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Home My WebLink AboutBuilding Permit #361-11 - 10 WOODRIDGE DRIVE 10/29/2010 II o`No oT BUILDING PERMIT � y�,,• -IN."b � TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _y - — Date ReceivedgDRATED 'l`� Permit NO: 9SSACFIUS�( Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION . .. rinf - 6 PROI? ERTY OWNER �'; r,, .. es... lie MAP 210�_PARCELf ad ZONING DISTRICT Historic District lage' yes Machine Shop Vil TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ❑ One family ❑ N g ❑ Industrial I _ ❑Addition l�wo or more famil El Alteration No. of units: 2 ❑ Commercial ❑Assesso Bldg ❑ Others: p'�Zepair, replacement rY g ❑ Demolition ❑ Other Septic D Well D Floodplain ❑1lVetlarids ❑`Watershed District, 0 Water/Sewer. ' �i DESCRIPTION OF WORK TO BE PERFORMED: De.09e Identification Please Type or Print Clearly) 3; OWNER: Name: Phone: Address: CONTRACTOR Name: �U- 1APhone�GJLeL y Address: Date:: Supervisors Construction License: 10 D Home Impr ement License: Exp. ater. 3 -7,V� " I ARCHITECT/ENGINEER s Phone: y 4 TI Reg. No. Address:- FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 7 ? 6-0a, as FEE: $ Check No.: � � Receipt No.: NOTE: Persons contracting with u re istered contractors do not have access to the guarantyfund ��'�� ' nature of contractor` Signature of Agent/Owner Sig f Plans Submitted ET Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑+ Tg/Massage/Body Art ❑ Swiunming Pools Well - - - ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY i INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING &'DEVELOPMENT ❑ ❑ COMMENTS - CONSERVATION Reviewed on Signature i - COMMENTS I HEALTH Reviewed on Signature COMMENTS w Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Sic nature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DIEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/elate COMMENTS- Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of dieter location, mast or service drop requires approval of Electrical Inspector Yes No DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For de artrment use I i ® Notified for pickup - Date F Doc.Building Permit Revised 2010/october I _ s d Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers •Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Flo or/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Il=n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording anust be submitted with the building application Doc:Building Permit Revised 2008 Location No. Date '' MORTp TOWN OF NORTH ANDOVER 9 a Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ '� sACMuse 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ _ Check # 23621 Building Inspector NORTH TO" of Andover No. 3(ol - 02o rt -_ �=== A K E or lover, Mass., COCMICMEWICK ADRATE D I"P�,�'�� U BOARD OF HEALTH P�F= IIMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT Vv .. ..... �. ... yrs ............... ....�....... .......................................................................... Foundation has permission to erect. ......:.....:.: .............. buildings on....1.Q.......�/.�.0 RRough a to be occupied as:.......... ......1....;..... ............... ...... .......... �..�. Ii ... �/ .I.I ......... Chimney provided that the person accepting is permit shall in every respect conform to terms of the plication on file in Final al 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 CONSTRU T TS Rough ...................................... Service BUILDING INSPECTO Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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 1 - Street No. SEE REVERSE SIDE Smoke Det. D.C. Contracting Inc. Additions, Kitchens, Baths , Decks , Home repairs ,Excavation work Commercial fit ups* finished basements* Dumpsters pAv�d cul.ezi,Aw Pres%dev+.t i 428 Pleasant st. N Andover Ma.01845 Office 978 .689 4797 Home 978 683 0397 Fax 978. 686 6337 Cell 978 815 7745 Ala. License -# 001821 * Insured * Home improvement # 120199 Dgbuilding8aol.com I authorize David to replace the railings and decking on 49 decks at Woodridge homes at a cost of $73, 500. 00. X Date /0/, Cy1i�oh .l i 4.x6x tli Vc- -,Ir-ilz-T" r' l Ile 3 k,{S{5 0"d £. A 9 e nuc --eC�(y, (?Ja � l BUI LDG _ MAWN- RM CONSULTANTS UJC*h -K(t(� HAMPTON,NH ---- 6J 1?€ - 5=r`-0 f E { , Fk ' ( A ego O ? _� _' � �• � �oat `�► .:':'� `� -_., r T s 428 PLEASANT ST :.. "- �n p ppyppVER,ISA O'F89S+292(! 17 i➢$ i8E4riY�4`tt ; t;crs� C5 A&21 F 30 D/t if IIJ P"` f 2$PLEASM""T Sfti u F 1+3-AlNbo ER.91' �l- - %� t. t a lop,;r„err, `.f�Ge �%�p9L�594�8d�GtRE�kTi& 6� ,�5�•f6sP1@6Ctb ---- Vb 'MR Tsg 'IW224 DA R JL VO GL 'H ANno iER; 1 EJrnd retic et�r3 4 4 VU/Z1/ZU10 11:52 LAA 1 5TS 588 5350 Nacgonald 8 PBngione Q001/001 ALCcc R CERTIFICATE OF LIABILITY �:�»�Y,' INSURANCE au THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE Ct:R71FiCA1'E HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER Tiff: COVPC T1 AFFORDED BY THE P THIS BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CON$MVTE A CONTRACT SIE WEEN THE RUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCK AND THE CERTIFICATE HOLDER. IMPORTANT: If OBrlifleafa hoc—lit-Is an ADDITIONAL INSURED,the p6RW1813)must be endarwW. If SUBLATION 15 WAIVED,suty�to the terms and conditions of the POIICY.09 taln PONCIM RST rsqutro an 0111dMement. A r rt an this�dales not wrd4r rlgilfis to tha �+1111kate hotdw to Neu of Each endarwnsnt(s)- PRODUCER MHC001121d$Pangione insurance Agency P.Q.BOX 428 (978)688-MMI 104 Main Street North Andover,MA 01845 DAb5OT12i72518 AP/ IIIp l _ BrW)RED O G Ittc TRAVELERS CASMTYSSURteTY CO OF IL 19048 428 Rte888nt St. e: SA INDEMNIffTiN$I1R,44CE CC) 33818 N Andover,MA 01845 wwm C: AMERICAN HOME ASSURANCE COMPANY 19380 j Et9UOs -...--�-- — COVERAGE; CERTIFICATE NUMBER: MON HUNIt : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAAAi !ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQLIIREMW,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WrrH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES OESMSED HEREIN 18 SUWEa1T TO ALL THE TI-RMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMrrS SHOWN MAY HAVE SEEN REDUCED BY pAID CLAIMS. TYMOFB,1suIrANCE Pbuc#w PWCT=p A 0Ea1ERALUABRM r-680-1553R18-1-ACJ-10 0&17/2010- 05117r20t1 €ACH orcuARn.C6 g 1000w0 c1AL GENERAL LL4BILITY S 30001)0 GLAIM64-WADE 10 4GC11R MExi; ('®. E -- PERSONAL&ABV KRW 4 ...1000000 ALAcaaA 3 2001 GEN•L AGGPEgATO LIMIT APPUES FM P AG6 3 2{)bOOQb PDLICY PRO- 3116538 S AUTOMOBILE UABILRY --.- 07/12P2010 b7/12f2019 CflMaINo 8&moI.E LAWIr >; 9000;}00 ANY AUTO i�Yddmrl) -— ALLOWN_D AUTAS RMLY P WRY(Par pmw) 3 $GKV2U=AUTO$ 9C61LY INJURY(PQr aaii w) S KRED AUTOS PROPOM O t 1Pe*x�erX) _ N0144WNEO AUTDS f S UMBRELLA UAB OMR EAp{Or ENCE S EXCIM UA9 .._•• REt3 TE g DEDUC7IBLE S AND _ REiEMWN wCOM74107 srA1IY Drt+ s C Yeses LrAelerrY Ulm 03!3112010 03/31f2O11 ANY F'RD I�p�pA� omGF3tMMPER EXCLUDED? E-1 NIA EL EACH ACCIDENT s 100000 �Imc4tory In NN) Kdaw" undr Ek DISEASE-eA EMPLOYEE S 1011100 FkjN OP OREIRATIONS Maw EL.PIB"-Fo.ICY LWT S 500000 VBWF4PTION OF OK-ItATgM I LOSATIOM r VENMESS tAttnh Atm 101.AIIE@On�i r S .aue nmora R+�+�r•pu ! CERTIFICATE HOLDER CANCELLATION $MOULD ANY OF THE AROW DESCRIBED pouCES a CANCELLED eaFOM THE 00 RaATMN DATE THEkEOF. NOTICE vALL BE DELIVERED W ACCORDANC9 WffM THE POLICY pilMnIONS. AUrNORMW RIPREREM•AIM t�19®8,2009 ACORD CORPORATION. All rights req;Y . ACORD 26(20081b9) The ACORD name and 1090 are registered marks 0f ACORD The Commonwealth ofMassachusetts Department of Industrial,Accidents Office of Investigations 600 Washington Street Boston,MA 021X.1 �'� s4' www.rnass.gov1dia Workers' Compensation.Insurance Affidavit: Builders/Contractors/FIectricians/Phx>noi.bers Applican-t Information /,f Please Print Legibly NaMe(B.usiness/Organization/Individual): a uiiA Address:- �- City/State/Zip: /�f'Y� tr2 M 0 Phone#: � �� 6 ��i 7 Are you an employer?Check the appropriate box: Type of project(required): 1.�am a employer with 9 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.r 7. ❑Remodeling . ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I1.❑Plumbing repairs or additions myself. [No workers'comp. c.152, §1(4),and we have no 12.❑Roofrepairs insurance required.]t employees.[No workers' 13.❑Other 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: o� �1�Ca" ��`•' � eA9 C1U (q V'`� (U Policy#or Self-ins.Lic.#: UJ G q F 17Y CU-7 Expiration Date: ' 1 ``�� c�c�6 i2r`ca �. tz / Jae( r� d S Job Site Address: (//U � � �i!''r �l City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do liereby certify under thepai idpenaldes ofperjury that the information provided above is true and correct. Signature: 9]/ Date: Phone#: 117 �5 Official use only. Do not write in this area,to he completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: