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HomeMy WebLinkAboutBuilding Permit #308-16 - 67 GLENNCREST DRIVE 9/9/2015 Je ✓E1� 22 N BUILDING PERMIT UD 1 O�.ct`-e �6q�0 6 TOWN OF NORTH ANDOVER 16, APPLICATION FOR PLAN EXAMINATION Permit Nog, o� (r Date Received �qs q,,Eo•Q��cS SACHUS Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION _ 6 7 6 LeA-)CK&.sr j)/'�l u t- Print PROPERTY OWNER )�A G/94e/0/z- Print 100 Year Structure yes n MAP 1 t PARCEL:_. ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building XOne family El Addition ❑Two or more family El Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other El $eptic 1Nell ❑ Floodplain El Wetlands ❑ Watershed Distnct 0 W.ater/S`ewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Named _(�rrvi d Y Phone: Address: 7 L�rOC l�£Jfi J/�1�� ��• I7iL�fid JFK, MA O1 E yS P66F/Wr Contractor Name: �ALc'mvCoi,UF Phone: 1979 (DU � Email Address: .-L3; 12 CcJ t�z�►-, �� , U r� B A . 0,. Ar4o Jc,-, NA- V J F Y� Supervisor's Construction License: ��3SExp. Date: Date: improvement License: ( � S p. Home Impr �o� Ex� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ �Cb FEE: $ L) / �� ,�� Check No.: _-s�' Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the aranty fund _ - . „ - - - - Location �' Leh cr ir j �- �r— No. — Date . - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee y $ TOTAL $ J — Check# F f r Building Inspector M 4v 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 4 U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ 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 DEP4AR MENT =Ternp'Dumpste��on siteyesa,; "moo C located at 124 Main Street ;f Fire Departmentsignature/date, r � - COMMENT5 Y s , ,+• ' ttri x' Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Suii,mning 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Si nature i COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Sgnafure& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street F,�LREDEPAR+TrMENT Teni Dum stet, on site es Loeatg. t l2,,4iMaintStreet partment signature/date .�. 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) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 i 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 4 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 Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit j Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract i Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And i Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) -I 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) iiBuilding Permit Application Certified Proposed Plot Plan t 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) j i. Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 . k NORTH Town of 2 . t ,. ndover No. _ t h Z h ver, Mass T % LAME 1 COCKICMf WICK �qS RATED 11 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT ........ `�'.�,�r10, ............ BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .......... ...... ........................ Rough tobe occupied as ................ .. ......r. ........... f!. .................................................................... Chimney provided that the person acceptin this permit shall in every spect conform to the terms of the application Final on file in 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 CONSTRUCTION STARTS Rough Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. DAVID CASTRICONE PRES. CASTRICONE ROOFING & SIDING INC. ROOFING, SIDING & REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 231 R SUTTON STREET UNIT 3A, NO.ANDOVER, MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In Haverhill 978-374-7314 I/we 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 bAw described: Owner's Name......F—,. .....: ..%.I /.at .........,....................................t...........T hone Job Address...... ........City .,. .M..� .xt.'1-e-f............State...l.....1 .... Specifications: . .......................... // q- Ship ex. ......... isting shingles. ✓Aliply new drip edge to all edges. Ddlw/� r ....................................................................................................I..... .`....................................................................................................... ✓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. /-t/ l f rn Q� J� �/rrD�f,��� �s ��� .............................................................................................................l.t...................................;..,............. .,...... . t/Apply fir pig untlerluyment. iu tall rr< vent to / f s D. ekf'Enlo S / ,r�1i�t. .............. ................. ............... ................. ................................_,.............................................................. ,/Reroof using -' shingles with a ' _year warranty. ................:T .....................�... . Z�'Ounterflash chinutcy.✓New,vent pipe flashing. f egal disposal of all debris. r 1t� geJ! n.................. i ............... Arca(s)to be worked on: . pg��+ .. rr. ..r�. e � . .cl s.. ..� s..>......... ............................... ... .. . :...j'.C.-OF.. .................. ' , ..e f.w...a res x. .o...ta.�o.................. p� �C..�Woard..rel.► ....:...... ....�°.:.. r......:........ ...... ... ...... ...... ........... .. .......... ......... n........ .. ... Roof bplacement rf necessary @ /sheet .......:................................................................................................................................... ................. .................... .. Five Year Workmanship Warranty(Not Transferable) Manufacturer's Warranty as sp died by menu cturer The7tctor agrees to perform the work and i the materials specified above for the S of S....0.1-y-Q............ayable......J_`L411.0....on...5 ....... Payable.............................on................................ alance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability w 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,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 owncr(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.Property may be subject to mechanic's lien if unpaid.It is further agreed that this contract may be assigned by contractor,and also that the obligations hereof shall bind and apply I to their heirssuccessors or estates of the panics.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 not herein stated.Any,subsequent agreement in reference hereto shall be binding only if in writing and signed by all parties. w All Home Improvement Contractors shall 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 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 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&Siding Inc,231R Sutton St.,No.Andover,MA 01845. dZ. � IN WITNESS WHEREOF,the parties have hereunto signed their names this.......a.....day of..............�..........,20J. Accepted: .:A. . Signed... ..... ....................................... Owner Signed............................................................................. Owner I ................................................................... David Castricone,President Town of North Andover of "`Yo6 -1 � Building Department ti7P A 27 Chai-les Street t , NonL A—tidover, Massachusetts 01845 1r �O i r8) 688-93,45 Fax (978) 688-9542 S, '4 CHus E� DEBRIS DISPOSAL FOFJ%'1 Gorda ce with tie provisions of MGL c 40 s 54, and a condition of u { g permit the debris resulting from the wor.: slLail Le disposed o P a o-oper!y licensed solid waste disposal facility as defined by MGL cl 1 s.i504 ceb )Q ,,01 be disposed of in at J P Facility location Signature of Applicant D3i.e ;a t \OfL A eemoi tio;; perrruI f7om the Town of Not?h Andover must oc obtained for this project t!ueu�h the Office of the Building Inspector. i �Y The Counnonwealth oJrIE assachuSet`d':s Departlnew of Industrial Aceideatts 0Jj ice OfUnvestig tions t=t u t Y1 �4` rtr�-1 600 �'illlSl1111atoil uti-eet A Boston, AL4 02111 {TAy yr� iv;vw.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Cont> actor•s/Eiecti-icians/Plumbei-s kpplicaut Information Please Print Legibly kTame (Business/Organization/Individual): ^I)A`LL l.H.�TI'21Cd,u� ►�Ob Ff S I�I�C1 ��� address: .23 f K Suj TbO ST 00 rr 3A :ity/State/Zip: . �. &WA_ A O�Yf Phone #: G t 3 re you an employer? Check tete appropriate box: 'Type of project (required): I am a employer with q 4. ❑ I am a general contractor and I employees(full and/or part-time}. have hired the sub-contractors 6. E] New construction 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp, insurance comp. insurance) required.] 5. ❑ We are a corporation and its 10.EJ Electrical repairs.or additions 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions �o workers myself. ' com right of exemption per MGL y P• ' insurance required.] t c. 151, ](4). and we have no 12.� Roof repairs employees. [14o workers' 131-1 Other- comp. thercomp. insurance required.) 1 applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. itractors that check this box must anached an additional sheet showine the name of the sub-comractors*and state whedher or not those entities have oyees. if the sub-contractors have employees,they must provide their %vorkersl comp.policy number. u an employer that is providing workers'compenst- on insurancefor irry emplovoes. Below is the policv acrd job site �rrilatfoll. trance Company Name: G i?-A 17 l'1T_- —ST f)—/e 0-SL-)(LAJ0C f. a cy # or Self-ins. Lic. H: �N 0 3c �q -10\3 Expiration Date: Site Address: �7 -rlz,t`)l_1��? �12-IUB City/State/Zip: ��• ►'11UD t1 /l. /v d It ach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). the to secure coverage as required under Section 25A of N4GL c. 152 can lead to the imposition of 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 WORK 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 �stigations of the DIA for insurance coverage verification. r hereby certify under the pains and penalties of perjury that the infornrrtion provider{above is trite and eorr•ect. nature: �. C Date: rite : /b is �t� J�d'� . Official rise only. Do not write in this area, io be completed by cite%or town offtciaL City or Town: Pcrmit[Llcense 9 issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Tov n Clerk 4. Elecirical inspector S. Plurrhbing Inspector Aco �� CERTIFICATE OF LIABILITY INSURANCE 9/10/2014 ) 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 endorsement(s). PRODUCER CONTACT NAME: Susan Donnell Eastern Insurance Group LLC PHONE (800)333-7234 Fac No: 233 West Central St E-^"'41LADORE .sdonnell@easterninsurance.com INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURER A:Western World Insurance Co INSURED INSURERSCommerce Insurance Company 4754 David Castricone Roofing 6 Siding Inc, DHA: INSURERCGranite State Insurance Co. 231 Rear Sutton Street, Unit 3A INSURER0: INSURER E North Andover MA 01645 INSURER F: COVERAGES CERTIFICATE NUMBERMaster 14-15 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. INSR I ADOL SUER POLICY NUMBER MMIDDYtYEVYY MM/ODYr­EXP LIMITS LTx TYPE OF INSURANCE GENERAL LIABRJTY EACH OCCURRENCE S 1,000,000 X I COMMERCIAL GENERAL LIABILITY DAMAGE t U RENTEDPREMISES Ea occurrence $ 50,000 A CLAIMS-MADE 7 OCCUR NPP1388404 /6/2014 /6/2015 MED EXP(Any one Person) S 11 000 L I PERSONAL 8 ADV INJURY $ 1,000,000 UGENERALAGGREGATE S 2,000,000 �N'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AIG S 2,000,000 x I Pa_IcY I I PaaF1oc S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea agideno S 11000,000 AUTO BODILY INJURY(Per person) S ALL OWNEDSCHEDULED �ALr OS x AUTOS CNGCV /1/2014 8/1/2015 BODILY INJURY(Per accident) S j x LaEO AUTOS x NON-OWNED PROPERTY DAMAGE AUTOS� Per accident S I utoBRE.LLA LIAB OCCUR ��L1Ae EACH OCCURRENCE S F_xCLAIMS-MADE AGGREGATE $ DEC) 1 1 RETENTIONS C WORKERS COMPENSATION WC -STATU0TH. S AND EMPLOYERS'LJABILITY YIN YY PROPRIETOR/PARTNER/EXECUTIVE OFFCERAMEMSER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT S 100 000 (Ma-d.--y to NH) WC003989723 /23/2014 /23/2015 If yes:oesm6e under E.L.DISEASE-EA EMPLOYEE S 100 000 0_SCRI=-TION Or OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 I I DESCRIPTION Or OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,A more space is required) Roo=i_g s siding contractor I CERTIFICATE HOLDER CANCELLATION astricone,foofing Se Sid>ng SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Unit 3A ACCORDANCE WITH THE POLICY PROVISIONS. 231 R Sutton Street AUTHORIZED REPRESENTATNE North Andover, MA 01845 John Koegel/MET ACORD 25(2010105) I ©1988-2010 ACORD CORPORATION. All rights reserved. NSD25 nn:rrr;+n+ Tho A!:(1Rl1 Hama�n.i Innn aro ronigfnrorim orLo of Sr`rlq tl Massachusetts - Department of Public Safety Board of Building Regulations and Standards C -nctructiun suhcrN i,,r specialth License: CSSL-099358 DAVID T CASTRIONE . 31 COURT STREET NORTH ANDOVER MA'10184 5 , r1: _ ��• �Xp!ratlOn ommissloner 12/16/2015 Office of Consumer Affairs&Business Regulation I:1Bi OME IMPROVEMENT CONTRACTOR l registration: 104569 ration 7/14/2016 Type: Private Corporatic DAVID CASTRICONE ROOFING,SIDING& David Castricone 231 R SUTTON ST SUITE 3A NORTH ANDOVER, MA 01845 — Undersecretary