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Home My WebLink AboutBuilding Permit #234-14 - 14 Longwood Avenue 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: —3 Ll_ Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION - . PRQPERTY OWNER Pr lob Year Old Structure yes MAP NO:' ZONING DISTRICTS Historic District yes . - _ . Machine Shop Village, _ yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: Wbemolition ❑ Other 0 Septic ❑Well ❑ Floodplain ❑Wetlands Watershed Distract ❑Water/Sewer . .. DESCRIPTION OF WORK TO BE PERFORMED: i Identification Plea Ty r learly) OWNER: Name: � Phone: I Address: v L CONTRACTOR Name: _ `,�. -Phone: 5� Address: Supervisor's Construction License:_CS.-Ma F,!- _ _ Exp Date: Home Improvement License: _ _. . Exp. Date: ARCHITECT/ENGINEER Phone: " Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: /P7 Receipt No.: ��✓�� NOTE: Persons contracting with unregistered contractors do not have acceskt nature,6f 91g1ature.of contractor` Plans Submitted 0 w__ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Building Department The fol('owing 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 ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li 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) ' i ❑ Building Permit Application i ❑ 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) ❑ Copy of Contract ❑ 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 apnaal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm-tted with the building application Doc: Doc.Bui?ding Permit Revised 2012 i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE-OF-SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑,. _ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc.- ❑ _ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: DATE APPROVED PLANNING & DEVELOPMENT` ❑ ❑ i COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes • 1 Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Tow;: Engineer: Signature: Located 384 Osgood Street FIRE!DEPARTMENT - Temp Dump'ster on`site yes no Located at 124 Mair Strdet:. Fire Departme►it signature/date-, '` . . , .- 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 DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A-F and G min.$100-$1000.fine NOTES and DATA— (For department use III B Notified for pickup - Date i i Doc.Building Permit Revised 2010 i i I Location A No. 3 7—��/ Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ r" ` ,. 6 Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Feed $ TOTAL $ Check# �/ 7 26351 Building Inspector NORTH Town of . ? � : �� ndover No. 234— 1 t - }� ver MassO*oh A- COCNICNIWICK V� 7a A�Ri1TE0 �'P�,`'�5 S U BOARD OF HEALTH Food/Kitchen PERMIT T D-y Septic System THIS CERTIFIES THAT ......,��„C'F� .{vylo�; ...&'g..1 ...�1..J' ................................................... BUILDING INSPECTOR ' - Foundation has permission to erect ............... buildings on ..,1. .. ��' r'�{.: F.. .!�: .......................... ........... ........ . .. �— Rough to be occupied as ................ .. .� ...../..,�:. �..�.....��'C .... .�?:G1. :c�..................................... 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 CONSTRUCTION W-ARTS Rough Service .............. ........ .. ...•..... .+.......................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done I FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Town'of North Andover NORTH q BuildingDepartment o �c�`E° 16 p .f 96 0 1600 Osgood Street OL North Andover MA 01845 .�', ' • ' Tel: 978-688-9545 Fax: 978-688-9542 fyr s b ET 10 T A COC NICNE WICK`y DEMOLITION OF RWLDING AFFIDAVITDRITED '4SSq C HUSH'( DATE OWNER'S NAME &ADDRESS LOCATION OF PROPERTY TO DEMOLISH DESCRIPTION. CONTRACTOR'S NAME &ADDRESS DEPART S FF DEPT. OF PUBLIC WORKS -WATER: SEWER: 0 . DEPT OF CONSERVATION HEALTH D Septic Well C HISTORIC COMMISSION rM s�W-Afe-- bks l,.i�� 6 �n /"'fes SP/Y •�t�neo GAS P,� aG�o/� - f rt E� �1�%�-s• ,.. ELECTRIC TELEP i f CABLE C �;Oa TAXES POLICE FIRE �-EXTERMINATOR DU -ON/OFF STREET DIG SAFE NUMBER DATE REC'D BLDG. INSPECTOR Doc.form demolition of building affidavit Massachusetts-Department of Public Safety Board of Building Regulations and :Standards Construction Sulam isor License: CS-005693 x` tis�t m E•.� ,,r, �`. DAVIDA KIND 65 EAST INDIA ROW#36H ROSTON.'.1 S 02110 'I&pi ration Commissioner 01113/2014 i ACCOUNT NUMBER. Colonial PEST CONTROL INC. APPOINTMENT44UMBER 32 LAKE AVENUE•WORCESTER, MA 01604-5823 1-800-525-8084 SERVICE ADDRESS: BILLING ADDRESS(if pre-approved): 17�.v/C 7 .0 a s-r 4 S E-MAIL ADDRESS PHONE# SERVICE CODE TARGET MSDS SHEETS AND LABELS AVAILABLE UPON REQUEST. REMARKS: /V 0 e v d e4/C o (= IMPORTANT: 1-um Please allow 30 days WJCl�:AA`71� C' c `j e R r->`� �S for control for all insect infestations (Except termites) SERVICE AMOUNT Please allow 14 days for con- AMOUNT trol for all rodent infestations. PAID -- Warranty Information: METHOD OF PAYMENT '""�� ❑ NAME ON CARD1� <�2� / CARD NUMBER EXP.DATE All work has been completed to my satisfaction. SIGNATURE CUSTOMER SIGNATURE DATE SERVICED SERVICED BY _ .4co v® CERTIFICATE OF LIABILITY INSURANCE 9%12%2013) 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 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 lieu of such endorsement(s). PRODUCER CuNtACi NAME: M P ROBERTS INS AGCY INC PHONE (g78) 683-8073 �C No;(978) 683-3147 1060 Osgood Street A/AILo Ext: ADDRESS:sandi @mproberts insurance.com North Andover, MA 01845 -INSURER(S) AFFORDING COVERAGE NAIC# INSURERA:ESSEX INSURANCE CO INSURED KINDRED HOMES INC INSURER B:MERCHANTS MUTUAL INSURANCE CO CORP. INSURER C:ASSOCIATED EMPLOYERS INS CO P.O. BOX 483 INSURER D: NORTH ANDOVER, MA 01845 INSURER E 978-688-6558 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. INSR TYPE OF INSURANCE ADD s e POLICY F POLICY EXP INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 UAMA13I,z IQ HEN I ED CLAIMS-MADE FRI OCCUR PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 0 A 3DM5468 7/22/137/22/14 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ EXCLUDED OTHER: $ AUTOMOBILE LIABILITY Ea accident _ $ 1,000,000,000,000 ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED MCA7014524 03/08/13 03/08/14 B AUTOS X AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4 EXCESS LIAB —d CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION1 PER - AND EMPLOYERS'LIABILITY YIN X STATUTE ER _ ANY PROPRIETOR/PARTNER/EXECUTIVE WCC500-5008521-2013A 08/1/1308/1/14 E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? ❑ NIA )Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe und DESCRIPTION OFeOPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) IIS CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BEAN EL D C C LE BEFORE NORTH ANDOVER MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1988-2073 ACO'RD CORPORATION. All rights reserved. ACORD25(2013/04) The ACORD name and logo are registered marks of ACORD I Columbia Gas-, of Massachusetts A N%Source Company 995 Belmont Street Brockton,MA 02301 Date: August 26,2013 To Whom It May Concern: The address listed below has had the gas service(s) disconnected and is now ready for demolition. ADDRESS : 14 Lorraine Ave TOWN : N Andover STATE : Massachusetts Sincerely, Jane Mikal Maintenance Administrator Integration Center Columbia Gas Of Massachusetts 508-580-0100 Ext 1304 i nationalgrid 40 Sylvan Rd Waltham MA 02451 August 14, 2013 David Kindred 14 Lorraine Ave North Andover, MA RE: Service Removal for Building Demolition. Dear Mr. Kindred, This letter is to confirm that,per your request,National Grid has removed the electrical service and meter number from at 14 Lorraine Ave North Andover, MA as of 819113. If you have any questions or need further assistance, please feel free to contact me at(78.1) 907-3519. Sincerely, f Angelic Butler Customer Fulfillment Ph#781-907-3519 Fax# 1-888-266-8094 angelic.butler@nationalgrid.com i i