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Home My WebLink AboutBuilding Permit #968-2016 - 62 BANNAN DRIVE 10/13/2015Permit No#: /0 //S - BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received Date issued: -':o Zlb IMPORTANT: Applicant must complete all items on this page LOCATION Boonoo 3r/,Ve- Print PROPERTY OWNER Print' 100 Year Structure MAP (nKPARCEL: ZONING DISTRICT: Historic District Machine Shop Village 0* t%ORTH f 0 yes I no yel I no yes%J no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building XOne family [I Addition 0 Two or more family El Industrial 11 Alteration No. of units: El Commercial --XRepair, replacement D Assessory Bldg El Others: El Demolition El Other 0 Septic DWell 0 �Ioodplain. 11 Wetlands 0 Watershed District n Water/Sewer DESCRIPTION OF WORK TO BE PV-XVUXMtU: 6-sAilwk n Identificab - Please Type or Print Clearly OWNER: Name: PrIG; JA Phone: Address: Aolae�l Contractor Narne: n(( )J9e �?66 A?6i Phone: Email: rig -,4) Address: �31 YL �A A '-16L,rt-&A tRV-1, ARA) Z7, 3� 617E, Supervisor's Construction License: —Exp. Date: f Home Improvement License: 16 �T/o 19 Exp. Date: ARCH ITECT/ENG I NEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIPMOO PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. goo "I Total Project Cost: $ 4 ta FEE: $ A) 4�p Check No.: so� Receipt No.:_ NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Location 22 go kj No. Date TOWN OF NORTH ANDOVER ,Certificate of Occupancy $ Building/Frame Permit Fee s Foundation Permit Fee Other Permit Fee $ TOTAL $ Plans Submitted Plans Waived [T Certified Plot Plan F1 Stamped Plans F1 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art F1 swimming Pools 11 Well Tobacco Sales 11 Food Packaging/Sales [I Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature C01 MMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connectionisignature & Date - Driveway Permit DPW Town Engineer: Signature: rn" LOcatea Jd4 USgood Z:itreet �J'WMPSFe. qo'n'pe, ly a V11 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 MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) El Notified for pickup Call Email Date Time Contact Name Doc.BuildiDg Pennit Revised 2014 M 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 OTE: All dumpster permits require sign off from Fire Departmeht 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (if Applicable) ,6 Mass check Energy Compliance Report (If Applicable) ,4., Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 16 Building Permit Application 4, 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 2012 IECC Energy code Engineering Affidavits for Engineered products 10TE: 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 Doe: Building Permit Revised 2014 V, rA 7m dMMMlW Lu 0 Cc r - o LU r.L cD Z C!) Z CD 0 E (D CL U) (D CD Cl) 0 -1.- 0 Cf) U) E (n - -J I - r4 .0 z P IL M Cf) w M LLI r > 0 0 0,0 > Cf) CL z x 0 LLJ —0 0 z CL W - tm cf) r- 0 (1) 0 w '— = LU L41) �: 0) LU —i > 0 . S Ol.- '0 a. z CL CL 00 0 0 U) M 0) 0 CL 0 U) CL) co CD Cl) cc m o 2 0 0 "u) :2 .2 z Ln A- 4.. 0 LU E a 0 -0 a) CL (A —j cn cn 0 r- 0 cc o L- 0 , CL 0 0 > �E 0 E 0 z 0 E 0 " (L CL CL CD r_ a CL 0 z 0 CL 0 CL cl: cr- 0 0 1 -- 0 CC z u u LLI u ... LU 0 M CL 2 LAj in IA u m z z ui U. z CL < 0 —A CA CL Q < z ui z z LU 0 S5 LL LU 6 z Ln ro C) a) a) a) -0 -Z b.0 :3 E to m — cu bZ :$ OZ D r_ " ai 0 0 CL 0 0 :E o S 0 o :3 -- E 0 a) (n LL U L.L Ln L.L L.L ca V) Ln 7m dMMMlW Lu 0 Cc r - o LU r.L cD Z C!) Z CD 0 E (D CL U) (D CD Cl) 0 -1.- 0 Cf) U) E (n - -J I - r4 .0 z P IL M Cf) w M LLI r > 0 0 0,0 > Cf) CL z x 0 LLJ —0 0 z CL W - tm cf) r- 0 (1) 0 w '— = LU L41) �: 0) LU —i > 0 . S Ol.- '0 a. z CL CL 00 0 0 U) M 0) 0 CL 0 U) CL) co CD Cl) cc m o 2 0 0 "u) :2 .2 z Ln A- 4.. 0 LU E a 0 -0 a) CL (A —j cn cn 0 r- 0 cc o L- 0 , CL 0 0 > �E 0 E 0 z 0 E 0 " (L CL CL CD r_ a CL 0 z 0 CL 0 CL DAVID CASTRICONE, PRES. CASTRICONE ROOFING & SIDING INC. ROOFING, SIDING & REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 231R SUTTON STREET UNIT 3A, NO. ANDOVER, MA01845 In North Andover 978-683-3420 InBoxfo.rd978-887-6147 InHaverhiII978-374-7314 I/we the owner(s) of the premises mentioned below, hereby contract with and aut6rize you as contractor, to fiumish 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: Owner's Name .... . . ................... / .......... Tel one#—..a.s.,,� R..Lly.4 Job Address .... ...... vt . ................. City ... 04;YV. -ef ......... State .... IIA4 ..... Specificalions /S *t'r' i'p- 'e, *x' i *s't'i i i'g* -s'ii i n*g-1`e-s' ...................................................................... I .......................... ....... ...... .......... -4 ................................... ....... ....................................................................... Apply .. (a_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. ....... .. ... .. .... ... ....... . . .... . .. . . ..... - . .. App . ly .. fel . t .. pi , perS . nger . I . a . y . me . n . t. 1.1 ... ri . d -g . e. . vent .. t . o ..... �j ...... ....... ...................... .............. I ...... I ................................. r) �p ........... . ........ . ....................................................................... ......................... X-*��shinglcs with a c1l) year warranty. TLZ �L4 ................................................................................... ................. . ........... I evv vent p ashing. �Counterflasli chimney. I isposal of all debris. ...... . ... .. ... .. . ... . . Are a(s) to be w o i k e d o n ........... . . .......... ............... . . ...... .. 0. .. e.0--5 ..... 0 .............. 4 ..... . .. . . ................... —44 Roof board replacement if neces . sary* .... /sheet o . ........... I .................. I ...................................................................................... ............ .... .. ..... ............ ....................... Five Year Workmanship Warranty (Not Transferable) Manufacturer's Warranty as sFpe' ed b f turer.. The,0'�ractor a rf y a., ..... .......... s vto e orm the work T(d Art above for the S of S.... the materials specift Payab ......... on.. dlp . ............... . Payable ..... 7= .............. on ......... = .................. A' alance payable on completion ofjob Owner or Owners are not responsible for Property Damage or Liability whil-0�6�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. . objects coming loose from walls, crumbling plaster, exposed nads, dust in attic or other living Lrials are property of contractor. Any dumpster placed by contractor is for his use only. Upon spaces). Items in attic may need to be covered by homeowner. All in. completion ofabove woik 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 thak 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 it= and conditions of the contract and/or any lien in connection herewith. Property may be subject to mechanic's lien ifunpaid. 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 ofthe parties. The undersigned warrant(s) that 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). Them are no rilimsentations, 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 shaH be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to the Office of Consumer Affairs and Business Regulations, Tel. (617) 973-8700. 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 MdL 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 the.reof understood and that no representation or agreement notherein 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 This contract may be cancelled, without penalty or obligation, within three business days of the below -referenced date. Mail or deliver a signed and dated notice or send a telegram to Castricone Roofing & Sidmig Ific, 1 utton St., No. do r, MA 01845 IN WITNESS YMEREOF the parties have hereunto signed their names this ...... .... .. .... day of .. "5. 1 . ..... 20.. 23 An, vO Ql---/ Accepted: 6ear7e U,7 Signed........ ....... .......... ...... .................................. Owner Signed......... ................................................................... Owner David Castricone, President The Connnonweakh 0i'MassachuSeas Depai-anew of Indushrial.Acciden6 Ojj'zce ofInvestig, ations 600 U11'ashitzglon Street Boston, AL4 02111 IM111.111ass.govIdia Workers' Compensation Insurance Affidalvit: Buildei-s/Conti-actoi-s/Electi-icians/Plumbei-s %Tame (13 usiness/Organ ization/I nd ivi dual): `ity/State/Zip:.A/o,- Andmf, HA o'/lop-hone 02 re ou an employer? Check the appropriate bom: I am a employer with 4. E] I am a general contractor and I have hired the sub -contractors ernpl oyees (ful I arid/or part -lime). *- I am a sole proprietor or partner- listed on lhe attached sheet. ship and have no employees working for me in any capacity. [No workers' comp. insurance required.) I am a homeowner doing at I work myself. [No workers' comp. insurance required,] 1 These sub -contractors have employees and have workers' comp. inSLirance.1 5. M We are a Corporation and its officers have exercised their right of exemption per MG1_ c. 152- 1(4). and we have no employees. [No workers' comp. insurance uired.) Type of project (required): 6. F1 New construction 7- El Remodelino 8. n Demolition 9. E] Building addition C. 10.0 Electrical repairs or additions I I.E] Plumbing repairs or additions 12,J��] Roof repairs 13.0 Other - I applicant that checks box #1 must also M 1 our the section below showing iheir workers' compensation policy fiiformation- meo-ners; who submit this affidavit indicating they we doing all %vork and 1hen hire outside conrractors Must submit a new offidavit indicating such. itTaciom thut check this box must attached an addifional sheei shotvm2 ihe name of the sub-COT)ITactors'and sta'le whether or not those entities have oyees. I f the sub-coniraciors have employees, they must provide their xvorL-ers� comp. policy number. u an employer that isproviding, workers'competistvion ills" rri., ce foi- ;, lY emplo-pees- Below is the policv alldiob site wmalio,ri. irance Company Name: A� Ajamww CY 4 or Self -ins. Lic. 9: Expiration Date: Site Address: 419(2�� &W12em City/State/Zip: 114 7.-7 3ch 'a copy of the workers' compensation policy declaration page (showing the policy number and expiration dqte). Lire to secure coverage as required unde.r Section 25A of MGL c. 152 can lead to the imposition o'criminal penalties of a up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORIC ORDER and a fine !p to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of 2stigations of the DIA for insurance coverage verification. hereby Certify under the pains andpenalties ofperjury that file hy,ormatz . on provided ahove is trite atid eorrect. nature: CJZ�1� Date: me 9 : L9 X0,-0 .1 OfficillIll-Veonly. City or Town: PermitfUcOise # issuing Authority (circle one): 1. Board of Health 2. Building Depari-inent 3. City/Town Clerk 4. Electrical Inspector 5. Pkirribing Inspector 0 a ACC>RO `%� CERTIFICATE OF LIABILITY INSURANCE F DA (MMIDONYYY) 1 9/16/2015 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 policy(ies) 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 endomement(s). PRODUCER Eastern Insurance Group LLC 233 West Central St Natick MA 01760 Co MNT CT NA EA Select Dept. . ,,. (800) 333 (781)586-8244 pHC Fft .�%� -7234 x66807 lAJC Nol: E-MAIL ADDRESS: selectwork@easterninsurance. com INSURER(S) AFFORDING COVERAGE NAIC INSURER A. -Wes tern World Insurance Cc INSURED David Castricone Roofing & Siding Inc. 231 Rear Sutton Street, Unit 3A North Andover MA 01845 INSURER B:Commerce Insurance Company 34754 INSURER C.Granite State Insurance Co. INSURER D: INSURER E INSURER F GOVERAGES CERTIFICATE NUMBER:CL159964794 Rr-vl-^Ilr)m 11JI 1111,111pr-Q& 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, INSR .LTR. TYPE OF INSURANCE ADOL INSR SUBRI WVO POUCY NUMBER POLICY EFF (MMJDD1YYYY POLICY EXP IMM/DOfYYYYI UMITS GENERAL UABILITY EA2H C' -SU RENCE $ 1,000,000 MERCLAL GENERAL LIABILITY !in.CLAIMS-MADE 'A.A�;E 75TENT ED PREMISES (Ea occurrence) S 50,000 A Fx] OCCUR TPIP1404373 9/6/2015 9/6/2016 MED EXP (Any one person) S 1,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN L AGGREGATE LIMIT APPLIES PE _� PRODUCTS - COMPIOP AGG S 2,000,000 T POLICY F—]_PRO- =T F Loc I I AUTOMOBILE LIABILITY COMBINrD SINGLE—LIMIT (Ea accident) S 1,000,000 BODILY INJURY (Per person) S B ANY AUTO Ix ALL OWNED Fy__1 SCHEDULED AUTOS AUTOS BCNGCV 8/1/2015 8/1/2016 --ni) $ BODILY ZURY (Per cddL NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMA�Tff (Per accIdent) S $ UMBRELLA LIAB EACH OCCURRENCE $ EXCESS UAB AGGREGATE DED RETENTION$ $ C WORKERS COMPENSATION AND STATJU,� JOTH- X I I EM P LOYERS' LIABILITY YIN TWC DRY , IM T�' I FIR E.L. EACH ACCIDENT $ 100,000 ANY PRC)PRIE-TOR/PARTNEPJEXECUTIVE OFFiCERIMEN`15ER EXCLUDED? NIA (Mandatory in Nh) WC003989723 9/23/2014 9/23/2 015 If describe under E.L. OISEASE - EA EMPLOYEE S 100,000 ns, DESCRIPTION OF OPERATIONS below KC003989723 9/23/2015 9/23/2016 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 1011, Additional Remarks Schedule, if more space Is required) Roofing & sicLing contractor rlF0TIl=Ir�A1r= — — w I v00-zU I U Ak.,UKU UUKI'UKATION. All rights reserved. INS025 oninn.�i ni This Ar.r)Qn n2ma 2nel I^n^ nra roetieforari mnrLea ^f arr)on 11�QL-L-M I IUM Castricone Roofing & Siding Un' it 3A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. 231 R Sutton Street AUTHORIZED REPRESENTATIVE 'North Andover, MA 0 1845 John Koegel/KH3 ACORO 25 [201n/n_;1 w I v00-zU I U Ak.,UKU UUKI'UKATION. All rights reserved. INS025 oninn.�i ni This Ar.r)Qn n2ma 2nel I^n^ nra roetieforari mnrLea ^f arr)on Massachusetts - Department of Public Safeq Board of Building Regulations and Standards C,n%tructimi SLII)Cl'% INI)j- SpL,cj�jIj\ �-icense: CSSL-099358 DAVED T CASTRI'ItONE 31 COURT STRE.ET NORTH ANDOVER Mas --XP;ration Commissioner 12116/2015 Office of Consurner.�`f'fafirs & Business Regulation "j)WEIROME IMPROVEMENT CONTRACTOR g istration: 104569 Type: ration: 7/14/2016 Private Corporatic DAVID CASTRICONE ROOFING. SIDING & David Castricone 231 R SUTTON ST SUITE 3A NORTH ANDOVER, MA 0184 5 Undersecretary