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HomeMy WebLinkAboutBuilding Permit #217-16 - 65 PEACH TREE LANE 5/1/2018 NORTH A r�,� � � BUILDING PERMIT I `w�` TOWN OF NORTH ANDOVER 32 y��t o APPLICATION FOR PLAN EXAMINATION Date Received � • ` Permit No#• � 'o°R'�7ED gSSAC HUS�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATI ON Print PROPE--RTY`01NNER � �r - �`� ;Pant' 100 Year Structure yes no MAP cLARCEL�t: ZONING DISTRICT Historic Disfnct y` yes no. Machine Shop Village yes no. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 'p One family ❑Addition ❑Two or more family ❑ Industrial 'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ S&ep#ic ❑1lVell b i Floodplain, '�Wetlandsrf '° .1�Vatersedi D stnctg D Water /,Seer ' { _ DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: -�� -t- .3 `^ti ,xW&-43!my Phone: -33:�-4 �I Address <o _ P a, �. :� � ne. "6-t Contractor Name: ho Email. - �"�✓ i .a '= I'I _ Address vcJ� w .�s ,tee=c„n� 'Supervisor's Construction License Ep`` x Date III n .License.- Ex Date Home.lmproveme t p; e- ARCH ITECT/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: $ Al Off, GrP FEE: $ — f Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund _ j: . - . wo�7.- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinuning Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennan.ent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM (PLANNING & DEVELOPMENT Reviewed On WV � Signature- COMMENTS ignatureCOMMENTS CONSERVATION Reviewed on Signature moi- COMMENTSto_"�- C ['mbS HEALTH Reviewed on , Signature, . COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes p � M Plbanning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp ®umpster on site yes` z9.All } �$ no =� .pnatuIh !jj4 COMME 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 i NOTES and DATA— (For department use) Vj� n �- � C or ® Notified for pickup Call Email Date - - W Time Contact Name -------------- Doc.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 Copy of Contract 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 Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit � Photo Copy of H.I.C. And C.S.L. Licenses �- Copy Of Contract Plan Of Proposed Work With � Floor/Cross Section/Elevation Sprinkler Plan And p Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) - . 4. Engineering Affidavits for Engineered products IS OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) BuildingPer--mit Application ! '. 4, 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. K Date /S . - TOWN_OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $� 'K Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# C. I s B&Idmg Inspector r F NORTy own o E h over , 0 No. soh ver, Mass, /� /f �dCOC KIC441WICK y1� AERATED S U BOARD OF HEALTH E RM IT T LD Food/Kitchen Septic System s��rJ �D � / BUILDING INSPECTOR THISCERTIFIES THAT ............................/............ ....(.. ........................................................................... > Foundation has permission to erect buildings on ... .?........ . ?.` r�`t:.. e:........................ /� Rough to be occupied as .................:...Z)e . .Ac..a"VeP74.............................................................................. Chimney 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final IPERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO STARTS Rough Service ........... ...... .. x�-:---...................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final r No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. NMI M M M Mi M ME M M MMMMEM MENN M MEN NO M MENEM NONE M M MMMIIM MN mmmmi ON ME MEMO M MENEM M M M No M IN ME ME M 11 M M M M ME M ME ME NNE ON N ON M M M M NMI M IN M I M ME M M III M I M MMEN mom 0 1 M ME MEN 0 1 M M MM M I M M Mrm 0 M ME MINE M NMI M NNE MOM NMI N EMS mm M NM ME M M= ENE 0 M MI ,gum ME M M ON IN MMEMMMM ME MI No IN= M M ME M N MOM mm I SEEM M N M M MM E mom =267.24(CB15) =266.03(CB16) =267.77(CB17) T)=265.91 Q s, 16 67.24 CZ � �,\ � a� � � c�2 6yO��'y6��'� off► '44 40 \ c� \ N 0 i t� 9 `—~fit\- ��� \ &•,c\��f�� i� aOi AN v-, G cq 49' „�� 9� y North Andover MIMAP May 29, 2015 �:. •";' s. �, ,+ � r} Y�f '� -�: �yR.�� .. +G c � k _� v Vis, it , ti �a s >. r.w f � ; u yy Od". f r. J � a / _ s w w w t a y ' 's Y?� y m y� + Y 4 , Interstates —I Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Roads Meters Data Sources:The data for this map was produced by Merrimack 4-1 Easements t NOR7N q Valley Planning Commission(MVPC)using data provided by the Town of Q tato �r North Andover.Additional data provided by the Executive Office of Q MVPC Boundary -? 4<< re�e�Q Environmental Affairs/MassGIS.The information depicted on this map is ❑Parcels for planning purposes only.It may not be adequate for legal boundary definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER WomwMAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING ry .THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY i OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT * o � ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION 9SSAGNUS�t 1"=46 ft w ° North Andover MIMAP June 1, 2015 00 098Ar02^1' o i '772 PEAGHTREE LN ~ °°:oss�A ai3ii ;7�i��PEACH�tTREE�LN 09_•8:-01„b20. :.•sal�r' �' -.. kilt •_'S31k,',! 1 >W. sant u AW. 131,Er ._. C t65PEACH�*TREE: N it /p .. .. l / 1A. .,197.34' fi - lCt MW mk sant,a �ittt .f :_ alir "098�A.O,l�i;8 • 155 PEACHTREE 109svA 011 ) — Rail Line Wetlands Zoning- Interstates O Exempt Lands 0 Busine s 1 District _I I*Busine s 2 District Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —SR 9 Busine s 3 District Meters Data Sources:The data for this map was produced by Merrimack C Busine s 4 District 1401111- Valley Planning Commission(MVPC)using data provided by the Town of -- Roads O Genera Business District �f t�ao 6'qy North Andover.Additional data provided by the Executive Office of 8 Planne Commercial Dev ,Easements 00 �a�� Environmental Affairs/MassGIS.The information depicted on this map is !9 Corrido Development Dist 3' L for g purposes only,It may not be adequate for legal bounds ®MVPC Boundary - 13 Corrido Development Dist p _ to plannin y, y q g boundary definition NO Interpretation.THE TOWN LI NORTH ANDOVER Q Municipal Boundary ®Corrido Development Dist h 9 MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING SE Industri 11 District _ Zoning Overlay - # ; THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY 6 Indus tri 12 District w ; OF THESE DATA,THE TOWN OF NORTH ANDOVER DOES NOT 0 Adult Entertainment • t SO Industri 3 District i Downtown Overlay District - �►.o K4� �, ♦ ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF ©Historic District Industri I S District 9+ Reside ce 1 District 11q o++��p'yP� THIS INFORMATION 0 Water Protection G Reside ce 2 District SSgCHU$E ❑Parcels 0 Reside ce 3 Di' tncI Hydrographic Features de ce 4 District .. —Streams 1"=34 ft de ce 6 District YYY de ce 6 District ���,geResidential District North Andover MIMAP June 1, 2015 a 098.A-0121 0 72 PEACH TREE LN 098.A-0131 71 PEACH TREE LN o98.A-0120 : 098.A-0132 ::- ___-... .. 65 PEACH TREE LN 098:A-0119 ::. s:.I •... ...._. 197,34 4 _4i flu .._:•'�xltr.•:�: s�i� Z. 098.A;0142=" ... all •• :_:_. ::, ... Sk 7. 098.A-0118 55 PEACH TREE LN 098.4=0117 Rail Line Interstates - -I Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —SR Meters Data Sources:The data for this map was produced by Merrimack --Roads - tLORTq- Valley Planning Commission(MVPC)using data provided by the Town of pf tato ,s'gti North Andover.Additional data provided by the Executive Office of C,Easements j. bei +6 00 - Environmental Affairs/MassGIS.The information depicted on this map is MVPC Boundary - C L for planning purposes only.It may not be adequate for legal boundary definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER 0 Municipal Boundary F 9 MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING – Trails IC THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY ❑Parcels - ^ # OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF Q Hydrographic Features ./� o+�t�o >�� —Streams THIS INFORMATION U - ,SSACM5E� Wetlands 0 Exempt Lands 1"=34 ft "�° WESTFORD INSURANCE Fax:978-692-0429 Jan 6 2015 08:35am P001/001 rCER�TIFICATE HULL 1-I Ur w. In CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD01/0612015 IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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 NAME: Eric Semple Westford Insurance Agency PHONE FAx PO Box 308 CA No Ext):978-6923073 (PJC -692-0429 No): 978-692-0429 E MAIL Westford,MA 01886 ADDRESS:Eric@Wesffordinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Liberty Mutual Insurance 24198 INSURED MawFiaroules DBA INSURERB: Hollywood Interiors_, PO+BOX 486 INSURERC: Westford, MA 01.886 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 UULZiUbK POLICY TYPE OF INSURANCE POLICY NUMBER MMIDD EFF LTR MM/DDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE 1-91 OCCUR CB04592815 10/04/2014 10/04/2015 D GE RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY E PROJECT D LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ 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 AUTOS AUTOS Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER I OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street Bldg 20,Suite#2035 AUTHORIZED REPRESENTATIVE North Andover, MA 01845 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD WESTFORD INSURANCE Fax:978-692-0429 Jan 30 2015 10:54am P001/001 36,81.2015 16:43:57 Guard Iri51Ni1IICe Guard Iwatice Group 1/1 CERTIFICATE OF LIABILITY INSURANCE DATEIMMI0D1YYYY) W0612015 THIS CERTIFICATE 1S 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ( IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the cerillicate holder In Ileu of such endorsement(s). PRODUCER NAME: WESTFORD INSURANCE AGENCY PHONE t 224 Littleton Road E-MAIIL aooREss: __ PO Box 308 INSURER($}AFFORDWGCDVERAGE NAICf Westford MAO 1886 -•••---_.....................___.._..—_ —..................___ INSURERA: AmGUARD Insurance CompanY INSURED INSURERS: Mark Haroules dba Hollywood Interiors INSURER : - - PO Box 486 1Ns(raERo 1NSURERE: - Westford MA 01886 INSURER : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABM FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REClUIREMENT,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 POLICY EFF POLICY EXP LTR POLICY NUMBER MMADP{YYl OLIC YYYY LIMITS GENERAL LIABILITY EACH c-cr '<RENCE $ ✓_ ICOMMERC,ALG=NERALuABIL,TY ?REMISES�,Eaoo;crc+ncr - - "_A:M'r`d 0 'I: MEC ESP(rnJOa:pe,x) I I $ 1 I ....._._.� _.. PEFSON/•LEADV N.1.P.Y $ -- ;E»c`RALaA:REGATE $ _----- :-_ �hL AGGP.EGA--LIMIT WP,.;E;,PEP t r'R!iDLl,TF':AMPi�r A06 It P(A.ICY 1-1 '.-0c i $ AUTOMOBILE LIABILITY ' N� �Eaa,rn.uid _ AN"AUTC I EtDIL":NJ_RtlPcrc-erten) L AL:-C',NED F-mED-iLC•C' I is iITH.''i:,l RY(FeracceeM) (AUTOS AU'.OS R0 ERTYDAMA HIREDk.:TC Al,rr?S I(Fdr BGCJd0n11 ° I g I UMBRELLA LIAR ri�� ! EArH OCCUP.REI�fE $ 'EXCESSLIAB .AGGREGATE S OCD rETENTr;:.,�S s A WORKERS COMPENSATION ATU- OT - ANOEMPLOVERS'LIAHILITY YIN R2WC512664 ig/23/2014 /23/2015 -R' •;MIT^ ANi PROPRI_TOPJPA.PTI\,ERIEXE:'ITI1r' `.FL EACHACCID_•J7 $ 100,000 Of'CER,MEM6fR E;C'_UD_CO FE N IA I _.._....... (Mandatory in NH) I `C L;IEEASE•-_A EAIPLOYE; 5 100,000 11 yps,describe cTcar D=Fn.R:PTIONO=OP,RA'ONSae.ow _L-d5C!SE-?0LICYLIMIT $ 500,000 I , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apsce is required) The workers compensation policy does not provide coverage for Mark Haroules CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 Osgood Street Building 20 Suite 2035 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ..*,,, �ZJANJ ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ee aria�raaa2tue�c��¢�J i� �� Q'QICGCFGGUtd��. Office of Consumer Affairs s&Business Regulahou lOMEIMPROVEMENTCONTRACTOR WOE,egistration: '33806 piration 8/1'.3/2015' TyPe: DBA MGH CONTRACTING r { 9 MARK HAROULES� 118 CONCORD RD WESTFORD, MA 01886 Undersecretary 9LOZ/L£/LO �.i?uolsslwwo0 uoi;ejidx3 F $9881Q= CIROASaAA CINOJNOJ 811 • �,. ate. SIIO9 XuvNi 6VZ000 SO :asuaoII [gs�:tt�dnS uo1lzina;stroj f spiepue;S put'suopjn6a�j 6uepphq}o peo9 'AlaleS oilgnd jo.;uawuedaQ- s:4asnyoesse jN