Loading...
HomeMy WebLinkAboutBuilding Permit #61 - 25 ROYAL CREST DRIVE 7/24/2007Permit NO: / Date Issued: d BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition )'Two or more family ❑ Industrial ❑ Alteration No. of units: 1 �^ ❑ Commercial pair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ©-:Septic-IJVeI) -�i l=1oal�t1 i Wetlands: U1laersed tsrrc# Water/Sewer DESCRIPTION OF WORK TO BE PR FORMED: SA,W . S D i1'G li N t+ O n Identification Please Type or Print Clearly) 1 OWNER: Name: I vvi cc -en vr-c s2eA:ePhone��U�/ n c S1 Address: V� c> -a, G.\ cv e_ k F tinx� _ J. P d GUNTRAtTOR Name "= e -c ve c�c� EPhon�.( Address:` F Stap�rvisor�sdnstrt#it�rt'Lise� ... Exp, tie. 1 -roma Irv% rnrromo1 itnnCn -�'"' t '"1 I;Yi1. r r1 ?". ». x. _... ARCH ITEC /ENGINEER) 5P4v�U ssoc,c&- Phone: Address:lc0Jnu-L --j ��,s'K-- " G-c-rc waReg. No. 3 1 !) ,S- .3 FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. dp Total Project Cost: $ Pan�(56 FEE: $ lQ Check No.: � Receipt No.:2_0 q-2--Z— NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owrie: Signature of conttagtor 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 PLANNING & DEVELOPMENT ❑El COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS 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 Located at 384 Osgood Street 7777 .irJlpSoC-on site VeS �` nri Located at 124 Main Street-,,,,, . Fire .Department�si6n'AWiWdlate " 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 21A —F and G min.$100-$1000 fine NOTES and DATA — For department use ❑ Notified for pickup - Date ..................................................................................................................................................................................................................................................................................................................................................................................... ...................................................................................... Doc.Building Permit Revised 2007 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 V Building Permit Application lot Plan Workers Comp Affidavit photo Copy of H.I.C. And C.S.L. Licenses OCopyLa Of Contract or/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ,,w—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 L, 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 �I Z O EM4 x w Ca ❑ 41 az \ � a c9'i w z ~ w° v U .� w 0�. -� a w W u '� a cc ~ W E z cc C C�7 O ` C N O c ~ O C3 V p, C `pR m C O 0 L m „7,!I, Q Y ted, • wm„ C u4 m O YW Q 7 = V = m F d 04, Goy 0 0 ,N ... * -- _► " is ' ` m v O �3G cm O c_ C N y m34*4 o :44 CDcamGo �Q o,ct 0 C q o �C d0 Q o n o c = m : 0J 3 ~ $ y o8� W CO .r -0t uml ; tit O C = N C.3 mca COD O' mI Om G _ a ca a f- z Sa m 0 g 0 z O U ag U O v 2 0 W W TREELINE Construction Incorporated 130 Westborough Street, Millbury, MA 01527 (508) 767-0090 PROPOSAL June 1, 2007 Aimco 639 Granite Street Suite 312 Braintree, MA 01284 Attn: Larry Kelly, Maintenance Superintendent Re: Replacement of damaged balconies PROJECT: Royal Crest Estates North Andover, MA SCOPE OF WORK: Supply Labor, Safety fencing and barricades, equipment, tools, trucking, and supervision as required to complete the work as noted. Work associated with Replacement of balconies: • Procure professional services of Structural Engineering Firm to design proper structural repairs. • Visit site with Structural Engineer for measurements and observation of existing conditions. • Mobilize equipment, tools, supervision, and labor to site. • Place and fasten all necessary SAFETY BARRICADES and PROTECTION to adjacent surfaces and grounds -Demolish existing concrete balcony deck and remove debris off site. • Construct shoring and form work as necessary including caulk joint. • Perform continuous housekeeping and cleaning operations at work areas. • Supply, place, and weld reinforcing steel as per drawings by Structural Engineer. • Procure concrete pump with clean out bin and set up for concrete pour. • Procure Redimix concrete and pump, pour and finish as required Redimix concrete for replacement reinforced concrete structural deck. • Supply and install weatherproof caulking at joints as per drawing. • Remove form work, shoring, and SAFETY BARRICADES with complete clean up of work area. COSTS Associated with Structural Engineering: $ 900.00 COSTS Associated with work as described for repairs to one (1) balco : $ 5,33. 0 Page 2. NOTE: Continuous housekeeping and SAFETY for residents is paramount to this project. EXCLUSIONS: Police or Fire details, and Security. Any work or materials not specified or outlined that is added to the above description for scope of work. please call with any questions regarding means and methods to be employed in the 'Scope of work as noted in this proposal. Respectively, Xen Salsman 13/4 Ll f C (-tt m Cl D O m� x N rr r -4 1/4" v m N NrffLe -�'c n M rn C) - CP D O r= z —4 O 0 N NFri eV 1 1/2" cmrn-0 D� D CLR 13/4 Ll f C (-tt m Cl D O m� x N rr r -4 1/4" v m N NrffLe -�'c p r x -0 0 h Cl� mm mm � pr m�� m - CP D O r= z r cn (n �v�v N NFri m N cmrn-0 D� D � N i0 G (E I m G N N 0 4 � I —i — cmn I (E C8xllb n g r O_ mz m� 'a 'f m (' Dm t— N (;�S- 12 �1)6)qt���,� PROJECT: BALCONY REPAIR APARTMENT BUILDING 51 NORTH ANDOVER, MA FOR: TREELINE CONSTRUCTION SERVICES JOB NO.: 21029 130 WESTBOROUGH STREET DATE: 04-26-01 REV. 1: 05-11-01 MILLBURY, MA 01521-2100 SPAULOING ASSOCIATES CONSULTING ENGINEERS 19 NORWICH STREET WORCESTER, MA 01608 TEL. (508)-754-1177 FAX (508)-754-7385 X n�N D c 17D(1 D 7011 QD rn Jp D �m �Q zm E� 41 n0 M Z D� m v KITTREME INSURANCE AG Fax:5083936983 Apr 30 2007 03:14pn �P002Ibi� 03�YYYY) CERTIFICA I t OF LIABILITY INSURANCE 72EEI05KI C4I30107 FACOUC6R T-� _ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON 7141^ CERTIFICATE FittLedge insurance Agency Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEtNO OR 155P Otis St., P.O. Sax 1.1.29 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Korthboro «KA 01532 Phone:508-•393-7744 Fax:508-393-6983 INSURERS AFFORDING COVERAGE iNA{C# INSURED kINSURERA NAUTILUS INSURANCE E&2I ANY I:HauRERB: Hanover insurance Group 22292 TrseGalino Const"ction Inc. INSURER. C: AMrlaaa ecm¢ iaeuramm W. 150 Westboro street INSURER 0: i ! R18IIRQR E' I f'C1V FitIIGFS. TSE 5OLVEE OF INSURANCE LISTED BELOWHAVE 6e" ISSUED TO THE RNSURED NAMED ABOYE FOR THE POLICY PERIOD iNDiCATED. NOTYVITHSTANDING ANY RECUIREMEAT, TERM 0 CONDITION OF ANY CONTRACT OR OTHER DOCUN'_NT NTH RESPECT TO W HiCH THIS CERTIFICATE MAY BE =UID OR MAY PERTAIN. THE INOUKANrEe Al QORGED BY THE POLICIES DESCRIBED HEREIN M SUBJECT TO ALL TNF TERMS, EXCLUSIOVS AND CONDITIONS OF SUCk POLICIES. AGGREGATE _WITS SHOt" MA`. HAVE BWf-N R-CDL+CEG BY PAIC CLAIMS. TaK INSAUV TYOEOF INSURANCE ! POLICYNI)MBER LTRPOLICY CY GATE lWQON. FIZ1 DATE MM I LIMIT$ GENERAL LIABiLiTY I ; EACHOCCURRENCE a 1000000 " A VIWERCIALGENERAL LkABIL?TY NC659999 04122/37 'v 4'-''v"t.4ftTf— a4%�� 108 ! PREMISESiEOOgc",19e` $ 100000 CLAIMS MADE : X ii OCCUR MED EXP (Any One PeMO^% 8 5000 � PERSO.'NAL & ADV INJUfty I : 1000000 I ; GtNSP.AL.4G3fiEtiA'.'E � S 2ono0aa y--' _ _ GEN'L AGGREGATE LPAIT APPLIES PER: � i � � PROOUC'i b` - CGM4 C:P G+3 i $ 2 a 0 000 0 n s 7 i POL<'CY � aEC i i LOG AUTOMOBILELIABIL!ri s j AwYAuro AFN$38702400 ; 07/27/06 ! GOWNEDSIKj EI,I.ttT � $1000000 07/27/07 I _ _ : ALL OWNED AUTOS l BODILY INJURY S I i I X SCHEDULED AUTOS i I Par oeraol ? t JARED AUTOS 1 Fat>DILY INJURY 4X ! y(� NCwCYVNEC AtJTc 5 ! j i r¢I alien xj I i I i ' PROPERTY DAMAGE GARAGE LIABILITY T .L ! AUT: ONLY . EA ACCIDENT 5 AUTO OTHER THAN EA AvG� 1 i AUTO WAY' AGG I S EXCESSIUMBRELLA LIABILITY — i EACH OCCURPS14CE F AGGkeGuTF„ F i OCCUR i CLAIM.' MADE I I I i DEDUCTIBLE ? ^p ! RF-TF-NTIQN $ I MlO1tY ER$ CtjmPENSATIDN RND 1 i- 1 ' i 07 X TORY LIMITS 1 ER + E>y1PLOVERs`LIABILITY i WC8979703 C I 12/24/06 I 12/24107 E.L. EACH ACC?DENT 121040000 ANY PROP-liETORMARTNERIEXECUTiV'E E.L,OlStOSE FA 04A4C1YE61 G 1000o00 I OPFICEWMEMSEREXCLUDED? x }e�. e�-1 z s ,„gar upEGl4L rROY131ONS neiiJw i e.t. t7!3+.a3e • rUL IST Ls.*rr S 1000000 i t)TNZ;.4 f 1 I i OEI?CRiP'r*N OF OPER:+T ONS 114CfiTiON$ 7 VENICLEs r EXCLUSIONS AWED BY 6NDORSiWl T: SPECIAL Peiot'ISIONS II !f CERTIFICATE HOLDER CANCELLATION Town of Andover Attn: Building Dept. Bartlett Street Andover M 01810 Ac -- 25120011091 AM+JyE^t ?tiCU4.1 aur OPTWEASOVE DESCRIBED POC CIES BE CANCELLED BEFORE THE EXPRATION DATE_ THERECF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS YlTe rm NOTrCE TO THE CERTIFICATE_ HOLDER NAMED TO THE LES-, RUT FA'lUP.E TO DO SO SHALL :MPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPCNN THE INSURIER, ITS AGENTS OR Pee 9 (rS. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 100 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumb licant Information ers Name (Business/Organization/Individual): ��iee1 `� Address: \ 'b U s City/State/Zip:v' A\4"-.� � Q `�-�.-� phone #: ,S,5�2�5�C-77 Are you an employer? Check the appropriate box: 1.I am a employer with j ")- 4. ❑ I am a general contractor 2. ❑employees (full and/or pat�em .* I am a sole proprietor or and I have hired the sub -contractors listed partner- ship and have no employees on the attached sheet. _ These sub -contractors have working for me in any capacity. [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation 3 • E]required.] I am a homeowner doing all and its officers have exercised their work myself. [No workers' comp. right of exemptibii per MGL c. 152, § 1(4), and we have insurance required.] t no employees. [No workers' com Type of project (required): 6. ❑ New construction 7• Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0 Roof repairs p. insurance 1equrred.] I 13 ❑ Other *Any applicant that checks box a I must also fill out the section bel Homeowners who submit this affidavit ow showing their workers, compensation policy mformahon. Contrac t indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tors that check this box must attached an additional sheet showing the name of the sub-contrwtnm ­4 .>,d_.•._�_ _ It am an - - - --.13 wmp. policy mtonnation. information. employer that is providing workers' compensation insurance for my employee& Below is the policy and iob sirs Insurance Company Name: �cc.� C�,SsU v�=.ire. Co Policy # or Self -ins. Lic. #:U Ck'7 e>k7Q 3 C Expiration Date: , Job Site Address: Attach a copy of the workers' compensation policy declaration page(showingCity/State/Zip: number'.c1 Failure to secure coverage as required under Section 25A of MGL o 52 can lead to the impositionof criminal date). fine up to $1,500.00 and/or one-year imprisonment, as well as civil 1 penalties of a of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office f of a STOP WORK ORDER d a fine Investigations of the DIA for insurance coverage verification. r,r,. a....,.-- - � --ix «neer me pains and L that the information provided above is true and correct 00cial use only. Do not write in this area, to be completed by city or town ufJiciai: City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 6. Other Contact Person: 4. Electrical Inspector 5. Plumbing Inspector Phone #: I FZ aw v cc LL Ucc ;N J O 1� Z W 'U X d7 N _N w �n Z10E O O U LL 0 w w o N 111!llQ�d y t- (� rn o w. w 00 a0 N Ln w :mow : Q C z .- 4 0 m f "-Z w co y Q LLi G a Z:5 "stn Z M Cr ) E U a Z n O { v v o C:) U wpm U r o � N _ Z am w ¢ ww m N m y w C, a � d NF- U F— `. a0 >p wu-c O o LLJ O cc ALLr U t py Ii L Z 2¢ z • • Q Ci 2 _ GI) 4) mNs-w @ n Z w w Z En 0 Q J m ry N W� o Z O < O wF-O U CII A LL rn m w s� n e Q Znw J, aid, J w W Z 3:m o W< X N -'w 5 .H Y t w FZ aw v cc LL Ucc ;N J O O 'U X N _N w �n Z10E Z U LL 0 w w o N Qv t- (� rn o w. w 00 a0 N Ln w z : Q 0 z .- :¢ m @ L co y Q LLi s\ v Z:5 w y Q < Cr w a H wpm r 2Qw w ¢ ww 0 Location CLA T-. No. Date .4 A TOWN OF NORTH ANDOVER Certificate of occupancy $ Building/Frame Perm it Fee $ 04 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r) 204 Z - g Building Inspector