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HomeMy WebLinkAboutBuilding Permit #359 - Exception 11/7/2007 MUILuirvv TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received �SSACHUgE� Date Issued: 6 IMPORTANT Applicant must complete all items on this age 1 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family [I Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ROOM [�ESCRIPTI NOF WORK TO BE PREFORMED: G22.e 1lent' icatio—n Please Type orPrint Cle�rly) Wd OWNER: Name: ,g &41 e � Phone: Address - iii F eti 4��� N � �' �I&I����j��I� 'K' k 5 P ����� d�'IS� P''h•'C � �.�rrirZ'^�y`,.y': ., ARCH Phone:,.! -_ 9f� Re No. Address: g FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ d.Sdff " FEE: $ Check No.: 1 Receipt No.: d� NOTE: Persons contracting with unregistered contractors do of hav acc to the guaranty fund .nxaw,�ca aou ussaxu ,..r�. ,.n,, 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 - U FORM DATE REJECTED DATE APPROVED PLANNING &.-DEVELOPMENT ❑ ❑ COMMENTS _ DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVE HEALTH ❑ El COMMENTS Zoning Board of Appeals: Variance, Petition No: -Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature & nate Located at 384 Osgood Street Driveway Permit ' j " D z �. k( `j.Fh 7-777 a .:.,µ s ,:' sad' ill--- F 2�, ��. s sx >s rpe m w rt �uJ s r Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq.A.: 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 - Date Doc.Building Permit Revised 2007 �` ' 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 NOTE: 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/Crossection/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 NOTE: 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 c3 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location /Dl S ei4/ O,cfT No. Date NORTM TOWN OF NORTH ANDOVER 3? � . 0� F 9 Certificate of Occupancy $ �ss+cHust Building/Frame Permit Fee $ Foundation Permit Fee $ " Other Permit Fee $ 4 TOTAL $ Check # 2071 ] Building Inspector V40RTII Town of No. o dover, Mass. y T O �+ LAK 1 ' .Q COCMICKEwICK �ipSDRATED l BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.......... .....CI. .....oci Irl........ BUILDING INSPECTOR... .�.. Foundation has permission to erect........................................ buildin s ow.. Lire! �r r#A .. . ............ r1i ............ .... Rough to be occupied as... �� ��ir�„ Chimney .....0!........� I"'1. provided that the person accepting this p d shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUSTARTS ELECTRICAL INSPECTOR Rough ....................................................................... _ ............... Service BUILDING INS Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. Clio 26095 3ILVIE3 ACORD. CERTIFICATE OF LIABILi7YM,INSURANCE o7/MT PRooucBIe :TitIS tiR11HlICATi 101li6tlW Ai A MATTt1R a INfORUATION ; d.K McWRhy Ins.Agcy.Inc. ONL1TANo CONPERti NO R16MT8 UPON TNR CERTUICATE 10 Centennial Drive YlN�COtTIFICw1R 0=NOTA1IIQt0,9XI OCR Aum THE ammAOE ArPORO W BY THE POLICES BELOW. Peabody .MA 01960 978$32-U" IN81lRERS AMRD811G COVERAGE �NAJC INVAGO INsURER k, ArmrlCar+States Insurance Company 33618 Silverio Construction Inc. ;N3uaERa The Charter Oak Fre Insurance Compa 543 Woburn Street INSUIIERD: 30oq Indemnity Insurance Co. Wilmington,MA 01887 I,eURERD, IIALNIBR Q COVERAGES THE POLICIES OF INSURANCE U4T33O BELOW HAVE OWN 133UEO TO THE INSURED NAMED ADOBE FOIL THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHIP DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUGD OR MAY PERTAIN.THE INSURANGS AFFORDED SY THE POLICIES OESCri10E0 HERRN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITICNS OF SUCH POLIC43.AGGREGATE LIMITS SHOWN MAY MAK SEEN REDUCED YY PAID CLAIMS, TYPE OF BISURANOE POLCY WISER tT1v! 04 LIMRi A GENERAL L.IA AFY 01COSS49183 07131/07 07/31/08 FAC+OCCUaaENOE $1,000,000 AMA r NTED X CGMMERGAL GENERAL LIABILITY 3000 CLAIMS MADE a OCCUR MED EXP( arm WMI) $10,000 PERSONAL LADY INJURY S1.000.000 3ENERALAOCREGATE s2.000.000 GEYL AGOR90ATE UNIT APPLIES PER PRODUCTS•COM►IOP ADO s2.000.000 POLICY LOC C AUTOMOBILE LIABILITY 3116540 07/31/07 07131MS COMBINED SINGLELIMR $ (EA sdddsn0 ANY ALTO ALL OWNED AUT03 SOGLY INJURY 32501000 X scnEDULEDAuros (Pu ww) X 1«aED AUTOS iK dm)INJURY $500,000 X NON.OVVNEO AUTOS PROPERTY DAMAGE $100.000 (ru wadant) GARA*E LIA HUTY AUTO ONLY-CA ACCIDENT 1 ANY AUTO OTHER THAN EA ACC $ AUTO CNLY: AGG f Exca6VUNIBRELLA LIABINTY EACH CCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE S $ cEOUCT SLE j FM'ENTION 3 $ B woRlcEasco.PENaATaN AND XOU84833Y93707 07/31!07 07!31!06 X wC STA u- crn• EwLOYERs LIABILITY E.L.EACH ACCIDENT 3100 000 ANY PRcpmjfTOR/PARTNER'EXECUTIVE O"ICEIVMEMBER EXCLUDED? j E.L.CIFAASE-EA EMPLOYEE1$100,000 If yes,doWto VidaE,L.CISEASE-POLICY LIMIT 3500 000 b SPE I v IONS bew OTNEN I I 0M RIPTION OF OPERATIONS)LACAnom I vaKcLBs I EXCL.USION3 ADOEO BY ENOMEkWAT I SMCLAL PROVI=-%* CERTIFICATE MOLDER CANCELLAT N SrWULD ANY OF THE ABOVE DESCRIBED POUCIEE BE CANCELLED KFONE THE EXPIRATION For Insured's Purposes DATE THEREOF,TNEKiU1NGINSVRER'MLLENCEAVORTOWAIL _Ifi— 0AY3Vvm TEN Nonc&TO THE CERTIFICATS HOWIR NAMED TO THE LER,BUT FAILURE TO 00$0 31MLL NrPOE!MO DOUGATION OR UAYIUTY OF ANT 0M UPON THE IN3UREa-ITS AGENTS OR RE►RQEENTATMES. O M'�• TATTVE ACORD 25(2001109) 1 o(2 It54M LEG 0 ACORD CORPORATION 1IIIB8 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to,operaWa business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25CM states"'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #k 6.17-727-4900 ext 406 or 1-877-MASSAFE ` Fax# 617-727-7749 Revised 1122-06 www.mass_gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations w 600 Washington Street Boston,MA 02111 � <W www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print):,e ibl Name(Business/Organization/Individual): Address: City/State/Zip: Phone.#: Are on an employer?Check the/appropriate box: Type of project(required):,, 1. I am a employer with 4. E] I am a general contractor and I employees(full and/or part-hme).* have hired the sub-contractors 6. ❑New construction 2.❑ Lam a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers9. ❑Building addition [No workers' comp, insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.E]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.r_1 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:, Policy#or Self-ins. Lic.#: Q_ 3� e.�? 7� Expiration Date:� � c Job Site Address�����iri � City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pa' s a penalties of perjury that the information provided above is true and correct. Si nate : Date: 17-115-1 Phone#: _ Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ✓le P � 0/ BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number..;O 005387 gl�fhdater 4/0:8,/1947 042008 Tr.no: 22088 RestnEt�d 00 JOHN L SILVER"- 4 845 WOBURN S 01887 " �J WILMINGTON, Cortlmissioner MA ✓die C�oar�n�rea�� o�✓�aoaacrLccae�4 , Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration`-,106478 ,I Expiration 7/ 312008 Type: Private Corporation S!LVERIO CONSTRUCTION CO _'INC.. t John Silverio 845 WOBURN STREETS#5_, C-1 1^J!LMINGTON, MA 01887 Deputy Administrator I I E S T I M A T E MOYNILAN NORTH Rb.A7TMP- TITrMM7D -T-uo ro six 3-26 X63 CrES rsr srF] TI'. TIME 07:58 0 t7:7R'_'R AFLLITI6, M.� U15c'-g-9126 n j 761-15� 0500 976-6o4-3310 FP1:- -97S-66--0872. SOLD TO: £ST111 c� ESTIMATE ONLY. GOOD FOR 7 DAYS ' ESRB96 DATE 10/18/07 ESTIMATE ON ONLY. GOOD FOR 7 DAYS SNIP TO. o 0001 TIME 08 :24 0� J SILVERIO CONST PHASE 000 T� 125 jtiTYNDEKIST FARM RD ( HORSE FARM AT END ) PACE 6 0 ANDOVER, MA FOR: DLVD ON ORDER / T SCH D'IE:10/18/07 ORD:121415-00 YOUSILVERIO/125 WYNDEKT IN OUT TYP: WHS OUR TRUCK ORI} DTE:10 i_8 0 7 ��m 3 / / OTH 0EER TER 96 06 0 -c PRODUCTS & QUANTITIES MAY DO NOT ADD AN-Y SHIP-TO'S TO THIS ACCOUNT PER x MARY WITH ACttJAL CONSTRUCTI0N MICHAEL MOYNIHAN � r-- c c c ��� m NE ITEM I�7O_ QTY U/1d DESCRIPTION UN��RICE EXT PRICE x z 0 co _� co rn IS NOT A RECEIPT*** M .a 0 Go NET SALES: 2037. 93 OT_HR CHR.G: 0.00 TAX: 101 .90 TOTAL: 2139. 83 -v 0 rn IS LVER10 � CONSTRUCTI . . COMMERCIAL ■ RESIDENTIAL Board of Building Regula (ons and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Reqistration: 106478 Type: Private Corporation Expiration: 7/23/2008 SILVERIO CONSTRUCTION CO., INC. John Silverio -- - 845 WORBURN STREET#5 WILMINGTON, MA 01887 Update Address and return card. Mark reason for chars . )PS-CA1 Co 50M-05,06-PC8490 p 1 Address — Renewal - Employment Lost Card ,o, ��ce TDammaru�o.¢�z a�[� iude�6 \ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 106478 Board of Building Regulations and Standards Expiration: 7/23/2008 One Ashburton Place Rm 1301 Type: Private Corporation Boston,Ma.02108 SILVERIO CONSTRUCTION CO., INC. 4Silverio 854VdCBURN STREET#5 ^: L;b11NGTON. MA 01887 Deputy Administrator No valid without signatureBoard of Buildin Regulations One Ashburton P ace, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 04/08/1947 Number: CS 005387 Expires: 04/08/2008 Restricted To: 00 JOHN L SILVERIO 845 WOBURN ST WILMINGTON, MA 01887 Tr. no: 22088 Keep top for receipt and change of address notification. )PS-CAI O 50M-04,05-PC8698 845 Woburn Street Wilmington, Massachusetts 01887 781-944-3219 978-694-4064 0 1-800-585-3219 FAX 978-694-4067 ...CD Fw-- O Z � � 1'-0"DEEP X 2'-0" WIDE X ALL NAILS TO BE N O STAINLESS STESTEEL. `.EREO AR Q 5'-0" LONG CONC. FOOTING. c @ �F V.14F J`r? GAURD RAIL TO 12" SONO TUBES W/ 3#5 VERTICAL ��` Yr ; m Z BE AT 42" O.C. AT 4'-0" BELOW GRADE. r � ' `" , P.T. 2X12 STAIR P.T. 6X6 POSTS c STRINGERS AT 12" O.C. 3 N 3 �r,,. 6•?bTOFd. F N MAX. SPACING OF 0 0 0 r -- r V BALLASTS TO BE 4". f d 2X8 LAG BOLTED INTO \� ! H EXISTING STRUCTURE AT 12" O.C. �/ d � � >Y as N o sr EXISTING ROOF) EXISTING ROOF W us h I r n Zi n m in I I Z O m rs 2X6'S AT 16" O.C. z < • 4 M M J 1 1 EDGE OF WALL C- 00 BELOW. W ao W ag STAIR FRAMING PLANxl - ROOF FRAMING PLAN • IlJZ 12 um z ' � � d 17'-0" 5'-0" 7 • v o W r 0 OC h 18R AT 6.67" -----•------- W W < in Vf }- y" 17T AT 11" I 1 I 1 I 1 ON 3'p' i \ i W Alrl A A - - - IA -8Y2 3'—8Y, PITCH PITCH EDGE OF WALL BELOW 7'-5" Z ROOF PITCH 7/12 NEW 2X4 WALL W I I AT 16" O.C. > {�W PROVIDE NEW 2X8 RAFTER ' 0 I O U SPIKED TO EACH RAFTER LOW RIDGE UNE ONE EACH SIDE. -- - -- --- - - ¢ L O PROVIDE ICE AND --A �� o s SECTION A CENTERLINE OF EXISTING WATER AT VALLEY. O ROOF HEADER. 1/4 Z LJ c W cfo cn SECOND FLOOR PLAN ROOF PLAN oW � z a� cn� 0 «• `� Z F= OB Za F- V) � 0c3E- Q oO� � o o —I a CL S � z 0 a-