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Home My WebLink AboutBuilding Permit #628-13 - 64 BLUE RIDGE ROAD 3/28/2013Permit NO: Date Issued: LOCATIO PROPER - TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT• Applicant must complete all items on this page Print 1uu Year uia structure yes MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village ves no no no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District El Water/Sewer DESCRIPTION OF WORK Tv tat PtM1-UM1V1tu: L C rAs « & G 15x- r.-Aw j V- S�-*I c ctJALA JAI shrjW g!!—�iC' Identification Please Type or Print Clearly) OWNER: Name: Phone: Haaress: CONTRACTOR Name:V,--CcimPhone: Address: Supervisor's Construction License: Exp. Date: �, � � �A 3 Home Improvement License: / 3S 3 / Exp. Date: � Ada - AQ/-, ARCHITECT/ENGINEER Address: Phone: Reg. No FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.5.00 PER S.F. jg�Total Proj v Cost: $9' C1 C�� FEE: $ /� OCD Check o.: as -35` Receipt No.: NOTE: Perso ontracting with unregistered contractors do not have access to the guaranty fun Signature of Agent/Owner Signature, of.contracto Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ -,91 Location No. 6 -2f — Date s 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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED U DATE APPROVED Reviewed on Signature Reviewed on Siqnature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Commen Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Tow o Engineer: Signature: FIRE DEPARTMEiVT - Temp Dumpster on site Located at'124 Main Street Fire Departrnerflt.pignature/date x: COMMENTS yes Located 384 Osgood Street no 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 - Date [ i Doc.Building Permit Revised 2010 Building Department The fohowing 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o 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 Li Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed Plot Plan ❑ 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) ❑ 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 app: al 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 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 14,000.00 m $ - $ 168.00 Plumbing Fee $ 21.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 21.00 Total fees collected $ 310.00 64 Bluerid a Road 928-13 on 4/1/2013 Install gas insert in basement, Remodel exisitng bath v 'a■ c � S n p Z (� o M C. r. L5o D cam. c=n .a o < v� CL Cr — cD CDD O � _ OD N■ CL o v, � v 0 z CD V--* O CD a CD i o ° 2 Z5 =� < ID V� �• ° 0 5Q m O oin � T o� o NW �p 'o cn CD 2 ° r . N -D-I U3 � W rt �D ID CD z ' Q o to . S m� CD o0=U cn- 00U) ID Om ° v°N' to c 0 r0 toL _ - y ; �' C_ � M U)CD `T n v' y CL . �Z O ma' ° D* ME N rt CA O @ ° Z ° _ -'• O D—i rt cn CD ?: ' D cD c CD _R -g 0m: oA 0: �rt O: v O W y VI O fD (D rD - O W C 7 (D .n m m M T :O O pCq S >W N T O LA O O aqq S m m [1 m 0 T 3 .Z7 O D=q S C Z G1 m O T O n S 7 ,O O DCq S T O 7 O_ p C p Z 70 N (D �. r) tin 3 T O Q \ n 3 WO O D J Xe � 0/t-/� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration - - Registration: 135313 Type: Individual Expiration: 3/22/2014 JOHN DIVECCHIA JOHN DIVECCHIA 6 SCHOOL HILL LANE. NORTH READING, MA 01864 Tr# 224957 Update Address and return card. Mark reason for change. ~- E] Address Renewal F-] Employment F] Lost Card PS-CA1 0 50M -04/04-G101216 ✓lam 1°o�.�v�no�uuea�l/z o'�/�/iao�acauaetta Office of Consumer Affairs & Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: .F 135313 Type: Office of Consumer Affairs and Business Regulation Expiration: 3/22/2014 Individual 10 Park Plaza - Suite 5170 == `= '= === Boston, MA 02116 TJODIVECCHI,"!':;=-r� AR/11/2013/MON 12;20 PM A&K Fowler Insurance FAX No, 1-978-664-22H i R. UUl/UUl can CERTIFICATE OF LIABILITY INSURANCE WT5(MM/DLYYYYY) TYPE OF INSURANCE 3/11/1 TFIS 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 PETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder Is an ADDITIONAL. INSURED, the poliey(ies) must be endorsed. If SUBROGATION IS WAIVED, subjoet to the terns and conditions of the policy, certain policies may require an endorsement A dat meat on this certificate does not confer rights to the certificate holder in lieu of such eridorsement(s). : PRODUCER A & K Fowler Insurance LLC 200 Park Street North Reading, MP; 01864 CONTACT NAME: - PHONE 978 664-0366 FAX (976) 564-2209 .Mp�� ADDR@SS: GENERAL LIABILITY COMMERCIAL GENERAL LEAD ILITY CLAIMS -MADE ® OCCUR INSUREWSi AFFORDING COVERAQE NAICA INSURERA: Preferred Mutual Insurance Com 3/1d/13 INSURED DiVeechia Brothers Const. Co. 6 School Hill Ln- North Reading,` Mh 01864 INSURERB;,Arbella Mutual In$urance Compa INwRERc:Travelers Insurance Company : . 'INSURER DINSURER E: 1 NSURE•R F GEN'LAGGREGATELIMITAPPUESPER POLICY PR 7 LOC GVVCKA[atS CFRTIFICATF NLIMRFR- Dc%ner/nkr ►uleenro. THIS IS TO CERTIFY THAT THE POLICIES OF (NSURANCE 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. I.TR TYPE OF INSURANCE DOL im SUER 18a POLICY NUMBER POLICY O M YYY MM/oDIYYY�Y LIMITS p, GENERAL LIABILITY COMMERCIAL GENERAL LEAD ILITY CLAIMS -MADE ® OCCUR CPP0100566728 3/1d/13 3/14/14 EACH OCCURRENCE $ 500,000 DAMAGE TO RENTED $ 100 ,000 NG0 OP (ArwonB Deman) $ 000 PERSONAL&ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1 GEN'LAGGREGATELIMITAPPUESPER POLICY PR 7 LOC PROOUC78-COMP/OPAGG $ 000 8 AUTOMOBILE LIAmu ry ANYAUTO w�D X AUTOSAUTOS OS WNED HIREDAVTOS _ NON-OAUTOS 1020015432 3/12/13 3/12/14 C ataEDcNd,rt M $ BODILY INJURY (Per person) $ 500.000 BODILYINJURY(Peraccidont) $ PROPEaidenRTYDAMAGE $ 8f PQf $ UMBRELLALIAB EXCESSLIA9 OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEO RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXC-CUTNE Y/ N OFFICER/MEMBER EXCLUDED? (lyes. dory in and IIyy68 deealibeunder DESCRIPTION OF OPE RATIONS bMIDW NIA 7PJLTB0277N71012 3/22/12 3/22/13 WCSTATLI- OTN- E OE Nf 100,000 ELDIS L�AE -EA EMPLOYEE 100,000 E.L. DISEASE-POLICYLIMIr Is 500,000 DESCRIPTION OF OPERATIONS/ LOCATIONSIVENICLES(Att.chACORDIA1,AdMortelRerraftSchedule. ifmore spam Isragilrod) Insurance Verification - 64 Blue Ridge Rd. — vw�� V HIY IiGLLq 1 I V h Town, of North Andover Fax 978-688-9542 North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI= THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RPPRESENTAVVE A. Boutin, CIC ® 1988-2010 ACC ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E -Mail: All riahts reserved.