The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #207-15 - 14 WINDKIST FARM ROAD 9/5/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: b� Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION V W Ad iZ' __ :.<14 _ / Print PROPERTY OWNER ru�f S _ Print 100 Year Old Structure yes MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family [+Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Aseptic OWell ❑ Floodplain ❑Wetlands ❑ Watershed District ater/Sewer DESCRIPTION OF W RK TO BE,PERFORMED: Identification rlease Ty r Print Clearly) / OWNER: Name: /1 s5 Phone: 17 Address: CONTRACTOR Name: N N15Phone: J_. Address: �)'d U1C &_4C(.J Supervisor's Construction License: �5'_QHSs` Exp. Dater 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 B SED ON$125.00 PER S.F. Total Project Cost: $ �%JJV � r5 0 6 FEE: $ (,k Check No.: Receipt No.: NOTE: Persons contracting wit ugreg.ster )cotractors do not have access to he uaran u d Signature of Agent/Owner ignature of contra or Plans Submitted PI ns 4aived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OF:SEWERACEDISPOSAL 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.APP _OVED PLANNING & DEVELOPMENT ❑ [ 3 `J COMMENTS- IU �/�0 CONSERVATION Reviewed on Si nature COMMENTS j) ,v', t cj�-) 6/---- HEALTH Reviewed on i 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 DPW Tow;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTML�'NT =Temp Dumpster on site yes no Located-at 124 Mair Street Fire Departinerit 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 Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter-166 Section M=F and G min.$10041000 fine NOTES and DATA— (For department use ® Notified for pickup - Date S Doc.Building Permit Revised 2010 Building Department The fol;owing is-a-list of the required forms to be filled out for the appropriate permit to be obtained. Roofivg, Siding, Interior Rehabilitation Permits o Building Permit Application a Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses a Copy of Contract o 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 o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) a Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan a Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o 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 apw al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Building Permit Revised 2012 Location L J No. 0 Date -7 . TOWN OF NORTH:ANDOVER Eb ' • Certificate of Occupancy r $ Building/Frame Permit Fee $ l0 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check - " <=� Building Inspector NORTH own of E ndover Q y.: to % h , ver, Mass, I COCNICMl WIC.( y1. A04ATED ►.P��S S V BOARD OF HEALTH Food/Kitchen PERMIT T LD�^ Septic System THIS CERTIFIES THAT y ........ BUILDING INSPECTOR has permission to erect ........... buildings on �. (�/.�.4!lc K-C�':� w- Foundation ............... ..... ..... .. .... .......� .................... ' Rough \4 —� �! ... ....��Q. ,�6F!-`�1�'.................................................... Chimney to be occupied as .. ....... .............. ... ... . .. y 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 CONSTRUCTIO TART Rough Service ................. ......... ....... ......................................... BUILDING INSPECTOR Fina GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. SEE REVERSE SIDE k r• ��'�7i�t� —1 �'s. �'- 'TIS�.�, � �—��•,��' 4§«y a J 5 aol— Elevated Deck with'a Sweeping Staircase The owners wanted a grand outdoor living space,but they also wanted a deck that looked as if it was conceived as an integral part of the house—not an afterthought. 3: f! 1 � , �f J/ ti i 4- rf r .- -- - g GROUND VIEW }� E 7-1 195 REFERENCES 1. Definitive Subdivision Plan recorded as Plan #12957, E.N.D.R.D.. NOTES 1. PURPOSE: The purpose of this plan is to show the location for the Proposed Pool & Pool House shown in relation to zoning offset requirements. Offset dimensions shown shall not be used to mark 90.84 lot lines, structures or any other features. Drainage 2. LOT LINES: Lot lines shown were derived from Easement reference 1, and not from the results of a property survey obtained by this office. The proposed 10.0' Proposed 0.0''` structure locations have been provided by client's representative. Existing utilities have not been Poo determined or identified by this office. 35.0' Proposed 3. ZONING: The property shown is located in the 20' Shed _ - d 282' (under Deck) z '' / o Residential "R-2" Zoning District. #14 / / tN OF / Lot 17 DAvm J. 0 t $' Lot 18 DeBAY 12�� \ 1.oof ACRE / � No gt2(CI t3 / L LAt1� L=148.81' N Drainage R=265-00- Easement \ 126.01 Windkist Farm Road Proposed o Plot Plan o00, Scale: 1"=50' Date: Aug. 26, 2013 14 Windkist Farms Road North Andover, Mass. Prepared for: Mike Pasco CORNERSTONE Land Consultants, Inc. Civil Engineering•Land Surveying•Land Planning 61 Main Street • P.O. Box 657 • Pepperell,MA 01463•978-433-8100 Job No. 13-122 Dwg. No-9288 decks by kiefer i L2,�•Jl��t�l�� .►� �� W �Wim"�;� � 'i `+ V�n�.► � f,!'L'�n�t1�1 V L!S��I S 40 7� \ \ \ 4P i Formacast _ Colu �� t.\\\ ��: (3)2AN f {/ fil �xto MATERIALS USED FOR THIS DECO Framing Tripled 200s for beams Stairs 2x12s for stringers 2x8s for ledgers Hardware Metal lally columns ,q//Q joists Permacast columns Decking 1x4 1p6 Copper flashing Fascia 1x12 Koma trim Joist hangers Railing 2x4 posts Lag screws and washers 2x4 rails Masonry Concrete 2x2 balusters Concrete tube forms 1x12s for curved portions of railing Oversized 2x4s Posts 1x4 %x8 196 i �e Tpnnrmzo7uaea�i a�C>�acfivaeG Office of Consumer Affairs&Business Regulation _ ME IMPROVEMENT CONTRACTOR_ egistration: ;7821 'Type: . xpiration: =IK112015 Individual VINCENT E.Br%%A1 = = ' VINCENT BOWLES -£ 95 JONES AVE DRACUT,MA 01826 Undersecretary b�Q�/,L WZO Jau0lsstuRw3 i uoiTejidx3AN $TO1tVTIQ. ' JAV SUM S6 Lgmo-3O:asueoi� spuepuej$sp%Msuo4ein6aa Blu!pjtna'}o pjeo8 lAm3110d 10 Wampedap-snasnPesseW , 2/5/2013 3:18 PM FROM: Cooney Agency James L. Cooney Insurance Agency, Inc. TO: 9784540652 PAGE: 002 OF 002 ACORN, CERTIFICATE OF LIABILITY INSURANCE DATE(MNYDDlYYY'Q02/05/2013 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: ff the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed H SUBROGATION IS WANED,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 NAME: Catherine Barcus James L. Cooney Insurance Agency, Inc. PHONE . 978.459.0505 x23 I FAUX,No)*978.459.0044 327 Gorham Street ADDRESS: cbarcus@cooneyagency.com Lowell, MA 01852 INSURER(S)AFFORDING COVERAGE MAIC r Gerri Brown INSURER A: Travelers Indemnity Co of Amer 25666 INSURED VINCENT E. BOWLES VIN'S REMODELING -INSURER B: 95 JONES AVENUE INSURER C: DRACUT, MA 01826 INSURER 0: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 12/13 WC only 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MID LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) S CLAIMS-MADE 1-1OCCURMED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ POLICY PIEECCT LOC $ AUTOMOBILE LIABILITY (Es accident) $ ANY AUTO BODILY INJURY(Per parson) $ ALL OWNED SCHEDULED AUTOS AUTOS INJURY BODILY (Per accident) $ HIRED AUTOS �p�D (Per awdenq $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION IHUB7A936088 1012212012 10122013 X I TORY LIMITS ER AND EMPLOYERS'LIABILITY — IN ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E L DISEASE-EA EMPLOY!J 100,000 If yes,descnbe under DESCRIPTION OF OPERATIONS below 3A-MA E L.DISEASE•POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) Owner not included on Workers Comp.coverage 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. AUTHORIZED REPRESENTATIVE Ei 1 een Gibson CAB O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD NX The Commonwealth ofdlassachusetts Department of IndustriglAccWd is Office of Investigations qV 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legib Name(Business/OrganizatiorAndividual): ) it7 is Ar/.Ott Address: f ? City/State/Zip: Are you an employer?Check he appropriate box: Type of project(required): 1. I am a em to er with 9 4. ❑ I am a general contractor and I p y have Hired the sub-contractors 6. E]Now construction employees(full and/or part-time).* 2.El or proprietor I am a sole ro rietor partner- listed on the attached sheet. 7• E]Remodeling ship and'have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 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 we have no 12.E]Roof'repairs insurance required.] employees.[No workers' comp.insurance required.] 13.❑Other Any applicant that checks box#1 must also fill out the section below showingtheirworkers'compensation policy information. I Homeowners who submit this affidavit indicating they ai•e doing all work and then hire outside contractors must submit anew 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:. � 6 t,)er (�Wcole� Policy#or Self-ins.Lic. 3 Expiration Date: rob Site Address:_ f 7 GC1f ytl , � 'b� Attach a.copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 ofup 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. I do hereby c ti under t e ins an enaltie ofperjury that the information provided above is true and correct. - Simature: Date: Phone#: ��4 ��5 5 ✓�, Fonly. Do notwrite in this area,to be completed by city or town official.n: Permit/License# ority(circle one): 1.Board of health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5—Plumbing Inspector 6.Other - - - Contact Person: Phone#: Information 2nd ffuustruuefl®.u"s " Massachusetts General Laws chapter 1.52 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under 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"Neitherthe commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public 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-contractor(s)name(s),address(es)and phone number(s)along with their certificates)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 may be 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 the appropriate line. City or Town Officials -Please be sure that-the affidavit is-complete-andprintecl legibly: The"DepattmeritliCs-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 which will be used as a reference number. Iu addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current Policy information(if necessary)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. A new 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 should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: Tho Cowmaaweaftl of mfassacahvsPtts Depart=tit ofladustilal.A.celdelits Office .f Ti stigatiolis 600 Washitagton Street Boston?SIA 021 Z 1 TO,A 617-727-4900 at 406 or 1.-$77-MASSAFF, Revised 5-26-05 FaX#617-727-7749 a xv i