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HomeMy WebLinkAboutBuilding Permit #254-13 - 50 ROYAL CREST DRIVE 9/19/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: _I Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 50 Royal Crest Drive . North Andover,MA. Print. PROPERTY OWNER Aimc,o North Andover LLC Print` . 100 Year Old Structure yes no X MAP NO: 25 PARCEL35/66 ZONING DISTRICT: RD5 Historic District yes noX Machine Shop Village yes noX . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition X Two or more family 0 Industrial ❑Alteration No. of units: ❑ Commercial tj Repair, replacement ❑Assessory Bldg 0 Others: ❑ Demolition N Other Waterproofing < Stairs ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Provide exterior foundation waterproofing and replace stairwells Frith railings as necessary at Building 23--24- 26- 49 Identification Please Type or Print Clearly) Dan Ydllanazzo OWNER: Name: Aimco North Andover LLC Phone:617-639--6052 Address: 50 Royal Crest Drive North Andover,Yia. T.V.h.J.Ca-rp - CONTRACTOR Name: Lawrence V MAW4 Phone: R Address: .4S r-T[O LJAQJ s'E" J9jZ*ewToC-?3, HA 0 ZlFq Supervisor's Construction License: C S - 0! 7?Q5' Exp. Date: y 7 Home Improvement License: Exp. Date: Coa�aaa3 a•je k.itud CO,d.4ul Ah► S , 1#4c- ARCH ITECT/ENGI NEER #4c.ARCHITECT/ENGINEER To I-M IQ-. V�swca�ska 1�C _ Phone: 9 '7F-- L1-33 -r10 & Address: 6I Nl*i#t S� POS. b ST. P-2p9ZAe)1. MA Reg. No. HASS 1'E 221?.S FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: 7S`C( I Receipt No.: 2-&81 V NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature ofAgent/Owner Signature of contractor 'R 'N,M44.,W-- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted LT Plans Waived ❑ Certified Plot Plan 11Stamped Plans ❑ I TYP `OF':SE WERAGE:DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ 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- ❑ ❑ COMMENTS CONSERVATION Reviewed on Siqnature t (+tpc.G t I2 COMMENTS Sae PEP %.L D4 m S�-n - LI 1sT'., ?Q� °LaKST2dcra�fl C�a����� ax S C`��r,oh h 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 DPW Tow;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located-at 124 Mair Street Fire Departmerit 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 Ll Notified for pickup - Date Doe.Building Permit Revised 2010 Building Department The foEriwing is4list of the required forms to be filled out for the appropriate.permit to be obtained. Roofivg, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract u Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks La Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit L3 Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract Li Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract E3 Mass check Energy Compliance Report u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cas<s if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the aper-al 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 Location 2. { Kc) G No. Date F • - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee $1-5 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# � _ 26878 B ilding Inspector � NORTI� Town of ? ? Andover O - 0 No. 26q ... 14 * h jo�0;�S.A. h , ver, Mass, 2��3 COCHICKIWKu ORATED PPp�.�y S U BOARD OF HEALTH Food/Kitchen P E R �l Septic System THIS CERTIFIES THATMET 1 _ L�,�'. ....,�.,I�1r, .................................. BUILDING INSPECTOR . . ...... Foundation has permission to erect .......................... buildings on ..............�.�,Q 1.. �►T.. / .�►��:.. Rough E:A +%% to be occupied as ..... ...!�� 11 + .Ck!!�� .. Y�1!+�' chimney r provided that the person accepting this permit shall in every respect conform 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 §TAARTS 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 — .......................... ct t14RT1y ty TOWN OF NORTH ANDOVER ,.;+ :•.oo OFFICE OF n BUILDING DEPARTMENT 400 Osgood Street North Andover,Massachusetts 01.845 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 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 ZtO or-- ' ge piping at the specified 1. MA buildings. JoH. Ssgc A. NIEWSKI AUTHORIZED SIGNATURE: t rr 2 5 °September 13, 2013 n'Y•fT y.r REGISTRATION: Mass. PE # 29775 NOTE: ENGINEER"WET STAMP"MUST BE AFFIXED TO THIS FORM Control Construction Form revised 11.151004 BOARD OF APPEALS 688.9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Massacnusetts -uepartment of Putinc batety Board of Building Regulations and Standards Construction Supervisor License: CS-017809 LAWRENCE V M,t`WN 65 HOWARD ST f jjV BRAINTREE Mk 021 J.•G•� J1 . ,� �ta�` Expiration Commissioner 07/19/2015 0 DATE AC40 CERTIFICATE OF 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(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 Cristina NAME: T. Edmund Garrity & Co. , Inc. PHONE , (617)354-4640 FAX o:(617)354-5828 545 Concord Ave. ADDRIESS:cristina@garrity-insurance.com INSURERS AFFORDING COVERAGE NAIC# Cambridge MA 02138 INSURERA:Ohio Security Insurance CO INSURED INSURER B: L.V.M.J. Corporation INSURERC: 65 Howard Street INSURER D: INSURER E: Braintree MA 02184 INSURER F: COVERAGES CERTIFICATE NUMBER:HASTER 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGETO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE X❑OCCUR BLS1455690302 /13/2013 /13/2014 MED EXP(Any one person) $ 5,000 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 $ ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident _ $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PeOPERTYtDAMAGE $ HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ TORYWORKERS COMPENSATION WC ".ITS OTH- AND EMPLOYERS'LIABILITY YINANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (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) 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 W Garrity/CRISTI ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025/9ninn51 M Tlsa Ancipri noma anti Innn era ranic#ararf m2rtrc of Airnpn 0 DATE(MMIDDIYYYY) ACC j' CERTIFICATE OF 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). CO AC PRODUCER NAME. Albert J. Tonry & Co. , Inc. PHONE (617)773-9200 FAC (617)773-9920 300 Congress Street o AI Ss: INSURERS AFFORDING COVERAGE NAIC f Quincy MA 02169 INSURER A commerce Insurance 34754 INSURED INSURER B: L. V. M. J. Corporation INSURER C: 65 Howard. Street INSURERD: 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. S POLICY EFF POLICY EXP INSRLTR TYPE OF INSURANCE POLICY NUMBER WDDNYYYI.(MMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE rI OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO ECTLOC $ AUTOMOBILE LIABILITY Ea ac ideINEDSINGLELIMiT 1,000,000 BODILY INJURY(Per person) $ $ ANY AUTO ALL OWNED X SCHEDULED LJ1808 /15/2013 /15/2014 BODILY INJURY(Per accident) $ X AUTOS X NON-OWNED PPe�aeaden DAMAGE $ HIREDAUTOS AUTOS $ rj 000 Medical payments UMBRELLA LIAB OCCUR EACH OCCURRENCE $ ElEXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ TH- WORKERS COMPENSATION WCSTATU- O ORYR AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes.describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS LOCATIONS/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 ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover 120 Main Street AUTHORIZED REPRESENTATIVE North Andover, MA 01845 L Tonry Jr./CDIGRA " ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS075 mmnnsi n1 Tha arng2 l noma�nrl Innn aro ranic4arari morka of ArnRr1 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.wcritn!a.org). 1. Name,address, telephone number and facsimile number or email address of the INSURED.- Name: NSURED.Name: L. V. M. J. Corporation dba: Mailing Address: 65 Howard Street .Braintree MA 021841150 Physical Address: Phone: (781)848-6030 Fax or email: Ivm46(cDbeld.net 2. 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 certso.*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: 416/2013 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 inthrrnation(including changes in exposure not yet reported to the carrier)that will assist the carrier in the issuance of the Certificate of Insurance. NOTE.An additional insureds)shall not be listed on any Certificate of Insurance unless such additional insureds)is a named insured on the policy. None