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HomeMy WebLinkAboutBuilding Permit #255-14 - 49 ROYAL CREST DRIVE 9/19/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: J ' Date Received Date Issued: I PORTANT: A hcant must complete all items on this page LOCATION 50 Royal Crest Drive -Northi Andover,Ma. J Print PROPERTY OWNER Aimco North Andover. LLC . - Print" . 100 Year Old Structure yes nog MAP NO: 91.5_PARCEL: '45166_ZONING DISTRICT: Historic District yes nX Machine Shop Village yes noX TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition CXTwo or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 10 Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition §Other ❑ Septic ❑Well 0 Floodplain ❑Wetlands 0 Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Provide exterior foundation waterproofing and replace stairwells with railing as necessary at Building 23- 24- 26- 49 Identification Please Type or Print Clearly) Dan Millanazzo OWNER: Name: Aimco North Andover LLC Phone: 617-639-6052 Address: 50 Royal Crest Drive North Andover,Ma. L.V.M.J.Corporation CONTRACTOR Name: Lawrence V Mawn Phone: 781-848-6nin Address: 65 Howard Street Braintree Ma.02184 Lawrence V.Mawn Supervisor's Construction License:CS--017809 Exp. Date: 07/19/2015 Home Improvement License: Exp. Date: Cornerstone Land Consultants ,Inc ARCHITECT/ENGINEER John A. Visniewski PE Phone: 978-433-8100 Address:61 Main Street P.O.Box 657 Pepperell,Ma. 01461Reg. No. Mass PE 29775 FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �2�� FEE: $ Check No.: . Receipt No.: red contractors do not have access to the uaran and NOTE: Persons contracting with unregistered g tJ'.f Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted I Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE-OP 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 ❑ X0==1 INX COMMENTS II CONSERVATION Reviewed on Signature COMMENTS See DEP 716 242-1599± NACC 112 work jh No work to start until preconstruction conditions complete HEALTH Reviewed on Signature - ' 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 r DPW Tow;, Engineer: Signature: Located 384 Osgood Street FIRE-DEPARTMENT - Temp Dumpster on site yes no Located-at 124 Mair Street Fire Departmeritsignature/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 LI Notified for pickup - Date 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. Roofiv,g, Siding, Interior Rehabilitation Permits Li Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract u Floor Plan Or Proposed Interior Work Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Li Building Permit Application o Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses Li Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report L3 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 apo,W period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Bui?ding Permit Revised 2012 f� f� Location RO"1111l ✓Q v F 3 No. 1 Date .. . - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 26879 Building Inspector NORTH own of E ndover O - 0 No. � 4p - h ver, Mass, 2013 COC LAK I NIc"t—c a• A0R^TIE S u BOARD OF HEALTH Food/Kitchen PERM, j�IT T D Septic System mc-z )4 • A LL BUILDING INSPECTOR THISCERTIFIES THAT .................................................401... .................................................................... has permission to erect .......................... buildings on � .�. � Foundation �t ..^�.........-.Q. ``�g ...............,.,.�.._..(.. .... ......... .......'............; Rough to be occupied as .!---^ ft%f �1.,��.,W4e..r i.... .�X.v! I64....4,1 Chimney provided that the person accepting this permit shall in every respect confol'Ifi to the terms of the application 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 T TS 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 �,o,�T►, TOWN OF NORTH ANDOVER oo' OFFICE OF I. BUILDING DEPARTMENT 400 Osgood Street North Andover,Massachusetts 01.845 D.Robert Niceita, 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. Vs 23, 24, 26 & 49 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 subs or . ge piping at the specified buildings. HNly A. NiEWSKI AUTHORIZED SIGNATURE: CIVII Se tember 13 DATE. p , 2013 REGISTRATION: Mass. PE# 29775 NOTE: ENGINEER"WET STAMP"MUST BE AFFIXED TO THIS FORM Control Comuvcrion Form revised 11.15.2004 BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Massachusetts -uepartment of runt►C safety Board of Building Regulations and Standards Construction Supervisor License: CS-017809 LAWRENCE V MAUN 65 HOWARD ST..; 6 s BRAINTREE M9 021 , J.•�..�� . �� �4''t Expiration Commissioner 07/19/2015 L � AC40RV CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYY� 9/18/2013 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 Cri.sti.na -NAME: T. Edmund Garrity & Co. , Inc. PHONE (617)354-4640 A No:(617)354-5828 545 Concord Ave. AbMDRESS:cristina@garrity-insurance.com INSURERS AFFORDING COVERAGE NAIC# Cambridge MA 02138 INSURERA:Ohio Security Insurance Cc INSURED INSURER B: L.V.M.J. Corporation INSURER C: 65 Howard Street INSURERD: INSURER E: Braintree MA 02184 INSURER F: COVERAGES CERTIFICATE NUMBERNASTER COI 2013 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 NUMBER MM/DDY EFF MM/DDY EXP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 'AAGX COMMERCIAL GENERAL LIABILITY PREMISEREMIS TO RENTED 100,000 S Ea occurrence $ A CLAIMS-MADE a OCCUR BLS1455690302 /13/2013 /13/2014 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOSAUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I WC STATU- OTH- AND EMPLOYERS'LIABILITY LIMITS I I FR ANY PROPRIETOR/PARTNER/EXECUTIVE� NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Excavation & Hauling. CERTIFICATE HOLDER CANCELLATION lvm46@beld.net SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 120 Main Street AUTHORIZED REPRESENTATIVE North Andover, MA 01845 A Garrity/CRISTI ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025/7n1nnm m Tho Arnpn nomas and Innn 2ro ronic4ororl marirc of A(:npn a DATE ACC V CERTIFICATE 4F LIABILITY INSURANCE 9/18/2013 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: Albert J. Tonry & Co. , Inc. PHONE (617)773-9200 FAC (617)7739920 300 Congress Street Eo19 W o Ss• INSURERS AFFORDING COVERAGE NAIC# Quincy MA 02169 INSURER A:Commerce Insurance 34754 INSURED INSURER B L. V. M. J. Corporation INSURER C 65 Howard Street INSURER D INSURER E: Braintree MA 02184 INSURER F: COVERAGES CERTIFICATE NUMBER:CL139407107 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL TYPE OF INSURANCE SUBR POLICY NUMBER POLICY EFF POLICYIm LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DMAGE TO RENTED— COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE FIOCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ JECT —1 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1 000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED LJ1808 /15/2013 /15/2014 BODILY INJURY(Peraccident) $ S AUTOS QED PPaeadnDAMAGE HIREDAUTOS AUTOS erreS $ Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION WCSTATULIM - OTH- AND EMPLOYERS'LIABILITY YIN ITOR sl ER ANY PROPRIETOR/PARTNER/EXECUTIVEF—] NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Any and all jobs performed usual to an Excavation contractor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE L Tonry Jr./CDIGRA """` ACORD 25(2010105) O 1988-2010 ACORD CORPORATION. All rights reserved. INS075 oninmi ni Tha ai nDr1 nama and Inns ara ronte4arael mance of jarnio 1 MASSACHUSETTS ASSIGNED RISK POOL REQUEST FOR CERTIFICATE OF INSURANCE Use this form to request a Certificate of Insurance from the Assigned Risk Pool Carrier(A.I.M. Mutual Insurance.Co.). Please provide all of the requested information, including the facsimile number(s) of the person or persons to whom the Certificate of Insurance:should be issued. If this form is fully and accurately completed, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided below, within two(2) business days of the carrier's receipt. This Form may be mailed or faxed to the Assigned Risk Pool Carrier. To obtain each carrier's contact information refer to the Certificates of Insurance section located in the Producer Community section of the Bureau's website(www.wcribma.orq). 1. Name,address; telephone number and facsimile.number or email address of the INSURED: Name: . L. V. M. J. Corporation dba: Mailing Address: 65 Howard Street Braintree MA 02184-1150 Physical Address: Phone: . (781)848-6030 Fax or email: Ivm460-beld.net Z. Name,address, telephone number and facsimile number or email address of the CERTIFICATE HOLDER: Name: Town of North Andover Mailing.Address: 120 Main Street North Andover MA 01845 Physical Address: Phone: Fax or email: Fax Number 3. Name,address, contact person,telephone number and facsimile number or email address of the PRODUCER: Name: Albert J. Tonry&Co.. Inc. Mailing Address: 300 Congress Street Quincy. MA 02169 Contact Person: Cheryl A. DiGravio. Phone: (617)773-920.0 Fax or email: (617)773=9920 or certs(7a.tonrv.com. 4. Policy Number, Policy Effective Date and Policy Expiration Date If a Certificate of Insurance is needed for more than one policy term,provide the Policy Number, Effective Date and Expiration Date for each policy term. If the policy has not yet been issued, you must attach a copy of the Notice of Assignment. Policy Number: VWC1.0060082462013A Effective Date: 4/6/2013 .. Expiration Date: 4/6/2014 5 List any special requests for optional coverages/endorsements(see Page 2 for listing of coverages available in the pool and the conditions of availability)or additional inforrhation rincluding changes in exposure not yet reported to the carrier)that will assist thecarrierin the issuance of the Certificate of Insurance. NOTE:An additional insureds)shall not be listed on any Certificate of insurance unless such additional insured(s)is a named insured on the policy. None