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HomeMy WebLinkAboutBuilding Permit #258-14 - 39 ROYAL CREST DRIVE 9/18/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: _I Date Received t i Date Issued: 17 1 Ci IMPORTANT: Applicant must complete all items on this page UU LOCATION/ Print PROPERTY OWNER , LAC CC) NCSQ,-�-► t�jtl�Lz C� Print 100 Year Old Structure yes dSp MAP NO: 2!�-> PARCEL:3_T ZONING DISTRICT:�Historic District yes dD Machine Shop Village yes ID TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition `CTwo or more family ❑ Industrial ❑Alteration No. of units: 04-C I ES ❑ Commercial N;gepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well 0 Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: �x-T�(I�IJ� W!A''T�f1--�P DC�FI��► X14-(�S � �L.l�I�i� Identification Please Type or Print Clearly) �! OWNER: Name: "CoPJo2Tl�-��t ��1� L(..� Phone: 61! '�65�1 SZ Address: L N e:7 ' CONTRACTOR Name: La4, 0 rb 1-. Phone: 91) 4---j� Ef 66 Address: Supervisor's Construction License: CS 014177, Exp. Date: II Z( Home Improvement License: Exp. Date: ? nn ARCHITECT/ENGINEER Phone: Address: u 0M Q 2D .�0-� 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: $ FEE: $ Check No.: iusC'Nd\ Receipt No.: U� D NOTE: Persons contracting with unregistered contractors do not have access to the guaranty and Signature of Ac entt/Owner Sig nature of contractor Plans Submitted' l Plans Waived ❑ Certified Plot Plan 0 Stamped Plans Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans F1 TYPE OF SEWERAGEDISPOSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑ 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 I COMMENTS HEALTH Reviewed on Signature COPMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConnectioniS_ignature& Date Driveway Permit DPW Tow;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dump'ster on site yes no . Located at 124 Main Street Fire Department 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 21A-F and G min.$100-$1000 fine NOTES and DATA— For department use ® Notified for pickup - Date Doe.Building Permit Revised 2010 J Building Department The folowing is a list of the required.forms to be filled out for the appropriate permit to be obtained. Roofirg, Siding, Interior Rehabilitation Permits o` Building Permit Application u Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses u Copy of Contract u Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks u Building Permit Application o Certified Surveyed Plot Plan u 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) o Mass check Energy Compliance Report (If Applicable) u 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) u Building Permit Application u Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) k o Copy of Contract L3 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 casts if a variance or special permit was required the Town clerks office must stamp the decision from the Board of Appeals that the apnaal 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.Building Permit Revised 2012 it 1 L BUILDING PERMIT ,� y` •� :` °� TOWN OF NORTH ANDOVER ° s APPLICATION FOR FOR PLAN EXAMINATION Permit NO: Date Received Y ~ S�.44U Date Issued: IMPORTANT:A licant:.inust complete all items on this page .. c re- EAM of T u MCO= orh oae, ` f TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential C7 New Building D One family o Addition Two or more family ❑ Industrial 0 Alteration No.of units: Varies 0 Commercial X Repair, replacement ❑Assessory Bldg C Others: D Demolition X1 Other {lly�tWaterproofing, Stairs&Rails 6 '.�.y t 4Y Provide exterior foundation waterproofing and replace stairwells with railings as necessary at Bldg #'s 35, 37, 39 & 40 Identification Phase Type or Print Clearly) Dan Millanazzo AIMCO North Andover, LLC OWNER: Name: phone: (617) 639-6052 Address: 50 Royal Crest Dr.; N. Andover MA -Sa V Si�.qi• t c.+4 —..-.. eL.l- i,«.i. g,.�' ( $ VK00 d yf¢ Sd M1'> _�31,�P. } f x+.i .t >'+".;"": ;°._yNp '^'.'Eia *f".F¢w.a .." {l■K, -' ;} s ° n'f `,"" y k'§tih.�#' 'S"":i. ONT k p^'s /� f1�re� s• 5ulpe� `Is CnstrronL+ lohVJstce _ ; a 'H . 'YC.' S ^ �L` � • � � ,* & �,°'F 'sT n'i�,�; (;��, f'%}*Y��''+ham f�. �$`: -------------- Cornerstone Land Consultants, Inc. ARCHITECT/ENGINEER John A. Visniewski. PE Phone:. (978) 433-8100 Address: 61 Main St.: P.O. Box 657: Pepperell MA 01463 .Reg. No.Mass,, PE 29775 FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ES'nMATEA COST BASED ON$125.00 PER S.F. Total Project Cost: $ 25,000.00 FEE; $ 300.00 Check No.: Receipt No.: NOTE: Persons contracting with u regisitered contractors do not have access to the guaranty and Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer ® Tanning/Massage/Body Art ❑ Swimming Pools 0 Well ❑ Tobacco Sales ❑ Food Packaging/Sales 0 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 ❑ COMENTS CONSERVATION ❑ 17- 13 COMMENTS 'DOP -#d /6 9 LtLVAX--ut �� 1 DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street I TV ,b,..:x x �:r•rz"-a`� 47 k fµonz TOWN OF NORTH ANDOVER n OFFICE OF BUILDING DEPARTMENT t � 400 Osgood Street North Andover,Massachusetts 0.1845 I D.Robert Nicetta, Telephone(978)688-95454.Building Commissioner 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. #'s 35, 37, 39 & 40 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 s r S inage piping at the specified buildings. `�' HN �9cy t X1 AUTHORIZED SIGNATURE: w 9o, ISTS FSS�o September 13, 2013 IF REGISTRATION: Mass. PE #29775 NOTE:ENGINEER"WET STAMP"MUST:BE AFFIXED TO THIS FORM Control Canswction Foms mvixd 11.15.2004 BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 H:EALTH.688-9540 PLANNING 688-9535 Aassachusetts - Department Of Public Safety Board of Building Regulations 9 ns and Standards Construction superl isut• License: CS-014178 JOHN A VISNI 4sjG 94S HIRLEYAT PEPPERELI MA�0.1.,4,63 Commissioner ExPiration 11/21/2013 i ACQ® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/14/2013 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 CONTACT Ted Noyes W.E. Noyes & Son Insurance Agency, Inc. fAICPHONE (978)425-9595777 (AICFax No):(978)425-9160 73 Front St AIL ADDRESS:ted@wenoyes.com P.O. BOX 1248 INSURERS AFFORDING COVERAGE NAIC# Shirley MA 01464-1248 INSURERA:Hartford Ins Co 19682 INSURED INSURERB:Sentinel Insurance Company, LTD 11000 CORNERSTONE LAND CONSULTANTS, INC CORNERSTONE INSURERC:Twin City Fire Ins. Co. 9459 P 0 BOX 657 INSURER D.Hanover Insurance Company2292 INSURER E: PEPPERELL MA 01463 INSURER F COVERAGES CERTIFICATE NUMBER-CL136740677 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. INSR ADDL UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RE TED PREMISES Ea occurrence $ 300,000 A CLAIMS MADE OCCUR X 8SBATN5795 /3/2013 /3/2014 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY ECOe BINEDiSINGLELIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 08UECZJ94H /3/2013 /3/2014 BODILY INJURY(Per $ AUTOS AUTOS ( ) X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ TERR $ X UMBRELLA LIABOCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR HCLAIMS-MADE AGGREGATE $ 5,000,000 DED I x I RETENTION$ 10,000 X 8SEATN5795 /3/2013 /3/2014 $ C WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/NLIM T,1ER CRYANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1 000 000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) 8WECCM4902 /5/2013 /5/2014 E.L.DISEASE-EA EMPLOYEE $ 1,000"000 If yes,describe under CRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DES D PROFESSIONAL LIABILITY LHNA023436 6/8/2013 6/8/2014 PROFESSIONAL LIABILITY $1,000,000 DEDUCTIBLE $7,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Property Name: Royal Crest Estates IN. Andover) Contract #:15646-0000419087 - CP - 00001 Coverage includes owner as Additional Insured's as expressly nominated under the insurance provisions of the contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AIMCO NORTH ANDOVER, LLC ACCORDANCE WITH THE POLICY PROVISIONS. 50 ROYAL CREST DRIVE AUTHORIZED REPRESENTATIVENORTH ANDOVER, MA 01845 Ted Noyes/TNOYES ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025rgninnslni Tho Arnpn n!ama=nrl Innn Ara rarda+ararl m2rlre of Ar:opin NORTIy Town of E �� Andover 0 tonNo. - 1�} _ y h , ver, Mass, -Sej. 201; COCHICHIW1cK y�• A�OAT ISE ID ApP��S S V BOARD OF HEALTH Food/Kitchen PERMIT L D Septic System LL C BUILDING INSPECTOR THIS CERTIFIES THAT ........ .W..�...J1,..... .. ....... �.. ..................................... Foundation has permission to erect .......................... buildings on ... ...�Q.. ki...Cin te .. ... L� r Rough 4A to be occupied as ... .. - 'i�.l!�... .t... .................. ...... !..!.1.''. .. ..... Chimney provided that the person accepting this permit-1W1 i'n eve res ect conform to the terms of the applica Ion p p p 9 p ever 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 CONSTRUCTION ST Rough Service ............................... ................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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 f a Location No. —' Date r . - TOWN OF NORTH ANDOVER Dp Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ J A f� Check#A����r"r 2 V o 7 Building Inspector