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HomeMy WebLinkAboutVINYL SIDING %AORT}i BUILDING PERMIT o���VFD ,6 9Po TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o Permit No#: Date Received ��Q�RATED PPPR.jS ° SSacHus� Date Issued: / IMPORTANT: Applicant must complete all items on this page LOCATION �Cc, :rte PROPERTY OWNER 1�Ve r rpt Me /14 el d/ 0/t 1;—6�- Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District ye no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 'WRepair, replacement ❑Assessory Bldg 11Others: ❑ Demolition YOther ❑ Septics ❑Well ❑ Floodplain ❑Wetlands Watershe`cf Distract l Y ' iS; t 1 i f { I Y ❑ U `l&y,d 9� r / ❑Water/Sewer s r � , DESCRIPTION OF WORK TO BE PERFORMED: Identification- _Please Type or Print Clearly OWNER: Name: �r,rv,Z Phone: ` Address: 9�7 Ae Y'�i ' = c Contractor Name:: Phone: '-� Email: Address: ,�i J-/ Supervisor's Construction License: L'S x,9,3 S",f Exp. Date: /a /6' - Home Improvement License: Exp. Date: 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: $ FEE: $ 5 Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sia ' � E IAORTH Town of ndover 0 $A- I _n ® �® LAK ver, ass,'S$ COC BOARD OF HEALTH Food/Kitchen PERMiT T LD Septic System THIS CERTIFIES THAT .,/ ` � ` F o `s C w�` BUILDING INSPECTOR . ... ..... has permission to erect .......................... buildings on .s..7.. .... . ........ ................................. Foundation Rough to be occupied as l -5�.....!�: ......................��./............................................ Chimney provided that the person accepting this permit shall ifi every respect 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 EXPIRESPERMIT IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS Rough Service .......... ..... ..cl�G ................................. Final BUILDING INSPECTOR y GAS INSPECTOR Occupancy Permit Required to CCu,2V uildin 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. DAVID CASTRICONE CASTRICONE ROOFING&SIDING INC. ROOFING,SIDING&REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 oZ 3 I QWSUTTON STREET,1100210,N0.ANDOVER,MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In llaverhlll 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 below described: T0 Owner's Name...).s.4:: ......U �::j..... ..j..,Telfephone#.....................................-..........J......... Job Address........5 ........ ........................................I city..... �...4 !'t `"r? a.................StateAlA.......... Specifications: Areas to be covered: t.....................................( ll.s�.��:.!.! j. '.�...�:�.... +.5' ............ ....SCi�a�................................................. ✓Apply vinyl siding and corners. Type: t � _y� r t Ct +,cam Q 11OV trGil7C�ti y ........................ :.....................:...... ... ....... .r... �tL ......................... .. .. t/Cover fascia boards and rake boards. Install vinyl soffit - lid lid / perforated ................................................................ 71 Cover wood casings around Windt cos. rQ Replace any gable vents and dryer vents with vinyl. ..............�.y.— pply underlayment. Type: I t, h 0 U-5e_U1(`t111 ...........:.................,..f..�........ ............ .. Existing siding stripped / go-every 5 U fiS gal disposal of all debris. ...............................................................................;.................... Rotted wood replaced @ 6 ............. .................................................................................................. S/sheet or i65/toot. : ( -� .................. t..............................................,...............................................................................................................................,,... e:{HWLI' ....... "....................................................................................................................I........ ....................................................................................................................................................................................................I................. ..................................................................................................................................................................................................................... One Year Workmanship Warranty(Not Transferable) Manufacturer's Warranty as specified b LL a chrr The co tractor agre to rform the work an�jfumi h the materials specified above for the SUM of$.. . (2 ,....` I Payable... .Q........on....,,. T. �' ........... Payable....��i1.0........on....d. ...� Yl. .IK 107 `Balance payable on completion of job Owner or Owners are not respo�ble for Property Damage or Li ility while fob 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).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 Olen 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 die 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 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, All Home Improvement Contractors 4pll be registered and any inquiries about a contractor or subcontractor relating to a registration should be dirgcted4&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....9.. ......, y of............Lj�......,20..J.5... Accepted: C U Signed................. .. ..... ............. ............I............... Owner �\1 Signed............................................................................. Owner .t1... ..l..Ctlrll.:t.f:.....�.r.k3�ti;r.�1.��:�.ci:�'.�'r-L—•, David Castricone,President The Commonwealth of Massachusetts - Department oflndustriglAccidents Office of Investigations to 600 Washington Street .Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ' Please Print Legibly Name(Business/Organizatiordfndividual): �.O Lt)4D C..1-)f 7X 1C�-�_L /� ryy�i/��i,, y Address: City/State/Zip: It'd, 111V U) 1-114 6)/1VS— Phone#: 9�)t (b��_JY,)'V Are you an employer?Check the appropriate box: Typo of project(required): 1.Nf I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9 E]Building addition [No workers' comp.insurance 5. El We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. a 152,§1(4),a-ad we have no 12•❑Roofrepairs insurance required.]t employees:'[No workers' 13X Other ,5 ink Gam' comp.insurance required.] !Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they Lire doing all work and then hire outside contractors must submit a new affidavit indicating such. 1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy anti job site information. Insurance Company Name: 6,� Policy#or Self-ins.Lie.#: ZV C 00_3_ Y E �'7�t Expiration Date: Job Site Address: % '.�" %L e,7- City/State/Zip: 10d. yl- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. - Signature: C Date: Phone#• 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 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: DATE JMWDDffYYY A� 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 $llSan Donnell NAME: Eastern Insurance Group LLC PHONE (800)333-7234 AIC No: 233 West Central St E-MAIL ADDRESS:sdonnell@easterninsurance.com INSUREI AFFORDING COVERAGE NAIC# Natick MA 01760 INSURER A:Western World Insurance Co INSURED INSURER B Commerce Insurance Company 4754 David Castricone Roofing & Siding Inc, DBA: INSURERC:Granite State Insurance Co. 231 Rear Sutton Street, Unit 3A INSURER D: INSURER E: North Andover MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBERklaster 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S A CLAIMS-MADE I X1 OCCUR MPP1388404 9/6/2014 9/6/2015 MED EXP(Any one person) S 1,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY PRO-JFQ.T F-1 LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) S 1,000,000 BANY AUTO BODILY INJURY(Per person) S ALL OWNED rx SCHEDULED CNGCV /1/2014 /1/2015 BODILY INJURY(Per accident) S AUTOS AUTOSPROPERTY DAMAGENON-OWNED S X HIRED AUTOS AUTOS Peraccident S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTIONS $ C WORKERS COMPENSATIONSTATU- OTH- AND EMPLOYERS'LIABILITY YIN ItCRY LIMITS I I ER ANY PROPRIETOR/PARTNERIEXECUTIVE❑ E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) C003989723 9/23/2014 9/23/2015 E.L.DISEASE-EA EMPLOYEE $ 100,000 '.. If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Roofing & siding contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John Koegel/MET ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 mmnnsi m Th.ernwn n-and Innn arc—ictnrcrl mo lrc of ACnon Massachusetts - Department of Public Safety Board of Building Regulations and Standaras (�QWrurriun Super1 n n Sl)L't:L h ._ cense CSSL-099358 _, 11' DAVID T CASTRICONE 31 COURT STREET : NORTH ANDOVER Nuw01�8 5 , Commissioner 12/16/2015 Office of Consumer;lffairs& Business Ilei eulation `11– HOME IMPROVEMENT CONTRACTOR Oegistration: 104569 -!41, ;r'' Type: \,.;;Expiration: 7/14/2016 Private Corporatio DAVID CASTRICONE ROOFING, SIDING& David Castricone 231 R SUTTON ST SUITE 3A NORTH ANDOVER, MA 01845— Underseeretary N Fown of North Andover of s`0 K R 7 I-{ ° Building Department 27 Charles Street Nonl, ndover, Massachusetts OI845 *� ?o ` (c78) 688-9545 Fax (978) 688-9542 CSACHUS01 DEBRIS DISPOSAL. FOR VI o carce with the provisions of MGL c 40 s 54, and a condition of perm I t 7 the debris resulting from the worl� sliall be disposed D2- lr a oroper!y hcensed solid waste disposal facility as defined by MGL cl 1, sl 502 T ne cebr)s be disposed of in /at Facility location c /I Signature of ApDhcant Date i i \OTI A demolition pe.rrniI Erom tate Town ofMyth .Andover must be obtained for th is A pro ect t!uough the Office of the Building Inspector. i= 1. r