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Home My WebLink AboutBuilding Permit #149-2011 - 88 DUNCAN DRIVE 8/20/2010 BUILDING PERMIT of µoRTh (.LCD " TOWN OF NORTH ANDOVER 32 s r'_ APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received °4 A DRArED#,I Date Issued: (� �SSACHu`- IMPORTANT:Applicant must complete all items on this page f' � CATION ' (1l CA ilk �1Zf (�el U(E �Pn PRQPERTY OWNER__ E? = _ Print MAP 210 , PARCEL - ZONING DISTRICT:. Histonc`D�stnet e`s no. -.. . - y Machine Shop Village ye .0 no. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ~ One family Addition Two or more family Industrial Alteration No. of units: Commercial FefIS replacement Assessory Bldg Others: tion Other Floodplain Wetlands Watershed Districtewer _.__ _ - DESCRIPTION OFWORK TO BE PREFORMED: ISM Identification PIease Type or Print Clearly) OWNER: Name: r�ra , / If� rah Phone Address: l Un(Cul k 6 vr-1 o I� 1 CbNfTRACTQR Name. . L C1C. 0 U Phone . '�_ �2 ;- AddressS`1'�Z t _ ��_ + T - T Supeniisor's Consucfion License:_ 1.-.l 3 Exp`:: Date.: Home Improvement License (: `{'�(�` ®a - �- _. - - Exp � E Vie' ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ c) (oQ . 0-0 FEE: $ Check No.: Receipt No.: �j 1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner ::Signatureof confracto=; " Location O�- DUl1 e'G,,, !�rL. o No. Date 10 NORTp TOWN OF NORTH ANDOVER 3?0�•,`•o I•,�O Certificate of Occupancy $ sA�Ms<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 26g �, "i Building Inspector 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 COMMENTS f a 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 Os ood Street FIRE"DEPARTMENT Temp Dumpsfer on site yes no,_ Located-at--124 Main Street Fire-Departents�gnatue/date :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) ❑ 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 _u 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 o 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 NORTH ToVM of An over VO o -�= A K E -o dover, Mass., COC MICME.CK !�S RATED P' 5 BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .. .(: ... .i!^� .......................................i.................................. Foundation has permission to erect........................................ buildings on t5o......... . .?.rl. .!` -�-�.... �.�. ...:........... Rough to be occupied as. .,, ....... ....177k. r3 .�, ...... 1...:....................................... himney provided that the person accepting this permit shall in ev n aspect conform to the terms of 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 UNLESS CONSTRUC S ARTS ELECTRICAL INSPECTOR Rough ....... Service B 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. The Commonwealth of Massachusetts _ Department oj*Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information n Please Print Legibly Name (Business/organization/Individual):_ A� I 1.A TR C�N R Ott F I�►�Y 1 SID 1 N�T i N Address: 2p� Su-r rntJ Sr aZ�n-E-!r City/State/Zip:XANb0 JF,!(. MJb O t S uS Phone#: °I-)9 (e 6 3 3 4 2.0 Are,you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with 4. ❑ I 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 working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t 9. Building addition oration and its 10.❑ Electrical repairs or additions required.] 5. ❑ We are a corporation 3.E:1I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. JNo workers' comp. right of exemption per MGL 12.®'Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box Ill must also fill out tip section below showing their workers'compensation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractois 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. 1 ant an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. f Insurance Company Name:-T\n Q_ \ 0,%(1 Ce Qn A M1>fill4 G f- S ocb_ 'M Policy #or Self-ins. Lic. #: \N ,9 9 5 a, ; , Expiration Date: p c� Job Site Address: o U D uR car bV)\ v& City/State/Zip: �\LJ , (J d\4r. HA 611 w 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 imprisomnent, as well as civil penalties in the fonn 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 coveraye verification. 1 do hereby certify under the ams andpenalties ofperjury that the information provided above is true and correct. Signature-. � cl, . C Date: Phone#: 20 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.BGilding Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town of North Andover F t%nRT O�i16��,0 Q Building Department o 27 Charles Street ~ '0 North Andover, Massachusetts 01845 i n V (978) 688-9545 Fax (978) 688-9542 A °° :wH 0?Aron IS �y -TA HUS 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 work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 50a. The debris will be disposed of in/at: Ann Facility location f 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, , f)G 1 6 1010 /i DAVID CASTRICONE CASTRICONE ROOFING&SIDING INC. �io �a........... S ROOFING,SIDING&REMODELING REPLACEMENT WINDOWS (� V HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 y 200 SUTTON STREET,SUITE 226,NO.ANDOVER,MA 01845 (� In North Andover 978-683-3420 In Boxford 978-887-6147 In Haverhill 978-374-731 4 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: pn •s Owner's Name........ . dl GarY! ...................... . ......Te hone#..... ...... .....ht. ........ ...I.....f........`...Job Address.....dlbc ..L.� Specifications: ......................................................................................:.............................................................................................................................. ✓Strip existing shingles�(� .Apply new drip edge to all edges. �e 8�� .. .... .... ....... ....... ............................................................................................................................................................. „4.ply........ ......_feet. ..ice...and...water.*ate* ..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. ...................................................................................................................................................................................................... 'ply felt p nderlayment. ---In"stall ridge vent to ...........s , ,.. ............ ......... . ......... .. ................................................................................................... . •'lteroof using - r � shingles with a ` year warranty. ...................................................................................................................................................................................................................... -Counterflash chimney. -New vent pipe flashing. legal disposal of all debris. .2.:`.. .. ..................... .. ................................................. Areas)to be worked on: q / ........................................... .. ...Sf e f S...... exn v��r. ...../`A.v.t /...... 1.6.. ............................. ..............I................. r.:Ar,......... .... ........ ..................... ..... . m ...........�,�..r5 ...... .�. �., ...... r....�...,r.�....�. t,�t...i..r t_rG>fE G - '3 dZ C G t W D V11:............................................. .1 ..............7r-.......................k....l...................... .................. Roof board replacement if necessary @ Gd /sheet o� `-/foot. ...................................................................................................................................................................................................................... Two Year Workmanship Warranty(Not Transferable) M'anufacturer's Warranty as specified by man facturef,ao The contractor agrees to perform the work and furnish the materials specified above for the SUM of$..........tx ,9..�.v.. .. Payable.............................on................................. Payable.............................on.................................. Balance payable on completion of job Owner or Owners are not responsible for Property Damage or Liability while job 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 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 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 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. 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 parties have hereunto signed their names this..................day of.....a......................20........... Accepted: Signed..... ................... Owner Signed............................................................................. Owner ................................................................... David Castricone,President The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/.Plumbers Applicant L>Iformation Please Print Legibly Name (Busvzessiorgaiiizati,)t>rindividt>al): SAV 11 CM161COP4 'Q 06 F V NLY I S lD 1 N(, M, , Address: City/State/Zip: .JkNDO SEK. tft1 0 1 S(4� Phone#: °17 (e 3 3 y 20 Are,you an employer? Check the appr(gi.riate box: Type of project(required): 1.® 1 am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. E]New construction 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. insurancecomp. insurance.t 9. Building addition. required.] �• ❑ We are a corporation and its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.E] 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'k Other 61dr/V( comp. insurance required.] *Any applicant that checks box 111 must also fill out the section below showing;their workers'compensation policy information. C Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractois that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have eatployees. if the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing worker,'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:71( e— i C_ cz Co Mj( o-4 Policy #or Self-ins. Lic. #: W C.9 7 S A I y 1,,) '1 Expiration Date: q - ),3. 20 t ° Job Site Address: g 1 U hn)ov, 0,4& City/State/zip: N6 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 crnninal penalties of a foie 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 Officc of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under the pains and,_pp_e_nalties of perjury that.the information provided above is true and correct. Signature: i:)21. C Date: _ Phone#: 10 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 S.Plumbing Inspector 6. Other Contact Person: Phone#: Town of North Andover t%ORT + o 40 s �o Building Department O ti m 27 Charles Street A North Andover, Massachusetts 01845 it in (978) 688-9545 Fax (978) 688-9542 „wK. qAle 0' $ACHUS��y DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of. Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: f ems, Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. PRODUCFR FAX 508 G53-60hq THIS CERTIFIC=ATE IS ISSUED A5 A MA I-TER OF INI-ORMAT)ON Eastern Insurance Group LLC Comm rcitjl ONLY AND CONFERS NO RIGH i!;i UPON THF (',FR71FiCATP- 233 West CenLral Street HOLVER.TH16 CERTIFICATE DOE$ NOT AMF'.ND,F.XT ,NI?OR __ALTER_ T H E Q 0 V I�R AG,E A I;F 0 R 1)E D H Y THIN 1 0 L,I G I 1z.,S Uj c L C)W, Natick, MA 0.1,760 5eler-L Ext.53389 INSURERS AFFORDING COVERAGE NAIL It INWRLU David Castricone INSURUIA: - c o otatePA 200 5ution 5-G Su';to 226 North AnOuver, MA 01845, INSURER 0: I INS,JRr NN -[I E. I HE PDI-fGlf-,'j OF IN!3URANGE LU BELOW LOW HAVE HE'EN EN ISSUED TO TIDE INSURED NAME=D ABOVE FOR TI IL"POLICY'PD100 11101(�ATED,NOTWITHSTANDING P1 ANY 1�0UIRriN45NT,TOW Of�(,'(.)NDj J'ION Or ANY CONTRACT OR OTHER DOCUMENT WI'rI-I PE-SPECT TO b�,-HICH THIS 3 171-RTIFICA1 I.--MAY BE ISSUED 01C MAY PERTAIN,T1 117 II,H;IJRANCr-.Al-17ORDEID DYTI IL flouciEs Di:Fcp.jBr-D I-lr--nr-:IN IS SUBJECT TO ALL THE TC-RMS.EXCLUSIONS AND CQ(,Q(TIC%I'$0(7!;UCFI LIMITS S1 IOWN MAY HAVL:ULLN REDUCED UYPAID CLAIM lf,1411 -Lm . POLICY FVFPC ME POLICY EXPIRA I-ION IWtofINlullm:t POLICY NLMBFR GENIINAL LIAMLI I Y COMMENCIAL(3VNEAAL"L IA Lill-I-1-Y T(j Jj(-NTF15 41: "..(La CLAIMS MAI-.)P- Dcclirl -2F JAWCS -urcu.aficul— mco cxr(Any one pornon) PERSONAL K Al)V INJURY Q L PHOULIUl'i-Cumvlor AGO 7 POLICY ElF Lac ALIYOMOMLE LIAMLITY CID LIMIT ANY AUTQ 11-4 fg:r.1dcn1) OkI.A.Ovoa=p/kIj 4Q.5 BUDILY INJUNY 5011=OULED AU 105 (1'131 pel,l1r11 HIRLD A0TP5 BOOILY INJURY 1,1014-OWNED AUTOS PROPIfFIVY DANIACf! fpef w,06911t) GARAGE LIAIJILII Y AQT0 ONLY,EA AGCIDL.N 1 ANY ALIT"O OTHER THAN PA ACQ AUTO ONLY: AGO EXCI-SSIUMUM I-LN A LIARILIT r-ACI I DCCI,1Rr1 NCr- OCCLIP CLAIM$MADE R E,I I-N1 ION WOFIKFR-LJ COMPF.N4ATION AND WCC5274.609/23/2009 09/23/X-,-i1 )( CIVIPLOYCH'I'LIADILITY li-ORY-LIME-S-1. I ER_ A A14YPPQPIIII-.-r(.r4PAfAlt4l:R0.-'Y,(-(It)'rivf E.L.EACH ACrIIJFNT s 100,000 Itg , s,0csc,10r E.L.DISEASE-FA EMPLDYEF $ 100,000 Al.PROVIhill')NS I-Olow I,IMII' $ 110 -0-t 00 0 OTHER JUNU t.(3CATj0N1IIVl'HIV.LE!jjF 77A ZIPYICJN I 5IL WI _XC:LkJ9I0N-q ADDED Fly FNDOf13FMFNT I f.`,PPGIAI-Pnovisic)Ns SI-I0ULC1AI`IY0r7'II5A00VC David Castricone Roof ing & Sidng i 200 Sutton Street EXPIRATION DAI E THrREQr 'HE 1,90UINCINSURER WILL 1-'NVEAVOH 10 MAIL 1() DAYS WRITTEN NO1,`TO THF CE,ITIFICATE HOI.DFR NAMED TO THF LEFT, Suite 226 mt-IT rAILUn.E TO MAIL B(J,-,H 'rlr-r SHALL IMPOS-i.-No OnLIGIA-flON OR LiAnit-fTY North Andover , MA 01-845 Or ANY K1141:1 UPONYI-IF JYS ArrNT*011 AurHGRIZFD REP1112SENTATIVE IS*tacvy Brice-/PKG ACORD 25(200,1(08) (-f-;ACOIID CORPORATION 1988 "Pul vl"u/ -pcuu|yL/ccnae License: CS SL syaoo ' nesmc/"u/u: RF)mo HOME IMPROVEMENT CONTRACTOR Registration: 104569 Type; 7/1412012 P�vu�Cuqmmdu �V|O CASTR|CONE �xp/na/un� U 31C0URT8TREET STR\cONEROOFING,SIDING& NORTH ANDOVER, K4A018'|bWil David Custhuune � mooSUTTON sTSUITE za» NORT�AND0vsR. ymU�o�s Undersecretary Tr;,: y9338 � � ' ` ' � ` / � . ` � � � ' � � ` � ~ � � `