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HomeMy WebLinkAboutBuilding Permit # 6/7/2016 ,rOWN OF NOR'"M AND(WER APPLICATION FOR PLAN EXAMINATION Date Receive C04 Permit NO: Date lssued-61 -, terns on.this IMPORTANT LOCATION_— PROPERTY OWNER.—_zV61�51d_ plint _& ING DISTRICT: MAP NO.: ()6� . PARCEL: -,Q0W,-G-0N HISTORIC DISTRI YES [I TYPE AND FTSE OF BUILDING PROPOSED USE TYPE OF. IMPROVEMENT Non-Residential ]Residential 0 New Building EFJ One family l Two or more family o Industrial [-1 Addition No. of units: 0 Alteration 0 AssessorY Bldg.,�_ 0commercial !Ri R epair,replacement r� Demolition 01 Odiers: [--I Other L[i_MovinLrelocationj_ FJ Foundation only RK TO BE PREFORMED DESCRIPTION OF WU f , W ), ot Identification Please Type or Print Clearly) Phone—: / r,4 ,R: Name:— OWEN Address:-- Q7 1_3,PAe-o,) N CONTRACTOR Name: Address, Supervis or,s Construction License 162 0/P Home Improvement License: ARCHITECT/_ENQ1_NE_'E__R _ --- -Re g.N`o._____,__----- FEE �S.12.00 PER S1000-00 OF THE TOIAL ESTIMA TED COST R N$125.00 P E,R S.F. ,SCHED 11LE.B ULDING PE RMIT Iota],Project ____x12.00==TEE:$_ 2�rjfL Receipt No.: !,oq-6�? Check No.:---..— Page I of 4 U r '40 00 Z, yam* .... Plans Submitted ❑ Plans Waived ❑ `Gerif Plot Plan F-1 Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ ming/Massage/Body Art ❑ Swimming Pools El Well ❑ Tobacco Sales El Food Packaging/Sales F1 Private(septic tank, etc. ❑ Pennanent Dwnpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGM OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS Sicinature 7, CONSERVATION �9"� Reviewed on 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/Si nature & Date Driveway Permit DPW Town Engineer: Signature: —Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS t TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public Sewer ❑ Tobacco Sales Food Packaging/Sales ❑ Well ❑ L1Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contrac Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE F OLLON:'ING SECTIONS FOR OFFICE IF-ISE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special,Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Temp Dumpster on site yes_no Fire Department signature/date ,AORTH Town of2 Andover ® _ i o «H� h Ve1r, SSS' zat COCHICHEWICK y1' A04ATED U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System a== THIS CERTIFIES THAT .. BUILDING INSPECTOR ,.... Foundation has permission to erect .......................... buildings on . .. ...... ........... . ... .... .. Rough to be occupied as .. A f...... . . ... 1;k" ............................................... Chimney provided that the person accepting this permit shall in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST / I aRough Service ..... ............................... .. .............. ..... Final BUILDING INSP OR GAS INSPECTOR Occupancy Permit Required t® Occupy BuRough Display in s Conspicuous Place on thePremises — o Not Remove Final No Lathing r Be® Wall To One FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. t The - wealth ®f assac. users Executive Office ofHealth and Human SeiWces Massachusetts Rehab0tation ConwVssion 600 Washington tee - CHARLES D.BAKERosto a 0211.E-1. 04 GOVERNOR � KARYN E.POLITO LIEUTENANT GOVERNOR MARYLOU SUDDERS (617)204-3600 SEGPaTARY 1(300)245-6543 ADELAIDE R�4E Voice/TDD(617)20413$63 COMMISSIONER FAX(617)727-1354 CERTIFICATION FOR MAJOR 1 M F P or A I® MODIFICATION C HOME ACCESSIBILITY ADAPTATIONS (H ) DATE: May 20, 2016 The Massachusetts Rehabilitation Commission (MRC) certifies that; Accessible Solutions Division of Wood Wise Has been awarded the job to provide MAJOR housing modifications noted in the bid received for MRC Consumen Olena Granik 27 Beacon dill Rd. North Andover in the amount o 8,849 All work is to be conducted in accordance with the Scope of work, Architectural . drawings, Building Codes, regulations, guidelines and most current specification language of the Commission, and shall adhere to agency time standards for such work to be completed. Please submit an invoice and MRC Payment Voucher for payment for these services. 1091d".19 6ZIe Martha uirk Adaptive Services Coordinator CET # FYI 6®27 Conrad Guardraiiy�tern 3.1" 4"x4"vinyl sleeve over- 3.1 ver 3.1" n,ax treated wood-or our post max. Noce rora80&.0s mount system(not included) Ct eliwm on 8t dye, 9 12 42" 40" R 4 36 " Nott No NxWnum in bosom rat.SuMoft Blatt is m4flmd U Ground Clearance-2" Li W ins oaton to(Not the lnlarnOoM ReWdffel Code. AT 113 POINTS FOR ALL AT 113 POWTS FOR ALL LENGTHS GREATER THAN 8 FT.®�) LENGTH$GREATER THAN OFT, a 3.5"x 3.5"PVC T-Rail Profile 2"x 3.5"Rectangular Profile PVC Bottom Rail Extruded 6063-T5 Aluminum"H"Insert Aluminum reinforced Aluminum reinforced ri1 I i 1.5"x 1.5"Molded 1.5"x 1.5"PVC Picket 1.25"x 1.25"PVC Picket 1"x 1"PVC Picket PVC Spindle(LMT) 4"PVC Post Sleeve Bracket Fastening Schedule Bracket to Post Bracket to Rail PVC Molded T-Rai! Bracket LMT (6)#10 X 2-1/4"SS Wood (4)#10 X 3/4"SS Screws Screws PVC Rail Bracket AWM (4)#12 x 1-1/2"SS Wood (4)#12 X 3/4"SS Screws Screws Zinc Stallion Die Cast Eclipse (6)#10 X 2"SS Wood (4)#10 X 1"S5 Self- 1.5"x 1.5"Blow-Molded 7/8"x 1.5"Rectangular Bracket Screws Drilling Sheet Metal Alpine Spindle PVC Picket Screws Support Block Bracket to Bottom Rail (2)#10 X 3/4"SS Self-Starting Pan-Head Screws \\ 1 y; 3 r g i Y n ' 4 i _ mm lisp .y h` ry r. wwa+�n.�'aE.:` ':ZS �•� 4�y � _ aYr•^ N Residential Property Record Card#1 of 1 Parcel Year.2018 as o312015 PARCEL ID:2107058.B-0006-0000.0 MAP 058.B BLOCK 0006 LOT 0000.0 PARCEL ADDRESS:27 DEACON HILL BLV as 61 PARCEL INFORMATION Tax 101 Sale Price: 326000 Book: Tax Class: T Sale Date: 5!27/2010 Page: Tot Fin Area: 1200 Sale Type: P Cert/Doc: 100604 Tot Land Area: 0.21 Sale Velld: Y Qwner#1: HALLORAN,JOHN,J. Grantor. BURKE Owner#2: CIO ALFREDO SARACENO,JIR. Inspect Date: 8/2 41201 2 Road Type: T Exempt-BIL%: 0/0 Addres01: 27 BEACON HILL BOULEVARD Meas Date: 5/1 312 01 1 Rd Condition: P Resid-B/L%: 1001100 Address#2: Entrance: C Traffic: M Comm-B/L%: 0/0 NORTH ANDOVER MA 01845 Collect ID: RRC Water: Indust-B1L%: 010 Inspect Reas: R Sewer; Open Sp-B/L%: 010 RESIDENCE#1 INFORMATION LAND INFORMATION NBHD CODE: 5 NBHD CLASS: 5 ZONE., R4 Style: RN Tot Rooms: 5 Main Fn Area: 1200 Attic: Seg Type Code Method Sq-Ft Acres IMiu-11213 Value Class Story Height: 1 Bedrooms: 2 Up Fn Area: BsmtAraa 1040 P 101 9200 0.21 1007 186101 Root. G full Baths: 2 Add Fn Area: FnBsmt Area: i 'S Ext Wall; WS Half Baths: UnfinArea: Bsmt Grade: Masonry Trim: Ext Bath Fix. Tot Fin Area: 1200 RCNLD: 133983 Foundation: CN Bath QuaI:_ M Kitoh Ouat T Eff Yr Built: 1975 MktAdl:_ Heat Type: HW Ext Kitch: Year Built: 1950 Sound Value: Fusl Type: G Grade. A Cost Bldg: 134000 _ Fireplace: 1 Bsmt Gar Cap: Condition: AG Att Str Vail: Sir Unit Msr j MsHEDE STRUCTURE Grade INFORMATIONd% God /FIE/R Cost Class Central AC: N Bs"Gar SF: Pct Complete: Att Str Val2: Ali Gar SF: 380 '/.Good P/FIFJR: /100110087 to Porch Tvoe .Qrcn n eg P0 ch Grade Factor W 170 J Q VALUATION INFORMATION Current Total: 302100 Bldg: 134000 Land: 168100 MktLnd: 168100 SKETCH Prior Tot: 288100 Bldg: 1258800 Land: 162300 MktLnd: 162300 t. PHOTO W �\ I 170 Sq.Ft- 40 10 F FM G Sq 1040 Sq:Ft, 60 Sq.F 380 Sq.Ft. 9 20 20 20 26 - B 19 -U- 40 27 BEAC©N,HILL ELVD i E ClIx The Commonwealth of Massachusetts Department of Industrial Accidents X Congress Street,Suite 100 Boston,MA 02.114-2017 www mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibiy Name (Business/Organization/Individual): WOOD WISE CONSTRUCTION INC. DBA ACCESSIBLE SOLUTIONS Address: P. 0• Box 1330 City/State/Zip: Leominster MA 01453 Phone#: 978-534-9211 Are you an employer?Check the appropriate box: Type of project(required)' i.[SI am a employer with --4-employes(full and/or part-tine).* 7. ❑New construction 2,Q I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.(No workers'comp.insurance required.) 9. Demolition 3.F1 am a homeowner doing all work myself.(No workers'comp.insurance required.]t ❑ 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I wilt ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5,❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These subcontractors have employees and have workers'comp.insurances 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 1 ❑Other 152,i 1(4),and we have no employees.lNo workers'comp.insurance required.) *Any applicant that checks box#1 must also fill out the section below,showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors 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. I am an employer that isproviding workers'compensation insurance for my employees Below is thepolicy andjob site information. Insurance Company Name: Travelers Ins. Policy#or Self-ins.Lic.#: 6KUB070I N65-4-15 Expiration Date: 07/01/2016 Job Site Address: 27 Beacon Hill Blvd. City/Statetzip: N.Andover MA 01845 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violadon•punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. I do hereby certify under the pains and penalties of perjury Heat the f 1formation provided above is true and correct Date: 6/6/2015 Phone#: 978-534-9211 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#: WODWm1 OP ID:SM CERTIFICATE OF LIABILITY INSURANCE 05/2612016 THIS ciaRnmcxrE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, ECIUD OR ALTER THE COVERAGE AFFO D 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 Neu of such endorsemen s. PRODUCER NOME: Anthony F.S.Whitton The insurance Place®Gardner Anderson Bogle?&Mayo IA! PHONE g732.109x; N,.976-632.1149 20 Pearson Soultvard a: Gardner,MA 01440 Bernice A.Morrill INSUIREIRM AFrORDINo COVERAGE NAcs INSURER A..Travelers Indemnity of Ct. 25652 INSURED WoodWise Construction Inc INsummB:Arbella Protection ins.Co. 41360 dba Accessible Solutions PO x 1330 INSURERC: Leominster.MA 01453 ERD: E: - INSURER F., COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISPED 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. LLgryR TYPE OF INSURANCE POLICY NUMBER C an RAN& LIMITS GENERAL Imo' EACHOCCIJR19NCF s 1,000,000. B X COMMERCIAL GENERAL LIABILITY X 0500055514 06/26/2015 06!2612016 PREMISgSaagWj $ 100,00 CLAIMS-MADE ®OCCUR MED EXP(Arty a:e pwson) $ 5,80 PERSONAL d ADV INJURY S 1,000,00 GENERA.AGGREGATE $ 2,500,00 GEPrLAGGREGATE UWTAPPLIES PER: PRODUCTS•COMPIOPAGG $ 2.000,00 X PQLICY F-1 JECT PRO- LOC $ AUTOMOBILE LIABILITY BIN DSlNGLE LIMIT a ANY AUTO BODILY INJURY{Per person) $ AUT AUT�OSSUtEO BODILYINJURY(Pat accident) $ HIRED AUTOS NON-OWNED P 0 ACCT OAMAGE $ $ UMBRELLALIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR ET AGGREGATE $ RETENTION $ WORKERS COM TION WCSTATU- 0TH- A ANY OPReANDEMKo TOWARr cUTNE Y® NIA 6KUB-0701N65 15 07101/2015 0710112016 E.L.EACH ACCIDENT : 500,00 (Mandalay In NH) EL.DISEASE-EA EMKOYEE1 S 500,00 Ifyas d rba under DESSGRIPt10N OF OPERATION!$ E.L.DISEASE•POLICY LIMIT $ 500,00 DEECRIATION OF OPERATIONS I LOCATIONS I VEHICLES~ACORD 181,Addloonai Rwaft 8chodWe,I more space Is requrraM RE: Saracen® residence, 27 Beacon Hill Blvd,N.Anclover,Ka 01585 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Andover ACCORDANCE WITH THE POLICY PROVISIONS. Bldg Dept Bldg 20 1600 Osgood St Ste 2035 ee rill IVE B North Andover,MA 01645 Bernice A.Morrill 0 1985.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS 27 Construction Supervisor JAMES W CHESBROUGH PO BOX 1330 LEOMINSTER MA 0 e ZC; Expiration: Commissioner 10/3112017 Office of Consumer Affairs and Business Regulation 10 Park Plaza.® Suite 5170 Boston, Massachusetts 02116 Home Improvement Co"or Registration Registration: 115815 Type: Private Corporation ! ' Expiration: 4/20/2018 Tr# 419291 WOOD WISE CONSTRUCTION INC! JAMES CHESBROUGH w PO BOX 1330 LEOMINSTER, MA 01453 r i Update Address and return card.Mark reason for change. "t Address 0 Renewal n Employment Lost Card SCA 1 0 20M-05/11 /,./ a� - Vfl6 �F1111OltC9li'Veal111 Q19AI-JJCCCtmueltJ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: jegistration:;;<' 15g15 Type: Office of Consumer Affairs and Business Regulation xpIration;:---,.Q0-__-- /2Q4$ Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 WOOD WISE CONS7itJ£:Tt01t _'' ACCESSIBLE SOLUTION JAMES CHESBROUGH F. G• T30 LEOMINSTER,MA 01453 Undersecretary �,,lidhout signature