HomeMy WebLinkAboutMiscellaneous - 81 FURBER AVENUE 4/30/2018Location 7'5 E--( c r Oq A
No. 007
Check # 3 3i
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ o0
'/J oe 7
i ' . .7777 -
Building Inspector
DECTAM CORPORATION
Specialty Contractors
August 27, 2007
North Andover Board of Health
1600 Osgood Street
Building 20, Suite 2-36
North Andover, MA 01845
RECEIVED
AUG 2 9 2007
TOWN Or NCRTH ANDOVER
978.470.2860
fax 978.470.1017
RE: Stearns Residence, 81 Furber Avenue, North Andover, MA 01810 (Basement)
Dear Sir or Madam:
Please be advised that Dec -Tam Corporation will be performing an asbestos abatement
projects at the above referenced location. This work is scheduled for
September 07, 2007 thru September 07, 2007
All applicable local, state and federal agencies have been notified of this work.
Please let me know if you have any questions.
Sin st ards,
Peter D
Sales Estimator
PD/cam
Enclosure
Environmental Remediation Services - Surface Preparation - Facilities Services
50 Concord Street - North Reading, MA 01864 - www.dectam.com - solutions@dectam.com
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Note: Transfer
Stations must
comply with the
Solid Waste
Division
Regulations 310
CMR 19.000
Commonwealth of Massachusetts
Asbestos Notification Form ANF -001
B. f=acility Description (cont.)
! !
a. Name of General Contractor
c. Ci /Town d. Zip Code
(COMMERCE & INDUSTRY
f. Contractor's Worker's Comp. Insurer
6. What is the size of this facility?
1100060418
Decal Number
C. /Asbestos Transportation and Disposal
1. Transporter of asbestos -containing material from site to temporary storage site (if necessary):
a. Name of Transporter _
—.i ' r
! !
c. City/Town d. Zip Code
2. Transporter of asbestos -containing waste material
SERVICE TRANSPORT
PETER DUFFi
b. Address
b. Authorized Signature
r --
P
s
c. City/Town
e. Telephone Number area code and extension)
i WC5311226
j 112/2812007 i
g. Policy Number
h. Exp. Date (mm/ddlyyyy)
X1537
J 11
___
a. Square Feet
b. Number of floors
C. /Asbestos Transportation and Disposal
1. Transporter of asbestos -containing material from site to temporary storage site (if necessary):
a. Name of Transporter _
—.i ' r
! !
c. City/Town d. Zip Code
2. Transporter of asbestos -containing waste material
SERVICE TRANSPORT
PETER DUFFi
w
a. Name of Transporter
b. Authorized Signature
KNEW CASTLE, DE
19721 0
c. City/Town
d. Zip Code
3. E
I
a. Refuse Transfer Station and Owner
i Gnnr �; �nlj�ti
I �
L
c. Ci /Town
d. Zip Code
4. IMINERVA ENTERPRISES INC
I
a. Final Disposal Site Location Name
19000 MINERVA ROAD
j
c. Final Disposal Site Address
10H
_ -._
144688
e. State
f. Zip Code
The undersigned hereby states, under the
penalties of perjury, that he/she has read the
Gornmonwoalth 4f Massachus8 to regulations
Bnn 3psulatjnn a` fishy my �—R -5 00 and,'
:rt,..fi_r_i.on f: fr.,r. .., ..f.: -r'Ct
.:.
� aniviiiaN.GGi; ` iUii;�
b_ Address
e. Telephone Number
from removal/temporary site to final disposal site:
58 PYLES LANE
b. Address
18779999559
e. Telephone Number
b. Address
I.
e. Telephone Number
I
b. Final Disposal Site Location Owner's Name
jWAYNESBURG
d. Citv/Town
g. Telephone Number
iPETER DUFFY �
PETER DUFFi
b. Authorized Signature
10812312007
c. Positicn/TiBe
d. Date (mm/dd/,yyyy)
19784102866 _
!DEG TAM
e. +e!evhcn5� Number
i Gnnr �; �nlj�ti
lrr
eDEP: Print Receipt
Submittal Summary & Receipt
Your submission is complete. Thank you for using DEP's online reporting system. You can
select "My Homepage" to review your status.
DEP Transaction ID: 143477
Date and Time Submitted: 8/23/2007 4:45:13 PM
Other Email :
Form Name: BWP - Asbestos Notification form- ANF001
Payment Information
DEP code: 26057
Date: 8/23/2007 4:45:09 PM
Amount ($): 85
Billing Info: Brian Fitzsimons —Card — 6000
Contractor
Contractor Number. AC000035
Name: DEC -TAM CORPORATION
Address: 50 CONCORD STREET, NORTH READING, MA 01864
978-470-2860
Supervisor
CHARLES BREWER
Project Monitor
Lab
Location
BASEMENT
Project Start Date
9/7/2007
Page 1 of 1
https:Hedep.dep.mass.gov/Restricted/webpages/printreceipt.aspx 8/23/2007
= TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
,sus wax _
A"iF
v.e.
BUILDING PERMIT NUMBER: DATE ISSUED:
0o Z J 02 t
SIGNATURE: % o a
Building Com missioner/I for of Buildings Dafe
i �>!;�rluly 1-s11r; llvruxmArlulV t
1.1 Property Address:
13
1.2 Assessors Map and Parcel
0 z (
Map Number
Number:
6c)y5'--
Parcel Number
An t M r ,Q _ 1 v� ✓
{ \�
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Areas
Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard
Side Yard
Rear Yard
Required Provide Required
Provided
R
red Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public ❑ Private ❑ Zone Outside Flood Zone ❑
1.8
Municipal
Sewerage Disposal System:
0 On Site Disposal System ❑
SEUTIU1V 2 - PROPERTY OWNERSHW/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) Address for Service
Signature
2.2 Owner of Record:
Name Print
Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature
3.2 Register
Company N
Telephone
Home Improvement
Address for Service:
A -r< 5� ht . I&
Not Applicable ❑
License Number
Expiration Date
Not Applicable ❑
f Z 5-�& a--
C Registration Number
a33Iloa--
Expiration D to
O
Z
M
90
0
ic
r
M
z
0
0/,'
SECTION 4 - WORKERS 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 .......0 No ....... ❑
SECTION 5 Description of Proposed Work check au
applicable)
New Construction ❑
Existing Building ❑
Repair(s)
❑
Alterations(s) ❑
Addition ❑
Accessory Bldg. ❑
Demolition ❑
Other
lk
Specify
Brief Description of Proposed Work:
�
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
{iJE+FICIA:[tSE
-
(}N.Y
...
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
Q DC7
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
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, 6-ect t McibaU411 as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Pri ame
Signature of Own6r/AgetYD
NO. OF STORIES
t
e
SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TAMERS 1 sT
2 ND 3 RD
SPAN
DMNSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS 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
Town of North Andover
Building Department
27 Charles Street
North Andover, Massachusetts 01845
(978) 688-9545 Fax. (978) 688-9542
DEBRIS DISPOSAL FORM
µoRT{1
_,�tta° �6
d/4 COCMCM K■ i• T
7S
TED
In accordance with the provisions of MGL c 40 s 54, anda condition of
Building permit-# nom- the debris resulting from the work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL c 11, sI 50a.
The debris will be disposed of in /at:
Ev-&-4 -
Facility location
Signature of App icant
cz 3
Date
NOTE: A demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
7
5
Date: Uovim�xv-ZUn
Address:
RE: dew C�;nc�� fov�
Dear 1 0m
Bay State Roofing Inc, proposes to furnish all material, labor and equipment necessary to perform the following scope of work.
1 Remove approximately ZM sq. I of the existing asphalt shingle roof down to the wood deddng.
Z Install new ice and water shield along the 2 ' roof edge and 444 e t f tys
V around all the roof penetrations
Install new 151b. felt paper throughout the roof area.
Install new flit i . n i SL aluminum drip edge along the roof perimeter.
A new (�+r AAG y'�- `�
asphalt roof shingle will be installed over the W� \ substrate.
ew en
All roof penetrations and flashing will be installed according to the manufacturers recommended
specifications and details. )
'A "j ��kmvl'�Y'
Bay State Roofing Inc. will
�properly
ydispose of all roof debris in our own waste containers.
Total price for this work: $
t/
_ NOTE: Any wood decking that needs replacement will bean additional $2.00 per sq. L
I hope this proposal is acceptable. If you should have any questions or comments please contact me at your earliest convenience.
Respectfully,
Sean K Mahoney, President
Rnv CYatr. Rnnfino Inn
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
workers' Compensation Insurance Affidavit
Name Please Print
Location: PV vo_j� tlA
City,N V . CJ_V_1 Phone #
F -1
I am a homeowner performing all work myself.
I 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.
Company :name:
Address
CUPhone #:
Failure to secure coverage as required` under` Section 25A or L 152 can lead to the iinp. osition criminal, Penalties of,o` ine up to $1, 00
and/or one years' iti prisonmenttas iKeD_as.tiv i.penatties.inihala m �d-ASIQP:WDRK.DROEk.md aJ!ne_of. $1110 1 O_day_against_ ne_ I
understand that a copy of this statement may be forwarded'to the Office of Investigations of the DIA for coverage verfication.
I do hereby certify under the ins and penalties of perjury that the information provided above is true and correct.
Signature . Date— 9/c /0"�
Print name Phone 7 Y "�(0
Official use only do not write in this area to be completed by city or town official
City or Town Permit/Licensing
Building Dept
E]Check if immediate response is required
Licensing Board
F-1
Selectman's Office
Contact person: Phone #t: E]
Health Department
o
Other
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Office Use Only
U, >: �ommorw�ol of :t ass*ust is Permit No. ,
Mepartment of �uhlir feta Occupancy 8 Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 Heave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK !'
All work to be performed in accordance with the Massachusetts Electrical Code,
527 CMR 12:00 Y
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date '? �S
%K or Town of NORTH ANDOVER To the Inspector 4f Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) ,73 IE --0/7,8m— �
Owner or Tenant c,- , %/4�L-
YL
Owner's Address E&711
�-
Is this permit in conjunction with a building permit: Yes No C (Check Appropriate Box)
Purpose of Building �6/,bm Utility Authorization No.
Existing Service _ IC10 Amos -ZLO-J 2 ZA") Volts Overhead 01 Undgrnd r No. of Meters
r^
New Service 170 Amps _J Volts Overhead Unogrnd C No.
of Meters
Number of Feeders and Ampacity %S /� �S GI-!ili Zt? 20 07f1��r�hG
Location and Nature of Pr000sed Electricai WorK Z - S'7KsK 7 09bP1 M
No.
of Lch;ing Cutlets 8
�, i
No. of Hot Tubs
�
Total
No. of Transformers KVA
No.
of Lighting Fixtures
/�
v�ar
Above—
Swimming ?poi crno —
In -
crnc.
_ '/�
Generators KVA
i
No. of Emergency Lighting
No.
of Receptacle Cutlets
2�
No. of Cil turners
7�'( I
Battery Units
No.
of Switch Outlets
No. of Gas turners
FIRE ALARMS No. of Zones
No. of Detection and
Total
No.
of Ranges
(�I
No. of Air Cont.
!ons
Initiannd Devices
No. of Sounding Devices
No. of Self Contained
Devices
No.of Heat Total Total
No. of Disposals Pumps. Tons K.1 (D
i
No.
of Dishwasners
I Space/Area Heating
KW
cv
DetectiontSounding
Municipai-Other
Local _ Connec^on —
nc Devices KW d
No. of Dryers Heating
No. of No. of
Low Voitace
No.
of Water Heaters
KW
I Signs Sailasts
tp
Wiring
No.
Hyero Massaee Tubs
(01
I No. of Motors Tctal HP
OTHER / Genn10) n f�� /7TH/ l/I C7T�I
INSURANCE COVERAGE: Pursuant to the recutrements of Massacnuseas cenerai Laws _
1 have a current Liaodity Insurance Polio inc!ueing Ccmctetec Ccerattons Coveraee or its sucstantial ecuivatent. YES /r NO _ I
have suomrteo valid proof of same to the Office. YES = NO = If you have checked YES, please indicate the type of coverage by
cheCKing the aoprooriate pox. leIg
INSURANCE bZ BOND = OTHER = (Please Spec:fy)
1 (Exptr tion Date)
Estimated Value of El e into Work S /Soo c
WorK to Start �/ Inscect:on Date Recuestec: Rouch �J� Final 1154--e Signed under the P natttes of perjury: t �p
FIRM NAME STA�LT�7� �LECT721C/A't'i � Ce",0LC� fes/ S F. LIC. NO.
Licensee Sior.ature—LIC. NO.�/ TO
Bus. Tel. No. el.17- Z?
Address
Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee cc es not have tha insurance coverage or its substantial eautvatent as re-
gwreo by Massachusetts enerai L�ws;= tha y signature on anis permit application waives this recwrement. Owner i nn(P!ease checK one► e✓ Teieonone No.M-1—M-77PERMIT FE. S
(Signature of Owner orvA4entl x-5565
Date .....
203
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
SACHU
This certifies that ...... 11.0.wv ....... 7 A.
has permission to per 4 ................
form ....... W.. J?. 1.
wiring in the building of ....... ........ 7 .. .................
at ..........7.3....... I -ex ---,-............................... North Andover, Mass.
Fee.... ..... .... Lic. No . ...... z .... ...............................................................
ELECTRICAL INSPECTOR
11#4 J a 9 #/,q lee"?
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File