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HomeMy WebLinkAboutBuilding Permit #837 - 220 SUTTON STREET 6/25/2010BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: g3 -% Date Issued: Date Received pORTy 32 yE r,�, ...e, •6 �O 4( TYPE OF IMPROVEMENT New Building Addition Alteration Repair, replacement Demolition PROPOSED USE Residential One family Two or more family No. of units: Assessory Bldg — Other Non- Residential Industrial Commercial Others: peptic Welly - - Floodplain Vlie#lands _. – - 1NatelSewer. IlVate shed D�stric# '- N --•--mss �$_ - .�s:..a<:——.s.,rs, �-� 3Rc�H° ei: .—v. 4>.��". _ «r� �.. � _ _ _ q DESCRIPTION OF WORK TO BE PREFORMED: (f, Identification Please Type or Print Clearly) OWNER: Name: vt I D T ,��., Phone 475- 6� Address: CONT07 a OR 'Na s'[ �``P - k` `Phone A�i.dress.• ! T ,;Sb Enrisors ConstructionL°icense P µa = % Z= Expo Date III V ---g< Homme mp�rovefnentgLicense7 f ARCHITECT/ENGINEER `T?P.nw i�S d� 'F��� Phone: Address: Reg. 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: $--Ltt�z—ors FEE: $�� Check No.: l 7 Receipt No.: 0,32 NOTE: Persons contracting with unregist�ed contractors do not have access to the guaranty 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 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 COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street ,- _ FIRE -R `,R Temp dumps#er ona si#e yes Lmoaated at-1243VI fiStfeet Frye Department signature/da#e M 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 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 o 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) ❑ 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) ❑ 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 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 Doc: Building Permit Revised 2008 Location �2 0 0 c' 7%� No P37 Date 4w, TOWN OF NORTH ANDOVER 6 0 Certificate of Occupancy $ CH Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL s 7?0 Check# A9 2 3 0 A / Building Inspector-. W Cd AS'S m C O L ts . O i OF C y O C rr V� e0 O O VA 4-c: O U I H it Ea O W m 1:oc Q W Cc O �`som j � Q C4 m ® .\c 3 \ccm Cc y m �m o m ✓` ;CLU >. y = CD �p C H CS Ma 0 � ci C O 1-- � '00, C m IJJ a0� y mrH C o w fl L LL C+' m% p •co �dt C w E IS cp U m p m C COP) a m :a o A O H == =tea=m a GwG or. o Q w C O p O O w v cn O C w Ck, C r�G w" w C U) w" C w w" W cn cn W Cd E CL N L_ Go O H c 0 cm m ac CO c _ CID O cm C �C N CD Z O Z 0 v NNN �1 0 I Com_ ca Q O LA p� O 'E m m CD 0 CD CL O 0 O O O � co C o C ■v J 'fl d O t0,, C CD 0 CL v vs c C C ■ C _c L CO2 AS'S m C O L ts . O i �t C y O C rr V� e0 O O VA 4-c: O I H it Ea .''r m 1:oc c m Cc O �`som j � Q C4 m ® .\c 3 \ccm Cc y m �m o m ✓` ;CLU >. y = CD �p C mom CS Ma 0 � ci C O 1-- � '00, C m IJJ a0� y mrH C o w fl L LL C+' m% p •co �dt C w E IS cp U m p m C COP) a m :a o A O H == =tea=m E CL N L_ Go O H c 0 cm m ac CO c _ CID O cm C �C N CD Z O Z 0 v NNN �1 0 I Com_ ca Q O LA p� O 'E m m CD 0 CD CL O 0 O O O � co C o C ■v J 'fl d O t0,, C CD 0 CL v vs c C C ■ C _c L CO2 Jun.25, 2010 10:39AM MCCABE ASSOCIATES }y2 V ni b LL:\l7 Tn ' T. � T-• oi `'iwSSCi..iSe :S s, D. Robert'1�ice,,a, Buildine Commissioner No -5848 P. 1/1 Telephone(978)688-95454''' Fax (978)688-9542 CONTROL CONSTRUCTION — SECTION 116.01M.S.B.C. CERTIFICATE OF EN-GINEERiNG!.A-R !i!TEC TURF; 13ULDING ENISPECTOR T G A '� OF NORTH ANDOVER 400 OSGOOD STREET 'FORTH ANDOVER I\/.1A 01845 I, Stever. Houle HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT Best Clearers, 220 Sutton Street DOES CONFORT� IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOW NG: 0/1 AUTHORIZED SIGNATURE: DATE: jur_e 10, 2010 REGISTRATION: 4 6.74 3 NOTE: ENGINEER ""VET STAMP" MUST BE C-rrol Construction Form revised 11.15.2004 THIS FORM OF C' 2 STEVEN SV R. HOULE t No. 46743�� °.� �Fc1 S7 ONAL BOARD OF APPEALS 6,R8 -t i ). " �. Oj�$.':KV:4.1�10!V 6Si;-9J3(? i-, t.. �E '•95e(i .PLAIV"Niivii G�T•`??i> Important: When filling out computer, use only the tab key to move Your cursor - do not use the return key. rrS Keep a copy tor your tiles ;ot have a MAD. MAR, or MA5 followed by your Area Code and Telephone Number. Massachusetts Department of Environin4rital Protection Bureau of Waste Prevention — Hazardous Waste Generator DEP Region: Registrail. ilon ❑ NE ❑ SE ; ❑ CE ❑ WE For DEP Use: FMF# I am registering as: i i, Very small quantity generator of hazardotls.v.iaste (less than 220 pounds or 27 gallons/month) or Very small quantity generator of waste oili (less than 220 pounds or 27 gallons/month) or ❑ Small quantity generator of waste oil (220 jo 2,200 pounds or 27 to 270 gallons/month) dame of dompany } iviawng aaaress State{ Zip code E-mail Haoress uiryhown Street aadress wnere waste is proaucea MA l -- A.M..A R� (� vin --- Zi code State p iitynown —09—V s�i2 —' SIC code Type of b smess ` r . MV Generator Registration Identification Number (12 Chara 1, rs) Hazardous Waste Gallons per [)isposal, Storage, Treatment, and/or Recycling Generated (check) Month Prior to (Name of company and address where waste is taken or Treatment, i type of treatment or recycling on site of generation) Recycling or Disposal a ❑ Waste Oil ❑ Solvent 7 ❑ Acid or Alkali j i Other (name): g b F Raiuf6 UIC i CERTIFY IFY -THAT UNDER PEINAL I Y OF I have personaiiy examined and am familiar with the ci�nar{ nrigina! information submitted in finis documeni an�d'.aii attachments, and that based on my inquiry of those the appropriate individuals immediately responsible for ob,Wirting the information, i believe that the information is true, MassDEP Regional nfoo accurate onri rnrnplgfie r Attn: 6WP jVame of operator Title genreo.doc • 4/06 uate Generator Registration • Page 1 of 3 The Commonwer¢ith of Massachuveav Department o f Industrial -4ccidents Office ofrnvestigations 600 Ff7ashin,.ton Ski -tet .80ston, MA 62111 Workers' Compensation Insnran'�eAffidavit: ass-ov1&a Eailders/ContractorsTlectricians/Plambers Name (Business/Organiz,6.m ndividual): City/State/Zip: D trz-'� _T Phone #: Are yo,It an empIoyer? Check the appropriate boa: 1. I am a employer with 4. ❑ I am a o employees (full and/or- part-time). * have hired thcontractor and I 2. ❑ I am a sole proprietor or partner- listed on thee sub -contractors ship -4 have no employees the attached sheet I working for me in any capacity. [No workers' comp; insurance required.] 3. [].1 am a homeowner doing all work myself [No workers' comp. insurance required.] t These sut:)-contractors have workers' comp, insurance. 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL C. 152, § 1(4), and we have no employees. [No workers' comp Type of project (required): . 6. ❑ New construction 7. ❑ Remodeling g• ❑ Demolition 9. ❑ Building addition 10.13 ElecfricaI repairs or additions .11.0 Plumbing repairs or additions 12•❑ Roof repairs —L duce red I 13 • ❑ Other `-nI, zpphc-- + thaat c. ecL- box.4l must also � ' c��f fee eecii �� , Homeowner who submitthis - b— ' aor:Ws cosi eY affidaVif indiCating fhC)� 2= d�:..g iii 'w Gie and r r••••••,, ••LL ;--•:•u''. o'u. �Contiactora that chwk flus box must at�che; , .,� then"hire outside conj xor; m� . ,�. su—uooal sheet showingthe .t a new ri�ridavit indicating such. same of the s,_� n -tuts and tbeir wixi.....• T .. tear cs' provcdcng workers' compensatini-r r—y lurarnmon informationnsurancefor my employeesBelow is the policy and job site Insurance Company Name: 14P'L W-1-1 ,n,� Policy # or Self -ins. Lic. #. —(02V' 422' I (3 2 Q S210 -_g Expiration Date: I L Job Site Address: Attach a copy of the workers' compensation policy declaration .page (showinRty/5tatc/Zip: D Failure to secure coverage as required under Section 25A ofM the poh`y'lumber and expiraiim date). fine up to $1,500.00 and/or one-year imprisonment, as well as Glc. 152 can lead to the imposition of criminal Of up to $250.00 a day against the violator. Be advised that a co Penalties of a Penalties in the form of a STOP WORK ORDER and a fine Investigations of the DIA for ' Fy °f statement may be forwarded to the Office of insurance coverage verification. - � --• 1j-rguar enc paces and M ofPe1JurJ'thQtthc inforrnaiiM provided above is true and correct i Official use only. Do not write in this area, to be co mplelad C431 or Town_ by ctiy or town official Permit/L,icense # Issuing Authority (circle one): I. Board of Health 2. Building Department .3. Citf' /Town 6. Other Clerk 4. Electrical Insp ector S. Plumbinb Inspector Contact Person: Phone #: DATE (MM/DD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE J6/8/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mathias Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4 yr HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 200 Sutton Street, Suite 160 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover, MA 01845 710-voo-ijii INSURED Cast Builders Inc. 200 Sutton Street North Andover, MA 01845 rrnvGQAr_Gc INSURERS AFFORDING COVERAGE NAIC# INSURER A: Max Specialty Insurance Company INSURER B: Hartford Underwriters Insurance Company INSURER C: INSURER D: INSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR D'L NSRD TYPEOFINSURANCE POLICY NUMBER POLICY M ppCTIVE PDATE MM PR LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I-N 11-11 PREMISES Ea occr.....$CLAIMSMADE MERCIAL GENERAL LIABILITY MEDEXP(Anyoneperson) $ 5 000 CI OCCUR PERSONAL&ADV INJURY $ 1000000 A k MaxO13100002883 12/01/09 12/01/10 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PEa LOC AUTOMOBILE LIABILITY ANYAUTO — COMBINED SINGLE LIMIT (Ea accident — -- $ BODILY INJURY (Per person) $ ALL OW NED AUTOS SCHEDULED AUTOS BODILY INJURY (Peraccident) $ HIRED AUTOS NON•OWNEDAUTOS ' PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY AUTOONLY- EAACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTOONLY: AGG EXCESSfUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CICLAIMSMADE $ $ DEDUCTIBLE $ RETENTION $ STATU0TH- YLIMITSWORKERSCOMPENSATIONAND TOCRE E. L. EACH ACCIDENT $ 100,000 EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMSEREXCLUDED? 6S60UB-4102P23-8 12/11/09 12/11/10 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT $ 500,000 Ifyes, describeunder SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Additional Insured: Winchester Hospital Dr. Lemonaire's Suite 100 Andover By -Pass North Andover, MA 01845 ACOR D 25 (2001 /08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE T THE ERT ICATE OLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMP / 0 0 ION OR IABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REP / NTAT I, ©ACORD CORPORATION 1988 ,tzOPTt, TO NIN OF NORTH ANDOVER Uy.tLcn •rr Z6 OFFICE OF BUILDING DEPARTMENT NT 400 Osgood Street North Andover, Massachusetts 01845 D. Robert Nicetta, Building Commissioner 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, Steven Houle HEREBY CERTIFY THAT THE BUILDING CONSTRUCTED AT Best Cleaners, 220 Sutton Street DOES CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS FOR THE FOLLOWING: AUTHORIZED SIGNATURE: DATE: June 10, 2010 REGISTRATION: 46.743 NOTE: ENGINEER "WET STAMP" MUST BE Control Construction Fonn revised 11.1.5.2004 THIS FORM \N OF r,�1Ss��1 o� STEVEN 11 0 R. U HOULE No. 46743 )4 ��►. FS510NAL E BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 1-1f,`=M8-9540 PLANNING 688-9535 �/ /\k a A 0 /. > m §22 . .� f t . °CL ƒ = \ U) fcc �0 \ ./\U) 2 b 2 2 ■ u < < e .. �}}CN � Z