HomeMy WebLinkAboutBuilding Permit #35 - 782-802 Waverly Road 7/26/2006 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATIONof N°RT a qti
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Permit NO: J Date Received y
e
r' O4q c
Date Issued: • v OqA 9D
9SSACHU`���
IMPORTANT: Applicant must complete all items on this page
LOCATION � jj_-i.�,(�, ��—
P int I
PROPERTY OWNE �Iti�v�6t rp
Pnnt
MAP NO.: PARCEL: p ZONING
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑New Building ❑ One family
❑ Addition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units:
❑ Repair, replacement ❑ Assessory Bldg ❑Commercial
emolition
❑ Moving(relocation) ❑ Other ❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
t r aJ I�tax��r> ,
Identification Please Type or Print Clearly)
OWNER: Name: I (), t L Phone: DC7– 4�
Address:_ N ,L VA
CONTRACTOR Name: , MA�,,e ���, �� Phone:
Address:_ ZS
Supervisor's Construction License:_ C�C� 8 Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER S� Name: Phone:41`7 -7 2_,5c,
Address: 2 g-, c;)MA4aa Sr ��pau l Reg. No.
FEE SCHEDULE.BULDING PERMIT.•$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost :$ �� p�Q x =FEE:$
Check No.: Receipt No.: ?�
Page 1 of 4
rPublic
F SEWARGE DISPOSAL Swimming Pools ❑ `
❑ Tanning/Massage/Body Art ❑
ewer
❑ Tobacco Sales ❑ Food Packaging/Sales [IWell '
❑ Permanent Dumpster o ite
Private(septInnt
Electric Meter location to
project
NOTE: th unr red c tractors do not have access to ar my fund
Signature Signature of contractoPlans SubnsW ' ed ❑ Certified Plot Plan ❑ St ped Plans ❑OLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
i
COMMENTS '
i
t
0
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
d
COMMENTS
I
Zoning Board of Appeals:Variance, Petition No:
i
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water&Sewer connection/Signature& Date Driveway Permit
Temp Dumpster on site yes—no Fire Department signature/date
i
Building Setback(
Front Yard Side Yard Rear Yard
Required Provided Required Provides Required Provided
DIM
ENSION
Number of Stories: Total square feet of floor area,based on Exterior dimensions.
Total land area,sq. ft.:
j
NOTES and DATA—(For department use)
E
,
M
i
Page 3
f4
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created JMC.Jan.2006
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
i
❑ 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
Addition Or Decks
❑ Building Permit Application
❑ 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)
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
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
i
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Pave 4 of 4
/4�r to 1` 0,5 Cyd` .y
Location Q/) 09_ t 31/',
( (�J No. 635+ a 7 0 Date
MaRT� TOWN OF NORTH ANDOVER
a 6 - rn a
40&0—M�� S
+ Certificate of Occupancy $
Building/Frame Permit Fee $
ACMUS
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
Building Inspector
NORTIy
Town 0 g over
C' _-- LA dower, Mass., •I No. 3 Soo
24,
2COCMICMEWICK
ADRATED
7`S BOARD OF HEALTH
{ PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.... ... .l.0 G.........OQ..•..... 0.........'Q..�................................ Foundation
.................... ... .. ....................... Rough
has permission to TCI`... �!1�lT�................ buildings on .......�.�.� �
•
to be occupied as.......... • Chimney
..... .... .. . . . . .. . . ... . . .. . . . . . . . ... . .....................
provided that the person accepting this permit shall in every respect nform to the terms of the application on file in Final
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 5 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIOW_ TS_ Rough
Service
t-L Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
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.
SEE REVERSE SIDE Smoke Det.
II`
I
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
at: (�b eL f,y is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c11, S150A.
Also, note Permits are required under Fire Prevention laws'Chapter 148 Section
10A.
The debris will be disposed of in:
P�
..
(Location of Facility)-,
Signa"-of1PP=mi-t
Fire.Department Sign off: Od fr,
Dumpster Permit
Date
I
f
it
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54 a condition f
P o Building Permit
at: is that the debris resulting ngfrom this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
C 11, S 150 A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
10A.
The debris will be disposed of m:
(Location of FacCA'
a
Signature of ermit Applic
Fire. Department Sign off:
Dumpster Permit
Date
i
O
anzw Doi P
P.O. Box 154, Fremont, NH 03044-0154
Tel. 603.895.4900 Fax 603.895.4922
Demolition &Environmental ***Inspections&Consulting 'Licensed & Insured
June 21, 2006
Graydon McCormick
72 Turnpike Street
North Andover, MA 01845
Re: Abutters Notification
To Whom it May Concern:
Please be advised that we will be demolishing the homes located at the following
addresses:
1. 768 Waverly Road North Andover, MA
2. 782 Waverly Road North Andover, MA
3. 792 Waverly Road North Andover, MA
4. 802 Waverly Road North Andover, MA
5. 814 Waverly Road North Andover, MA
6. 21 Turnpike Street North Andover, MA
7. 29 Turnpike Street North Andover, MA
8. 35 Turnpike Street North Andover, MA
9. 41 Turnpike Street North Andover MA
,
10.47 Turnpike Street North Andover, MA
We will mobilize on or about July 15, 2006 W begin demolition.
Dan
President, Danley Demolition Inc.
Mad 23 06 09:03a Ins Offices 6036353815 P. 1
ACDM- CERTIFICATE OF LIABILITY INSURANCE OS 23/ooh
THIS CERTIFICATE IS ISSUED AS A mATTPR OF wFoRmATm
Leo Rush Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
25 Old Lawrence Rd HOLDER. TIVS CERTIFICATE DOES NOT AMEND, EXTEND OR
Pelham, NH 03076 ALTER THE.COVERAGE AFFORDED BY THE POLICIES BELOW.
603-635-2539 INSURERS AFFORDING COVERAGE NAIC#
29suPED Danley Dem6 on, ruc waUM A n nsuranae g
Rehfim B sslve
P O Rax 154 eo-qER C, ver n Iters
Fremont, HH 03044 DMAM& nM=ance
603-895-4900 CoIony Insurance/Mating
COVERAGES
THE POLICIES OF INSURANCE LISTED MOW HAVE BEEN MSUED TO THE INSURED NAS ASOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REOURBMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCLWXt WITH RESPECT TO WI9CH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN.THE INSURANCEAFFORDF,D BY THE POLICIES DESCRIBED HEREIN s SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE UMTS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAQASS..FM Rum
�
LtaTYPE OF JUSURAWDE POLICY NUMBER pq DA LUIS
GENERAL LIABILITY EACH OCCURRENCE S , r OW
COMMERCIAL GEN12RAL M t UTY PFSAJISES(EaawRerce S 50,000
CLVIASMADE OCCUR BEOExpikwones-- I S zk�axu
A 0009127 03/29/2006 03/29/2001 PEFwNAL&AD pUURY S A 000 000
r
GENERAL AGGREGATE $ ► r
000
GEN'L AGGREGATE UMIT APPLIES PER PRODUCTS-COMPACP AGG S 11000,000
POLICY PRO- LOC
AUTIOMMMU48JUTY OMONE sn Le LIMIT 5 1,000,000
ALL OWNED AUTOS
BODa.YMJURY S
SCNSDULED AUTOS TPM palsott)
$ HIRED AUTOS 034498870 03/30/2006 03/30/2007
NON•OWNEDAUTOSPROPERTY DAMAGE fP«a nll 5
S
GARAGE UASLff` AUTO)Ob+LLY•EA AGCOW S
ANYAUTO �'
DTHERrr.,w EaACc s
AUTOONLY: A60 S
EXCESSRIWRELLA UA BIUW EACH OCCURRENCE $ , t
OCCUR 0 CLAWMAAE AGGREGATES 2,000,
142343 04/07/2406 03129/200? S —
]s ol=aucnBl>=
$ 10,000 s
s
a MERSCOMPENSRTIONANG XITURMI
C � � � 6S60D838148422 10/17/2005 10/111/2006ROPOUNTOrAIARINSWEXECUTM E.L.�A S ,ouu
aayye� Et D -EA EMPLOYE ,
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PROVI
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OTHER as Per Scasdale
D Equipment Floater 606DIN03719 11/13/2005 11/13/2006
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aEscRl>TIONOFOPERATIOMIL.OCATIDMIVEHICLBS!EXCLUMONSADDEDBYENOO NTJSPECIALPROVLSl0115
DM OLTTION CONTRACTOR
Walgreens, Waverly Street E Route 114, No Andover, MA
Additional insureds but only with respect to work done by insured:
D F Pray Inc, Rice North Andover LLC and Mark Investments Inc
CERTIFICATE HO M
SHOUW ANY OF THE ABOVE DESCRIBED PODS BE CANCELED BEFORE THE EX�tA
D F Pray Inc DATE THEREOF.THE ISSUING WAVER WLL ENDEAVOR TO mAm_30CWYs tNFQIiTeI
Se Anthony Street NO!r(-TOTHE SATE HOLDER NAND HE TOTLEFT,BUTFALURE TO DO SO SHALL
Seekonk, 02?71 WOW NO OBUGATfON OR LiABRITY OF ANY IQND UPON THE NSURER.ITS AGENTS OR
REPRE�rT wws
895-4922 AUTHDTaaaEp ATr4
ACORD26(2001t08)
OACORD COWORATMN1988
07/26/2006 09:05 FAX 15083363384 GFPRAY—FAX-2 001A002
Te B D OF BUtLD (i REGULATTIIONS
License: CONSTRUCTION SUPERVISOR
Number. CS 064841
Birthdate;07101/1966
Expires:0710112006 Tr_no: 1887.0
Restricted: 00
RONALD H LAAPRISE
312 SOWEN ST
FALL RIVER, MA 02724
Commissioner
;//et l[a.w ii"'efi'.s
WARD OF BUILDIP40 RMULATIONS
License: CONSTRUCTION SUPERVISOR
U- Number. CS 064615
Birthdate:00 7j'X35
Expires:0x11?x1007 Tr.no: 12135
Restricted- 00
VINCENT H VILLELLA
181 RESERVOIR AVE �}
$W!1NSEA, FAA 07.777
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7
oMtrt of Neth Andover
Building Dep "matt g� ` �.• �
North /' ndmw lA Oleo Q ,x
Tel: 978 8 .Ow F '
mac: �7
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ENGINEERS (343ess Street
ARCHITECTS assachusetts 02210
PLANNERS .242.9222
CONSTRUCTORS 42.9824
rp.com
April 2,2007
Mr. Gerald Brown
Building Inspector
Town of North Andover
1600 Osgood St.
North Andover,MA 01845
RE: Field Report#8
Walgreens Plaza --
Waverly Road
Permit No. 043
EK Project No.0500.13.272
Dear Mr. Brown:
I have been reviewing Walgreens and PETCO relevant masonry test reports for conformance with the
specifications permitted for construction. In addition I walked the site to review exterior sheathing and
clapboards installed on PETCO&Walgreens and the interior construction of Walgreens. I report that
work done to date,appears to be in compliance with the plans and specifications permitted for
construction.
Should you have any questions please feel free to call.
Very truly yours,
\/4.-avec 4., &00'&
Michael A. Cassavoy,P.E.,R.A.
Vice President
MAC/mac
c: Russ Benassi—D.F.Pray
JA2005 Projects\050013.272\Documents\Construction\Field Reports\Field Report 04-02-07.doc