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Home My WebLink AboutBuilding Permit #115-14 - 88 HAY MEADOW ROAD 5/1/2018 r' �1ORTH 1) 00�«ao BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: z�.'I y Date Received Date Issued: �9SSACNUSEt IMPORTANT: Applicant must complete all items on this page LOCATION (�V Na,-1 1°t�'G�0.oi.J oetc, Ahr (nA +r1Aqyer 0'J/ UIS(IS Print PROPERTY OWNER A10 Print MAP NO: 101- 6 PARCEL:A I0 ZONING DISTRICT: Historic District yes n 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 ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer -� i13 t .2 7' aSP yu J �red- -fro k $ Jro p!a c�. �o �e H c e t or- toll 1.4 k� AOONyed ky �yvtrely�f;oy�� ivy ties Identification Please Type or Print Clearly) OWNER: Name: Phones Address: NO r c/ /VL�/D a C/ CONTRACTOR Name: 97 "f Phone: Address: �9 A41k fir' Al ACS l k /V a 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: $ Z�5FEE: $ 00 Check No.: 6"60 Receipt No.- Abe;96 s NOTE: Persons contracting with unregistered contractors do not have access to th guaranty f d Signature of Agent/Owner Signature of contracto i 'J ICA Plans Submitted ❑ PlansWaived-[] 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 I .CONSERVATION Reviewed on �� - � Si nature COMMENTS &D C - 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 f DPW Tow;; Engineer: Signature: Located 384 Osgood Street 7Fire' DEPARTMF-;*SIT =Temp Dumpster on site yes. no I d at 124 Mair, Street Departinerit-signature/date o b r{ e y 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 i ® Notified for pickup - Date Doe.Building Permit Revised 2010 Building Department The folCowing isa list of the required forms to be filled out for the appropriate.permit to be obtained. I Roofing, Siding, Interior Rehabilitation Permits Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses Li Copy of Contract o 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 o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) L3 Mass check Energy Compliance Report (If Applicable) Li 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) Li Building Permit Application o Certified Proposed Plot'Plan o Photo of H.I.C. And C.S.L. Licenses a Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report Li 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 apn--al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application i Doc: Doc.Building Permit Revised 2012 1 � i Location No: �7 Date / A • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 2 9 & 6 � 6 BurGng Inspector 08/02/2013 FRI 10:22 FAX 1 781 324 4253 Paul Murphy Insurance 2001/001 �® CERTIFICATE OF LIABILITY INSURANCE �'�`""`�e '13 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 CERTIRCATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A staiBment on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Paul T. Murphy Insurance Agena PHONEFax 626 Broadway EIC.N 781 321-9700 A/ No. (781) 324-4253 -MAILS : Malden, MA 02148 INSURERS)AFFORDINO COVERAGE NAIC/I . .. . ..__ INSURER A:Safety INSURED _..•___... INSURER a-Zurich Cooper Bros Asphalt Paving Inc INSU RER0 57 Long Pasture Rd INSURERD: North Andover, , MA 01845 INWRER s- 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 - -'ADD S POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MIDDY MM/DD/YYYY LIMITS A GENERALUABILITY BNAOO10388 5/9/13 5/9/14 EACH OCCURRENCE $ 1,000,000 X §OQNQA RCIALOENERALLlAB1UTY DAMAGE TORENTr $ 10 CLAIMS-MADE OCCUR ME SXP(Ary ono,Porxm) $ 10,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGRECATELIMIT APPLIES PER PRODUCTS-00MP/OP AGO S 2,000,000 POLICYPROT- 40C $ A AUTOMOBILELIABIUTY 1501305 7/13/13 7/13/18 E.TidMl $ 1,000,000 ANYAUTO BODILY INJURY(Por poison) $ --ALLOWNED X SCHEDULED !ltl P BODILY INJURY(Per accident) $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPHRfY DAMAGE AUTOS oroccidoni $ A X UNBRELLALIAB X OCCUR Cl-U0001316 5/9/13 5/9/14 EACHOCCURR&NCE s 1,000,000 EXCESSLIAB CLAIMS-MADE AGGREGATE S 1,000,000 DED RETENTION S $ MRKERSCOMPENSATION AND EMPLOYERS'LIABILITY Y I N 005147063 5/2/13 5/2/14 X Tr, CS'TATU• OTN• ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIOEM' S 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NHl E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yYea describe under DES,RIPTIONOFOPERATIONS below E.L.DIS EASE-POLICY LIMIT S 1,000,000 i DESCRIPTION OF OPERATIONS/LOCA71ONS/VEHICLES (Attach ACORD 101,Additional Rams Aa Schedule,E more spam Isrogrirod) Paving-Coverage subject to policy terms, conditions, and exclusions. CERTIFICATE HOLDER CANCELLATION 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. North Andover, MA AUTHORIZED REPRESENTATIVE cis 198 1D ACORD CO ION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks ACORD Phone: Fax:. (978) 688-9542 E-Mail: r , NORTH uc ' ver 0 � - No. * - h ,� ver, Mass, Coc NICMt WICM �1 s � BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ......... ... .. ............... V/i...G�� c� .. .......................................... BUILDING INSPECTOR ../... .. ..... ......�� ...../ t� L ►�/ <e O' Foundation has permission to erect.......................... buildings on � �!" ` ....:........ ..................:'�.......... ..................... Rough to be occupied as .................. X.v2.7...................... ....................... 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ................. ..... . ..:__::�"7....................... Final BUILDING INSPECTOR 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. SEE REVERSE SIDE Commercial • Residential • Industrial OOpeP P.O. Box 1084 • Andover, MA 01810 Bios_ cooperbrospave@yahoo.com ,� Asphalt Paving, Inc. Family Owned and Operated •_•' ''� "3rd Generation Committed to Excellence" www.cooperbrospaving.com (978)475-3259 (800)660-5599 FULLY INSURED PROPOSAL SUBMITTED TO ii PHONE DAT STREET JOB NAME CITY,STATE AND ZIP CODE JOB LOCATION J�✓ CONTACT PERSON FAX CELL PHONE 0a gyp\ gy V U We hereby submit specifications and estimates for: Dig out old asphalt, loam, rocks, etc., excavate area for desired size and dispose Re-grade and compact gravel base as needed 2( Install ( 1 ; ) inches of binder coat asphalt V Install ( �, !. ) inches of finish coat asphalt CA ❑ Clean existing pavement area, apply tack coat for adhesion, install leveling course of asphalt as needed for new paving ❑ Reclaim/Pulverize existing pavement 1—�,,—"'> . ❑ Emulsify and sand all joints upon completion for adhesion 41 Comments: i Notes: *Proposed Price is based on current liquid asphalt cost,any increase in this cost will have to be adjusted accordingly if said increase occurs upon inception,acceptance,or construction phase of this project. *Payment by credit card will be charged a 3%processing fee. Pe Prapose hereby to furnish material and labor—complete in accordance with above specifications, for the sumQ f: d dollars Payment to be made as follows: All workmanship is guaranteed for ( ) year(s).All work to be completed in a AUTHORIZED workmanlike manner according to standard practices.Any alteration or deviation from above specifications involving extra costs will be executed,and will become an extra SIGNATURE charge over and above the estimate.Cooper Bros.,Inc.cannot be held responsible for chemical spills,vegetation growth,tire marks or marks due to sharp objects,tunneling or burrowing by small animals ie.chipmunks etc.,evidence of clay material or any low Note:This proposal may be withdrawn by us if not lying areas retaining water.Customer to adjust landscape when and if necessary for accepted within days. new pavement.All materials furnished by Cooper Bros.,Inc.are at approximate depths p y before compaction,and are owned by Cooper Bros.,Inc.until paid for in full.Customer agrees to save and hold harmless Cooper Bros:, Inc.Asphalt Paving.Cooper Bros., Incre does not recommend or guarantee resurfacing badly cracked areas.Incorporated ference is the standard terms and conditions on the reverse side of this proposal. repIaxtre crf 19rnVa9a -The above prices,specifications conditions are satisfactory and are hereby accepted.You are SIGNATURE orized to do the work as specified.Payment will be made as ned above. SIGNATURE e of Acceptance 88 Hay Meadow Road, North Andover, MA 01845 Asphalt Court for Kids Layout—Aug 2013 Michael Foley 617-501-5484 1 I 6 1 i IN 1 1 lb i 9 3iR1,1,131 14 I In l I UFlat ii 1 a emifytha 4 D Q r s s - {:� �.4" ; �' w .�; _ > •1 • +�r uta r c NIL_ il't �� ri h� is _ ,+l • � �- �� ti � '�ti I.�-.,�!•�t� :. �� r J~ 10 CL i.J � / �.t '.'; � �' ! + def tf. •�: �I r i 1 1 � r Fi ti � t.;r; -ter •- , 8 23'x 27' 40 40 : ..•:• 1 t,;� J I goo ��'- �•�^ .,_iii +'"� _ .�� S• Qm ..ry •r.�, ^f IN NORTH ANDOVER- MA. REM LAW SURME"MS i L wTl,GtM ST., LYAIIL MSS. � t certify that the dwelling is X„fir i located as shown and can- formed to the zoning laws of WILLIAM 1 �Q '7'f RALPH O 806 2SQ2 when mmstructed 4 A6,-#h i wcpdd � f r f t i . .o C) ,v • ff F • ! t 'r Y, crIFY rar c ArY Q7Y�'E rmr 71,x" Sy y �, AV tars aAN MS A�PAR� Afi�i A IMS PLAN A/,'�-Aqr[L�Ci1TEt7 WITh1N A PLA�7 TAPE JWAWY 4W M MT&p F49 iwzAf AREA AS LMZASATM GLV 71'1 `MP Aig9IMsE pgovgkS 4%y. 4cF&r-7S P5f W f IrY f,e,,00vaV 49 z79Y TAF I Y ALAN ,fHf �Y AGIA6/6,iE1VT A Y qq !f AbT 6tE IT'S .��L grm �/,�8/�. LCSE�! J7T LdE'7 fN1I/1 fi�i�79��,iTY.I r1> cmrxrr rwr mfrs I��°LcCTIQN M .DV AL�7�i ' A 1H Me 1 1 NlCtL STAAQU , FW m14Ti W im.w 1�'TIpKS" AS AWTED QY TIS'Au p.-,... Bq;1[c'3o�i P'Al 33> CERT. V^�51+ 7"s A6`2A7IGW cis'LAAIl7 3'G14Y `!7 C1YIL E1NSIA S, CaVM >f 09/-v 33-y ,t Z00'd BS£.6# £SLZSL6BL6 SZ:£Z 800VZT*.r)fIY