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Home My WebLink AboutBuilding Permit #816 - 110 WOODCREST DRIVE 5/14/2012 BUILDING PERMITof "°pTH TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION r NO: Permit i. Date Received ACsE HU I` Date Issued: ° s IMPORTANT Applicant must complete all items on this page tid'+•-n i. -.+ t:r y r , .5"•'•= ,,. .-s Jai C_ st - r 1rr ,�-k '`} + „' .r5 � �� •r � IC.lS�j �+4F 7 �r a ..� L.rF �} 3 Z�� y.S 1'" e _ r� „ ,,..r 1 /F v i?' _➢ y y4yPlnd r''"Fx 5� '.'aar� '�^?3 i�' ,�.,r�- L7'�-t' ,i_:'N�I'• i:t4 . . i2 ' �-n� 3. a r 'i `f..��'^aY"''S_.�i i. -ar•-F, 3-,..5s � y � ��-'�`�.x;�c`�i'�=, �}', lan"I.+clt��1 �i�S�$ti•7 ��.3r�, -i"�rtl'filf��s., 'I �i'�-��sk�rac,-• F ice,.' -�3:. �s. � t to " k`.+r c'Nr tfib., r,, - .. k.x••p,�.rg _ k'vn'. ti az- t�`�yG� ••� t'- ;�'rj�a � sr .�'��x r � ,f`^171� �,,�>,v. -`S'4i m\[�cr,y-��+,. 5 �s v5.�1. .ifs ro p .ruT .-•5.c. ar - ,' .. , -.;�t;� .,5-k .s•. 1 J7 w7r'r � 31-7 ,� � yti....�T�,�•l�..u,imr-• .�y��ra�j•l,ir.�Ye'��'"'��z3_:.7� t,Y�',a"�Z z� r> -'t?"s, :� .,r-`.�� 'IVia� y,, � `''�'�%f �.��,L"Cr'p. r- {.d a��.� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building - _ One family _ Addition T Two or more.family Industrial Alteration No. of units: _ Commercial Repair,,replacement- Assessory Bldg Others: Demolition Other �1 }��n:,A_ •�i -r`r,'2r r_�rr i i`T" / #"�°-:i 1F ,..�•.�"r_,�.].,�..7 -__:r..:s�c4.�-.�-5 is>�- 'S'�'r 5 �IAar � -y u., R y?.'� ."'� ��Jpl 'c-h"�3,JrV/�I � 'i.`cty.d"'tom �T ^•_.�L 5 L`---✓ [; � 1 �JI r r� �5, � a� 'a� -1{..� J:, r.f � + �"t-=filtc s.s•i.;. 4.'� d r2Z-c: ' S '��' a'�w�+ts,.k�"-,.^�'i �.J�!-r.,r ri-a �"�' �..., .Ka�:T-�17!'IET�t x�??ti"s k Ya��.:�� 'S__ .7M �Y}'.,F,:c r-II' �..�.. �� 't-x e+^cY r •i�i i`�• ati•"`'Fvti rt � 1 C by +a+E ��.- .,_ .. _..._. _.__ ;7,..t'f_ -_r.�-.a.._ be �F_...�'3--dk rY '� �r'r..x-•.,�,s.�rm $-..Vii'.,: }'�.•xe�',`�,��,�_.�4� t:;� i 1.��* r{ _ DESCRIPTION OF WORK TO BE PREFORMED: Ab(�� Identific do Please .'ype or Print Clearly) OWNER: Nam Il'�i Phone:&/? Address: /- t?� � 411-P ISO 4... .. � �xL. <p3,d .h.F4: �-�• x "tt''"3 Wry" t •n. MEN 'a3� ,•vaES'.s -;T'e`vi.+rte t�`u " ley -3 �3 r- '{,- ¢5i� � 7�'J}I�i '�',r`� �` " � - k r r .. .1%�r..•_ "'�,-� '��•c-rte f w-" 3�� .� � �`�].��'�§'S�'�� i.r ��y��J�'�✓L�T"`'`�V v�''Sj � Y 4 R�r�.- �'T3'`"4{'.•'-i"'G 71Y 1 �..3..� - E N' 7 .3 y r t 5.�-��`"lr�'L r+..: ��-.-, -r a t. '?�l�rs-.r r-�r��`' �-��, r 'c i'yx�.'r'ul=.w�i"-,•_ � 11 ��.�'[��,�,kwi�f, • �" I�f �5.�„0 �,� - ��am- ,'�'• �:-��„ t .,�-�rl�rri �x�w• a��a ai3�,�-"� � � � aC4 z? -'9-A.t 1 1�A ¢ ��11T P, ,i!°!U'i h' - �r ? �a,y.;z, }� ,F.,,. �s ,�JJ,,;;�� C a Y'+ y r' - ,,,r r�=•y''2"T -f h:y,._�1- :�y„ a-i�. . t.u ,....-SFr ::$�Tt'}-'_ Ay.'rl'7C'`�' I MINIM G"S4- ��'1r' 7 c fr rxL Yom.,i�w'y„", ,'ri"r,E 5 1��irStial [-^ c::.'�-'�•dj l`�'J' � ��D��'WU � �"-,.i+r•�� .r eK � �'� i9 r �Yk., .�c�r 1�-x1AC t k'�;Ly,� c-C''C.�� i 11�F`+,�:- � _ _9 F,rsj'�.�,yy r'�". �,�yf�5.�,�r'f�r�-atif��h 4�t1 �2-:1 •;� -f�r�.fi�'rr3`-��;�n,j��t �+-.,,�--i'yt-°:^-G.c�r� is'a -� x..t;=''�� jtt�' � � y Via: �:' i •Jk'''Y c?;;,a� A'IF,_c� :^w.K �'pi,�'^r' .fir'Y c'�c' " /_ .b,.d t V�3- ti,�- r i "H4'�_�"- 'r��f .3.l��ue ,.,..f.�•t.'�„ '''''-'cie "'14�:�..r-` -a� - J� �.. F: x,_Vr 1 v �.�t�..0 ,� ^�7.v� ^:r�..:;�s5c�^-�r•,��T r v':�..r;^ :.:ar_;.��'?��f��.�`•�-•�.1)�,.h�ved'kv�yy,1�F•r"�,_'- g. r"�(!.. ', "r" ': '-'. g.Y ��`k1'. •-7i"�-,•a� '-;sj'�.--i•T.�rr-� ,w�s�� '^'S= ,�.,�w��.,,�,.}�.F�r,�.z.��s'��ifir.� i151�1�11�� S-r 9� '1✓�+�w7� ca+.�{s?-.....z. ! F��.:.�x...� 1r F•�- � �x i.ka�.a.� �Y t 1 fi `�' � �rF1i�`f Y r*- •L_ R` 'S'C'�. f ARCHITECT/ENGINEERo e: 7 7� AddressReg. No. FEE SCHEDULE:BULD/NG PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ -2zov FEE: $_ 2j O Check No.: Receipt No.: ,^ ./ NOTE: Persons contracting with unregistered contractors do not have access to b anty fund Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools ; Well - Tobacco Sales FoodPackaing/Sales {1 f C` Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM k DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS ` i CONSERVATION Reviewed on `/ / Signature tom. _•er-..1T_ I/'► r / Co M ibi c N i� DO I ,!& � e rj� (a D►\- 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/Signature& Date Driveway Permit j DPW Town Engineer: Signature: Located:`384 Osgood Street an i =IRRE ► 111E#I�i ' � D erxpqrpter��Ysitee '� ono =Locate�i�f4Jain Street 's �p �j LT �F7Te(�ef3aTGnellt�� r/�L�j IY� ' X. S t 9 Y L v d k C0.1�71i111�1IT5 t i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup - Date f Doc.Building Permit Revised 2010 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or..Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit- - ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract F ❑ Floor/Crossection/Elevation Plan Of Proposed Nork,With Sprinkler Plan And Hydraulic Calculations (If Applicable) " - I ❑ "ass 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 .v-New Construction (Single and Two Family) t ❑ Building Permit Application o er ' r i Propose' t .c .P.' cam_ ,,,Ulf i .. r- „ e. P�oE t tar t ❑ 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) ❑ Copy of Contract o Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In 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 ' must be submitted with the building application a Doc:Building Permit Revised 2008 f . t h h: fS Location—/z/ �/I��%��G/LG4 No.491K, _ Date,!? / "k c ar,,, ' • '° TOWN OF NORTH ANDOVER. , • �� Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ r Other Permit Fee $ * . TOTAL $ Check# 700 25297 Building Inspector N®RTH 0 0 over I No. X LAKE 10 , over, Mass., 1� O COCMIC EWICK A0 ATE �� S J BOARD OF HEALTH Food/Kitchen Septic System • �� L '441) 1` BUILDING INSPECTOR THIS CERTIFIES THAT........................................................................... .�.......I............ Foundation has permission to erect........................................ buildings on ....1.� Rough ......... .............................. .......... ® Chimney to be occupied as............. ...... .. ............... .� .. ....... . ........... .��..�*............................................................. provided that the person accepting this permif shall in every respect conform to the terms of the application on file in Final 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 3 A PERMIT EXPIRES IN 6 MONTHS • ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T Rough ............ ............................................................... Service BUILDING INSPECTOR Final i Occupancy Permit Required to Occupy Building GAS INSPECTOR I Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No LathingWall To Be Done or Dry DSV FIRE-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner ` Street No. SEE REVERSE SIDE smoke Det. HOJZTCAGE PLOT PON : S.E.C. & ASSOCIATES, LLC 138 NEWTON RD. PLAISTOW, NH 03865 PHONE 603.382.5065; FAX 603-382.5216 MORTGAGOR. EDWARD P k HEATHER L. ANKIEWICI DEED N RRREEF 10108 PG. 3 AOORESS OF PRINCIPLE BUILDING: 110 WOODCREST OR. N ANDOVER, MA pA E OF FINS11918 N OCT 21, 2004 SCALE 1" 50 285 �6 32 65 h v a � LOT 52 . 53,005 S.F. ^� LOT 53A t X01 STCRY 0 0 ai OF k.1s r o� ALBERT T. !� L 50.00 a TRUDEL a. NO 38869 ID Q o„ eSs9E EPE WOODCREST DRIVE °5L LA CMrncatlon to. BANK OF A ERICA The opproatnatt leco4on or Inr,pprnclpa nructun/e th,s erorlgage Plot Plan vas prePored sp ealOcalL.la contorm +th the local-tonlnbyfova n effect .hent ortgoga purp0eee only and,1 is not intent did a rep....nl.d Constructed and of is exemptfrom n01.b0n enl0rcament to be o properly Ime or land survey This pion Is not l0 be used act,on unocr Moss Bi nae un, cnaP 4o A. Sec 7 t0"tabhsh any of the properly Im Cs for any p'lpose. NO Ths princ�plc structure on this plan Is not rTenspOn fOYll y Is extends to Npnc llendt vq. a1 occupant. y located thIn sP id A.od hor d ors.o. scaled bon. a ThaiOA�ipno�ul0�0e ueew for Ung 16�n oL'erm9ter or�dYi ��ri of Athos FIRM slo 250098-000SC a 9 P i a Date 612E 1993 FII.Na 30007 Job N.. 29904 n....... ... ...n.urs [ n..e.nn N®RTIy Town of - Andover - tit 0 .. d.over, 3Aass.,LAKE 1� O COCHIC EWICK A�RATEo P'PCC� `TBOARD OF HEALTH Food/Kitchen Septic System L 'aw) I` BUILDING INSPECTOR THISCERTIFIES THAT...............:..........................................................Z.... ......... .�.................... Foundation 1.1has permission to erect........................................ buildings on .... ......... .............................. ........... Rough to be occupied as............. ...... ....... .Ir .. ....... ............. .�i�.. .,............................................................ Chimney provided that the person accepting this permif shall in every respect conform to the terms of the application on file in Final 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 3 A PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T Rough .................................... ................................................................ Service BUILDING INSPECTOR 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 r Until Inspected and Approved by the Building Inspector. Burner f - Street No. SEE REVERSE SIDE smoke Det. r t r OLL170L :#Jl i.auo„simiu.�; btOZ/9/I, :U 1idx3 • s. 088 40`dW '(1-1�1lj3NVM } 1S Ave 5Z r OSSOf1SOINVjS NOS`r 9� OLLb01 .SO. :asuaarj a>;u9011 'JOSinaadnS uoiyan.ilsuo0 1 p�1t #� buttro1.1 otlila1}ttlard t3lssju r Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration == Registration: 156563 ___-" —.• Type: DBA Expiration: 7/17/2013 Tr# 214691 a SANTOSUOSSO CONSTRUCTION( JASON SANTOSUOSSO I ( Y 25 BAT ST ` WAKEFIELD, MA 01880 date Address and return card.Mark reason for change. P Address R Renewal Employment Lost Card DPS-CA1 0 50M-04/04-G101216 �amve�rLB�. ness e� License or reg�strat�on valid individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 156563 Type: Office of Consumer Affairs and Business Regulation Expiration: 7/f1,7/2013 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 S OSUOSSO CONSTRUCTI.QN,?- JASON SANTOSUOSS_ =; 25 BAY ST WAKEFIELD, MA Undersecretary Not v d ifithout SiNiture The Commonwealth ofMassachusetts - Department oflndustrigl Accidents Office oflnvestigations W_ 600 Washington Street Boston,MA 021.7.7 www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contrcactors/ElectriciansfPlumbers Applicant Information Please Print Lep-ibly Name(Business/Organ'rzation/fndividual): qAgL ��d �j O!VS�'GUcoe-� Address: GC111 3_r, tY P:_ / Ci /State/Zi W5_r d 0. hone#: -7 (677d Are you an employer?Check the appropriate box: Type ofproject(required): 1. am a employer with 1 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/orpart-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7• E]Remodeling ship and' El 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 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. c. 152,§1(4),and wehave no 12.❑Roofrepairs insurance required.]i employees.[No workers' .13.1]Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they Die doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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% Policy#or Self-ins.Lic.#: Expiration Date: Sob Site Address: /f tj60QCieC5_r DKt -Pity/State/Zip:_ /V', Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL o.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 DTA for insurance coverage verification. I tlo hereby cert iter t and penalties ofperjury that the information provided above is true and correct. - Si ature: Date: -10-%a Phone#: -791 S97 -7 76 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#: information and Instructions . Massachusetts General Laws chapter 152 requires all employers to provide worker s' compensation for their employees. Pursuant to this statute ane « employee is defined as ...eve person in theservice, . •"...every s rvice ofanotherunder any contract ofhire express or implied,oral or written. An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shallnot because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been 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 necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on theappropriate line. ' City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number whichwill be used as a reference number. In addition,an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(ifnecessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and shquld you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Gommonwoalt� of�iassa.,chvsPtts Dop.artweiatofSndustxdalAccidents Office ofIuvestigatiow 60 WashiWoa Strout Basion?MA 02111 TO,#617-72,7_4900 ext406 or 1.-87TM SS.AFE Revised 5-26-05 Fax 0 617^727-7749 www-mass,govaa Santosuosso Construction HIC License # 156563 Jason Santosuosso CSL # 104770 18 Gail St. Topsfield MA 01983 781 5896770 To: cAOWrz W;xz /C) W-d69esz�sr �z. . -tv ilPOY E2 YvI A. �o M"jo LjUrFC.T" OF tdUN& We are to furnish material and labor to complete in accordance with these specifications, for the sum of: $ ` C)O.-10 Payments due as follows: $ ;L Sa=,o paid as deposit, Balance of $ Q,0-6.ab due upon completion. All material is guaranteed to be as specified. All work to be completed in a workman like manner according to standard practices, any alteration or deviation from above specifications involving extra cost will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our control. We carry workmans comp insurance and Liability insuranc Authorized Signature '�� -la Customers Signature