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HomeMy WebLinkAboutBuilding Permit #1067-15 - 95 LACY STREET 6/17/2015 NoRty BUILDING PERMIT aD,bgtio TOWN OF NORTH ANDOVER -� APPLICATION FOR PLAN EXAMINATION Permit No#: v Date Received ��SSgArED CHu`����� Date Issued: I PORTANT: Applicant must complete all items on this page LOCATION 95- L$e S Print PROPERTY OWNER e F%.vt i I '- Prinf 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yesno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building wr6ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ElAssessory Bldg 11 Others: &Demolition ❑ Other feptc , ell Floodplain ❑1Netlands ❑ ,Watershed District [j Water/Sewer,. ___._ s___. _. DESCRIPTION OF WORK TO BE PERFORMED: s �firre -0 t4 C6�— Identification- Please Type or Print Clearly OWNER: Name: tj `7tiladLg1,1i Fo-&% ;/4, r— )-!,I Phone: '9 Address: jZ,?.�' (-�t� fit. ®-r cry /n Contractor Name: Phone: Email: Address: ' Supervisor's Construction License: Exp. Date: . I. Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No, FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1111000.00 OF THE TOTAL ESTIMATED COST BA/SED ON$125.00 PER S.F. Total Project Cost: $�D, ��Q, ®U FEE: $ 12S Check No.: 23 S- Z Receipt No.: ' p NOTE: Persons contracting with unregistered contractors do not have access to th guaranty fund 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 m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on /Z- /5- Si nature . COMMENT0�bQ �..�� C-)"I C( �Gc.f at ��2 � HEALTH Reviewed on ?�� nature � COMMENTL4 :�—j &�, (C 1 Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Con nection/si nat U316' DrivewaV Permit LPDPW Town Engineer: Signature: FIRE DEPAR+TtMENT tTernDm _ter�onLsite! yes � ,.;.. Located 384 Osgood Street um Locatetl a -T4W[Tgjiain St eet, `` • }" ����"_ "` �" __,� '� r_ ; F reDepart nts g ature/date �, i )' • [. �� -"J'iE��t .a.Ys .a.. ..r � �..-�.nf.•.:.��a.s.oa---.--'-- -- ...s.��-._ate.=_-..-... .����--.:. 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 Date Time Contact Name I a Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. II Roofing, Siding, Interior Rehabilitation Permits 4. Building Permit Application 4. Workers Comp Affidavit �& Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 4� 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) Copy of Contract 2012 IECC 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 rte" Location L Date . - TOWN OF NORTH ANDOVER • ���['LED���' , e • Certificate of Occupancy $ Building/Frame Permit Fee $�2- Foundation Permit Fee $ Other Permit Fee $ A TOTAL $ Check Building Inspector � NORTIi own of toAndover 0 Vh ver, Mass, A I c0c"1c"*W.Cx ,1 S U BOARD OF HEALTH Food/Kitchen PERMIT L D Septic System "� BUILDING INSPECTOR f ��t' ........; ; ....., ........... ...... ........ .. .... J*r ......................THIS CERTIFIES THAT t ...... Foundation has permission to erect .. .................. buildings on ..�....1. (to.. ............................. �00Rough to be occupied as ...........IIIL ................................................ 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MO S ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T Rough Service ..................T. .. ...... .. ..... .... 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. Town of North Andovert%0 R Tii Building Department �0' 'b 0 �f'- '.'�, as6 O L 1600 Osgood Street Bldg 20, Suite 2035 North Andover MA 01845 0 •� � Tel. 978-688-9545 45 Fax: 978-688-9542 DEMOLITION OF BUILDING AFFIDAVIT 019,& Coc"I2 IWICKAreD If `�1 '�S,gSSgC HUS�A,`h DATE OWNER'S NAME &ADDRESS LOCATION OF PROPERTY TO DEMOLISH DESCRIPTION CONTRACTOR'S NAME &ADDRESS DEPARTMENT SIGN-OFFS DEPT. OF PUBLIC WORKS -WATER: SEWER: TREE WARDEN �_1TOWN ENGINEER Q o" `JDEPT. OF CON VA I N O'�HEALTH DEPI.AIAWZ�ffSEPTIC LL f/ HISTORIC COMMISSION v PLANNING AJ ior- GAS IYA ELECTRIC' TELEPHONE l/ tA - � �OTAXESIM't •OA_0(4 POLICE Z7" FIREjt- ' (� � 3 EXTERMINATOR W �\ �` DUMPSTER— ON FF STREET DIG SAFE NUMBER BLDG INSPECTOR Building Demolition Affidavit nationalgrid 40 Sylvan Rd Waltham MA 02451 June 5, 2015 Walter Maribito 95 Lucy St North Andover MA 01845 RE: Service Removal for Building Demolition. Dear Walter Maribito: This letter is to confirm that, per your request, National Grid has removed the meter and the service drop at 95 Lucy St., North Andover, MA as of 6/04/15. If you have any questions or need further assistance, please feel free to contact me at (508) 357-4661. Sincerely, Shimat Kamal Order Processing Representative Customer Order Fulfillment ph # 508-357-4661 fax# 315-460-9149 r Down Payment Amount CK Number Cash$ CC$ AERMI)VIX. Received at Completion Amount CK Number Cash$ CC$ Mission / Cast.# DATE OF INSPECTION 6//,�C/t�t\ RESIDENTIAL PEST CONTROL ONE-TIME SERVICE AGREEMENT PURCHASER r l PREMISES c Name S �'� C �/ .^ �N,,I ) Name Address "r Address r ' City n�_ ,-s�� r ,ll �c�l° City 1J-), K A,\ y_)' State ' r\ Zipo l 'H) State MP Zip Telephone Telephone ' r7 ETelh,.e OfficeAC1 ( �jC1Z) J 1 .�"�+ Route Grade Same Day TERMINIX WILL PROVIDE SERVICE FOR THE PESTS CHECKED BELOW: SERVICE CHARGES FOR YOUR TERMINIX PROTECTION ARE SPECIFIED BELOW: ❑Indoor Tick Control ❑Paper Wasps Service Charge $ ~ C; Plus Tax $ ❑Indoor Flea Control ❑Yellow Jackets Total Amount Due ' ❑Clothes Moths ❑House Crickets METHOD OF PAYMENT- El Black AYMENT:❑Black Widow Spiders ❑Hornets _D Remitted with agreement-check# 2 ❑Remit to Service Technician ❑Brown Recluse Spiders ❑ r�`,c k ❑Post Billing(With Tem inix Management Approval) ❑ Carpet Beetles �'�� ❑Visa/Master Card/Discover/AMEX/Sears NAME AS ITAPPEARS ON THE CARD SPECIAL INSTRUCTIONS: Effective for a period of thirty(30)days from �, /ll `� ,for the sum of$ ) ) (subtotal plus sales tax ),Terminix will service the identified property for the pests checked above. This agreement terminates in thirty(30)days.If additional service is requested during the thirty(30)day period,service will be performed at no additional cost to the Purchaser. This agreement does not guarantee against present or future damage to the building or contents, nor provide for the repair or compensation thereof. This agreement does not provide for the control of subterranean termites, dampwood termites, drywood termites,fungus,wood boring beetles or other pests not checked above. Upon request Terminix will provide the Purchaser with a copy of the manufacturer's specimen label of the pesticides(s)which will be used to treat the premises. NOTICE: YOU,THE PURCHASER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FOR AN EXPLANATION OF THIS RIGHT. THE TERMS AND CONDITIONS ON THE REVERSE SIDE, INCLUDING THE MANDATORY ARBITRATION AGREEMENT,ARE PART OF THIS AGREEMENT t In the event you have any question or complaints,you may contact a Terminix Re{i esentative by calling 1-800-,,TEFMI "((1-800-837-6464 ) 1W-, Terminix Representative Signature' Date Cuhtomer Signature i Dae rminix.com Key93 I / Key#33218 Rev.2/11 RP2/11 02010 The Terminix International Company,Limited Partnership.All rights reserved. TERMS AND CONDITIONS 1. FUTURE DAMAGE.Terminix is not responsible and does not guarantee against present or future damage to the building or contents,or provide for the repair or replacement thereof.This Agreement does not provide for the control of termites,fungus,beetles,or any other pests not indicated herein. 2. LIMITATION OF LIABILITY. in consideration of the sums charged by Terminix hereunder and as a liquidated damage and not as a penalty, and NOTWITHSTANDING ANY CONTRACT,TORT OR OTHER CLAIM THAT TERMINIX SHALL HAVE BEEN NEGLIGENT IN THE.PERFORMANCE OF IT'S DUTIES TO PURCHASER, (I) THE SOLE RESPONSIBILITY OF TERMINIX TO PURCHASER OR ANYONE CLAIMING THROUGH PURCHASER UNDER THIS PLAN OR OTHERWISE IS TO RE-TREAT THE PROPERTY AND (II) PURCHASER AND ANYONE CLAIMING THROUGH PURC14ASER EXPRESSLY RELEASE TERMINI X FROM.ANDAGREE TOINDEMNIFY TERMINIX WITH RESPECTTOANY OTHER OBLIGATION WHATSOEVER TO PURCHASER OR ANYONE CLAIMING THROUGH PURCHASER. THIS PLAN DOES NOT GUARANTEE. AND TERMINIX DOES NOT REPRESENT.THAT PESTS WILL NOT RETURN. 3. NOTICE OF CLAIMS,ACCESS TO PROPERTY. Any claim arising out of or relating to this Agreement must be made during the term of tins Agreement and in writing to any Terminix office;failure to make such written claim during the term shall be a waiver of said claim.The only obligation of Terminix to Purchaser or anyone claiming through Purchaser arising out of or relating to this Agreement is to re-treat and then only if a valid claim is made during the term of this Agreement.In the event of any claim by Purchaser or anyone claiming through Purchaser for anything other than for Terminix to re- treat the identified property'.Purchaser and anyone claiming through Purchase shall pay all of the costs and expenses of Terminix,including but not limited to, attorneys'fees,relating to or arising out of such claim.Purchaser must allow Terminix access to the identified property for any purpose contemplated by this Agreement and failure to allow Terminix such access will terminate this Agreement without further notice. 4. DISCLAIMER. A. The liability of Terminix under this Agreement will be tenninated if Tenninix is prevented from fulfilling its responsibilities under the terms of this Agreement by reason of delays in transportation, shortages of fuel and/or materials, strikes, embargoes, fires, quarantine restrictions, earthquakes, hurricanes.or any other act of God or circumstances or cause beyond the control of Terminix. B. This Agreement does not cover and Terminix will not be responsible for damage resulting from or services required for the failure of Purchaser upon notice from Terminix to promptly cure at the Purchaser's expense any condition witch prevents proper treatment or inspection or is conducive to infestation, EXCEPT AS PROHIBITED BY LAW,TERMINIX DISCLAIMS ANI'LIABILITY AND SHALL NOT BE RESPONSIBLE FOR INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL, EXEMPLARY, PUNITIVE, STIGMA AND/OR LOSS OF ENJOYMENT DAMAGES. THE GUARANTEES AS SPECIFICALLY STATED iN THIS AGREEMENT ARE GIVEN 1N LIEU OF ANY OTHER GUARANTEE,OR WARRANTY OR OTHER RESPONSIBILITY,EXPRESS OR.IMPLIED,INCLUDING ANY WARRANTY OR MERCHANTABILITY OR FITNESS FOR A PARTICULA11 PURPOSE. 5. CHANGE IN LAW.Terminix perforins its services in accordance with the requirements of law.In the event of a change in existing laws as it pertains to the services herein.Tenninix reserves the right to revise the service charge or terminate this Agreement. 6. NON-PAYMENT DEFAULT.In case of non-payment or default by the purchaser,Terminix has the right to terminate this Agreement.In addition,interest at the highest rate allowed will be assessed to and paid by Purchaser for the period of delinquency. 7.ENTIRE AGREEMENT.This Agreement constitutes the entire agreement between the parties and no other representatives or statements will be binding upon the parties.if any part of this Plan is held to be invalid or unenforceable for any reason,the remaining terms and conditions of the Plan shall remain in full force and effect. 8. MANDATORY ARBITRATION.Purchaser and Tenninix agree that any claim,dispute or controversy("Claim")between them or against the other or the employees,agents or assigns of the other,and any Claim arising from or relating to this Agreement or the relationships which result from this agreement, including but not limited to any tort or statutory Claim,shall be resolved by neutral binding arbitration by the American Arbitration Association("AAA"), under the Rules of the AAA in effect at the time the Claim is filed("AAA Rules").Any arbitration hearing at which the parties appear personally will take place at a location within the United States federal judicial district in which Purchaser resides.AAA Rules and forms may be obtained and all claims shall be filed at any AAA office,www.adr.o b or by calling 1-800-778-7879.Each party shall be responsible for paying its own attorneys'fees,costs and expenses; the arbitration fees and arbitrator compensation shall be payable as provided in the AAA Rules.However,for a Claim of$15,000 or less brought by Purchaser in his/her/its individual capacity,if Purchaser so requests in writing,Terminix will pay Purchaser's arbitration fees and arbitrator compensation due to the AAA for such Claim to the extent they exceed any filing fees that the Purchaser would pay to a court with jurisdiction over the Claim.The arbitrator's power to conduct any arbitration proceeding under this arbitration agreement shall be limited as follows:any arbitration proceeding under this agreement will not be consolidated or joined with any arbitration proceeding under any other agreement,or involving any other property or premises,and will not proceed as a class action or private attorney general action.The foregoing prohibition on consolidated,class action and private attorney general arbitrations is an essential and integral part of this arbitration clause and is not severable from the remainder of the clause.The decision of the arbitrator shall be a final and binding resolution of the Claim.This arbitration agreement is made pursuant to a transaction involving interstate commerce and shall be governed by the Federal Arbitration Act,9 U.S.C. Sections 1-16.Judgment upon the award may be entered in any court having jurisdiction.Neither party shall sue the other party with respect to any matter in dispute between the parties other than for enforcement of this arbitration agreement or of the arbitrator's award.THE PARTIES UNDERSTAND THAT THEY WOULD HAVE HAD A RIGHT OR OPPORTUNITY TO LITIGATE DISPUTES THROUGH A COURT AND TO HAVE A JUDGE OR JURY DECIDE THEIR CASE,BUT THEY CHOOSE TO HAVE ANY DISPUTES DECIDED THROUGH ARBITRATION. 9. SEVERABILITY.If any part of this agreement is held to be invalid or unenforceable for any reason,the remaining terms and conditions of this agreement shall remain in full force and effect. BOSTON Residential Exterior General Pest Control 84 CUMMINGS PARK Master Agreement#:8341-0187525 ,r,ERM1111O WOBURN, MA 01801 Work Order#:13975865297 (800)837-6464 Customer Name: STEPHANIE O'MAHONY Home Phone: (978)686-3332 Service Technician: BRADY,JOHN J. Date/Time In: 06/16/2015 01:33 PM Contact Name: Work Phone: (978)683-1164 Employee Number: 8341 Date/Time Out: 06/16/2015 02:10 PM Customer#: 3434209 Cell Phone: License/Cert#: 22551 Page: 1 Sales Agrmt#: 15043928 E-mail Address: somahonyelectric@yahoo.com Supervisor Name: ELFSTROM,BRETT D. Service Address: 95 LACY ST Supv.License/Cert#: 31350 NORTH ANDOVER,MA 01845 Service Type: Special Billing Address: 143 LACEY STREET Customer Since: NORTH ANDOVER,MA 01845 General Information Areas Inspected:Inside&Outside Material Usage Generation Mini Ellks. Pests Targeted Post Treatment Precautions Active Chemical: DIFETHIALONE 0.0025% Mice-No Activity Noticed Do not tamper with or touch rodent traps EPA Reg#: 7173-218 Treatment: Bait Placement Applied Amount: 10.000 Each(200 gm) Equipment: Tamper-Resistant Station Areas Inspected/Treated EXTERIOR AREAS Trap-Glue--Rat Pests Targeted Post Treatment Precautions Active Chemical: NONTOXIC Mice-Activity Noticed No post-application precautions recommended. EPA Reg#: EXEMPT Norway Rat-Activity Noticed Treatment: Rodent Trap Placement Roof Rat-Activity Noticed Applied Amount: 6.000 Each Equipment: Trap--Glue Areas Inspected/Treated BASEMENT-RESIDENTIAL Comments Thank you for choosing Terminix.Your business is appreciated. Summary of Charges Previous Balance: $0.00 Current Charges: $250.00 Subtotal: $250.00 Tax: $0.00 Total: $250.00 Pa merits Method of Payment:Check number 36842 $250.00 Customer Service Technician Signature: `- � Date:06/16/2015 Signature: Date:06/16/2015 STEPHANIE O'MAHONY JOHN J.BRADY Customer payments can be made either at www.terminixcom or by mailing payments to:Terminix Processing Center,PO 8ox742592,Cincinnat;OH 45274-2592.Please include your customer number,noted above.Call 1-800-TERMINIX with questions or to find out about our Easy Pay options. Call 1.800.TERMINIX or visit Terminix.com I©2014 The Terminix International Company Limited Partnership.All Rights Reserved.37335 1 i BOSTON Residential Exterior General Pest Control TERMINIXO 84 CUMMINGS PARK Master Agreement#:8341-0187518 WOBURN, MA 01801 Work Order#:13105095433 (800)837-6464 Customer Name: STEPHANIE O'MAHONY Home Phone: (978)686-3332 Service Technician: BRADY,JOHN J. Date/Time In: 06/16/2015 12:31 PM Contact Name: Work Phone: Employee Number: 8341 Date/Time Out: 06/16/2015 01:26 PM Customer#: 3434209 Cell Phone: License/Cert#: 22551 Page: 1 Sales Agrmt#: 10186375 E-mail Address: somahonyelectric@yahoo.com Supervisor Name: ELFSTROM,BRETT D. Service Address: 143 LACEY STREET Frequency: Quarterly Supv.License/Cert#: 31350 NORTH ANDOVER,MA 01845 Service Type: Regular Billing Address: 143 LACEY 57REET Customer Since: 6/14/10 NORTH ANDOVER,MA 01845 General Information Areas Inspected:Inside&Outside Material Usage 565 Plus XLO Formula II Pests Targeted Post Treatment Precautions Active Chemical: PYRETHRINS.5%PIPERONYL BUTOXIDE Wasps-Activity Noticed Harmful if swallowed. 1% EPA Reg#: 499-290 May cause eye,nose,throat,or skin irritation. Treatment: Contact Treatment Applied Amount: 2.000 Ounce Equipment: Aerosol Areas Inspected/Treated EXTERIOR AREAS Maxforce FC Ant Gel Bait Pests Targeted Post Treatment Precautions Active Chemical: FIPRONIL.001% Pavement Ants-Activity Noticed EPA Reg#: 432-1264 Treatment: Bait Placement Applied Amount: 2.000 Gram Equipment: Bait Gun Areas Inspected/Treated KITCHEN Termidor SC.06% Pests Targeted Post Treatment Precautions Active Chemical: FIPRONIL 0.06% Carpenter Ants-No Activity Noticed Do not allow unprotected persons,children,pets to touch/replace EPA Reg#: 7969-210 items/bedding,to contact/enter treated areas til dry. Treatment: 1 ft Up and 1 ft Out Perimeter Band Applied Amount: 4.000 Ounce Equipment: Comp.Air Sprayer Areas Inspected/Treated EXTERIOR AREAS Tri-Die Bulk Dust Pests Targeted Post Treatment Precautions Active Chemical: PYRETHRINS)%,PBOIO%,SILICON GEL400General Spiders-Activity Noticed Avoid breathing vapors,mists,or dust. EPA Reg#: 499-429 _ Treatment: Crack&Crevice Treatment Harmful if swallowed. Applied Amount: 0.200 Ounce Equipment: Hand Duster May cause eye,nose,throat,or skin irritation. Areas Inspected/Treated BASEMENT-RESIDENTIAL EXTERIOR AREAS GARAGE Comments Thank you for choosing Terminix.Your business is appreciated. Summary of Charges Previous Balance: $-324.00 Current Charges: $106.00 Subtotal: $-216.00 Tax: $0.00 Total: $-216.00 Auto Pay Exp 05/16 Customer Service Technician �� Signature: Unavailable Date: Signature: Date:06/16/2015 JOHN J.BRADY Customer payments can be made either at ww vterminixccm or by mailing payments to:Terminix Processing Center,PO Box 742592,Cincinnah,OH 45274-2592.Please include your customer number,noted above,Call1-800-TERMINIX with questions or to find out about our Easy Pay options. Call 1.800.TERMINIX or visit Terminix.com I©2014 The Terminix International Company Limited Partnership.All Rights Reserved.37335