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Home My WebLink AboutBuilding Permit #1315-2016 - 85 HILLSIDE ROAD 6/16/2016 Y pORTM O�sT�ec iagti BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received A �,SSA Date Issued .(.0 CHUS�tt IMPORTANT: Applicant must complete all items on this page LOCATION .PRORERTY,OWNE �'2' Print MAP NO PARCEL: ZONING bISTRICT' Historic District yes no Machine Shop Village yes - no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ane family Addition _ Two or more family n Industrial h Alteration No. of units: n Commercial eo Repair, replacement - Assessory Bldg n Others: -1 Demolition - Other Septic, ''n.Well Floodplain, n Wetlands n Watershed.District Water/Sewer Identification Please Type or Print Clearly) , OWNER: Name: F_)o Psqt,0 (� S CKA A(,t 1AtJ Phone: 716 '(a 8 7- t 7 Zig Address: l UL C D T 0 l /K_ -CONTRACTOR Name: _Phone: "Address: ,-^ Supervisor's Construction.License• � Ex Date: Home Improvement License: Exp: Date:„ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLD/ G PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: i ®� FEE: $ Check No.: L419VReceipt No.: M52 NOTE: Persons contracts with nregi ered contractors do not have access to the g ty fund Signature of Agent/Owner nature of:contractor' w t i • 3r ti NORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION T Z• y�j O m ,P 1. 4 a` Permit No#: Date Received � °R•tTEU PP 45 SSq CH use Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes 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 . El Septic . ❑1Nell ` ' ❑°FI©odplain 1Netlandsf ❑t,Watershed�'Ristnetn 3 ❑Water/Sewer , DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email. Address: i Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ._ -- -- Plans Submitted ❑ Plans Waived ❑ Certified Plot flan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sew ❑ Tanning/Massage/Body Art ❑ Swiumning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature i COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature & Date Driveway Permit DPW`gown Engineer: Signature: Located 3 Osgood sg Street t F E DP�R�TIVIENT TempDumpste ion siteyesY � � �k ,; cx, `nog ' , ., `►; iLocated at 124 Mam St_ est, ark ` .�, _�„` R. fw ter{ Fire ®epa men Signa..— /date ,,•°,,r� f 1 ' �e,.+.i•a `� .imsa. � .'eT"..�:.�'F2"" l—�*'-+'�,'4�"`i1`2""�i.`.�- �' i t E NITS' Y r "; _` v I i i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. f I Total land area, sq. ft.: I I ELECTRICAL: Movement of Dieter location, mast or service drop requires approval of Electrical Inspector Yes No I, DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department apse) i I ti i t �I i i ® Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit 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 Floor/Cross Section/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 OTE: 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) a Copy of Contract I 2012 I ECC 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 Altr'^ r l�till y f No. _.-G f, Date 45fq10 i • • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit.Fee $ I : Foundation Permit Fee $ i Other Permit Fee $ N TOTAL $ t t. j Check# t1 �R Building Inspector f Enter construction cost for fee cal - North Andover Fee Calcination Construction Cost 22,000•.00 m $ - $ 264.00 Plumbing Fee $ 33.00 Gas Fee 100 comm. $ 110:01.00, Electrical Fee $ 33.00 Total fees collected $ 430.00 85 Hillside Road 1315-2016 on 6/16/2016 2 bathroom remodel NORTH ® : EAndover O 0 s� p h ver, Mass, �o�«��«ew.cK �1• �dS RATED VBOARD OF HEALTH PERMIT L 0 ummk Food/Kitchen Septic System THIS CERTIFIES THAT ... ... .�P��/': . ........ ....... .. . . ... .. ..�. .. .. ,. 9 ,,, BUILDING INSPECTOR has permission to erect ........ buildings on ... .. „�,�„�, ,,,,,6. Foundation .. .................. ....... Rough to be occupied as .� � ... ..flAn . ..:... ..., .�. .... y ,,,,,,,,, ...... Chimne provided that the person accepting this permit shalry respect conform to the t ms of the app kation 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TIONS Rough Service . ... .. .. .. ... ........ ....... Final BUILDING IN TO GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools n Well ❑ Tobacco Sales ❑ Food Packaging/Sales -1 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 ❑ ❑ COMENTS CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street I� FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main.Street. Fire Department si natu reldate COMMENTS :;- �a�"�*��. 1 ' , 1 ` e � t - I 60 . i all 4 . s-- t Z`- I N - 1, 4 v ` \ f a Y Via- The Commonwealth ®f Massachusetts , a Department of Fire Services Office of the Maze Fire Marshal "'T a P.0.Box 1025 State Road,Stow,MA 01775 Permit NoIY1 PERM. 1T T Date; (City of Town) (Mf pplicable) Dig Safe Number Mn accordance with the provisions of M.G.L. Chapter 10as provided in section 5 2 7 CMR 34 This Permit is granted to: Start Date Full name of person,Firm or Corporation Permissionto locate dumpster for construction/renovation/demolition of structure Comments: dumpster be 25 ' from structure or covered with tarp or plywood Restrictions: at end of workday at (Give location by street and noor describe in suc manner as to provied adequate identification of location) Fee Paid This Pe will expire ( ignature of offccal granting pe Offical granting permit (Title) TNIC PPP MIT M!LCT RF r-f)PJ-qPIC'I Ifll ICI V PncZTt=n I IPnM TNP PRFMICFq .r CHRIS-8 OP ID:KW CERTIFICATE OF LIABILITY INSURANCE DATE(M4/20 osrlr2o6 1 s THIS 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 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 COONNTACT Fitts Insurance Agency Fitts Insurance Agency,inc. NA PHONE Fax 2 Willow Street,Suite 102 AIC No EI:508-620-6200 Arc No):508-481-0227 Southborough,MA 01745-1020 EnMA L Fitts Insurance Agency s:info@fittsinsurance.com INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Commerce Insurance Company Z34754 INSURED Chris Arena INSURER B: Arena Construction 139 Forest Street INSURER C: Franklin,MA 02038 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 TYPE OF INSURANCEDL SUBR POLICY EFF POLICY EXP LIMBS LTR I SD WVD POLICYNUMBER MMIDD MMIDD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE FRIOCCUR P7258 0810112015 08/0112016 DAMAGE To RENTEU PREMISES Ea occurrence $ 100,00 X Business Owners MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,0110,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY❑JPERCOT- F—]LOC PRODUCTS-COMP/OP AGG $ 2,000,0011 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT aaccident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE Paraccidm» $ HIRED AUTOS AUTOS $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONPE OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS r LOCATIONS/VEHICLES(ACORD 101,Additional Remarl s Schedule,may be attached if more space Is required) Contractor CERTIFICATE HOLDER CANCELLATION TOWNNO3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept 1600 Osgood St. AUTHORIZED REPRESENTATIVE North Andover,MA 01845-2909 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ARENA-1 OP ID:SH DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 06H412016 THIS 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 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 HONE CT Robert A.Fair Jewell Insurance Agency,Inc. PHONE F 1101 Worcester Road Arc Nc Ext:508$79-1310 FA No): 508-872-2764 Framingham MA 01701 E-MAIL RobertK Farr ADDRESS: INSURERS)AFFORDING COVERAGE NAIC d INSURERA:Continental Casualty Company 2044.3 INSURED Christopher Arena d/b/a INSURERS: Arena Construction INSURERC: 139 Forest Street Franklin,MA 02036 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. MSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INMS WVTI POLICY NUMBER MIDDIYYY MMIDDIYYYY LIM11S COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE FIOCCUR DAMAGE 0 ENT PREMISES(Eaoccurrence) $ MED EXP(Any one person) $ _ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO ❑LOC PRODUCTS-COMPlOP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER7_7511-1- AND EMPLOYERS'LIABILITY STATUTE I JER A ANY PROPRIETORIPARTNERlEXECUTIVE YIN 6S59UB-4605P27-2-16 04/14/2016 04114/2017 E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? El N 1 A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB 1$ .5100,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached K more apace Is required) CERTIFICATE HOLDER CANCELLATION NORTAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Department AUTHORIZED REPRESENTATIVE Fax: 978-688 542 � I� 1600 Osgood Street North Andover MA 01845 d' ""'�� n 4000 71114A Arn0n!`n00nDATink1 All.;-kk..,...a i Office of Consumer Affairs and Business Regulation F 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement COntractor Registration Registration: 132752 Type: DBA Expiration: 4/2/2017 Tr# 262961 ARENA CONSTRUCTION CHRISTOPHER ARENA - 139 FOREST ST FRANKLIN, MA 02038 _ Update Address and return card.Mark reason for change. SCA i Co 20M-05/11 Address [:] Renewal ❑ Employment ❑ Lost Card �%1e�a�n�nantuerrllL�f^.��j'a;t;trcc�urn(li _ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 132752 Type: Office of Consumer Affairs and Business Regulation VExpiration 4/2/2017 : DBA 10 Park Plaza-Suite 5170 ARENA CONSTRUCTION Boston,MA 02116 CHRISTOPHER ARENA 139 FOREST ST FRANKLIN,MA 02038 Undersecretary Not valid without signature i i I if Massachusetts-Department of Public Safety Board of Building Regulations and Standards License: CS-057809 t:rrz CHRISTOPHER S ' 139 FOREST ST FRA IIaM MA Expiration .6rgc. Commissioner 07/18/2017