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Building Permit #251-14 - 40 ROYAL CREST DRIVE 9/18/2013 (3)
« * FORTH BUILDINGPERMIT ��°6`1`10` "oma TOWN OF NORTH ANDOVER � APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received +' O'O Date Issued: �SSACHU`r�� IMPORTANT: A licant must complete all items on this pa e a x; + « — (Ciesf� tate PRt ?1111t�A1MCr#ttnox .. .� r MAP N+� �' ►� � � ¢ � CT. RD Istan � yas na X s ,M � :?Vlfla e TYPE.OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0 One family ©Addition X Two or more family D Industrial C Alteration No. of units: Varies 0 Commercial X Repair, replacement ❑Assessory Bldg 0 Others: Demolition X Other Water roofin , Stairs& Rails ka y & zpSM R � � . .y ���4w"R£ JM1ah�r� tMi, vS ti Provide exterior foundation waterproofing and replace stairwells with railings as necessary at Bldg. #'s 35, 37, 39 & 40 Identification Please"Type or Print Clearly) Dan Mlllanazzo OWNER: Name: AIMCO North Andover, LLC phone: (617) 639-6052 Address: 50 Royal yCrest Dr.; N. Andover MA A tiE r y �✓.il � i� i1 MaiWSt-, PM B x-.,5'7T r _ �e Q . . 1UlA�1,4t�3 p ro s CQnstructlo l� e. John �V�ii:s � ���#�� �,� � � r% t 112111. P77 kei , ➢ ws rage $ Rr tl �' f ++, , �e'. Cornerstone Land Consultants, Inc. ARCHITECT/ENGINEER Job[]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$9000.00 OF THE TOTAL ESTIMATED 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 unregistered contractors do not have access tv.the guaranty and Plans Submitted X1 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer ® Tanning/Massage/Body Art Swimming Pools D Well ❑ Tobacco.Sales ❑ Food Packaging/Sales D 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 / /ATn/� ut uLad- nzu e&J-zuj-,eAtn aydiAau 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 Conrfect on]Signaturs&D a.. Driveway Permit Located at 384 Osgood Street IR�'L 0 R M T r . ;, NT e r y A r r • TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT a # 400 Osgood Street North.Andover,Massachusetts 01845 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 CONSTRUCTEDAT 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 _ s inage piping at the specified buildings. HN s,�y s AUTHORIZED SIGNATURE: FSS/0 6 September 13, 2013 REGISTRATION: Mass. PE # 29775 NOTE:ENGINEER"WET STAMP"MUST BE AFFIXED TO THIS FORM Con"I Consuuauon Form revised L 1.15.2004 BOARD OF APPEALS 6.W9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688:9535 i lAassachusetts - Department0f Public Safety Boars! Of Building Re ulation 9 sand Standards C un.sh'uctiml Suhcr,ism. License: CS-014178 JOHN A VISIUNVSKI 94 SBBZLEYST PEPPEREL6NM,,01463l - -- 7JT I41 1� Commissioner Expiration 11/21/2013 #ACS CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD"YYY) 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(les) 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.NAME: Ted Noyes W.E. Noyes & Son Insurance Agency, Inc. PHONE . (978)425-9595 F'O`X (978)925-9160 73 Front St ADDRES :ted@wenoyes.com P.O. BOX 1248 INSURERS AFFORDING COVERAGE NAIC p Shirley MA 01464-1248 INSURER A:HartfOrd Ins Co 19682 INSURED INSURERB:Sentinel Insurance Company, LTD 11000 CORNERSTONE LAND CONSULTANTS, INC CORNERSTONE INSURERC:Twin City Fire Ins. Co. 29459 P 0 BOX 657 INSURER D:Hanover Insurance Company 2292 INSURER E PEPPERELL MA 01463 INSURER F: COVERAGES CERTIFICATE NUMBERCL136740677 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 TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS ' GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 300,000 A CLAIMS-MADE OCCUR X D8SBATN5795 /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/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITYO BINEDtSINGL LIMIT(Ea 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED Fy_1 SCHEDULED 08UECZJ9456 /3/2013 /3/2014 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident TERR $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 AR EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 X 08SEATN5795 /3/2013 /3/2014 $ C WORKERS COMPENSATIONWC STATU- 0TH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 11000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) �8WECCM4902 /5/2013 /5/2014 E.L.DISEASE-EA EMPLOYE $ 1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D PROFESSIONAL LIABILITY LHNA023436 6/8/2013 6/8/2014 PROFESSIONAL LIABILITY $1,000,000 DEDUCTIBLE $7,500 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE I Ted Noyes/TNOYES ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025rgninnslni Tho ArnDn namo 2nrl Innn nra ranictarorl mnrlre of Ar:npn w� Location No. ( Date -1 f . - TOWN OF NORTH ANDOVEP ti Certificate of Occupancy $_ Building/Frame Permit Fee $ �?5• Foundation Permit Fee Other Permit Fee $ TOTAL $ Check O Ls 2 Building Inspector