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Home My WebLink AboutBuilding Permit #Exception - 66 COLONIAL AVENUE 5/1/2018 BUILDING PERMIT of "°oTN qti TOWN OF NORTH ANDOVER ?tb�ti • °., o� APPLICATION FOR PLAN EXAMINATION J ' ' c� 1` Permit NO: Date Received e, "�»,T.o �SSACHU`�� Date Issued: IMPORTANT: Applicant must complete all items on this page �- LOCATION o U Iv, L LC t pri PROPERTY OWNER "" _ Print ' MAP NO: ID,7 PARCEL: AA, ZONING DISTRICT: Historic District yesno !Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential, Non- Residential New Building One famil Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer ^-� DESCRIPTION OF WORK TO BE PREFORMED: C1 U C-- S � C e:r o `t-0.,C S c-ST ac *Nn e.- (, � A Le-�r �i a,� "I 4.e C\e,(A.. �, c Infi 5 de x U u�) O-C tb.[ C. -fClwar �- '-(3 Identification Please Type or Print Clearly) OWNER: Name: "C�.r� .�, sem,G` Phone: Address: Nva- CONTRACTOR Name: 6z/e- Lo-,)J Phone:q�b � �:� SS-a Address: /30 Ave- Supervisor's Supervisor's Construction License: Exp. Date: 6 `c;L 1l (o Home Improvement License: p 7 Exp. Date: ` ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ a 00 FEE: $ 3O "-- Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfu Signature of Agent/Owner Signature of contractor �"� 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 r RV CONSERVATION Reviewed on �� Si nature COMMENTS �J ? ° HEALTH Reviewed on f O Si nature 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 - Temp Dumpster on site yes no Located at 124 Main Street Fire Department 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 Applicatiorf ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. License ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: 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 ❑ 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 ❑ 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 ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 6L S fo t -fib ct A MAY 0 8 2009 NORTH ANDOVER CONSERVATION COMMISSION (7 c lz - N/F A C BUILDERS S84032'52"E 126.37' s MAY 0 8 2009 \ r 1dl, NOTH ANDOVER \ Q CONSERVAY ON COMMISSION STONE&CONCRETE RETAINING WALL ........ � LIMIT OF WORK .............. . \ O ::::::.:. ................... :. ::::: :::::::: :: :::::: ::::::::::::::::: ::......:::::::. h ...... ..... ........................... ::: ;:;:::DRIVEWAY: ::. :::.:::::.::. :._::. ........ .............. .. ............. .... ......... ............. ................. ,. . :; :: :_: .......... .... .................... .... ...................................... .................::::. ...........\: \ N/F A C BUILDERS --� 66 COLONIAL AVE \ ASSESSORS MAP 107B, 152 LOT 149 \. FENCE \ 0.51 ACRES i �• � � `\, c o ��•..\ / EXISTING 4 O ` SEPTIC < SYSTEM \• \ EDGE OF WETLANDS <2 occ`� \ ` \ NNI RIP RAP N SLOPE `\ EXISTING 103.34' SEPTIC TANK \ �� A \ �. 25'NO DISTURB ZONE 122.46' �. S86051'23"E N85°10'50"E 50'NO BUILD ZONE N/F LAREAU N \ \ coN; \ ee I100'BUFFER ZONE - -- �. r'(1XT4ZRD t7 A TTlIAT A n 7lT TTT Ir .4 f AORTH O`t�a.e° 16 '1.0 FO A 9SSgCHus CONSERVATION DEPARTMENT Community Development Division May 26,2009 Jeremy and Cori Segal 66 Colonial Avenue North Andover,MA 01845 66 Colonial Avenue, North Andover Expansion of an Existing Deck Conservation Conditions of Approval, NACC #52 Pursuant to section 4.4.2 A of the North Andover Wetlands Protection Regulations,Cale Wood Construction,LLC,on behalf of Jeremy and Cori Segal,homeowners,filed for a small project for work proposed at 66 Colonial Avenue,North Andover.The work consists of the construction of two stairways (one nine steps and the other four steps) to access the rear and side yards from an existing 192 s.f. deck. Two (2) sonotube footings will support a 3' x 3' platform from which the stairs will extend. The stairways will land on 4" concrete pads. Approximately 100 total s.f. of work is within the 100-foot buffer zone to a wetland resource area which is located to the rear (west) of the existing house. Soil disturbance for the work is limited to the installation of the new sonotube footings and will be performed by hand. Work will be conducted approximately 70-feet from the edge of a Bordering Vegetated Wetland (BVW).The Conservation Department conducted a field inspection of the property and agreed with the location of the wetland boundary. During the May 20,2009 public meeting,the North Andover Conservation Commission(NACC) voted unanimously to approve this project as described above.The following conditions were hereby mandated for the proposed work: RECORD DOCUMENTS: Conservation As-Built Plan,66 Colonial Avenue,North Andover, Massachusetts,Assessors Map 107B,Lot 149, dated March 10,2008 and Revised 4/15/08,sketch of stairs prepared by applicant;and hand sketch of deck and stairs with proposed measurements by Cale Wood of Cale Wood Construction L.L.C.received May 8,2009 Project proposal/description of work prepared by Cale Wood of Cale Wood Construction L.L.C.received May 8,2009. CONDITIONS: 1. Accepted engineering and construction standards and procedures shall be followed in the completion of the project. 1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web www.http://www.townofnorthandover.com/conservel.httn 2. Excess material and construction debris shall be properly disposed of off site. 3. Upon completion of the approved project and site stabilization, please contact the Conservation Department for a final inspection. 4. This permit shall expire on November 30,2009. Please do not hesitate to contact me should you have any further questions or concerns in this regard. Thank you in advance for your anticipated cooperation. Respectfully, ORT�H ANDOV R CONSERVATION DEPARTMENT CJ er A. ugh onservation Administrator 1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web wxvw.http://www.townoftiorthandover.com/conservel.htm Massachusetts The Commonwealth of k� ! Department of Industrial Accidents � i Office of Investigations 600 Nrashington Street i Boston, MA 02111 www_mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plambers Applicant Information Please Print LeQibl Name (Business/Organiza6on/Individual): Address: City/,State/ZiF: CLJsL,\(' A4 Phone 3 S-� Are you an employer?Check.the appropriate box: 11 am a employer with 4. ❑ l am a general contractor and I Type of project(required): employees(full and/or parl-time).* have fired the sub-contractors 6 ❑Naw construction 2.❑ I am.a.sole proprietor or partner_ listed on the attached sheet.$ 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me.in any capacity, workers' comp.insurance. g, ❑ ,Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs�ImTe�] officers have exercised their rep rs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No-worke'rs'comp. c. 152, §1(4),and we have no 12.[] Roof repairs insurance required.]t employees. [No workers' comp. insurance required.] I3.❑.Other *Any applicant that checks bo>:'11 t must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are daring all work and then hire outside contractors must submit a new affidavit indicating such. 4cont actors that check this box must atmahed an additional sheet showing.the name of the sub-contractors and their workers'corn,-.policy infamudon. lam an employer that is.providwg:workers'compensation insurance for my employees: Below is file policy and job site information. Insurance Company Name: ' Al Policy#or Self-ins.Lie.#: f/y(� ��2 r'�� / Expiration Date: lei O Job Site Address:_ t,--)Jd,6J a / L City/State,/Zip: � Attach a copy of the workers' compensation policy declaration page(showiag the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$4500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains d penalties of perjury that the information provided above is true and correct Signature: 1/7 � Date `-) Phone#: 6 Ic-- f [aluse only. Do not write in this area,to be completed by city or town ofciaL Town• Permit/License# Authority(circle one):of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. 'However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance'coverage required" Additionally, MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation•affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cavy workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for-the permit or license is being requested,notthe Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self*rtsured companies shoed ent-their self-insurance 1.license number on the appropriate dine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. in addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under".lob Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for f rtum permits or licenses. A new affidavit must be filled out each year. When a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 TeL #617-7274900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax#617-727-774 www.m2ss.gov/dia Ak \ OPEN SPACE � ,. R ,L 584 32'52"E 126..37 V F Ln r X40 149.8 /j- - - - -' ��G �b� �� `��— ' " �. � •\• 29824k `s� 122.46 \\ . i �I85'10"50"E 34 586'51'2,Y'fr- 3. ' ♦ ° ,C r 29 A.C. S U I L 0 F- RS I P 1— A, v SCALE.- 1 " = 40' \ 54 ,9 . = 1 S E.�. : � 57- ?r1 13Z" @ 143,-,� \:),,i 1 Lo%z) )4Z 5\AWT 7 l01 " .-,r \Adc . C", k<,/ r .- , n /L.? U4f431LUU7 LU c7 7so.)rrr rvj ,tea,ra.r,�... a,.� ••-•— --- ACOGATE(MMD/YM)TM. CERTIFICATE OF LIABILITY INSURANCE 04/29/2009 PR OrUG.R MW&-, (978)374.$365 Fax: (978)374-775t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION R B KIMBALL INSURANCE AGENCY INC. ONLY AND COMERS NO RIGHTS UPON THE CERTIFICATE P 0 80X 1390 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR HAVERHILL MA 01831-1890 ALTER THE 20YERAOR AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE NAIC 0 Agency LIC N:MA 178047.0 INS.URED I INSURER A: EMPLOYERS FIRE INSURANCE WOOD, CALE M. INSURER 8: GRANTE STATE INSURANCE C/O CALE WOOD CONSTRUCTION,LLC 'INSURER C; ST PAUL TRAVELERS INSURANCE 130 14YATT AVENUE HAVERHILL MA 01835 INSURER 0; ENCOMPASS INSURUANCE i INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED Bnow HAVE BErsN ISSUED TO THE INSURED NAMED ABOVE FOR TWr POLICY PERIOD INOICATGD, NOTWITHSTANDING ANY REOUIREMENT,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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED RY PAID CLAIMS. mRA017 TY40PIN9URANCE POLICY NUMBER ( �fYC"ECTIve I POLICY EXPIRAYMN LIMITS GENERAL LIABILITY F811,166505 06/07/08 06/07/09 EACH,OCCURRENCE s„ -,.,,,, 1,000,000 0AMAQE TO RENTflG 'g 30O,OOD X COMMERCIAL GENERAL LIABILITY PREMISES(EA nrnMmi) ... _.__ 00 CLAIMS MADE I.X OCCUR MED.EXP(Any aria Par%W) 3 51000 ' PERSONAL 6 ADV INJURY 4 A1,000LOOO Xj S 500.E 916 PO DED GENERAL AGGREGATE ! 2,000,000 N """' PRODUCTS-COMPIOP AGG 5 2 000 000 GEN'L AGGREGATE LIAR APPLIES PER:, „,t......5......,,. X POLICY _..- ,EC LOG I AUTOMOBILE LUiBLLITY BA3564A68907AUF 19/13/08 12/13109 COMBINED SINGLE LIMIT ; ANY AUTO (Ea awdem) ALL OWNED AUTOS BODILY INJURY (Per perodn) ! 250,000 X SCHEDULED AUTOS C X HIRED ALTOS BODKY INJURY X NON-OWNED AUTOS (Pe vcddenl) S 600,000 .. . . ... PROPERTY DAMAOF E 200,000 (Per aeddenl) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN EA ACC ! AUTO ONLY: AGG ! EXCESS I UMBRELLA LIABILITY I I EACH OCCURRENCE S OCCUR I I CLAIMS MAGE I AGGREGATE 3 ' f DEDUCTIBLE ! RETENTIONS S WCT429114 06/10/08 06110/09 "'C tTATu I I OTHER vWRKER6GOMPENSATONANO X ioavLlNrte EMPLOYERS'LIABILITY E.L.EACH ACCIDENT ! 500,000 AMY 8 rVf OFFICERAWMM01 excL DEO7ECUTE.L,DISF•ASE-EA EMPLOYEE 9 500,000 =.ILRsGYnown E.L.DISFASF•POLICY LIMT 8 . ».. .. 50. 0,000 OTHER: DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS FRAMING,SIDING, WINDOWS,DOORS,PORCHES, DECKS AND ETC...INCLUDING WEATHER TIGHT SURFACING AND ASSOCIATED SUB- CONTRACTOR CARPENTRY SERVICES WITH COVERAGE PROVIDED BY THE POLICIES LISTED ABOVE SUBJECT TO THE TERMS AND CONDITIONS OF THE INSURANCE CONTACT ONLY,THEREIN. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES PE CANGELLEO BEFORE THE EXPIRATION DRFe INSURER Le UTDE� 1600 OSGOOD STREET STE.2-36 WRITTEN NOTICE THEREOF, HOLDER NAMEDO ThLEFT, FAILUR NORTH ANDOVER,MA 01845-1048 TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TWE IN$URGR, TEL:978488.9545 FAX:978.888-9542 IT'S AGENTS OR REPRESENTATIVES, AUIT140FIRED REPRFSENTAYNE Attention: Malcolm D.Kimball Jr. ACORO 26(2001108) Certificate 0 2080 0 ACORD CORPORATION 1988 CALE WOOD CONSTRUCTION L.L.0 Invoice 130 HYATT AVE HAVERHILL,MA 01835 Date Invoice# 4/23/2009 26 Bill To jeremy segal P.O. No. Terms Project Item Description Est Amt Prior Amt Prior% Qty Rate Curr% Total% Amount deck build a custom set of stairs 2,100.00 1 2,100.00 100.00% 100.00% 2,100.00 consisting of a platform and a two directional set of stairs. Decking will be a grey composite to match existing decking,and railings will be pressure treated to match existing. includes permits.(exact layout of the stairs will be determined upon starting of job as we are going in two directions on to different elevations). 01 Plans... Plans and Permits,all permit 0.00 0.00 fees paid by cale wood construction l.l.c will be reimbursed by the home owner PAYME:.. PAYMENTS WILL BE AS 0.00 0.00 FOLLOWS:800.00 DUE UPON SIGNING,800.00 AFTER FOOTINGS AND FRAMING ARE DONE, BALANCE UPON THE DAY OF COMPLETION PLEASE IGN AND SEND DEPOSIT Total $2,100.00 Payments/Credits $0.00 Balance Due $2,100.00 t_ . er� N Board of Building Regulations and Standards ROME IMPROVEMENT-CoNT`611 = E Registratiori:, 138958 rzxpiratjon:-5f3o/2009 Tr# 262267. -P-pe: DBA CALE WOOD CONSTRUCTION +r CALE WOOD I 130 HYATT AVE. q 8RA'DFORD,MA 01835 Administrator _ . .'Nlassuchusett-s- Department of Public Safety Board of Building Rel-dations and Standards Construction Supervisor .License License: CS 84086 Restricted to: 00 CALE WOOD 130 HYATT AVE HAVERHILL, MA 01835 Expiration: 6/29/2010 ; ('unm�isiunrr Tr#: 28500