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Home My WebLink AboutSTRIP AND REROOF (7) IJIL®ING PERMIT �aoRry ®��tL�o ,g�tio TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#• ,) Date Received �,R'�R`T neo t � Date Issued: �' IMPORTANT: Applicant must complete all items on this page LOCATION ,; 7 6 l t,4) % Print PROPERTY OWNER Print 100 Year Structure yes n MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building Xone family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg- ❑ Others: ❑ Demolition ❑ Other r'asSe t�c�'�,"`❑rWell 'r ❑ Floodplain ❑Wetlands ❑l Watershed Distract r r ; DESCRIPTION OF WORK TO BE PERFORMED: �l'rr m�sbl l e- f P Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: `/ L I G P �� c� i� L)�o�- I �f %s F ntractor Name: OA5'�rCc�r�fP66ri�6 Phone: 6l®78 6 3Y-)-C' Address: I �: �'�� Sit (�6� , - je, Supervisor's Construction License: Gt--�S-0 Exp. Date: Home Improvement License: ( � �(� Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. (4 d Total Project Cost: $ q' FEE: $ xy Check No. e t Receip No.: � NOTE: Persons contracting with unregistered contractors do not have access to the aranty fund IAORTH own of ndover E. :..'..,.' . IST®. � _ ® C, of 1q, �nKa ver, Mass, COC MIGMlw'[K �1. �d AD4ATED '' C S V BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT ......... ,1,ric1®, BUILDING INSPECTOR has permission to erect ....................... buildings on ...... ...... .�'�... Foundation v Rough tobe occupied as ................ .. . . .... ... ................. .................................................................... 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 PERMIT EXPIRES IN 6 MONTHSELECTRICAL INSPECTOR UNLESS C ST CTI STARTS Rough Service ................................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® 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, FRES. 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 InHaverhill 978-374-7314 Uwe the owner(s)of the premises mentioned below,hereby contract with and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the following specifications,terms and conditions,on premises b¢f4w described: Owner's Name......E ZL)... . ........ Tlyhoneift . .......... .... ... .... el,,L��,,.V.,F_r:.............State...AW.... Job Address...... specification: ...........I—.........G.. ✓Strip existing Shingles. lz1)I*),I*y1,1, ..............I..................................... ...... ............ .......... ........ .............................................................................. Apply--3--fect ice and water shield membrane to bottom edges of house.3 feet ice and water chic I membrane in valleys and bottom edges of any unheated areas of house. 1 11 .................................................................................................... ........ r ...................I........ In '11.ventt....to....................J......................... �...../..I._......'`-, .......11.......................... I/Reroofusing(l,iShingles with a year Warranty. t" .................................................................................................................... tegaldisposal lifall debris. ............................ ... ................... ............ V.. .......... Arca(s)to be worked on; .................... ................ ......... _Zr ............... ..... ................. ....... ...... .4f........ ............ �)14 C /ILItvs� VJ .........................*............ . ...... ....... Roof board replacementif necessary 0_arj�,& /�s�liiect —/foot. ....... .............................. ....................................................... .................... .. ........................ b ,.0 . ,t.rer ..0............... tractor agrees to perform the work andfivAmisb the materials specified above for the S of$..... ...***...*.......................... ;y*.*;sp*iried y Five Year Workmanship Warranty(Not Transferable) Manufacturer's Warranty z in no The ,Vayable... ............... 7 Payable.............................on................................ Palance payable on completion ofjob Owner or Owners are not responsible for Property Damage or Liability ej b is in operation. Contractor is not responsible for arty damage to the interior of property,including pro-existing conditions(i.e.water stains,crumbling plaster,exposed nails)or conditions resulting from application of materials specified above (i.e.objects coming](lose from walls,crumbling plaster,exposed nails,dust in attic or other living All spaces). Items in attic may need to be covered by homeowner. materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion ofabovo 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 Wood 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 promises and diet legal title thereto stands of record in his(Ilicir) narrics(s).There are no representation,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 panics, 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,,...�*:L.... �f Completion date......................................................... Receipt of a copy of this con'tact 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. IN WITNESS WHEREOF,the parties have hereunto signed their names this.....11'....,day of..... ...........20J.4 Accepted: Signed.....1r........ Owner ......................................... Signed............................................................................. Owner .................................................... David Castricone,President foNvn of North Andovero� N0R'rH �AV O 0 Building Department ° t�7iPr A 2"/ Char-les Street x ' ;'\�ion1, A—ndover, Massachusetts 01845 (975) 688-9545 Fax (978) 685-9542 �SACHUSES DEBRIS DISPOSAL FOUM with tlhe provisions of MGL c 40 s 54, and a condition of ?_nn.n„ perrmt Y the dehns resulting from the wort: sli- l be disposed of in a property licensed solid waste disposal tacility as defined by MOL C l sl 502 Tie cbr�s �-��il be disposed of in /at Facility location Signature of Applicant �l P A NOTE A demoinion permit W the Town of Noah .Andover must be obtained for this project duough the Office of the Building Inspector. r sad i Th e �orrrrrlon weat'h of Tfassachusei'i's Depar•tinerri of hidustrial.Aceidefzts Of cee of Invesiigradons 600 �i�flsfrittaton Street Boston, ALA 02111 fr^ 1Vt'JZV.111aSS.g01r1dda Workers' Compensation Insurance Affidavit: Builders/Conti-actor-s/Electi;-icians/Plumbers kpplicapt Information Please Print Legibly f �J c NTamc (Business/Organization/Individual):� ,��/I�IT�1CdIUL 1�0 F} J 1 D ily(7 , �4A Wdress: =_23 i R SU-f Tu) - V N t rt 3A :ity/State/Zip: Imo' &W�vtk A oil Y Phone #: ql7n (vu `30t re you an employer? Check the appropriate box.- 'Type of project (required): I am a employer with ❑ 4. I am a general contractor and I 6. ❑ New construction � have hired the sub-contractors employees(full and/or part-time).* I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demoli[ion working for in an capacity. employees and have workers' g y P t' 9. ❑ Building addition No tivorkers' comp. insurance comp. insttrance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their am a homeowner doing all work officers Plumbing repairs or additions myself. o workers' com right of exemption per MOL m y p. c.C15?, t 1(4), and eve have no 12-�Roof repairs insurance required.] 13.❑ Other i employees. [No workers' COMP. insurance required.] t nppticant that dtecks box itl 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. ttractors that check this box must attached an additional sheet shoevine the name of the sub-comractors'and state whether or not those entities have oyecs. If the sub-contractors have employees, they must provide their X:rorkers'comp.policy number. re an employer that is providing workers'compensation hisurarce for ir,t, enplouees. Below is the policy and job site )rmation. trance Corn party Name: UV—No cy# or Self-ins.Lic. 11: C) 7 Expiration Date: Site Address: is ( l.,(HJT �94 UL City/State/Zip: �� f7�(7 t1 Je12 acre a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Lire to secure coverage as required under Section 25A of MGL 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 tp 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. r hereby certifv raider the pai;ts atnd penaltiesof perjury that the information provided above is trite and eorrect. nature: C Date: the 9: 11� J� . Official us-e only. Do not write in this Brea, to be completed by cite:or offtciaL City or'Town:, Permitri,icense h Issuing Authority (circle one): 1. Board of)health 2. Building Department 3. City/Town Clerk 4. Elecirical inspector S. Plumbing inspector CERTIFICATE OF LIABILITY INSURANCE DATE Oo14' 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(les) 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 Susan Donnell NAME: Eastern Insurance Group LLC PHONE (800) A 333-7234 F_X No: 233 West Central St AbMC)RES .IL .sdonnell@easterninsurance.com ADD INSURERS AFFORDING COVERAGE NAIC k Natick MA 01760 INSURER A:Wes tern World Insurance Co INSURED INSURERB:Commerce Insurance Company 4754 David Castricone Roofing 6 Siding Inc, DHA: INSURERC.�iranite State Insurance Co. 231 Rear Sutton Street, Unit 3A INSURER D: INSURER E: North Andover MA 01645 INSURER F: COVERAGES CERTIFICATENUMBERMaster 1d-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. INSRADDL SUBR POLICY EFF POLICY EXP LTR I TYPE OF INSURANCEPOLICY NUMBER MWDDrYYYY) (MWOOfYYYYI LIMITS GENERAL LIARfUTY EACH OCCURRENCE S 1,000,000 I COMMERCIAL GENERAL LIABILITY PREMISES Ea AMA ET RENTED occurrence) X 50,000 S A =CLAIMS-MADE ❑X OCCUR tTPP1388404 /6/2019 /6/2015 MED EXP(Any one person) S 1,000 L-1 PERSONAL&ADV INJURY $ 1,000,000 II GENERAL AGGREGATE $ 2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 I X I POLICY r_1 PRO- LOC S AUTOMOBILE UABIUTY EOMe01SINGLE LIMIT S 1 DOD DDD ANY AUTO BODILY INJURY(Per person) S III----ALL OWNED X SCHEDULED CNGCv /1/2014 8/1/2015 �I.ALFI. AUTOS BODILY INJURY(Per accident) S j X 'I ED AUTOS X NONAUT-OWNED PROPERTY DAMAGE S I Per accident �I S UMBRELLA UAB EACH OCCURRENCE S EXCESS UAB HOCCUR CLAIMS-MADE AGGREGATE $ I I DED 1 1 RETENTIONS S C WORKERS CORPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N :.NY PROPR:ETORlPA,4TN ER/EXECUTIVE OFF tCERA.tE.MSER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT S lOD 000 (Mandatory in NH) C003989723 /23/2014 /23/2015 It yes descnS—under E.L.DISEASE-EA EMPLOYEE 5 100,000 DESCRI:--iION Or OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 I j DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Rcc:i�g siding contractor I CERTIFICATE HOLDER CANCELLATION Castricone Roofing 8c Siding SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Unit 3A ACCORDANCE WITH THE POLICY PROVISIONS. 231 R Sutton Street AUTHORIZED REPRESENTATIVE North Andover, MA 01845 John Koegel/MET ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. 11d SD 25 nnTh.A!:()pr1 Hama anri Inns oro roniGforori marine of Gl;rlq rl Massachusetts - Department of Public Safety Board of Building Regulations and Standards C'Mtructiuu SuherN iso SIiCCi;ilt\ ucense: CSSL-099358 DAVID T CASTRICONE, 31 COURT STREET if NORTH ANDOVER MPGR, 5 , ✓.,L,. ��• Expiration Commissioner 12/16/2015 `. '�-��r' �o;uirroiuncvr�/�r`r,..��ir.i.;nc•�rcinf/; Office of Consumer Affairs&Business Regulation yfi --KOME IMPROVEMENT CONTRACTOR (; �{",egistration: 104569 -<, Ex iration: 7/14/2016 Type: > �;�' p Private Corporatic DAVID CASTRICONE ROOFING,SIDING& David Castricone 231 R SUTTON ST SUITE 3A NORTH ANDOVER, MA 01845 — Undersecretary