HomeMy WebLinkAboutBuilding Permit #594-11 - 33 ROYAL CREST DRIVE 3/7/2011 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: q — l Date Received
Date Issued: �
IMPORTANT:Applicant must complete all items on this age
LOCATION Royal Crest BUILDING #
Print
PROPERTY OWNER AIMCO Ro d Crest Estates LLC UNIT#
Print
DISTRICT: Historic District yes no X
MAP NO: PARCEL: ZONING Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑One family
❑Addition ❑Two or more family El Industrial
El Alteration No. of units: [i Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
El Demolition Other Demolition .� - -
-� -.' M e0 0o ain-' �Wetlands ^`, `y. ® aarshed District,
��® Se fi ❑well f ,, P *ad
DESCRIPTION OF WORK TO BE PERFORMED:
VwLf
(identification Please Type or Print Clearly)
Phone:
OWNER: Name:
Address:
` CONTRACTOR Name: Thomas H.Kinnal Phone: 978-360-0051
Address: 286 Broadway,Haverhill MA 01832 •
Supervisor's Construction License: CS 82747 Exp. Date: 6/20/2012
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address:
Reg. No.
FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S-F-
Total Project Cost: $ %01
(� FEE: $ 0 ./
Check No.: �S �i�� Receipt No.: 3 3
NOTE: Persons contracting with unregistered contractors do not have access to the g aranty fund
�
� F": Slg"natureiofcontractor
�Si riaturelofA exit/Owners . T -.- __ __ .v .
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
I i
TYPE OF SEWERAGE DISPOSAL `,,
❑ Swimming Pools ❑ ` ` i
Public Sewer Tanning/Massage/Body Art ❑ ,
• �.
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ ,
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
i
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑ f
I
COMMENTS I
CONSERVATION Reviewed on Signature
COMMENTS i
i
HEALTH Reviewed on Signature
COMMENTS —
e
Zoning Bbard of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
-onservation Decision: Comments
E: Nater& Sewer Connection/signature&Date Driveway Permit
ase )PW Town Engineer: Signature:
e al Located 384 Osgood Street
P su 'IRE DEPARTMENT -Temp Dumpster on site yes no
,ocated at 124 Main Street
lire Department signature/date
)c: I
OMMENTS
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
El Notified for pickup - Date
Doc:.Buildiug Permit Revised 2008mi
r
i
Building Department i
. a
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
o Building Permit Application
I o Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses r
o Copy of Contract
o Floor Plan Or Proposed Interior Work
' ❑ Engineering Affidavits for Engineered products
)TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit k
I
Addition Or Decks C
. I
❑ Building Permit Application
o Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
i ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
i
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
❑ Engineering Affidavits for Engineered products
1 rE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
w
i New Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan f
o Photo of H.I.C. And C.S.L. Licenses
` ❑ Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
F Hydraulic Calculations (if Applicable)
❑ Copy of Contract
o Mass check Energy Compliance Report
P ❑ Engineering Affidavits for Engineered products
E: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit
ases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
e appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
e submitted with the building application
1 {
I
)c: Doc.Building Permit Revised 2008mi
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C NORTH '9
TONM Of
Andover
No. 020 41 _
4 o dover, IVlass., -
A-0 COCHICHEWICK
�J ADRAT E D P'?
qS E� BOARD OF HEALTH
Food/Kitchen
Septic System
BUILDING INSPECTOR
PERM IT
THIS CERTIFIES THAT....... rH .:." `• .................... Foundation
.........I....................................................................
1
has permission to erect.................. buildings on ........ z-..-".1...............
........�. "' `. .. .............,,...... ............ Rough
IJ J.j a, W ......�.... Y. r s... Chimney
to be occu ied.as .�
provided that the person accepting this permit shall in every respect conform to the terms oft a application on file in Final
this office, and to the provisions of the Codes and By relating to the Inspection, Alteration and Construction of
PLUMBING INSPECTOR
Buildings in the Town of North Andover.
I
VIOLATION of1he Zoning or Building Regulations Voids this Permit. Rough
Final
i
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRU N TART Rough
..........................................
Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to OcCltipy Building GAS INSPECTOR
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.
1 SEE REVERSE SIDE
@rllentri(:: 12�;i�5 d�I�UlseB��SJO�I��
ACO ,- CERTIFICATE OF LIABILITY INSURANCE 7DATE
123/2010nYY'I)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HUGS Interna$tl®naI New England ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
222 II�IIGI@zel�BGv� MOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fall River,MA 02722
500 235-2200 INSURERS AFFORDING COVERAGE NAIL
INSURED INSURER A. Peerless Insurance CO
Anderson lnsulatlOn,Inc.,at a$l INSURER B: AIM Mutual Insurance Co
P.O.Box 2003 INSURER C: Maine Employers Mutual Ins Co
Abington,MA 02351
INSURER D:
INSURER E:
COVERAGES
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.
POLICYFf EFFECTIVE POLICY EXPIRATION
LIMITS NS TYPE OF INSURANCE POLICYNUMBER � DA (MWD
A GENERAL LIABILITY CBP8185064 07101/2010 07/01/2011 EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY DPREMISE§(Ea AMAGE TO RENTED oce1 _ $100.000
CLAIMS MADE ®OCCUR MED EXP(Any one Person) $5,000
X PD Ded:$1,000 PERSONAL BADV INJURY
$1.000.000
GENERAL AGGREGATE $2 OOO 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGC, s2,000,000
POLICY X JECOT- LOC
A AUTOMOBILE LIABILITY BA8189064-MA 07/01/2010 0710112011 COMBINED SINGLE uMlr1
A ANY AUTO BA8300334-ME 0710112010 - 07101/2011: (Ea accident) ,000,000
ALL OWNED AUTOS
BODILY INJURY $
X SCHEDULED AUTOS (Pei Pew)
X TIRED AUTOS
BODILY'INJURY $
X NON-OWNED AUTOS (Peraxident)
PROPERTY DAMAGE' $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTOEAAGC $_�
OTHER THAN --
AUTO ONLY: AGG, $
A EXCESS/UMBRELLA unlsiLmr Ot98189764 0710112010 0710112011 EACH OCCURRENCE. $10,0 0 000
X "OCCUR D CLAIMS MADE AGGREGATE $10,000,000
DEDUCTIBLE $
X RETENTION $10,000 $
B WORKERS COMPENSATION AND WRZ8002170032010 07/01/2010 0710112011 � We sTATu- oTN=
EMPLOYERS'LIABILITY
C ANY PROPRIETOR/PARTNER/EXECUTIVE 1810085168 07/01/2010 07101/2011 E.L.EACH ACCIDENT $500,000
�FIppERIMEMg EXCLUDED? N
endatacy in N� t_J: E.L.DISEASE-.EA EMPLOYEE $500,000
!f yyes,describe under
SPECIAL PROVISIONS below _ E.L.DISEASE-POLICY LIMIT $500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES i F-NCLUSIONS ADDEDBY ENDORSEMENT 1 SPE--!AL PROVISIONSu
1)Project Elescription, See tl€e oll61 ing pages.,at a pplic;Able.,
2)Certfficate Holder or Others as Additional Insured: See tbll®1 ing Pages,
3)Genoral Liability Coverage hiciudes, brut Is nat I4rIuIted xv,'.
. .
(See Atta�.hed Oescrut^Nuns
CERTIF CAT E HOLDER 'ANCEu. a 100 IC Dugs�E3 'Nan P a,'e�rtTtrtnent
BF D 3a .:rr 'HF r mw�,'i
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o.i. ..TEE.. T_e_ -aL4sNG5N!"' :, RVt?i--_. ,Cl.W, .._.";h` ��:,.t5 ].,.-1 riti
n 9
t {t
otts - 0cli.i Millen$ 1.+f puhiic '`iRil'C` .
Vy
o tral74di " Re".11l ations 1;4d ;taml;ai
<er;sr: cs 103974
PeStricted to: 00
- SCOTT WILLIAMSON �4�;,
238 PARK AVE "
ABINGTON; MA 02351
:rat;or.: 8/7/2013
103974
1)it t rl +l: +, �xilblli �zlt'v,.
Board a}I BliSIEISSI i dal'i,
- C.VSSSpYi.iCafa;�3'! Supervisor Shed° ll�';' L,t,-;ertSe -
LieeTlSe: G SL 102768
restricted to: IC
SCOTT WILLIAMSON
-23 VERNON STREET
ROCKLAND, MA 02370 "
a >.
ittton: 8117/2012
;r 102768
Locatio C/l�
No. Date
NORTH TOWN OF NORTH ANDOVER
Of••. o ,h
3? � •• 0
0 9
• ; : Certificate of Occupancy $ `
cHUS Building/Frame Permit Fee $
t
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check 3
2 3 9 6 5Building Inspector