that is providing worker,'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:71"e, \ �.S�Lr_C c e C4 mpa_1V G(- S,+Oc e V A- Policy #or Self-ins. Lic. #: �,9 9 a,`I y Co Expiration Date: Job Site Address:---5 d.O 5 ka [PAO.4 Pbil e( C�-c d d City/State/Zip:I )D AAA awl MA A 6 b�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 forth 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 certifyu der aims and etjalttes ofperjury that the information provided above is true and correct. � cam. Signature: Dater la _ Phone#: h 13 bQ Official use only. Do not write in this area, to be completed by city or'tuwn 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 Y3uildi>tag Ilcp;i>t'11111;I1C ., - �-: � _ 27 Ch:ules Street ]�iortll Audove:r, Massachusetts 0.184 5 (978) 68 8-954 5 Fax (979) 688-95,12 C11U5o I DEDR S :DISPOSAL FORM i l:n accordance Willi the provisions of MGL c 40 s 54, and a condition of Building permit: # the debris re:.. sting from the work sluill be disposed of in a pioperly lice-lised solid waste disposal faeilit.) as defined by MGL, c11, s150a. i The debris Will be disposed of in/at: I"acifily ll,`,'i111011 Signature of Applicant Date NOTE: A clernolihon permit frora the Town of North Andover must be obta.M.ed for tlik project tluo><iglt the Of[iee o:f the Bu[[cling Inspector. 11HODUCER (50015,51-t"M FAA 508---IJ53-808,9 11-113 CERTIFICATE 19 155WED A3 A MAI-TIZzli 01:7)wORMATION Grotil:t UC Cormnercial ONLY AND CONFERS NO RIGHT' -Ifik- [.,F�RTIFICATO Ea�tern Insurance1 233 West CLmLral St I'Lle L HOLDER.THIS CER-I"iFICATL DOCS NOT AMF.NQ,EXTV;1,40 OR Fly 1'FII- LIL--LOW, Natick, MA 01760 5ele.cL CM-53389 INSURERS AFFORDING COVERAGE NAIG Ilt INWRLO (lave{ QA5tricone —Inc- —IN3UREvA A: The Insurance co Or su, Ll P 1,00 SuLtun st; INSURER B, su.,to, Norl;h Ari(h*.ive.r, MA 01845) INSURER D: COVERAGES 1'I1E POLIGIF,i OF INJUI(ANGE LI11I E*U 0ELOW HAVE 01-EN ISSULD TO THE INSURED NAMED Vr.-FOR TIMI_ 1'0W OR 01-ANY C('-)N-I'I--�AC)'OP OTHEI'l DOCumEN'r wlrFt Rj=-.,;pECT TO VvPCMQ0 INDIQATED.NOTW111-15TANDING I-I CH THIS CERI IHCAI 1.-.MAY LIE ISSUED OIR MAY PERTAIN,7111"INFANIANCEAR'01RIDED DY'F1 IE POLICIES DESCRIBrD HEREIN IS SUBJEC'I-Tk0 ALL THE TE'F(N18-EXCLWINONG ArJO QQML)ITI0N1,;OF*UCH lloi.IGILS,AG(.WftC('ATL.LIMI-I 5 3HOWN MAY I-IAVL ULLN PEOUCEID UY PAID CLAW5. 114�14 _LmPOLICY NUMBER ODUCY F��IR,�FION UM11.5 CIENCHAL LIA1111.1 FY commi-Im.,mi-tA:(,ji:nACLIAHILI I-N' flA—MA C,'T—T C—JiFL.Q-j—r " 113L $ CLAIMS MADE (:)Cc lift _.2131_M15_.2131_M15L MCD CXP(Any one pormml IN-RSONAL K ADV INJUI:(y IqL-.1�1-14AI A(�'0QJ-U-QAfI: IkN'L AG0110'3A I I-L-MI I A1'11.11 IT-Ii. POLICY LQC AvromonlLE LIAMIT(V LIMIT ANYAUTC1 "LL ow,-Jf,p,kv I Qt, 1301JILY INJUNY SCHUAILED AU 105 (Po" )Qr;mq k-INIZI)Al.)1011 B00ILYWAIRY ti 14014-0WHED AIJ T OS mccirfin1l) (Par lycl(Imm) GARAGE LIAIIILI I Y AIjT0 ONLY, AW,'Ati'10 OTHER THAN HA A(;(; $ AUTO ONLY: AGO $ 31UMURELL.A I 1A1311-11 Y EACI I OCCUQW-INCIE A G G H F G A 1'r RET17 NT4)N I ..........:—............ S�I LT W(.)f4KF.Rq COMPFINSATIDN AND --W(T)7 5 iT4.6 09/2.3/2009 —09/23/ ...... FA A A14Y PPOPIRIF.J(F4)i'Af4*lt4i*.Ri[.-Y.F-C,t)*I'IVF. L.L.EACI I ACCIDENT 1 100,000 E.L.D15r-Aif-I.*.A EMPLOYEI: IF .100,000 ............ Pl�)I)CY J,IMIJ $ j00 000 011ILH —Am.w.n—nvrt4n—ow4FMF:l-AT i SPIXIAL imovigioNs 7,—cf.,� -- ------- 0 L D SHOULD AIHY,0r YI19 ADOVIC' "OLICIC$�,C(J%NW.LjzC1 OLI!011e ytic- David Castricone Roof ing & Siding EXPIRATION DATE THEREOF !111:199UING INUUREfi YVILLI-Nf)FAVJ)Ij 10 MAIL 200 Sutton Street DAYS WI1ITTENN0j,I..,., TO'IHI-(,Ell'rIFICAIFHOI..DF.FtNAMED T01tii-.LEFT, suite 226 BUT FAILI-1115 TO MAIL SUI-,H m",T[CF AHALL IMPOST;NO C1131-16ATICIN OR LIAHII-ITY NorLb Andove-r. , MA 0-.1845 QF ANY KINU th-ONYI-Ir 11,16i.-it IYFj Arol:NT5 Q11 ALITHORIZIED 1`11EIRRIESENTATIVE Stacey BriceIPKG -A Brice`PKI; ACORD 26(200'1108) C,:.;AG0RD CORPORATION 1989 Lirensr: CS SL 993;it1 /�a "��rtc��arrcarcclC� o`._G�ix dacfiudelkl a Resh'icled In_ R11-,WS Office of Consumer Afl;;irs&13usmcss Regulalioi� NF ''"°i� 1 HOME IMPROVEMENT CONTRACTOR }-a Registration: .1.04569 Type: r i`.; 1�ii�,, t i ' Expiration: 7/14/2012 Private Corporatio DAVID CAS RICONL= 3"I COURT S1 -I 1` CASTRICONE ROOFING, SIDING& NORTHANDQVER, MA 01E.fd15 � ,��!r��';, - :..tiiiEr��" David Castricone 200 SUTTON ST SUITE 226 _ Ixpiralion: 1�'/1G/201'I ;' NORTH ANDOVER, MA 01845 Undersecretary , y