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HomeMy WebLinkAboutBuilding Permit #011-16 - 56 Royal Crest Building 23 7/1/2015 ry "'T pORTI♦ 9 O . BUILDING PERMIT 3� a° ,•_ .•_'"•;° o� TOWN OF NORTH ANDOVER � APPLICATION FOR PLAN EXAMINATION - Permit NO: / Date Received sS wren S t'(y Date Issued: aCHU IMPORTANT:Applicant must complete all items on this page LOCATION Royal Crest Estates - 50 Royal Crest Drive - Building 23 Print PROPERTY OWNER AIMCO North Andover, LLC Print MAP NO: 25 PARCEL: 35%66 ZONING DISTRICT: RD5 Historic District yes no X Machine Shop Village yes no X TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition A Two or more family ❑ Industrial N Alteration No. of units: ❑ Commercial N Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands. 0 Watershed,District ❑Water/Sewer Repair damage within Electrical Utility Room due to fire during the upgrade of Secondary Service Electrical Lines to Building 23. Install soffits within hallway and each unit kitchen area for installation of upgraded 200 AMP services to units from utility room. Identification Please Type or Print Clearly) OWNER: Name: AIMCO North Andover, LLC-Dan Milinazzo Phone: (617)639-6052 Address: 50 Royal Crest Drive, North Andover, MA 01845 CONTRACTOR Name: Phone: , Cornerstone Land Developers, LLC (978)433-8100 Address: 61 Main Street-P.O. Box 657, Pepperell, MA 01463 Supervisor's Construction License: .john A.Visniewski,CS Exp. Date: CS-014178 11/21/2015 10 Home Improvement License: Exp. Date: <: Cornerstone Land Consultants, Inc. ARCHITECT/ENGINEER John A. Visniewski, P.E. Phone: (978)433-8100 Address: 61 Main Street-Box 657; Pepperell, MA 01463 Reg. No. MA P.E. 29775 FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 3,285.78 FEE: $ -27-34W 96 ­__� Check No.:_ � Receipt No.: Qa TJ NOTE: Persons contracting ith a 'stered contractors do not have access to the guaran fund Ar signature of Agent/Owner Signature_of contractor •., Plans Submittedfl"' Plans Waived ❑ Certified Plot Pian. Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swnnmmg 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 m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS i CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes S "Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature & Date Driveway Permit DPW Town]Engineer: Signature: Located 384 Osgood Street x77�. .moi t.'i.i:-` 3'1.z �C' }t..tyr 1,,FIRE DEP.ARTMEiVT x Temp ©umpster on site yesF d �t 1 or; ted at 124 Main Street = q^� Mon Fire Depart nt sign atu -1 M .yi�`'1; ,'�.w�.:'.stx`k���}f+{+ � � #• y T�.�`• �, aye .: , ; �:��"t`tf:� t �,*��.;��t��f S,- j _ ,a' ter�d4.. �,r�,j��" /'+ C �.� w•s�'� ,�[ tc. t.i v•� crc r 3 4 ; •� � �`� ssRR .. � }i�a • e ' k`l'iOMMCN� '..' r ? �•_ t�fx '"ar qtr � ..}{•�w'!'si �" ��,+ � �, \ Y { ,, �y' P� t S�r�d• i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I 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 Call Email Date Time Contact Name Doc.Buildiug Permit Revised 2014 Building Department 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 4. Building Permit Application � Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 1 Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4, Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products . OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit i n and Two Family) New Construct (Single o ( g y) Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location No.- (,? Date / . - TOWN OF NORTH ANDOVER Certificate of Occupancy $- Building/Frame Permit Fee Foundation Permit Fee_ $ Other Permit Fee $ TOTAL. $ c Check# • d Building Inspector 29 NORTH Town of E ., ndover h ver Mass j o C0CNIC.1.'CK �.9 A0R'17r,ED S V BOARD OF HEALTH %PERMPT T D Food/Kitchen Septic System THIS CERTIFIES THAT ............................................ BUILDING INSPECTOR ....................... m.... ...................................... . Q+ _T,�jV� Foundation has permission to erect .......................... buildings on2....... �. .'°t:�....................... ...................... Rough Rep to be occupied as .... .le :`C'A.I... ! :. .��........ dw.....R .ftln:............................................... Chimney provided that the person accepting this permits all 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 6T S ELECTRICAL INSPECTOR UNLESS CONSTRUCTI Rough Service .......................... .................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy.Buildinz 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. ACC>RU® CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY) �� 6/30/2015 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. HCNI1 Ext: (978)425-9595 ac No:(978)425-9160 73 Front St E-MAIL ADDRESS: P.O. BOX 1248 INSURER(S)AFFORDING COVERAGE NAIC# Shirley MA 01464-1248 INSURERA:ESseX Insurance Co. INSURED INSURERB:Hartford Underwriters Cornerstone Land Developers, Inc. INSURER C: PO BOX 657 INSURER D: 61 Main St INSURER E: Pepperell MA 01463 INSURER F: COVERAGES CERTIFICATE NUMBER CL1561150214 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 ADD BR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/YYYY1 (MMIDDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE � OCCUR DAMAGE TO RENTED - 50,000 PREMISES Ea occurrence $ 3PA5422 6/10/2015 6/10/2016 MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT F—] LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Employee Benefits $ 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 X HIRED AUTOS X AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A X EXCESS LIAR X CLAIMS-MADE AGGREGATE $ 2,000,000 DED I X I RETENTION$ 10,000 NAPXS00005504 6/10/2015 6/10/2016 $ WORKERS COMPENSATION PE OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE X ER ANY PROPRIETOR/PARTNER/EXECUTIVE TBI 6/18/2015 06/18/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A B (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 L_ __r--------------------------------7 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Coverage includes owners as additional insureds. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE AIMCO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AIMCO Regional Operating Center ACCORDANCE WITH THE POLICY PROVISIONS. 50 Dinsmore Ave Framingham, MA 02184 AUTHORIZED REPRESENTATIVE NEIG/Noyes/CVALIT ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r9n14011 A��oma® CERTIFICATE OF LIABILITY INSURANCE 6Ai(2015' 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. PHONE (978)425-9595 FAIC No DX (978)425-9160 73 Front St E-MAIL ADDRESS: 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. 29459 P O BOX 657 INSURER D:Hanover Insurance Company 2292 INSURER E PEPPERELL MA 01463 INSURER F: COVERAGES CERTIFICATE NUMBER CL1541349506 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 SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO E T D PREMISES Ea occurrence $ 300,000 A CLAIMS-MADE FX]OCCUR X OBSBATN5795 4/3/2015 /3/2016 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 LIABILITYEa BINEDtSINGLE LIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED OBUECZJ9456 /3/2015 /3/2016 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ TERR $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A X I EXCESS LIAB CLAIMS-MADE OBSELATN5795 /3/2015 /3/2016 AGGREGATE $ 5,000,000 DED I I RETENTION$ X $ C WORKERS COMPENSATION WC STATU- I 1OTH- AND EMPLOYERS'LIABILITY YIN I TORY LIMITS I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatary In NH) OSWECCM4902 /5/2015 /5/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D PROFESSIONAL LIABILITY HNA023436 01 6/8/2014 6/8/2015 PROPFESSIONAL LIABILITY $1,000,000 DEDUCTIBLE $7,500 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Property Name: Royal Crest Estates IN. Andover) Contract #:17660-419087-CPe-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 Ted Noyes/CVALIT �f�j(_ c ACORD 25(2010105) 01988-2010 ACORD CORPORATION. All rights reserved. INS025/gmmn.,it m Tho arnon name and Innn aro rnnic4nrrori mnrlrc of arnon Massachusetts -Department of Public Safety x Board atians and Standards of Building'Re4u4 Construction Supcn'i%or -014178 Y5 License: CS �. JQMN A VLSNMWIW a 94 S9MLEY ST PEPPERLL MA 01 ',' X1-0 Expiration 11121!2015 J Commissioner