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Home My WebLink AboutMiscellaneous - 425 Waverly � 1 1 I D i II i I ', �10RTFJ O A ►- 71 � d+ SSS "`""Sty APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPECTION ' Building Permit# 0 y� ADDRESS&OCATION OF PROPERTY : Y Map Parcel Lot Number SUBDIVISION __L/1_�: rvr v�✓w p DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: FIVE(5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS$20.00)WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. Permit Issued to: Address SIGNED RO ING CONSERVATION PLANNING E2 �v DPW-WATER METER �(.0 SEWER/WATER CONNECTION NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW Ka 4 1 4k Signature File: Application for OC form revised Jan 2007 i Location411 �'' `'�' No. Date �l— C' NORTH TOWN OF NORTH ANDOVER f D Certificate of Occupancy $ CNUs t� Building/Frame Permit Fee $ irk Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # M 18763 Building Inspecto. 1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT4 OR DEMOLISH A ONE OR TWO FAMILY DWELLING F.7. .7 BUILDING PERMIT NUMBER: DATE ISSUED. C_ SIGNATURE: Building Commissioner r of Buildin Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O lAl A-v`fir t/ J Map Number ParceTNfirnber 0` 1.3 Zoning Information: 1.4 Property Dimensions: rGi G Q /" / Zarin Distrid Pr Ld Area Fronto ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required I Provide E294red I Provided Required Provided ,,y Z v 1.7 Water Supply M.G,.C.40.§34) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: -Public ❑ private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENTHistoric District: Yes No rn 2.1 Owner of Record ��e Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: / —7 W V / ame n Address for Service: i Si ` lure Telephone SECTION 3-CONSTRUCTION SERVICES go 3e.-9 icensed Construction Supervisor: Not Applicable ❑ ,5 7 7��,,"kl,�,P,,, ( Licensed &i/struction Supervisor: 0�`3� 7 y� License Number Ad 4��k, 12�-- ,/�/ !F 7l /C)7 ic igna Telephone O S��f/// Expiration ate rSWUND 3.2 Registered Home Improvement Contractor Not Applicable . Company Name Registration Number M Address Expiration Date ^� Signature Telephone Y Y Y SECTION 4-WORKERS COMPENSATION(M:G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and sub itted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. e7l Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction V Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Atli t•[' ?�� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OF>F'ICI USE EJNLZn- Completed b permit a licant • r= y r ,, 1. Building (a) Building Permit Fee Ot) Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection i�• 0C 6 Total 1+2+3+4+5 (j Check Number SECTION 7a OWNER AUTHORIZATION TQWgUMIPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BU17.DING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to wor authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AG/ENT PECLARATION I, i C as Owner/Authorized Agent of subject property �r Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print N 'e SigLat&re of caner/A ent Date NO. OF STORIES SIZE 6 2 BASEMENT OR SLAB 576 A SIZE OF FLOOR TIMBERS 1 2 ND 3 PD SPAN DMIENSIONS OF SILLS >rG �' DM,ENSIONS OF POSTS DINIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE z 3 DOMENIC J. SCALISE ATTORNEY AT LAW 89 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 TELEPHONE (978) 682-4153 FAX (978) 794-2088 EMAIL djs@djscalise.com November 8, 2005 Mr. Gerald A. Brown, Building Inspector Town of North Andover 400 Osgood Street North Andover, MA 01845 RE: Thomas &Helen Pickard 427 Waverly Road North Andover, MA 01845 Dear Mr. Brown: Concerning the above captioned matter, this letter will confirm our prior conversations regarding the re-building of a two-stall garage on property owned by Mr. and Mrs. Pickard, located at 427 Waverly Road, North Andover, Massachusetts. The Pickard's residential lot is located behind a lot of land that was formerly owned by Alan Hope and is now owned by Stephen Smolak. Access to the Pickard lot is by a driveway off of Waverly Road. The original multi-family house on the front lot was recently demolished and four(4) new residential condominiums are being constructed by Mr. Smolak. Request is hereby made on behalf of the Pickards to issue a building permit to re-build a two-stall garage on their premises. Pursuant to the Zoning By-Laws, Chapter 9 "Non- Conforming Uses" Section 9.3.3, the Building Commissioner can issue a building permit in the event that..... "Alteration to a structure which encroaches upon one or more required yard setbacks, where the structure, after alteration, will comply with all current by-law requirements, except for yard setbacks (the provisions of this clause shall apply regardless of whether the lot complies with current area and frontage requirements)." The Pickards presently have a foundation which is approximately 18 feet from the front line of their lot. The homeowners will build a new single story two-stall garage on the existing foundation. I have enclosed herewith copies of plans for the proposed garage, as well as a drainage plan showing the location of the Pickard property and garage foundation. t T DOMEINIC J. SCALISE Gerald A. Brown, Building Inspector November 8, 2005 Page Two Please review this matter and contact me at your earliest convenience. Very truly yours, eenic J calise DJS/cm cc: Alan Hope Stephen Smolak Thomas &Helen Pickard _ NOTES: F E E E NCE DEEDS ASSESSORS PEFEREiVCE sols' _ 1.LOCATION OF ALL-UNDERGROUND.UTILITIES SHOWN,HEREON Rc MAP 2? LOT 130"" ARE APPROXIMATE AND ARE BASED ON A COMBINATION OF FIELD N.E.r,.U. COOK 7 42 2- PAGE, 204 LOCATIONS AND- COMPILING INFORMATION"FROM PLANS SUPPLIED BY VARIOUS:UTILITY COMPANIES AND GOVERNMENT"AGENCIES. IN LOCUS ACCORDANCE WITH M.G.L.CHAPTER 82 SECTION 40 INCLUDING AUENDMENTS ALL CONTRACTORS SHOULD NOTIFY IN WRITING ALL /})� ®�� DISTRICT: .�� UTILITY COMPANIES AND GOVERNMENT AGENCIES PRIOR.TO ANY . ' REFERENCE PLANSEXCAVATION WORK OR CALL DIG-SAFE AT 1-800-322-4844. MIN. LOT AREA 12,500 S.F HALIFAX FT ,� . DRYAD ST. �� 1) E.C. 315 - MIN. LOT FRONTAGE .1.00 FT. " - MARENGO ST. " 2) E.C.L.O. 2498 MIN. FRONT SETBACK 30 FT. MIN. SIDE SE BACK = 15 FT. a MIN. REAR SETBACK = :30 FT. LOCATION MAP N11 r TIMOTHY H.. PACKARD EXISTING & HELEN. M. NEWELL APARTMENT SMH RIM=71.19 BUILDING LINVERT=61.72 / QS 7 DMH DWELLING W I 15' WIDE DRAINAGE EASEMENT CB TOP I d Y RPD END INV = 59.0 1 INV T7 _10, wro 67 SrRL,� LIMIT OF 100'- UMl OF 200' h ^jam CT/0RE�l1EgS_Etij£' "g» '_`g78•Sj00 SUFFER.ZONE RIVE�RONT..AEXISTII�G !�"'j S 40 p`�S_ O 28"W b - I y11FOUNPAjION ig'q . 67 INV 60.6' CAR' JnJ GAR.' _\� I:• 1 '" 1 NIT Z" U-2 ": i 67 1 . DWELLING57' G681 IAR. .UNIT 3 66 f N/F CB / - UNIT'4 GAR. ®� j 1 .l o COLONIAL VILLAGE PAVEMENT. 730.. I 70 1 4 DaSUNG DEVELOPMENT J _ 3I f = 6PORCH JAI INV 59.65 ��__ ` 1 � __ = �Typl�aZ) I ' U 3 I MAP 22 L07 19 l wro_ l 0 1 SB+S),. E"EASEMENI r 01 260.28'E-'� Y �' 00 _ 1 N 67 1 D AINAGE PLANQ?r I . LOCATED.IN DWELLING LOT• 1 V 1.30 ,� N/F NORTH ANDOVER AM. I � NARDOZZA REALTY AREA = 26,000 '30.FT.t PREPARED FOR PERCENTAGE OF LOT s TRUST �j COVERED BY BUILDINGS MAP 22 LOT 20 CHA' H0P"E "O" v9LL Ps 20% S. 370 GREAT POND ROAD NORTH ANDOVER, MA..01845 SAIH.RIM=7251. S SCALE: 1" _. 40' DATE: 11 17/04 INVERT=62.32 REV: J/2.i/05,5110105 40 0 40 80 FT >� CHRISTIA tlSEY Yx,_SG/T l76' PROFESSIONAL ENGINEERS _ 160 SUMMER ST, HAVERHlLL.MA. 01830TEL. 976-373-0310 - (cj:2004 SY.CHRISTIANS£N& SERGI INC. - .. . . .... - - .. DRAWING. NO. 02067002 J. 201-411 1,811 ? W-211 ol p A 1 o o- tQ Ah Is Q A ,— II �b SCALER/4" =VAY, DAMARC DESIGN ARCHITECTURAL DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3630 427 WAVERLY ROAD JOS DAMARC DESIGN RESERVES THE RIGHT TO THISTo FJE REP PLAN AND NORTH ANDOVER, MA 01845 REVISION: SPECIFICATIONS. IN ANY SWIPE OR FORM OR ASSIGNED To ANYTHEY ARE NOT THIRDP°ARry WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. i r 20'-dl I 01 ;21-a11 .51_/V il I4'-211 - ----------- ------1 i I I 1 � N w 1 O ' 1 I O - x I 1 O � ' I � O O _ I , N I - --------------- --' 1 O I tJl- N353 C C-- C i SCALE:1 DAMARC DESIGN ARCHITECTURAL DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3830 N 427 WAVERLY ROAD JOB# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND SPECIFICATIONS. THEY ARE NOT TO BE REPRODUCED, CHANGED OR NORTH ANDOVER, MA 01845 REVISION: COPIED IN ANY SHAPE OR FORM OR ASSIGNED TO ANY THIRD PARTY WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. ----------------------------------------------------- V -75 1 --------------------------- Q) ________ ___________ z � Q O � O � z o � SCALE:1/4°=V-o" DAMARC DESIGN • ARCHITECTURAL DESIGN AND BUILDING DATE:03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3830 427 WAVERLY ROAD JOB# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND NORTH ANDOVER, MA 01845 REVISION: COPlm Nn ANY SHAPE OR FORM OR ASARE NOT To BE IGREPRODUCED,A C T�HIRDD PARTY WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. I 75 z N55 o o713 o ,a l C N 0 z 1O1-011 i „ _ , 0� DAMARC DESIGN SCALE:114 1- ARCF1fIECTURAI DFSI AND BUILDING 98-700 MAIN STREET•NORTH ANDOVER.MA 01845 (978) 725-3830 DATE:03-01-05 WE MOM JOB# SCCIFICA�DNSN_RE AFi�E NOT TO BETREPRODUCEO CH/WGFA OR 427 WAVERLY ROAD r COPIED IN ANY SHAPE OR FORM OR ASSIGNED 10 ANY TNIRD PARTY NORTH ANDOVER, MA 01845 REVISION: ,AT}{pDT THE WRITTEN PERMISSION OF DAMARC DESIGN. i I 0 i SCALEA14"=T-y' NMARC DESIGN ARCHRECMAL DESIGN ANO B ppyER, MA 01845 (978)725-3830 M, , NORTH 98-100 MAIN S DATE:03-01-05 Y ROAD JOB# OAMARC DESIGN RESERVES THE RIGHT TO THIS PIAN AND 427 WAVERL �PIm IN ANY SFWPE OR FORM 0 A5SI�GNED TrANY THIRD PAIM NORTH ANDOVER, MA 01845 REVISION: ,ppp{O()T THE wRri1EN PERMISSION OF OAMARC DESIGN. q -- C Q DAMARC DESIGN SCALE:1I4 =1-0 A. ffECNM pESIGN AND BUS ojjt MA 01845 (978) 725-3630 98-100 MAIN STREET NORTH DATE:03-01-05 ES TME RIGHT TO THIS PIAN ANO OR .IOB# S=itONSN TH�EIEEA R FDRM ORIIE ASSIGNED W TNIRD PAM 427 WAVERLY ROAD REVISION: TMlo�ur�Trlw mEN PERMISSWN OF OAMARC DESIGN. NORTH ANDOVER, MA 01845 V , i SCALE:1/4 =1-0 DA MARC DESIGN ARCHITECTURAL DESIGN No TM HANDOVER.MA 01845 (97ILDING8) 725-3830 98-100 MAIN STREET• DATE:03-01-05 JOB# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND 427 WAVERLY ROA® COPCIEDIN ANY TSHAPE DRE FORM OR ASSIGNED 0 pryYHTHIRO PARTY NORTH ANDOVER, MA 0'1845 REVISION: WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. F NORM own of C% r ,= �A dover, Mass., COCHICHE WICK ORATED �17 BOARD OF HEALTH Food/Kitchen PER T D Septic System � BUILDING INSPECTOR THIS CERTIFIES THAT...................... ..................................................... Foundation has permission to erect........................................ buildings on ..44... ....�.......7.............................. . ..... .......... Rough to be occupied as........ , + Chimney e provided that the person accepting this permit shall in every respect conf to the terms of the applicat' n file in Final this office, and to the provisions of the Codes and By-Laws relating to the nspection, Alteration and Co rucipon of Buildings in the Town of North Andover. lox ybd/ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough rt's.A.---P.......................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant Fire Department Sign off: ��W./, Dumpster Permit Date rymm U - LU 1 KCLC^Qc rvmm INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION le-Al Zl PONE i r5APPLICANT ��.d//G r l/�1� - LOCATION: Assessors Map Number PARCEL SUBDIVISION / LOT (S) STREET '-/ y 7 t/4- ST. NUMBER 7 OFFICIAL USE ONL riECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT d FIRE DEPARTMENT ?ECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ov/dia www.mass. - g Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organizatio _Individual . N5AP � &1,2:�/, Address:-7 6:- &Le 5' City/State/Zip:t dZFQ✓6Phone #: Are you an employer?Check the appropriate bop- 1. ow Type of project(required): I.El am a employer with 4. I atn a general contractor and I 6. O New construction L&grnployees(full and/or part-time).* have hired the sub-contractors 2. aa sole proprietor or partner- listed on the attached sheet. + or ❑ Remodeling m ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152,§1 4 ,and we have no O 12.F] Roof repairs insurance required.]t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#I must also till 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 their workers'comp.policy information. 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.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing thepolicy 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 tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the forth 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. /do hereby certify under t re pam.Tdpenapainslties of per'u hat the information provided above is true and correct. Si nature: Date: O b`— Phone#: / '7 Official use only. Do not write in this area,to be completed b cit or town official 11 } p y y f1' 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#: 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 operate a 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, §25C(7)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-contractors)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 may be 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. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia i i s I w 201-411 I,RII 51-611 141-211 A I N � c - 41 e e e e I S O s iNl-1 9- ^^'a, Qb 0 i SCALE;1/4°=V-0" DAMARC DESIGN AR-100 MAIN DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3830 ....� 427 WAVERLY ROAD JOB# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND NORTH ANDOVER, MA 01545 COPIED ANS. THEY ARE NOT TO BE REPRODUCED, CHANGED OR REVISION; COPIED IN ANY SHAPE OR FORM OR ASSIGNED TO ANY iF11R0 PARTY WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. 4 III 201-411 1-8.. 31,6 I�'-2•• -- i -73 - ----------- ------, I I o I , N CCC � � O - 1 I I I I O � ' I z - I I O ' - I N I I - I I --------------- --� Q3 o o z � Nj3 O SCALER/4" =1'-U' DAMARC DESIGN ARCHITECTURAL DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3630 OPP 427 WAVERLY ROAD JOB# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND NORTH ANDOVER MA 01845 COPIED DCIN NS. THEY ARE NOT TO BE REPRODUCED, CHANGED OR REVISION: WITHO T THE WRITTEN PERMISSION OF ASSIGNED TO ANY DESIGN.THIRD PARTY --------=-------------------------------------------- 7t5 ' I -73 I I I I I I i I I I I I I I I I I I I I I I I I I I I I I I I I 1 I I I I • I I I L---------------- ---------------- --------------- ---J Q S VXX 7 � O Q -R c� Z 0 SCALE:1/4"=1'-0" DAMARC DESIGN • ARCHITECTURAL DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3630 427 WAVERLY ROAD JOB# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND NORTH ANDOVER, MA 01845 REVISION: COPIED Nn ANY SHAPE OR FORM OR ASSONS. THEY ARE NOT TO BE IGNED TO ANY THIRD DPOARTY WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. I 0 00 Q < z 71 > `� As z � 73 I i i V , z � s � N i 11 101-011 SCALE:1/4° =v-o- DAMARC DESIGN ARCHITECTURAL DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3630 427 WAVERLY ROAD Job# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND SPECIFICATIONS. THEY ARE NOT TO BE REPRODUCED,D ED, CHANGED OR NORTH ANDOVER, MA 01845 REVISION. COPIED IN ANY SHAPE OR FORM OR ASSIGNED TO ANY THIRD PARTY WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. i i e i i O SCALER/4° =1'-U' DAMARC DESIGN 98-100CMAIN DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3830 427 WAVERLY ROAD JOB# Cn DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND CHANGED OR NORTH ANDOVER MA 01845 REVISION: COPIED INANYSHAPE NS. THEY OR FORM OR ASSIGNED TO NOT TO BE ANY THIRD PARTY ! WITHOUT THE WRRTEN PERMISSION OF DAMARC DESIGN. Q � C D jLj i SCALE:1l4"=1'-0° DAMARC DESIGN ARCHITECTURAL DESIGN AND BUILDING DATE: 03-01-05 98-100 MAIN STREET, NORTH ANDOVER, MA 01845 (978) 725-3630 427 WAVERLY ROAD JOB# DAMARC DESIGN RESERVES THE RIGHT TO MIS PLAN AND GED OR NORTH ANDOVER, MA 01845 REVISION: COPED INANYSHAPE OR ORM ORA SNS. THEY ARE NOT TO BE IGNED TO ANY THIRD PARTY -- WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. 1 i 6 7 O SCALE:1/4"=1'-0° DAMARC DESIGN ARCHITECTURAL DESIGN AND BUILDING MAIN DATE: 03-01-05 89-100 MAIN STREET, NORTH ANDOVER, MA 01945 (979) 725-3630 427 WAVERLY ROAD ,SOB# DAMARC DESIGN RESERVES THE RIGHT TO THIS PLAN AND NORTH ANDOVER, MA 01845 COPIED ANY THEY ARE NOT TO BE REPRODUCED, CHANGED OR REVISION: COPIED IN ANY SHAPE OR FORM OR ASSIGNED TO ANY THIRD PARTY WITHOUT THE WRITTEN PERMISSION OF DAMARC DESIGN. 4, NOTES: P6P6G ac \ n - �A RE�'=RE d W CE F E A � �'�� "' E E' 1.LOCATIDN Or ALL UNDERGROUND.UTILITIES SHOWN.HEREON ' G F;� _ ARE APPROXIMATE AND ARf BASED ON A COMBINATION OF FIELD N.E.1'..D. .BOOR' 7422PAGE- 204 MAP 22 LOT 130 LOCATIONS AND COMPILING INFORMATION.FROM PLANS SUPPLIED �. BY VARIOUS UTILITY COMPANIES AND GOVERNMENT AGENCIES. IN LOCUS 3 ( ACCORDANCE WITH M.G.L.CHAPTER 82 SECTION 40 INCLUDING AMENDMENTS ALL CONTRACTORS SHOULD NOTIFY IN WRITING ALL ��/tll�� DISTRICT R4 UTILITY COMPANIES AND GOVERNMENT AGENCIES PRIOR TO ANY yg � � C> PLANS /� I tl 49 ar EXCAVATION WORK OR CALL DIG-SAFE AT 1-800-322-4844. �SI o REFERENCE �7 Y F HAuFAr ST.�--I. {�`� MIN. LOT AREA' _ 12;500 S.F. .ti DRYAD sT. �� 1) E.C.L.G. 3152 MIN. LOT FRONTAGE 100 FT. MAR-' sr. 2) E.C.L.O. 249& MIN. FRONT,SETBACK 30 FT. Po ,J a MIN. SIDE SE;BACK = 15 FT. 0 MIN. REAR SETBACK = 30 FT. iv.TS. LOCATION MAP N/F TIMOTHY" H. PACKARD PRT NG APAARTMENT SMH RIM=71.19 & HELEN M. NEWELL BUILDING INVERT=61.72 / d DMH DWELLING WITH w � 15' WIDE DRAINAGE EASEMENT 7 CB TOP . 3 PZRFD ENG INV = 59.0 N' INV T _L WID67 o -A- ( ` 260.0p LIMIT OF 100' LIMIT' OF 200 I 1- N SEy�L g s N78. 7, p `'UF°ER"ZONE RIVE(�ZFRONT AREA H qp PV28"W EXlST1 G 7. C S=F e INV = 60.6 yroFOUN ATION i$ I 67' GAR.' - ��JJ GAR. _ •' O" UNIT 1 NIT 2 U-2 i 67 i p - . 66 681 1 v -� DWELLING 52 GAR.U-3. UNIT 3 NSF i CB 1 UNIT a U-4. 11 X00 ; 4 COLONIAL VILLAGE £xismo I17I DEVELOPMENT PAVEMENT. - 7,3 p• 1 1 2 MAP 22 LOT 19 = _ PORCH i I M v. J �•�O INV = 59.65 70' �_[TYPiGAT) 1 k- A S w/DE EASE ? O e 26p.Do, ! 66 A 67 DRAINAGE PLAN LOCATED IN DWELLING ti LOT 1.30 NIF NORTH ANDOVER MA. I NARDOZZA REALTY AREA = 26,000 so. TRUST PREPARED FOR PERCENTAGE OF LOT COVERED 'BY BUILDINGS MAP 22LCT 20 CHARLEQ HOPE C. 370 GREAT POND ROAD NORTH ANDOVER, MA. .01845 SAIH.R/M=72.51. bmf SCALE: 1" =".40' DATE: 1111704 INVERT=6?.32 REV: 512111 5,511 40 c`.o,. C. 40 80 FT p PROFESSIONAL FESSIONAL ENGINEERS HRISTlfiNSE ly>.,SERC �. . :..LAND SURVEYORS 160 SUMMER ST. HAVERHILL.MA.: :61630 . TEL. 978-373-0310; - - @ 2004 BY:CHRISTIANSEN&SERGI INC. - - - .i .. . DRAWING NO. .02067002 I` it VORBACH ARCHITECTURE Robert J.Vorbach—Architect 58 Manchester Street Nashua,New Hampshire 03064-2114 Telephone/Fax:603-886-1738 Date:5/24/2006 Building Department and Inspectional Services North Andover, Massachusetts 08145 RE: Four(4)Unit Residential Project 425 Waverly Road North Andover, Massachusetts 01845 Dear Sirs, As of the date of this report the issues critical to this office regarding 425 Waverly Road were as follows: DIVISION 1: GENERAL DATA No Issues DIVISION 2: SITE CONSTRUCTION The site is still at rough grade condition. Construction debris need to be cleared from the site. Catch basins are in place. DIVISION 3: CONCRETE Basement slabs have not been poured in units 441 and 443. Basement slabs have been poured in units 437 and 439.No garage slabs have been poured. DIVISION 4: MASONRY No Issues DIVISION 5: METALS No Issues DIVISION 6: WOOD AND PLASTICS Framing for main structures is complete. Entrance porch and rear deck ledgers have been installed. DIVISION 7: THERMAL AND MOISTURE PROTECTION Roofing(Asphalt Shingles)over main structures is complete. Metal drip edges at eaves are complete.No vinyl siding has been installed.No insulation has been installed. Fire seperation walls between units are complete. I DIVISION 8: DOORS AND WINDOWS Vinyl windows and sliding doors by"Paradigm"have been installed in all units. Exterior entrance doors by"Therma-Tru"have been installed.No garage doors are installed. Windows have not been sealed at exterior yet. DIVISION 9: FINISHES No interior or exterior finishes are installed at this time. DIVISION 10: SPECIALTIES Fireplaces have been set in framed openings but are not yet connected to gas line or flue. DIVISION 11: EQUIPMENT: No Issues DIVISION 12: FURNISHINGS No Issues DIVISION 13: SPECIAL CONSTRUCTION No Issues DIVISION 14: CONVEYING SYSTEMS No Issues DIVISION 15: MECHANICAL Tub/Shower and shower units have been placed on second floor of three units. Plumbing is underway and is about 50%complete. DIVISION 16: ELECTRICAL Electrical work(outlets and switches)have been installed on first and second floors of most units.No wire has been run yet. Wiring has been run for fire alarm system. C'\S��RED AVol R�y/� Sincerely D No. 9085 8:0S Robert J. Vor ��h i J VORBACH ARCHITECTURE Robert J.Vorbach-Architect 58 Manchester Street Nashua,New Hampshire 03064-2114 Telephone/Fax:603-886-1738 Date:8/01/2006 Building Department and Inspectional Services North Andover,Massachusetts 08145 RE: Four(4) Unit Residential Project 425 Waverly Road North Andover, Massachusetts 01845 Dear Sirs, As of the date of this report the issues critical to this office regarding 425 Waverly Road were as follows: DIVISION 1: GENERAL DATA No Issues DIVISION 2: SITE CONSTRUCTION Some construction debris have been cleared from the site. DIVISION 3: CONCRETE Basement slabs have been poured in units 441 and 443. DIVISION 4: MASONRY No Issues DIVISION 5: METALS No Issues DIVISION 6: WOOD AND PLASTICS This office found several locations in three (3)of the units where point loads were not structurally supported. These loads relate to beams supporting second floor framing. These locations were marked and then shown to the General Contractor. This framing issue shall be corrected and checked accordingly. DIVISION 7: THERMAL AND MOISTURE PROTECTION No insulation has been installed. Installation of vinyl siding at 60% complete. DIVISION 8: DOORS AND WINDOWS Basement window glazing has been installed.No garage doors installed. DIVISION 9: FINISHES No interior or exterior finishes are installed at this time. DIVISION 10: SPECIALTIES Fireplaces have been set in framed openings but are not yet connected to gas line or flue. DIVISION 11: EQUIPMENT: No Issues DIVISION 12: FURNISHINGS No Issues DIVISION 13: SPECIAL CONSTRUCTION No Issues DIVISION 14: CONVEYING SYSTEMS No Issues DIVISION 15: MECHANICAL Plumbing is underway and is about 90%complete. Furnace units are in place but are not yet connected to gas line or to ducts. Metal ductwork is underway with first floor duct runs, and vertical runs to second floor. Some first floor grills and flex duct are in place. Sprinkler system piping will start during the second week of August. DIVISION 16: ELECTRICAL Unit 437 is completely wired. Unit 439 is 50%wired. Remaining units (441, 443)have had first floor wiring started. D qq�y/� J. Sincerely, �, s C3 No. 9W5 l 8 ATsf?�ld W Robert J. Vorb �r I i VORBACH ARCHITECTURE Robert J.Vorbach—Architect 58 Manchester Street Nashua,New Hampshire 03064-2114 Telephone/Fax:603-886-1738 Date:9/18/2006 Building Department and Inspectional Services North Andover, Massachusetts 08145 RE: Four(4)Unit Residential Project 425 Waverly Road North Andover, Massachusetts 01845 Dear Sirs, As of the date of this report the issues critical to this office regarding 425 Waverly Road were as follows: DIVISION 1: GENERAL DATA No Issues DIVISION 2: SITE CONSTRUCTION No Issues DIVISION 3: CONCRETE Garage floor slabs have been poured in all four units. Slab control joints have been cut. DIVISION 4: MASONRY No Issues DIVISION 5: METALS No Issues DIVISION 6: WOOD AND PLASTICS All point loads from beams have been structurally supported as mandated by this office. 1 X 3 strapping has been installed on first and second floors, and in garages in all units. The cantilevered beam in the basement of unit 443 has been supported with two (2)P.T. 2 x 6 studs. DIVISION 7: THERMAL AND MOISTURE PROTECTION Windows and exterior doors have been sealed at perimeter and vinyl siding is at about 95%complete. Fiberglass batt insulation has been installed behind some tub/shower units and in some sections of rear exterior walls in all units. ,J DIVISION 8: DOORS AND WINDOWS Basement windows are glazed and are thus complete. DIVISION 9: FINISHES No Issues DIVISION 10: SPECIALTIES No Issues DIVISION 11: EQUIPMENT: No Issues DIVISION 12: FURNISHINGS No Issues DIVISION 13: SPECIAL CONSTRUCTION No Issues DIVISION 14: CONVEYING SYSTEMS No Issues DIVISION 15: MECHANICAL Sprinkler system installation is at 50% complete relative to all units. Plumbing is complete in all units. Smoke and carbon monoxide detector boxes are in place. Second floor metal and flex ducts are being installed along with supply and return air grills. DIVISION 16: ELECTRICAL Electrical work continues in alighting ll units. Recessed fixtures have been installed in all units primarily on first floors. Wiring is about 95%complete in units 437 and 439. ARCy/� J. Sincerely o No. 9085 "rr' BADS Robert J. Vo ��1 -�Arcie I l OCT-21-2005 1144 E.C.S.1. 603 642 9223 P.01 2111 Route 125— Kingston,NH 03848 'C Environmental P.O.Boa 1147— Atkinson,NH 031311 cog Papoose"rice Tel: 603-642-9200 x204 �2a11tt,4 Faw 6034542.9229 00G� Incorporated d Chris Markey: cmarkeVGe"i-nh.com �pLIA; Fax/Letter of Transmittal Date: Friday,October 21, 2005 FAX: Nosh Andover,MA From:Chris Markey Fire:978-686.9495 Police:978681.1172 Health Department:978.688-k'i42 Building In ector/Code.North Andover TEL Fre:978.688.9590 Pages-.2 Police:978683-3168 Health:978-668-9540 Building In or/Code:North Andover AWITIONAL Town Asbestos Fee:not required CC:File,customer REOUIREMENTS Tank Permit Fee: O Urgent 0 For Review 13 Please Comment ❑Please Reply ❑Please Recycle •Comments On October 24 2005 Environmental Compliance Specialists Inc.will be providing asbestos abatement at 425 Waverly Rd. The work hours on the site tM1 be weekdays from 7 am.to 3:90 pm. Slate notification documents are attached. It there are any additional notification requirements or,if you have any questions or concerns. please do not hesitate to call Regards, Christopher Markey Project Coordinator Whin 9pM1hv"Builds C.arrtldence T -d ZL T T T SSBL6 4dOU 801 T od Janopud 44JON dLE :Z T SO Ta 430 12/30/2005 11:27 FAX 9785560284 ESS [A001 Engineeriag& Surveying Services 70 Bailey's Court Haverhill Ma 01832 (978)556-0284 December 29,2005 To: Gerald Brown,Building Inspector RE.425 Waverly Road Gerald, On Decernber 28,2005 I was asked to inspect the excavation at 425 Waverly Road. The A&B horizon(top and subsoil)have been removed and crushed stone has been added. The bottom of excavation is in the C horizon.The existing soil is adequate for the ' proposed building. Any questions regarding this matter,please feel free to contact me at 97$.556.0284. f Sincerely, Y Greg Saab,Civil Engineer&Soil Evaluator RECEIVED i DEC 3 0 2005 BUILDING D�P�s Engineering & Surveying Services 70 Bailey's Court Haverhill Ma 01832 (978) 556-0284 December 29, 2005 'o: Gerald Brown, Building Inspector RE: 425 Waverly Road Gerald, On December 28, 2005 1 was asked to inspect the excavation at 425 Waverly Road. The A & B horizon(top and subsoil)have been removed and crushed stone has been added. The bottom of excavation is in the C horizon. The existing soil is adequate for the proposed building. Any questions regarding this matter, please feel free to contact me at 978.556.0284. Sincerely, Greg Saab, Soil Evaluator OF IAASSq�yG � Morin Clayt n Morin,P.E. C3 #30969 �SSION N OCT-21-2005 11=44 E.C.S. I. 603 642 9223 P.02 Commonwealth of Massachusetts 10002143e ` Asbestos Notification Form ANF-001 DsealNumber witeri !lin A. Asbestos Abatement Description wtr.a Oldng out foam on%e oomput*r um 1. e.is this facility tee exempt-ci town,district,municipal housing authority,owner-occupied crdy live job key residence of four units or less?U Yes 0 No to move your cursor-do not b.Provide blanket decal numberif applicable: elanket Decal Number use the return key' 2. Facility Location' 425 WAVERLY ROAD 425 WAVERLY ROAD s. eF Stre*t as NORTHANDOVER IMA 01845 I�Ot c.City/Town d.Slate s.ZIP Code a Ons Number I"STRUCTIONS 3. Worksite Locatim t.uu sections of MIS HALLBATtiROOM,BASME —1 r r�� s.f3uilding IVam*IBtlllding Location b ec.Wing ---� 1ST d.Floor e.Room form must be compteted In order to comply" 4. Is the facility occupied? ❑Yes Q✓ No DEP notification rggLiromera o1310 CMR ,s 5. Asbestos Contractor: and 00DivtaioaENVIROtWNE1dTAL COMPLIANCE SPECT 54 OLD JACOBS ROAD d occupational b.Ad s safety(DOS) Nem* nd'iAailon GEORGETOWN 01853 803642s�200 raquaemsrrls 4453 a C !Town d.Z' s,Telephone Number cm$ 0.12 ACON407 g.Contract Type: Written ❑Verbal L M9*Nulnbar JESSE WRIGHT VP aci6lCan Perwn i.Conlan)Person's iUe THOMAS R TILTON AS030462 6- a,Narvi eronrarr b.S ervlsorlForeman DOS r�ettlfiCallon NumberNO" AM031 tiO4 7' s N!L d P AAo r b.Probe Monitor Outs CerfficaUOu N er PROSCiENCE AA000156 e.Name d Asbestos Ana rcal is 1 rm 003 Gerhllcabon bar R o/2412oo5 b.F7b1d dWvvvvl 2o05 a 9' a.Pro n Dab b. rgrd a 7AM-330PM d,woi c h�orrm� un.g N a,work nouns Mon• . 0 10. a.What type of project is offs? �o 21 Demolition ❑Renovation JASSESTOS r ❑Repair Q Other.please specify: b.Describe 11. a.Check ebatement procedures: ° v Glove bag ❑Encapsulation o Enclosure ❑Disposal only Cleanup ❑Other,sPecty= P Full containment b.Describe Z a 12. Is the job being conducted' ✓Q Indoors? ID Outdoors? ® ani t�,� .1�2 Asbe9toa Notrlicaiion Form-Page I d 3 Z 'd ZLTiTe96G6 -4dea aaijod Janopud 44JON dGE :ZT SO 12 -4°0 OCT-21-2005 1144 E.C.S.1. 603 642 9223 P.03 Commonwealth of Massachusetts ••- 100024688 . Asbestos Notification Form ANF-001 �'""" ` A. Asbestos Abatement Description (cont.) 13. Total amount of each type of Asbestos Containing Materials(ACM)to be removed,enclosed.or wica sulated: 120 450 a.Totall W" ucis im— vial o Oram aces square c.Boiler,breaching,duct,tank 100 d.Insulating cement surface coatings Lin. Sq.It. in.R. 9ft r a.Corrugate or layered paper 101 L—�J I.Tmwel/Sprayer comings pipe Insulation Ln.R, .R. n.R. 45 R. t----J h.Transite board.well board 450 g.Spreyon Tireproofrng Lln. q. Lin.ft. (Sq.fl i.CWW.wovan fabrics it.ft. S'—n' j.099.please 6peciN: LMR g p; k.Thermal,solid core pipe 110 Insulation Lin.R. Sq. L Spey 14. Describe ft decontamination systems)to be used: 3 CHAMBER DECON 15. Describe the containerizationldisposal methods to comply with 310 CMR 7,15 and 453 CMR 5.14(2)(g): MILL POLY BAGS OR LINED DRUMS PROPERLY LBLO&DSPD IN APPROVED LANDR 16. For Emergency Asbestos Operations,the DEP and DOS officials who evaluated the emergency: VINNY FE>f1LICE a.NAMO at VER Official b.Title 1090/2005 1 10510843 VDiFe MM or Authorization d.DEP Waiver* GARY GASPER o.Name of 005 official I.UQ5 Valciale 101YOf2005 05-M-N6 �N 9.Data(mrrvtr"W)Of AU11110 satlOn h•DOS Waive?0 =-tea 17. Do prevailing wage rates as per M.G.L.c.149,§26,27 or 27A-F apply to this project?[)Yes No �0 B. Facility Description N RESIDENCE �0 1, Current or prior use of facility: �o 2. Is the(acidly owner-occupied residential with 4 units or less? []Yes NO STEPHEN SMOLAK 17620ALE STREET 3. a.F Goner Name b.Addna NORTH ANDOVER 1 101846 978-36"215 r c.Cit/Town d.70 Code e.Telephone Number fares code and exterraion �O TEPHEN SMOLAK I ISAME --LL 4. a.Nance Of Fachl Owner's Oft-s"Manrger 0,On-Site Man er Address -Z SAjy E 01845 SAME �Q C.ciyROwn d.Zip Code e,Telephone (area code and extension) an10olap.doc•10102 Asbestos Nolification Form•Pa e E -d ZLTTiBSOL6 -zdaa orot:TOd JOAOPud 42JOW dLE :21SO Ta 1400 OCT-22-2005 11:45 E.C.S. I. 603 642 9223 P.04 Commonwealth of Massachusetts too024639 Asbestos Notification Form ANF-001 0ecs1Numbw B. Facility Description (cont.) 5' I ge at t3meral CoMracla ^-7i b.Addrass a Cit Hurn d a•Telephone Number area codeand extenslan ALG JWC00663995761 0312Q12006 f.Contraoor's Workers Comp.Insurer a.Pollcv Number h.Ex .Uete auNddl 2000 3 S. What is the size of this fadlW a.Square Feet b.Number of goers C.Asbestos Transportation and Disposal 1. Transporter of asbestos-containing material from site to temporary storage site(if necessary): Nota:ns"Wer a.Name of Trans rxlar h.Address Stations must E-- comply Wdth the C.Cityfr~ d.Zip Code e.Telephone Number Solid Waste Division 2. Transporter of asbestos-containing waste material from removal/lemporary site to final disposal site: Regulations 310 CMR 19.000 SERVICE TRANSPORT GROUP PO BOX 2132 a.Nemo al Trans Brier b.Address BRISTOL 15007 a Cth#Town d. Cod a.Tele hono Number 771 3. a.Refuse Transfer Station and Owner b.Address C Clir — dd.ZII. Ctb e.T hone Number 4. A&L SALVAGE INC a.Find RmgEm Site Location Name b.Final Disposal Site location owners Name 1f22s STATE ROUTE 4s LISBON c.rinal OIa o al Site Address d.CA!Town OH F44432 M e.Sled f.Zip code g.Telephone Number �o 111110 D. Certification N The undersigned hereby states,under the IC14RISUARKEY penalties of perjury.that he/she has read the 0.Name b-Authorized Si nature c Commonwealth of Massachusetts regulations 1JOB COORDINATOR 10/2tf2005 for the Removal.Containment or `,PbsitionfrAb d.Data mmtdd Encapsulation of Asbestos.453 CMR 6.00 arM (03)842-9200 ECS 310 CMR 7.15.and that the information Contained in this notification is true and Correct •.Telephone 1.Ra regent' �0 to the beat of his/her knovAedge and belief. III1 RT 125 G Address LL KINGSTON Nle —� 03848 h.Crty/fown i.Zip Code �Q A anf001 ap.doc•10102 Asbestos Notification Form•Page 3 of 3 TOTAL P.04 b 'd OLTTT89BL6 -zdaa aoiTod Janopud 44JON dLE :21 SO Ta 400 OCT-21-2005 1146 E.C.S. I. 603 642 9223 P.01 2" Fro 111 Route 125- Kingston,NH 03848 v► �'r Environmental P.O.Box 1147- Atkinson,NH 03811 Compliance Tel: 603-642-9200 x204 speclalists Fax: 603-642-9223 OO G� Incorporated Chris Markey: cmarkey0ecsi-nh.com MPt_td�►N Fax/Letter of Transmittal Date: Friday, October 21, 2005 FAX: North Andover,EIA From:Chris Markey Fire:978-688-9495 Police:978-881-1172 Health Department:978-688-9542 Building Inspector/Code:North Andover TEL: Fire:978-688-9590 Pages:2 Police:978-683-3168 Health:978-688-9540 Building Ins ectodCode:North Andover ADDITIONAL Town Asbestos Fee:not required CC:File,customer REQUIREMENTS Tank Permit Fee: ❑Urgent I3 For Review ❑Please Comment ❑Please Reply ❑Please Recycle •Comments On October 24 2005 Environmental Compliance Specialists Inc.will be providing asbestos abatement at 425 Waverty Rd. The work hours on the site will be weekdays from 7 a.m.to 3:30 p.m. State notification documents are attached. N there are any additional notification requirements or, if you have any questions or concerns, please do not hesitate to call Regards, Christopher Markey Project Coordinator Whwe Compliance MdW Confidence OCT-21-2005 11:46 E.C.S. I. 603 642 9223 P.02 I Commonwealth of Massachusetts 100024639 ?, Asbestos Notification Form ANF-001 Decal Number When filling out A. Asbestos Abatement Description When forms to the 1. a.Is this facility fee exempt-cit town,district,municipal housing authority,owner-occupied computer,use tY Y� P 9 Y P only the tab key residence of four units or less?❑Yes Z No to move your cursor-do not b.Provide blanket decal number if applicable: Blanket Decal Number use the return key. 2. Facility Location: 4255 WAVERLY ROAD 425 WAVERLY ROAD a.Namg of Faclilty b.Sireet A4.dre113 NORTH ANDOVER 101845 11=�i c.City/Town d.State e.Zip Code r.Telephone Number INSTRUCTIONS 3. Worksite Location: 1.All sections of this HALL,BATHROOM,BASME J 11ST I form must be a.Building Name/Building Location b.Building# c.Wing d.Floor a.Room completed in order to comply with 4. Is the facility occupied? ❑Yes E No DEP notification requirements of 310 CMR 7.16 5. Asbestos Contractor and the Division or O=palional ENVIRONMENTAL COMPLIANCE SPECIALIS 54 OLD JACOBS ROAD Safety(DOS) a.Name b.Address notification requlrementa of 453 GEORGETOWN� 1 01833 6036429200 CMR 6.12 C.C' !Town d.Zip Code e.Telephone Number AC000407 OS icense umber g. Contract Type: []✓ Written ❑Verbal t.DJESSE WRIGHT VP act Contact Person 1.Contact Person's Title 6 THOMAS R TILTON AS030452 a.Name of On-Site Su erviaodForemen b.Su ervisor/Foreman DOS Certification Number 7 ES&T AM03199 a.Name of P 'ect Monitor b. ro ect Monitor DOS Cortication Number PROSCIENCE AA000156 8' a.Name of Asbestos Analytical Lab b.Asbestos Analytical Lab DOS Cefftcajiffl Number �0 9 10/2412005 1 1110124=05 a.Pro ect Stan Date mmld b.End Date mm/dd/ �0 7AM-33OPM N c.Work hours Mon n. d.Work hours Sat-Sun. 10. a.What type of project is this? Q Q Demolition ❑Renovation ASBESTOS �w ❑Repair Other,please specify: b.Describe 0 11. a.Check abatement procedures: ...��o ❑✓ Glove bag ❑Encapsulation ®o D Enclosure ❑Disposal only �LL ❑Cleanup []Other,specify: ❑✓ Full containment b.Describe Q 12. Is the job being conducted. Indoors? ❑Outdoors? �• ��.. an=lap.doc•10102 Asbestos Notification Form•Page 1 of 3 OCT-21-2005 11:46 E.C.S. I. 603 642 9223 P.03 Commonwealth of Massachusetts �. 100024639 Asbestos Notification Form ANF-001 Decal Number A. Asbestos Abatement Description (cont.) 13. Tota(amount of each type of Asbestos Containing Materials(ACM)to be removed,enclosed,or encapsulated: 120 450 a.Total p pas or ducts(linear ri.I otai otner su aces square c.Boiler,breaching,duct,tank 100 d.Insulating cement surface coatings Lin.tt. Sq.ft. Lint. 5 .ft. e.Corrugated or layered paper 10 t 1 f.Trowel/Sproyer coatings pipe insulation rLin.ft. Q.lt. Lin Sq. 71 g.Spray-on fireproofing u h.Transits board,wall board 450 Lin SS .f�JLin i.Cloths,woven fabrics L ..ft. S� i.other,please specify: Lin, t, SQ.ft. k.Thermal,solid core pipe insulation Lin.ft. sq.ft. 1.Specify 14. Describe the decontamination system(s)to be used: 3 CHAMBER DECON 15. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g): fi MILL POLY BAGS OR LINED DRUMS PROPERLY LBLD&DSPO IN APPROVED LANDFILL 16, For Emergency Asbestos Operations,the DEP and DOS officials who evaluated the emergency: VINNY FERLICE a.Name of rile 10120/2005 110510943 c,Deta mm/dd of Authorisation d.DEP Waiver# GARY GASPER e.Name of DOS Official f.DOS Officiali e 10/20/2005 05.392-NB g.Date(mm/ddlyyyy)of Aulhonzation It.DOS Waiver If g�--0 17. Do prevailing wage rates as per M.G.L.c. 149,§26,27 or 27A-F apply to this project?❑Yes No ZO m ° B. Facility Description N �o 1. Current or prior use of facility: RESIDENCE �o 2. Is the facility owner-occupied residential with 4 units or less? ❑Yes ✓l No 3 STEPHEN SMOLAK 762 DALE STREET a.Facility Owner Name b.Address -° NORTH ANDOVER 01845 978-360-0215 c.City/Town d.Zi Code a.Telephone Number area code and extension STEPHEN SMOLAK ISAMIF 4. a.Name of Facility Owner's on-Site Manager b.on-Site Mangpe Address Z SAME 1 101845 ISAME 4 c.Cltyrrown d.Zip Code a.Telephone Number(area code and e)dension) anf001ap.doc•10/02 Asbestos Notification Form•PUL&AU EN OCT-21-2005 1146 E.C.5. 1. 603 642 9223 P.04 Commonwealth of Massachusetts -- 100024639 Asbestos Notification Form ANF-001 Decal Number B. Facility Description (cont.) 5. aa.Name rel Contractor � b.Address c.Cf /Town d.Zi Code e.Telephone Number area code and extension ALG WC006639O5701 1 103/20/2006 f.Contractors Wodcers Comp.Insurer A.policy Number �h.Exp.Date mm/dd/ 6. What is the size of this facility? 2000 3L�_ a.Square Feet b.Number of Doors C. Asbestos Transportation and Disposal 1. Transporter of asbestos-containing material from site to temporary storage site(if necessary). Note:Transfer a.Name of Trans orter b.Address Stations must —1 1 comply with the c.City/Town d.Zip Code e.Telephone Number solid waste Dlvlalon 2. Transporter of asbestos-containing waste material from removal/temporary site to final disposal site: R"vieftm;310 CMR 10.000 ISERVICE TRANSPORT GROUP PO BOX 2132 a.Name of Transporter b.Address BRISTOL 119007 c.CIl/Town d.Zip Code e.Tele hone Number 3. a.Refuse Transfer Station an� _i b.Address C.CA/Town d.Zip Cod-as I e.Telephone Number 4. IA S L SALVAGE INC a.Final Ois al$As Location Name b.Final Disposal Site Location Owners Name 11225 STATE ROUTE 45 1 JUSSON c.Final Dis osal Site A d.Cit/Town OH144432 e.State 1.Zip Code g.Telephone Number �O ° D. Certification �N The undersigned hereby states,under the CHRIS MARKEY ®° penalties of penury,that he/she has read the a.Name b.Authorized Signature o Commonwealth of Massachusetts regulations IJOB COORDINATOR 10/21/2005 for the Removal,Containment or o.Position/Thle d.Date mm/dd/ Encapsulation of Asbestos.453 CMR 6.00 and 1(603)642-9200 JECS1310 CMR 7.15,and that the information contained in this notification is true and correct B.Tele one Number f.R resenti to the best of his/her knowledge and belief, Jill RT 125 U' IKINGSTON NH 03848 i h.City/rown I.Zip Code Z �Q anM01ap.doc•10/02 Asbestos Notification Form-Page 3 of 3 TOTAL P.04 i MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800, Ma Only (800) 392-6108, Fax (617) 557-5675 10/13/05 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec.313 1 NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 Re: Insured: JOHN KEANE Property Address: 11 WALKER RD #3, NORTH ANDOVER, MA 01845 Policy Number: 0862688 Type Loss: Theft Date of Loss: 09/28/05 Claim Number: 221896 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, chapter 139, Section 3 B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. MPIUA Claims Division CMA00021 �I