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HomeMy WebLinkAboutMiscellaneous - 47 COCHICHEWICK DRIVE 4/30/2018 Y \ �-/7 C'o Gf�icy�ly!c�/c i I BUILDING PERMIT of "0RTOI q TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 0 :1 Permit NO: Date Received �4QDR, TED g 'Et Date Issued: SSACH►15 ` 2 . I I10'IPORTANT Applicant must complete all items on this page s f LOCATION` BSc$ S- -- �`_ � f s GO G�\G�c \G G b1/' Print G, PROPERTY OWNER. Pnnt MAP 210 PARCEL ZONING DISTRICT Historic District es no a }� - - ; . 'Machine Shop Vrllage yes r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building 0 i A wo or more family Industrial Alteration No. o uni s. Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic VClell FloodplainW'etlands VVaterst ed District t. Water/Sewer' - _ ;. DESCRIPTION OF WORK TO BE PREFORMED: BILA a ate. Dom. Gr we„� s Identification Please Type or Print Clearly) OWNER: Name: (�a�V a,^ �� }� Lt—G Phone: 1 Address 2$ ut,. 4S(S4 -CONTRACTORN T ° ame �,J�\�\ciw, G �f°er �./ Phone. .7!-a Address-', a1 o h� w =A rr A Sir. W n��,✓.,t � Supervisor's Construction Licensel�t �$ l Ex Date 1�t a p I Home Improvement License 12 O1 to _ Exp Date _ Zo ARCHITECT/ENGINEER W����a I w+ �a,� �,s Phone: a'l8 �S~1 3351 �� MQ► Address:ly 5 s{,� Reg. No. A497. i FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ Z e1 D yDFEE. $_ c;z a -5 — I I Check No.: j�c -� Receipt No.: 20/Ypo' 1 I NOTE Persons contracting h unregistered c ntractors do not have access t the guar n fu> Sigrature..of;Agent/Owner atiare of contractor 1 I I I I - i i I � � I 6 WILLIAM BALKUS ASSOCIATES A&- CIKIFEN I I THN SOtTFH MAIN STRU-7 TOPSRE D MA 0198 3 AW113AIXUSASSOCC A01-COM I TEL 978 8873351 FAX 978 887 9290 MEMORANDUM TO: MR. GERALD BROWN FROM: WILLIAM BALKUS I 1 DATE: APRIL 1, 2011 I I SUBJECT: CAMPION HALL CONDOMINUMS, 29 TO 49 COCHICHEWICK DRIVE I BUILDING TYPE: 111 A I I USE GROUP: R-2 I UNITS: 7, 8, 9, 11 I have reviewed the completed work done on the above listed units;including the common areas, and to the best of my ability, I would say that the work meets the original design concept and the I requirements of the hossachusetts State Building Code. I Res ly S. I No. William Balkus n 4452 j ' l�slre►d,�'� I 1 II i I I I I I I l 1 I I I I � I parr. � . 3 ats F6 � CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Pettiit Number 825-2010 Date:April 4, 2011 THIS CERTIFIES TRI AT I THE BUILDING LOCATED ON 47 Cochiche ick Drive North Andover- I MA 01845 I Campion Hall Flo I MAY BE OCCUPIED AS unit ACCORDANCE I _____IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. _ I I i I Cerfi_fi_egte Issued tp cow-pion-Es#rtes,LLC 1518 Cochichewick Drive North Andover,MA 01845 �I I Buil g Spec t r . I Fee: 100.00 l Receipt: 24021 j I I I I i i I I I I I i I NORTH BUILDING PERMIT ED '6�'ti'p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO• Date Received gZ.ED SSAC140 Date Issued: IMPORTANT:Applicant must complete all items on this page -47 PROPER�T�Y'01NNER� �,l�/�/a t S rL t u --.--P`�-�-.Pant -s T_ _._ O BARGEE: ZONI.NG'DIS�TTRICT;_ `MAP►N �Historic�Distncf yes. trio _ .. . ;Mach ne'Shop�Vllage5 yes. no F TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 1 ❑ New Building 0 One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial W Repair, replacement ❑Assessory Bldg ❑ Others: 0 Demolition ❑ Other OSeptic: +®SWell Floodplairi Wetlands ' D Vllatershed ©i_stFict •0�1Nate`r/,Sewer' DESCRIPTION OF WORK TO BE PREFORMED: 12e w2 a 2 'T ✓mae I00rs uh i roj-vi-I TpI •e�vok' s'i Identification Please Type or Print Clearly) OWNER: Name: ze Phone:o' 79 85a M3 // 6aov-em r, -5A i Address: 7 C O Gh I Lt e w 1 c. Pt- tCONTRACT40,R Name: rhe _-C ei1 s1i c�efic�� Phone 1-22--340 -7q (Adtlerss ��c� vc S _ �- __ /!/t t u:2 y _ _ vv. Sup_ervtsor stConsf'ruction License �_ _. ,_ _ _. =Exp.: ®ate;,; fHoelmprovemeEx e:tL [Dal ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: (Z�Z -71k, NOTE: Persons contracting with unregistered contractors do not have access to the guara and Sgnature�ofAgent/Ovvne�, Signature of contracto _ 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 CONSERVATION Reviewed on Sicinature i COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street ice- ---�-� � _ - E ARTMENT Tempi®Ll terjon)ste Eyes _- _{no. iFIREDEP Locatedtat 124iMain1;Street i (Fire A ftmenf�signature/bate`._ i I Dimension Totals uare feet of floor area, based on Exterior dimensions._ Number of Stones. q � 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 1 MGL Chapter 166 Section 21A—F and G min.$10041000 fine ! NOTES and DATA— For department use i J 1 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 M ' i I Building Department ro The following is a list of the required forms to be filled out for the appropriate permit to be obtained. f Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit i Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work Wifih Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit I New Construction (Single and Two Family) i ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (if Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products (MOTE: 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 DEPARTMENTMFORM07 Revised 2.2008 Location No. O Date NORTPI TOWN OF NORTH ANDOVER F R } Certificate of Occupancy $ s�cMusEt�'' Building/Frame Permit Fee $ 3 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1! 24918 1 BuildV Inspector The Commonwealth ofMassachusetts Department oflndustrial Accidents Office of Investigationg 600 Washington Street s� Boston,MA 021-11 wwH.mass gov/d'ia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers App licaut Information . Please Print Legib Name(Business/Organization/fndividual): G ` ,t Address: C) City/State/Zip- Phone#: 9 6 D 7 Are you an employer?Check the appropriate box: 1.Q -I am a employer with 4. ❑I am a general contractor and I Type of project(required): - employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached shget.t 7• ❑Remodeling ship and have no employees These sub-contractors have 8. []Demolition working for me in any capacity. workers'comp.insurance. [No workers'comp.insurance 5. ElWe are a corporation and its 9• ❑Building addition 3.❑ required.] .officers have exercised their 10•❑Electrical repairs or additions I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c.152, §1(4),and we have no aired. �' em12.❑Roofrepairs insurance re ] q employees.[No workers comp,insurance required.] 13.0Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 workerscompensation insurance for nzy employees Below is the policy ani!job site information. A Insurance Company Name: S S C /,Ct �-4 Policy#or Self-ins.Lie.M 5- 1/J a 7 7 Q /_20 l - Expiration Date: /G — /5_7_ Job Site Ad C. dress: Ci /State/Z 1 p Ae� /A.(,//e9rAttach a copy of the workers'compensation Policy declaration page the policy number and ex iia 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 ofthis statement maybe forwarded to the Office of Investigations of the D9 for insurance coverage verification. I Ido hereby certify under tIz p ins a allies o ` P fperjury that the information provided above is true and correct. Si ature: lc Date: Mone F only. Do not write in this area,to be completed by city or town official. Town: Permit/License# orit circle one): ) I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.PIumbing Inspector 6.Other Contact Person: Phone#: . NQRTiy 0 0 _ over No. �o o' , �` lover, Mass., Q -CIA I � COCHICHEWICK ORATED S BOARD OF HEALTH Food/Kitchen Septic System - .PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT.....:..(.&.f ........................'��s .1 .................. ►""""""""""' Foundation has permission to erect........... ........................... buildings on ...q�......�.1 ....�i. .�.1�. ......� Rough to be occupied as............... ..... ... .�.f® ..........'Fr �� �/ Chimney provided that the person accepting thi permit shall in every respect conform to the terms of the application on file in Final 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIRough ....................................... ............................................................ 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.