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HomeMy WebLinkAboutMiscellaneous - 24 BERKELEY ROAD 4/30/2018 (2)1 Location No. f% Date -2 MORT►, TOWN OF NORTH ANDOVER Certificate of Occupancy $ �ssACMBuilding/Frame Permit Fee $ �f Foundation Permit Fee $ Other Permit Fee $ TOTAL $' S - Check # 4 5 S 9 l/ Building InspecidFr < TOWN OF NORTH ANDOVER ` BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING o-ow�l;,�f k 'I") BUILDING PERMIT NUMBER: DATE ISSUED:���� 1.3 . Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft SIGNATURE: Rear Yard Buildin o s] ne /I u] ngs Date Provided SECTION 1- SITE INFORMATION 1.1 Property Address: moi' 1.2 Assessors Map and Parcel Number: o l y C? O "' Map Number Parcel Number 1.3 . Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.LC.40. 54) 1.5. Flood Zone Information: PQblic ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: ' Licensed Construction Supervisor: Address` {f2�/trr�ac� l� cam..�5 Signature Telephone Not Applicable ❑ 060 l 1 2— License Number !a Expiration Date 3.2 Registered Home Improvement Contractor] Av t1 Not Applicable ❑ Company Name 5'/ Registration Number Address Expiration Date Si nature Telephone SECTION 4 - WORXERS COMPENSATION (M G.L. C 152 § 25c(6) , Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit._ Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction. ❑ Existing Building Z Repair(s) ❑ Alterations(s) B' . Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Descriptions of Proposed Work: i SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be —eem ete �O7FICI�S�f31�ii''° k 1. Building �.. (a) Building Permit Fee Multiplier j 2 Electrical (b) Estimated Total Cost of C i Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I as Owner/Authorized Agent of subject property p:. Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I 0_, as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief j� i Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TRABERS 1 s 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY o IS BUILDR-4G ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print 7—d yyr l� r3 Loation �( E'�t £ c City J, Phone cam a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job - Com a ob-Compa _Address % �7� EQ 1. . city: 'e )� �c c G Phone # Insurance Co 1 V,QlL" v �2 k,'ze. Policv.# �. — .3 .% S ::3 Company name. Address Phone#: Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one- years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($10O.00) a day against me_ understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under• the pains and penalties of perjury that the information provided above rs bve and correct Signature /�° Date 4 — `-f — Print name / rt �' f 0 t Phone # official use only do not write in this area to be completed by city or town official' Building Dept []Check if immediate response is required Building Dept Licensing Board Q Selectman's Office Contact person:_ Phone #: 0 Health Department F1 Other FORM WORKMAN'S COMPEVSATION Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978)688-9545 Fax(978)688-9542 DEBRIS DISPOSAL FORM v Qttgo ,6�a�O ro .. y� V GOGNI[KlWKM 1' In accordance with the provisions of MGL c 40 s 54, and a condition of. Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 50a. The debris will be disposed of in /at: Facility location Signature of Applicant Date — p-( C-)( NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. �rnnn�gr Page of Free Estimates " 105 Haverhill Street' 'Fully Insured t .Methuen, MA 01844)- THOMPSON'S ROOFING (978) 691-1355 t Shingles — Slate — Rubber Roof Single Ply — Copper Work PROPOSAL SUBMITTED TO PHONE DATE David Crucioti 10-7-00 STRE ET JOB NAME 24 Berkeley Road CITY, STATE AND ZIP CODE North Andover JOB LOCATION MA ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: Install aluminum drip edge around roof line Apply ice and water shield 3 ft. up all along edges Reshingle with a 25 year Architect shingle Install new flanges around soil pipe Cut in a ridge vent Remove all work related debris 25 year warranty on material 10 year guarantee on labor Construction lic. 3060112 Imvr_ovement#128612 M 3propogt hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: Three thousand eight hundred and fifty ----- dollars ($ 3.850.00 Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving Authorizetl extra costs will be executed only upon written orders, and will become an extra charge over and Signatu i abovE the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully Note: This proposal may be rn.0-11 by W—k--'c !`n.nnnnceti.... 1---- Zfrceptanct of propool — The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: 6"1 t 08EK 2 31, 2 Db0 —1—awn uy us it not acceptea wtnm days.. Signature4 Signature ' i F 1 CA TE OF L I A B I L I T Y I N S U R A N C E DATE 05-08-00 (MM/C^(YY)I PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R:GHTS ~ UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALT PELHAM -NSURANCE SVCS INC THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1.?1 BRIDGE STREET INSURERS AFFORDING COVERAGE PELHAM NH 03076 - INSURER A: The Maryland �'SUR�D INSURER B: Liberty Mutual Thomas Doyle INSURER C: DBA Thom sons Construction 8 Roofing 8 West Ste. INSURER D: Salem NH 03079 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO, ': THSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS �,RTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL: THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION T4 TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1.000.000 A [X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (An one fire) $ 300.000 [ ] CLAIMS MADE [X] OCCUR SCP 34865353 04.15-00 04.15.01 MED EXP (Any one person) $ 10.000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,00^.0^0 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 1'] [ ]POLICY [ ]PROJECT [ ]LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Each accident) $ i ALL OWNED AUTOS BODILY INJURY [ SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY VON -OWNED AUTOS $ • PROPERTY DAMAGE [ (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ [ ANY AUTO OTHER THAN EA ACC 5 [ AUTO ONLY, AGG $ EXCESS LIABILITY EACH OCCURRENCE $ [ ] OCCUR [ ] CLAIMS MADE AGGREGATE $ [ ] DEDUCTIBLE $ ] RETENTION $ $ WORKER'S COMPENSATION AND ( ] WC STATUTORY [ ] OTHER B EMPLOYER'S LIABILITY WC2.31S-314995.019 04.21.00 04.21.01 E.L. EACH ACCIDENT $ 100.000 E.L. DISEASE -EA EMPLOYEE $ 100.000 E.L. DISEASE -POLICY LIMIT $ 50C.nn0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS -Roofing. I. i CZRTIFICATE HOLDER [ ]ADDITIONAL INSURED: INSURED LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR Don Foss TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED 9 Gumpus Pond Rd. TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR Pelham NH 03076 REPRESENTATIVES. AUTHORIZ REPRESENTATIVE % Page 1 ^f 2 i k o� o r- o o 3 o co a e K,'i_ ;r . CO) 10 to O coo 'C Cl) CD am CO) CD o C r Fe a ?C 90 C:j CL CO) R® CD CD CD a cr ? MC sm CD CSD O CCD C CD �� CD CL t= CO2 COC H O 10 � CD .O.o. 71 O CD O CD O cn n O cn n ``cn �3 olq C'1 C 0 0 Z CD. CD 0 J2 0 C O CD m C 0 N O d CO) N nv' Rcr CA ® esu �® Mu ynom .. ► �O► m N m4 =r ,� •+ CLrn � O go CO3 CD ® =rCD is CD C I i Z:s.c�s O N A =r . CD N ` CL ® O N 00 O. CDN to CL C cr CCD O U2 ® N X O CD Co m c, ® 0 CD LOD ® ..: gym: g3C CD oCD: go a �. nn.: 0 C',0: ®0 gyCD: cn o cn T"l W ro w ° b w 0 O wil Po C) ® x° rD 06) r+ O cn Cn I °o 7C n° m M IMM U) 0 m •� o CO) C-)0 10 cm Q C _ OtIr V C*Cr1 a° r C s �Z cn CU � O ,� Cn �• y In ® of O '9 V J Ow CD CDD Q 0 a �'• C f0 ,c mCD In CD ® !D Q 0 c CCD ®y, CO CD CD s N! CD CD CD o� CD o z 0 O O m O cc O C CD m O N O O. N N m dy �•® co O m n ® n H C2 C26 C-3 m O w O ff's eea L -. a Pf7 co .i O a CD ? 4Z i N CD m H CL� H O O cr CL go W CL p�G O O �f C an N® H O .Oo► H CD CO C, C., CD CD CCD _ CD CD CD 03 z O 0 c CD i P 'fid iCD CD SO-Crf �'. w, C o ~� n a. d p f E3 I 2 Il y It r 7d z O 0 c CD TOWN OF NORTH ANDOVER PERMIT FOR WIRING rpt This certifies that .............................................................. has permission to perform .... ...... ......................... wiring in the building of ................................................ at. ...... ............................ i:, ..... . North Andover, Mass. Fee.: !rR.. 0 (��' , ........... Lic. No .............. ......................................... .ELEcTwcAL NspEcToR Check# WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 4 Commonwea11A of ///assael'tudetld Official Use Or cc��r� ec]/ 2,part.,d o�.}ira SwvicPernnit No. Occupancy �✓ Occupancy and Fee Checkedlug _ BOARD OF FIRE PREVENTION REGULATIONS Rev. 11/99]. leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MGC), 527 CMR 12.00 (PLE.9SE PRINT iV INK OR TYPE :ILL hYrOluf;IT10N) Date: -C City or Town of: �)C�(n�I�� 1� ,� To the Inspector of Wires: By this application the undersigned gives notice of itis or her intention to perform the electrical work described below. Location (Street R Nun cr) Owner or Tenant Y� Telephone No. Owner's Address Is this permit In conjunction with a buildin r omit? Yes ❑ No Er (Check Appropriate Box) Purpose of Building �_c Utility Authorization No. Existing Service Amps / Volts' cnccad ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undord 1:1b Number of Feeders and Ampacity No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: Completion orthe rollvadne table nrav be n aimil br the hrsecrtor o% 1 Vires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fats ! o. of Total Transformers KVA No. of Lighting Outlets No. of ilot Tubs Generators KVA No. of L Lighting Fixtures Above Swimming Pool nid. C3In- rnd. C3Batte o Emergency o.Lighting • Units No. of Receptacle Outlets No. of Oil Burners FIRE ALAR►NIS No. of Zones No. of Switches No. of Gas Burners No. oetectnon and Initiating Devices a No. of Ranges No. of Air Cone). ataTons No. of Alerting Devices No. of Waste Disposers cat ump Totals: um er _ _pus _j_ KW__ _ _ o. o e - ontantc iDetection/Alerting Devices No. of Dishivashers Space/Area Heating KW Local ❑ Municipal❑Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or E uivaletnt No. of ea KW Heaters o. o i alo. of Sits Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Totai III? Telecommunications ti'irin No. of Devices or Equivalent OTHER: Attach additional detail if desired• oras required by the Inspector of ;Vires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. Tlie undersigned certifies that such cove a is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND El0I H1rR ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work:' " (When required by municipal policy.) Work to Start: I certifj-,, larder the FIR11I NAAIE: and Inspections to be requested in accordance with MEC. Rule 10, and upon completion. 7/ties a Perjury, t ratthe inform'nation on this application -is trite and complete. �-1(: '-lEi /�-/7 LIC. NO.: ' A l Licensee: �57�—%,1�/U Signature LIC. NO.: (If applicable. enter • ,verr t - in 0 ficence gryj' ne. a Bus. Tel. No.- Address: �o �e. IX Tho �%� �DU� 9�1.�Z_ Alt. Tcl. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licen -does not have the liability insurance coverage normally required by law. By my signature below, 1 hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent F :Rr1tIT FEL: Signature Telephone No. r10HTk""e a+��qS rnrn'f%SJ Zoning Bylaw Review Form Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 Phone 978=688-9545 Fax 978-688-9542 street: Ma /Lot: a3 z : o Applicant: IDA.vilp Re uest: I a � a R ao1d2, �v� Date: y a 0 3 Please be advised that after review of your Application and Plans that your Application is DENIED for`the .following ZoningBylaw eeasons: Zoninci Oe -4 2emedy for the above is checked below Item # Special Permits Planning Board Item Notes C- Setback Variance Item Notes A Lot Area 3 , F Frontage Variance for Sin 1 Lot area Insufficient Independent Elderly Housing Special Permit Large Estate Condo Special Permit 1 Frontage Insufficient Earth Removal Special Permit ZBA 2 Lot Area Preexisting R-6 Density Special Permit 2 Frontage Complies Special permit for preexisting 3 Lot Area Complies 3 Preexisting frontage e s 4 Insufficient Information 4 Insufficient Information B use - 5 No access over Frontage 1 Allowed S G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting. 2 Complies 4 Special Permit Required 3 Preexisting CBA •t e S 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height g 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient y e I Building Coverage 6 Preexisting setback(s) 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting S 1 Not in Watershed H e S 4 Insufficient Information 2 In Watershed j Sign 3 Lot prior to 10/24/94N 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking N 1 In District review required 1 More Parking Required 2 Not in district C1 e S 2 Parking Complies 3 Insufficient Information 3 Insufficient Information 4 Pre-existing Parking 2emedy for the above is checked below Item # Special Permits Planning Board Item # Variance Site Plan Review Special Permit C- Setback Variance Access other than Frontage Special Permit Parkin Variance Frontage Exception Lot Special Permit . Lot Area Variance Common Driveway Special Permit Height Variance Congregate Housing Special Permit Variance for Sin Continuing Care Retirement Special Permit S Special Permits Zoning Board Independent Elderly Housing Special Permit Large Estate Condo Special Permit S ecial Permit Non -Conforming Use ZBA Planned Development District Special Permit Earth Removal Special Permit ZBA Planned Residential Special Permit Special Permit Use not Listed but Similar R-6 Density Special Permit Special Permit for Sign Special permit for preexisting Watershed Special Permit nonconforming The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based 'on verbal explanations by the applicant. nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for. this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file. You must file a new permit application form and begin the permitting process. -aa o?ao 1ttuiiding Department Official Signatuie Application Received Application Denied .� ry Plan Review Nalrrativ The following narrative is Provided`to further explain the .reasons for,D.ENIAL for the APPLICATION for the Property indicated on tte reverse side: Referred To: x - gQ-��LG� �rf/FPEeY <<,c: ifr 7V rrE r17,---- /,vsac�.r,Q,vo TIJ TsVE Z -,arC.G ov T//E [cr.fS �i�'.�/ A.VD T..G<T/T Des GcuiiGG� if'/Tl� T.lE '('OW ►� o� �;�, Q; � p,(p?Zav�,vG tE6v! aT,tzvS , 6.1.[o%tom JETd rGt'S -ZO W J7, -,--M1- S f!/.rTif�GC GEtT/�Y T//.IT TX/S O.✓EGC/.v6 /S �vOT GOe-4TcrG /.c/ Ts'E FEGEtoG f{Pa0 //.4L4�O APE.Q, yfaw.t/ OAC/ Ffiw'f " CO .•/v T /��NGL '� 25oog8 ocoaG - p i .� 2, IR -13 �•ti Ze oii �• /4:L O T F'�,41 O.PA%t�iV f�,P DAv o A, . i 1, va►� �1 7?/is PG4N f-O,P �Ade7�?rGE ��,c�sEs - .vor Fo.P � Boavo,Qy ac-!`E.Pnficlia' . oy� `••�4�'uv�.veY .tiFo.P�!- �E.e,P/�1.4G(� E-.liGiciEc'.P/,!/6 .SE.�Y/CES ,47-1CW' ra rE'y F,e�.t s E ��s�i'iiic e�coe-os/ GG /'-4 PY .sTt'E�7'