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HomeMy WebLinkAboutBuilding Permit #938-16 - 602 BOXFORD STREET 3/4/2016 ■ BUILDING PERMIT of NORrN q�2 �t QED­'646HO TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * -F Permit No#: Date Received �RAre* yea <5 J � �SSACHuss� Date Issued:"L70RTANT: Applicant must complete all items on this page LOCATION �� o Forin(t� PROPERTY OWNER s `-- ��� \ Prinr 100 Year Structure yes no MAP0) 5C PARCEL:��_ZONING DISTRICT: Historic District yes Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ElTwo or more family 11 Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: 6 Demolition ❑ Other Septic D Well ❑ Floodplain Wetlands ❑ Watershed District ❑ Ater Sewer DESCRIP ION OF WORK TO BE PERFORMED: Identification Please Te or Print Clearly OWNER: Name: Phone: Address: GSA v Contractor Name: Phone: 9 70 O'\t S Email: ax! > Address: \ Supervisor's Construction License: _Exp. Date: 1 Home Improvement License: Exp. Date: S D ARCHITECT/ENGINEER Phone: Address: Reg:-No. { FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ C� FEE: $ Check No.: Receipt No.: 20 NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund �I nature of.Aaent/Q Pr 4. L. ... Location ` j1 e)x ' --L No. 1 � J Q t� Date � 1 f - • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ' .1 ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 4j �0 f 8 11Buildingli spector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF 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 COMMENTS CONSERVATION Reviewed on Signature COMMENTS 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT Terrrp Dumpster onrslte yes no _ Lbcated;at 124Ndin Sttree# y Fjre.D e:partrnen#.sinatuTeltlate ;= a C. 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 Call Email Date Time Contact Name Doe.Building 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses a Copy of Contract ❑ 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 o Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) a 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 a Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses a Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ 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 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 NORTH own of : _ '' Andover O 0 0 ;;N:,- 42 4`2 1, ver, MassAfco� O " COC"11.2W.CM V �as RATED kill, � 7 V BOARD OF HEALTH Food/Kitchen PERIMIT T LD Septic System THIS CERTIFIES THAT ...�.�..�....�G'.il'Y1..C„�..................................................... .... ..................... BUILDING INSPECTOR Foundation has permission to erect ........... buildings on .. 1 ]�� Rough to be occupied as ....... ....� �L........ .. .Vii. ..... Y.. l.!+.`............................... Chimney provided that the person accepting this permit in eve respect corm to the terms of the application p p p g p every p pp 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 CONSTRUCTIO TARTS Rough Service ........... .... .. . . . ... ................................... B ILDING INSPECTOR.. Final 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. Town of North Andover tjoRTH q Building Department O . ,%,ED '6 �o It J% 1600 Osgood Street Bldg 20, Suite 2035 - North Andover MA 01845 #_ Tel: 978-688-9545 Fax: 978-688-9542 �c - t, my DEMOLITION OF BUILDING AFFIDAVIT °�A COCtl�CiW �`�1 U5���5 DATE OWNER'S NAME &ADDRESS S t L "o w ks I o rn`��D�� s o< Q�� S�.-tf'I- ®1 7 LOCATION OF PROPERTY TO DEMOLISH DESCRIPTION I& C>i b'6 CONTRACTOR'S NAME &ADDRESS s5 � C,,.sz,C DEPARTMENT SIGN-OFFS DEPT. OF PUBLIC WORKS -WATER: SEWER: r--- p TREE WARDEN N O&V"e TOWN ENGINEER DEPT. OF CONSERVATION, HEALTH DEPT.' L �, SSTIC G �1AfEI L St- T �C�trl i U' HISTORIC COMMISSION PLANNING ELECTRIC o S - i ©; Cc,..0 TELEPHONE TAXES POLICE FI RE EXTERMINATOR DUMPSTER-O OFF\ REETr, DIG SAFE NUMBER BLDG. INSPECTOR Building Demolition Affidavit 9 �� Sz,�sk� PEST CON7ROL SERVME AGREEME Dennis the Mennis Pest AGREEMENT NUMBER Pest Elimination Experts 30 Years 29 Locust Street No. 1555 Lynn, MA 01904 781-592-0023 a Fax 781-592-9513 Lic. #MA 18197 CUSTOMERSERVICE LOCATION tt "E L- owps STREET — CITY,STATE,and ZIP PERSON TO BE CONTACTED SERVICE PHONE N • �ti N�u�. PHONE TYPE OF PROPERTY TO E-SE VICED DATE S VIC BEGINS EXPIRATION DATE RENEWAL SERVICE TO BE PERFORMED a � �« ❑ ❑ Monthly ❑ Quarterly ❑ Other PESTS TO BE CONTROLLED: C S 4 tt ON � C: �j10X 1>J SPECIAL INSTRUCTIONS: wo TERMS AND CONDITIONS: SERVICE GUARANTEE:We agree to apply chemicals to control above-named pests in accordance with terms and conditions of this Service Agreement. All labor and materials will be furnished to provide the most efficient pest control and maximum safety required by federal,state and city regulations. SERVICE RENEWAL:This agreement shall be for an initial period of one year,and will renew itself annually unless either party cancels this agreement by giving thirty days written notice before any expiration date. ANNUAL AGREEMENT CHARGE $ r----� INITIAL SERVICE CHARGE $ `5� o �� COMPANYAUTHO ZED ;AT REp� ATEMONTHLY/QUARTERLY PAYMENTS $ L� Gr 3a 0( �— �Y __________—— $ CUSTOMER AUTHORIZED SIGNATURE DATE Reorder Product#7052 from-1-800-252-4011 GCopyright.CROWNMAX Date:2/11/16 From:MA/RI OSP Center 385 Miles Standish Blvd Taunton,MA 02780 1-866-686-1195 ma-ri-osp.center@one.verizon.com To: Bill Lumbard 978-265-8352 Re: Demolition This is to inform you that the Verizon facilities to 602 Boxford Street in North Andover,Ma have been disconnected and removed. Thank you, Steve Lunetta MA/RI OSP Center 385 Miles Standish Blvd Taunton,MA 02780 1-866-686-1195 ma-ri.osp.center@one.verizon.com A' 10 ad 40 Sylvan Rd,Waltham,MA 02451 February 19,2016 Bill Lumbard S &L Homes LLC 10 Middlesex Ave,Unit 1 Wilmington,MA 01887 RE: Service Removal for Building Demolition WR#21301204 Dear Bill Lumbard, This letter is a confirmation letter stating tl"at you requested National Grid to remove the electrical services at 602 Boxford St,North Andover.National Grid has removed electrical service per your as of 2/19/2015. If you have any questions or need further assistance,please feel free to contact me at(508)357-4982. Sincerely, n ISI c)t�� Vrtr Sterling B. Ortiz Order Processing Rep A Customer Fulfillment nationalgrid Ph#508-357-4982 Fax# 1-888-266-8094 Sterling.Ortizonationalgri d.com national . ro March 3, 2016 602 Boxford St North Andover MA 01845 This letter is to notify you that the gas service located 602 Boxford St North Andover,MA M45 was cut on 03/01/2016. If you have any questions, please feel free to contact me at 781-907-2924 Thank you, Kendra McAuliffe Czffa�'f c4(aAA@R nationalgrid Malden/Essex Customer FulFillment Gas NE kendra.mcaul iffeO)nationaig rid.corn 781.907.2924 VDAC ace group WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6S62UB-0G07681-1-15) NEW-15 INSURER: ACE AMERICAN INSURANCE COMPANY 1. NCCI CO CODE: 12165 INSURED: PRODUCER: S & L HOMES LLC WILMINGTON INS AGCY INC 10 MIDDLESEX AVENUE #1 PO BOX 1010 WILMINGTON MA 01887 WILMINGTON MA 01867 Insured Is A LIMITED LIABILITY COMPANY Other work places and identification numbers are shown In the schedule(s) attached. 2. The policy period is from 06-05-15 to 06-o5-16 12:01 A.M. at the Insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 1000000 Each Accident !� Bodily Injury by Disease: $ 1000000 �= Policy Limit Bodily Injury by Disease: $ 1000000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE- REPLACED BY ENDORSEMENT WC 20 03 06B _ v D. This policy includes these endorsements and schedules: s SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE a� 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY, DATE OF ISSUE: 06-19-is MS ST ASSIGN: MA OFFICE: ORLANDO DA ACE 24M PRODUCER: WILMINGTON INS AGCY INC 28PMK 015752 Z d ZS£L LSZ LOS'oN/S£:S '1S/L£:S SLOZ b UWH<I M=1> now=1 Fax Cover Sheet TRITON CONSTRUCTION MANAGEMENT INC 10 Middlesex Avenue, Unit 1 Wilmington, MA 01887 978-988-2343 Fax 978-657-8502 and to: From: Town of North Andover RICHARD STUART RSTUART@TRITON MANAGEMENT.COM Attention: Date 3-4-16 Mora Fax Number: #Pages(including cover) 2 978-688-9542 O Urgent ❑ Reply ASAP ❑ Please Review ❑ For yourinfonnation Comments: Please see attached workman's comp policy for S&L home LLC Let me know if you need any other information Thanks Rich L d Z8ELL8ZLE6'oN/8E:6 '15/8E:6 9LOZ b NHW(INd) WON I Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor , License: CS-076124 A), William H Lumbar 14 Bemis Circle: 11� Tewksbury MA 1187 ` Expiration Commissioner 02/18/2017