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HomeMy WebLinkAboutBuilding Permit - 135 ACADEMY ROAD 2/14/2017 (2) r 00RT11 0 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 0 CHU Permit NO- Date Receiv " 11(), I ed 2.] Date Issued: -c I P6 ANT: Applicant must complete all items on this page LOCATION 135 Academy Print PROPERTY OWNER KIM PI UL Print MAPZONING DISTRICT: Historic District NO- PA RCELZ ILI Machine Shop Village yes n o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial X Repair, replacement Assessory Bldg Others: Demolition Other X Septic Well Floodplain Wetlands Watershed District Water/Sewer Remove all cracked concrete floor on garages prepare to add 3"cocrete, floor 6000 PSI smooth finish.trig 24" width to 1-Ft deep building wall 20' X9 FT high with Dig 24" width to 1-Ft deep building wall 20' X9 FT high with concrete block to reinforce old concrete ceiling and foundation. Identification Please Type or Print Clearly) OWNER: Name: Kim Pick Phone, 978 689 4071 "Al Address: CONTRACTOR Phone: om, MMMMI- Address: e—6 S /" Supervisor's Construction License: r_1 wM 0 e Exp. Date:,,,> /— / ?--J Home Improvement License: Exp. Date: ARCH ITECT/ENGI NEER Phone: Address: Reg. No. FEE SCHEDULE: UL IN PERMIT. MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 0 Total Project Cost: $—FEE: $ Y-5,(Z , Check No.--Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guararty fund N0R7'F �9 Town of ndover . ® . ` 0 713 o L .......a0l 2 AK, h ver, Mass, �. toc-CM.W.CM ®S OATIE0 i. U BOARD OF HEALTH Food/Kitchen PERMIT. T LD Septic System THIS CERTIFIES THAT ...,�, •......... ..••.••....•.......................... BUILDING INSPECTOR rr Foundation has permission to erect.......................... buildings on ......[. ... �!. Ulm ,.. ......,,...... Rough to be occupied as .....�,�.f•�..I..�........ .. ............................... ,......,. " 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 ITEXPIRESIMONTHSELECTRICAL INSPECTOR UNLESST T Rough 16 .. 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. DATE(MMIDDfYyM ACo CERTIFICATE OF LIABILITY INSURANCE 01/13/2017 THISCERTIFICATE 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: kf 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 Iteu of such endorsement(s). coraracT PRODUCER NAME: Ari CalUillO PHONED 1. (978)$21-55256 AIC No: ONE FAMILY IN AGENCY LLC E-MAILRESS: acalvillo128@yahoacom 63 FAIRMOUNT ST REAR ADD INSURERS AFFORDING COVERAGE NAlGq 33758 FITCHBURG MA 01420 155URERA: AIM MUTUAL INS CO INSURED INSURER B: LAUDERLY G LIMA INSURERc: DELANIE CONSTRUCTION INSURER D: 11 CRIMSON CT INSURERS: LEOMINSTER MA 01453 lNSURERF: COVERAGES CERTIFICATE NUMBER: 118297 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 PoL cYt PS LIMITS INSR ADDL SUER POLICY NUMBER MMlDD MMIDDfYYYY LTR TYPE OF INSURANCEi SD MD EACH OCCURRENCE $ ��E COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS-MAGE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) 9 N/A PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S PRO- POLICY❑JECT 11 LOC $ OTHER: COMBINED SINGLE LIMIT $ Ea accident AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY(Per accident $ AALL UTOS OWNED SCHEDULED NIA AUTOSPROPERTY DAMAGE NON-OWNED Per accident S - HIRED AUTOS AUTOS $ EACH OCCURRENCE $ UMBRELLA LIAB OCCUR AGGREGATE $ EXCESS LIAB CLAIMS-MADE NIA S DED RETENTION$ WORKERS COMPENSATION PER EER AND EMPLOYERS`LIABILITY YIN E.L.EACH ACCIDENT $ 1,000,006 ANYPROPRIETORfPARTNEWEXECUTIVE NIA WA NIA AWC40070350452016A 11112!2016 11/1212017 A OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes,describe under E,L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORO 101,Additional Remarks Schedule,may be attached If more space Is required) emptoyees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits Workers'Compensation benefits will be paid to Massachusetts to employees in states other than Massachusetts If the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search toot at www.mass.gov/iwdtworkors-compensationlinveStigatiOns/. LAUDERLY LIMA has elected coverage effective 1212812016. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TOWN OF N ANDOVER 120 MAIN ST AUTHORIZED REPRESENTATIVE )j c� NORTH ANDOVER MA 01845 Daniel M.Cro r�y,CPCU,Vice President—Residual Market—WCRIBMA O 1988.2014 ACORD CORPORATION. All tights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Informadon and Insfirnefions Massachusetts General Laws chapter 152,requires all employers to provideworiers'campensation fox the>£employees. Pursuant to this statute,an emplayee is defined as"_..every person in the sorvice of an other under any confaact o£hire, express or implied,oral or written," An employer id defined as"an iu dividual,liartnership,association,corporation or other legal entity,or any two Or more of the foregoing engaged in a jolt t enterprise,and including the le gat representatives of a deceased employer,or the receivex'o> trustee*fan lndividnal,partnership,association or other legal entity,employing employees_•Nc)wdver the owner of a dwelling house having not more than,three apartments and who ic,91des therein,or the occupant o£th e dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or an the grounds or building appurtenant thereto shall.not because of such employment be deemed to be an employer" i MGL chapter 152,§25C(6)also states that"every state or local licensing agex3eysbalt thboldthe issriaiice or r eriav�aZ of a licen e ox paxmit to operate a business oz to construct brvxcliags Sn thcammonweallT for any oduced acceptable evidence of compliaDeDWith the insurance coverage xeruite applzcazltwlid has rrotpxd." A.dditionalty,MGT..chapter 152,§25C(�)states`NDither the commonwealth nor any of its political subdivisions shall enter mtp any contract for the performance of public work until acceptable evidence of compliance with,the ins trraneu requirements o£tbis chapter have beery.presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if Races_sary,supply�ub=coxntractor(s)naxax (s),addresses)and phonanumber(s)alongwiththezr certiflcate(s)of insurance. LimitedUability Companies(LLC)or Limited LiabilityPartucrsbips(LLP)withno employees other than the members or partners,are not required to carry workers'compensation insurance. If au LLC ox LL P d6&s have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial A.coi:dents for oon-gmation of insurance coverage_ Also be sure to sign and date the afdavR. The affidavit should be xetumed to the city or tow.0 that the application.for the permit or license is b Bing requested,not the Depaxtunent of 7ndusfxial•Accidexm s e Should you have any questions regarding the law or if you.axe req"i to obtain.aworkers' compDnsatioji poliay,pleaso call the Department at the numbewlisttdbolow. SelfixrsuodcorripaniesshoWdentertheir self insurance license nQmber ontho appropriate line. City or Town Officials Please be sure thatth(-,affidavit is complete and printed legibly. The Deparimeut has provided a space atthe bottom ofthe affidavit for you to fill out in the event tho Ofaco ofTnvestigations has to contact you regarding the applicant. Pleas be sure to£d1 in the permit/RaGnse number which,will be used.as a reference number_ In addition,an applicant that must submit multiplepammitflicease,applications ixa any given year,need only submit one aft davit indicating current polloy iufarmation ff necessny)acid under"Joh Site Address"the applicant slxould write"all lacatlons in (city or town)_"A copy of the affidavit that has been officially stamped or marked by the city or tovia may be provided to the applicant as proof that a valid affidavit is on Edo for fiTtare permits or Licenses. A new affidavit must be Mad out each year_Where a).cure ovrner or citizen is obtaining a license or permit not related to any business or com erclal ventaro (i.e,a clog license or pextrnitto burn leaves etc.)said person is NOT required to complete this affidavit. The DeparLmont's address,telephone and fax number: The Comm.onwadth ofMassachusctts Department ofTndustrialAccido is ] Congx'ess Streot, Saito 100 Boston,MA 02114-2017 T'el._#617-727-4900 end.7406 or 1.-877-MASSAPE Fax#617-727T7749 Rovised 02-23-15 wtvwmms.gov/dna. VTMassachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-081658 Construction Sup ervtsor LAUDERLY G LIMA 11 CRIMSON COURT y: LEOMINSTER MA 01453 l + �s Commissioner Expiration; 0 111 812 0 1 5 c char c ru ecr� cA^rca frccr cis L'nie;;�e yr registration valid for tnuT�'ic;zai 1S€a:�1 =� Cfice ci Ccnse��er-�£a�rs�8usmess ltegula��:� � - HOME MIPR0VEMENT CONT TOR Ss:a e ze expiration date. ?f found return to: Reglstra iorr`t 16(3187 Type, Office of Consumer Wairs and Business Regulation Ex iratfon_ 1 712124 1 8 DBA 13 f'•:r ?lain-Suite 5118 >" p - Boston- Lk LV2116 DF ANE CONSTRICTION LAUDERL)' LIMA 11 CRIMSON COURT z O V11tdST,f2,MA 01453underseeretary — id without signature g HISTORIC DISTRICT COMMISSION Town of North Andover, Massachusetts APPLICATION FOR CERTIFICATE OF APPROPRIATENESS Application is hereby made for the issuance of a CERTIFICATE OF APPROPRIATENESS under Chapter 40C for proposed work as described below and on plans,drawings,or photographs accompanying this application. CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: } New Building Addition ( ) Alteration Type of Building O Home O Garage ( ) Commercial (�) Other 2. Demolition or Removal of: ✓� f 3. Signs or Billboards ( ) New Signs O Existing Sign O Other 4. Structure: Fence O Wall ( ) Other TYPE OR PRINT LEGIBLY � , Date:_ Address of Proposed Work: a Owner / 'y � t.. Telephone# Horne Address(if different from above): l C " Agent or Contractor: C e `' / °' Telephone# l Address' . Assessors Map#: Assessors Lot#: Detailed Description of Proposed Work: Give all particulars of work to be done(see#8 below),including materials to be used,if specifications do not accompany plans. In case of signs,give locations of existing signs and proposed locations of new signs. (Attached additional sheet if necessary.) 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Authorized Signature: n' �oku Date: 0.1- o h' 1 1 the above prices specifications and conditions are satisfactory and are hereby accepted.You are authorized DELANE CONSTRUCTION to do the work as specified. Total $32,000-00 DATE(MWDDIYYYY) AC V CERTIFICATE OF LIABILITY INSURANCE 12/13/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE,HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pOlicy(ies) must be endorsed. s certificate does not confer rights to the SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate holder in lieu of such endorsement(s). CONTACT Art Calvillo PRODUCER NAME: PHONE 978-345-1499 FUG Ne: 978-345-7166 ONE FAMILY INSURANCE AGENCY LLC EMAIL Ex-q-- 63 FAIRMOUNT ST ADDRESS: art@ifamilyinsurance.com INSURERS AFFORDING COVERAGE NAIL# FITCMBURG MA 01420 1 SURERA.. ESSEX INSURANCE COMPANY INSURED INSURER B: LAUDERLY G LIMA INSURERC: DBA:DELANI CONSTRUCTION INSURER 0: 189 WILLARD ST APT 307 INSURERE: LEOMINSTER,MA.01453 INSURER P 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 N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITIO CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I5 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. A0931-SUER POLICY EFF POLICY EXP LIMITS ILTR TYPE OF INSURANCE POLICY NUMBER MMIDBIYYYY MMIDDIYYYY 1,000,000 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3ED7450 02/19/2016 2119/2017 DAMAG TO RENTED 100 000 A PREMISES Ea occurrence $ r CLAIMS-MADE ®OCCUR MED EXP(Anyone person) $ 5 r000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 G£N'L AGGREGATE LIMIT APPLIES PER: 2,000,000 PRO- LOC PRODUCTS-COMPIOPAGG $ POLICY E]JECT $ OTHER: COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY Ea accident BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY(Per accident) $ ALL OWNEDSCHEDULED AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per amIdenl HIRED AUTOS AUTOS $ EACH OCGURRENCE $ UMBRELLA LIAR OCCUR AGGREGATE $ EXCESS LIAR CLAIMS-MADE DED RETENTION WORKERS COMPENSATION STATUTE ETRH• AND EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE ❑NIA A OFFICERIMEMBER EXCLUDED? C.L.DISEASE-E4 EMPLOYE $ (Mandatory In NHI If yyes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Michelle De Aquin THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 515 Park `\ AUTHORIZED REPRESENTATIVE ART CALVILLO ''Fitchbur MA,014 0 _.___,._..... ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1/12/2017 Town of North Andover Mail-135 Academy Road Permit NIMT,k A PVER Maura Deems <mdeems@northandoverma.gov> Masao rus�trts 135 Academy Road Permit 1 message Harry Aznoian <haznoian@gmail.com> Wed, Jan 11, 2017 at 8:33 PM To: Maura Deems <mdeems@northandoverma.gov> Hi Maura, This e-mail is to document the conversation I had with Elias Nascimento. Mr. Nascimento indicated that he is the General Contractor representing the owners at 135 Academy Road, North Andover. He stated that the scope of his work he was seeking a permit for was to reinforce a basement wall under the garage and to resurface the interior floors of the garage located at 135 Academy Road. He estimated the size of the reinforcement wall to have a footing 24" wide by 12" deep and a 12"thick wall. Mr. Nascimento said that all of the work he would be performing would be performed in the interior of the house. Based on his conversation this applicant would not need to apply for a certificate of appropriateness from the North Andover Olde Center Historic Distinct Commission. Please feel free to contact me with any questions. Best Regards, Harry Aznoian Chairman i Olde Center Historic District Commission https:tlmail.googio,com/mail/ca/u/0/?ui=2&ik=aeO2b3b5c4&view=pt&search=inbox&th=159904ee7Ob7e29c&siml=159904ee7Ob7e2go 1(1 North Andover MIMAP January 10,2017 ;' / 83, ✓ "#84/ ""AP :00 ' 0s9.q-oo55 / %e r'' a`9 0 003/ 096.0-0066 /f ,• / ,,//'' ,��/ r' / #371 096.0-0002 j" dna, �` ir; /096.0-0073 r ✓ , r %f / 096.0-0081 #381 094.0-0083 / r/✓'f/ r/ I ,,f' 08059:0-0074 096. r 96.0-003,7' 096 0-0035 96.0409M ti." ^. / /. �, .� U5y,. ,CI#.q70a9g9' k``'+h / ' ✓' / ./r #8.5 0916.0-00 y6, #x113'/ f / 096.0-003x4 #4(71 r/ #73/0f„, ; � ` 096 0x0026 A" / / 096.0-0048 r r 05 .0 0(120 f r cal yr ry ✓a° 0/ �/ / r ! 7$10 , ✓ /T rl i, / #130 fA `a96.o-4078 059.0 0003 / , ' 'r,/ / , #41`1 i 96 0 x096:0-gg7a7 56 r 096 0 0039 P / /" W / r 750 y f ✓r` r r / 096. 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North Andover.Additional data prodded by the Exacutive Ofrcem Interat.te Dovmmwn Overlay District WA Planes Comrncrcial Dov �„ +'r s+a EmAren nenlal Affal.fMa..GIB,Tho Information deplemd on this map Is --Major Road t iletonc DhAnd torrid Development.Dist ` aL for planning purposes Only.It may nal be udeyuate for logal boundary Roads Osgood Smart Growth(40 --Comd Dovalopmant Dist 6 -•- "` fee dafmtllon or regulatory inlerpmtallon.THE TOWN OF NORTH ANDOVER q"r Easements Elydroglaphio Features Intl Comd Development Dist p' A MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING Industn t District yl y THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY ❑Parcels Streams Inductn 12 District * ^ y OF THESE DATA.,THE TOWN OF NORTH ANDOVER DOES NOT Wetlands P+ Indus 13 Dismct >< ° _i _ `C 4r ASSUME'.ANY LUABILRY ASSOCIATED WITH THE USE OR MISUSE!OF tlg Indirsln IS Uistocl 4 ^' «.`.. THIS INFORMA1lON E-apl Lands Reside ce 1 Dlsldct OO4i+eo F+ 4'b Reside c°2 Dlstdd �S$AIGNU°as'S Rc..aiAa se 3 Dlshid de ce 4 Dastrict 1°'=259 ft {�.da<e5Disaint r, '"Y' da cos Dismct. Osidonllm Disldet