Loading...
HomeMy WebLinkAboutBuilding Permit #473-14 - 2 Royal Crest 12/3/2013BUILDING PERMIT TOWN OF NORTH ANDOVER t (,I ` APPLICATION FOR PLAN EXAMINATION 1 y Permit NO: Date Received Date Issued: ��� `� 9SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATI,0N tltoyal Crest Estates0 R©yal Crest Drivd North:Andover}Ma ® Print 1 f .PROPERTY OWNER. Amco�North -ANdover LLC Fant MAP NO 25 PARCEL 35/66 ZO_ NING 01STRICT �t Historic District r yes n�x Machine Shop Village yes� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑kTwo or more family ❑ Industrial R Alteration No. of units: ❑ Commercial ® Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition EkOther Water roofin Septic ❑ Ne11y ; ❑ Flood lain [ Wetlanl p Y ❑ Waterslec:~ District . 0 V1/at!e Sewer Provide exterior foundation waterproofing and replace stairs with railings as necessary At building number 2 Identification Please Type or Print Clearly) Dan Millanzzo OWNER: Name: Aimco North Andover LLC Phone: 617-639-6052 Address: 50 Roval.Crest Drive North Andover— ma- Cornerstone Land Consultants,Ine ARCHITECT/ENGINEER John A. Vinsiewski PF Phone: 978-433-8100 Address: 61 Main Street -Pepperell, Ma. 01463 Reg. No. PE20775 FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. u Total Project Cost: $ 1,000.00 FEE: $144.00 Check No.: lis Ay Receipt No.: 1-1%0'0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Permit NO: Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received all items on this page "'" 1100 Year OId;Structure �Hlstoric District •ti lyes, no; 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: ❑ Demolition ❑ Other ;Septics ❑1Nell ❑Floodplain °.Wetlands - { ❑ W t rshed Dlstnct O';1/Vater/Sewer �TM _ - DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: ArlrlrPcc- CONTRACTQR`VN ffiO Addfess: _ ISupervlsors Construction `Llcei 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.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Slgnature=.o,�f Agent/OwnerRF =_ _ _ _ Slg�ature�of�contracto� . � _ � �r ��`�. Plans Submitted LJPians Waived 0 Certified Plot Plan L1Staroed Plans ❑ } r-} ..may Plans Submitted❑ PlansWaived-11 Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OF°-SEWERAGE:DiSP�OSAL - _ _ Public Sewer ❑ Tanning/Massage/Body Art ❑ ... Swimming Pools ❑ Well ❑_. Tobacco.Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc- -❑ Permanent Dumpster ori Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION Reviewed COMMENTS Cot HEALTH COMMENTS -P-'//17 V/-\' DATE.APPROVED re Reviewed on Signature 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 To-wEngineer: Signature: Located 384 Osgood Street .FIRE DEPARTMENT --Temp Dumpster on site yes no Located at=124;Mair,.Street ._ Fire Department . .- of t - .. a. .. • „-. .., ... .. -. COMMENTS illaw - 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 DANDER ZONE LITERATURE: Yes No MGL -Chapter 166 Section 21A -7F and G min.$100=$1000 .fine NOTES and ®ATA — (For department use ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department -The foli`,3wing i9-=a1ist 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 o 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) ❑ 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 ❑ 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 o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cask if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apo% -al 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.Bubjing permit Revised 2012 Location5V V No. Date 1 7j Check # sq�6 27150 TOWN OF NORTH ANDOVER " Certificate of Occupancy $ Building/Frame Permit Fee $ 144' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector id �r o� LZ rA E9* x u QW LL.? O D Q O m C .0 \ O LCL E ate+ N U Q. Ln p Z 0 m Cd I 'O 7 LL L to = = C E U C LL 0 a Z Z m t : d' C LL 0 a Z V u W LU0 t : K U to C lL O a Z Q l7 t bD 7 K C LL °C Q W W 95 LL N m z a+ CU L1 N �+ cu o d Y O N : LL. O O ; 0 C) U w 'Q12 :a N m Ov Z m Q • C7 O G V : J N N s FCL 4)m = CD ` it: �0 cn V� o �V L tm M _ N J La a ZF- _ Cl)`° L W _ po C c ��- O R O -a > a cn r_ U) X y W -0 E o o �.-. a.r- c m 4-T.2 �, �w > = W J �• CL Z CL CLm 41 _ �. 0 0 o N o O c = Q ea •o CD c W C -o z- o o •N a' a w = o .= .6..2 Z � N w v 0 _ oICL E V Q. 0-0 41 en N d •O _ O _0 O 2 i = 0 Q• 0 ;v ti i' w, v v 0 H � L o Q � a C : C Cc M J -0 O d Z Q 0 LLI W W 19 W U) I&ORTy OtiSw�e ,e"�y6 �i ss�tce�ust D. Robert Nicetta, Building Commissioner TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 Telephone(978)688-95454 Fax (978)688-9542 CONTROL CONSTRUCTION — SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BULDING INSPECTOR TOWN OF NORTH ANDOVER 400 OSGOOD STREET NORTH ANDOVER MA 01845 I, John A. Visniewski HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT Bldg. Vs 1 & 2 at 50 Royal Crest Dr. DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: Foundation waterproofing and subsurface drainage pining at the specified buildings. �P�-�" of �aY 10 . VtSht EWSr AUTHORIZED SIGNATURE: " No. 29775 A_ .O DATE: December 2, 2013 REGISTRATION: Mass. PE # 29775 NOTE: ENGINEER "WET STAINIP" MUST BE AFFIXED TO THIS FORM Control Cor=mction Form ra-,itd :1.14.2004 Edi.; \RUOF:tPP['.-kc _gill ',", 'P, 95; u f {, 1.. VA -1C' .. `- .!! HE::1 ! PL. 1 M1;,NG 1'4ti .5 10 ..-- --r - &v4j FACSIMILE COVER SHEET PHONE: (617)773-9200 FAX- (617)773-9920 Date:September 18, 2013 FroniXatherine M Pratt Page 3 of 3 ALDC r. -r J. Towzy Nc. Re: L. V. M. J. Corporation Enclosed is the certificate of insurance you requested as well as a copy of our request to A.I.M. Mutual Insurance Co. for a certificate of insurance evidencing workers' compensation coverage. The workers' compensation certificate will follow directly from A.I.M. Mutual Insurance Co.. ALUE:RT J, TORRY Cc Cr-�_ .: f' Wu 01b) -i -fly Of filfl. Fork fiu I C -r- AG ENC'y - 9 Nc. 10'11 81; fig!" URN irij$r1,11 1, 'MA n2,32.0. I ryfl CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) TYPE OF INSURANCE111M 9/18/2013 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 T. Edmund Garrity & Co., Inc. 545 Concord Ave. CONTACT NAME : CrlStlna AHC No Ext: (617) 354-4640 A1C NO: (617)354-5828 ADDRESS:cristina@garrity-insurance.com INSURERS AFFORDING COVERAGE NAIC # Cambridge MA 02138 INSURERA:Ohio Security Insurance Co INSURED L.V.M.J. Corporation 65 Howard Street INSURER B: INSURER C: INSURER D: INSURER E: Braintree MA 02184 INSURER F ".v-1-1 nWIWu"n. 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 LTR TYPE OF INSURANCE111M ADOL SUIJH M.0 POLICYNUMBER POLICY EFF MMIDD POLICY EXP MMIDDIY LIMITS GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR LS1455690302 /13/2013 /13/2014 DAM PREMISES Ee occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMPIOP AGG $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident) $ $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMSMADE AGGREGATE $ OED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? ❑ (Mandatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- I IOTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach AC ORD 101, Additional Remarks Schedule, if mores pace is required) Excavation & Hauling. —1. n 1— c LAIVVGLLA I WN lvm46@beld.net Town of North Andover Building Department 120 Main Street North Andover, MA 01845 ACORD 25 (2010/05) 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 Garrity/CRISTI'1.y"� ©1988-2010 ACORD CORPORATION_ All rinhts rPSPry PrI INSn75nninnsi m Tho ikrnRn norma nnrf Innn aro ranictorarl mnrtec of arnizn ...,,1, r -11 r vveu Dep 15 J.) : 1d; V1 "" Page 1 of 3 ^v .. J 7 • en 'o%11L_1"1C" CERTIFICATE OF LIABILITY INSURANCE DATe(rtnvoo CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 9/18/201313 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 policV, 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 Albert J. Tonry & Co., Inc. 300 Congress Street CONTACT NAMC: PHONE . (617)773-9200 FAC (617)773-9920 IAIC N, E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # Quincy MA 02.69 INSURED L. V. M. J. Corporation 65 Howard Street INSURERA:Corrawrce Insurance INSURER B : 34754 INSURER C: INSURER 0: Braintree MA 02184 INSURER E. INSURER F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LINED 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. INSRPOI LTR TYPF OF INSIIRANCFINSR POLICY NUMBER ICY FFF MMIODIYYYYJ POI ICY FXP (MfAIDDfYYYYj IMITS GENERAL LIABILITY FAC]H ($:17(1RRFNCF $ C:(�MML:R(:IALQLNERALLIAL14LIIY I)AMA(*-IUKH-N1I-I) PREMISES Ga occurrence _ MH 1 I -XP (Any rim.rine, n) U AIM:i-MAI )I- n 01AAA4 FF-KSONAI Y. AI )V INJURY $ CENERALACCRECATE S (II -MI A(iGKI —(iA1I-I IMII AHNI IF(i PFK' HH(>I )11(;ICi-C;OMHIS)P M;(t PRO I (S; HOI I(;V I I q AU IUMUBILt LIABILII Y COMBINED C PH3LE LIMB t -a ar1i11'R 1,000,00 13 ANY Atll U DODILY INJURY (Pei plesu„) u All OWNH) SCHHAPH) A. O:; At IOS J1808 2/15/2013 /15/2014 BODILY INJURY Yleracddsn0 7, NON OWNED HIRI-1) nut Og AUTOS' Lx PROPERTY DAMAGE acadcnt Medical nt-_ 5 UUU UMBRELLA LIAR ,r )-AC:H OC CURRFNCI- EXCESS LIAR CLAIMS MADE AGGREGATE 1)1-17 I I Ri-Il-NIIONS WORKERS COMPENSATION WC STATU UTI I AND EMPLOYERS LIABILITY YIN I OHY I IMII S: 2H, ANY PROPRIFTORIPARTNFR/FXPGIITIVF C.L. CACI I ACCIDOJT j UI+Ir tR1MtMUtR FXCLUUtU'/ u N I A (Mandatory in NI 1) If yy c:, dcxribc under DCEx:RIPTIUIJ Of OPCRATIONS E.L. DISEASE • EA EMPLOYE I. E.L. DISEASE -POLICY LIMIT �. below DESCRIPTION OF OPERATIONS/ LOCATIONS f VEHICLES (A1Wcn ACORD 101. AnOftional Remarks SCI1eatlle, IT more space Is regonea) Any and all jobs performed usual to an Mxcavation contractor_ CERTIFICATE HOLDER r.A1JrGl 1 ATInM Town of North Andover 120 Main Street North Andover, MA 01845 10105) 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 TOUry Jr . /CDIGRA O 1988-2010 ACORD CAR PA RATION All ►Inhtc rneon l IMCn9S ran, nna, n, . Tho At—non ., o..,o o.,,4 1....,. -- —Ire „t Annon - . -... . _... , vv --u JCP to L;) :.)o: V.L cVis Page 2 of 3 MASSACHUSETTS ASSIGNED RISK POOL REQUEST FOR CERTIFICATE OF INSURANCE Use this form to request a Certificate of Insurance frorn the Assigned Risk Pool Carrier (A.I.M. Mutual Insurance Co.). Please provide all of the requested information, including the facsimile number(s) of the person or persons to whom the Certificate of Insurance should be issued. It this form is fully and accurately completed, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided below, within two (2) business days of the carrier's receipt. This Form may be mailed orfaxed to the Assigned Risk Pool Carrier. To obtain each carrier's contact information referto the Certificates of Insurance section located in the Producer Community section of the Bureau's website (!,vw f. �,u�:r ltr-�q:11 t. Name, address, telephone number and facsimile number or email address of the INSURED: Name: L. V- M. J. Corporation dba: Mailing Address: 65 Howard Street Braintree MA 02184-1150 Physical Address: Phone: (781)848-6030Fax or email: Ivm46Qbeld-net 2. Name, address, telephone number and facsimile number or email address of the CERTIFICATE HOLDER: Narne: Town of North Andover Mailing Address: 120 Main Street North Andover MA 01845 Physical Address: Phone: Fax or ernail: Fax Numbei 3. Name, address, contact person, telephone number and facsimile number or email address of the PRODUCER: Name: Albert J. Tonry & Co.. Inc. Mailing Address: 300 Conaress Street Quincy. MA 02169 Contact Person: Cheryl A. DiGravio Phone: (617)773-9200 Fax or e►nail: _ (617)773-9920 or cert5(&tonry corn 4. Policy Number, Policy Effective Date and Policy Expiration Date If a Certificate of Insurance is needed for more than one policy term, provide the Policy Number, Effective Date and Expiration Date for each policy term. It the policy has not yet been issued, you must attach a copy of the Notice of Assignment. Policy Number: VVVC10060082462013A Effective Date: 4/6/2013 Expiration Date: 4/6/2014 6. List any special requests for optional coverages / endorsements (see Page 2 for listing of coverages available in the pool and the conditions of availability) or additional information (including changes in exposure not yet reported to the carrier) that will assist the carrier in the issuance of the Certificate of Insurance. NOTE: An additional insured(s) shall not be listed on any Certificate of Insurance unless such additional insured(s) is a named insured on the policy. Massachusetts - Department of Public Safety. Board of Building Regulations and Standards Construction Supervisor License: CS -017809 LAWRENCE V MAUN 65 HOWARD ST: � Y BRAINTREE Mk 02181 Expiration Commissioner l 07/19/2015 '- -�