Loading...
HomeMy WebLinkAboutBuilding Permit # 1/11/2017 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATI N * b Permit NO: Date Received 9 i�'vryiim rYT',4'6' Date Issued: o i IMPORTANT: Applicant must conn lete all items on this page LCCATIO:T,1 fVIP [�lO ` I�ARCI; . ����3NlN DII�T'RICT� Hi�tart�1Estrl�t: � ; M� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential LJklew Building ne family addition Etwo or more family Ondustrial IteNo. of units: Ebommercial e air, replacement LIssessory Bldg Others: emolitionEbther eptfc elll+ odplr etlrtst+erlte [ ttr ilerSer ? g ;q Ali 3 4'.4 y- c A. Identification Please Type or Print Clearly) OWNER: Name: ,.. ' + `� Phone: Address: CfiI�TRATOI Nettie t Pht�e� Address Sitter tsdr's 6hstt- t t Hort+ lrroe �t Ltc� E I � ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost, $ ���L FEE: $ O Check No.: .° Receipt No.: 1 NOTE: Persons contracting 7-th unre istered co tractors do not have access to the guaranty fund t Slgrtature at Agentlt7wn Signature of c htrac r 7 r= F, I Plans Submitted LL`J Plans Waived LLJ. Certified Plot Plan El Stamped Plans Lj TYPE OF SEWERAGE DISPOSAL Public Sewer Lj Tanning/Massage/Body Art Swimming Pools El Well 1E] Tobacco Sates El Food Packaging/Sales F71-1 Private(septic tank,etc. L"L J Permanent Dumpster on Site LLJ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED TI FE(71 PLANNING & DEVELOPMENT r-E L2j LLIJ COMENTS DA I E KEJLL;I tzU DAIEAPPRUVEU F-F 171 FE—11 1 CONSERVATION L�j COMMENTS DATE REJECTED DATE APPROVED FE7.1 r7 17 HEALTH LLJ LLJ COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision, Comments Conservation Decision: Comments Water & Sewer Connection/Sig nature& Date Driveway Permit Located at 384 Osgood Street p4i .... ....... 046 .6, M q . ......... rr T dc.attd- t' 2 �q 4 Mi c Street .......... ... '.D . ...... Fire ep'A", ..... ........ . ......... CC MIEITS .. ....... .. tAORTH .q own of 2 .� 6 ndover . 0 No. - g h ver, Mass, Q� T O E COC LAKNIC riE WICK � �,q A°Ramo rP�,��iy � U BOARD OF HEALTH Food/Kitchen PERMIT T D�� Septic System THIS CERTIFIES THAT .,...154i b.01 1.... C.AA.I..b P.LW.......... .,.... BUILDING INSPECTOR has permission to erect .......................... uildings on .... ,T. .... . .�*ll.......1 7 Foundation Rough tobe occupied as .... .. . ..........................S.r.R .................................................................. 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR- UNLESS CONSTRUCTI TARTS Rough Service .......... .... ..... 4.. ......................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy- uiMW Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Miall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Timberline H[)�'Shlngles I-lelp improve your home's tesale value wilh l'imbedine HD"'Shingles frorn GAF. Firnbedii4T�F-figh Definition")Shingles with Advanced Protection"!" Shingle-k.,rchnoIoqy aie the #tI-selling shingles,in Horth Arl)ffiCCL 'Firylbedine FID"Shingles wilt riot only potect youi most voluable asset but also beautify your hoppe for years to come. Colors Available In Your Area VVfwy I I 111 NO ��,nbeflkrm N ID,R�Oflkwoo�d Nfv"cxy,,�,e EOuwr hattm,"�10me,Hl",') C, f"'j n"arx, tdD rr�,x H"�Oovv T mM HO Tii,nbmdhne,HD @ung vi C4etn Q) Bira,em wnbaHme Town of North Andover Machine Shop Village Neighborhood Conservation District Commission 160OOsgoo(ISLrect NorthAndover,MA01945 �SSAC US Application For Certificate to Alter Instructions: ITM out the form below and submit to the Machine Shop Village NCD Corninission Cl-lairperson(contact info below), The goal of this application is to provide a clear understanding of the proposed alterations,and how they vary from the existing conditions. Your application must include photos or plat's of the existing conditions,and plans or drawings of the proposed changes. Include product&material descriptions for both existing and proposed conditions. Discussions with the Building Dept.or A4SV NCD Commission are not a substitute for filing an application. Date: J),1 a'�l It Contact Naive&Address: . v '0 , C — A 5- Project Address: c /9"9'1 st Project I.)esctiption (attach additional pages,if needed): cmc ;'uA EOL-e- 1 Ix)':u Information Provided: Photo/Drawing of Existing Conditions Photo/Drawing of Proposed Conditions Description of Existing Materials Proposed Materials to be used DescriptionlCatalog Cuts oTi Other— Inj6rmation (describe):_,,_.____-----—- 44 t;t0 0"1 '94 &� 416'+q W I A-A too of- Zee r MSV NCDCCLHTent Chair:Liz Fen nessy,77EIi-nSti,eet,lizettaf'entl(2,s,,�C(L)yLiho cml,978-688-2915 Yw uommummlimuuum uuuuu�'iuumm a'rmr✓�nuliiimmimmu im'w'n�ui mmmw;,mmmwmuuuo ww"' n'^mmm�m rvmnnrmiwvwww�wuomioioumrvmmwuw.. uum mm�mwm rvmmmmrvmmmmiuwmufiwwiw mmmiwwu PROPOSALNO. Cil i 2� SHEET NO. . DAIT PROPOSAL SUBMITTED TO: ADDRESS WORKC7 BEPERFORMEDFCr�..._..._..� _ .� ._. _ NAME nra�arr5S 5 — .._.. ....__._..._ . _..... _... _ 1 ._____.__.... MA o carr car rair.,aNs f'1 a PHONE NO, AFICI-11-FECT We hereby faropOSe to ful rtish the materials and faeiforrn the labor necessary for the completion of_..._... _ _ _ ....___.._..... ._._._ ..._.. . _........... ... .... A-V 17 _ .__ _. .._._._ ... _. _........... All material is guaranteed to be as specified, art(] the above work to be performed irl accordance with the drawings, and specifications submitted for above work, and completed in a substantial workmanlike manner for the stt'll of ......_ �_ Dollars ($ with payments to be rnade as follows: G' vvv . ; ('a^t��e 7�i`b✓� Respectfully submitted... .....�` .._.._ _. Any alkn ation or ciervicaWra train above ¢,pc,a ricaations j"volvir)g extra CO.is will taa, execlateaci only upon written order, and will hei,crrno can extra charge _.......__._ . ....... .___.. ......_... crve� ,�tra<i rahnva tare c tirrrtate. FOItl ar„lrc.�enaerats contingent upon strikes, ac, nidents,or delays beyond agar control. Note This ti proposal may he wltfldrawn by us if not accepted within,ict-P .�.__._....�....�_.�.....�..._._._�_..�...�_._���....��....�._.,,�� ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are sallsfGactory and are hereby accepted, You are authorized to do the word as specified. Payments will be made. as Outlined above. Signature 4! w _ �j p _._. ......_.__.. ...._.. k7atca Si nature .14”. MAr1E.IN USA iUiSSaCr7USet$g _D2 Beard or" ,,,, l�artmer,t o-1 P i'eaer ire'' �eg�;fetd ,� Public aaiE,A! 1.1111`tl[nLtjoiij''� F,S end�I<'.iiyaria_; License: CS " w r.slr),i, . FA-070432 DAVID E r ��� .IL, , 4 s s n TEw��� URY 11 01876, )f 1 t Comma v mkt iraiion sinner 01/23/2017 L�IDCas Pt' nl:ltif>, i 0fffce of COrts roi!lneri/l�! NQM�;IMA mer,4ttalrs$g s n��.;srir rYAe; >�OV�M�Nr CONrRAC s:+tation ,`✓ lndividuai r0lq e is ratio David Schaufus 1�zsso !rx ►ration, avid Schau(Us 12/02/2018 4 Hazelwood Aye Tewksbury MA 01876 - Dove rsecretary C North Andover MIMAP December 23, 2016 j 04210=001'9�� ',-. 031.0-4ao -0020. 042.0 031.0-0007 31.0-0019 r d 042.0=0026 �? ,1 ELM/ST 31.0-0281'MAIN ST 031,.o-oo41 10 E r ST 49 RICRDSON A� H A / , 042:0=0°025 31.0-00x1 042.0- ,ST 26'PILGRIM ST 0 ELM,,ST 031.0-0040 031.0-0039` � 4-0 3; PILGRIM ST. 295,MAINIST v � 031.0-0038 4' 042.0"0028 r° , "° 6 PILGRIM%ST 042:0-ap32 3'ELM ST' //"031.0-0043 4 MILTy01d ST lerr ,,�✓vxr��"��d 00;111 042.0-0029 031.0-0045 ' 29 :MAxra T `5� 318 MAIN S 62 MILT014 ST : Ne 042.0-0033 � 6 MILTO WAST 643.0-0035 53,M"IDDLESEX ST .0-0036 / 43;0-0034 W031.0-0046- o„ ✓` y�. 1 GREENE ST ' 031.0-0047 ,,, r 43 MIDDLESEX ST ' 031.0-0048 CJ'/0 U MIDDLESEX ST SFr 032'..0-0001 � 043.0-0044 11 GREENE ST 31 MIDDLESEX ST 124 MIFFLIN DR /043.0-0032 032.0/0002 a3 MIDDLESEX)ST /03 32.0-0008 043.0-0001 043.0-.0010 `"`1MIFFLIN DR 15 MIDDLESEX ST � N032.0-0003 7 MIDDLESEX ST 032.0-0035 114 MIFFLIN DR 28 MIDDLESEX ST - 043.0-0602 032.0 a0109 0WES17ST RD 20 MIDDLESEX ST U 032.0-0048 �2.0-0049 043.0-0003 12 MIDDLESEX ST 043:0-0004 032.0-0004 40 WEST BRADST RD E]MVPO Be Zoning Overlay Zoning ( Adult Entertainment Dlstdc Busino s 1 District (3 Municipal Boundary L')Machine Shop Village Ove i°' Bus Ine s2 District Horizontal Da tum; esS ire data or His Coordinate System,produced Merrimack --Rail Line C^d Watershed Protection Dial M Busino s 3 District Meters Data Sources:Tire data for This map was prrrduced by MaMmack Interstates Ej Hlstorio Mill Area N Busino s 4 District 14ORTF{ Walley Planning Commission(MWPC)using date Provided by the Tom of ra Interstate Medical Madjuana M Gone Business Distinct Ot x4fp r '9� Norlh Andover.Additional data provided by the Executive Office of -,-Mt.us Road El Downtown Overlay District 0 Planne Commercial Dev y4's •M6 d0 Environmental AffairsfhlassGIS.The Infornwtion depicted on this map is d Historic District Cord Dovolopment.Ulst ,; L for planning purposes only.it may not be adequate for legal boundary Roads Osgood Smart Growth(40 'r# Corddo Development Dist O A definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER 4w" Ease. ttydregraphic Features V Cordd Development[)far F' .. MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING CI Earcsls Indusw I i District * Y THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY Streams Indualn 12 Distill * y y OF THESE UA[A.THE TOWN OF NORTH ANDOVER DOES NOT ry Industry 13 District * ^d x44 ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE:OF 'i Wetlands N Industn j S District s"n "'' s` "[HIS INFORMATION Exempt Lands Reside ce 1 Districtf�'i,� Reside ce 2 District 4'M C HU$�'� Rnc'ide ce 3 Ulsirirt de co 4 District 1"=106 ft "de ce5District YYY de cis 6 District ,-,.a asldentlal DINtdct. The Commonwealth ofMassachusetts Department of Industrial Aeddents a I Congress Street, Suite 100 Boston,MA 02.114.2017 1vly mimss.gov/dia Workers, Compensation Iusurance Affidavit:Btlilders/Conti•slclol,s/Electricinns/Plurribel•s. 'fo BE FILED WI1'1I'IHE t'I;IttMITPING AUTHORITY. Anplicant Inforrnntion Please Print Le ibl Name(13tlsincsslOr�nnizntion/individual}:n � ���� �._�C�+� �_ Address: city/state/zip: t'��'3 a h? 1���1 Phone#:_ _.__......._._ Are you an employer?Cbeelt the appropriate box: Type of project(required): l�rn a employer wiltm 5 _employces(full and/or part-time).& 7. New coastructioll 2.Q 1 um a solo praprictar ar partnership and have no cnrployees working for me in $, n Remodeling my cnpacity. [No workers'comp.insurance terluired,] 9. Q l)etnolitioll 3.Fj I am it homeowner doing all work myself.[No workers'comp.insurtnrce rerluired.]l �-�1 10[]f3uildinl;addition 4,L_.11 am a homeowner and will be hiring contractors to conduct atl work on my property, I will msurc that illi contractors either have workers'compensatiotm insurance or are sole 11.Cf Electrical repairs or addition proprietors with no employees. 12.❑Plumbitlg repairs or additions 5. 1 am a general contractor and i have liked the sub•conmictors listed on the attached sheet. 13;toof repairs 'these subcontractors have employees and have workers'comp.insurnnce.l 6. we are n corporation and its officers have exercised their right of exemption per MGL c.. 14,Q Other 1(4),and we have no employees.[No workers'comp.insuralice required.] *Any applicant that checks box if l must also fill out the section below showing their tvarkers'compansaiion policy information. "homeowners who submit this affidavit indicating they are doing all work:arid then hire outside contractors must submit a now affidavit indicating 8101. =Contractors that check this box must attached an additional sheet showing the name of the sub-ewttractors and state whether or not those entities have enmpioyces. If the subcontractors have employees,they must provide their workers'comp.policy number, f am an employer that is providing workers'compensation irrsurarlce for arty employees. Below is the pollcy and job site itrforrrrafio11. Insuratice Company Name--------------- ; -- Policy 11 or Sell-ills,l.,ic,#:..__._ _ G..._..___ _�� s� �� ..__..__.. Expiration Date:_ Job Site Address: € _ , CilylStatel7ip:.._rc_. Attach a copy of the workers' compensation policy declaration page(shorving the policy number and expiration(late). Failut•e to secure coverage as recluixed underNIGI.,c. 152,§25A is a criminal violation punishable by a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in tie Poral of a STO,11 WORK ORDER and a Linc of tip to$250,00 a (lay against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for itasurance coverage veritic I do hereby ' edify mel , e r a _ e) ll o '7 ij11►y that the information provided above i'True 111111 correct. Si mnuttn•c; r, _ 17ate: _-_.�a'._.�r..__�Ll+� Phone Official use only. Do not mite,/it this area,to be completed by city or town official. City or Town: ... ___„ Permit/i.icense it Issiting Anthol'ity(circle one): I,Board of Ifealth 2,Building Depai'tluent 3.Cityffown Cleric 4.Electrical Inspector 5.Plumbing Inspector 6,Other Colitact Per:sott: ._.._..__ Phone#1: �.� OP ID:WC ' ,a►coRo CERTIFICATE OF LIABILITY INSURANCE DATE iMMfDD1YYY`!) 12/2312016 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 poUcy(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 Se rove&Hall Insur.Assoc.lnc NAME' 300 North Main St. rPHONElr .Exn: _ _ FAX Not: Andover,MA 01810 E-MAIL Patrick D.Hall ADDRESS: PRODUCER CUSTOMER ID#:JRCBU-1 W INSURER(S)AFFORDING COVERAGE NAlC# INSURED JRC Builders,Inc. INSURER A:Commerce Insurance Co. 34754 PO Box 911 INSURER e:AEIC 11104 Tewksbury,MA 01876 -- INSURER C:Arbella Protection Ins.CO. 41360 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 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. INSRR DOL R POLICY EFF POLICY EXP LIMITS -� TYPE OF INSURANCE POLICY NUMBER MWDD MWDU! GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence)_$ 100,000 CLAIMS-MADE �OCCUR MED,EXP(Any one person) $ $,000 BGPPZQ 06/09/2016 06/09/2017 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM PIOP AGG $ 2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTOW1114r BODILY INJURY(Per person) $ ALL OWNED AUTOS 1020020157 0410812016 0410812017 - BODILY INJURY(Per accident) $ C X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (PERACCIDENT) $ X NON-OWNEDAUTOS $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB PX_ CLAIMS-MADE AGGREGATE $ ACP417301-15 06/09/2016 06109/2017 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATIONX TORWC STATU- OTH- AND EMPLOYERS'LIABILITY Y LIM T ER B ANY PROPRIETORIPARTNERIEXECUTIVE YIN N E.L.EACH ACCIDENT $ 1,000,00 (Mandatory In ER EXCLUDED? N 1 A WCC-500-6011685 01118/2016 0111812017 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILT. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD I �iOp71f A Town of North Andover Machine Shop Village Neighborhood Conservation District Commission 1600 Osgood Street NorthAtrclot•er, MA 018,1 s�cKusE Application For EXCLUSION From Certificate to Alter For Items 9,10 or 11,provide the following documentation: Photos/drawings of existing doors, windows or siding, as applicable 2!�Description/Catalog Cuts of proposed materidls to be used for doors, windows or siding Plan and elevation of reconstruction for Item 1I Determination: This project is determined to be Kexempt ❑not exempt from review by the Machine Shop Village Neighborhood Conservation District Commission. Projects that are not eremot must complete the Application for Certificate to Alter, available from the Building Department and be reviewed by the Commission. Determination mad by: Signature Lb ze tTh S Neighborhofo C :servation District Commissio t `� Date Page 2 Current Chair:Liz Fennessy.77 Elm Street,IizettafennessyCO)yahoo.com,978-688-2915 Scanned by CamScanner NpRTP{ Town of North Andover I Machine Shop Village Neighborhood Conservation District Commission 4' 1600 Osgpod Strcet North And(wer, MA 018,15) ,SshcNUSE' AplLhcation For EXCLUSION From Certificate to Alter Certain alterations are excluded from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicants for exempt projects must f ll out the form below and submit to the Commission Chairperson(contact info below). Date: -44 Contact Name&Address: � r — _d tL9 M&44 4 S _ r Project Address: Project Description(attach additional pages,if needed): 1a Ck +ivy1r,-- 5 14 _Q Exclusion From Review Requested For: ❑ 1. Interior Alterations existing conditions including materials, design and dimensions. ❑ ?.Storm windows and doors,screen windows and doors. © 9.Replacement of existing substitute doors,substitute siding or substitute ❑ 3. Removal,replacement or installation of windows with new materials that are gutters and downspouts. substantially similar to the existing condition. ❑ 4.Removal,replacement or installation of window and door shutters. ❑ 10. Replacement of original fabric windows or doors with substitute ❑ 5.Accessory buildings of less than 100 windows or doors that maintain the square feet of floor area. architectural integrity with respect to form,fit and function of the original ❑ G. Removal of substitute siding. windows or doors. ❑ 7.Alterations not visible from a public ❑ 11.Reconstruction,substantially similar in way, exterior design,of a building,damaged or destroyed by fire,storm or other disaster, 8. Ordinary maintenance and repair of provided such reconstruction is begun architectural features that match the within one year thereafter. MSV NCDC Page i Current Chair:Liz Fennessy,77 Elm Street.lizelta€ennessy,fgy,ahoo.com� Scanned by CamScanner