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HomeMy WebLinkAboutBuilding Permit #954-2016 - 68 MAYFLOWER DRIVE 5/1/2018 BUILDING PERMIT o` OO-to o oT 6gtiv TOWN OF NORTH ANDOVER -+" *' ` o APPLICATION FOR PLAN EXAMINATION _ Permit No#: ,6 Date Received gSSACHUs�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Yn I 0 Ire(N a D D t T Print 100 Year Structure yes no MAP 1 PARCEL: �-'�, ZONING DISTRICT: Historic District yes Machine Shop Village yes no I TYPE OF IMPROVEMENT PROPOSED USE Resi ntial Non- Residential ❑ New Building Vbne family f ❑Ad ition ❑ Two or more family ❑ Industrial plAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Sgptic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District mater/Sewer_ _ _- DESCRIPTION OF WORK TO BE PERFORMED: �P !3(D �e��b`�l G-, L�se��C►r-�h 1DI��!51'�@�� �i9��� Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: tOL, lVtAofie: 979•-&9L; Address: /0 �, c# "DRIVii Supervisor's Construction License: `S Q 7 oG�3©oZ Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING QERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ fD &*d FEE: $ /20 Check No.: 7- 1_3 Receipt No.: ekI01 NOTE: Persons contracting wunregis ed contractors o not haver ss tot aYanty fund Signature of A, en wner 2,z Signature f contractor i Plans Submitted ❑, Plans Waived El Certified Plot Plan ❑ , Stamped Plans ❑ f -pypE "F 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 Reviewed On Signature_ 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 Os ood 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 Call Email t Date Time Contact Name Doc.Building Permit Revised 2014 f ! sf i 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 o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract Li 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 d Building Permit Application Li Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses a Copy Of Contract ❑ Floor/Cross Section/Elevation Flan 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) a Building Permit Application o 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:Building Permit Revised 2014 1 , Location No. � � Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ �l Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 7JI1s l Building Inspector_ 4/26/2016 Town of North Andover Mail-Fwd:50 Mayflower OVER 26a RMaura Deems <mdeems@northandoverma.gov> achuts, Fwd: 50 Mayflower 1 message Jean Enright <jenright@northandoverma.gov> Thu, Apr 14, 2016 at 11:17 AM To: Skip Cheney <scheney@northandoverma.gov> Cc: Maura Deems <mdeems@northandoverma.gov>, Tim Willett <twillett@northandoverma.gov> Hi Skip, T. Willett confirmed that 70 Mayflower Drive is now 68 Mayflower Drive. I have added 68 to Laserfiche with the map/block/lot of 107.B-0016-0068.0 (same configuration as other addresses within the parcel). The new address, 68 Mayflower, is currently not in MIMAP. Jean ------- Forwarded message -------- From: Tim Willett <twillett@northandoverma.gov> Date: Thu, Apr 14, 2016 at 8:45 AM Subject: Fwd: 50 Mayflower To: Jean Enright <jenright@northandoverma.gov> Yes, it was changed from 70 Mayflower to 68. There is one giant parcel there, with all the condos on it, not separate ones. ------- Forwarded message ------- From: Jean Enright <jenright@northandoverma.gov> Date: Wed, Apr 13, 2016 at 2:55 PM Subject: Fwd: 50 Mayflower To: Tim Willett <twillett@northandoverma.gov>, Skip Cheney <scheney@northandoverma.gov> Hi, Can either of you confirm Ben Osgood's information? If 70 Mayflower Drive has become 68 Mayflower Drive did the map/lot information get changed? Jean -------- Forwarded message -------- From: Maura Deems <mdeems@northandoverma.gov> Date: Wed, Apr 13, 2016 at 2:38 PM Subject: 50 Mayflower To: Jean Enright <jenright@northandoverma.gov> Jean, ` https:Hm ai I.googl e.com/m ai I/u/0/?ui=2&i k=aeO2b3b5c4&vi ew=pt&search=i nbox&th=1541559dga5fOe5l&s i m 1=1541559d9a5fOe5l 1/4 4/26/2016 Town of North Andover Mail-Fwd:50 Mayflower Ben Osgood did not provide the information on the permit but according to GIS it is 107.B-0016-0050.0. 68 Mayflower was originally 70 and I was told by Ben Osgood on 3/18/16 that DPW had made the address change. Maura Maura Deems Building Department Assistant Town of North Andover 1600 Osgood Street Bldg. 20 Suite 2035 North Andover, MA 01845 Phone 978.688.9545 Fax 978.688.9542 Email mdeems@northandoverma.gov Web www.northandoverma.gov +ta , Sincerely, Jean Enright i Assistant Director Community and Economic Development Town of North Andover hftps:Hm ai I.googl e.com/m ai I/u/0/?ui=2&i k=aeO2b3b5c4&view=pt&search=i nbox&th=1541559d9a5fOe5l&si m l=154155gd9a5fOe5l 214 F NORTH Town of And 0 . ti L oh ver, Mass, [CIC MIC Nl WICN V1 A RA'r 0, C1 U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .... �° :.. �!.Nl :� f.�...................... Foundation has permission to erect .......................... buildings ............................ Rough to be occupied as ............ ` /iS�l:. ���: .F: .. ................ '...`.�.a.4�........................... Chimney provided that the person accepting this permit shall in eve.wrespect conform t6 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 ReguWions Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough Service ................. ...... . .. .. .. .. .. .................................. Final G 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. P�a Iia r � F . Rooms c ,tea e- OL i 1 1 } NOTICE NOTICE TO a a TO EMPLOYEES EMPLOYEES O,t� S14• The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL, ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114 2017 617-727-4900 — http:/Iwww.state.ma.us/dia As required by Massachusetts General Law,Chapter 152,Sections 21,22&30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ACE GROUP NAME OF INSURANCE COMPANY P.D. BOX 1450 MIDDLEBORO. MA 02344-1450 ADDRESS OF INSURANCE COMPANY (6562UB-OG23626-9-15) 08-15-15 TO 08-15-16 POLICY NUMBER EFFECTIVE DATES M P ROBERTS INS AGENCY 1060 OSGOOD STREET NORTH ANDOVER MA 01845 NAME OF INSURANCE AGENT ADDRESS PHONE# OLD SALEM VILLAGE OF NORTH HEPATICA DRIVE & ANDOVER CONDOMINIUM TRUST: MAYFLOWER DRIVE NORTH ANDOVER MA 01845 EMPLOYER ADDRESS rte• EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE i MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services �= provided by the treating physician will he paid by the insurer, if the treatment is necessary and reasonably ' connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 011818 W20PIG15 TO BE POSTED. BY EMPLOYER 11 Massachusetts -Department of Public Safety Board of Building aegulatiors and Standards L1 I,UIIJII UlUti JUlJ.3up- I"1 V(.lGl License: CS-075302 BENJAMIN C OSGbOD 69 Old Village Late UJI!North Andover M-A0 .A X41Expiration Commissioner 12/04/201E